Abstract
In addition to physical activity, diet is a crucial component of lifestyle management. However, consensus as to which dietary approach is most efficacious remains elusive. Overall, energy restriction has been shown to consistently result in weight loss and to benefit adiposity-associated comorbidities, such as, dyslipidaemia, hypertension and insulin resistance. Lower carbohydrate intake results in relatively less insulin secretion to maintain normal glycaemia, which may be especially beneficial in someone who is resistant to insulin and/or has some insulin secretion abnormalities as is seen in the metabolic syndrome.
Because hypocaloric low-carbohydrate diets combined with a reduction in saturated fat can improve insulin sensitivity, glucose tolerance, reduce triglyceridaemia, increase circulating high-density lipoprotein cholesterol and result in substantial weight loss, it should be recommended as a part of lifestyle modifications in patients with metabolic syndrome.
While definition of “an optimal diet” is still elusive, a lifestyle that includes a reasonable restriction of carbohydrates or a consumption of low-glycaemic index food items can improve metabolic risk profiles in men and women.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Reaven GM (1988) Banting lecture (1988). Role of insulin resistance in human disease. Diabetes 37(12):1595–1607
Grundy SM, Cleeman JI et al (2005) Diagnosis and management of the metabolic syndrome. An American heart association/national heart, lung, and blood institute scientific statement. Executive summary. Cardiol Rev 13(6):322–327
Sullivan VK (2006) Prevention and treatment of the metabolic syndrome with lifestyle intervention: where do we start? J Am Diet Assoc 106(5):668–671
American Heart Association Nutrition, Lichtenstein CAH et al (2006) Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation 114(1):82–96
Minich DM, Bland JS (2008) Dietary management of the metabolic syndrome beyond macronutrients. Nutr Rev 66(8):429–444
Abete I, Astrup A et al (2010) Obesity and the metabolic syndrome: role of different dietary macronutrient distribution patterns and specific nutritional components on weight loss and maintenance. Nutr Rev 68(4):214–231
Muzio F, Mondazzi L et al (2007) Effects of moderate variations in the macronutrient content of the diet on cardiovascular disease risk factors in obese patients with the metabolic syndrome. Am J Clin Nutr 86(4):946–951
Anton SD, Han H et al (2009) Effect of calorie restriction on subjective ratings of appetite. J Hum Nutr Diet 22(2):141–147
Redman LM, Heilbronn LK et al (2009) Metabolic and behavioral compensations in response to caloric restriction: implications for the maintenance of weight loss. PLoS One 4(2):e4377
Paddon-Jones D, Westman E et al (2008) Protein, weight management, and satiety. Am J Clin Nutr 87(5):1558S–1561S
Parra D, Ramel A et al (2008) A diet rich in long chain omega-3 fatty acids modulates satiety in overweight and obese volunteers during weight loss. Appetite 51(3):676–680
Soenen S, Westerterp-Plantenga MS (2008) Proteins and satiety: implications for weight management. Curr Opin Clin Nutr Metab Care 11(6):747–751
Rutledge AC, Adeli K (2007) Fructose and the metabolic syndrome: pathophysiology and molecular mechanisms. Nutr Rev 65(6 Pt 2):S13–S23
Lee J, Xu Y et al (2010) Multiple abnormalities of myocardial insulin signaling in a porcine model of diet-induced obesity. Am J Physiol Heart Circ Physiol 298(2):H310–H319
Poudyal H, Panchal SK et al (2012) Chronic high-carbohydrate, high-fat feeding in rats induces reversible metabolic, cardiovascular, and liver changes. Am J Physiol Endocrinol Metab 302(12):E1472–E1482
Pasanisi F, Contaldo F et al (2001) Benefits of sustained moderate weight loss in obesity. Nutr Metab Cardiovasc Dis 11(6):401–406
Ilanne-Parikka P, Eriksson JG et al (2008) Effect of lifestyle intervention on the occurrence of metabolic syndrome and its components in the Finnish Diabetes Prevention Study. Diabetes Care 31(4):805–807
Orchard TJ, Temprosa M et al (2005) The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial. Ann Intern Med 142(8):611–619
Van Gaal LF, Wauters MA et al (1997) The beneficial effects of modest weight loss on cardiovascular risk factors. Int J Obes Relat Metab Disord 21(Suppl 1):S5–S9
Langford HG, Blaufox MD et al (1985) Dietary therapy slows the return of hypertension after stopping prolonged medication. JAMA 253(5):657–664
Stamler R, Stamler J et al (1987) Nutritional therapy for high blood pressure. Final report of a four-year randomized controlled trial–the Hypertension Control Program. JAMA 257(11):1484–1491
Whelton PK, Appel LJ et al (1998) Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). TONE Collaborative Research Group. JAMA 279(11):839–846
Wing RR, Koeske R et al (1987) Long-term effects of modest weight loss in type II diabetic patients. Arch Intern Med 147(10):1749–1753
Kelley DE, Wing R et al (1993) Relative effects of calorie restriction and weight loss in noninsulin-dependent diabetes mellitus. J Clin Endocrinol Metab 77(5):1287–1293
Hamman RF, Wing RR et al (2006) Effect of weight loss with lifestyle intervention on risk of diabetes. Diabetes Care 29(9):2102–2107
McLaughlin T, Carter S et al (2006) Effects of moderate variations in macronutrient composition on weight loss and reduction in cardiovascular disease risk in obese, insulin-resistant adults. Am J Clin Nutr 84(4):813–821
Brehm BJ, Seeley RJ et al (2003) A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. J Clin Endocrinol Metab 88(4):1617–1623
Latner JD, Schwartz M (1999) The effects of a high-carbohydrate, high-protein or balanced lunch upon later food intake and hunger ratings. Appetite 33(1):119–128
Samaha FF, Iqbal N et al (2003) A low-carbohydrate as compared with a low-fat diet in severe obesity. N Engl J Med 348(21):2074–2081
Yancy WS Jr, Olsen MK et al (2004) A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial. Ann Intern Med 140(10):769–777
Foster GD, Wyatt HR et al (2003) A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med 348(21):2082–2090
Stern L, Iqbal N 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(10):778–785
Dansinger ML, Gleason JA 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(1):43–53
Gardner CD, Kiazand A 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(9):969–977
Sacks FM, Bray GA et al (2009) Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med 360(9):859–873
de Lorgeril M, Renaud S et al (1994) Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet 343(8911):1454–1459
Cornier MA, Donahoo WT et al (2005) Insulin sensitivity determines the effectiveness of dietary macronutrient composition on weight loss in obese women. Obes Res 13(4):703–709
Ma Y, Li Y et al (2006) Association between carbohydrate intake and serum lipids. J Am Coll Nutr 25(2):155–163
Liese AD, Gilliard T et al (2007) Carbohydrate nutrition, glycaemic load, and plasma lipids: the Insulin Resistance Atherosclerosis Study. Eur Heart J 28(1):80–87
Grundy SM (1986) Comparison of monounsaturated fatty acids and carbohydrates for lowering plasma cholesterol. N Engl J Med 314(12):745–748
Harber MP, Schenk S et al (2005) Alterations in carbohydrate metabolism in response to short-term dietary carbohydrate restriction. Am J Physiol Endocrinol Metab 289(2):E306–E312
Pittas AG, Das SK et al (2005) A low-glycemic load diet facilitates greater weight loss in overweight adults with high insulin secretion but not in overweight adults with low insulin secretion in the CALERIE trial. Diabetes Care 28(12):2939–2941
Ebbeling CB, Leidig MM et al (2007) Effects of a low-glycemic load vs low-fat diet in obese young adults: a randomized trial. JAMA 297(19):2092–2102
Tay J, Brinkworth GD et al (2008) Metabolic effects of weight loss on a very-low-carbohydrate diet compared with an isocaloric high-carbohydrate diet in abdominally obese subjects. J Am Coll Cardiol 51(1):59–67
McAuley K, Hopkins C et al (2005) Comparison of high-fat and high-protein diets with a high-carbohydrate diet in insulin-resistant obese women. Diabetologia 48(1):8–16
Low CC, Grossman EB et al (1996) Potentiation of effects of weight loss by monounsaturated fatty acids in obese NIDDM patients. Diabetes 45(5):569–575
Gumbiner B, Low CC et al (1998) Effects of a monounsaturated fatty acid-enriched hypocaloric diet on cardiovascular risk factors in obese patients with type 2 diabetes. Diabetes Care 21(1):9–15
Heilbronn LK, Noakes M et al (1999) Effect of energy restriction, weight loss, and diet composition on plasma lipids and glucose in patients with type 2 diabetes. Diabetes Care 22(6):889–895
Parker B, Noakes M et al (2002) Effect of a high-protein, high-monounsaturated fat weight loss diet on glycemic control and lipid levels in type 2 diabetes. Diabetes Care 25(3):425–430
Brinkworth GD, Noakes M et al (2004) Long-term effects of advice to consume a high-protein, low-fat diet, rather than a conventional weight-loss diet, in obese adults with type 2 diabetes: one-year follow-up of a randomised trial. Diabetologia 47(10):1677–1686
Rizkalla SW, Taghrid L et al (2004) Improved plasma glucose control, whole-body glucose utilization, and lipid profile on a low-glycemic index diet in type 2 diabetic men: a randomized controlled trial. Diabetes Care 27(8):1866–1872
Sheard NF, Clark NG et al (2004) Dietary carbohydrate (amount and type) in the prevention and management of diabetes: a statement by the American Diabetes Association. Diabetes Care 27(9):2266–2271
Lundgren H, Bengtsson C et al (1989) Dietary habits and incidence of noninsulin-dependent diabetes mellitus in a population study of women in Gothenburg, Sweden. Am J Clin Nutr 49(4):708–712
Marshall JA, Hamman RF et al (1991) High-fat, low-carbohydrate diet and the etiology of non-insulin-dependent diabetes mellitus: the San Luis Valley Diabetes Study. Am J Epidemiol 134(6):590–603
McKeown NM, Meigs JB et al (2004) Carbohydrate nutrition, insulin resistance, and the prevalence of the metabolic syndrome in the Framingham Offspring Cohort. Diabetes Care 27(2):538–546
Guthrie JF, Morton JF (2000) Food sources of added sweeteners in the diets of Americans. J Am Diet Assoc 100(1):43–51, quiz 49–50
Lewis CJ, Park YK et al (1992) Nutrient intakes and body weights of persons consuming high and moderate levels of added sugars. J Am Diet Assoc 92(6):708–713
Jenkins DJ, Wolever TM et al (1981) Glycemic index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr 34(3):362–366
Ford ES, Liu S (2001) Glycemic index and serum high-density lipoprotein cholesterol concentration among us adults. Arch Intern Med 161(4):572–576
Brand-Miller JC (2004) Postprandial glycemia, glycemic index, and the prevention of type 2 diabetes. Am J Clin Nutr 80(2):243–244
Levitan EB, Cook NR et al (2008) Dietary glycemic index, dietary glycemic load, blood lipids, and C-reactive protein. Metabolism 57(3):437–443
Radulian G, Rusu E et al (2009) Metabolic effects of low glycaemic index diets. Nutr J 8:5
Wood RJ, Fernandez ML (2009) Carbohydrate-restricted versus low-glycemic-index diets for the treatment of insulin resistance and metabolic syndrome. Nutr Rev 67(3):179–183
Kabir M, Rizkalla SW et al (1998) A high glycemic index starch diet affects lipid storage-related enzymes in normal and to a lesser extent in diabetic rats. J Nutr 128(11):1878–1883
Scribner KB, Pawlak DB et al (2007) Hepatic steatosis and increased adiposity in mice consuming rapidly vs. slowly absorbed carbohydrate. Obesity (Silver Spring) 15(9):2190–2199
Scribner KB, Pawlak DB et al (2008) Long-term effects of dietary glycemic index on adiposity, energy metabolism, and physical activity in mice. Am J Physiol Endocrinol Metab 295(5):E1126–E1131
Flint A, Moller BK et al (2006) Glycemic and insulinemic responses as determinants of appetite in humans. Am J Clin Nutr 84(6):1365–1373
de Rougemont A, Normand S et al (2007) Beneficial effects of a 5-week low-glycaemic index regimen on weight control and cardiovascular risk factors in overweight non-diabetic subjects. Br J Nutr 98(6):1288–1298
Brand-Miller J, McMillan-Price J et al (2008) Carbohydrates–the good, the bad and the whole grain. Asia Pac J Clin Nutr 17(Suppl 1):16–19
Agus MS, Swain JF et al (2000) Dietary composition and physiologic adaptations to energy restriction. Am J Clin Nutr 71(4):901–907
Roberts SB (2000) High-glycemic index foods, hunger, and obesity: is there a connection? Nutr Rev 58(6):163–169
Jenkins DJ, Kendall CW et al (2002) Glycemic index: overview of implications in health and disease. Am J Clin Nutr 76(1):266S–273S
Halton TL, Willett WC et al (2006) Low-carbohydrate-diet score and the risk of coronary heart disease in women. N Engl J Med 355(19):1991–2002
Lutsey PL, Steffen LM et al (2008) Dietary intake and the development of the metabolic syndrome: the Atherosclerosis Risk in Communities study. Circulation 117(6):754–761
Hedley AA, Ogden CL et al (2004) Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. JAMA 291(23):2847–2850
Ford ES, Giles WH et al (2004) Increasing prevalence of the metabolic syndrome among u.s. Adults. Diabetes Care 27(10):2444–2449
Borkman M, Campbell LV et al (1991) Comparison of the effects on insulin sensitivity of high carbohydrate and high fat diets in normal subjects. J Clin Endocrinol Metab 72(2):432–437
Garg A, Grundy SM et al (1992) Comparison of effects of high and low carbohydrate diets on plasma lipoproteins and insulin sensitivity in patients with mild NIDDM. Diabetes 41(10):1278–1285
Sarkkinen E, Schwab U et al (1996) The effects of monounsaturated-fat enriched diet and polyunsaturated-fat enriched diet on lipid and glucose metabolism in subjects with impaired glucose tolerance. Eur J Clin Nutr 50(9):592–598
Bisschop PH, de Metz J et al (2001) Dietary fat content alters insulin-mediated glucose metabolism in healthy men. Am J Clin Nutr 73(3):554–559
Mayer EJ, Newman B et al (1993) Usual dietary fat intake and insulin concentrations in healthy women twins. Diabetes Care 16(11):1459–1469
Maron DJ, Fair JM et al (1991) Saturated fat intake and insulin resistance in men with coronary artery disease. The Stanford coronary risk intervention project investigators and staff. Circulation 84(5):2020–2027
Parker DR, Weiss ST et al (1993) Relationship of dietary saturated fatty acids and body habitus to serum insulin concentrations: the Normative Aging Study. Am J Clin Nutr 58(2):129–136
Heine RJ (1993) Dietary fish oil and insulin action in humans. Ann N Y Acad Sci 683:110–121
Schwab U, Uusitupa M et al (1993) Effects of two fat-modified diets on glucose and lipid metabolism in healthy subjects. Ann N Y Acad Sci 683:279–280
Uusitupa M, Schwab U et al (1994) Effects of two high-fat diets with different fatty acid compositions on glucose and lipid metabolism in healthy young women. Am J Clin Nutr 59(6):1310–1316
Fasching P, Ratheiser K et al (1996) No effect of short-term dietary supplementation of saturated and poly- and monounsaturated fatty acids on insulin secretion and sensitivity in healthy men. Ann Nutr Metab 40(2):116–122
Lovejoy JC, Smith SR et al (2002) Effects of diets enriched in saturated (palmitic), monounsaturated (oleic), or trans (elaidic) fatty acids on insulin sensitivity and substrate oxidation in healthy adults. Diabetes Care 25(8):1283–1288
Budohoski L, Panczenko-Kresowska B et al (1993) Effects of saturated and polyunsaturated fat enriched diet on the skeletal muscle insulin sensitivity in young rats. J Physiol Pharmacol 44(4):391–398
Vessby B, Unsitupa M et al (2001) Substituting dietary saturated for monounsaturated fat impairs insulin sensitivity in healthy men and women: the KANWU Study. Diabetologia 44(3):312–319
Summers LK, Fielding BA et al (2002) Substituting dietary saturated fat with polyunsaturated fat changes abdominal fat distribution and improves insulin sensitivity. Diabetologia 45(3):369–377
Xiao C, Giacca A et al (2006) Differential effects of monounsaturated, polyunsaturated and saturated fat ingestion on glucose-stimulated insulin secretion, sensitivity and clearance in overweight and obese, non-diabetic humans. Diabetologia 49(6):1371–1379
Keys A, Parlin RW (1966) Serum cholesterol response to changes in dietary lipids. Am J Clin Nutr 19(3):175–181
Dayton S, Pearce ML (1969) Diet high in unsaturated fat. A controlled clinical trial. Minn Med 52(8):1237–1242
Turpeinen O, Karvonen MJ et al (1979) Dietary prevention of coronary heart disease: the Finnish Mental Hospital Study. Int J Epidemiol 8(2):99–118
de Lorgeril M, Salen P et al (1999) Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation 99(6):779–785
Hu FB, Stampfer MJ et al (1997) Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med 337(21):1491–1499
Finley CE, Barlow CE et al (2010) Glycemic index, glycemic load, and prevalence of the metabolic syndrome in the cooper center longitudinal study. J Am Diet Assoc 110(12):1820–1829
Jones JL, Fernandez ML et al (2011) A Mediterranean-style low-glycemic-load diet improves variables of metabolic syndrome in women, and addition of a phytochemical-rich medical food enhances benefits on lipoprotein metabolism. J Clin Lipidol 5(3):188–196
US Department of Agriculture and US Department of Health and Human Services (2010) Dietary guidelines for Americans 2010, 7th edn. US Government Printing Office, Washington, DC
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer-Verlag Wien
About this chapter
Cite this chapter
Cornier, MA., Draznin, B. (2013). Low-Carbohydrate Diets in the Treatment of the Metabolic Syndrome. In: Beck-Nielsen, H. (eds) The Metabolic Syndrome. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1331-8_7
Download citation
DOI: https://doi.org/10.1007/978-3-7091-1331-8_7
Published:
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-1330-1
Online ISBN: 978-3-7091-1331-8
eBook Packages: MedicineMedicine (R0)