Summary of findings 2. Summary of findings table ‐ Low‐carbohydrate weight‐reducing diets compared to balanced‐carbohydrate weight‐reducing diets in overweight and obese participants without T2DM (weight‐reducing phase followed by weight‐maintenance phase).
| Low‐carbohydrate weight‐reducing diets compared to balanced‐carbohydrate weight‐reducing diets in overweight and obese participants without T2DM (weight‐reducing phase followed by weight‐maintenance phase) | ||||||
| Patient or population: overweight and obese participants without T2DM (weight‐reducing phase followed by weight maintenance phase) Setting: outpatient clinics, medical/research centres in high‐income countries Intervention: low‐carbohydrate weight‐reducing diets Comparison: balanced‐carbohydrate weight‐reducing diets | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with balanced‐carbohydrate weight‐reducing diets | Risk with low‐carbohydrate weight‐reducing diets | |||||
| Change in body weight (kg) at 3 to < 12 months ‐ not measured | ‐ | ‐ | ‐ | ‐ | ‐ | |
| Change in body weight (kg) at ≥ 12 months | The mean change in body weight (kg) at ≥ 12 months ranged from ‐5.5 to ‐1.5 kg | MD 0.3 kg lower (2.77 lower to 2.16 higher) | ‐ | 73 (3 RCTs) | ⊕⊕⊝⊝ Lowa,b | Low‐carbohydrate weight‐reducing diets may result in little to no difference in change in weight at 1 to 2 years. |
| Weight loss of at least 5% at ≥ 12 months ‐ not measured | ‐ | ‐ | ‐ | ‐ | ‐ | |
| Cardiovascular mortality ‐ not measured | ‐ | ‐ | ‐ | ‐ | ‐ | |
| Change in DBP (mmHg) at ≥ 12 months | The mean change in DBP (mmHg) at ≥ 12 months was ‐6 mmHg | MD 6 mmHg lower (17.55 lower to 5.55 higher) | ‐ | 13 (1 RCT) | ⊕⊝⊝⊝ Very lowc,d | The evidence is very uncertain about the effect of low‐carbohydrate weight‐reducing diets on change in DBP at 1 year. |
| Change in LDL cholesterol (mmol/L) at ≥ 12 months | The mean change in LDL cholesterol (mmol/L) at ≥ 12 months was ‐1.15 to ‐0.14 mmol/L | MD 0.08 mmol/L lower (0.44 lower to 0.28 higher) | ‐ | 56 (2 RCTs) | ⊕⊝⊝⊝ Very lowa,d | The evidence is very uncertain about the effect of low‐carbohydrate weight‐reducing diets on change in LDL cholesterol at 1 to 2 years. |
| Constipation at 3 to < 12 months ‐ not measured | ‐ | ‐ | ‐ | ‐ | ‐ | |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; MD: mean difference | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
| See interactive version of this table: https://gdt.gradepro.org/presentations/#/isof/isof_question_revman_web_420946341206467227. | ||||||
a Serious risk of bias: All information is from studies at high overall risk of bias b Serious imprecision: OIS not met c Serious risk of bias: All information is from a study at high overall risk of bias d Very serious imprecision: OIS not met; 95% CI for the pooled estimate is consistent with the possibility for important harm and for important benefit