{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:03:51Z","timestamp":1790708631588,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nut in Clin Prac"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Low\u2010carbohydrate diets (LCDs) are widely adopted for metabolic management, but their long\u2010term cardiometabolic effects in diverse populations remain unclear. We aimed to evaluate the association between self\u2010selected moderate LCD adherence and cardiometabolic parameters in individuals with and without diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective cohort study included 9658 participants from the Brazilian Longitudinal Study of Adult Health (ELSA\u2010Brasil; baseline: 2008\u20132010; follow\u2010up: 2017\u20132019). LCD adherence (carbohydrate &lt;45% of total energy) was assessed through validated food frequency questionnaires. Quantile regression models, adjusted for sociodemographic, lifestyle, and clinical factors, were used to analyze changes in body mass index (BMI), blood pressure, insulin, and homeostatic model assessment for insulin resistance (HOMA\u2010IR) and beta cell function (HOMA\u2010B).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among individuals without diabetes, those who followed an LCD only at the follow\u2010up showed decreased insulin levels (\u03b2\u2009=\u2009\u22120.33 [95% CI, \u22120.6 to \u22120.1] \u03bcIU\/ml), HOMA\u2010IR (\u22120.11 [\u22120.2 to \u22120.1] \u03bcIU\/ml), and HOMA\u2010B (\u22124.95 [\u22127.2 to \u22122.1] \u03bcIU\/ml) alongside modest BMI increases (0.16 [0.1\u20130.3]). Consistent LCD adherents (at both time points) showed a decrease in HOMA\u2010B (\u22123.21 [\u22126.4 to \u22120.1] \u03bcIU\/ml) and an increase in BMI (0.29 [0.2\u20130.4]). In individuals with diabetes, LCD adherence led to reduced HOMA\u2010IR (\u22121.25 [\u22122.2 to \u22120.3] \u03bcIU\/ml) and insulin levels (\u22123.61 [\u22126.0 to \u22121.2] \u03bcIU\/ml).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Moderate LCD adherence improved insulin sensitivity and reduced pancreatic demand in individuals without diabetes. Despite slight BMI increases, LCD may be a feasible dietary strategy for metabolic risk management in middle\u2010aged and older adults. Personalized nutrition approaches are recommended to optimize outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ncp.70099","type":"journal-article","created":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T05:51:04Z","timestamp":1770443464000},"page":"1349-1359","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of a low\u2010carbohydrate diet on cardiometabolic parameters in individuals with and without diabetes: An 8\u2010year longitudinal study within the ELSA\u2010Brasil cohort"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7810-0621","authenticated-orcid":false,"given":"Leticia Batista","family":"de Azevedo","sequence":"first","affiliation":[{"name":"Postgraduate Program in Nutrition and Health Federal University of Esp\u00edrito Santo Vit\u00f3ria Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haysla Xavier","family":"Martins","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Public Health Federal University of Esp\u00edrito Santo Vit\u00f3ria Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4561-122X","authenticated-orcid":false,"given":"Oscar Geovanny","family":"Enriquez\u2010Martinez","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Public Health Federal University of Esp\u00edrito Santo Vit\u00f3ria Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria del Carmen Bisi","family":"Molina","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Nutrition and Longevity Federal University of Alfenas Alfenas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00685-8"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)02317-1"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1590\/1980-549720190030"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-387-78665-0_32"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.26633\/RPSP.2020.32"},{"key":"e_1_2_9_7_1","volume-title":"Leading Causes of Death and Disease Burden in the Americas: Noncommunicable Diseases and External Causes","author":"Pan American Health Organization","year":"2024"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41392-024-01771-x"},{"key":"e_1_2_9_9_1","volume-title":"StatPearls","author":"Patel R","year":"2024"},{"issue":"1","key":"e_1_2_9_10_1","first-page":"69","article-title":"Low\u2010carbohydrate diets and cardiometabolic health: the importance of carbohydrate quality over quantity","volume":"78","author":"Sievenpiper JL","year":"2020","journal-title":"Nutr Res"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12944-019-1035-2"},{"key":"e_1_2_9_12_1","unstructured":"Instituto Brasileiro de Geografia e Estat\u00edstica \u2010 IBGE.Pesquisa de or\u00e7amentos familiares 2017\u20102018: an\u00edlise do consumo alimentar pessoal no Brasil. 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