Ketogenic diet

Peer-Reviewed Scientific Articles​

Effects of weight loss during a very low carbohydrate diet on specific adipose tissue depots and insulin sensitivity in older adults with obesity: a randomized clinical trial

URL: https://nutritionandmetabolism.biomedcentral.com/articles/10.1186/s12986-020-00481-9
Journal: Nutrition & Metabolism
Publication Date: 08/2020
Summary: Weight loss resulting from consumption of a diet lower in CHO and higher in fat may be beneficial for older adults with obesity by depleting adipose tissue depots most strongly implicated in poor metabolic and functional outcomes and by improving insulin sensitivity and the lipid profile.

Key Takeaways

Older adults were able to deplete excess fat tissue and improve insulin sensitivity by utilizing a ketogenic diet.

Ketogenic Diet and Health

URL: https://www.lidsen.com/journals/icm/icm-06-02-015
Journal: OBM Integrative and Complementary Medicine
Publication Date: 04/2021
Summary: Carbohydrate-restricted ketogenic diets (KD) were introduced in the mid-19th century as a weight loss method with a resurgence of its use in epilepsy treatment in the 1920’s. Research conducted over the last several years provides evidence that KD’s can confer beneficial effects for several chronic metabolic diseases, including obesity, type-2 diabetes, and polycystic ovary syndrome. In recent years, emerging evidence suggests KD’s may also have therapeutic benefits for some cancers and for neurological conditions such as Alzheimer’s disease, Parkinson’s’ disease, multiple sclerosis, traumatic brain injury, and spinal cord injury. Finally, as the physiological mechanisms by which a KD operates become increasingly understood, we speculate that several other health conditions (e.g., autism, cystic fibrosis, COVID-19) that may improve from consuming a KD. The potential to reduce or eliminate long-term pharmaceutical treatments and their potential adverse effects by modifying diet patterns justifies additional research, particularly rigorously conducted clinical trials with long-term follow-up. This brief review describes a selection of the recent studies of KD as applied to chronic metabolic diseases, and provides an estimate of the quality of the evidence for KD’s effects. We also describe and appraise some of the risks and misconceptions attributed to KD which may limit the widespread use of KD’s among physicians and healthcare providers.

Key Takeaways

Since the introduction of the ketogenic diet in the 1920's as a treatment for epilepsy, the diet has proven to show many metabolic benefits that prove useful in the treatment of diseases such as type 2 diabetes, PCOS, obesity, Alzheimer's, Parkinson's, multiple sclerosis, and brain/spinal injuries. This dietary pattern is being studied more and more, and the fact that this dietary treatment can reduce or prevent the use of pharmaceutical medication warrants more rigorous studies. In addition, this dietary pattern may prove useful for other health conditions as well from autism to COVID-19. The ketogenic diet may be pivotal in the future of medicine.

Favorable Effects of a Ketogenic Diet on Physical Function, Perceived Energy, and Food Cravings in Women with Ovarian or Endometrial Cancer:
A Randomized, Controlled Trial

URL: https://pubmed.ncbi.nlm.nih.gov/30200193/
Journal: Nutrients
Publication Date: 08/2018
Summary: Ketogenic diets (KDs) are gaining attention as a potential adjuvant therapy for cancer, but data are limited for KDs’ effects on quality of life. We hypothesized that the KD would (1) improve mental and physical function, including energy levels, (2) reduce hunger, and (3) diminish sweet and starchy food cravings in women with ovarian or endometrial cancer. Participants were randomized to a KD (70:25:5 energy from fat, protein, and carbohydrate) or the American Cancer Society diet (ACS: high-fiber, lower-fat). Questionnaires were administered at baseline and after 12 weeks on the assigned diet to assess changes in mental and physical health, perceived energy, appetite, and food cravings. We assessed both between-group differences and within-group changes using ANCOVA and paired t-tests, respectively. After 12 weeks, there was a significant between-group difference in adjusted physical function scores (p < 0.05), and KD participants not receiving chemotherapy reported a significant within-group reduction in fatigue (p < 0.05). There were no significant between-group differences in mental function, hunger, or appetite. There was a significant between-group difference in adjusted cravings for starchy foods and fast food fats at 12 weeks (p < 0.05 for both), with the KD group demonstrating less frequent cravings than the ACS. In conclusion, in women with ovarian or endometrial cancer, a KD does not negatively affect quality of life and in fact may improve physical function, increase energy, and diminish specific food cravings. This trial was registered at ClinicalTrials.gov as NCT03171506.

Key Takeaways

This study demonstrated that women with ovarian and endometrial cancer experience a reduction in starchy food cravings, improved physical function, and a reduction in fatigue when eating a ketogenic diet compared to the high fiber low fat diet recommended by the American Cancer Society.

A Ketogenic Diet Is Acceptable in Women with Ovarian and Endometrial Cancer and Has No Adverse Effects on Blood Lipids: A Randomized, Controlled Trial

URL: https://pubmed.ncbi.nlm.nih.gov/31352797/

Journal: Nutrition and Cancer

Publication Date: 07/2019

Summary: Ketogenic diets (KDs) are emerging as effective therapies for several chronic diseases, including cancer. However, concerns regarding safety and adherence may prevent clinicians from prescribing KDs. We hypothesized that a KD does not negatively affect blood lipid profile compared to a lower-fat diet in ovarian and endometrial cancer patients, and that KD subjects would demonstrate acceptable adherence. Subjects were randomized to either a KD (70% fat, 25% protein, 5% carbohydrate), or the American Cancer Society diet (ACS; high-fiber and lower-fat). Blood lipids and ketones were measured at baseline and after 12 weeks of the assigned intervention. Adherence measures included urinary ketones in the KD and 4 days’ diet records. Diet records were also examined to identify general patterns of consumption. Differences between the diets on blood lipids and dietary intake were assessed with Analysis of covariance and independent t-tests. Correlation analyses were used to estimate associations between dietary intake and serum analytes. At 12 weeks, there were no significant differences between diet groups in blood lipids, after adjusting for baseline values and weight loss. Adherence among KD subjects ranged from 57% to 80%. These findings suggest that KDs may be a safe and achievable component of treatment for some cancer patients.

Key Takeaways

Ketogenic diets do not have negative effects on blood lipids, and adherence in a group of cancer patients ranged from 57-80%. This combined with the ketogenic diets likely benefit in cancer patients makes it an achievable addition to cancer therapy.

A Ketogenic Diet Reduces Central Obesity and Serum Insulin in Women with Ovarian or Endometrial Cancer

URL: https://pubmed.ncbi.nlm.nih.gov/30137481/
Journal: The Journal of Nutrition
Publication Date: 08/2018
Summary: In women with ovarian or endometrial cancer, a ketogenic diet (KD) results in selective loss of fat mass and retention of lean mass. Visceral fat mass and fasting serum insulin also are reduced by the KD, perhaps owing to enhanced insulin sensitivity. Elevated serum β-hydroxybutyrate may reflect a metabolic environment inhospitable to cancer proliferation. This trial was registered at www.clinicaltrials.gov as NCT03171506.

Key Takeaways

Women with ovarian cancer were able to utilize the ketogenic diet to lose fat without losing muscle mass. They were also able to reduce the fat surrounding their organs and improve metabolic markers such as insulin, insulin sensitivity, IGF-1. Additionally they had increased levels of ketone bodies, which may play a role in fighting cancer.

Consuming an All-Meat Ketogenic Diet for the Long-Term Management of Candida Vulvovaginitis and Vaginal Hidradenitis Suppurativa: A 47-Month Follow-Up Case Report

URL: https://www.cureus.com/articles/119195-consuming-an-all-meat-ketogenic-diet-for-the-long-term-management-of-candida-vulvovaginitis-and-vaginal-hidradenitis-suppurativa-a-47-month-follow-up-case-report
Journal: Cureus
Publication Date: 10/2022
Summary: This case report describes long-term therapeutic management in a 33-year-old diagnosed with Candida vulvovaginitis and vulvar hidradenitis suppurativa 47 months previously. Candida spp. yeasts are part of many women’s normal vaginal microflora, and the development of vulvovaginal candidiasis is typically a result of a disturbance in the patient’s microbial ecosystem, which manifests itself by intense pruritus, erythema, swelling, and thick white vaginal discharge. Hidradenitis suppurativa is a chronic auto-inflammatory skin condition that causes painful weeping lesions in areas of dense apocrine glands. Although certain mechanisms underlying the pathogenesis of Hidradenitis Suppurativa (e.g., risk factors include smoking, obesity, and family history) have been investigated, a definitive explanation remains elusive.

Nutritional intervention in the form of an all-meat ketogenic diet may be considered therapy in the management of both diseases, as successfully seen in this case report. The patient refused standard of care with oral fluconazole for Candida vulvovaginitis and surgical removal for Hidradenitis suppurativa, and instead consumed a zero-carbohydrate all-meat ketogenic diet mostly of beef with strict adherence to the diet for 43 days in which symptoms ceased.

Key Takeaways

Hidradenitis Suppurativa is a skin infection that occurs in areas of the body with skin folds/creases such as the armpit, groin, vulva, etc where the skin becomes red, painful, and drains pus. This patient had hidradenitis suppurativa and a yeast infection in her vulva and vaginal region. She refused antibiotics, and instead did a carnivore diet. After 43 days of the carnivore diet, her symptoms were gone and the infections cleared.

The ketone body β-hydroxybutyrate mitigates ILC2-driven airway inflammation by regulating mast cell function

URL: https://www.cell.com/cell-reports/fulltext/S2211-1247(22)01278-5?
Journal: Cell Reports
Publication Date: 09/2022
Summary: Ketone bodies are increasingly understood to have regulatory effects on immune cell function, with β-hydroxybutyrate (BHB) exerting a predominantly anti-inflammatory response. Dietary strategies to increase endogenous ketone body availability such as the ketogenic diet (KD) have recently been shown to alleviate inflammation of the respiratory tract. However, the role of BHB has not been addressed. Here, we observe that BHB suppresses group 2 innate lymphoid cell (ILC2)-mediated airway inflammation. Central to this are mast cells, which support ILC2 proliferation through interleukin-2 (IL-2). Suppression of the mast cell/IL-2 axis by BHB attenuates ILC2 proliferation and the ensuing type 2 cytokine response and immunopathology. Mechanistically, BHB directly inhibits mast cell function in part through GPR109A activation. Similar effects are achieved with either the KD or 1,3-butanediol. Our data reveal the protective role of BHB in ILC2-driven airway inflammation, which underscores the potential therapeutic value of ketone body supplementation for the management of asthma.

Key Takeaways

Ketone bodies produced during a ketogenic diet have an anti-inflammatory effect. These ketones have even been shown to decrease inflammation in the lungs by suppressing an inflammatory cell type called mast cells. Therefore, ketogenic diets can be used as a supplemental treatment for asthma.

Ketone Bodies can provide Neuroprotection in Neurological Diseases

URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6581710/

Journal: Front Neurol

Publication Date: 05/2016

Summary: There is growing evidence that ketone bodies, which are derived from fatty acid oxidation and usually produced in fasting state or on high-fat diets have broad neuroprotective effects. Although the mechanisms underlying the neuroprotective effects of ketone bodies have not yet been fully elucidated, studies in recent years provided abundant shreds of evidence that ketone bodies exert neuroprotective effects through possible mechanisms of anti-oxidative stress, maintaining energy supply, modulating the activity of deacetylation and inflammatory responses. Based on the neuroprotective effects, the ketogenic diet has been used in the treatment of several neurological diseases such as refractory epilepsy, Parkinson’s disease, Alzheimer’s disease, and traumatic brain injury. The ketogenic diet has great potential clinically, which should be further explored in future studies. It is necessary to specify the roles of components in ketone bodies and their therapeutic targets and related pathways to optimize the strategy and efficacy of ketogenic diet therapy in the future.

Key Takeaways

Ketone bodies produced by fat burning metabolism likely have a protective effect on the brain. Ketogenic diets have been used in the treatment of neurologic diseases such as epilepsy, Parkinson's, Alzheimer's, and traumatic brain injury. The exact mechanism that ketones play in protecting the brain is still being studied, but the current evidence points to the ketone's ability to reduce oxidative stress, reduce inflammation, and maintain energy supply in the brain.

Beneficial effects of ketogenic diet in obese diabetic subjects

URL: https://link.springer.com/article/10.1007%2Fs11010-007-9448-z

Journal: Molecular and Cellular Biochemistry

Publication Date: 04/2007

Summary: Obesity is closely linked to the incidence of type II diabetes. It is found that effective management of body weight and changes to nutritional habits especially with regard to the carbohydrate content and glycemic index of the diet have beneficial effects in obese subjects with glucose intolerance. Previously we have shown that ketogenic diet is quite effective in reducing body weight. Furthermore, it favorably alters the cardiac risk factors even in hyperlipidemic obese subjects. In this study the effect of ketogenic diet in obese subjects with high blood glucose level is compared to those with normal blood glucose level for a period of 56 weeks. A total of 64 healthy obese subjects with body mass index (BMI) greater than 30, having high blood glucose level and those subjects with normal blood glucose level were selected in this study. The body weight, body mass index, blood glucose level, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, urea and creatinine were determined before and at 8, 16, 24, 48, and 56 weeks after the administration of the ketogenic diet. The body weight, body mass index, the level of blood glucose, total cholesterol, LDL-cholesterol, triglycerides, and urea showed a significant decrease from week 1 to week 56 (P < 0.0001), whereas the level of HDL-cholesterol increased significantly (P < 0.0001). Interestingly these changes were more significant in subjects with high blood glucose level as compared to those with normal blood glucose level. The changes in the level of creatinine were not statistically significant. This study shows the beneficial effects of ketogenic diet in obese diabetic subjects following its long-term administration. Furthermore, it demonstrates that in addition to its therapeutic value, low carbohydrate diet is safe to use for a longer period of time in obese diabetic subjects.

The effect of a low-carbohydrate, ketogenic diet on nonalcoholic fatty liver disease: a pilot study

URL: https://link.springer.com/article/10.1007%2Fs10620-006-9433-5

Journal: Digestive Diseases and Sciences

Publication Date: 02/2007

Summary: Nonalcoholic fatty liver disease is an increasingly common condition that may progress to hepatic cirrhosis. This pilot study evaluated the effects of a low-carbohydrate, ketogenic diet on obesity-associated fatty liver disease. Five patients with a mean body mass index of 36.4 kg/m2 and biopsy evidence of fatty liver disease were instructed to follow the diet (<20 g/d of carbohydrate) with nutritional supplementation for 6 months. Patients returned for group meetings biweekly for 3 months, then monthly for the second 3 months. The mean weight change was −12.8 kg (range 0 to −25.9 kg). Four of 5 posttreatment liver biopsies showed histologic improvements in steatosis (P=.02) inflammatory grade (P=.02), and fibrosis (P=.07). Six months of a low-carbohydrate, ketogenic diet led to significant weight loss and histologic improvement of fatty liver disease. Further research is into this approach is warranted.

Key Takeaways

Low carbohydrate ketogenic diets can be an effective way to reverse fatty liver related to obesity and facilitate weight loss.

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