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Supporters claim the exclusive focus on reducing fat is oversimplified, and that low-fat diets are not automatically healthy ones. The western world is not suffering from a collective failure of will to exercise, but has been encouraged to eat more carbohydrates, which in turn stimulate appetite and more eating.

Replacement of calories from carbohydrates with meat may result in high consumption of saturated fat and cholesterol, which many authorities believe will increase the risk of heart disease. Moreover, it has been hypothesised that the kidneys can become overworked and that a related change in blood acidity can lead to bone loss, but trials testing the hypothesis have found no evidence of kidney damage or loss of bone.

Advocates point to scientific trials demonstrating the efficacy and safety of low carb diets. Several independent clinical trials have shown that low carb diets can successfully be used to lose weight. These trials found that, in the short term, risk factors for heart disease and diabetes — such as blood serum cholesterol and insulin levels — tended to improve in spite of increased consumption of saturated fat and cholesterol. The trials were of short duration, and were not able to assess the long-term health effects of the diet.