Impacts of carbohydrate‐restricted diets on micronutrient intakes and status: A systematic review
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Summary: A systematic review of published evidence on micronutrient intake/status with carbohydrate‐restricted diets (CRD) was conducted in Web of Science, Medline, Embase, Scopus, CENTRAL, and ClinicalTrials.gov up to October 2018. We identified 10 studies: seven randomized controlled trials (RCTs) (“Atkins”‐style, n = 5; “Paleolithic” diets, n = 2), two Atkins‐style noncontrolled trials and one cross‐sectional study. Prescribed carbohydrate varied 4% to 34% of energy intake. Only one noncontrolled trial prescribed multivitamin supplements. Dietary intakes/status were reported over 2 to 104 weeks, with weight losses from 2 to 9 kg. No diagnoses of deficiency were reported. Intakes of thiamine, folate, magnesium, calcium, iron, and iodine all decreased significantly (−10% to −70% from baseline) with any CRD types. Atkins diet trials (n = 6; 4%‐34%E carbohydrate) showed inconsistent changes in vitamin A, E, and β‐carotene intakes, while a single “Paleolithic” diet trial (28%E carbohydrate) reported increases in these micronutrients. One other “Paleolithic” diet (30%E carbohydrate) reported a rise in moderate iodine deficiency from 15% to 73% after 6 months. In conclusion, few studies have assessed the impacts of CRD on micronutrients. Studies with different designs point towards reductions in several vitamins and minerals, with potential risk of micronutrient inadequacies. Trial reporting standards are expected to include analysis of micronutrient intake/status. Micronutrients in foods and/or supplements should be considered when designing, prescribing or following CRDs.
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With ketogenic diets, heart failure and neurological problems from thiamine deficiency have been reported, as well as reduced intakes of folate, iron and magnesium.
“With ketogenic diets, heart failure and neurological problems from thiamine deficiency have been reported [76, 77], as well as reduced intakes of folate, iron and magnesium [12].”
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- Authors
- Churuangsuk, C., Griffiths, D., Lean, M. E. J., & Combet, E.
- Affiliations
- University of Glasgow (GB)
- Corresponding author
- Combet, Emilie
- Venue
- Obesity Reviews
- Publisher
- Wiley
- Published
- 2019-04-22
- Volume
- 20
- Issue
- 8
- Pages
- 1132-1147
- ISSN
- 1467-7881 (ISSN-L)
- 1467-789X
- OpenAlex
- W2924487770
- Cited by
- 92
- References
- 28
- Citations by year
- 2026: 9 · 2025: 10 · 2024: 36 · 2023: 15 · 2022: 5 · 2021: 7 · 2020: 7 · 2019: 2
- FWCI
- 0.62
- Type
- journal article
- Language
- en
- Open access
- green
- eprints.gla.ac.uk
- Licence
- Locations
- Obesity Reviews (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion, cc-by-sa)
- Funders
- Prince of Songkla University
- Topics
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- low-carbohydrate diet, micronutrient intake, micronutrient status, Atkins diet, Paleolithic diet, thiamine, folic acid, magnesium, calcium, iron, iodine deficiency, vitamin A, vitamin E, beta-carotene, multivitamins, weight loss
- MeSH terms
- Body Weight, Energy Intake, Humans, Nutritional Status, Micronutrients, Diet, Carbohydrate-Restricted
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