New study: is low carb sustainable in the long run?

close up of calendar on the table

A team of researchers in Japan has been studying low carbohydrate diets. In a study published in January 2014, the researchers had already found that a moderately low-carbohydrate diet is more effective than calorie restriction for improving lipid profile and blood sugar control in type-2 diabetics.

Now, in a new study, the team set out to find out whether eating a moderate low-carb diet is sustainable, effective and safe long term.

The researchers followed 200 patients with type 2 diabetes over a period of three years. They found that a moderate carbohydrate restriction (70–130 g/day) was enough to have a positive effect on the patients’ health markers, and that the diet is “highly effective, safe and sustainable”. They added that:

Over 36 months, the [moderate low carb] intervention showed sustained effectiveness (without safety concerns) in improving HbA1c, lipid profile, and liver enzymes in Japanese patients with type 2 diabetes.

Nutrients: Efficacy of a Moderately Low Carbohydrate Diet in a 36-Month Observational Study of Japanese Patients with Type 2 Diabetes

One of the big criticisms of low-carbohydrate diets is the claim that they are unsustainable long term, so it’s great to see teams of researchers carrying out studies to find out about the effects of following a low-carbohydrate diet over longer periods of time.

Check out our free guide to learn more about different levels of carbohydrate restriction. We also have some fantastic video courses, like this one, for getting started on a low-carbohydrate diet.

Low carb basics



Low carb for beginners


New study: Four weeks on the keto diet leads to big weight loss and improved health markers

Groundbreaking study: low carb is an effective treatment for fatty liver


  1. Pieter
    2 years on low carb, not looking back :)
  2. Mary Titus
    16 years on a very low carb ketogenic lifestyle. I'm not looking back.
    Reply: #34
  3. C. Steely
    I have been on low carbs or Atkins for two years. All my blood panels are now perfect. A1c is down from 8.9 to 5.0 Liver panel is better now than before starting the diet. I feel better than ever and have lost 35 lbs.
  4. Robin L Olson
    I went no sugar, low carb about 1 year ago, my arrhythmia is so much better and my weight is down 45lbs without exercise or lower any other food intake. Not looking back either
  5. N.Carter
    I hate doing low carb I feel like I’m always just wanting to eat something carb rich or feeling like I can’t just live regularly
    Reply: #30
  6. Cynthia Wellington
    Went lchf about 9 months ago due to chronic migraines. It was a choice between this or epilepsy pills to treat the migraine frequency. I'm down 45lbs. Went from 3 to 5 migraines a week to 1 or 2 a month. Will I ever stop lchf? No! Do I miss the way I used to eat? No! This gave me my life back and dont ever plan on giving it up!
  7. Jean Gonynor
    Been low carb Atkins for most of my adult life (I am 51). My blood work is phenomenal, I have amazing energy, I'm never hungry and I eat wonderful tasty food. I will never go back.
  8. Blaze Jordan
    I went low carb six months ago after being diagnosed as a type 2 diabetic. I've lost 67 lbs. My a1C went from 14.0 down to five point eight in 6 months time. I've adjusted to the lifestyle. I've learned how to eat healthier. But also eat my "guity pleasures" in moderation. I've never felt better and im not Looking back.
  9. Jamie.
    Cutting out any type of macro isn't healthy nor sustainable long term. I don't care what anyone says. But the quality of the carbs count. Instead of bread, rice or pastas, eat vegetables and low glycemic fruits, and watch not too eat too much fruit as it contains sugar it all adds up. Even tho alot of people can do and stay on low carb diets doesn't mean you should or it's healthy for long term overall health.
  10. Marie
    First, I found Keto three years ago while prepping for my wedding. It helped me get skinny and cleared my skin issues.

    Then, I loosened up a bit because...why not? I wanted some cake and pretzels.

    When I got preggo, I stayed low carb. Now that the baby is 1, I've gone back to keto.
    This is the lifestyle that just keeps on giving!!!

    Next up, trying to convince my diabetic mom that most of what she "knows" about food is dusty old science.

  11. Andrea
    Jamie, I hope you add that caveat to high carb low fat too. HCLF is insanely unsustainable. As is vegan (talk about cutting out a food group). Note that HCLF can't fulfill all nutrients without processed wheat (ie the fortified nutrients). Yet low carb and high fat can.
  12. Catherine Leal
    Don't consider it a diet but a wonderful life style change. Practiced low carb for many years. Best ever. Could never go back.
  13. Jamie
    Andrea, absolutely!! I don't eat high carb low fat either. I eat lots of green veggies with olive oil and eat avocado as well, yunno the healthy fats and some seafood sometimes turkey, fruit and whatever I feel I need at the time and I really don't need junk foods, as I dont want that stuff anymore as my palete has grown used to healthier fare, I really believe nothing should be eaten in excess and alone, there is a place in the diet for a combination of fats proteins and carbs. I just dislike extreme diets including low fat. There needs to be a healthy ratio of all the macro and micro. And trust me I've tried every kind of diet. Keto included. I tried keto for a year one time put on weight!. I tried vegan and Atkins low fat , vegetarian ect.... I've literally exhausted myself trying every dam diet out there. At the end each individual should try what works for them. From personal experience diets don't work for me. When I stop obsessing over every little thing and just focus on foods that nourish and help my body is when I look and feel my best. Low carb and low fat both made me feel terrible and I didn't feel it was sustainable for me. Each body is different. But I think cutting out nutrient rich food groups is a recipe for disaster. It is. I do a lot of nutritional science and research as I love it and it is my passion to help and educate others, I love to help prople feel good and want others to live long pain free lives:)
  14. Jamie
    I also enjoy naturally eating only when hungry. Which for me is a natural form of intermittent fasting. Usually I go most days anywhere from 16 at least till 23hours, even sometimes every 46 hours if I start to feel sluggish and want a reset in my digestion. I believe Dr fung on his studies, on the timing of eating being even more important, since no matter what you eat healthy or not, that every time you eat something your insulin goe up if you can reduce the amount of times you eat you reduce the amount of times insulin goes up which causes fat storage on your body if its constantly going up.Intermittent fasting also is supposed to help us live longer I advise anyone to look into intermittent fasting even if you only fast 12 hours you still get some great benefits most people do that unknowingly already overnight when they eat their last meal.
  15. Wiscdev
    The study linked from this post says it was for six months. Nowhere does it say 3 years. In fact it ends with: "Because the number of subjects enrolled was small and the study duration was short, longer multi-
    centre studies with a larger sample size are needed to con-
    firm our findings." The study does not appear to be about long term low carb diets at all.
    Reply: #32
  16. Mary
    I followed a low carb high fat diet for years and it was fantastic until about 10 years later when I developed an allergy to eggs ( ate too many) an intolerance to high fat causing inflammation in joints (early onset arthritis) and endless fatigue due to low blood sugar. I learned so much from the diet though so I continue to practice the basics but now I eat more whole grains and fruit and am able to maintain a steady healthy weight and feel better doing it!
  17. Imright
    Wow, what a load of crap. Lol low carb, good luck not getting a heart attack by 25.
    Replies: #20, #31
  18. Freddie
    Ask the Inuit- it was their traditional diet for centuries. I think that constitutes a long-term study and the answer is yes, sustainable for a lifetime.
  19. Gary
    I'm on a carb only diet (I eat nothing but potatoes and pizza crusts), and I feel fantastic! ??
  20. Mark Twain
    Imright- I've been doing it for a long time (20) year. I'm healthy as can be. No medical issues. Praised by my doctor for excellent health. So, where's your facts to support I'll get a heart attack?? Your comment is deplorable. I know what it's done for me, and read all the comments of folks on it...nothing but praise. You should change your name to "imwrong".
  21. Mark
    Can anyone tell me how to maintain and not lose or gain after I've reached my weight loss goal? I've been limiting carbs to 30 per day on keto. I've almost reached my goal and want to maintain.
  22. Valerie
    You conveniently forgot to mention the weight loss results. About 1kg lost after 3 years.
    Disappointing, to say the least.
    Given that most people look into the low-carb diet for weight loss purposes, using this study to claim that it is "effective" is just plain dishonest.
  23. Margie
    The link where it says “new study” is to a 2014 study. In the middle there is a different link which is to the study being discussed in the article.
  24. Bryan
    Been doing low carb for 4 months and have never felt better. I have more energy, feel full with less calories, and have lost a significant amount of weight. I have no desire to eat carbs again.
  25. Lesley
    I've been low sugar, low carbs, high fat, high protein for 3 months. Lost 12 kg with no extra exercise. Never really feel hungry, have never felt better. Keep sugar to 24g/day and carbs around 50 to 100g/day. Totally sustainable and easy.
  26. Julian
    I am 58 exceptionally active and still take part in competitive MMA.
    I stay low carb most of the time but every few months need to have a beer and a pizza, normally for my sins I pay a penance of several days 24 hour fasting.
    WHY does beer not show it's carb content on the label instead of just it's alcohol % ?
  27. Esther
    These studies are encouraging.

    I am about 4 months into LCHF. I have told lots of friends about it. One friend had fatty liver. And another high cholesterol/ weight.
    They are doing quite well, and spreading the word :-)
    I’m on a plateau with my weight, but all clothes are loose. So still happy :-)
    And will never go back to my old eating habits

  28. robert
    LCHF + IF since Feb 2014 = 4 years 2 months. All is very good. It IS sustainable!
  29. Tanya
    May 15th will be 2 years on keto. Down 60 lbs. and feel amazing. No longer even think about the pre-diabetic state I was in. I will never go back to the sad life I was living then. It is definitely sustainable.
  30. John
    This means that you are insuline resistant. Keep it up and the cravings will disappear.
  31. John
    Seriously, did you do any research or are you ignorant?
  32. Antoinette
    It talks about a 36 month study, last I checked 36 months:12=3 years!
  33. ? nk
    I have thyroid and cholesterol issues and am within the suggested bmi..tried Keto meal plan suggested by diet doctor for two weeks and barely lost a kg?If you notice there is a day where you are eating 4 eggs? I have now gone back to my usual pattern and my conclusion is that if you have been eating well and in moderation then Keto is definitely NOT A WAY to go!i felt more stressed ? than anything to be honest..
  34. Sarah Red
    Mary this is exactly what I need to hear. 16 years is maybe the longest i've heard people go. I want to make sure it's long term sustainable.
  35. Murray
    I’ve been following a low carb lifestyle for just over 6 months and have dropped 90 pounds so far. I have occasional cheats but have found that my hunger is satisfied and cravings for junk food is lowered. I can’t see going back to old poor habits when this seems so easy.
  36. Chuck
    In Feb 2021, my a1c was 8.8, up from 6.8 three months earlier. My triglercerices and hdl were skyrocketing also. The same day I started on keto. No sugar, no sweets, no bread, no starch. Three months later, my a1c was 5.7; triglycerices and HDL were cut by 2/3, and my kidney and liver functions returned to normal. I lost 50 pounds. My six month blood work was even better. My 54 year old blood looks like the blood of a teenager. No meds. In a few weeks I'll be at the 1 year mark on my very low carb diet. Weight is still off and I feel great. It's a life changer and a life saver. I can never go back.
  37. PatG
    60 years old been LCHF for over 7 mos. HbA1c was 10.1 now 5.4. Trig to HDL ratio .867. VLDL 12, yes twelve. Lost 23 lbs 193 to170 abs always visible. Never hungry, sleep way better off Metformin. Staying LCHF forever.

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