低碳饮食vs低脂饮食，谁的效果好？谁更健康？

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结论速览

通过实验数据汇总分析，得出结论：

1. 低碳饮食组在体重、甘油三酯、血压指标的降低明显多于低脂饮食组

2. 低碳组在LDL-C和HDL-C胆固醇的指标高于低脂组，但这不代表不健康

3. 两组在空腹血糖、胰岛素、糖化血红蛋白和C反应蛋白的数值没有明显差异

低碳饮食vs低脂饮食，哪个更好？

在之前的案例分享中，我和大家说过我曾经是一个“传统减肥法”的拥簇。什么是“传统减肥法”呢？低脂肪、低热量、大量运动是它的重要元素。

而生酮饮食，要求低碳水、中等蛋白、高脂肪的饮食结构。对于它的效果，我想已经不用多说~关注我们的酮学尤其是群里的小伙伴每天都在看到。

那么低脂和低碳这两种减肥流派，究竟谁的效果更好？高脂的生酮饮食对身体有没有伤害？

2013年在英国营养学期刊上发布了一篇研究《极低碳的生酮饮食与低脂饮食对长期减肥的随机对照试验的荟萃分析》可以给你一个满意的答案。这份研究还得到了国家卫生组织（CNPQ）拨款的支持（130639 / 2011-7）。

Nassib Bezerra Bueno等四位作者在研究中收集了MEDLINE，CENTRAL，ScienceDirect等多个数据机构的实验数据，这些实验都是将成年人随机分配到“低碳”饮食组和“低脂”饮食组，研究其在12个月内及后续的身体变化。

在研究中，主要的分析指标有：

体重

甘油三酯

胆固醇（高低密度脂蛋白）

血压（收缩压和舒张压）

空腹血糖

胰岛素

HbA 1c（糖化血红蛋白）

C反应蛋白（免疫性蛋白）

体重

大家最关心的当然是体重啦！毕竟无论是低脂或者低碳，大部分人执行它的最主要目的还是减重（脂）。

让我们先来实验汇总数据（以示实验的真实严肃）：

（a）体重，（b）甘油三酯，

（c）HDL-胆固醇（HDL-C），（d）LDL-胆固醇（LDL-C）

LFD：低脂组；VLCKD：低碳组

对13个单独研究（1415名患者）的汇总数据显示，与分配到低脂的个体相比，分配到低碳组的实验对象体重降低明显更多（加权均数差- 0·91（95％CI - 1·65， - 0·17）kg，P = 0.02; I 2 = 0％，P = 0·47）。

结论：低碳饮食在降低体重上效果更好！

血脂（甘油三酯和胆固醇 )

如生酮饮食一样，低碳组在实验中摄取了更多的脂肪。很多酮学都担心，脂肪吃多了难道不会血脂高吗？

血脂主要包括甘油三酯和胆固醇两个指标，让我们看一下这两个指标对比结果。

甘油三酯

如上一节的图片所示，对12项单独研究（1258名患者）的数据汇总显示，分配到低碳组的实验对象在甘油三酯指标上的下降比低脂组明显更多（加权均数差-0·18（95％CI -0·27，-0.08）mmol / l，P <0.001; I 2 = 12％，P = 0·33）。

并且，除了一组24个月随访的实验没有具体数据外，所有的实验均显示出了这个结果！

胆固醇

如上图数据所示，对12项单独研究（1257名患者）的数据汇总显示，低碳组实验对象的的HDL-C（高密度脂蛋白胆固醇）水平显着增加（加权均数差- 0·09（95％CI 0·06,0·12）mmol / l，P <0· 001; I 2 = 9％，P = 0·36），LDL-C（低密度脂蛋白胆固醇）水平显着增加（加权均数差-0·12（95％CI 0·04,0·2）mmol / l，P = 0· 002; I 2 = 0％，P = 0·7）。

看来低碳组的胆固醇指标果然是明显的升高了！这是不是说明高脂肪的饮食对身体有危害呢？

首先，高密度脂蛋白胆固醇（HDL），主要负责运输胆固醇到肝脏，是我们俗称“好的胆固醇”，对身体健康没有任何影响。

我们最常听到的说法是低密度脂蛋白（LDL）是所谓的坏脂蛋白，且认为LDL和心脏病密切相关。

但是呢，国外研究发现，LDL也是分种类的，分成大/小颗粒。

大颗粒低密度脂蛋白：顾名思义，粒子大，研究发现这类脂蛋白和心脏病没有关系。

小颗粒低密度脂蛋白：小粒子，可以自由通过动脉管壁，和心脏病有着一定关系。

Krauss等研究人员发现，高脂肪摄入量与低碳水摄入相结合，提高的是大尺寸LDL-C的水平，而大尺寸LDL-C的对动脉粥样硬化程度是远低于小颗粒的LDL-C的！

结论：低碳饮食不仅可以降低甘油三酯水平，所提升的胆固醇水平对身体基本没有影响，所以低碳可以降血脂！

血压（收缩压和舒张压）

与耸人听闻的“高血脂”如影随形的，就是“高血压”了。那么低碳饮食和低脂饮食在血压上有什么影响呢？

（a）收缩压（SBP）和（b）舒张压（DBP）的绝对变化

LFD：低脂组；VLCKD：低碳组

血压包括收缩压SBP和舒张压DBP。如上图数据所示，对12项单独研究（1257名患者）的数据汇总显示，各组间收缩压SBP无差异（加权均数差VLCKD - 1·47（95％CI - 3·44,0.5）mmHg，P = 0.14 ; I 2 = 33％，P = 0 ·13）。

然而，低碳组的舒张压DBP指标比低脂组明显降低（加权均数差 - 1·43（95％CI - 2·49， - 0·37）mmHg，P = 0.008; I 2 = 3％，P = 0·41）。

结论：低碳饮食对降血压效果更好！

空腹血糖、胰岛素、HbA 1c、C反应蛋白

这几项数据在两组中的差异不大，所以两种不同的饮食方法并没有什么区别。

小结

通过对实验数据的汇总和统计学分析，学者发现低碳饮食相比于低脂饮食，在减体重、降血脂和降血压方面有着更好的效果。

由于摄入了更多的饱和脂肪，低碳组的胆固醇水平有所增高，但增高的胆固醇类型对心脑血管无害。

另一方面，低碳饮食并没有对胰岛素水平有着更明显的改变，并且作者认为由于低碳饮食对大众饮食习惯的改变更多，执行起来的难度也会更大一些。

只要你有足够的意志力和决心，放心的减少碳水，多吃脂肪吧！

它的效果和安全性可是有科学实验的背书哦！

下期见，喵~

参考文献

Bueno,N, Melo,I, Oliverira,S, Ataide,T(2013) Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. British Journal of Nutrition, Volume 110, Issue 7.14 October 2013 , pp. 1178-1187. https://www.cambridge.org (accessed 9 Augest 2018).

World Health Organization (2012) Obesity and overweight. http://www.who.int/mediacentre/factsheets/fs311/en/ (accessed 10 May 2012).

Ggebakan, O, Kohl, A, Osterhoff, MA, et al. (2011) Effects of weight loss and long-term weight maintenance with diets varying in protein and glycemic index on cardiovascular risk factors: the diet, obesity, and genes (DiOGenes) study: a randomized, controlled trial. Circulation 124, 2829–2838.

Ornish, D (1997) Every Day Cooking With Dean Ornish. New York: Harper Collins.

Sears, B & Lawren, W (1995) Enter the Zone. New York: Harper Collins.

Weight Watchers Publishing Group (1997) Weight Watchers New Complete Cookbook. New York: Macmill.

Accurso, A, Bernstein, R, Dahlqvist, A, et al. (2008) Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal. Nutr Metab (Lond) 5, 9.

Alhassan, S, Kim, S, Bersamin, A, et al. (2008) Dietary adherence and weight loss success among overweight women: results from the A to Z weight loss study. Int J Obes (Lond) 32, 985–991.

Sacks, FM, Bray, GA, Carey, VJ, et al. (2009) Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med 360, 859–873.

Krieger, JW, Sitren, HS, Daniels, MJ, et al. (2006) Effects of variation in protein and carbohydrate intake on body mass and composition during energy restriction: a meta-regression. Am J Clin Nutr 83, 260–274.

Hession, M, Rolland, C, Kulkarni, U, et al. (2009) Systematic review of randomized controlled trials of low-carbohydrate vs. low-fat/low-calorie diets in the management of obesity and its comorbidities. Obes Rev 10, 36–50.

Nordmann, AJ, Nordmann, A, Briel, M, et al. (2006) Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials. Arch Intern Med 166, 285–293.

Santos, FL, Esteves, SS, da Costa Pereira, A, et al. (2012) Systematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors. Obes Rev 13, 1048–1066.

Moher, D, Liberati, A, Tetzlaff, J, et al. (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151, 264–269.

Sterne JAC, Egger M & Moher D (2011) Addressing reporting biases. In Higgins JPT, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions version 5.1.0 [updated March 2011]. http://www.cochrane-handbook.org (accessed 10 March 2012).

Robinson, KA & Dickersin, K (2002) Development of a highly sensitive search strategy for the retrieval of reports of controlled trials using PubMed. Int J Epidemiol 31, 150–153.

World Health Organization Expert Consultation (2004) Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 363, 157–163.

Higgins JPT & Deeks JJ (2011) Selecting studies and collecting data. In Higgins JPT, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions version 5.1.0 [updated March 2011]. http://www.cochrane-handbook.org (accessed 22 March 2012).

18Higgins JPT, Altman DG & Sterne JAC (2011) Assessing risk of bias in included studies. In Higgins JPT, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions version 5.1.0 [updated March 2011]. http://www.cochrane-handbook.org (accessed 21 March 2012).

Deeks JJ, Higgins JPT & Altman DG (2011) Analysing data and undertaking meta-analyses. In Higgins JPT, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions version 5.1.0 [updated March 2011]. http://www.cochrane-handbook.org (accessed 01 April 2012).

DerSimonian, R & Laird, N (1986) Meta-analysis in clinical trials. Control Clin Trials 7, 177–188.

Higgins JPT, Deeks JJ & Altman DG (2011) Special topics in statistics. In Higgins JPT, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions version 5.1.0 [updated March 2011]. http://www.cochrane-handbook.org (accessed 01 April 2012).

Harbord, RM & Higgins, JPT (2008) Meta-regression in stata. Stata J 8, 493–519.

Peters, JL, Sutton, AJ, Jones, DR, et al. (2008) Contour-enhanced meta-analysis funnel plots help distinguish publication bias from other causes of asymmetry. J Clin Epidemiol 61, 991–996.

Egger, M, Smith, GD, Schneider, M, et al. (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315, 629–634.

Vetter, ML, Iqbal, N, Volger, S, et al. (2010) Long-term effects of low-carbohydrate versus low-fat diets in obese persons. Ann Int Med 152, 334–335.

Stern, L, Iqbal, N, Seshadri, P, et al. (2004) The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial. Ann Intern Med 140, 778–785.

Foster, GD, Wyatt, HR, Hill, JO, et al. (2010) Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet: a randomized trial. Ann Intern Med 153, 147–157.

Brinkworth, GD, Noakes, M, Buckley, JD, et al. (2009) Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo. Am J Clin Nutr 90, 23–32.

Iqbal, N, Vetter, ML, Moore, RH, et al. (2010) Effects of a low-intensity intervention that prescribed a low-carbohydrate vs. a low-fat diet in obese, diabetic participants. Obesity (Silver Spring) 18, 1733–1738.

Gardner, CD, Kiazand, A, Alhassan, S, et al. (2007) Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A to Z Weight Loss Study: a randomized trial. JAMA 297, 969–977.

Ebbeling, CB, Swain, JF, Feldman, HA, et al. (2012) Effects of dietary composition on energy expenditure during weight-loss maintenance. JAMA 307, 2627–2634.

Westman, EC, Feinman, RD, Mavropoulos, JC, et al. (2007) Low-carbohydrate nutrition and metabolism. Am J Clin Nutr 86, 276–284.

Volek, JS, Sharman, MJ & Forsythe, CE (2005) Modification of lipoproteins by very low-carbohydrate diets. J Nutr 135, 1339–1342.

Krauss, RM, Blanche, PJ, Rawlings, RS, et al. (2006) Separate effects of reduced carbohydrate intake and weight loss on atherogenic dyslipidemia. Am J Clin Nutr 83, 1025–1031.

Berneis, KK & Krauss, RM (2002) Metabolic origins and clinical significance of LDL heterogeneity. J Lipid Res 43, 1363–1379.

Appel, LJ, Sacks, FM, Carey, VJ, et al. (2005) Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: results of the omniheart randomized trial. JAMA 294, 2455–2464.

Anonymous (2001) Primer on statistical significance and P values. Eff Clin Pract 4, 183–184.

Wadden, TA, Volger, S, Sarwer, DB, et al. (2011) A two-year randomized trial of obesity treatment in primary care practice. N Engl J Med 365, 1969–1979.

Alberti, KG, Zimmet, P, Shaw, J, et al. (2005) The metabolic syndrome – a new worldwide definition. Lancet 366, 1059–1062.

Kass, L, Weekes, J & Carpenter, L (2012) Effect of magnesium supplementation on blood pressure: a meta-analysis. Eur J Clin Nutr 66, 411–418.

Ried, K, Sullivan, TR, Fakler, P, et al. (2012) Effect of cocoa on blood pressure. The Cochrane Database of Systematic Reviews, issue 8 CD008893.

Haufe, S, Engeli, S, Kast, P, et al. (2011) Randomized comparison of reduced fat and reduced carbohydrate hypocaloric diets on intrahepatic fat in overweight and obese human subjects. Hepatology 53, 1504–1514.

Phillips, SA, Jurva, JW, Syed, AQ, et al. (2008) Benefit of low-fat over low-carbohydrate diet on endothelial health in obesity. Hypertension 51, 376–382.

Lagiou, P, Sandin, S, Lof, M, et al. (2012) Low carbohydrate-high protein diet and incidence of cardiovascular diseases in Swedish women: prospective cohort study. BMJ 344, e4026–e4037.

Friedman, AN, Ogden, LG, Foster, GD, et al. (2012) Comparative effects of low-carbohydrate high-protein versus low-fat diets on the kidney. Clin J Am Soc Nephrol 7, 1103–1111.

Greenberg, I, Stampfer, MJ, Schwarzfuchs, D, et al. (2009) Adherence and success in long-term weight loss diets: the dietary intervention randomized controlled trial (DIRECT). J Am Coll Nutr 28, 159–168.

Institute of Medicine (2011) Finding What Works in Health Care: Standards for Systematic Reviews. Washington, DC: The National Academy Press.

Centre for Reviews and Dissemination (2009) Systematic Reviews: CRD's Guidance for Undertaking Reviews in Health Care. York: York Publishing Services.

Shai, I, Schwarzfuchs, D, Henkin, Y, et al. (2008) Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med 359, 229–241.

Dansinger, ML, Gleason, JA, Griffith, JL, et al. (2005) Comparison of the atkins, ornish, weight watchers, and zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA 293, 43–53.

Davis, NJ, Tomuta, N, Schetcher, C, et al. (2009) Comparative study of the effects of a 1-year dietary intervention of a low-carbohydrate diet versus a low-fat diet on weight and glycemic control in type 2 diabetes. Diabetes Care 32, 1147–1152.

Dyson, PA, Beatty, S & Matthews, DR (2010) An assessment of low-carbohydrate or low-fat diets for weight loss at 2 year's follow-up. Diabet Med 27, 363–368.

Foster, GD, Wyatt, HR, Hill, JO, et al. (2003) A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med 348, 2082–2090.

Lim, SS, Noakes, M, Keogh, JB, et al. (2010) Long-term effects of a low carbohydrate, low fat or high unsaturated fat diet compared to a no-intervention control. Nutr Metab Cardiovasc Dis 20, 599–607.

McAuley, KA, Smith, KJ, Taylor, RW, et al. (2006) Long-term effects of popular dietary approaches on weight loss and features of insulin resistance. Int J Obes (Lond) 30, 342–349.

Truby, H, Baic, S, deLooy, A, et al. (2006) Randomised controlled trial of four commercial weight loss programmes in the UK: initial findings from the BBC “diet trials”. BMJ 332, 1309–1314.

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