Low-carbohydrate diets in the treatment of the metabolic syndrome

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.