Studies and real life observation have indicated that macro nutrition internvention of low-carb diets has centered on weight loss in obese and overweight people as well as patients with or at risk for cardiometabolic diseases such as type 2 diabetes and nonalcoholic fatty liver disease. Ketogenic diets have also been
By far, the most research in low-carb approaches has shown that low-carb diet, and specifically ketogenic approaches, induces rapid induction of weight loss. Initial weight loss is due partly from water loss, but fat loss occurs with adherence to the low carb approach. With all dietary intervention, as adherence to the diet wanes, weight loss effect becomes similar to other dietary approaches after one year. It is notable that most of the low-carb studies generally use an ad-libitum approach of caloric intake (limiting carbs instead), while most comparison diets are calorie-restricted. In general, shared decision making is a valid and person-centered approach in determining nutritional approaches to weight loss.
Before medications, carbohydrate control has been the cornerstone of glycemic control in both type 1 and type 2 diabetes. Dietary carbohydrates increase insulin needs, and reduction of carbohydrate intake can improve glycemic control.A recent study demonstrated a significant reduction of insulin and oral medications and hemoglobin A1c reduction with ketogenic approaches while demonstrating a high adherence to the intervention at 12 months. Also, markers of cardiometabolic risk factors improved. Approaches to nutritional lifestyle approaches to diabetes (medical nutrition therapy) have included low carb as an option in recent guidelines. Recent prospective and randomized controlled trials have demonstrated a consistent benefit in glycemic control, weight loss, and sustained medication reduction using a very low carb approach (< 14% of energy from carbohydrates).
As mentioned above, the effect of low-carb diets on cardiovascular risk factors continue to be controversial. While a few studies have demonstrated an increase in LDL cholesterol with low-carb diets, others showed negligible changes. However, other metabolic markers, such as lowering triglycerides, increases in HDL, have been demonstrated with low-carb diets.