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Keywords = ketogenic low-carbohydrate

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19 pages, 1376 KiB  
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, Qai Ven Yap, Su Lin Lim, Yuki Wei Yi Ong, Victoria Chantel Hui Ting Wee and Chin Meng Khoo
Nutrients 2025, 17(15), 2541; https://doi.org/10.3390/nu17152541 - 1 Aug 2025
Viewed by 331
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 [...] Read more.
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. Full article
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19 pages, 3780 KiB  
Article
Effects of Soy Protein on Liver and Adipose Tissue Inflammation and Gut Microbiota in Mice Fed with Ketogenic Diets
by Wen-Keng Li, I-Ting Wu, Wan-Ju Yeh, Wen-Chih Huang and Hsin-Yi Yang
Nutrients 2025, 17(15), 2428; https://doi.org/10.3390/nu17152428 - 25 Jul 2025
Viewed by 341
Abstract
Background: Studies on ketogenic diets with a higher percentage of fat composition have revealed conflicting results regarding the modulation of lipid metabolism and tissue inflammation. Furthermore, studies on soy protein consumption in ketogenic diets remain limited. In this study, the effects of [...] Read more.
Background: Studies on ketogenic diets with a higher percentage of fat composition have revealed conflicting results regarding the modulation of lipid metabolism and tissue inflammation. Furthermore, studies on soy protein consumption in ketogenic diets remain limited. In this study, the effects of ketogenic diets on hepatic and adipose tissue inflammation and of soy protein replacement in ketogenic diets were investigated. Methods: Mice were randomly assigned to a control diet (C), ketogenic diet (KD), or ketogenic with soy protein (KS) groups for an 18-week experiment. Both ketogenic diet groups were fed a low-carbohydrate, high-fat diet during the first 12 weeks and a ketogenic diet during the last 6 weeks of the experiment. The KS group was fed the same diet as the KD group, but soy protein was substituted for casein during the last 6 weeks. Results: The KD and KS groups exhibited higher plasma β-hydroxybutyrate levels; a higher incidence of hyperlipidemia; and lower blood glucose, mesenteric fat mass, adipose tissue TNF-α, IL-1β levels, and NLRP3 protein expression compared with the C group. In the gut microbiota analysis, the KD group had a higher F-B ratio than the C group. Greater A. muciniphila abundance and a lower F-B ratio were noted in the KS group compared with the KD group. Conclusions: Although ketogenic diets decreased mesenteric fat mass and adipose tissue inflammation and modulated NLRP3 expression, they were associated with hepatic inflammation and gut dysbiosis. Soy protein consumption in a ketogenic diet did not differ from casein consumption regarding diet-induced tissue inflammation, but it may have altered the gut microbiota. Full article
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14 pages, 1004 KiB  
Article
Beyond Weight Loss: Comparative Effects of Tirzepatide Plus Low-Energy Ketogenic Versus Low-Calorie Diet on Hepatic Steatosis and Stiffness in MASLD
by Luigi Schiavo, Biagio Santella, Monica Mingo, Gianluca Rossetti, Marcello Orio and Vincenzo Pilone
Nutrients 2025, 17(15), 2409; https://doi.org/10.3390/nu17152409 - 24 Jul 2025
Viewed by 453
Abstract
Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver condition globally, strongly linked to obesity, insulin resistance, and type 2 diabetes (T2D). Tirzepatide (TZP), a dual GIP/GLP-1 receptor agonist, improves glycemic control and reduces body weight and the [...] Read more.
Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver condition globally, strongly linked to obesity, insulin resistance, and type 2 diabetes (T2D). Tirzepatide (TZP), a dual GIP/GLP-1 receptor agonist, improves glycemic control and reduces body weight and the liver fat content in patients with obesity and T2D. However, its effect on liver-specific outcomes such as steatosis and fibrosis remains incompletely characterized. Low-energy ketogenic therapy (LEKT), a nutritional strategy characterized by carbohydrate restriction and nutritional ketosis, may enhance hepatic β-oxidation and reduce hepatic lipogenesis. To date, however, the combination of TZP and LEKT has not been studied in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). This study aimed to compare the hepatic and metabolic effects of TZP combined with either LEKT or a conventional low-calorie diet (LCD) over a 12-week period. Methods: Sixty adult patients with MASLD undergoing TZP therapy were prospectively assigned to either an LEKT or a conventional LCD, with 30 participants per group. As primary endpoints, the controlled attenuation parameter (CAP, an index of hepatic steatosis) and liver stiffness measurement (LSM, an index of liver fibrosis) were assessed at the baseline and after 12 weeks using FibroScan®. Secondary outcomes included changes in body mass index (BMI), glycated hemoglobin (HbA1c), and liver enzymes. Adherence to both diet and pharmacological treatment, as well as tolerability, were systematically monitored throughout the intervention period. Results: Both groups showed significant reductions in body weight (TZP + LEKT, p = 0.0289; TZP + LCD, p = 0.0278), with no significant intergroup difference (p = 0.665). CAP and LSM improved significantly in both groups, but reductions were greater in the TZP + LEKT group (CAP −12.5%, p < 0.001; LSM −22.7%, p < 0.001) versus LCD (CAP −6.7%, p = 0.014; LSM −9.2%, p = 0.022). Between-group differences were statistically significant for both CAP (p = 0.01) and LSM (p = 0.03). Conclusions: Based on these preliminary findings, we support the hypothesis that the combination of TZP and LEKT may be superior to TZP with an LCD in reducing hepatic steatosis and stiffness in individuals with obesity. Full article
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18 pages, 1430 KiB  
Article
BMI-Specific Nutritional Education Priorities for Weight Management in Osteoarthritis
by Ashley N. Buck, Danae C. Gross, Jieun (Jenna) Kim, Erica L. Rauff, Jennifer M. Dinallo, Lauren M. Abbate, Todd A. Schwartz, Nicholas J. Beresic, Connie B. Newman and Sarah P. Shultz
Nutrients 2025, 17(13), 2056; https://doi.org/10.3390/nu17132056 - 20 Jun 2025
Viewed by 603
Abstract
Background/Objectives: The educational needs of individuals with OA and obesity can drive personalized resources for effective dietary interventions that align patient interests with weight and disease management. Therefore, the purpose of the present study was to evaluate differences in nutritional education topics [...] Read more.
Background/Objectives: The educational needs of individuals with OA and obesity can drive personalized resources for effective dietary interventions that align patient interests with weight and disease management. Therefore, the purpose of the present study was to evaluate differences in nutritional education topics of interest between patients with OA who are characterized as having higher (≥30 kg/m2; HBMI) and lower BMI (<30 kg/m2; LBMI). Methods: Cross-sectional survey data (n = 296) were dichotomized into HBMI (n = 172; BMI: 38.67 ± 6.59 kg/m2) and LBMI (n = 124; BMI: 25.59 ± 3.00 kg/m2) groups. A mixed-method approach examined group differences across four primary domains: (i) strategies for weight management and healthy lifestyle, (ii) interest in vitamins and supplements, (iii) foods and nutrient with anti-inflammatory properties, and (iv) dietary patterns for weight loss. Logistic regression models compared topic interests between groups. Thematic analysis of open-ended responses captured additional insights. Results: Compared to LBMI participants, those in the HBMI group showed greater interest in weight loss strategies, emotional eating, and diets such as low-carbohydrate and ketogenic approaches, but less interest in general supplement information and plant-based diets. HBMI also had greater interest in practical strategies (e.g., feeling full, affordable foods) and reduced interest in certain anti-inflammatory foods. Both groups expressed a desire for evidence-based resources on foods that promote joint health. Conclusions: BMI-specific differences in nutritional education preferences highlight the need for tailored, patient-centered strategies in OA management. Addressing these differences may improve the effectiveness of education interventions and enhance patient–provider communication around diet and lifestyle in OA care. Full article
(This article belongs to the Special Issue The Role of Physical Activity and Diet on Weight Management)
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14 pages, 257 KiB  
Review
Low-Carb and Ketogenic Diets in Type 1 Diabetes: Efficacy and Safety Concerns
by Emmanouil Korakas, Aikaterini Kountouri, Goran Petrovski and Vaia Lambadiari
Nutrients 2025, 17(12), 2001; https://doi.org/10.3390/nu17122001 - 14 Jun 2025
Viewed by 1431
Abstract
Despite advances in technology, the overall management of type 1 diabetes mellitus (T1DM) remains suboptimal. The idea of restricting carbohydrate intake to decrease glycemic spikes and insulin requirements has been revisited in recent years. After impressive results in the fields of type 2 [...] Read more.
Despite advances in technology, the overall management of type 1 diabetes mellitus (T1DM) remains suboptimal. The idea of restricting carbohydrate intake to decrease glycemic spikes and insulin requirements has been revisited in recent years. After impressive results in the fields of type 2 diabetes (T2DM) and epilepsy, low-carbohydrate (LCD) and ketogenic (KD) diets have gained renewed interest as a possible treatment option for T1DM. In this narrative review, we discuss the available data regarding LCDs and KDs in both the adult and pediatric populations. Research data is still scarce, as most studies are short-term and show considerable heterogeneity in dietary composition and patient outcomes. In general, carbohydrate restriction enhances glycemic control by reducing postprandial glucose excursions, improving time-in-range, and lowering HbA1c, with conflicting effects on other parameters such as lipid profile and body weight. Adverse effects such as hypoglycemia and diabetic ketoacidosis are rarely reported, although some concerns have been raised regarding growth in children. The correct implementation of these diets requires a multidisciplinary approach by highly specialized healthcare professionals, who will address the medical, social, and psychological concerns that a restrictive diet entails. Large-scale and long-term studies are needed to provide more robust data before carbohydrate restriction can be widely applied to patients with T1DM. Full article
(This article belongs to the Special Issue Advances in Nutrition and Lifestyle Interventions for Type 1 Diabetes)
40 pages, 1730 KiB  
Review
Integrative Strategies for Preventing and Managing Metabolic Syndrome: The Impact of Exercise and Diet on Oxidative Stress Reduction—A Review
by Ana Onu, Daniela-Marilena Trofin, Andrei Tutu, Ilie Onu, Anca-Irina Galaction, Dragos-Petrica Sardaru, Dan Trofin, Cristiana Amalia Onita, Daniel-Andrei Iordan and Daniela-Viorelia Matei
Life 2025, 15(5), 757; https://doi.org/10.3390/life15050757 - 8 May 2025
Cited by 3 | Viewed by 2400
Abstract
Metabolic syndrome (MetS) is characterized by central obesity, insulin resistance, hypertension, dyslipidemia, and chronic inflammation, significantly increasing the risk of cardiovascular disease and type 2 diabetes. Effective management of MetS is critical, with exercise being a key intervention. This review analyzed the effects [...] Read more.
Metabolic syndrome (MetS) is characterized by central obesity, insulin resistance, hypertension, dyslipidemia, and chronic inflammation, significantly increasing the risk of cardiovascular disease and type 2 diabetes. Effective management of MetS is critical, with exercise being a key intervention. This review analyzed the effects of different exercise intensities—low, moderate, and high-intensity interval training (HIIT)—on metabolic health, oxidative stress (OS), inflammation, and cardiovascular function. A search of Medline, PEDro, and EBSCO identified 2251 articles, with 159 studies published between 1999 and 2025 included after screening. Low-intensity exercise improved insulin sensitivity, reduced OS markers (e.g., MDA, 8-OHdG), and enhanced antioxidant enzyme activity. Moderate-intensity exercise showed similar benefits with notable reductions in inflammatory markers (e.g., IL-1β, TNF-α). HIIT promoted fat loss and improved metabolic markers but temporarily increased OS and inflammation. Dietary strategies also play a critical role. The Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH) diets are well established, emphasizing nutrient-dense foods like unsaturated fats and fiber to reduce inflammation and manage weight. The ketogenic diet (KD), a high-fat, low-carbohydrate approach, has recently gained attention for its metabolic benefits. KD induces ketosis, improving insulin sensitivity, reducing triglycerides, and enhancing fat oxidation. Studies show KD effectively reduces body weight and glucose levels, though long-term adherence and nutrient deficiencies remain challenges. Intermittent fasting also showed potential benefits, though effects on glucose metabolism were inconsistent. This review underscores the need for tailored approaches combining exercise, diet, and fasting to optimize MetS outcomes, offering integrative strategies for prevention and management. Full article
(This article belongs to the Special Issue Diet and Vascular Disease)
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17 pages, 812 KiB  
Review
Ketogenic Diet in Steatotic Liver Disease: A Metabolic Approach to Hepatic Health
by Fabrizio Emanuele, Mattia Biondo, Laura Tomasello, Giorgio Arnaldi and Valentina Guarnotta
Nutrients 2025, 17(7), 1269; https://doi.org/10.3390/nu17071269 - 4 Apr 2025
Cited by 3 | Viewed by 2655
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major cause of chronic liver dysfunction worldwide, characterized by hepatic steatosis that may progress to nonalcoholic steatohepatitis and cirrhosis. Owing to its strong association with metabolic disorders, current management focuses on weight reduction via lifestyle [...] Read more.
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major cause of chronic liver dysfunction worldwide, characterized by hepatic steatosis that may progress to nonalcoholic steatohepatitis and cirrhosis. Owing to its strong association with metabolic disorders, current management focuses on weight reduction via lifestyle modifications. Recently, the very-low-calorie ketogenic diet (VLCKD) has emerged as a promising intervention due to its potential for rapid weight loss and reduction in liver fat. This review aims to evaluate the clinical evidence regarding the impact of ketogenic diets on hepatic steatosis. We conducted an extensive MEDLINE literature search in databases including PubMed, Scopus, and Web of Science up to December 2024. Studies assessing the effects of ketogenic or low-carbohydrate high-fat diets on liver fat, evaluated by imaging, histology, or biochemical markers, were included. The analysis indicates that ketogenic diets significantly reduce hepatic fat content and improve metabolic parameters, including insulin sensitivity and liver enzyme levels. Evidence further suggests that substituting saturated fats with unsaturated fats or replacing carbohydrates with proteins may enhance these benefits. However, considerable variability exists among studies and long-term data remain limited. Although short-term outcomes are encouraging, potential adverse effects such as dyslipidaemia, gastrointestinal disturbances, and transient ‘keto flu’ symptoms require careful clinical monitoring. Future research should focus on elucidating underlying mechanisms, optimizing dietary composition, and assessing long-term safety to establish ketogenic diets as a robust strategy for managing MASLD. Full article
(This article belongs to the Special Issue Clinical Impact of Ketogenic Diet)
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25 pages, 2040 KiB  
Review
Investigating the Therapeutic Potential of the Ketogenic Diet in Modulating Neurodegenerative Pathophysiology: An Interdisciplinary Approach
by Iqra Shabbir, Keying Liu, Bakhtawar Riaz, Muhammad Farhan Rahim, Saiyi Zhong, Jude Juventus Aweya and Kit-Leong Cheong
Nutrients 2025, 17(7), 1268; https://doi.org/10.3390/nu17071268 - 4 Apr 2025
Cited by 2 | Viewed by 4947
Abstract
The ketogenic diet (KD) is a dietary intervention comprising a high-fat, low-carbohydrate, and moderate-protein intake designed to induce a metabolic state known as ketosis, whereby ketone bodies are produced as an alternative source of energy. Initially established as a treatment for intractable epilepsy, [...] Read more.
The ketogenic diet (KD) is a dietary intervention comprising a high-fat, low-carbohydrate, and moderate-protein intake designed to induce a metabolic state known as ketosis, whereby ketone bodies are produced as an alternative source of energy. Initially established as a treatment for intractable epilepsy, the KD has subsequently gained significant attention for its potential to manage neurodegenerative diseases, including Alzheimer’s, Parkinson’s, and Huntington’s disease. Ketone bodies, such as beta-hydroxybutyrate (BHB), have been demonstrated to possess neuroprotective properties. The increasing prevalence of neurodegenerative diseases, such as Alzheimer’s, Parkinson’s, and Huntington’s disease, poses a significant public health challenge worldwide. With neurological disorders being the second-leading cause of death globally, the need for effective therapeutic interventions has never been more urgent. Recent evidence suggests that dietary interventions, particularly the ketogenic diet, offer promising potential in mitigating the progression of these diseases by influencing metabolic processes and providing neuroprotective benefits. The ketogenic diet, characterized by high-fat and low-carbohydrate intake, induces ketosis, leading to the production of ketone bodies like beta-hydroxybutyrate, which enhance mitochondrial efficiency, reduce oxidative stress, and modulate inflammatory pathways—mechanisms critical in neurodegenerative pathophysiology. This review explores the role of the ketogenic diet in managing neurological conditions, examining its mechanisms of action, historical context, and therapeutic efficacy. The paper also discusses emerging evidence linking the ketogenic diet to improved cognitive function, reduced motor symptoms, and enhanced mitochondrial activity in patients with neurodegenerative disorders. Additionally, the review highlights the need for further research to refine the therapeutic applications of the ketogenic diet, investigate its impact on various neurodegenerative diseases, and better understand its potential long-term effects. This study underscores the importance of nutrition as a vital aspect of the treatment strategy for neurological diseases, advocating for continued exploration of dietary interventions to improve brain health and function. Full article
(This article belongs to the Section Nutrition and Neuro Sciences)
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14 pages, 6260 KiB  
Review
Ketogenic Diet and Gut Microbiota: Exploring New Perspectives on Cognition and Mood
by Yuhan Jiang, Yili Chen, Youmeng Chen, Xinrong Gong, Zhiyu Chen and Xin Zhang
Foods 2025, 14(7), 1215; https://doi.org/10.3390/foods14071215 - 30 Mar 2025
Cited by 1 | Viewed by 3203
Abstract
The ketogenic diet (KD) is a dietary regimen characterized by low carbohydrate intake and moderate protein levels, designed to simulate a fasting state and induce ketosis for the production of ketone bodies from fat. Emerging research underscores KD’s potential in improving cognitive functions [...] Read more.
The ketogenic diet (KD) is a dietary regimen characterized by low carbohydrate intake and moderate protein levels, designed to simulate a fasting state and induce ketosis for the production of ketone bodies from fat. Emerging research underscores KD’s potential in improving cognitive functions and regulating mood. Investigations into its safety and efficacy have centered on its anti-inflammatory properties and its impact on neurological health and the gut–brain axis (GBA). This review delves into the relationship between the KD and gut microbiota, emphasizing its potential role in cognitive enhancement and mood stabilization, particularly for managing mood disorders and depression. The investigation of the KD’s physiological effects and its role in promoting cognition and emotion through gut microbiota will pave the way for innovative approaches to personalized dietary interventions. Full article
(This article belongs to the Special Issue Interactions Between Food Compounds and Gut Microbiota)
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19 pages, 5115 KiB  
Article
Sex-Specific Anti-Inflammatory Effects of a Ketogenic Diet in a Mouse Model of Allergic Airway Inflammation
by Carolyn D. Ekpruke, Omar Borges-Sosa, Christiane A. Hassel, Dustin Rousselle, Lyidia Dinwiddie, Maksat Babayev, Ahmed Bakare and Patricia Silveyra
Int. J. Mol. Sci. 2025, 26(7), 3046; https://doi.org/10.3390/ijms26073046 - 26 Mar 2025
Viewed by 891
Abstract
Asthma, a chronic inflammatory airway disease, leads to airflow obstruction and exhibits sex differences in prevalence and severity. Immunomodulatory diets, such as the ketogenic diet (high fat, low carbohydrate, moderate protein), may offer complementary benefits in managing airway inflammation. While anti-inflammatory effects of [...] Read more.
Asthma, a chronic inflammatory airway disease, leads to airflow obstruction and exhibits sex differences in prevalence and severity. Immunomodulatory diets, such as the ketogenic diet (high fat, low carbohydrate, moderate protein), may offer complementary benefits in managing airway inflammation. While anti-inflammatory effects of ketogenic diets are documented in cardiovascular diseases, their impact on asthma, especially regarding sex-specific differences, remains unexplored. Few studies on diet and asthma have considered sex as a biological factor. To test the hypothesis that a ketogenic diet affects airway inflammation in a sex-specific manner, we used a mouse allergic airway inflammation model. Male and female C57BL/6J mice (3–4 weeks old, n = 5–6/group) were fed a ketogenic diet or normal chow for 12 weeks. From weeks 7 to 12, mice were challenged intranasally with house dust mite allergens (HDM) 5 days/week to induce airway inflammation. Lung tissue was analyzed 72 h post-exposure using flow cytometry to assess immune cell populations, and data were analyzed with two-way ANOVA. The ketogenic diet increased body weight in allergen-exposed mice, with a greater effect in males than females (p = 0.0512). Significant sex–diet interactions were noted for alveolar macrophages, CD103+, CD11B+, and plasmacytoid dendritic cells (p < 0.05). Eosinophil reductions were observed in males but not females on the ketogenic diet. The diet also increased NKT cells and decreased NK cells in males but not females (p < 0.001). These findings highlight sex-specific effects of ketogenic diets on lung immune responses, with stronger impacts in males. Full article
(This article belongs to the Special Issue Molecular Research in Asthma and Allergy)
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17 pages, 866 KiB  
Article
Low-Carbohydrate (Ketogenic) Diet in Children with Obesity: Part 1—Diet Impact on Anthropometric Indicators and Indicators of Metabolic Syndrome and Insulin Resistance
by Ivanka N. Paskaleva, Nartsis N. Kaleva, Teodora D. Dimcheva, Petya P. Markova and Ivan S. Ivanov
Diseases 2025, 13(4), 94; https://doi.org/10.3390/diseases13040094 - 25 Mar 2025
Viewed by 1079
Abstract
Background: The ketogenic diet has been successfully used in the last 100 years in the treatment of epilepsy and other neurological disorders. In recent decades, it gained wider application in the treatment of obesity, metabolic syndrome, and type 2 diabetes. However, there have [...] Read more.
Background: The ketogenic diet has been successfully used in the last 100 years in the treatment of epilepsy and other neurological disorders. In recent decades, it gained wider application in the treatment of obesity, metabolic syndrome, and type 2 diabetes. However, there have been only a few studies on its use in children with obesity and associated metabolic disorders. Objectives: To determine the clinical and metabolic effects of a well-formulated low-carbohydrate (ketogenic) diet in children with obesity. Methods: One hundred children with obesity and metabolic disorders underwent initial anthropometric, laboratory, and ultrasound examinations. They were placed on a well-formulated ketogenic diet and monitored for 4 months. The 58 patients who completed the study underwent follow-up examinations to assess the effects of the diet on anthropometric, clinical, and laboratory markers of metabolic syndrome and insulin resistance, cardiovascular risk factors, and certain hormone levels. Compliance with the diet, common difficulties in adhering to it, side effects, and positive changes in the patients’ health were analyzed. Results: At the end of the study, the average weight loss for the entire group was 6.45 kg, with a reduction in BMI of 3.12 kg/m2. Significant improvements were also observed in insulin resistance indicators, including fasting insulin levels, HOMA-IR index, QUICKI (p < 0.0001), and adiponectin (p = 0.04). The cases of hepatosteatosis decreased twofold, the number of patients with arterial hypertension was significantly reduced, as well as the number of children receiving antihypertensive therapy. Additionally, the number of patients meeting the criteria for metabolic syndrome decreased threefold. Conclusions: A well-formulated short-term ketogenic diet is effective in treating obesity, metabolic syndrome, and related comorbidities, and can be part of a comprehensive approach for these patients. Full article
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21 pages, 1290 KiB  
Review
Structural Concepts, Definition, Classification, and Macronutrient and Food Composition of Carbohydrate-Restricted Diets for Individuals with Type 2 Diabetes Mellitus: A Scoping Review
by Fharlley Lohann Medeiros, Ana Carolina Fernandes, Mariana V. S. Kraemer, Marina Padovan, Greyce Luci Bernardo, Paula Lazzarin Uggioni, Alex Rafacho and Rossana P. C. Proença
Nutrients 2025, 17(6), 1061; https://doi.org/10.3390/nu17061061 - 18 Mar 2025
Viewed by 1532
Abstract
Objective: This study aimed to review the structural concepts, definition, classification, and macronutrient and food composition of carbohydrate-restricted diets (CRDs) for individuals with type 2 diabetes mellitus (T2DM). Methods: A scoping review was conducted following Joanna Briggs Institute guidelines. Searches were performed in [...] Read more.
Objective: This study aimed to review the structural concepts, definition, classification, and macronutrient and food composition of carbohydrate-restricted diets (CRDs) for individuals with type 2 diabetes mellitus (T2DM). Methods: A scoping review was conducted following Joanna Briggs Institute guidelines. Searches were performed in Scopus, PubMed, Web of Science, and Embase, including texts published in Portuguese, English, and Spanish. Official documents from governments, regulatory agencies, and international diabetes organizations were also consulted. Results: In total, 79 articles and 17 official documents were analyzed. The following structural concept was identified: restricted carbohydrate intake decreases the need for endogenous and exogenous insulin, contributing to the maintenance of glycemic control, and justifies its consideration among the nutritional therapy options for individuals with T2DM. CRDs varied in definition, classification, and macronutrient composition. Studies failed to provide detailed information on the food composition of diets, precluding an in-depth understanding of metabolic effects. The existence of several approaches with varying recommendations makes it difficult to generalize the results. International CRD guidelines for T2DM adopt divergent definitions, compromising interpretation, recommendation, and even adherence. Conclusions: Although the concept of CRDs justifies their adoption within the nutritional therapy choices for T2DM, the multiple denominations can hinder understanding and comparison between studies. The lack of information on food composition and carbohydrate types compromises the assessment of the effects and adherence to CRD-based nutritional interventions. We emphasize the need for methodologically consistent studies that evaluate CRDs based on fresh and minimally processed foods with a low glycemic index to support official diabetes guidelines and organizations. Full article
(This article belongs to the Special Issue Effects of Sugars and Sugar Alternatives on Human Health and Disease)
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12 pages, 740 KiB  
Opinion
Myths and Facts Regarding Low-Carbohydrate Diets
by Nina Teicholz, Steven M. Croft, Ignacio Cuaranta, Mark Cucuzzella, Mariela Glandt, Dina H. Griauzde, Karen Jerome-Zapadka, Tro Kalayjian, Kendrick Murphy, Mark Nelson, Catherine Shanahan, Jodi L. Nishida, Robert C. Oh, Naomi Parrella, Erin M. Saner, Shebani Sethi, Jeff S. Volek, Micalla Williden and Susan Wolver
Nutrients 2025, 17(6), 1047; https://doi.org/10.3390/nu17061047 - 17 Mar 2025
Cited by 1 | Viewed by 78705
Abstract
As the prevalence of chronic diseases persists at epidemic proportions, health practitioners face ongoing challenges in providing effective lifestyle treatments for their patients. Even for those patients on GLP-1 agonists, nutrition counseling remains a crucial strategy for managing these conditions over the long [...] Read more.
As the prevalence of chronic diseases persists at epidemic proportions, health practitioners face ongoing challenges in providing effective lifestyle treatments for their patients. Even for those patients on GLP-1 agonists, nutrition counseling remains a crucial strategy for managing these conditions over the long term. This paper aims to address the concerns of patients and practitioners who are interested in a low-carbohydrate or ketogenic diet, but who have concerns about its efficacy, safety, and long-term viability. The authors of this paper are practitioners who have used this approach and researchers engaged in its study. The paper reflects our opinion and is not meant to review low-carbohydrate diets systematically. In addressing common concerns, we hope to show that this approach has been well researched and can no longer be seen as a “fad diet” with adverse health effects such as impaired renal function or increased risk of heart disease. We also address persistent questions about patient adherence, affordability, and environmental sustainability. This paper reflects our perspective as clinicians and researchers engaged in the study and application of low-carbohydrate dietary interventions. While the paper is not a systematic review, all factual claims are substantiated with citations from the peer-reviewed literature and the most rigorous and recent science. To our knowledge, this paper is the first to address potential misconceptions about low-carbohydrate and ketogenic diets comprehensively. Full article
(This article belongs to the Special Issue Ketogenic Diet in Therapy and Rehabilitation)
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40 pages, 5510 KiB  
Review
Ketogenic Diets for Body Weight Loss: A Comparison with Other Diets
by Damian Dyńka, Łukasz Rodzeń, Mateusz Rodzeń, Anna Pacholak-Klimas, Georgia Ede, Shebani Sethi, Dorota Łojko, Karolina Bartoń, Ken Berry, Adam Deptuła, Żaneta Grzywacz, Peter Martin, Jen Unwin and David Unwin
Nutrients 2025, 17(6), 965; https://doi.org/10.3390/nu17060965 - 10 Mar 2025
Cited by 2 | Viewed by 58316
Abstract
With the prevalence of obesity and overweight increasing at an alarming rate, more and more researchers are focused on identifying effective weight loss strategies. The ketogenic diet (KD), used as a treatment in epilepsy management for over 100 years, is additionally gaining popularity [...] Read more.
With the prevalence of obesity and overweight increasing at an alarming rate, more and more researchers are focused on identifying effective weight loss strategies. The ketogenic diet (KD), used as a treatment in epilepsy management for over 100 years, is additionally gaining popularity as a weight loss method. Although its efficacy in weight loss is well documented, the areas where it may be beneficial to other dietary approaches need to be carefully examined. The objective of this paper is to identify the potential benefits of the KD over alternative dietary weight loss strategies based on a comprehensive literature review. It has been shown that the KD may be more bioenergetically efficient than other dietary strategies, inter alia owing to its effect on curtailing hunger, improving satiety and decreasing appetite (influence on hunger and satiety hormones and the sensation of hunger), inducing faster initial weight loss (associated with lower glycogen levels and reduced water retention), and controlling glycaemia and insulinemia (directly attributable to the low-carbohydrate nature of KD and indirectly to the other areas described). These effects are accompanied by improved insulin sensitivity, reduced inflammation (through ketone bodies and avoidance of pro-inflammatory sugars), reduced need for pharmacological obesity control (the diet’s mechanisms are similar to those of medication but without the side effects), and positive impacts on psychological factors and food addiction. Based on the authors’ review of the latest research, it is reasonable to conclude that, due to these many additional health benefits, the KD may be advantageous to other diet-based weight loss strategies. This important hypothesis deserves further exploration, which could be achieved by including outcome measures other than weight loss in future clinical trials, especially when comparing different diets of equal caloric value. Full article
(This article belongs to the Special Issue The Effects of Ketogenic Diet on Human Health and Disease)
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24 pages, 1118 KiB  
Review
Dietary Patterns and Migraine: Insights and Impact
by Yi-Hsien Tu, Ching-Mao Chang, Cheng-Chia Yang, I-Ju Tsai, Ying-Chen Chou and Chun-Pai Yang
Nutrients 2025, 17(4), 669; https://doi.org/10.3390/nu17040669 - 13 Feb 2025
Cited by 1 | Viewed by 5175
Abstract
Migraine is a prevalent neurological disorder characterized by significant disability and triggered by various factors, including dietary habits. This review explores the complex relationship between diet and migraine, highlighting both triggering and protective roles of dietary patterns and specific nutrients. Evidence suggests that [...] Read more.
Migraine is a prevalent neurological disorder characterized by significant disability and triggered by various factors, including dietary habits. This review explores the complex relationship between diet and migraine, highlighting both triggering and protective roles of dietary patterns and specific nutrients. Evidence suggests that certain foods, such as alcohol, caffeine, chocolate, MSG, nitrates, and tyramine, can trigger migraines in susceptible individuals. Conversely, dietary interventions, including carbohydrate-restricted diets, ketogenic diets, vitamin D3 supplementation, omega-3 fatty acids, Mediterranean dietary patterns, and increased water intake, have shown potential in reducing migraine frequency and severity. Observational studies also indicate that maintaining a healthy diet, rich in fruits and vegetables and low in processed foods, is associated with better migraine outcomes. The effectiveness of these interventions varies among individuals, underscoring the importance of personalized approaches. Future studies should further explore the role of diet in migraine management, focusing on randomized trials to establish causality and refine dietary recommendations for patients. Full article
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