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Table 1 Summary of finding for effects of carbohydrate-restricted diets and intermittent fasting in adults with overweight/obesity

From: 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

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
  1. aThe basis for the assumed effect is the mean change of outcomes compared to baseline in the control group across studies, and the corresponding effect (and its 95% CI) is based on the assumed effect in the comparison group
  2. bmLCD for overweight/obesity: Patient or population (patients with overweight/obese), Intervention (mLCD)
  3. cVLCD for overweight/obese: Patient or population (patients with overweight/obesity), Intervention (VLCD)
  4. dIntermittent fasting for overweight/obesity: Patient or population (patients with overweight/obesity), Intervention (intermittent fasting)
  5. CI confidence interval, GRADE Grading of Recommendations Assessment, Development and Evaluation, mLCD moderately-low carbohydrate or low carbohydrate diet, LDL-C low-density lipoprotein cholesterol, HDL-C high-density lipoprotein cholesterol, HbA1c glycosylated hemoglobin, VLCD very-low carbohydrate diet, HOMA-IR homeostatic model assessment for insulin resistance
  6. GRADE Working Group grades of evidence: High quality (Further research is very unlikely to change our confidence in the estimate of effect); Moderate quality (Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate); Low quality (Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate); Very low quality (We are very uncertain about the estimate).