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Nutrients
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Low-Carbohydrate Diets and Health Outcomes
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Low-Carbohydrate Diets and Health Outcomes

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (20 July 2021) | Viewed by 53250

Special Issue Editor

Dr. Yasuyuki Nakamura

E-Mail Website
Guest Editor
Department of Public Health, Shiga University of Medical Science, Otsu, Sihga 520-2192, Japan
Interests: cardiovascular disease; epidemiology; nutrition; genome-wide association study

Special Issue Information

Dear Colleagues,

The effectiveness of diets low in carbohydrates and high in protein and fat in promoting weight loss and reducing cardiometabolic risk has been shown in several systematic reviews and meta-analysis studies. A recent prospective cohort study and meta-analysis showed that both high- and low-percentage carbohydrate diets were associated with increased mortality, with minimal risk observed at 50–55% carbohydrate intake. After seeing summarized case reports of low-carbohydrate diets (LCD) in clinical practice, the following questions now need to be answered: (1) what are the reasons for high- and low-percentage LCD being associated with increased all-cause mortality? (2) are there ways to avoid mortality risk in extremely low-carbohydrate diets? (3) LCD are costly in general. How can we overcome this problem, especially in developing countries? (4) does genetic background plays a role in preference for LCDs?

Dr. Yasuyuki Nakamura
Guest Editor

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Keywords

  • low-carbohydrate diets
  • all-cause mortality
  • extremely low-carbohydrate diets
  • developing countries
  • genome-wide association study

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Published Papers (5 papers)

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Research

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9 pages, 584 KiB  
Article
Changes in Bone Metabolism and Antioxidant Defense Systems in Menopause-Induced Rats Fed Bran Extract from Dark Purple Rice (Oryza sativa L. Cv. Superjami)
by Soo Im Chung, Su Noh Ryu and Mi Young Kang
Nutrients 2021, 13(9), 2926; https://doi.org/10.3390/nu13092926 - 24 Aug 2021
Cited by 7 | Viewed by 2494
Abstract
Menopause is a matter of concern for women’s health due to a deficiency of female hormones; additionally, reactive oxygen species and aging can cause osteoporosis. Food becomes increasingly interesting as a menopausal woman’s alternative to hormone therapy. The effects of ethanol extracts from [...] Read more.
Menopause is a matter of concern for women’s health due to a deficiency of female hormones; additionally, reactive oxygen species and aging can cause osteoporosis. Food becomes increasingly interesting as a menopausal woman’s alternative to hormone therapy. The effects of ethanol extracts from dark purple Superjami rice bran on bone metabolism and antioxidant defense systems in menopause-induced animal models were evaluated. Female rats underwent sham surgery or were ovariectomized to induce a menopause-like state. Rats were divided into a sham control group (SHAM), an ovariectomized control group (OVX), and an ovariectomized grou supplemented with Superjami rice bran extract group (OVX-S) and fed for 8 weeks. The OVX groups exhibited significantly more weight gain, amounts of bone turnover biochemical markers (alkaline phosphatase, osteocalcin, and C-terminal telopeptide), bone loss, lipid-peroxidation and oxidative stress than the SHAM group. However, Superjami bran extract added to the diet resulted in a significant reduction in body weight and lipid peroxidation, as well as enhanced bone metabolism and antioxidant enzyme activities, in ovariectomized rats. These results propound that extracts from Superjami rice bran have therapeutic potentiality against bone loss and oxidative stress in menopause-induced states and will be useful in preventing postmenopausal osteoporosis and oxidative damage. Full article
(This article belongs to the Special Issue Low-Carbohydrate Diets and Health Outcomes)
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14 pages, 6000 KiB  
Article
Male and Female Rats Have Different Physiological Response to High-Fat High-Sucrose Diet but Similar Myocardial Sensitivity to Ischemia-Reperfusion Injury
by Natacha Fourny, Carole Lan, Monique Bernard and Martine Desrois
Nutrients 2021, 13(9), 2914; https://doi.org/10.3390/nu13092914 - 24 Aug 2021
Cited by 6 | Viewed by 3106
Abstract
Prediabetes is a strong predictor of type 2 diabetes and its associated cardiovascular complications, but few studies explore sexual dimorphism in this context. Here, we aim to determine whether sex influences physiological response to high-fat high-sucrose diet (HFS) and myocardial tolerance to ischemia-reperfusion [...] Read more.
Prediabetes is a strong predictor of type 2 diabetes and its associated cardiovascular complications, but few studies explore sexual dimorphism in this context. Here, we aim to determine whether sex influences physiological response to high-fat high-sucrose diet (HFS) and myocardial tolerance to ischemia-reperfusion injury. Male and female Wistar rats were subjected to standard (CTRL) or HFS diet for 5 months. Then, ex-vivo experiments on isolated perfused heart model were performed to evaluate tolerance to ischemia-reperfusion injury. HFS diet induced fasting hyperglycemia and increased body fat percent to a similar level in both sexes. However, glucose intolerance was more pronounced in female HFS. Cholesterol was increased only in female while male displayed higher level of plasmatic leptin. We observed increased heart weight to tibia length ratio only in males, but we showed a similar decrease in tolerance to ischemia-reperfusion injury in female and male HFS compared with respective controls, characterized by impaired cardiac function, energy metabolism and coronary flow during reperfusion. In conclusion, as soon as glucose intolerance and hyperglycemia develop, we observe higher sensitivity of hearts to ischemia-reperfusion injury without difference between males and females. Full article
(This article belongs to the Special Issue Low-Carbohydrate Diets and Health Outcomes)
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11 pages, 961 KiB  
Article
Diabetes Risk Reduction Diet and Endometrial Cancer Risk
by Giovanna Esposito, Francesca Bravi, Diego Serraino, Fabio Parazzini, Anna Crispo, Livia S. A. Augustin, Eva Negri, Carlo La Vecchia and Federica Turati
Nutrients 2021, 13(8), 2630; https://doi.org/10.3390/nu13082630 - 30 Jul 2021
Cited by 26 | Viewed by 4221
Abstract
Diabetes increases endometrial cancer risk. We investigated the role of a diabetes risk reduction diet (DRRD) on the risk of endometrial cancer using data from a multicentric, Italian hospital-based case–control study (1992–2006) enrolling 454 histologically confirmed cases of endometrial cancer and 908 controls [...] Read more.
Diabetes increases endometrial cancer risk. We investigated the role of a diabetes risk reduction diet (DRRD) on the risk of endometrial cancer using data from a multicentric, Italian hospital-based case–control study (1992–2006) enrolling 454 histologically confirmed cases of endometrial cancer and 908 controls matched by age and center. We derived a DRRD score assigning higher scores for higher intakes of cereal fiber, fruit, coffee, polyunsaturated:saturated fatty acid ratio, and nuts and for lower glycemic load and lower intakes of red/processed meat and sugar-sweetened beverages/fruit juices. The odds ratios (OR) of endometrial cancer according to the DRRD score were derived by multiple conditional logistic regression models. The OR for high (DRRD score >24, i.e., third tertile) versus medium–low adherence to the DRRD was 0.73 (95% confidence interval, CI, 0.55–0.97). Similar results were observed after the exclusion of diabetic women (OR 0.75; 95% CI, 0.56–1.00) and allowance for total vegetable consumption (OR 0.80; 95% CI, 0.60–1.07). Inverse associations were observed in most of the analyzed subgroups. The OR for high DRRD combined with high vegetable consumption was 0.45 (95% CI, 0.28–0.73). Our results suggest that diets able to reduce diabetes risk may also reduce endometrial cancer risk. High vegetable consumption combined with high adherence to the DRRD may provide additional benefit in endometrial cancer prevention. Full article
(This article belongs to the Special Issue Low-Carbohydrate Diets and Health Outcomes)
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21 pages, 1165 KiB  
Article
Low Carb and Ketogenic Diets Increase Quality of Life, Physical Performance, Body Composition, and Metabolic Health of Women with Breast Cancer
by Ulrike Kämmerer, Rainer J. Klement, Fabian T. Joos, Marc Sütterlin and Monika Reuss-Borst
Nutrients 2021, 13(3), 1029; https://doi.org/10.3390/nu13031029 - 23 Mar 2021
Cited by 43 | Viewed by 13219
Abstract
Breast cancer (BC) patients often ask for a healthy diet. Here, we investigated a healthy standard diet (SD), a low carb diet (LCD), and a ketogenic diet (KD) for BC patients during the rehabilitation phase. KOLIBRI was an open-label non-randomized one-site nutritional intervention [...] Read more.
Breast cancer (BC) patients often ask for a healthy diet. Here, we investigated a healthy standard diet (SD), a low carb diet (LCD), and a ketogenic diet (KD) for BC patients during the rehabilitation phase. KOLIBRI was an open-label non-randomized one-site nutritional intervention trial, combining inpatient and outpatient phases for 20 weeks. Female BC patients (n = 152; mean age 51.7 years) could select their diet. Data collected were: Quality of life (QoL), spiroergometry, body composition, and blood parameters. In total 30, 92, and 30 patients started the KD, LCD, and SD, respectively. Of those, 20, 76, and 25 completed the final examination. Patients rated all diets as feasible in daily life. All groups enhanced QoL, body composition, and physical performance. LCD participants showed the most impressive improvement in QoL aspects. KD participants finished with a very good physical performance and muscle/fat ratio. Despite increased cholesterol levels, KD patients had the best triglyceride/high-density lipoprotein (HDL) ratio and homeostatic model assessment of insulin resistance index (HOMA-IR). Most metabolic parameters significantly improved in the LCD group. SD participants ended with remarkably low cholesterol levels but did not improve triglyceride/HDL or HOMA-IR. In conclusion, both well-defined KDs and LCDs are safe and beneficial for BC patients and can be recommended during the rehabilitation phase. Full article
(This article belongs to the Special Issue Low-Carbohydrate Diets and Health Outcomes)
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Review

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15 pages, 500 KiB  
Review
The Low-Carbohydrate Diet: Short-Term Metabolic Efficacy Versus Longer-Term Limitations
by Thomas M. Barber, Petra Hanson, Stefan Kabisch, Andreas F. H. Pfeiffer and Martin O. Weickert
Nutrients 2021, 13(4), 1187; https://doi.org/10.3390/nu13041187 - 3 Apr 2021
Cited by 57 | Viewed by 29131
Abstract
Background: Diets have been a central component of lifestyle modification for decades. The Low-Carbohydrate Diet (LCD), originally conceived as a treatment strategy for intractable epilepsy (due to its association with ketogenesis), became popular in the 1970s and since then has risen to prominence [...] Read more.
Background: Diets have been a central component of lifestyle modification for decades. The Low-Carbohydrate Diet (LCD), originally conceived as a treatment strategy for intractable epilepsy (due to its association with ketogenesis), became popular in the 1970s and since then has risen to prominence as a weight loss strategy. Objective: To explore the efficacy, limitations and potential safety concerns of the LCD. Data Sources: We performed a narrative review, based on relevant articles written in English from a Pubmed search, using the terms ‘low carbohydrate diet and metabolic health’. Results: Evidence supports the efficacy of the LCD in the short-term (up to 6-months) for reduction in fat mass and remission of Type 2 Diabetes Mellitus (T2D). However, the longer-term efficacy of the LCD is disappointing, with diminishment of weight loss potential and metabolic benefits of the LCD beyond 6-months of its adoption. Furthermore, practical limitations of the LCD include the associated restriction of food choices that restrict the acceptability of the LCD for the individual, particularly over the longer term. There are also safety concerns of the LCD that stem from nutritional imbalances (with a relative excess of dietary fat and protein intake with associated dyslipidaemia and increased risk of insulin resistance and T2D development) and ketotic effects. Finally, the LCD often results in a reduction in dietary fibre intake, with potentially serious adverse consequences for overall health and the gut microbiota. Conclusions: Although widely adopted, the LCD usually has short-lived metabolic benefits, with limited efficacy and practicality over the longer term. Dietary modification needs tailoring to the individual, with careful a priori assessments of food preferences to ensure acceptability and adherence over the longer term, with avoidance of dietary imbalances and optimization of dietary fibre intake (primarily from plant-based fruit and vegetables), and with a posteriori assessments of the highly individual responses to the LCD. Finally, we need to change our view of diets from simply an excipient for weight loss to an essential component of a healthy lifestyle. Full article
(This article belongs to the Special Issue Low-Carbohydrate Diets and Health Outcomes)
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