Download PDF
Aktuelle Ernährungsmedizin 2022; 47(01): 57-60
DOI: 10.1055/a-1730-3733
Viewpoint

Low-Carb-Diäten – die unvoreingenommene und evidenzbasierte Betrachtung ist überfällig

Low Carb Diets – The Unbiased and Evidence-Based View is Overdue
Nicolai Worm
1   Deutsche Hochschule für Prävention und Gesundheitsmanagement, Ernährung
,
Richard Feinman
2   State University of New York Downstate Health Sciences University, Department of Cell Biology
,
Katharina Lechner
3   Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Zusammenfassung

Die zahlreichen nachgewiesenen, gesundheitlich positiv bewerteten Mechanismen und Effekte einer Low-Carb-Ernährung werden im Mainstream der Ernährungsmedizin zum Nachteil der effektiven Betreuung von Patienten – allen voran solchen mit Prädiabetes und Typ-2-Diabetes (T2D) – oftmals außer Acht gelassen. Dabei basiert die Argumentation eher auf Vorurteilen als auf Fakten, was Fortschritte auf dem Gebiet der Ernährungsmedizin behindert. Mit diesem Viewpoint soll dem Leser die Möglichkeit gegeben werden, sich über die Vorteile einer kohlenhydratreduzierten Ernährung zu informieren, Vorurteile abzubauen und (Schein-)Argumente ohne wissenschaftliche Basis zu erkennen. Auf Basis einer umfassenderen Bewertung kann dann besser entschieden werden, welche Therapieoption für den jeweiligen Patienten, auch unter Berücksichtigung dessen Präferenz, geeignet ist.

Abstract

Despite numerous medical indications with proven benefits for health, low carb diets continue to be largely disregarded by mainstream nutritional experts. This has been very harmful to science in this area. In addition, the adversarial nature has been a barrier to progress in personalized clinical care. Those who have suffered most are the patients who, at best, are confused and often given bad advice – especially the subgroup with prediabetes and type 2 diabetes (T2D) who would benefit from therapeutic interventions involving carbohydrate restriction. The aim of this Viewpoint is to shed light on the potential benefits of low-carbohydrate diets and thus provide a counterpoint to their persisting negative connotation. This might help medical providers to implement personalized nutritional strategies, taking into account patient preference.

Schlüsselwörter

kohlenhydratreduzierte Ernährung - Low-Carb-Diät - Nebenwirkungen - Typ-2-Diabetes - LDL-Cholesterin

Keywords

low-carbohydrate diet - low-carb diet - side effects - type 2 diabetes - LDL - cholesterol


Publication History

Article published online:
10 February 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

Letter to this article:

Antwort zum Beitrag: „Low-Carb-Diäten – die unvoreingenommene und evidenzbasierte Betrachtung ist überfällig“Aktuelle Ernährungsmedizin 2022; 47(01): 61-61
DOI: 10.1055/a-1737-0564

 

  • Literatur

  • 1 Feinman RD, Pogozelski WK, Astrup A. et al. Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutrition 2015; 31: 1-13 DOI: 10.1016/j.nut.2014.06.011.
    CrossrefPubMedGoogle Scholar
  • 2 Evert AB, Dennison M, Gardner CD. et al. Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report. Diabetes Care 2019; 42: 731-754
    CrossrefPubMedGoogle Scholar
  • 3 Lennerz BS, Koutnik AP, Azova S. et al. Carbohydrate restriction for diabetes: rediscovering centuries-old wisdom. J Clin Invest 2021; 131: e142246
    CrossrefPubMedGoogle Scholar
  • 4 Worm N, McKenzie A, Lechner K. Ernährungsempfehlungen bei Typ-2-Diabetes: Grundlegendes Umdenken. Dtsch Arztebl 2021; 118: 12-18 DOI: 10.3238/PersDia.2021.11.05.06.
    CrossrefPubMedGoogle Scholar
  • 5 Bosy-Westphal A, Müller MJ. Prävention nicht übertragbarer chronischer Erkrankungen durch „gesunde“ Ernährung. Dtsch Med Wochenschr 2021; 146: 389-397 DOI: 10.1055/a-1248-5539.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 6 Kirkpatrick CF, Bolick JP, Kris-Etherton PM. et al. Review of current evidence and clinical recommendations on the effects of low-carbohydrate and very-low-carbohydrate (including ketogenic) diets for the management of body weight and other cardiometabolic risk factors: A scientific statement from the National Lipid Association Nutrition and Lifestyle Task Force. J Clin Lipidol 2019; 13: 689-711 e681
    CrossrefPubMedGoogle Scholar
  • 7 Masi D, Risi R, Basciani S. et al. Very Low-Calorie Ketogenic Diets to Treat Patients With Obesity and Chronic Kidney Disease. J Ren Nutr 2021; 31: 340-341
    CrossrefPubMedGoogle Scholar
  • 8 Li RJ, Liu Y, Liu HQ. et al. Ketogenic diets and protective mechanisms in epilepsy, metabolic disorders, cancer, neuronal loss, and muscle and nerve degeneration. J Food Biochem 2020; 44: e13140
    PubMedGoogle Scholar
  • 9 Athinarayanan SJ, Hallberg SJ, McKenzie AL. et al. Impact of A Two-Year Trial of Nutritional Ketosis on Indices of Cardiovascular Disease Risk in Patients With Type 2 Diabetes. Cardiovascular Diabetology 2020; 19: 208 DOI: 10.21203/rs.3.rs-78136/v1.
    CrossrefPubMedGoogle Scholar
  • 10 Qu C, Keijer J, Adjobo-Hermans MJW. et al. The ketogenic diet as a therapeutic intervention strategy in mitochondrial disease. Int J Biochem Cell Biol 2021; 138: 106050
    CrossrefPubMedGoogle Scholar
  • 11 Davies MJ, D’Alessio DA, Fradkin J. et al. Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2018; 41: 2669-2701 DOI: 10.2337/dci18-0033.
    CrossrefPubMedGoogle Scholar
  • 12 Oyabu C, Hashimoto Y, Fukuda T. et al. Impact of low-carbohydrate diet on renal function: a meta-analysis of over 1000 individuals from nine randomised controlled trials. Br J Nutr 2016; 116: 632-638
    CrossrefPubMedGoogle Scholar
  • 13 Suyoto PST. Effect of low-carbohydrate diet on markers of renal function in patients with type 2 diabetes: A meta-analysis. Diabetes Metab Res Rev 2018; 34: e3032
    CrossrefPubMedGoogle Scholar
  • 14 Merlotti D, Cosso R, Eller-Vainicher C. et al. Energy Metabolism and Ketogenic Diets: What about the Skeletal Health? A Narrative Review and a Prospective Vision for Planning Clinical Trials on this Issue. Int J Mol Sci 2021; 22: 435
    CrossrefPubMedGoogle Scholar
  • 15 Martin-McGill KJ, Bresnahan R, Levy RG. et al. Ketogenic diets for drug-resistant epilepsy. Cochrane Database Syst Rev 2020; 6: CD001903
    CrossrefPubMedGoogle Scholar
  • 16 Goldberg IJ, Ibrahim N, Bredefeld C. et al. Ketogenic diets, not for everyone. J Clin Lipidol 2021; 15: 61-67
    CrossrefPubMedGoogle Scholar
  • 17 Gjuladin-Hellon T, Davies IG, Penson P. et al. Effects of carbohydrate-restricted diets on low-density lipoprotein cholesterol levels in overweight and obese adults: a systematic review and meta-analysis. Nutr Rev 2019; 77: 161-180
    CrossrefPubMedGoogle Scholar
  • 18 Dong T, Guo M, Zhang P. et al. The effects of low-carbohydrate diets on cardiovascular risk factors: A meta-analysis. PLoS One 2020; 15: e0225348
    CrossrefPubMedGoogle Scholar
  • 19 Falkenhain K, Roach LA, McCreary S. et al. Effect of carbohydrate-restricted dietary interventions on LDL particle size and number in adults in the context of weight loss or weight maintenance: a systematic review and meta-analysis. Am J Clin Nutr 2021; 114: 1455-1466
    CrossrefPubMedGoogle Scholar
  • 20 Lechner K, von Schacky C, McKenzie AL. et al. Lifestyle factors and high-risk atherosclerosis: Pathways and mechanisms beyond traditional risk factors. Eur J Prev Cardiol 2020; 27: 394-406 DOI: 10.1177/2047487319869400.
    CrossrefPubMedGoogle Scholar
  • 21 Krauss RM, Kris-Etherton PM. Public health guidelines should recommend reducing saturated fat consumption as much as possible: NO. Am J Clin Nutr 2020; 112: 19-24 DOI: 10.1093/ajcn/nqaa111.
    CrossrefPubMedGoogle Scholar
  • 22 Worm N, McKenzie AL, Lechner KL. Paradigmenwechsel in den Empfehlungen zur Ernährung bei Typ-2-Diabetes. InfoDiabetologie 2021; 15: 34-42
    PubMedGoogle Scholar
  • 23 Tay J, Thompson CH, Luscombe-Marsh ND. et al. Nutritional adequacy of very low- and high-carbohydrate, low saturated fat diets in adults with type 2 diabetes: A secondary analysis of a 2-year randomised controlled trial. Diabetes Res Clin Pract 2020; 170: 108501 DOI: 10.1016/j.diabres.2020.108501.
    CrossrefPubMedGoogle Scholar
  • 24 Gepner Y, Shelef I, Komy O. et al. The Beneficial effects of Mediterranean diet over low-fat diet may be mediated by decreasing hepatic fat content. J Hepatol 2019; 71: 379-388 DOI: 10.1016/j.jhep.2019.04.013.
    CrossrefPubMedGoogle Scholar
  • 25 Seidelmann SB, Claggett B, Cheng S. et al. Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis. The Lancet Public health 2018; 3: e419-e428 DOI: 10.1016/s2468-2667(18)30135-x.
    CrossrefPubMedGoogle Scholar
  • 26 Worm N, Lechner K. Sind Low-Carb-Diäten lebensgefährlich?. Aktuel Ernahrungsmed 2019; 44: 185-187
    Article in Thieme ConnectPubMedGoogle Scholar