The SA Journal Diabetes & Vascular Disease Vol 15 No 2 (November 2018)

RESEARCH ARTICLE

SA JOURNAL OF DIABETES & VASCULAR DISEASE

VOLUME 15 NUMBER 2 • NOVEMBER 2018

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Review assesses low-fat/high-carb and high-fat/low-carb diets

strong US research review agreed that

no specific fat-to-carbohydrate ratio

is best and that an overall high-quality

diet that is low in sugar and refined grains

will help most people maintain a healthy

weight and low chronic disease risk.

‘This is a model for how we can

transcend the diet wars,’ said lead author

David Ludwig, professor in theDepartment

of Nutrition at Harvard Chan School and

a physician at Boston Children’s Hospital.

‘Our goal was to assemble a team with

different areas of expertise and contrasting

views, and to identify areas of agreement

without glossing over differences.’

The authors laid out the evidence for

three contrasting positions on dietary

guidelines for fat and carbohydrate

consumption: high consumption of fat

causes obesity, diabetes, heart disease,

and possibly cancer, therefore low-fat

diets are optimal; processed carbohydrates

have negative effects on metabolism;

lower-carbohydrate or ketogenic (very-

low-carbohydrate) diets with high fat

content are better for health; and the

relative quantity of dietary fat and

carbohydrate has little health significance

– what’s important is the type of fat or

carbohydrate source consumed.

They agreed that by focusing on diet

quality – replacing saturated or trans

fats with unsaturated fats and replacing

refined carbohydrates with whole grains

and non-starchy vegetables – most people

can maintain good health within a broad

range of fat-to-carbohydrate ratios.

Within their areas of disagreement,

the authors identified a list of questions

that they said can form the basis of a new

nutrition research agenda, including: do

diets with various carbohydrate-to-fat

ratios affect body composition (ratio of fat

to lean tissue) regardless of caloric intake;

do ketogenic diets provide metabolic

benefits beyond those of moderate

carbohydrate restriction, and especially

for diabetes; and what are the optimal

amounts of specific types of fat (including

saturated fat) in a very-low-carbohydrate

diet?

Finding the answers to these

questions, the researchers said, will

ultimately lead to more effective nutrition

recommendations.

Source: Medical Brief 2018