Just Read: Total Energy Expenditure is Higher on a Low-Carbohydrate Diet

2018.05 Low Carb and Low Carbon - Ted Eytan MD-1001 1021
2018.05 Low Carb and Low Carbon – Ted Eytan MD-1001 1021 (View on Flickr.com)

Thanks to study lead author David Ludwig, MD, PhD, (@DavidLudwigMD) for letting me know about his latest publication, and noting, his helpful addition to my graphic above:

Following weight loss, people on lower carbohydrate diets were able to eat more food to keep their weight stable than people on high carbohydrate low-fat diets, putting another nail in the coffin of low fat diets and “calories-in/calories-out”

This study (a meta-analysis) expands on work done over the last 30 years by (a) combining the results of studies and (b) partitioning studies by their duration, because it’s known that it may take the body several days/weeks/months to adapt to a low-carbohydrate diet. In the adaptation phase, there may be a slowing of metabolism and other side effects.

The net increase in total energy expenditure for studies lasting longer than 17 days is 135 calories a day. A feeding study in 2018 showed even greater increases based on the underlying metabolic health of subjects. See: Just Read: The Metabolic Advantages of a Lower Carbohydrate Diet

Additional information/copyright for the forest plot figure: Forest plot of total energy expenditure effect among 29 trials comparing lower- and higher-carbohydrate diets. Trials are listed according to intervention duration in ascending order (i.e., shortest duration at top). Full citations for the individual trials can be found in Supplementary Data.

Unless provided in the caption above, the following copyright applies to the content of this slide: © The Author(s) 2020. Published by Oxford University Press on behalf of the American Society for Nutrition.This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact [email protected]


  1. Ludwig DS, Dickinson SL, Henschel B, Ebbeling CB, Allison DB. Do Lower-Carbohydrate Diets Increase Total Energy Expenditure? An Updated and Reanalyzed Meta-Analysis of 29 Controlled-Feeding Studies. J Nutr [Internet]. 2020 Dec 3; Available from: https://doi.org/10.1093/jn/nxaa350
  2. Ebbeling CB, Feldman HA, Klein GL, Wong JMW, Bielak L, Steltz SK, et al. Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial. BMJ [Internet]. 2018;363:4583. Available from: https://dx.doi.org/10.1136/bmj.k4583
Ted Eytan, MD