British Journal of Nutrition

Full Papers

Human and Clinical Nutrition

Effects of low-carbohydrate diets v. low-fat diets on body weight and cardiovascular risk factors: a meta-analysis of randomised controlled trials

Nadia Mansoora1 c1 , Kathrine J. Vinknesa1 , Marit B. Veierøda1a2 and Kjetil Retterstøla1a3

a1 Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, PO Box 1046 Blindern, 0317 Oslo, Norway

a2 Oslo Centre for Biostatistics and Epidemiology, Institute of Basic Medical Sciences, University of Oslo, 0372 Oslo, Norway

a3 Lipid Clinic, Oslo University Hospital, Rikshospitalet, 0373 Oslo, Norway


The effects of low-carbohydrate (LC) diets on body weight and cardiovascular risk are unclear, and previous studies have found varying results. Our aim was to conduct a meta-analysis of randomised controlled trials (RCT), assessing the effects of LC diets v. low-fat (LF) diets on weight loss and risk factors of CVD. Studies were identified by searching MEDLINE, Embase and Cochrane Trials. Studies had to fulfil the following criteria: a RCT; the LC diet was defined in accordance with the Atkins diet, or carbohydrate intake of <20 % of total energy intake; twenty subjects or more per group; the subjects were previously healthy; and the dietary intervention had a duration of 6 months or longer. Results from individual studies were pooled as weighted mean difference (WMD) using a random effect model. In all, eleven RCT with 1369 participants met all the set eligibility criteria. Compared with participants on LF diets, participants on LC diets experienced a greater reduction in body weight (WMD –2·17 kg; 95 % CI –3·36, –0·99) and TAG (WMD –0·26 mmol/l; 95 % CI –0·37, –0·15), but a greater increase in HDL-cholesterol (WMD 0·14 mmol/l; 95 % CI 0·09, 0·19) and LDL-cholesterol (WMD 0·16 mmol/l; 95 % CI 0·003, 0·33). This meta-analysis demonstrates opposite change in two important cardiovascular risk factors on LC diets – greater weight loss and increased LDL-cholesterol. Our findings suggest that the beneficial changes of LC diets must be weighed against the possible detrimental effects of increased LDL-cholesterol.

(Revised June 23 2015)

(Received October 26 2015)

(Accepted October 28 2015)

(Online publication December 04 2015)

Key words

  • Low-carbohydrate diets;
  • Low-fat diets;
  • Weight loss;
  • Cardiovascular risk factors


  • CHO:carbohydrates;
  • DBP:diastolic blood pressure;
  • LC:low CHO;
  • LF:low fat;
  • RCT:randomised controlled trials;
  • SBP:systolic blood pressure;
  • TC:total cholesterol;
  • WMD:weighted mean difference


c1 Corresponding author: N. Mansoor, fax +47 22851398, email


  Both authors contributed equally to this work.