Effects of energy-matched low- versus high-carbohydrate diets on glycaemic control, lipid profile, and body composition in healthy adults: a systematic review and meta-analysis of randomised controlled trials

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◆ 논문 초록 (Abstract)

BACKGROUND: The comparative effects of energy-matched low-carbohydrate (LC) versus high-carbohydrate (HC) diets on metabolic and anthropometric outcomes in healthy adults remain unclear. OBJECTIVE: To evaluate the effects of LC diets (≤ 44% of total daily caloric intake [TDCI] from carbohydrate) versus HC diets (≥ 45% TDCI) on fasting glycaemia, insulinaemia, blood lipids, and body composition in non-medicated, disease-free adults under energy-matched conditions. METHODS: Randomised controlled trials (RCTs) were identified through systematic searches of PubMed and secondary sources up to April 2025. Eligible studies compared energy-matched dietary interventions and reported pre- and post-intervention data for fasting blood glucose (FBG), fasting insulin (FINS), blood lipids (total cholesterol [TC], HDL-cholesterol [HDL-C], LDL-cholesterol [LDL-C], triglycerides [TAG]), and/or body composition. Pooled effect sizes (Hedges’ g) and 95% confidence intervals (CIs) were calculated using a random-effects model. RESULTS: Eighteen RCTs involving 905 participants met the inclusion criteria. LC diets produced greater reductions in FBG (g = - 0.364; 95% CI - 0.709 to – 0.019; P < 0.001) and FINS (g = - 0.190; 95% CI - 0.361 to - 0.014; P = 0.034) compared with HC. TAG decreased (g = - 0.379; 95% CI - 0.540 to - 0.219; P < 0.001), and HDL-C increased (g = 0.389; 95% CI 0.229 to 0.550; P < 0.001) under LC diets. HC diets led to a greater reduction in LDL-C (g = -  0.225; 95% CI - 0.406 to - 0.043; P = 0.009). No significant effects were found for TC. LC diets also reduced body mass (g = - 0.183; 95% CI - 0.349 to - 0.017; P = 0.031) and fat mass (g = - 0.304; 95% CI -  0.548 to - 0.059; P = 0.015) to a greater extent than HC, with no effect on fat-free mass. CONCLUSION: Under energy-matched conditions, LC confers modest advantages for glycaemia, HDL-C, and TAG, whereas HC better lowers LDL-C. Most effects do not depend on exercise status, offering evidence to guide carbohydrate intake recommendations in diets where total caloric intake remains unchanged.

◆ 원문 정보
저자: Anagnostou A, Larumbe-Zabala E, Fiore J, Roberts J, Naclerio F
저널: Eur J Nutr
연도: 2026
DOI: 10.1007/s00394-025-03862-z

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