Beyond epilepsy management: A narrative review of the health effects of ketogenic diets

Abstract

The Ketogenic diet (KD), characterized by a low-carbohydrate/high-fat intake, induces a state of ketosis, where the body primarily relies on using fat for energy instead of carbohydrates. This diet is historically used in epilepsy management. Recently, KD has been the subject of increased research and public interest for its additional potential health effects. This narrative review offers an overview of the potential health effects of the KD and outlines its clinical implications. We searched PubMed and Google Scholar for randomized controlled trials (RCTs) published between 2014 and 2024, exploring the health effects of KD in humans beyond epilepsy management. We included 34 RCTs on various diseases and health outcomes. The findings highlight that the KD is particularly effective for weight loss and metabolic health, making it especially relevant for individuals with obesity and metabolic syndrome, both of which are of major public health concern worldwide. Additionally, the KD shows significant promise in managing neurological disorders, particularly Alzheimer's and Parkinson's diseases, with studies suggesting improvements in cognitive function and disease progression. The diet has also been shown to reduce the frequency and severity of migraines, offering potential relief for those affected. Furthermore, the KD may improve reproductive health, though more research is needed in this area. While the diet demonstrates benefits in these key areas, potential risks, including impacts on kidney and liver function, nutrient deficiencies, and adverse pregnancy outcomes, must be considered. The majority of included RCTs were of limited sample size and duration. Therefore, KD may be a promising dietary approach for weight control, neurological disease, and metabolic syndrome management, yet individualized guidance based on the medical history of each patient is crucial. Further research with larger samples and longer follow-up duration is needed to address existing gaps and improve our understanding of the health effects of the KD.

Keywords: Cardiometabolic Health; Ketogenic Diet; Neurodegenerative Diseases; Randomized Controlled Trial; Weight Management.