Faculty of Life Sciences and Medicine, King's College London, London WC2R 2LS, UK.
Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903, BR, Brazil.
Nutrients. 2020 Dec 9;12(12):3774. doi: 10.3390/nu12123774.
The rise in obesity has emphasised a focus on lifestyle and dietary habits. We aimed to address the debate between low-carbohydrate and low-fat diets and compare their effects on body weight, low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), total cholesterol, and triglycerides in an adult population.
Medline and Web of Science were searched for randomised controlled trials (RCTs) comparing low-fat and low-carbohydrate diets up to September 2019. Three independent reviewers extracted data. Risk of bias was assessed using the Cochrane tool. The meta-analysis was stratified by follow-up time using the random-effects models.
This meta-analysis of 38 studies assessed a total of 6499 adults. At 6-12 months, pooled analyses of mean differences of low-carbohydrate vs. low-fat diets favoured the low-carbohydrate diet for average weight change (mean difference -1.30 kg; 95% CI -2.02 to -0.57), HDL (0.05 mmol/L; 95% CI 0.03 to 0.08), and triglycerides (TG) (-0.10 mmol/L; -0.16 to -0.04), and favoured the low-fat diet for LDL (0.07 mmol/L; 95% CI 0.02 to 0.12) and total cholesterol (0.10 mmol/L; 95% CI 0.02 to 0.18). Conclusion and Relevance: This meta-analysis suggests that low-carbohydrate diets are effective at improving weight loss, HDL and TG lipid profiles. However, this must be balanced with potential consequences of raised LDL and total cholesterol in the long-term.
肥胖率的上升强调了生活方式和饮食习惯的重要性。我们旨在解决低碳水化合物和低脂肪饮食之间的争议，并比较它们对成年人群体重、低密度脂蛋白胆固醇（LDL）、高密度脂蛋白胆固醇（HDL）、总胆固醇和甘油三酯的影响。
我们在 Medline 和 Web of Science 上搜索了截至 2019 年 9 月的比较低脂肪和低碳水化合物饮食的随机对照试验（RCT）。三位独立评审员提取数据。使用 Cochrane 工具评估偏倚风险。使用随机效应模型，根据随访时间对荟萃分析进行分层。
这项对 38 项研究的荟萃分析评估了总共 6499 名成年人。在 6-12 个月时，低碳水化合物与低脂肪饮食的平均差异荟萃分析结果有利于低碳水化合物饮食的平均体重变化（平均差异-1.30kg；95%置信区间-2.02 至-0.57）、HDL（0.05mmol/L；95%置信区间 0.03 至 0.08）和甘油三酯（TG）（-0.10mmol/L；-0.16 至-0.04），而有利于低脂肪饮食的 LDL（0.07mmol/L；95%置信区间 0.02 至 0.12）和总胆固醇（0.10mmol/L；95%置信区间 0.02 至 0.18）。
这项荟萃分析表明，低碳水化合物饮食在改善体重减轻、HDL 和 TG 脂质谱方面是有效的。然而，这必须与长期内 LDL 和总胆固醇升高的潜在后果相平衡。
