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Article

The Effect of Short-Term Healthy Ketogenic Diet Ready-To-Eat Meals Versus Healthy Ketogenic Diet Counselling on Weight Loss in Overweight Adults: A Pilot Randomized Controlled Trial

by
Melissa Hui Juan Tay
1,*,
Qai Ven Yap
2,
Su Lin Lim
3,
Yuki Wei Yi Ong
4,
Victoria Chantel Hui Ting Wee
4 and
Chin Meng Khoo
5
1
Department of Dietetics, National University Hospital, Singapore 119074, Singapore
2
Biostatistics Unit, Yong Loo Lin School of Medicine, National University Singapore, Singapore 117597, Singapore
3
Asia Longevity Medical Centre, Singapore 238859, Singapore
4
Nutrition and Dietetics, Health and Social Sciences, Singapore Institute of Technology, Singapore 828608, Singapore
5
Division of Endocrinology, Department of Medicine, National University Hospital, Singapore 119074, Singapore
*
Author to whom correspondence should be addressed.
Nutrients 2025, 17(15), 2541; https://doi.org/10.3390/nu17152541 (registering DOI)
Submission received: 19 June 2025 / Revised: 30 July 2025 / Accepted: 31 July 2025 / Published: 1 August 2025

Abstract

Background/Objectives: Conventional ketogenic diets, although effective for weight loss, often contain high total and saturated fat intake, which leads to increased low-density lipoprotein cholesterol (LDL-C). Thus, the Healthy Ketogenic Diet (HKD) was developed to address these concerns. It emphasizes calorie restriction, limiting net carbohydrate intake to 50 g per day, prioritizing unsaturated fats, and reducing saturated fat intake. However, adherence to the HKD remains a challenge in urban, time-constrained environments. Therefore, this pilot randomized controlled trial aimed to investigate the effects of Healthy Ketogenic Diet Ready-To-Eat (HKD-RTE) meals (provided for the first month only) versus HKD alone on weight loss and metabolic parameters among overweight adults. Methods: Multi-ethnic Asian adults (n = 50) with a body mass index (BMI) ≥ 27.5 kg/m2 were randomized into the HKD-RTE group (n = 24) and the HKD group (n = 26). Both groups followed the HKD for six months, with the HKD-RTE group receiving HKD-RTE meals during the first month. Five in-person workshops and mobile health coaching through the Nutritionist Buddy Keto app helped to facilitate dietary adherence. The primary outcome was the change in body weight at 6 months. Linear regression was performed on the change from baseline for each continuous outcome, adjusting for demographics and relevant covariates. Logistic regression was performed on binary weight loss ≥5%, adjusting for demographics and relevant covariates. Results: In the HKD group, participants’ adherence to the 50 g net carbohydrate target was 15 days, while that in the HKD-RTE group was 19 days over a period of 30 days. Participants’ adherence to calorie targets was 21 days in the HKD group and 23 days in the HKD-RTE. The average compliance with the HKD-RTE meals provided in the HKD-RTE group was 55%. The HKD-RTE group experienced a greater percentage weight loss at 1 month (−4.8 ± 3.0% vs. −1.8 ± 6.2%), although this was not statistically significant. This trend continued up to 6 months, with the HKD-RTE group showing a greater percentage weight reduction (−8.6 ± 6.8% vs. −3.9 ± 8.6%; p = 0.092). At 6 months, the HKD-RTE group had a greater reduction in total cholesterol (−0.54 ± 0.76 mmol/L vs. −0.05 ± 0.56 mmol/L; p = 0.283) and LDL-C (−0.43 ± 0.67 mmol/L vs. −0.03 ± 0.52 mmol/L; p = 0.374) compared to the HKD group. Additionally, the HKD-RTE group exhibited greater reductions in systolic blood pressure (−8.3 ± 9.7 mmHg vs. −5.3 ± 11.0 mmHg), diastolic blood pressure (−7.7 ± 8.8 mmHg vs. −2.0 ± 7.0 mmHg), and HbA1c (−0.3 ± 0.5% vs. −0.1 ± 0.4%) than the HKD group (not statistically significant for any). Conclusions: Both HKD-RTE and HKD led to weight loss and improved metabolic profiles. The HKD-RTE group tended to show more favorable outcomes. Short-term HKD-RTE meal provision may enhance initial weight loss, with sustained long-term effects.
Keywords: healthy ketogenic diet; weight loss; obesity; meal replacement; metabolic outcomes; Asian; adults healthy ketogenic diet; weight loss; obesity; meal replacement; metabolic outcomes; Asian; adults

Share and Cite

MDPI and ACS Style

Tay, M.H.J.; Yap, Q.V.; Lim, S.L.; Ong, Y.W.Y.; Wee, V.C.H.T.; Khoo, C.M. The Effect of Short-Term Healthy Ketogenic Diet Ready-To-Eat Meals Versus Healthy Ketogenic Diet Counselling on Weight Loss in Overweight Adults: A Pilot Randomized Controlled Trial. Nutrients 2025, 17, 2541. https://doi.org/10.3390/nu17152541

AMA Style

Tay MHJ, Yap QV, Lim SL, Ong YWY, Wee VCHT, Khoo CM. The Effect of Short-Term Healthy Ketogenic Diet Ready-To-Eat Meals Versus Healthy Ketogenic Diet Counselling on Weight Loss in Overweight Adults: A Pilot Randomized Controlled Trial. Nutrients. 2025; 17(15):2541. https://doi.org/10.3390/nu17152541

Chicago/Turabian Style

Tay, Melissa Hui Juan, Qai Ven Yap, Su Lin Lim, Yuki Wei Yi Ong, Victoria Chantel Hui Ting Wee, and Chin Meng Khoo. 2025. "The Effect of Short-Term Healthy Ketogenic Diet Ready-To-Eat Meals Versus Healthy Ketogenic Diet Counselling on Weight Loss in Overweight Adults: A Pilot Randomized Controlled Trial" Nutrients 17, no. 15: 2541. https://doi.org/10.3390/nu17152541

APA Style

Tay, M. H. J., Yap, Q. V., Lim, S. L., Ong, Y. W. Y., Wee, V. C. H. T., & Khoo, C. M. (2025). The Effect of Short-Term Healthy Ketogenic Diet Ready-To-Eat Meals Versus Healthy Ketogenic Diet Counselling on Weight Loss in Overweight Adults: A Pilot Randomized Controlled Trial. Nutrients, 17(15), 2541. https://doi.org/10.3390/nu17152541

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