{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:22:36Z","timestamp":1790882556923,"version":"4.1.0"},"reference-count":177,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,9,22]],"date-time":"2021-09-22T00:00:00Z","timestamp":1632268800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>The decades-long dietary experiment embodied in the Dietary Guidelines for Americans (DGA) focused on limiting fat, especially saturated fat, and higher carbohydrate intake has coincided with rapidly escalating epidemics of obesity and type 2 diabetes (T2D) that are contributing to the progression of cardiovascular disease (CVD) and other diet-related chronic diseases. Moreover, the lack of flexibility in the DGA as it pertains to low carbohydrate approaches does not align with the contemporary trend toward precision nutrition. We argue that personalizing the level of dietary carbohydrate should be a high priority based on evidence that Americans have a wide spectrum of metabolic variability in their tolerance to high carbohydrate loads. Obesity, metabolic syndrome, and T2D are conditions strongly associated with insulin resistance, a condition exacerbated by increased dietary carbohydrate and improved by restricting carbohydrate. Low-carbohydrate diets are grounded across the time-span of human evolution, have well-established biochemical principles, and are now supported by multiple clinical trials in humans that demonstrate consistent improvements in multiple established risk factors associated with insulin resistance and cardiovascular disease. The American Diabetes Association (ADA) recently recognized a low carbohydrate eating pattern as an effective approach for patients with diabetes. Despite this evidence base, low-carbohydrate diets are not reflected in the DGA. As the DGA Dietary Patterns have not been demonstrated to be universally effective in addressing the needs of many Americans and recognizing the lack of widely available treatments for obesity, metabolic syndrome, and T2D that are safe, effective, and sustainable, the argument for an alternative, low-carbohydrate Dietary Pattern is all the more compelling.<\/jats:p>","DOI":"10.3390\/nu13103299","type":"journal-article","created":{"date-parts":[[2021,9,21]],"date-time":"2021-09-21T22:34:01Z","timestamp":1632263641000},"page":"3299","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":55,"title":["Alternative Dietary Patterns for Americans: Low-Carbohydrate Diets"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8702-0351","authenticated-orcid":false,"given":"Jeff S.","family":"Volek","sequence":"first","affiliation":[{"name":"Department of Human Sciences, Ohio State University, Columbus, OH 43017, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3322-3978","authenticated-orcid":false,"given":"Stephen D.","family":"Phinney","sequence":"additional","affiliation":[{"name":"Virta Health, San Francisco, CA 94015, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald M.","family":"Krauss","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Medicine, University of California, San Francisco, CA 94143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3312-8193","authenticated-orcid":false,"given":"Richard J.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura R.","family":"Saslow","sequence":"additional","affiliation":[{"name":"Department of Behavior & Biological Sciences, University of Michigan, Ann Arbor, MI 48109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Gower","sequence":"additional","affiliation":[{"name":"Department of Nutrition Sciences, University of Alabama, Birmingham, AL 35233, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"William S.","family":"Yancy","sequence":"additional","affiliation":[{"name":"Department of Medicine, Lifestyle and Weight Management Center, Duke University, Durham, NC 27705, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet C.","family":"King","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences & Toxicology, University of California, Berkley, CA 94720, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick M.","family":"Hecht","sequence":"additional","affiliation":[{"name":"Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA 94115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Teicholz","sequence":"additional","affiliation":[{"name":"The Nutrition Coalition, New York, NY 10011, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce R.","family":"Bistrian","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center, Boston, MA 02215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama","family":"Hamdy","sequence":"additional","affiliation":[{"name":"Joslin Diabetes Center, Harvard Medical School, Boston, MA 02215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Dietary Guidelines Advisory Committee (2020). 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