Here is a collection of research articles from scientific journals, pertaining to low carb and high fat diets. They are grouped by topic in the Table of Contents below.
For each article, I’ve included a short summary of its main findings. You can navigate to the individual article by clicking on the underlined title.
These studies show that a diet low in carbs and high in fat, like the ketogenic diet, is effective for treating obesity, insulin resistance, diabetes, and other metabolic conditions. Conversely, high consumption of carbs and high insulin is often the cause of these issues. Meal frequency and timing is equally important — high meal frequency (like snacking or grazing) increases weight and reduces satiety, whereas fasting between meals or skipping meals is beneficial for keeping insulin low.
Benefits of a Low Carb Diet:
- Weight Loss / Metabolic Syndrome
- Diabetes Reversal / Insulin Sensitivity
- Carbs / Sugar
- Soft Drinks
- Fruits & Vegetables
- Meal Frequency
- Dark Chocolate
- Cheese / Dairy
- Heart Health
- Hair Loss
Negative Effects of Carbs:
Weight Loss / Metabolic Syndrome
Choi et al. 2020, Nutrients, Impact of a Ketogenic Diet on Metabolic Parameters in Patients with Obesity or Overweight and with or without Type 2 Diabetes: A Meta-Analysis of Randomized Controlled Trials
From studying 14 randomized control trials using the keto diet for metabolic control for overweight patients, they found that the keto diet resulted in greater glycemic control, substantial weight reduction, and improved lipid profiles, compared to low fat diets.
Goss et al. 2020, Nutrition & Metabolism, Effects of weight loss during a very low carbohydrate diet on specific adipose tissue depots and insulin sensitivity in older adults with obesity: a randomized clinical trial
From a 8-week randomized trial of 34 obese men and women (age 60-75), participants lost an average of 9.7% total fat on a very low carb diet and 2.0% on a low fat diet. The very low carb group experienced 3 times greater loss in visceral adipose tissue compared to the low fat group.
Hyde et al. 2019, JCI Insight, Dietary carbohydrate restriction improves metabolic syndrome independent of weight loss
Obese participants diagnosed with metabolic syndrome (linked to cardiovascular risk like heart disease and stroke) were given low/med/high carb diets. After 4 weeks, a low carb diet was found to be most effective at reversing metabolic syndrome, compared to moderate and high carb diets.
Ebbeling et al. 2018, BMJ, Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial
Weight gain after weight loss is thought to be due to decreased energy expenditure. Lowering carbohydrate intake increased energy expenditure during weight loss maintenance, which may increase the chances of successful obesity treatment.
Gibas & Gibas 2017, Diabetes Metab Syndr, Induced and controlled dietary ketosis as a regulator of obesity and metabolic syndrome pathologies
From a study of 30 adults diagnosed with metabolic syndrome over 10 weeks, a keto diet with no exercise out-performs a standard American diet with exercise in terms of weight, body fat percentage, BMI, and hemoglobin A1c.
Sackner-Bernstein et al. 2015, PLoS One, Dietary Intervention for Overweight and Obese Adults: Comparison of Low-Carbohydrate and Low-Fat Diets. A Meta-Analysis
Compared to a low fat diet (<30% energy from fat), a low carb diet (<120 grams/day) has significantly greater improvements in weight loss and predicted cardiovascular risk, based on analysis of randomized control trials from 8 weeks to 24 months in duration.
Bazzano et al. 2014, Ann Intern Med, Effects of Low-Carbohydrate and Low-Fat Diets: A Randomized Trial
Nearly 150 men and women without cardiovascular disease or diabetes participated in either a low-fat or low-carb diet. The low carb diet was more effective for weight loss and cardiovascular risk factor reduction than the low fat diet.
Bueno et al. 2013, Brit J of Nut, Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials
From an analysis of randomized controlled trials (up to 2012, with at least 1 year of follow-up), they found that a keto diet achieved a greater weight loss than a low-fat diet in the long term.
Foster et al. 2010, Ann Intern Med, Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet: a randomized trial
Patients were treated with a low fat or low carb diet for 2 years. The low carb patients had more favorable changes in cardiovascular disease risk factors.
Shai et al. 2008, N Engl J Med, Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet
A 2-year study of obese women showed that the low carb diet is more effective for weight loss compared to both the mediterranean diet and low fat diet.
Dashti et al. 2004, Exp Clin Cardiol, Long-term effects of a ketogenic diet in obese patients
Obese patients were subjected to a 24-week ketogenic diet. After the study, patients had significantly decreased weight and body mass index, decreased total cholesterol, increased HDL cholesterol, decreased LDL cholesterol, decreased triglycerides, and decreased blood glucose. There were no significant side effects.
Samaha et al. 2003, N Engl J Med, A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity
Severely obese people have greater weight loss while on a low carb diet compared to a calorie-restricted, low-fat diet. While on a low carb diet, subjects improved in glycemic control, had no adverse effects on blood lipid levels, and had lowered triglyceride levels which is indicative of a cardiovascular benefit.
Diabetes Reversal / Insulin Sensitivity
Athinarayanan et al. 2019, Front. Endocrinol., Long-Term Effects of a Novel Continuous Remote Care Intervention Including Nutritional Ketosis for the Management of Type 2 Diabetes: A 2-Year Non-randomized Clinical Trial
In a 2-year study of Type 2 diabetics, participants selected either a low carb diet (initially <30 g total carbs daily) or standard diabetes care. In the group with the low carb diet, half of them reversed their diabetes. The group with standard care did not experience diabetes reversal or improvement, and some participants worsened.
Huntriss et al. 2018, Eur J Clin Nutr, The interpretation and effect of a low-carbohydrate diet in the management of type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials
From analyzing 18 randomized control trials of interventions for type 2 diabetic adults, the low carb diet resulted in favorable outcomes for HbA1c, triglycerides, and HDL cholesterol. It also reduced requirements for diabetes medication.
Boden et al. 2005, Ann Intern Med, Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes
Obese patients with type 2 diabetes were given a low carb diet; after 14 days, patients had significantly improved blood glucose profiles and insulin sensitivity as well as decrease triglyceride and cholesterol levels.
Carbs / Sugar
Mantantzis et al. 2019, Neu Bio, Sugar rush or sugar crash? A meta-analysis of carbohydrate effects on mood
From a systematic review and meta analysis investigating the relationship between carb ingestion and mood, carbs lower alertness within 1 hour of consumption and increase fatigue within 30 minutes of consumption.
Ginieis et al. 2018, Phys Beh, The “sweet” effect: Comparative assessments of dietary sugars on cognitive performance
A double-blind, placebo-controlled study of 49 people showed that consuming sucrose (sugar) and glucose leads to poorer performance on cognitive tasks such as simple response time and arithmetic.
Zheng et al. 2018, Diabetologia, HbA1c, diabetes and cognitive decline: the English Longitudinal Study of Ageing
From a study of 5189 subjects over 10 years, people with high blood sugar have a faster rate of cognitive decline including dementia than those with normal blood sugar, regardless if they are diabetic or not. The higher the blood sugar, the faster the cognitive decline.
Kearns et al. 2017, PLoS Biol, Sugar industry sponsorship of germ-free rodent studies linking sucrose to hyperlipidemia and cancer: An historical analysis of internal documents
The sugar industry secretly funded a study in 1965 to evaluate sugar’s effect on cardiovascular health. When the results suggested that sugar was harmful, they buried the data.
DiNicolantonio & O’Keefe 2017, Open Heart, J Markedly increased intake of refined carbohydrates and sugar is associated with the rise of coronary heart disease and diabetes among the Alaskan Inuit
Analysis of the Alaskan Inuit diet showed that higher consumption of carbs and sugar is linked to the rise of coronary heart disease and diabetes.
Grasgruber et al. 2016, Food Nutr Resesarch, Food consumption and the actual statistics of cardiovascular diseases: an epidemiological comparison of 42 European countries
From a study of relationships between nutritional factors and the prevalence of cardiovascular diseases in Europe, the major correlate of high cardiovascular disease risk was the proportion of dietary energy from carbs and alcohol, or potatoes and cereal carbs. Even unrefined cereals have high insulin indices.
Basu et al. 2013, Plos One, The Relationship of Sugar to Population-Level Diabetes Prevalence: An Econometric Analysis of Repeated Cross-Sectional Data
By studying food and diabetes prevalence in 175 countries, they found that for every 150 kcal/person/day increase in sugar availability (about 1 can of soda each day), there was an associated increase in diabetes prevalence of about 1%.
Tsai et al. 2005, Gut, Dietary carbohydrates and glycaemic load and the incidence of symptomatic gall stone disease in men
From a study with 12 years of follow up, results suggest that high carb consumption increases the risk of gall stone disease in men.
Gardener et al. 2012, J Gen Intern Med, Diet soft drink consumption is associated with an increased risk of vascular events in the Northern Manhattan Study
Daily consumption of diet soft drinks are linked to an increased risk for stroke and other vascular events.
Dhingra et al. 2007, Circulation, Soft drink consumption and risk of developing cardiometabolic risk factors and the metabolic syndrome in middle-aged adults in the community
Among middle aged adults, soft drink consumption is associated with higher incidence of cardiometabolic risk factors.
Schulze et al. 2004, JAMA, Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women
Sugary beverages are linked to weight gain and increase in type 2 diabetes in women.
Stanhope et al. 2009, J Clin Invest, Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans
Both glucose and fructose consumption contribute to weight gain, but fructose causes significantly higher cholesterol concentrations and reduces sensitivity to insulin.
Nielsen et al. 1980, Am J Clin Nutr, Impaired cellular insulin binding and insulin sensitivity induced by high-fructose feeding in normal subjects
Young healthy subjects were fed usual diets plus either glucose or fructose. After one week, the group with fructose feeding had a significant reduction in their insulin binding and insulin sensitivity, whereas the glucose group had no significant change. Fructose rather than glucose is responsible for the insulin binding/sensitivity issue in sucrose.
Fruits & Vegetables
Kaiser et al. 2014, Am J Clin Nutr, Increased fruit and vegetable intake has no discernible effect on weight loss: a systematic review and meta-analysis
Health experts often recommend eating more fruits and vegetables to lose weight. A review of two studies showed that increased fruit and vegetable consumption does not cause weight loss.
Howard et al. 2006, JAMA, Low-fat dietary pattern and risk of cardiovascular disease: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial
A study of nearly 50,000 women over 8 years showed that a diet low in fat and high in vegetables, fruits, and grains did not reduce the risk of cardiovascular disease, stroke, and coronary heart disease.
Koopman et al. 2014, Hepatology, Hypercaloric diets with increased meal frequency, but not meal size, increase intrahepatic triglycerides: a randomized controlled trial
In a 6-week randomized control trial of 36 lean healthy men, high meal frequency increases abdominal fat, but increasing meal size does not, which suggests that frequent snacking leads to obesity.
Leidy et al. 2010, Obesity, The influence of higher protein intake and greater eating frequency on appetite control in overweight and obese men
In a study of obese men, satiety and fullness-related responses were greater on a higher protein diet but lower when they increased their eating frequency. This challenges the idea that increasing the number of eating occasions increases satiety.
Cameron et al. 2010, Br J Nutr, Increased meal frequency does not promote greater weight loss in subjects who were prescribed an 8-week equi-energetic energy-restricted diet
Increasing meal frequency does not help promote greater weight loss.
Sievert et al. 2019, BMJ, Effect of breakfast on weight and energy intake: systematic review and meta-analysis of randomised controlled trials
In this systematic review of 13 randomized control trials published between 1990 and 2018, total daily energy intake for breakfast eaters was 260 kcal higher. Weight loss was slightly in favor of people who skipped breakfast (mean difference of 1 pound). Caution is needed when recommending breakfast for weight loss in adults, since it could have the opposite effect.
Betts et al. 2014, Am J Clin Nutr, The causal role of breakfast in energy balance and health: a randomized controlled trial in lean adults
In a 6-week randomized control trial (Bath Breakfast Project), obese adults either ate breakfast by 11 AM or fasted until noon. Contrary to popular belief, eating breakfast does not affect resting metabolism (resting metabolic rate stable within 11 kcal/d). Breakfast eaters averaged 539 extra calories per day compared to those that skipped breakfast.
Dhurandhar et al 2014, Am J Clin Nutr, The effectiveness of breakfast recommendations on weight loss: a randomized controlled trial
In a 16-week randomized control trial of 283 overweight adults, there was no weight loss difference between those who ate breakfast and those who didn’t. This is contrary to public health authorities who recommend breakfast to reduce obesity.
Brown et al. 2013, Am J Clin Nutr, Belief beyond the evidence: using the proposed effect of breakfast on obesity to show 2 practices that distort scientific evidence
This systematic review found that researchers studying the proposed effect of breakfast on obesity interpreted the available evidence in favor of their own bias. Belief that skipping breakfast causes weight gain is not supported by the strength of scientific evidence.
Schusdziarra et al. 2011, Nutr J, Impact of breakfast on daily energy intake
Reduced breakfast energy intake is associated with lower total daily intake. In other words, the more you eat for breakfast, the higher the total caloric intake over the entire day.
Kinouchi et al. 2018, Cell Reports, Fasting Imparts a Switch to Alternative Daily Pathways in Liver and Muscle
Fasting affects circadian clocks in the liver and skeletal muscle, which impacts metabolism. This can lead to improved protection against aging-related diseases.
Alirezaei et al. 2010, Autophagy, Short-term fasting induces profound neuronal autophagy
Short term fasts (24-48 hours) produce a therapeutic neuronal response in the brain.
Bhutani et al. 2010, Obesity, Improvements in coronary heart disease risk indicators by alternate-day fasting involve adipose tissue modulations
Obese subjects were studied over 10 weeks with an alternate-day fasting diet. At the end of the trial, their fat mass decreased, their LDL cholesterol was 25% lower, and their waist circumference was reduced.
Lamine et al. 2006, Tunis Med, Food intake and high density lipoprotein cholesterol levels changes during ramadan fasting in healthy young subjects
Analyzing young adults who fast during the month of Ramadan (abstaining from food and drink each day from dawn to sunset), blood lipoprotein metabolism improved with an increase of HDL cholesterol. This increase was lost after Ramadan.
Johnstone et al. 2002, Int J Obes Relat Metab Disord, Effect of an acute fast on energy compensation and feeding behaviour in lean men and women
A study of healthy men and women on a 36 hour fast did not lead to a stimulus to compensate after the fast.
Stewart & Fleming 1973, Postgrad Med J, Features of a successful therapeutic fast of 382 days’ duration
An old paper, but one of my favorites. A 27-year-old 456-pound man fasted for 382 days under doctor supervision, losing 276 pounds or 0.72 pounds/day, with no ill effects.
Greenberg & Geliebter 2012, J Am Coll Nutr, Coffee, hunger, and peptide YY
A study of healthy men showed that decaf coffee decreases hunger and increases the satiety hormone.
Huxley et al. 2009, Arch Intern Med, Coffee, decaffeinated coffee, and tea consumption in relation to incident type 2 diabetes mellitus: a systematic review with meta-analysis
High intakes of coffee, decaf coffee, and tea are linked to lower risk of diabetes.
van Dieren et al. 2009, Diabetologia, Coffee and tea consumption and risk of type 2 diabetes
Coffee and tea consumption is associated with a reduced risk of type 2 diabetes, which cannot be explained by magnesium, potassium, caffeine, or blood pressure effects.
Djousse et al. 2011, Clin Nutr, Chocolate consumption is inversely associated with prevalent coronary heart disease: the National Heart, Lung, and Blood Institute Family Heart Study
Dark chocolate consumption is inversely related to coronary heart disease in the U.S. population.
Grassi et al. 2005, Hypertension, Cocoa reduces blood pressure and insulin resistance and improves endothelium-dependent vasodilation in hypertensives
Consumption of dark chocolate decreases blood pressure, insulin resistance, and may provide some cardiovascular benefits.
Jiang et al. 2017, Metabolism, Cinnamaldehyde induces fat cell-autonomous thermogenesis and metabolic reprogramming
Human fat cells exposed to cinnamaldehyde, a compound in cinnamon, undergo thermogenesis, a process where the cells burn fat for energy.
Hlebowicz et al. 2007, Am J Clin Nutr, Effect of cinnamon on postprandial blood glucose, gastric emptying, and satiety in healthy subjects
Cinnamon consumption reduces blood glucose but has no significant effect on satiety.
Schulze et al. 2004, Am J Clin Nutr, Glycemic index, glycemic load, and dietary fiber intake and incidence of type 2 diabetes in younger and middle-aged women
From a study of over 90,000 women over 8 years, higher glycemic index foods are associated with an increased risk of diabetes, but fiber intake is associated with a decreased risk.
Chandalia et al. 2000, N Engl J Med, Beneficial Effects of High Dietary Fiber Intake in Patients with Type 2 Diabetes Mellitus
Thirteen patients with type 2 diabetes followed either a moderate fiber diet (24 g) or a high fiber diet (50 g). Both diets were prepared in a research kitchen with the same macro and energy content. The patients on the high fiber diet had reduced total cholesterol concentrations by 6.7%, triglyceride concentrations by 10.2%, and lipoprotein cholesterol concentrations by 12.5%.
Dalenberg et al. 2020, Short-Term Consumption of Sucralose with, but Not without, Carbohydrate Impairs Neural and Metabolic Sensitivity to Sugar in Humans
Over 10 days, healthy human participants had impaired insulin sensitivity when consuming sucralose with carbohydrates. Insulin sensitivity was not altered by sucralose or carbohydrate consumption alone.
Romo-Romo et al. 2018, Am J Clin Nutr, Sucralose decreases insulin sensitivity in healthy subjects: a randomized controlled trial
In a 2-week randomized control trial of healthy adults, daily sucralose consumption led to a 18% decrease in insulin sensitivity.
Storey et al. 2007, Eur J Clin Nutr, Gastrointestinal tolerance of erythritol and xylitol ingested in a liquid
Erythritol causes significantly less intestinal distress than xylitol.
Dean et al. 1996, Regul Toxicol Pharmacol., Chronic (1-year) oral toxicity study of erythritol in dogs
Erythritol (up to 3.5 g/kg body wt.) is well-tolerated in dogs over a 1 year period. No diarrhea, and no observed changes in body weight, plasma electrolyte concentrations, kidneys, organs, or tissues.
Noda et al. 1994, Eur J Clin Nutr, Serum glucose and insulin levels and erythritol balance after oral administration of erythritol in healthy subjects
Erythritol does not affect blood levels of glucose or insulin. More than 90% of the ingested erythritol is readily absorbed and excreted in the urine.
Kawanabe et al. 1992, Caries Res, Noncariogenicity of Erythritol as a Substrate
Erythritol is a promising sugar substitute from a dental point of view, as researchers found that it resulted in significantly less dental decay compared to sucrose (table sugar).
Murphy et al. 2020, Adv in Nut, High-Fat Ketogenic Diets and Physical Performance: A Systematic Review
From a review of previous studies, the keto diet does not appear to have a positive or negative impact on physical performance compared to mixed macronutrient diets.
Gregory et al. 2017, Int J Sports Exerc Med, A Low-Carbohydrate Ketogenic Diet Combined with 6-Weeks of Crossfit Training Improves Body Composition and Performance
Subjects following a low carb ketogenic diet and CrossFit training saw decreases in their body fat percentage, fat mass, and BMI while maintaining their lean body mass. They also had improvements in their performance power and time.
Evans et al. 2017, J Physiol, Metabolism of ketone bodies during exercise and training: physiological basis for exogenous supplementation
This review describes the physiology of ketone bodies during and after exercise, and in response to training.
Egan & D’Agostino 2016, Cell Metabolism, Fueling Performance: Ketones Enter the Mix
As exercise intensity increases, energy provision shifts from blood-borne free fatty acids and glucose towards intramuscular triglyceride and glycogen. Exogenous ketones can give a 2% improvement in athletic performance.
Barbanti et al. 2017, Neurological Sciences, Ketogenic diet in migraine: rationale, findings and perspectives
Reviewing clinical data from 150 patients in case reports and studies, it is possible that a keto diet is effective for episodic and chronic migraines. A keto diet helps restore brain excitability and metabolism, and to counter neuroinflammation. Precise mechanism is not clear. Paper includes a nice table of previous literature results.
Ramsden et al. 2014, Pain, Targeted alteration of dietary n-3 and n-6 fatty acids for the treatment of chronic headaches: A randomized trial
In a 12-week randomized trial of chronic daily headache sufferers, a dietary intervention of high Omega-3 (through flaxseed and fatty fish) and low Omega-6 (replacing high-PUFA oils with unrefined coconut oil, mac nut oil, olive oil, etc.) resulted in migraine reduction of roughly 80%.
Di Lorenzo et al. 2013, Funct Neurol., Diet transiently improves migraine in two twin sisters: possible role of ketogenesis?
A pair of twin sisters had high-frequency migraines, which improved during a keto diet that they followed in order to lose weight.
Cheese / Dairy
Chen et al. 2016, Eur Journal Nutr, Cheese consumption and risk of cardiovascular disease: a meta-analysis of prospective studies
An analysis of long-term cheese consumption based on 15 studies showed that higher cheese consumption is associated with a lower risk of cardiovascular disease. Note that cheese contains a high level of saturated fatty acids.
Kratz et al. 2013, Eur J Nutr, The relationship between high-fat dairy consumption and obesity, cardiovascular, and metabolic disease
From a review of 16 studies covering the relationship between dairy fat consumption, obesity, and heart disease, they found no evidence that dairy fat contributes to obesity or cardiometabolic risk. In fact, these studies suggest that high fat dairy consumption is inversely associated with obesity risk.
Nilsson et al. 2004, Am J Clin Nutr, Glycemia and insulinemia in healthy subjects after lactose-equivalent meals of milk and other food proteins: the role of plasma amino acids and incretins
Dairy products have high insulin responses despite their low glycemic index. From studying the insulin responses of healthy volunteers, researchers found that food proteins differ in their insulin response. For milk, it’s primarily whey protein that stimulates insulin.
Astrup et al. 2020, JACC, Saturated Fats and Health: A Reassessment and Proposal for Food-Based Recommendations
The U.S. dietary guidelines recommend restriction of saturated fats to <10% of calories to reduce cardiovascular disease (CVD). However, there is no robust evidence that saturated fat consumption (in particular, whole-fat dairy, dark chocolate, and unprocessed meat) will prevent CVD or reduce mortality.
Ramsden et al. 2016, BMJ, Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73)
In a randomized control trial of 9423 men and women, replacing dietary saturated fat with linoleic acid (from corn oil) resulted in no mortality benefit and no coronary benefit.
Adler et al. 2014, Cochrane Database, Reduced dietary salt for the prevention of cardiovascular disease
This analysis of randomized control trials does not support dietary advice of restricting salt intake for normotensive or hypertensive populations.
Ramsden et al. 2013, BMJ, Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis
In a randomized control trial of 458 men with a recent coronary event, an intervention by replacing dietary saturated fats with polyunsaturated omega-6 linoleic acid (from vegetable oils) resulted an increase in death rate from all causes (17.6% vs 11.8%), coronary heart disease (16.3% vs 10.1%), and cardiovascular disease (17.2% vs 11.0%). This is contrary to worldwide dietary guidelines that advise substituting polyunsaturated fats for saturated fats.
Sabate & Wien 2010, Asia Pac J Clin Nutr, Nuts, blood lipids and cardiovascular disease
Examining data from large epidemiological studies across two continents, an 8% reduction in risk of death from coronary heart disease was found for each weekly serving of nuts. Intake of nuts lowers total and LDL cholesterol.
Fernandez 2006, Curr Opin Nutr Metab Care, Dietary cholesterol provided by eggs and plasma lipoproteins in healthy populations
Egg consumption does not lead to higher risk of developing coronary heart disease, but in fact has multiple beneficial effects.
Malhotra 1967, Br Heart J, Epidemiology of ischaemic heart disease in India with special reference to causation
From analyzing >1 million Indian railway workers, heart disease in southern India, where dietary fats are seed oils composed of polyunsaturated fatty acids, is 7 times more common than for Punjabis in northern India, whose dietary fats come from animal fats composed of saturated fatty acids. This is most likely due to diet, and cannot be explained by smoking, socio-economic factors, physical activity, or stress.
Hirsso et al. 2006, Cent Eur J Public Health, Association of insulin resistance linked diseases and hair loss in elderly men. Finnish population-based study
From a study of 245 Finnish men at age 63, male pattern baldness was found to be common, but associated with insulin resistance related issues such as diabetes and hypertension. Rate of diabetes was almost twice as much in men with hair loss.
Matilainen et al. 2003, J Cardiovasc Risk, Hair loss, insulin resistance, and heredity in middle-aged women. A population-based study
From a study of 324 women at age 63, those with hair loss had significantly higher insulin resistance related parameters like waist/neck circumferences, waist-to-hip ratio, and insulin concentration compared to those with normal hair or very minimal hair loss.
Zhang et al. 2020, J Agric Food Chem, Ketogenic Diet Elicits Antitumor Properties through Inducing Oxidative Stress, Inhibiting MMP-9 Expression, and Rebalancing M1/M2 Tumor-Associated Macrophage Phenotype in a Mouse Model of Colon Cancer
From studying mice, results indicate that a keto diet can prevent the progression of colon tumor via oxidative stress.
Khodabakhshi et al. 2020, Nutr Cancer, Feasibility, Safety, and Beneficial Effects of MCT-Based Ketogenic Diet for Breast Cancer Treatment: A Randomized Controlled Trial Study [Hyperlipid]
In a randomized controlled trial of 60 breast cancer patients, half were assigned a keto diet and the other half was a control group with a standard diet. After 3 months, 100% of the keto group survived compared to 60% of the control group.
Ang et al. 2020, Cell, Ketogenic Diets Alter the Gut Microbiome Resulting in Decreased Intestinal Th17 Cells
Keto diets alter the gut microbiota due to the production of ketones, which inhibit bifidobacterial growth. Keto-associated gut microbiota reduces intestinal pro-inflammatory Th17 cells.
Mujica-Parodi et al. 2020, PNAS, Diet modulates brain network stability, a biomarker for brain aging, in young adults
From neuroimaging datasets, brain aging correlates with poorer cognition and accelerates with insulin resistance. Ketones increase the stability of brain networks
Green & Wang 2020, Food Control, First report on quality and purity evaluations of avocado oil sold in the US [UC Davis Press Release]
From testing 22 domestic and imported avocado oils, 15 were oxidized before the expiration date, and 6 were mixed with large amounts of other oils like sunflower, safflower, and soybean. Only 2 brands were pure and not oxidized: Chosen Foods and Marianne’s.
Goldberg et al. 2019, Science Immunology, Ketogenic diet activates protective γδ T cell responses against influenza virus infection
Mice on a keto diet were protected from lethal influenza infection.
Wong et al. 2018, Hawaii J Med Pub Health, Treatment of Prurigo Pigmentosa with Diet Modification: A Medical Case Study
Prurigo pigmentosa (“keto rash”) is a condition associated with ketosis, and can be successfully treated with antibiotics. Two cases are reported, where both had the rash successfully treated by increasing carb intake. In the second case, cessation of ketosis was not necessary; the patient (on the keto diet to treat seizures) increased carbohydrates to 90 grams per day (resulting in urine ketones of 80 mg/dL, occasionally decreasing to 40 mg/dL) and was able to stay in ketosis and seizure-free.
Harvey et al. 2018, J Nutr Metab., The Effect of Medium Chain Triglycerides on Time to Nutritional Ketosis and Symptoms of Keto-Induction in Healthy Adults: A Randomised Controlled Clinical Trial
In a 20-day randomized control trial, healthy adults starting a keto diet were given MCTs (medium chain triglycerides) or sunflower oil as a control group. The MCT group had a higher level of blood ketones at all times, but it was unclear whether this resulted in a faster time to nutritional ketosis compared to the control group. Keto induction symptoms were higher for the control group, except for abdominal pain in the MCT group.
Senyilmaz-Tiebe et al. 2018, Nat Commun, Dietary stearic acid regulates mitochondria in vivo in humans
Stearic acid (C18:0) has a dedicated pathway to regulate mitochondria activity. In humans, stearic acid ingestion caused mitochondria fusion in 90% of tested subjects. Stearic acid is likely a lipid metabolite sensed in humans and is part of the physiological response through which the body handles lipids.
Wan et al. 2017, EBioMedicine, Effects of Macronutrient Distribution on Weight and Related Cardiometabolic Profile in Healthy Non-Obese Chinese: A 6-month, Randomized Controlled-Feeding Trial
In a 6-month randomized controlled feeding trial, healthy Chinese participants were given isocaloric diets with 14% protein and varying levels of carbohydrates (46%, 56%, and 66% of energy from carbs) and fat from soybean oil. All 3 groups lost weight, but those that consumed more soybean oil lost the least amount of weight.
El-Rashidy et al. 2017, Metab Brain Dis, Ketogenic diet versus gluten free casein free diet in autistic children: a case-control study
Autistic children received either a keto diet, a gluten-free dairy-free diet, or a balanced nutrition diet (control group). After 6 months, both diet groups showed significant improvement in autism rating scales and evaluation tests, with the keto group scoring better in cognition and sociability than the gluten-free dairy-free group.
Islami et al. 2017, CA Cancer J Clin, Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States
Nearly half of all incident cancers and cancer deaths in 2014 were due to unhealthy and preventable behavior: cigarette smoking (29% cancer deaths), excess body weight (7%), and alcohol intake (4%).
Guyenet & Carlson 2015, Adv Nutr, Increase in Adipose Tissue Linoleic Acid of US Adults in the Last Half Century
In the last 50 years in the U.S., dietary polyunsaturated linoleic acid has greatly increased because dietary fat sources shifted towards polyunsaturated seed oils. Fatty acid concentration in adipose tissue reflects dietary intake. From a literature review of U.S. studies reporting linoleic concentration in adipose tissue, this concentration rose from ~10% in 1960 to ~20% in 2005.
Friedman et al. 2012, Clin J Am Soc Nephrol, Comparative effects of low-carbohydrate high-protein versus low-fat diets on the kidney
A low carb diet over 2 years is not linked to harmful effects related to kidney functions.
Lemieux et al. 2010, Mitochondrion, Dietary fatty acids and oxidative stress in the heart mitochondria
Rats were fed for 16 weeks with coconut, olive, or fish oil diet (saturated, monounsaturated, or polyunsaturated fatty acids, respectively). The rats fed fish oil (polyunsaturated) had highest oxidative stress in heart mitochondria, and the rats fed coconut oil (saturated) had lowest concentrations of oxidized proteins and peroxidized lipids.
White & Johnston 2007, Diabetes Care, Vinegar Ingestion at Bedtime Moderates Waking Glucose Concentrations in Adults With Well-Controlled Type 2 Diabetes
Drinking 2 tablespoons of apple cider vinegar at bedtime moderates the next morning’s fasting glucose concentration for those with type 2 diabetes.
Leosdottir et al. 2005, J Intern Med, Dietary fat intake and early mortality patterns–data from The Malmö Diet and Cancer Study
In a study including nearly 30,000 people over 5 years, those who ate more than 30% of their daily diet in fat did not have increased mortality, so current dietary recommendations regarding fat intake are not supported by these results.
Seddon et al. 2001, Arch Ophthalmol, Dietary Fat and Risk for Advanced Age-Related Macular Degeneration
Higher consumption of vegetable oil, monounsaturated, and polyunsaturated fats rather than total fat intake is associated with a greater risk for advanced age-related macular degeneration, a cause of blindness.
Gillman et al. 1997, JAMA, Inverse association of dietary fat with development of ischemic stroke in men
A study of over 800 middle-aged men during 20 years of followup showed that dietary intake of fat, saturated fat, and monounsaturated fat are associated with lower risk of stroke.
Must et al. 1992, N Engl J Med, Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935
An overweight adolescent is significantly more likely to have an increased risk of mortality from all causes and diseases, no matter the adult weight after 55 years of follow-up. In particular, colorectal cancer and gout among men, arthritis among women, and coronary heart disease among both groups. Being overweight in adolescence is a more accurate predictor of these risks than being overweight as an adult.
Hirsch et al. 1960, Am J Clin Nutr, Studies of adipose tissue in man. A microtechnic for sampling and analysis
Adipose tissue composition matches the fatty acid structure of dietary fat; no changes are seen at 20 weeks but adipose tissue closely resembles dietary fat at 160 weeks. See Figure 10 — patients ingested corn oil over a long period of time.
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