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      Low‐carbohydrate, healthy‐fat eating: A cost comparison with national dietary guidelines

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          Abstract

          Aim

          A low‐carbohydrate, healthy‐fat (LCHF) dietary approach has been demonstrated as an effective strategy for improving metabolic health; however, it is often criticised for being more expensive than following a dietary approach guided by the national, Ministry of Health nutrition guidelines. This study compared the cost of these two nutritionally replete dietary approaches for one day for a family of four.

          Methods

          In this descriptive case study, one‐day meal plans were designed for a hypothetical family of four representing the average New Zealand (NZ) male and female weight‐stable adult and two adolescent children. National documented heights, a healthy body mass index range (18.5–25.0 kg/m 2), and a 1.7‐activity factor was used to estimate total energy requirements using the Schofield equation. Total daily costs were compared based on food prices from a popular Auckland supermarket. Meal plans were analysed for their nutritional adequacy using FoodWorks 8 dietary analysis software against national Australian and NZ nutrient reference value thresholds.

          Results

          The total daily costs were $43.42 (national guidelines) and $51.67 (LCHF) representing an $8.25 difference, or $2.06 per person, with the LCHF meal plan being the costlier option.

          Conclusions

          We consider this increased cost for an LCHF approach to be negligible. In practice, less costly food items with similar nutrition qualities can be substituted to reduce costs further should this be a goal. The LCHF approach should therefore not be disregarded as a viable dietary approach for improving health outcomes, based on its perceived expense.

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          Most cited references17

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          Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet: a randomized trial.

          Previous studies comparing low-carbohydrate and low-fat diets have not included a comprehensive behavioral treatment, resulting in suboptimal weight loss. To evaluate the effects of 2-year treatment with a low-carbohydrate or low-fat diet, each of which was combined with a comprehensive lifestyle modification program. Randomized parallel-group trial. (ClinicalTrials.gov registration number: NCT00143936) 3 academic medical centers. 307 participants with a mean age of 45.5 years (SD, 9.7 years) and mean body mass index of 36.1 kg/m(2) (SD, 3.5 kg/m(2)). A low-carbohydrate diet, which consisted of limited carbohydrate intake (20 g/d for 3 months) in the form of low-glycemic index vegetables with unrestricted consumption of fat and protein. After 3 months, participants in the low-carbohydrate diet group increased their carbohydrate intake (5 g/d per wk) until a stable and desired weight was achieved. A low-fat diet consisted of limited energy intake (1200 to 1800 kcal/d;
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            Comparison of low fat and low carbohydrate diets on circulating fatty acid composition and markers of inflammation.

            Abnormal distribution of plasma fatty acids and increased inflammation are prominent features of metabolic syndrome. We tested whether these components of metabolic syndrome, like dyslipidemia and glycemia, are responsive to carbohydrate restriction. Overweight men and women with atherogenic dyslipidemia consumed ad libitum diets very low in carbohydrate (VLCKD) (1504 kcal:%CHO:fat:protein = 12:59:28) or low in fat (LFD) (1478 kcal:%CHO:fat:protein = 56:24:20) for 12 weeks. In comparison to the LFD, the VLCKD resulted in an increased proportion of serum total n-6 PUFA, mainly attributed to a marked increase in arachidonate (20:4n-6), while its biosynthetic metabolic intermediates were decreased. The n-6/n-3 and arachidonic/eicosapentaenoic acid ratio also increased sharply. Total saturated fatty acids and 16:1n-7 were consistently decreased following the VLCKD. Both diets significantly decreased the concentration of several serum inflammatory markers, but there was an overall greater anti-inflammatory effect associated with the VLCKD, as evidenced by greater decreases in TNF-alpha, IL-6, IL-8, MCP-1, E-selectin, I-CAM, and PAI-1. Increased 20:4n-6 and the ratios of 20:4n-6/20:5n-3 and n-6/n-3 are commonly viewed as pro-inflammatory, but unexpectedly were consistently inversely associated with responses in inflammatory proteins. In summary, a very low carbohydrate diet resulted in profound alterations in fatty acid composition and reduced inflammation compared to a low fat diet.
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              Dietary Intervention for Overweight and Obese Adults: Comparison of Low-Carbohydrate and Low-Fat Diets. A Meta-Analysis

              Background Reduced calorie, low fat diet is currently recommended diet for overweight and obese adults. Prior data suggest that low carbohydrate diets may also be a viable option for those who are overweight and obese. Purpose Compare the effects of low carbohydrate versus low fats diet on weight and atherosclerotic cardiovascular disease risk in overweight and obese patients. Data Sources Systematic literature review via PubMed (1966–2014). Study Selection Randomized controlled trials with ≥8 weeks follow up, comparing low carbohydrate (≤120gm carbohydrates/day) and low fat diet (≤30% energy from fat/day). Data Extraction Data were extracted and prepared for analysis using double data entry. Prior to identification of candidate publications, the outcomes of change in weight and metabolic factors were selected as defined by Cochrane Collaboration. Assessment of the effects of diets on predicted risk of atherosclerotic cardiovascular disease risk was added during the data collection phase. Data Synthesis 1797 patients were included from 17 trials with 99% while the reduction in predicted risk favoring low carbohydrate was >98%. Limitations Lack of patient-level data and heterogeneity in dropout rates and outcomes reported. Conclusions This trial-level meta-analysis of randomized controlled trials comparing LoCHO diets with LoFAT diets in strictly adherent populations demonstrates that each diet was associated with significant weight loss and reduction in predicted risk of ASCVD events. However, LoCHO diet was associated with modest but significantly greater improvements in weight loss and predicted ASCVD risk in studies from 8 weeks to 24 months in duration. These results suggest that future evaluations of dietary guidelines should consider low carbohydrate diets as effective and safe intervention for weight management in the overweight and obese, although long-term effects require further investigation.
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                Author and article information

                Contributors
                caryn.zinn@aut.ac.nz
                Journal
                Nutr Diet
                Nutr Diet
                10.1111/(ISSN)1747-0080
                NDI
                Nutrition & Dietetics
                John Wiley & Sons Australia, Ltd (Melbourne )
                1446-6368
                1747-0080
                24 April 2019
                April 2020
                : 77
                : 2 ( doiID: 10.1111/ndi.v77.2 )
                : 283-291
                Affiliations
                [ 1 ] School of Sport and Recreation, Human Potential Centre, Faculty of Health and Environmental Sciences Auckland University of Technology Auckland New Zealand
                Author notes
                [*] [* ] Correspondence: C. Zinn, School of Sport and Recreation, Human Potential Centre, Faculty of Health and Environmental Sciences, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand. Tel: +64 9 921 9999 ext. 7842; Fax: +64 9 921 9960.

                Email: caryn.zinn@ 123456aut.ac.nz

                Author information
                https://orcid.org/0000-0001-6185-7663
                Article
                NDI12534
                10.1111/1747-0080.12534
                7187181
                31020780
                6fa38f11-0680-41f7-a56f-fed81272ff13
                © 2019 The Authors. Nutrition & Dietetics published by John Wiley & Sons Australia, Ltd on behalf of Dietitians Association of Australia

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 25 November 2018
                : 21 February 2019
                : 26 February 2019
                Page count
                Figures: 1, Tables: 4, Pages: 9, Words: 5952
                Funding
                Funded by: AUT , open-funder-registry 10.13039/100008205;
                Award ID: Graduate Assistantship
                Categories
                Original Research
                Dietary Methodology
                Custom metadata
                2.0
                April 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.1 mode:remove_FC converted:28.04.2020

                cost,lchf,low‐carbohydrate,healthy‐fat,national nutrition guidelines

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