Evidence that supports the prescription of low-carbohydrate high-fat diets: A narrative review
Open accessAbstract
Low-carbohydrate high-fat (LCHF) diets are a highly contentious current topic in nutrition. This narrative review aims to provide clinicians with a broad overview of the effects of LCHF diets on body weight, glycaemic control and cardiovascular risk factors while addressing some common concerns and misconceptions. Blood total cholesterol and LDL-cholesterol concentrations show a variable, highly individual response to LCHF diets, and should be monitored in patients adhering to this diet. In contrast, available evidence from clinical and preclinical studies indicates that LCHF diets consistently improve all other markers of cardiovascular risk—lowering elevated blood glucose, insulin, triglyceride, ApoB and saturated fat (especially palmitoleic acid) concentrations, reducing small dense LDL particle numbers, glycated haemoglobin (HbA1c) levels, blood pressure and body weight while increasing low HDL-cholesterol concentrations and reversing non-alcoholic fatty liver disease (NAFLD). This particular combination of favourable modifications to all these risk factors is a benefit unique to LCHF diets. These effects are likely due in part to reduced hunger and decreased ad libitum calorie intake common to low-carbohydrate diets, allied to a reduction in hyperinsulinaemia, and reversal of NAFLD. Although LCHF diets may not be suitable for everyone, available evidence shows this eating plan to be a safe and efficacious dietary option to be considered. LCHF diets may also be particularly beneficial in patients with atherogenic dyslipidaemia, insulin resistance, and the frequently associated NAFLD.
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Studies investigating specific weight loss eating plans using a broad range of macronutrient composition in people with T2DM have produced mixed results regarding efficiency and efficacy on body weight, HbA1c, lipid profiles, and BP.
“Studies investigating specific weight loss eating plans using a broad range of macronutrient composition in people with T2DM have produced mixed results regarding efficiency and efficacy on body weight, HbA1c, lipid profiles, and BP [140,141,144,169,170,171,172,173,174,175,176].”
From Effects of diet, lifestyle, Chrononutrition and alternative dietary interventions on postprandial Glycemia and insulin resistance (2022) · cites this paper as [170]
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“Although it is clear that calorie restriction produces short-term weight loss, a growing body of research supports low-carbohydrate, high fat dietary approaches for healthy weight management [41].”
BackgroundLow-carbohydrate diets for overweight and obesity: A systematic review of the systematic reviews
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- Authors
- Noakes, T. D., & Windt, J.
- Affiliations
- University of Cape Town (ZA)
- University of British Columbia (CA)
- Corresponding author
- Noakes, Timothy David
- Venue
- British Journal of Sports Medicine
- Publisher
- BMJ
- Published
- 2017-01
- Volume
- 51
- Issue
- 2
- Pages
- 133-139
- ISSN
- 0306-3674 (ISSN-L)
- 1473-0480
- OpenAlex
- W2569694738
- Cited by
- 178
- References
- 137
- Citations by year
- 2026: 8 · 2025: 11 · 2024: 20 · 2023: 21 · 2022: 21 · 2021: 23 · 2020: 23 · 2019: 22 · 2018: 19 · 2017: 10
- FWCI
- 2.48
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal of Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Canadian Institutes of Health Research
- 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 high-fat diet, body weight, glycemic control, cardiovascular risk factors, LDL cholesterol, triglycerides, non-alcoholic fatty liver disease, insulin resistance, atherogenic dyslipidemia, blood pressure, HbA1c, satiety, dietary fat composition, palmitoleic acid, HDL cholesterol
- MeSH terms
- Blood Glucose, Body Weight, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Humans, Insulin Resistance, Lipids, Risk Factors, Satiety Response, Weight Loss, Randomized Controlled Trials as Topic, Diet, Carbohydrate-Restricted, Diet, High-Fat, Non-alcoholic Fatty Liver Disease
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