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Clinical Impact of Ketogenic Diet
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Clinical Impact of Ketogenic Diet

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: 5 March 2025 | Viewed by 16886

Special Issue Editor

Dr. Valentina Guarnotta

E-Mail Website
Guest Editor
Section of Endocrinology and Diabetology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, PROMISE, University of Palermo, 90127 Palermo, Italy
Interests: nutrition; diabetes mellitus; neuroendocrine neoplasms; endocrinology; obesity; pituitary disorders; adrenal tumours

Special Issue Information

Dear Colleagues,

The ketogenic diet is a dietary approach characterized by a high fat and low carbohydrate intake, aiming to facilitate weight loss, enhance mental clarity, and boost energy levels. Its use has been shown to be beneficial in several endocrine and non-chronic disorders.

The long-term outcomes of the ketogenic diet have not been clearly assessed and, for this reason, we are currently not able to establish whether the use of a ketogenic diet can aid clinicians in the long-term management of endocrine disorders. In addition, the relationship between ketone bodies and hormonal axes, including the hypothalamic–pituitary–adrenal axis and the Growth Hormone/IGF-1 Axis, has not yet shown.

This Special Issue encourages the submission of articles focusing on the long-term effects of the ketogenic diet in endocrine disorders (obesity, diabetes mellitus, reproductive disorders) and in some not yet investigated conditions, including hypothalamic–pituitary–adrenal axis and Growth Hormone/IGF-1 Axis disorders.

Dr. Valentina Guarnotta
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • ketogenic diet
  • obesity
  • diabetes mellitus
  • adrenal disorders
  • thyroid disease
  • reproductive disorders
  • acromegaly

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Published Papers (4 papers)

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Research

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15 pages, 2684 KiB  
Article
Sex- and Age-Specific Differences in Mice Fed a Ketogenic Diet
by Kenyon W. Sprankle, Mya A. Knappenberger, Erica J. Locke, Jack H. Thompson, Madison F. Vinovrski, Kaylin Knapsack and Stephen C. Kolwicz, Jr.
Nutrients 2024, 16(16), 2731; https://doi.org/10.3390/nu16162731 - 16 Aug 2024
Viewed by 1584
Abstract
The ketogenic diet (KD) is a high-fat, low-carbohydrate diet that results in the elevation of serum ketone bodies, known as ketosis. This metabolic consequence has been suggested as a method for treating neurological conditions, improving exercise performance, and facilitating weight loss for overweight [...] Read more.
The ketogenic diet (KD) is a high-fat, low-carbohydrate diet that results in the elevation of serum ketone bodies, known as ketosis. This metabolic consequence has been suggested as a method for treating neurological conditions, improving exercise performance, and facilitating weight loss for overweight individuals. However, since most research primarily uses male populations, little is known about the potential sex differences during the consumption of the KD. In addition, the effects of the KD on aging are relatively unexplored. Therefore, the purpose of this study was to explore sex- and age-specific differences in mice fed the KD. Male and female C57BL/6N mice at either 12 wks or 24 wks of age were randomly assigned to a KD (90% fat, 1% carbohydrate) or chow (13% fat, 60% carbohydrate) group for 6 wks. KD induced weight gain, increased adiposity, induced hyperlipidemia, caused lipid accumulation in the heart and liver, and led to glycogen depletion in the heart, liver, and muscle with varying degrees of changes depending on age and sex. While younger and older male mice on the KD were prone to glucose intolerance, the KD acutely improved rotarod performance in younger females. Overall, this study highlights potential sex and aging differences in the adaptation to the KD. Full article
(This article belongs to the Special Issue Clinical Impact of Ketogenic Diet)
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15 pages, 3239 KiB  
Article
Ketogenic Diet Induced Shifts in the Gut Microbiome Associate with Changes to Inflammatory Cytokines and Brain-Related miRNAs in Children with Autism Spectrum Disorder
by Nina P. Allan, Brennan Y. Yamamoto, Braden P. Kunihiro, Chandler K. L. Nunokawa, Noelle C. Rubas, Riley K. Wells, Lesley Umeda, Krit Phankitnirundorn, Amada Torres, Rafael Peres, Emi Takahashi and Alika K. Maunakea
Nutrients 2024, 16(10), 1401; https://doi.org/10.3390/nu16101401 - 7 May 2024
Cited by 2 | Viewed by 9834
Abstract
In this interventional pilot study, we investigated the effects of a modified ketogenic diet (KD) on children with autism spectrum disorder (ASD). We previously observed improved behavioral symptoms in this cohort following the KD; this trial was registered with Clinicaltrials.gov (NCT02477904). This report [...] Read more.
In this interventional pilot study, we investigated the effects of a modified ketogenic diet (KD) on children with autism spectrum disorder (ASD). We previously observed improved behavioral symptoms in this cohort following the KD; this trial was registered with Clinicaltrials.gov (NCT02477904). This report details the alterations observed in the microbiota, inflammation markers, and microRNAs of seven children following a KD for a duration of 4 months. Our analysis included blood and stool samples, collected before and after the KD. After 4 months follow up, we found that the KD led to decreased plasma levels of proinflammatory cytokines (IL-12p70 and IL-1b) and brain-derived neurotrophic factor (BDNF). Additionally, we observed changes in the gut microbiome, increased expression of butyrate kinase in the gut, and altered levels of BDNF-associated miRNAs in the plasma. These cohort findings suggest that the KD may positively influence ASD sociability, as previously observed, by reducing inflammation, reversing gut microbial dysbiosis, and impacting the BDNF pathway related to brain activity. Full article
(This article belongs to the Special Issue Clinical Impact of Ketogenic Diet)
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Review

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22 pages, 351 KiB  
Review
The Potential Effects of the Ketogenic Diet in the Prevention and Co-Treatment of Stress, Anxiety, Depression, Schizophrenia, and Bipolar Disorder: From the Basic Research to the Clinical Practice
by Maria Chrysafi, Constantina Jacovides, Sousana K. Papadopoulou, Evmorfia Psara, Theophanis Vorvolakos, Marina Antonopoulou, Antonios Dakanalis, Mato Martin, Gavriela Voulgaridou, Agathi Pritsa, Maria Mentzelou and Constantinos Giaginis
Nutrients 2024, 16(11), 1546; https://doi.org/10.3390/nu16111546 - 21 May 2024
Viewed by 4691
Abstract
Background: The ketogenic diet (KD) has been highly developed in the past for the treatment of epileptic pathological states in children and adults. Recently, the current re-emergence in its popularity mainly focuses on the therapy of cardiometabolic diseases. The KD can also have [...] Read more.
Background: The ketogenic diet (KD) has been highly developed in the past for the treatment of epileptic pathological states in children and adults. Recently, the current re-emergence in its popularity mainly focuses on the therapy of cardiometabolic diseases. The KD can also have anti-inflammatory and neuroprotective activities which may be applied to the prevention and/or co-treatment of a diverse range of psychiatric disorders. Purpose: This is a comprehensive literature review that intends to critically collect and scrutinize the pre-existing research basis and clinical data of the potential advantageous impacts of a KD on stress, anxiety, depression, schizophrenia and bipolar disorder. Methods: This literature review was performed to thoroughly represent the existing research in this topic, as well as to find gaps in the international scientific community. In this aspect, we carefully investigated the ultimate scientific web databases, e.g., PubMed, Scopus, and Web of Science, to derive the currently available animal and clinical human surveys by using efficient and representative keywords. Results: Just in recent years, an increasing amount of animal and clinical human surveys have focused on investigating the possible impacts of the KD in the prevention and co-treatment of depression, anxiety, stress, schizophrenia, and bipolar disorder. Pre-existing basic research with animal studies has consistently demonstrated promising results of the KD, showing a propensity to ameliorate symptoms of depression, anxiety, stress, schizophrenia, and bipolar disorder. However, the translation of these findings to clinical settings presents a more complex issue. The majority of the currently available clinical surveys seem to be moderate, usually not controlled, and have mainly assessed the short-term effects of a KD. In addition, some clinical surveys appear to be characterized by enormous dropout rates and significant absence of compliance measurement, as well as an elevated amount of heterogeneity in their methodological design. Conclusions: Although the currently available evidence seems promising, it is highly recommended to accomplish larger, long-term, randomized, double-blind, controlled clinical trials with a prospective design, in order to derive conclusive results as to whether KD could act as a potential preventative factor or even a co-treatment agent against stress, anxiety, depression, schizophrenia, and bipolar disorder. Basic research with animal studies is also recommended to examine the molecular mechanisms of KD against the above psychiatric diseases. Full article
(This article belongs to the Special Issue Clinical Impact of Ketogenic Diet)

Other

Jump to: Research, Review

13 pages, 290 KiB  
Systematic Review
Does the Ketogenic Diet Mediate Inflammation Markers in Obese and Overweight Adults? A Systematic Review and Meta-Analysis of Randomized Clinical Trials
by Mariangela Rondanelli, Clara Gasparri, Martina Pirola, Gaetan Claude Barrile, Alessia Moroni, Ignacio Sajoux and Simone Perna
Nutrients 2024, 16(23), 4002; https://doi.org/10.3390/nu16234002 - 22 Nov 2024
Viewed by 240
Abstract
Background/Objectives. The ketogenic diet has emerged as a potential treatment strategy for reducing inflammation. The purpose of this meta-analysis and systematic review is to look into how a ketogenic diet affects inflammatory biomarkers in persons who are overweight or obese. Methods. [...] Read more.
Background/Objectives. The ketogenic diet has emerged as a potential treatment strategy for reducing inflammation. The purpose of this meta-analysis and systematic review is to look into how a ketogenic diet affects inflammatory biomarkers in persons who are overweight or obese. Methods. We conducted an extensive search of Web of Science, PubMed, Scopus, and Google Scholar to find pertinent studies reporting changes in inflammatory biomarkers such as C-reactive protein (CRP), the erythrocyte sedimentation rate, and cytokines after a ketogenic diet. Results. Seven randomized controlled trials involving 218 overweight or obese individuals who followed a ketogenic or control diet over 8 weeks to 2 years were included in the review, and five of those were considered for the meta-analysis. The primary outcomes were CRP and IL-6 levels. The results reported significant decreases after treatment for CRP (mean of −0.62 mg/dL (95% CI: −0.84, −0,40), and a slight, but not statistically significant, reduction in IL-6 (mean of −1.31 pg/mL (95% CI: −2.86, 0.25). Conclusions. The ketogenic diet could contribute to modulating inflammation in obese and overweight subjects. Full article
(This article belongs to the Special Issue Clinical Impact of Ketogenic Diet)
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