Efficacy of a low-carbohydrate or ketogenic diet in preventing patient morbidity and mortality
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Clinical Inquiries question: What is the efficacy of a low-carbohydrate or ketogenic diet in the prevention of patient morbidity and mortality? Evidence-based answer: Ketogenic diets can reduce seizure incidence in refractory epilepsy (strength of recommendation [SOR] A: based on randomized controlled trials [RCTs] and systematic review). Low-carbohydrate diets are associated with weight loss in obese patients, although long-term evidence of weight-loss maintenance is not available (SOR A: based on meta-analysis of RCTs). Treatment of type 2 diabetes mellitus with low-carbohydrate diets demonstrated a decrease in hemoglobin A1c (HbA1c) levels (SOR C: disease-oriented evidence based on meta-analysis or RCTs). Low-carbohydrate diets paired with animal-based proteins are associated with increased mortality compared with moderate-carbohydrate diets, whereas low-carbohydrate diets with plant-based protein are associated with decreased mortality (SOR B: based on meta-analysis of prospective cohort studies).
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