**10. LCHF and non-alcoholic fatty liver disease (NAFLD)**

Non-alcoholic fatty liver disease (NAFLD) is characterised by elevated TG and low HDL-C concentrations with overproduction of VLDL and impaired clearance of TG-rich lipoproteins [94, 95]. It is also recognised that cardiovascular disease is the leading cause of death in NAFLD [96]. It has been shown that NAFLD with insulin resistance is the cause of atherosclerotic disease characterised by many of these features [97]. Since NAFLD is caused by excessive carbohydrate, especially fructose intake [98–100], it is postulated that a carbohydrate-restricted LCHF diet can reverse NAFLD.

using fats. However, these symptoms may be especially prevalent only in the period of adaptation to the diet, after which most subside. Some suggest additional sodium (especially for cramping) and fluid intake to minimise side effects, since excretion of water and sodium are

Low-Carbohydrate High-Fat (LCHF) Diet: Evidence of Its Benefits

http://dx.doi.org/10.5772/intechopen.73138

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Some have suggested that weight loss on LCHF diets is the result mainly of water loss. This increased diuresis may be true in the first weeks of carbohydrate restriction [104]. However, body composition by DEXA analysis indicates that long-term weight loss on the LCHF diet is

Trials show that adherence to LCHF and LFHC diets are similar [13, 72, 105]. On the other hand, a recent systematic review found a higher attrition rate from LFHC than from LCHF diets [106]. Therefore, sticking to a LCHF diet is perhaps as convenient as any other dietary plan and thus may be more sustainable as it tends to reduce hunger without need for specific calorie restriction. In fact, studies of long-term adherence of up to a year [38, 39] on the LCHF

From the current evidence and above reviews of lower carbohydrate diets, it can be postulated that LCHF diets reduce insulin resistance, improves glycaemic regulation and has positive effects on reducing cardiovascular risk factors, including reducing serum triglyceride, increasing HDL cholesterol, increasing LDL particle size and reducing blood pressure. A substantial proportion of individuals have also been shown to discontinue one or more

Low-carbohydrate high-fat (LCHF) diet has been shown to be as effective as other diets for weight reduction, through increased satiety and reduction in calorie intake. LCHF diet also helps improve glycaemic control in type 2 diabetes mellitus and in otherwise healthy patients

Some of the benefits of the LCHF diet results from the often large weight loss typically produced by this diet. Therefore, at least some of the beneficial changes from LCHF diet would also be experienced by patients prepared to adhere to any calorie-restricted diet. LCHF diets control energy balance through increased satiety and reduced ad libitum energy intake while encouraging the ingestion of a nutrient-dense diet by replacing refined foods with natural foods.

LCHF diets have beneficial effects on cardiovascular risk factors through their effect on blood lipid concentrations. They decrease triglycerides, apoprotein B and saturated fat levels in

increased on these diets as a result of reduction in insulin levels with LCHF diet [103].

predominantly the result of the loss of fat mass with some loss of fat-free mass [3].

**11.5. Weight loss on LCHF diets is due to increased water loss**

**11.6. Sustainability**

**12. Summary**

diabetes medication.

with insulin resistance.

have not identified any evidence of harm.

Thus, LCHF diet is likely to benefit patients with high TG to HDL-C ratios and NAFLD, all of which are common in the insulin-resistant individual. A recent lifestyle intervention trial reduced the prevalence of metabolic syndrome from 58 to 19% among obese and overweight patients treated with LCHF for 3–8 months, showing how quickly carbohydrate restriction can improve health in those with metabolic syndrome [37].
