Evidence map›Paper›PMID 34582545›Full record

Trial reportThe American journal of clinical nutrition2022

Effects of a low-carbohydrate diet on insulin-resistant dyslipoproteinemia-a randomized controlled feeding trial.

Cara B Ebbeling, Amy Knapp, Ann Johnson, Julia M W Wong, Kimberly F Greco, Clement Ma, Samia Mora, David S Ludwig

Erratum issued 4 registry-linked trialsOpen access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The American journal of clinical nutrition, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 4 registered trials, which are not on this map. Cited by 57 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
57citing papers in PubMed, 5 pooled it
9.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02068885 nacompletednot on this map

Dietary Composition and Energy Expenditure During Weight-Loss Maintenance

TypeinterventionalSponsorBoston Children's HospitalRan2014 to 2017Enrolled234ConditionsObesity, Diabetes, Cardiovascular DiseaseArmsFeeding study
NCT05121844 naactive not recruitingnot on this map

Use of Continuous Glucose Monitoring in Non-Diabetic Population to Compliment Signos Mobile Health Platform: Comprehensive Weight Optimization Program and Customized Lifestyle Modifications

TypeinterventionalSponsorSignos IncRan2021 to 2027Enrolled31,187ConditionsWeight Loss, Metabolic Syndrome, Pre-diabetes, Central ObesityArmsContinuous Glucose Monitor Device
NCT05874635 naactive not recruitingnot on this mapstarted 2023, after this paper: background citation

Use of Signos mHealth Platform in Participants With Non-Insulin Dependent Type 2 Diabetes: Weight and Blood Glucose

TypeinterventionalSponsorSignos IncRan2023 to 2029Enrolled20,000ConditionsWeight Loss, Metabolic Syndrome, Diabetes Mellitus, Type 2, Central ObesityArmsContinuous Glucose Monitor Device
NCT06214221 naactive not recruitingnot on this mapstarted 2024, after this paper: background citation

A Randomized Controlled Trial Evaluating the Safety and Effectiveness of the Intelligently-Driven Signos System for Personalized Weight Management in Overweight and Obese Adults

TypeinterventionalSponsorSignos IncRan2024 to 2026Enrolled380ConditionsOverweight and Obesity, Metabolic Syndrome, Weight LossArmsSignos System, Standard Lifestyle Education
3 · Its place in the literature

Who cites it

57 citing papers in PubMed, 5 syntheses or guidelines pooled it, 102 citations in OpenAlex.

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  16. Lipoprotein(a) and coronary artery disease: The need for universal screening - A case-based review.American heart journal plus : cardiology research and practice · 2025
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Cara B EbbelingNew Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, MA, USA.ORCID 0000-0002-7088-9859
Amy KnappDepartment of Biology, Framingham State University, Framingham, MA, USA.
Ann JohnsonDepartment of Food and Nutrition, Framingham State University, Framingham, MA, USA.
Julia M W WongNew Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, MA, USA.
Kimberly F GrecoInstitutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, MA, USA.
Clement MaHarvard Medical School, Boston, MA, USA.
Samia MoraHarvard Medical School, Boston, MA, USA.ORCID 0000-0001-6283-0980
David S LudwigNew Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, MA, USA.ORCID 0000-0003-3307-8544
Boston Children's Hospital · USFramingham State University · USBrigham and Women's Hospital · USHarvard University · US

Funding

Patient Centered Approaches to Preventing ASCVD EventsK24HL136852 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · 2022 to 2025
$247k
NHLBI NIH HHS K24 HL136852NIDDK NIH HHS K24 DK082730NIDDK NIH HHS R01 DK125273
6 · The paper itself

Abstract

backgroundCarbohydrate restriction shows promise for diabetes, but concerns regarding high saturated fat content of low-carbohydrate diets limit widespread adoption.

objectivesThis preplanned ancillary study aimed to determine how diets varying widely in carbohydrate and saturated fat affect cardiovascular disease (CVD) risk factors during weight-loss maintenance.

methodsAfter 10-14% weight loss on a run-in diet, 164 participants (70% female; BMI = 32.4 ± 4.8 kg/m2) were randomly assigned to 3 weight-loss maintenance diets for 20 wk. The prepared diets contained 20% protein and differed 3-fold in carbohydrate (Carb) and saturated fat as a proportion of energy (Low-Carb: 20% carbohydrate, 21% saturated fat; Moderate-Carb: 40%, 14%; High-Carb: 60%, 7%). Fasting plasma samples were collected prerandomization and at 20 wk. Lipoprotein insulin resistance (LPIR) score was calculated from triglyceride-rich, high-density, and low-density lipoprotein particle (TRL-P, HDL-P, LDL-P) sizes and subfraction concentrations (large/very large TRL-P, large HDL-P, small LDL-P). Other outcomes included lipoprotein(a), triglycerides, HDL cholesterol, LDL cholesterol, adiponectin, and inflammatory markers. Repeated measures ANOVA was used for intention-to-treat analysis.

resultsRetention was 90%. Mean change in LPIR (scale 0-100) differed by diet in a dose-dependent fashion: Low-Carb (-5.3; 95% CI: -9.2, -1.5), Moderate-Carb (-0.02; 95% CI: -4.1, 4.1), High-Carb (3.6; 95% CI: -0.6, 7.7), P = 0.009. Low-Carb also favorably affected lipoprotein(a) [-14.7% (95% CI: -19.5, -9.5), -2.1 (95% CI: -8.2, 4.3), and 0.2 (95% CI: -6.0, 6.8), respectively; P = 0.0005], triglycerides, HDL cholesterol, large/very large TRL-P, large HDL-P, and adiponectin. LDL cholesterol, LDL-P, and inflammatory markers did not differ by diet.

conclusionsA low-carbohydrate diet, high in saturated fat, improved insulin-resistant dyslipoproteinemia and lipoprotein(a), without adverse effect on LDL cholesterol. Carbohydrate restriction might lower CVD risk independently of body weight, a possibility that warrants study in major multicentered trials powered on hard outcomes. The registry is available through ClinicialTrials.gov: https://clinicaltrials.gov/ct2/show/NCT02068885.

Indexed as

Insulin ResistanceAdolescentAdultAgedBody Mass IndexCholesterol, HDLCholesterol, LDLDiet, Carbohydrate-RestrictedDiet, ReducingDyslipidemiasFemaleHumansInsulinIntention to Treat AnalysisMaleMiddle AgedCholesterol, HDLCholesterol, LDLInsulinTriglyceridescardiovascular disease risk factorsdietary triallow-carbohydrate dietmacronutrientsobesitysaturated fat

Identifiers

PMID34582545
PMCPMC8755039
OpenAlexW3204616016

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.