Effects of energy-matched low- versus high-carbohydrate diets on glycaemic control, lipid profile, and body composition in healthy adults: a systematic review and meta-analysis of randomised controlled trials
Abstract
The comparative effects of energy-matched low-carbohydrate (LC) versus high-carbohydrate (HC) diets on metabolic and anthropometric outcomes in healthy adults remain unclear. To evaluate the effects of LC diets (≤ 44% of total daily caloric intake [TDCI] from carbohydrate) versus HC diets (≥ 45% TDCI) on fasting glycaemia, insulinaemia, blood lipids, and body composition in non-medicated, disease-free adults under energy-matched conditions. Randomised controlled trials (RCTs) were identified through systematic searches of PubMed and secondary sources up to April 2025. Eligible studies compared energy-matched dietary interventions and reported pre- and post-intervention data for fasting blood glucose (FBG), fasting insulin (FINS), blood lipids (total cholesterol [TC], HDL-cholesterol [HDL-C], LDL-cholesterol [LDL-C], triglycerides [TAG]), and/or body composition. Pooled effect sizes (Hedges’ g) and 95% confidence intervals (CIs) were calculated using a random-effects model. Eighteen RCTs involving 905 participants met the inclusion criteria. LC diets produced greater reductions in FBG (g = − 0.364; 95% CI − 0.709 to − 0.019; P < 0.001) and FINS (g = − 0.190; 95% CI − 0.361 to − 0.014; P = 0.034) compared with HC. TAG decreased (g = − 0.379; 95% CI − 0.540 to − 0.219; P < 0.001), and HDL-C increased (g = 0.389; 95% CI 0.229 to 0.550; P < 0.001) under LC diets. HC diets led to a greater reduction in LDL-C (g = − 0.225; 95% CI − 0.406 to − 0.043; P = 0.009). No significant…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 905 participants or records.
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