Are low carbohydrate diet interventions beneficial for metabolic syndrome and its components? A systematic review and meta-analysis of randomized controlled trials.
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Abstract
Background: Diet plays a crucial role in metabolic syndrome (MetS) which might develop into diabetes mellitus and cardiovascular disease.
Objective: We aimed to evaluate the effects of low-carbohydrate diet (LCD) interventions on MetS and its components.
Methods: Four electronic databases including PubMed, Embase, Cochrane Central Register of Controlled Trials, and Medline were selected from database inception until March 2024. Randomized clinical trials in adults with MetS evaluated LCD interventions (50-130 g of carbohydrates/day or 10-40% of total dietary energy at 2000 kcal/day) and a control intervention for at least 12 weeks. Four reviewers independently extracted data and assessed risk of bias using Cochrane tool. Meta-analyses used a random-effects model to calculate mean differences (MD) and 95% confidence intervals (CI) and analyzed heterogeneity, sensitivity, and publication bias.
Results: A total of 41 articles satisfied the study's inclusion criteria. Thirty articles were incorporated in the meta-analysis, of which 25 were high-quality studies and 5 were of moderate quality. In total, 3806 adults were assessed. Pooled analysis of mean differences (MD) indicated that compared to the control dietary intervention, the LCD intervention reduced BMI (MD -0.43 kg/m2, 95% CI -0.75, -0.11), waist circumference (MD -0.77 cm, 95% CI -1.43, -0.12), systolic blood pressure (MD -1.19 mmHg, 95% CI -2.36, -0.02), diastolic blood pressure (MD -1.49 mmHg, 95% CI -2.36, -0.02), HbA1c (MD -0.62%, 95% CI -0.91, -0.32) and triglycerides (MD -0.24 mmol/L, 95% CI -0.42, -0.05), and increased high-density lipoprotein cholesterol (MD 0.06 mmol/l, 95% CI 0.03, 0.09). The subgroup analysis results indicated that the source of high heterogeneity might come from the dosage of intervention.
Conclusion: In summary, LCD interventions improved MetS-related biomarkers in adults with MetS. Moreover, further research is needed to determine the optimal intervention period of LCD on MetS.
背景：饮食在代谢综合征（MetS）中起着至关重要的作用，代谢综合征可能发展为糖尿病和心血管疾病。目的：我们旨在评估低碳水化合物饮食（LCD）干预对MetS及其成分的影响。方法：选取PubMed、Embase、Cochrane Central Register of Controlled Trials和Medline 4个电子数据库，从数据库建立至2024年3月。随机临床试验评估了LCD干预（50-130克碳水化合物/天或总膳食能量的10-40%，2000千卡/天）和对照干预至少12周。四名审稿人独立提取数据并使用Cochrane工具评估偏倚风险。meta分析采用随机效应模型计算平均差异（MD）和95%置信区间（CI），并分析异质性、敏感性和发表偏倚。结果：共有41篇文章符合本研究的纳入标准。30篇文章纳入meta分析，其中25篇为高质量研究，5篇为中等质量研究。共有3806名成年人接受了评估。平均差异（MD）汇总分析显示，与对照组饮食干预相比，LCD干预降低了BMI （MD -0.43 kg/m2, 95% CI -0.75, -0.11）、腰围（MD -0.77 cm, 95% CI -1.43, -0.12）、收缩压（MD -1.19 mmHg, 95% CI -2.36, -0.02）、舒张压（MD -1.49 mmHg, 95% CI -2.36, -0.02）、糖化血红蛋白（MD -0.62%, 95% CI -0.91, -0.32）和甘油三酯（MD -0.24 mmol/L, 95% CI -0.42, -0.05）。高密度脂蛋白胆固醇升高（MD 0.06 mmol/l, 95% CI 0.03, 0.09）。亚组分析结果表明，高异质性的来源可能来自干预剂量。结论：综上所述，LCD干预改善了met成人患者的met相关生物标志物。此外，LCD对MetS的最佳干预时间还需要进一步研究。
期刊介绍：
The International Journal of Obesity is a multi-disciplinary forum for research describing basic, clinical and applied studies in biochemistry, physiology, genetics and nutrition, molecular, metabolic, psychological and epidemiological aspects of obesity and related disorders.
We publish a range of content types including original research articles, technical reports, reviews, correspondence and brief communications that elaborate on significant advances in the field and cover topical issues.
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