Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal.
Current nutritional approaches to metabolic syndrome and type 2 diabetes generally rely on reductions in dietary fat. The success of such approaches has been limited and therapy more generally relies on pharmacology. The argument is made that a re-evaluation of the role of carbohydrate restriction, the historical and intuitive approach to the problem, may provide an alternative and possibly superior dietary strategy. The rationale is that carbohydrate restriction improves glycemic control and reduces insulin fluctuations which are primary targets. Experiments are summarized showing that carbohydrate-restricted diets are at least as effective for weight loss as low-fat diets and that substitution of fat for carbohydrate is generally beneficial for risk of cardiovascular disease. These beneficial effects of carbohydrate restriction do not require weight loss. Finally, the point is reiterated that carbohydrate restriction improves all of the features of metabolic syndrome.
Accurso
Anthony
A
State University of New York Downstate Medical Center, Brooklyn, New York, USA. rfeinman@downstate.edu.
Bernstein
Richard K
RK
Dahlqvist
Annika
A
Draznin
Boris
B
Feinman
Richard D
RD
Fine
Eugene J
EJ
Gleed
Amy
A
Jacobs
David B
DB
Larson
Gabriel
G
Lustig
Robert H
RH
Manninen
Anssi H
AH
McFarlane
Samy I
SI
Morrison
Katharine
K
Nielsen
Jørgen Vesti
JV
Ravnskov
Uffe
U
Roth
Karl S
KS
Silvestre
Ricardo
R
Sowers
James R
JR
Sundberg
Ralf
R
Volek
Jeff S
JS
Westman
Eric C
EC
Wood
Richard J
RJ
Wortman
Jay
J
Vernon
Mary C
MC