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The global prevalence of obesity is extremely high and affects both developed and underdeveloped countries, regardless of ethnicity, gender and age. On the other hand, the global interest in diets has increased, and people are obsessed with certain fad diets, accepting them as a magic bullet for their long-term problems. A fad diet is a popular eating pattern known as a quick fix for obesity. These diets are quite attractive because of the proposed claims, but the lack of scientific evidence is a big question mark. These diets are often marketed with specific claims that violate basic principles of biochemistry and nutritional adequacy. These diets may have protective effects against obesity and certain chronic diseases such as cardiovascular disease, metabolic syndrome and certain cancers. There is limited evidence to support the proposed claims; but some studies suggest the negative health consequences of long-term adherence to these dietary patterns. Many fad diets have emerged in recent years. This review article will examine the current evidence on the health effects of some of the most popular diets: the Atkins diet, the ketogenic diet, the Paleolithic diet, the Mediterranean diet, the vegetarian diet, intermittent fasting, and the detox diet.
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Obesity is one of the major public health concerns in this modern era. It is now considered a worldwide epidemic due to the gradual but continued increase in its prevalence. The global prevalence of obesity is extremely high and affects both developed and underdeveloped countries, regardless of ethnicity, gender and age. Obesity has tripled worldwide between 1975 and 2016, with childhood obesity on the rise (1). Factors that contribute to obesity include excess calories from fat and sugar, large portions of food, regular intake of junk food, access to fast food on the doorstep and limited physical activity (2 ). Obesity is an independent risk factor for morbidity and mortality. Being obese or overweight puts a person at greater risk of developing cardiovascular disease, hypertension, insulin resistance, diabetes, reproductive problems, liver and kidney disease (3).
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Despite the increase in the global prevalence of obesity, there is always a group that is very obsessed with dieting. Global interest in dieting has increased over the past twenty years. One study showed that there was a huge increase in internet searches related to weight loss issues between the years 2004 and 2018 (4). Meanwhile, people turn to fad diets (FDs), believing them to be a magic bullet for their long-term problems. FD is not scientific terminology, but a popular or trendy eating pattern known to be a quick fix for obesity (5). FD can be easily differentiated from a healthy, balanced diet based on its distinguishing characteristics: (i) promises of rapid weight loss (ii) lack of physical activity guidelines (iii) promotion of short-term changes in instead of achieving sustainable lifelong goals (iv) focuses on one type of food or eliminates any food group (v) cannot be sustained for life (vi) has doubts about adequacy nutritional (vii) does not provide health warnings to those with chronic diseases (viii) lacks scientific evidence to support the claims (5, 6) (Figure 1).
A wide variety of FDs have been proposed to date, ranging from low-carbohydrate diets to low-fat diets, high-fat diets to high-protein diets, those with detoxification claims, and others of Mediterranean or Paleolithic origin. . These diets are followed blindly but are associated with certain negative health outcomes as one size does not fit all. This review article will examine the current evidence related to the health effects of several popular diets, including the Atkins diet, the ketogenic diet, the Paleolithic diet, the Mediterranean diet, the vegetarian diet, intermittent fasting, and a detoxification
In the 1970s, cardiologist Dr. Robert Atkins developed a low-carbohydrate, high-protein (LCHP) diet, published in his book “Dr. Atkins’ New Diet Revolution” (7). This diet was promoted as a fast established weight loss. a life change in eating habits. Atkins believed that the metabolic imbalance resulting from the consumption of carbohydrates was the main cause of obesity. He claimed that this was the easiest and most energy efficient diet that mobilized more fat than any other diet to maintain weight loss. DA involves a severe reduction of carbohydrates, i.e. less than 5% of total caloric intake, an ad libitum intake of protein and fat, adequate fluid intake with vitamin and mineral supplements, and regular exercise ( 8).
The diet has four phases: an induction phase, a continuous weight loss phase, a premaintenance phase, and a lifelong maintenance phase (Table 1). The modified version of the AD (MAD) is currently available with the same four stages, but the net carb intake is slightly modified in each stage. The MAD is less restrictive, allowing the person to choose the number of net carbs in step 1, meaning 20, 40, or 100g of carbs and fat only allowed for stimulation. Weight loss is not the primary goal, but has shown promising results in reducing seizures in intractable epilepsy (9-13).
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There is substantial evidence to suggest that MA promotes greater weight loss than traditional diets. One of the first HR investigations was published in The New England Journal of Medicine in 2003. Brehm et al. (14) in a study assigned 53 obese and healthy women to two groups, namely a low-carbohydrate ketogenic diet (LCKD) or an energy-restricted low-fat diet (LFD) (carbohydrates: 55 %, proteins: 15%, fats: 30). ). %)). Over 6 months, LCKD subjects lost 8.5 kg compared to 4.2 kg in the LFD group. There were no comparable differences between groups in serum glucose, lipids, leptin and insulin, excluding triglycerides, which showed a significant decrease in the LCKD group.
In another randomized trial, 132 severely obese individuals (43% with metabolic syndrome and 39% with type 2 diabetes) were assigned to two groups. One group followed AD and the other followed LFD for 6 months. The results showed that people with LCD lost 3.8 kg more weight than those with LFD. No significant difference was observed in the two groups after 12 months (15). In another 1-year controlled trial, 63 obese participants were randomly assigned to AD or conventional LFD. After 6 months, the results showed that the LFD group lost less weight, i.e. 3.2 ± 5.6% than the AD group, i.e. 7.0 ± 6.5%. The AD group lost 4% more weight, had higher levels of high-density lipoprotein cholesterol (HDL-c) and lower levels of triglycerides (TG) than the other group. No significant differences were observed between groups in low-density lipoprotein LDL-c (16).
Several meta-analyses and systematic reviews have reported promising effects of low-carbohydrate diets on weight loss and cardiometabolic risk factors. Mansoor et al. (17) showed that the LCD group had a significant increase in HDL-c and LDL-c, and that there was greater weight loss and reduction in TG in contrast to those who followed LFD. Hashimoto et al. (18) reported that LCD resulted in a greater reduction in body weight and body fat mass than the control diet. LCD was associated with relatively more significant improvement in weight loss and reduced risk of atherosclerotic cardiovascular disease (ASCVD), compared with LFD (19).
Naude et al. (20) showed that both LCD and balanced diets showed weight loss. After 2 years of follow-up, there was no significant difference between the diets in terms of cardiovascular risk factors and diabetes. Bueno et al. (21) found that after 12 months or more, individuals following a very low energy restricted carbohydrate diet (VLCD) (carbohydrate: <50 g/day or 10%) compared with LFD (fat: <30%), is more important. improvement in HDL-c, LDL-c, TG and diastolic blood pressure (DBP), as well as reduction in body weight. Hu et al. (22) compared LCD and LFD and concluded that both diets were effective in reducing waist circumference, body weight, total cholesterol (TC), total ratio to HDL-c, LDL-c, TG, glucose in blood, serum insulin and blood pressure. . LCD showed a greater decrease in TG and a smaller decrease in LDL-c and TC, but increased HDL-c compared to LFD.
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The Atkins diet has not been studied extensively, although the studies mentioned above have high dropout rates and are sometimes inconclusive. Despite the rapid weight reduction, there are some concerns for people with comorbidities. There are some important potential complications associated with LCHP diets. There is conflicting evidence regarding the propensity for urinary stone formation of LCHP diets (23). A short-term study showed that healthy subjects who followed the LCHP diet for 6 weeks lowered urine pH, increased urinary acid excretion, and decreased calcium homeostasis. Therefore, they had a higher risk of stone formation (24). A prospective cohort study was conducted in Iran, with 1,797 participants who were followed for nearly 6 years. The results showed that a higher LCHP tertile diet correlates with a higher risk of chronic kidney disease (CKD) (25).
Metabolic acidosis is a frequent complication of LCHP diets. A case of a 40-year-old obese woman presenting with nausea, vomiting, dehydration, and dyspnea was reported. Investigations showed that he followed the FC, lost 9 kg and
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