Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100037, China.
Medical Research & Biometrics Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, 102300, China.
Eur J Clin Nutr. 2022 Jan;76(1):16-27. doi: 10.1038/s41430-021-00927-0. Epub 2021 Jun 24.
Our aim was to determine the relative effectiveness of two dietary macronutrient patterns (LFHC (low-fat, high-carbohydrate) diets and LCHF (low-carbohydrate, high-fat) diets) on weight loss and cardiovascular risk factors. We searched four databases including MEDLINE, EMBASE, Cochrane Library, and Web of Science to identify the eligible studies on March 13, 2020. Randomized clinical trials (RCT) were included which compared the effect of two diets (LFHC and LCHF) on weight loss, blood pressure, serum liquids, and blood glucose in overweight or obesity adults. Standardized mean difference (SMD) and 95% confidence interval (CI) were used for the pooled results. This paper included eleven studies involving 739 participants. Compared with LFHC diets, LCHF diets had a greater effect on weight loss (SMD = -1.01 kg; 95% CI -1.99 to -0.04, p = 0.04) and HDL-cholesterol changes (SMD = 0.82 mmol/l; 95% CI 0.43 to 1.21, p < 0.0001), but a smaller effect on total cholesterol decrease (SMD = 0.63 mmol/l; 95% CI 0.18-1.08, p = 0.006) and LDL-cholesterol decrease (SMD = 0.59 mmol/l; 95% CI 0.11-1.18, p = 0.05). Between the two groups, changes in lean mass, fat mass, systolic blood pressure, diastolic blood pressure, triglycerides, and glucose were non-significant. To conclude, both diets are effective for weight control and reduction of cardiovascular risk factors. And further studies with long-term follow-up are needed to confirm our results.
我们的目的是确定两种膳食宏量营养素模式(LFHC(低脂肪、高碳水化合物)饮食和 LCHF(低碳水化合物、高脂肪)饮食)对减肥和心血管危险因素的相对有效性。我们于 2020 年 3 月 13 日检索了四个数据库,包括 MEDLINE、EMBASE、Cochrane 图书馆和 Web of Science,以确定符合条件的研究。纳入了比较两种饮食(LFHC 和 LCHF)对超重或肥胖成年人减肥、血压、血清液体和血糖影响的随机临床试验(RCT)。使用标准化均数差(SMD)和 95%置信区间(CI)汇总结果。本文纳入了 11 项研究,共 739 名参与者。与 LFHC 饮食相比,LCHF 饮食在减肥方面的效果更大(SMD=-1.01kg;95%CI-1.99 至-0.04,p=0.04),对 HDL-胆固醇变化的效果更大(SMD=0.82mmol/L;95%CI0.43 至 1.21,p<0.0001),但对总胆固醇降低的效果更小(SMD=0.63mmol/L;95%CI0.18 至 1.08,p=0.006),对 LDL-胆固醇降低的效果更小(SMD=0.59mmol/L;95%CI0.11 至 1.18,p=0.05)。两组之间,瘦体重、体脂、收缩压、舒张压、甘油三酯和血糖的变化均无统计学意义。总之,两种饮食均有效控制体重和降低心血管危险因素。需要进一步进行长期随访的研究来证实我们的结果。