Effects of carbohydrate-restricted diets on low-density lipoprotein cholesterol levels in overweight and obese adults: a systematic review and meta-analysis

Gjuladin-Hellon, Teuta; Davies, Ian G; Penson, Peter; Amiri Baghbadorani, Raziyeh

doi:10.1093/nutrit/nuy049

Cited by 108Diet and metabolism studiesDietary Effects on HealthLipoproteins and Cardiovascular Health

Effects of carbohydrate-restricted diets on low-density lipoprotein cholesterol levels in overweight and obese adults: a systematic review and meta-analysis

Gjuladin-Hellon, Teuta, Davies, Ian G, Penson, Peter, Amiri Baghbadorani, Raziyeh·2019·Nutrition Reviews

DOI 10.1093/nutrit/nuy049

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Abstract

Context: Carbohydrate-restricted diets may increase low-density lipoprotein cholesterol and thereby cardiovascular risk. Objective: A systematic review and meta-analyses were conducted to compare the effects of very low, low, and moderate carbohydrate, higher fat diets versus high-carbohydrate, low-fat diets on low-density lipoprotein cholesterol and other lipid markers in overweight/obese adults. Data Sources: Medline, PubMed, Cochrane Central, and CINAHL Plus were searched to identify large randomized controlled trials (n > 100) with duration ≥ 6 months. Data Extraction: Eight randomized controlled trials (n = 1633; 818 carbohydrate-restricted diet, 815 low-fat diet) were included. Data Analysis: Quality assessment and risk of bias, a random effects model, and sensitivity and subgroup analyses based on the degree of carbohydrate restriction were performed using Cochrane Review Manager. Results were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol. Results: Carbohydrate-restricted diets showed no significant difference in low-density lipoprotein cholesterol after 6, 12, and 24 months. Although an overall pooled analysis statistically favored low-fat diets (0.07 mmol/L; 95% confidence interval [CI], 0.02-0.13; P = 0.009], this was clinically insignificant. High-density lipoprotein cholesterol and plasma triglycerides at 6 and 12 months favored carbohydrate-restricted diets (0.08 mmol/L; 95%CI, 0.06-0.11; P < 1 × 10-5 and -0.13 mmol/L; 95%CI, -0.19 to -0.08; P < 1 × 10-5, respectively). These favorable changes were more marked in the subgroup with very-low carbohydrate content (< 50 g/d; 0.12 mmol/L; 95%CI, 0.10-0.14; P < 1 × 10-5 and -0.19 mmol/L; 95%CI, -0.26 to -0.12; P = 0.02, respectively). Conclusions: Large randomized controlled trials of at least 6 months duration with carbohydrate restriction appear superior in improving lipid markers when compared with low-fat diets. Dietary guidelines should consider carbohydrate restriction as an alternative dietary strategy for the prevention/management of dyslipidemia for populations with cardiometabolic risk.

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VLCD/ketogenic diets are high in fat without limiting saturated fat, leading to increases in low-density lipoprotein cholesterol.
“In addition, VCLD/ketogenic diets are high in fat without limiting saturated fat, leading to increases in low-density lipoprotein cholesterol.[89][90][91][92]”
From Popular dietary patterns: alignment with American Heart Association 2021 dietary guidance: a scientific statement from the American Heart Association. (2023) · cites this paper as [91]

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Authors: Gjuladin-Hellon, T., Davies, I. G., Penson, P., & Amiri Baghbadorani, R.
Affiliations: State University of Tetova (MK)
Liverpool John Moores University (GB)
School of Sports Studies and Nutrition, Faculty of Education, Health and Community, Liverpool John Moores University, Merseyside, United Kingdom
Corresponding author: Davies, Ian G
ORCID: Gjuladin-Hellon, Teuta
Davies, Ian G
Penson, Peter
Venue: Nutrition Reviews
Publisher: Oxford University Press (OUP)
Published: 2018-12-13
Volume: 77
Issue: 3
Pages: 161-180
ISSN: 0029-6643 (ISSN-L)
1753-4887
DOI: 10.1093/nutrit/nuy049
OpenAlex: W2903621130
Semantic Scholar: 550146cd1701ae6db09a9c22b39543667da0b4c3
Cited by: 108
References: 138
Citations by year: 2026: 12 · 2025: 8 · 2024: 15 · 2023: 12 · 2022: 19 · 2021: 21 · 2020: 15 · 2019: 6
FWCI: 1.38
Type: journal article
Language: en
Open access: closed
Licence: academic.oup.com/journals/pages/about_us/legal/notices (vor)
Locations: Nutrition Reviews (publishedVersion)
PubMed (publishedVersion)
Funders: Liverpool John Moores University
Topics: Health Sciences › Medicine › Physiology › Diet and metabolism studies
Health Sciences › Medicine › Physiology › Dietary Effects on Health
Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
Keywords: low-carbohydrate diet, low-fat diet, LDL cholesterol, HDL cholesterol, triglycerides, lipid profile, overweight, obesity, dietary fat, cardiovascular risk, very low carbohydrate diet, dietary guidelines, weight loss dieting, dietary fiber, dietary protein, dietary sodium, dietary calcium, dietary magnesium, potassium intake, dietary iron
MeSH terms: Adult, Female, Humans, Cholesterol, HDL, Cholesterol, LDL, Male, Middle Aged, Obesity, Triglycerides, Diet, Fat-Restricted, Overweight, Diet, Carbohydrate-Restricted, Diet, High-Fat

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Effects of carbohydrate-restricted diets on low-density lipoprotein cholesterol levels in overweight and obese adults: a systematic review and meta-analysis

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