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Effects of low-carbohydrate diets, with and without caloric restriction, on inflammatory markers in adults: a systematic review and meta-analysis of randomized clinical trials

European Journal of Clinical Nutrition (2024)Cite this article

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Abstract

Low-carbohydrate diets (LCDs) have gained interest due to their favorable effects on health outcomes, such as inflammation. However, further research is needed to ascertain the overall effects of LCDs on inflammatory parameters, but at the same time considering weight loss and calorie intake. Thus, a systematic review and meta-analysis of randomized clinical trials was performed to investigate the effects of LCDs compared with low-fat diets (LFDs), with and without caloric restriction, on inflammatory markers in adults. PubMed, Scopus, and Web of Science were searched through March 2022 to select intervention studies addressing LCDs vs. LFDs, in which the following circulating inflammatory markers were used: C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α), and interleukin (IL-6). Analyses were conducted comparing LCDs vs. LFDs through weighted mean differences (WMD) or standardized mean differences (SMD) and 95% confidence intervals (95% CIs) using random effects models. The systematic review and meta-analysis included a total of 51 studies with a total sample of 4,164 adults, with or without other chronic diseases. Intervention durations ranged from 2–144 weeks. LCDs, compared with LFDs, significantly decreased body weight [WMD = −1.35%, p = 0.001], CRP [SMD = −0.1, p = 0.03], and IL-6 [SMD = −0.15, p = 0.09]. However, LCDs did not significantly decrease TNF-α [SMD = −0.02, p = 0.7] compared to LFDs. In conclusion, LCDs have a beneficial effect on markers of inflammation by decreasing CRP and IL-6; this effect has an association with weight loss. However, LCDs were not more effective than LFDs in decreasing TNF-α.

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Fig. 1
Fig. 2: Forest plot of the effects of low-carbohydrate diets vs. low-fat diets on body weight.
Fig. 3: Forest plot of the effects of low-carbohydrate diets vs. low-fat diets on CRP.
Fig. 4: Forest plot of the effects of low-carbohydrate diets vs. low-fat diets on TNF-α.
Fig. 5: Forest plot of the effects of low-carbohydrate diets vs. low-fat diets on IL-6.

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Data availability

Data extracted from included studies; data used for all analyses are publicly available.

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Acknowledgements

This systematic review and meta-analysis did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.

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Authors and Affiliations

  1. Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran

    Fatemeh Kazeminasab & Mousa Khalafi

  2. Department of Cancer Research Center, Shahid Beheshti of Medical Sciences, Tehran, Iran

    Maryam Miraghajani

  3. Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Guilan, Iran

    Mohammad Hossein Sakhaei

  4. Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV, USA

    Sara K. Rosenkranz

  5. Postgraduate Program, Faculdade UNIGUAÇU, Cascavel, PR, Brazil

    Heitor O. Santos

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  1. Fatemeh Kazeminasab
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  2. Maryam Miraghajani
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  3. Mousa Khalafi
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  4. Mohammad Hossein Sakhaei
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  5. Sara K. Rosenkranz
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  6. Heitor O. Santos
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Contributions

FK, MK, and MHS conceived and designed the study and extracted data. FK analyzed the data and completed the initial draft of the results. FK and MM drafted the initial manuscript. HS and SR revised the manuscript. FK, MM, MK, MHS, SR, and HS read and approved the final manuscript.

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Correspondence to Heitor O. Santos.

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Kazeminasab, F., Miraghajani, M., Khalafi, M. et al. Effects of low-carbohydrate diets, with and without caloric restriction, on inflammatory markers in adults: a systematic review and meta-analysis of randomized clinical trials. Eur J Clin Nutr (2024). https://doi.org/10.1038/s41430-024-01431-x

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