Evid Based Med 15:91-92 doi:10.1136/ebm1065
  • Treatment
  • Randomised controlled trial

Low-carbohydrate ketogenic diet and the combination of orlistat with a low-fat diet lead to comparable improvements in weight and blood lipids, but LCKD more beneficial for blood pressure

  1. Christopher D Gardner
  1. Correspondence to Christopher D Gardner
    Stanford Prevention Research Centre, School of Medicine, Stanford University, 251 Campus Drive, SPRC X310, Stanford, CA 94305-5411, USA; cgardner{at}

    Commentary on:


    After decades of ‘low-fat’ being promoted as the most appropriate dietary approach to weight loss,1 2 the unabated rise in obesity over the same period led to suggestions to consider alternative dietary strategies, the most prominent being ‘low-carb’. Since 2003, more than a dozen randomised controlled trials have conducted head-to-head comparisons of low-fat and low-carb diets. In general, the low-carb diets have proven to be as or more effective than the low-fat diets for weight loss and for some related metabolic variables among the populations studied.3,,6 Consistent findings in the trials to date have been that overall success at 1–2 years was modest for all diet groups, that long-term dietary adherence and participant retention were less than optimal, and that weight regain was common. In other words, no single diet has emerged as clearly superior. Additional similar trials …

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