Division of Endocrinology and Metabolism, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea.
Diabetes Metab J. 2022 May;46(3):355-376. doi: 10.4093/dmj.2022.0038. Epub 2022 May 25.
Carbohydrate-restricted diets and intermittent fasting (IF) have been rapidly gaining interest among the general population and patients with cardiometabolic disease, such as overweight or obesity, diabetes, and hypertension. However, there are limited expert recommendations for these dietary regimens. This study aimed to evaluate the level of scientific evidence on the benefits and harms of carbohydrate-restricted diets and IF to make responsible recommendations. A meta-analysis and systematic literature review of 66 articles on 50 randomized controlled trials (RCTs) of carbohydrate-restricted diets and 10 articles on eight RCTs of IF was performed. Based on the analysis, the following recommendations are suggested. In adults with overweight or obesity, a moderately-low carbohydrate or low carbohydrate diet (mLCD) can be considered as a dietary regimen for weight reduction. In adults with type 2 diabetes mellitus, mLCD can be considered as a dietary regimen for improving glycemic control and reducing body weight. In contrast, a very-low carbohydrate diet (VLCD) and IF are recommended against in patients with diabetes. Furthermore, no recommendations are suggested for VLCD and IF in adults with overweight or obesity, and carbohydrate-restricted diets and IF in patients with hypertension. Here, we describe the results of our analysis and the evidence for these recommendations.
低碳水化合物饮食和间歇性禁食(IF)在普通人群和患有心血管代谢疾病的患者中(如超重或肥胖、糖尿病和高血压)迅速受到关注。然而,对于这些饮食方案,专家的建议有限。本研究旨在评估低碳水化合物饮食和 IF 的益处和危害的科学证据水平,以便做出负责任的建议。对 50 项关于低碳水化合物饮食的随机对照试验(RCT)和 10 项关于 IF 的 RCT 的 66 篇文章进行了荟萃分析和系统文献综述。基于分析,提出了以下建议。对于超重或肥胖的成年人,可以考虑中度低或低碳水化合物饮食(mLCD)作为减轻体重的饮食方案。对于 2 型糖尿病患者,可以考虑 mLCD 作为改善血糖控制和减轻体重的饮食方案。相比之下,不建议糖尿病患者使用极低碳水化合物饮食(VLCD)和 IF。此外,对于超重或肥胖的成年人,不建议使用 VLCD 和 IF,对于高血压患者,不建议使用低碳水化合物饮食和 IF。在这里,我们描述了我们的分析结果以及这些建议的证据。