Long-term effects of very low-carbohydrate diet with intermittent fasting on metabolic profile in a social media-based support group

Very low-carbohydrate (VLC) diets are among many diets available for weight loss and diabetes control. In comparison with low-fat diets, VLC diets have shown more pronounced recuperation of insulin sensitivity as well as a steeper decrease of weight and triglyceride levels. However, there is a paucity of data pertaining to their sustainability beyond one year [1-4]. A randomized trial demonstrated that a VLC diet compared to a low-fat diet resulted in greater weight loss at 3 months that continued on at 9 months. However, follow-up at 2 years there no longer was a significant difference in weight loss, hyperlipidemia nor hemoglobin A1c (HgbA1c) levels [5,6]. Similarly, a larger randomized 2-year study observed a maximal weight loss in patients on a VLC diet at the 6-months mark after which the weight regain was observed. The same group published a follow-up study after 4 more years and observed that the patients on the VLC diet had a mean of 3 kg of weight regain [7]. Patients still showed a significant drop in their total cholesteroland triglyceride levels. Even though the authors reported an adherence rate of 67% to the diet, the sharp increase in weight and triglyceride levels after the 2-year dietary intervention phase was striking, raising doubts about the actual adherence rate. Usually, patients participating in nutritionand weight loss studies are randomly assigned to a particular diet which might explain their lack of motivation to continue this specific diet once the trial has ended. Thus, while the short-term effects of a VLC diet on weightand diabetes control are quite compelling, *Correspondence to: Nicole Jacobi, Division of Hematology and Oncology, Hennepin Healthcare System, Minneapolis, MN, USA, E-mail: Nicole. jacobi@hcmed.org