Effect of Carbohydrate-Restricted Diets and Intermittent Fasting on Obesity, Type 2 Diabetes Mellitus, and Hypertension Management: Consensus Statement of the Korean Society for the Study of Obesity, Korean Diabetes Association, and Korean Society of Hypertension

Abstract

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.

Updated Meta-Analysis of Studies from 2011 to 2021 Comparing the Effectiveness of Intermittent Energy Restriction and Continuous Energy Restriction

“…In 2022, the Korean Society for the Study of Obesity, the Korean Diabetes Association, and the Korean Society of Hypertension issued a consensus statement on the effects of carbohydrate-restricted diets and intermittent fasting on obesity, type 2 diabetes mellitus, and hypertension management. 10 , 11 The consensus statement does not make a clear recommendation for using IER in adults with overweight or obesity due to the lack of long-term studies and the heterogeneity of results from previous studies; moreover, the statement recommends avoiding IER in patients with type 2 diabetes because of a lack of evidence on its benefits, harms, and associated risk of hypoglycemia. The consensus statement and the results of previous meta-analyses of IER differ because the consensus project searched for only level-I evidence from randomized controlled trials (RCTs) that directly compared IER and CER with study durations of longer than 8 weeks.…”

Intermittent fasting for the prevention of cardiovascular disease: implications for clinical practice

“…Intermittent fasting (IF) has been rapidly gaining interest among the general population and patients with cardiometabolic disease (e.g., adults with obesity) ( 12 ). The term intermittent fasting is often defined as a reduced caloric intake on an intermittent basis which can vary from several hours during the day to a complete 24-h period (e.g., 5:2, TRE, ADF and Modified ADF) ( 1 ).…”

Affecting Factors for Dietary, Exercise and Behavioral Modification of Women on Diet Improvement through Mediating Effects of Improve the Quality of Life

“…http://dx.doi.org/10.20402/ajbc.2022.0060 시키고 있다 (Lee & Kim, 2015). 또한 사회적 유행으로 인해 건강이 담보되지 않은 마른 체형만을 강조하고 이로 인해 오히려 건강을 해 치게 되는 결과가 발생함에 따라 부적절한 다이어트는 사회적인 부담 이 되기도 한다 (Cho et al, 2009). 비만관리에 대한 중요성과 사회적 인 요구에 따라 기업 및 학계에서 다양한 연구들이 수행되어지고 있 으며 성공적인 비만의 관리를 위해 과학적이고 실질적인 효과를 보 이는 방법 중 식생활 개선, 운동 요법, 행동수정 요법이 있다 (Kim & Ahn, 2003).…”