Dalal J. Alsharif

The global obesity rate has risen significantly, prompting research into the optimal dietary strategies for weight loss, particularly in relation to macronutrient composition. Despite numerous studies, the most effective macronutrient balance for weight reduction remains under debate. The objective of this article is to compare the impacts of a low-carbohydrate diet and a low-fat diet on weight loss and cardiovascular health. A comprehensive literature review was conducted across PubMed, Scopus, Web of Science, and Google Scholar. Studies included randomized controlled trials and systematic reviews to provide a broad analysis of the evidence on a low-carbohydrate versus a low-fat diet. Short-term weight loss was significantly higher with a low-carbohydrate diet compared to an unrestricted low-fat diet. However, when matched for calorie intake, no significant difference in weight was observed between the two diets, suggesting that total calorie intake may be more influential than macronutrient composition. Notably, a low-carbohydrate diet induced a greater decrease in triglyceride levels and an increase in both high-density lipoprotein and low-density lipoprotein cholesterol levels compared to a low-fat diet.

Enteral nutrition (EN) is considered the first feeding route for critically ill patients. However, adverse effects such as gastrointestinal complications limit its optimal provision, leading to inadequate energy and protein intake. We compared the clinical outcomes of supplemental parenteral nutrition added to EN (SPN + EN) and EN alone in critically ill adults. Electronic databases restricted to full-text randomized controlled trials available in the English language and published from January 1990 to January 2019 were searched. The risk of bias was evaluated using the Jadad scale, and the meta-analysis was conducted using the MedCalc software. A total of five studies were eligible for inclusion in the systematic review and meta-analysis. Compared to EN alone, SPN + EN decreased the risk of nosocomial infections (relative risk (RR) = 0.733, p = 0.032) and intensive care unit (ICU) mortality (RR = 0.569, p = 0.030). No significant differences were observed between SPN + EN and EN in the length of hospital stay, hospital mortality, length of ICU stay, and duration of mechanical ventilation. In conclusion, when enteral feeding fails to fulfill the energy requirements in critically ill adult patients, SPN may be beneficial as it helps in decreasing nosocomial infections and ICU mortality, in addition to increasing energy and protein intakes with no negative effects on other clinical outcomes.