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Low-carbohydrate nutrition and metabolism^1,2,3

¹ From the Department of Medicine, Duke University Medical Center, Durham NC (ECW, JCM, and WSY); the Department of Biochemistry, SUNY Downstate Medical Center, Brooklyn, NY (RDF); private practice, Lawrence, KS (MCV); the Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT (JSV); the First Nations and Inuit Health Branch, Health Canada, Vancouver, Canada (JAW); the Center for Health Services Research, Durham Veterans Affairs Medical Center, Durham, NC (WSY); and the Department of Medicine (Professor Emeritus), University of California, Davis, Davis, CA (SDP)

The persistence of an epidemic of obesity and type 2 diabetes suggests that new nutritional strategies are needed if the epidemic is to be overcome. A promising nutritional approach suggested by this thematic review is carbohydrate restriction. Recent studies show that, under conditions of carbohydrate restriction, fuel sources shift from glucose and fatty acids to fatty acids and ketones, and that ad libitum–fed carbohydrate-restricted diets lead to appetite reduction, weight loss, and improvement in surrogate markers of cardiovascular disease.

Key Words: Nutrition • metabolism • macronutrients • glucose • insulin

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