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Review
. 2021 Sep 22;13(10):3299.
doi: 10.3390/nu13103299.

Alternative Dietary Patterns for Americans: Low-Carbohydrate Diets

Jeff S Volek  1 , Stephen D Phinney  2 , Ronald M Krauss  3 , Richard J Johnson  4 , Laura R Saslow  5 , Barbara Gower  6 , William S Yancy Jr  7 , Janet C King  8 , Frederick M Hecht  9 , Nina Teicholz  10 , Bruce R Bistrian  11 , Osama Hamdy  12
Affiliations
Review

Alternative Dietary Patterns for Americans: Low-Carbohydrate Diets

Jeff S Volek et al. Nutrients. .

Abstract

The decades-long dietary experiment embodied in the Dietary Guidelines for Americans (DGA) focused on limiting fat, especially saturated fat, and higher carbohydrate intake has coincided with rapidly escalating epidemics of obesity and type 2 diabetes (T2D) that are contributing to the progression of cardiovascular disease (CVD) and other diet-related chronic diseases. Moreover, the lack of flexibility in the DGA as it pertains to low carbohydrate approaches does not align with the contemporary trend toward precision nutrition. We argue that personalizing the level of dietary carbohydrate should be a high priority based on evidence that Americans have a wide spectrum of metabolic variability in their tolerance to high carbohydrate loads. Obesity, metabolic syndrome, and T2D are conditions strongly associated with insulin resistance, a condition exacerbated by increased dietary carbohydrate and improved by restricting carbohydrate. Low-carbohydrate diets are grounded across the time-span of human evolution, have well-established biochemical principles, and are now supported by multiple clinical trials in humans that demonstrate consistent improvements in multiple established risk factors associated with insulin resistance and cardiovascular disease. The American Diabetes Association (ADA) recently recognized a low carbohydrate eating pattern as an effective approach for patients with diabetes. Despite this evidence base, low-carbohydrate diets are not reflected in the DGA. As the DGA Dietary Patterns have not been demonstrated to be universally effective in addressing the needs of many Americans and recognizing the lack of widely available treatments for obesity, metabolic syndrome, and T2D that are safe, effective, and sustainable, the argument for an alternative, low-carbohydrate Dietary Pattern is all the more compelling.

Keywords: dietary guidelines; diets; eating patterns; high-fat; insulin resistance; low-carbohydrate; obesity; type-2 diabetes.

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Conflict of interest statement

JSV receives royalties for low-carbohydrate nutrition books, is co-founder and has equity in Virta Health Corp, and is a scientific advisor to Simply Good Foods; SDP receives royalties for low-carbohydrate nutrition books and is co-founder and has equity in Virta Health Corp; RMK is on the scientific advisory boards of Virta Health Corp, Seraphina Therapeutics, and Day Two, and has licensed patents for lipoprotein particle analysis; RJJ has received honoraria from Horizon Pharma and Danone, has stocks with XORTX Therapeutics, and has equity with Colorado Partners LLC (CRP); LRS is a consultant with Sentinel Management; WSY is a consultant for Guideline Central and dietdoctor.com; NT receives book royalties and honoraria for speeches via the Harry Walker Agency.

Figures

Figure 1
Figure 1
Expression of an insulin resistant or sensitive phenotype is a continuum that is strongly influenced by carbohydrate intake, with modulation based on genetic predisposition, age, and lifestyle choices.
See this image and copyright information in PMC

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