Table 1 Summary of finding for effects of carbohydrate-restricted diets and intermittent fasting in adults with overweight/obesity
Outcome | Illustrative comparative effecta (95% CI) | No. of participants | Quality of the evidence (GRADE) | |
|---|---|---|---|---|
Assumed effect (control) | Corresponding effect | |||
mLCDb | ||||
Body weight, kg (follow-up: 8–24 weeks) | –3.74 | –1.03 (–1.68 to –0.39) | 3,660 (24 studies) | ⊕⊕⊝⊝ Low |
Body mass index, kg/m2 (follow-up: 8–24 weeks) | –1.5 | –0.23 (–0.46 to 0.00) | 2,750 (15 studies) | ⊕⊝⊝⊝ Very low |
Waist circumference, cm (follow-up: 12–24 weeks) | –4.83 | –0.65 (–1.16 to –0.14) | 2,340 (15 studies) | ⊕⊕⊕⊝ Moderate |
Fat mass, kg (follow-up: 12–24 weeks) | –2.92 | –0.44 (–0.83 to –0.04) | 2,080 (14 studies) | ⊕⊕⊕⊝ Moderate |
Fat-free mass, kg (follow-up: 12–24 weeks) | 0.17 | –0.17 (–0.49 to 0.14) | 1,139 (10 studies) | ⊕ ⊕ ⊝⊝ Low |
Fat mass, % (follow-up: 12–24 weeks) | –2.7 | 0.09 (–0.45 to 0.64) | 445 (4 studies) | ⊕⊕⊝⊝ Low |
Systolic blood pressure, mm Hg (follow-up: 8–24 weeks) | –4.0 | –0.56 (–1.69 to 0.56) | 2,612 (19 studies) | ⊕⊕⊝⊝ Low |
Diastolic blood pressure mmHg (Follow-up: 8 ~ 24 weeks) | − 2.5 | − 0.69 (− 1.39 to 0.01) | 2615 (19 studies) | ⊕ ⊕ ⊝⊝ Low |
Triglyceride mg/dL (Follow-up: 8 ~ 24 weeks) | − 11.8 | − 13.76 (− 19.78 to − 7.74) | 2896 (24 studies) | ⊕ ⊕ ⊝⊝ Low |
LDL-C, mg/dL (follow-up: 12–24 weeks) | − 4.6 | 2.29 (− 0.41 to 4.99) | 2721 (21 studies) | ⊕⊝⊝⊝ Very low |
HDL-C, mg/dL (follow-up: 8–24 weeks) | − 0.8 | 2.61 (1.34 to 3.89) | 2448 (20 studies) | ⊕ ⊕ ⊕⊝ Moderate |
HbA1c, % (follow-up: 8–24 weeks) | −0.2 | − 0.20 (− 0.39 to − 0.01) | 739 (8 studies) | ⊕ ⊕ ⊝⊝ Low |
Fasting insulin, μU/mL (follow-up: 12–24 weeks) | −0.9 | − 0.94 (− 1.73 to − 0.16) | 1855 (13 studies) | ⊕⊕⊕⊝ Moderate |
Fasting glucose, mg/dL (follow-up: 8–24 weeks) | − 3.1 | –0.32 (–1.23 to 0.58) | 2143 (17 studies) | ⊕⊕⊝⊝ Low |
C-reactive protein, mg/L (follow-up: 8–24 weeks) | − 0.1 | − 0.34 (− 0.67 to − 0.01) | 1391 (11 studies) | ⊕ ⊕ ⊝⊝ Low |
Adiponectin, μg/mL (follow-up: 8–24 weeks) | 0.2 | 0.45 (0.15 to 0.76) | 1356 (8 studies) | ⊕ ⊕ ⊕⊝ Moderate |
VLCDcc | ||||
Body weight, kg (follow-up: 8–24 weeks) | −3.75 | −3.67 (−4.84 to − 2.51) | 1266 (14 studies) | ⊕ ⊕ ⊕⊝ Moderate |
Body mass index, kg/m2 (follow-up: 8–24 weeks) | −1.0 | −1.88 (− 3.11 to −0.65) | 388 (5 studies) | ⊕ ⊕ ⊕⊝ Moderate |
Waist circumference, cm (follow-up: 8–24 weeks) | −4.7 | −4.11 (−8.70 to 0.49) | 233 (2 studies) | ⊕ ⊕ ⊝⊝ Low |
Fat mass, kg (follow-up: 8–24 weeks) | −4.8 | −3.01 (−6.29 to 0.27) | 168 (3 studies) | ⊕ ⊕ ⊝⊝ Low |
Fat-free mass, kg (follow-up: 8–24 weeks) | −0.3 | −1.05 (− 1.75 to − 0.35) | 168 (3 studies) | ⊕ ⊕ ⊝⊝ Moderate |
Fat mass, % (follow-up: 8–24 weeks) | − 1.45 | − 1.88 (−2.87 to − 0.89) | 515 (4 studies) | ⊕ ⊕ ⊕⊝ Moderate |
Systolic blood pressure, mm Hg (follow-up: 8–24 weeks) | − 3.0 | − 1.97 (− 3.68 to − 0.25) | 506 (9 studies) | ⊕ ⊕ ⊕⊝ Moderate |
Diastolic blood pressure, mm Hg (follow-up: 8–24 weeks) | − 2.1 | − 0.68 (− 1.79 to 0.44) | 906 (9 studies) | ⊕ ⊕ ⊝⊝ Low |
Triglyceride, mg/dL (follow-up: 8–24 weeks) | − 11.9 | − 21.33 (− 30.46 to − 12.21) | 1059 (13 studies) | ⊕ ⊕ ⊝⊝ Low |
LDL-C, mg/dL (follow-up: 8–24 weeks) | –5.1 | 7.52 (3.34 to 11.70) | 1023 (12 studies) | ⊕ ⊕ ⊕⊝ Moderate |
HDL-C, mg/dL (follow-up: 8–24 weeks) | 0.0 | 4.30 (1.79 to 6.82) | 1058 (13 studies) | ⊕ ⊕ ⊝⊝ Low |
HbA1c, % (follow-up: 8–24 weeks) | − 0.15 | − 0.27 (− 0.50 to − 0.03) | 354 (6 studies) | ⊕ ⊕ ⊝⊝ Low |
Fasting insulin, μU/mL (follow-up: 8–24 weeks) | −1.55 | − 1.37 (− 2.89 to 0.15) | 603 (6 studies) | ⊕ ⊕ ⊝⊝ Low |
Fasting glucose, mg/dL (follow-up: 8–24 weeks) | − 2.9 | − 0.44 (− 2.66 to 1.78) | 730 (9 studies) | ⊕ ⊕ ⊝⊝ Low |
C-reactive protein, mg/L (follow-up: 8–24 weeks) | − 0.2 | − 0.63 (− 1.41 to 0.15) | 371 (5 studies) | ⊕ ⊕ ⊝⊝ Low |
Adiponectin, μg/mL (follow-up: 8–24 weeks) | 0.4 | 0.75 (0.29 to 1.21) | 181 (2 studies) | ⊕ ⊕ ⊝⊝ Low |
Intermittent fastingd | ||||
Body weight, kg (follow-up: 12–24 weeks) | − 3.62 | −1.22 (−3.49 to 1.05) | 554 (8 studies) | ⊕⊝⊝⊝ Very low |
Body mass index, kg/m2 (follow-up: 12–24 weeks) | −1.46 | −0.49 (− 1.13 to 0.14) | 380 (5 studies) | ⊕ ⊕ ⊝⊝ Low |
Waist circumference, cm (follow-up: 12–24 weeks) | −2.28 | −1.95 (−4.09 to 0.2) | 180 (3 studies) | ⊕⊝⊝⊝ Very low |
Fat mass, kg (follow-up: 12–24 weeks) | −1.1 | −0.36 (− 0.87 to 0.16) | 540 (8 studies) | ⊕⊝⊝⊝ Very low |
Fat-free mass, kg (follow-up: 12–24 weeks) | −3.7 | − 0.67 (− 1.95 to 0.62) | 540 (8 studies) | ⊕⊝⊝⊝ Very low |
Fat mass, % (follow-up: 12–24 weeks) | −0.9 | 0.27 (−0.48 to 1.01) | 142 (3 studies) | ⊕⊝⊝⊝ Very low |
Systolic blood pressure, mm Hg (follow-up: 12–24 weeks) | −5.7 | 0.87 (−2.56 to 4.39) | 404 (6 studies) | ⊕⊝⊝⊝ Very low |
Diastolic blood pressure, mm Hg (follow-up: 12–24 weeks) | −3.4 | −0.16 (−2.89 to 2.56) | 404 (6 studies) | ⊕⊝⊝⊝ Very low |
Triglyceride, mg/dL (follow-up: 12–24 weeks) | −22.0 | −1.51 (− 17.06 to 14.04) | 432 (6 studies) | ⊕⊝⊝⊝ Very low |
LDL-C, mg/dL (follow-up: 12–24 weeks) | −12.48 | −0.24 (−5.08 to 4.59) | 387 (5 studies) | ⊕⊝⊝⊝ Very low |
HDL-C, mg/dL (follow-up: 12–24 weeks) | 0.0 | −0.17 (−3.27 to 2.89) | 432 (6 studies) | ⊕⊝⊝⊝ Very low |
HbA1c, % (follow-up: 12–24 weeks) | −0.31 | 0.11 (−0.04 to 0.26) | 173 (3 studies) | ⊕⊝⊝⊝ Very low |
Fasting glucose, mg/dL (follow-up: 12–24 weeks) | −3.00 | −0.89 (−4.30 to 2.53) | 359 (5 studies) | ⊕ ⊕ ⊝⊝ Low |
Fasting insulin, μU/mL (follow-up: 12–24 weeks) | −2.6 | −0.43 (−1.99 to 1.14) | 314 (4 studies) | ⊕ ⊕ ⊝⊝ Low |
HOMA-IR (follow-up: 12–24 weeks) | −0.94 | −0.22 (−1.48 to 1.05) | 119 (2 studies) | ⊕⊝⊝⊝ Very low |