15
Low-Calorie Dietary Patterns
Typically 1000–1200 kcal/d for women and 1200–1600 kcal/d for men.
Considerations Weight Loss
• Consists of conventional foods and
1–4 meal replacements per day
• Structure is a moderate-fat, higher-
protein diet with reduced ref ined
carbohydrates, with a f ixed energy
allowance
• Can be used for more extended
periods of time as compared to
very-low-calorie diets
• Lower rate than the VLEDs
• Randomized controlled trials
demonstrate that the long-
term (>1 year) weight loss is not
different f rom the VLEDs
Risks
• Similar, but with a lower degree of risk than the VLEDs
• May be benef icial for introducing healthy eating habits, familiarizing
with dietary changes, and encouraging long-term weight maintenance
• Risk of malnutrition, and therefore needs guidance f rom a dietician
Carbohydrate-Restricted Dietary Patterns
Low carbohydrate: <130 grams of carbohydrate/d or <26% calories/d.
Very low carbohydrate (ketogenic): <50 grams of carbohydrate/d
(see Low-Calorie and Very-Low-Calorie Diets f igure)
Weight Loss Metabolic Effects
• May produce greater weight loss
compared to a fat-restricted dietary
intake for the f irst six months
• After six months, net weight loss
may be similar to other calorie-
restricted nutritional interventions
• Lower rate than the VLEDs
• Randomized controlled trials
demonstrate that the long-
term (>1 year) weight loss is not
different f rom the VLEDs
Risks
• May produce carbohydrate cravings within the f irst few days of
implementation, which may be mitigated by adding low-glycemic-index
carbohydrate foods
• May induce a gout flare in patients with a history of gout
• May result in malaise
• May pose challenges in patients with restrictions on dietary protein due
to severe kidney disease
• Monitor patients receiving treatment for diabetes mellitus and
hypertension for signs of hypoglycemia and hypotension; adjust
medications as necessary
