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Low-Carb vs Low-Fat

Both approaches produce weight loss. The direct comparison in randomised trials shows modest differences — and the most rigorous trial suggests those differences may largely disappear when food quality and calories are matched.

Quick read · 4 min

This may be relevant if you:
  • Are deciding between a low-carb or low-fat approach and want to know what the trials show
  • Have seen conflicting headlines about carbs vs fat and want a clear answer
  • Are trying to find the right dietary approach for the long term
In simple terms:
  • Both low-carb and low-fat diets produce weight loss — they work by creating a caloric deficit
  • In the most rigorous head-to-head trial (DIETFITS, 609 people), there was no significant difference in weight loss at 12 months
  • Low-carb may have a slight advantage in triglycerides and HDL; low-fat may lower LDL more
  • The best approach is the one you can actually maintain long-term — diet preference matters

Based on clinical trials · No rankings · Every claim linked to source

Last reviewed: March 2026

The DIETFITS trial — the most rigorous comparison

DIETFITS
609 adults with overweight · 12 months · Stanford University
JAMA 2018 ↗

When participants in the healthy low-fat group and healthy low-carb group were both instructed to eat high-quality food, minimise processed foods, and eat to satiety, there was no significant difference in weight loss at 12 months between the two approaches. Both groups lost approximately 5–6 kg on average.

Key takeaway: When calories and food quality are matched, macronutrient composition matters less than initially thought. Neither diet was superior at 12 months in this rigorous trial.

Meta-analysis data

33 RCTs · 3,939 participants · 6–23 months

Across 33 randomised controlled trials, low-carbohydrate diets produced 1.33 kg more weight loss than low-fat diets over 6–23 months. Low-carb also showed greater reductions in triglycerides, diastolic blood pressure, and higher HDL cholesterol.

Source: Frontiers in Nutrition 2022 [1]

What each approach offers

Weight loss (6–12 months)
Low-carb
Slight advantage in meta-analysis (+1.33 kg)
Low-fat
Similar when food quality matched (DIETFITS)
Triglycerides
Low-carb
Greater reduction
Low-fat
Smaller reduction
LDL cholesterol
Low-carb
May increase (diet-dependent)
Low-fat
Tends to decrease
HDL cholesterol
Low-carb
Greater increase
Low-fat
Smaller increase
Blood sugar control
Low-carb
Faster initial improvement
Low-fat
Similar long-term

Key caveats

  • The weight loss difference in meta-analyses (~1.33 kg) is modest and may not be clinically meaningful for all individuals.
  • Both approaches work primarily through caloric restriction — neither macronutrient is uniquely fattening or slimming.
  • "Low-carb" and "low-fat" each encompass a broad range of diet quality. An ultra-processed low-fat diet performs differently to a whole-food low-fat diet.
  • Adherence varies widely by individual preference, food culture, and lifestyle. The best diet is the one that can be sustained.
Medical disclaimer: This website is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before starting, stopping, or changing any treatment.

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