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The global prevalence of obesity is alarmingly high and is impacting both developed and underdeveloped countries, beyond the borders of ethnicity, sex, and age. On the other hand, the global interest in dieting has increased, and people are obsessed with certain fad diets, assuming them as a magic bullet for their long-term problems. A fad diet is a popular dietary pattern known to be a quick fix for obesity. These diets are quite appealing due to the proposed claims, but the lack of scientific evidence is a big question mark. Such diets are often marketed with specific claims that defy the basic principles of biochemistry and nutritional adequacy. These diets may have protective effects against obesity and certain chronic diseases like cardiovascular diseases, metabolic syndrome, and certain cancers. Limited evidence exists to support the proposed claims; rather certain studies suggest the negative health consequences of long-term adherence to such dietary patterns. Many fad diets have emerged in the previous few decades. This review article will explore the current evidence related to the health impacts of some most popular diets: Atkins diet, ketogenic diet, Paleolithic diet, Mediterranean diet, vegetarian diet, intermittent fasting and detox diet.

Obesity is one of the major public health concerns in this modern era. It is now considered a global epidemic due to the gradual but continuous increase in its prevalence. The global prevalence of obesity is alarmingly high and is impacting both developed and underdeveloped countries, beyond the borders of ethnicity, sex, and age. Worldwide obesity has tripled from 1975 to 2016, while childhood obesity is increasing dramatically (1). Excessive calories from fats and sugars, large portions of food, routinely junk food intake, availability of fast foods at the doorstep and limited physical activity are some of the contributing factors to obesity (2). Obesity is an independent risk factor for morbidity and mortality. Being obese or overweight puts a person at greater risk of developing cardiovascular diseases, hypertension, insulin resistance, diabetes, reproductive issues, liver and kidney diseases (3).

Despite the growing global prevalence of obesity, there is always a group that is highly obsessed with dieting. The global interest in dieting has increased in the last two decades. A study indicated that internet searches related to weight loss queries had immensely increased between the years 2004 to 2018 (4). In the meantime, people rush toward certain fad diets (FD), assuming them as a magic bullet for their long-term problems. FD is not a scientific terminology but rather a popular or trendy dietary pattern that is known to be a quick fix for obesity (5). FD can be easily differentiated from a healthy and balanced diet based on its characteristic features: (i) promises rapid weight loss (ii) absence of physical activity guidelines (iii) promotes short-term changes rather than achieving lifelong sustainable goals (iv) focuses on one type of food or eliminates any food group (v) cannot be maintained for life long period (vi) nutritional adequacy is questionable (vii) fails to provide health warnings for those with chronic diseases (viii) lacks scientific evidence to support the claims (5, 6) (Figure 1).

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A wide range of FDs has been proposed to date, ranging from low carbohydrate diets to low-fat diets, high-fats to high-protein diets, those with detoxification claims, and others of the 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 explore the current evidence related to the health impacts of some popular diets, including Atkins diet, ketogenic diet, Paleolithic diet, Mediterranean diet, vegetarian diet, intermittent fasting, and detox diet.

In the 1970s, a low carbohydrate, high protein (LCHP) regimen was developed by cardiologist Dr. Robert Atkins, which was published in his book “Dr. Atkins’ New Diet Revolution” (7). This diet was promoted as a quick weight loss plan based on a lifetime change in eating habits. Atkins believed that metabolic imbalance resulting from carbohydrate consumption is the major cause of obesity. He claimed that this is the easiest, high-energy diet that mobilizes fats more than any other diet for weight loss maintenance. The AD involves an extreme reduction of carbohydrates, i.e., less than 5% of total calorie intake, ad libitum intake of proteins and fats, adequate fluid intake with vitamin and mineral supplementation, and regular exercise (8).

The diet has four phases: induction phase, ongoing weight loss phase, pre-maintenance phase, and lifetime maintenance phase (Table 1). The modified version of the AD (MAD) is currently available with the same four phases but slightly modified net carbs consumption in each phase. The MAD is less restrictive, allowing the person to choose the number of net carbs in phase 1, i.e., 20, 40, or 100 g of carbs and fats are not just allowed but encouraged. The primary goal is not weight loss rather it has shown promising results in seizure reduction in intractable epilepsy (9–13).

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There is substantial evidence suggesting that AD promotes more weight loss than conventional diets. One of the first AD research was published in The New England Journal of Medicine in 2003. Brehm et al. (14) in a study allocated 53 healthy, obese women to two groups, i.e., low carbohydrate ketogenic diet (LCKD) or energy-restricted low-fat diet (LFD) (carbs: 55%, protein: 15%, fats: 30%). Over 6 months, the LCKD subjects lost 8.5 kg versus 4.2 kg in the LFD group. There were no comparable differences between the groups in serum glucose, lipids, leptin, and insulin excluding triglycerides that showed a significant reduction in the LCKD group.

In another randomized trial, 132 severely obese individuals (43% had metabolic syndrome while 39% had type 2 diabetes) were assigned to two groups. One group followed AD and the other followed LFD for 6 months. The results showed that LCD individuals lost 3.8 kg more weight than those on LFD. No significant difference was observed in both groups after 12 months (15). In another controlled trial of 1 year, 63 obese participants were randomly assigned to either the AD or conventional LFD. After 6 months, 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 between groups were noted in low-density lipoprotein cholesterol LDL-c (16).

Several meta-analyses and systemic reviews reported the promising effects of low carbohydrate diets on weight loss and cardiometabolic risk factors. Mansoor et al. (17) demonstrated that the LCD group had a significant increase in HDL-c and LDL-c, and had a greater weight loss and TG reduction in contrast to those following LFD. Hashimoto et al. (18) reported that LCD resulted in a greater reduction of body weight and body fat mass than the control diet. LCD was linked with moderately more significant advancement in weight loss and reduction of atherosclerotic cardiovascular diseases (ASCVD) risk, compared to LFD (19).

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Naude et al. (20) concluded that both LCD and balanced diets had shown weight loss. After 2 years of follow-up, there was no significant difference between the diets in terms of cardiovascular and diabetes risk factors. Bueno et al. (21) found that after 12 months or more, the individuals that followed an energy-restricted very low carbohydrate diet (VLCD) (carbs: <50 g/day or 10%) compared to LFD (fats: <30%) had a more significant improvement in HDL-c, LDL-c, TG and diastolic blood pressure (DBP) as well as the reduction in body weight. Hu et al. (22) compared LCD and LFD and concluded that both diets were efficient at reducing waist circumference, body weight, total cholesterol (TC), total to HDL-c ratio, LDL-c, TG, blood glucose, serum insulin, and blood pressure. LCD showed a greater decrease in TG, and less reduction in LDL-c and TC but increased HDL-c in comparison with LFD.

Atkins diet has not been extensively studied while those studies that have been mentioned earlier have high dropout rates and are sometimes non-conclusive. Despite the rapid weight reduction, there are some concerns for those with comorbidities. There are some considerable potential complications associated with LCHP diets. There is conflicting evidence on the urinary stone formation tendency of LCHP diets (23). A short-term study showed that healthy subjects followed the LCHP diet for 6 weeks, decreased urine pH, increased urinary-acid excretion, and decreased calcium balance was observed in them. Therefore, they had a greater risk of stone formation (24). A prospective cohort study was conducted in Iran, involving 1, 797 participants that were followed up for almost 6 years. Results showed that a higher tertile of LCHP diet correlates with a greater risk of chronic kidney disease (CKD) (25).

Metabolic acidosis is a common complication of LCHP diets. A case of 40 years old obese woman was reported, who was presented with nausea, vomiting, dehydration, and dyspnea. Investigations revealed that she was following AD, lost 9 kg in 1 month, and laboratory findings were consistent with ketoacidosis Chen et al. (26). Pregnant and lactating mothers should be cautious when following such a

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Naude et al. (20) concluded that both LCD and balanced diets had shown weight loss. After 2 years of follow-up, there was no significant difference between the diets in terms of cardiovascular and diabetes risk factors. Bueno et al. (21) found that after 12 months or more, the individuals that followed an energy-restricted very low carbohydrate diet (VLCD) (carbs: <50 g/day or 10%) compared to LFD (fats: <30%) had a more significant improvement in HDL-c, LDL-c, TG and diastolic blood pressure (DBP) as well as the reduction in body weight. Hu et al. (22) compared LCD and LFD and concluded that both diets were efficient at reducing waist circumference, body weight, total cholesterol (TC), total to HDL-c ratio, LDL-c, TG, blood glucose, serum insulin, and blood pressure. LCD showed a greater decrease in TG, and less reduction in LDL-c and TC but increased HDL-c in comparison with LFD.

Atkins diet has not been extensively studied while those studies that have been mentioned earlier have high dropout rates and are sometimes non-conclusive. Despite the rapid weight reduction, there are some concerns for those with comorbidities. There are some considerable potential complications associated with LCHP diets. There is conflicting evidence on the urinary stone formation tendency of LCHP diets (23). A short-term study showed that healthy subjects followed the LCHP diet for 6 weeks, decreased urine pH, increased urinary-acid excretion, and decreased calcium balance was observed in them. Therefore, they had a greater risk of stone formation (24). A prospective cohort study was conducted in Iran, involving 1, 797 participants that were followed up for almost 6 years. Results showed that a higher tertile of LCHP diet correlates with a greater risk of chronic kidney disease (CKD) (25).

Metabolic acidosis is a common complication of LCHP diets. A case of 40 years old obese woman was reported, who was presented with nausea, vomiting, dehydration, and dyspnea. Investigations revealed that she was following AD, lost 9 kg in 1 month, and laboratory findings were consistent with ketoacidosis Chen et al. (26). Pregnant and lactating mothers should be cautious when following such a

Fad Diet Without Being Standard Dietary Stock Vector (royalty Free) 2267805929