August 3, 2021

New review investigates the impact of ketogenic diet in patients with obesity and type II diabetes

Ketogenic diets has become increasing more popular the past few years to support weight loss, neurological disorders and those with insulin resistance.

In a meta-analysis published this week in Nutrients, researchers investigated the impact of a ketogenic diet and its effects on specific metabolic biomarkers in patients with obesity and type II diabetes.  

Ketogenic diets reduce insulin levels which redirects lipid metabolism and utilizes ketones as an alternative energy source instead of glucose. Ketones are non-carbohydrate energy sources that are converted from fatty acids in the body. Ketones are generated in the body by limiting carbohydrate to 5% to 10% of total daily dietary requirements.

This review consisted of 14 randomized controlled trials including 734 patients whom were overweight or had obesity, 444 diabetic patients, and 290 non-diabetic patients. The primary laboratory assessment included fasting glucose, HA1c, fasting insulin, C-peptide, total cholesterol, triglyceride, LDL cholesterol, HDL cholesterol, C-reactive protein (CRP) and serum creatinine. Body weight, body mass index (BMI), waist circumference, systolic blood pressure and diastolic blood pressure were also collected. The effects of ketogenic diets on glycemic control over a 3 to 12-month period were greater in patients with diabetes compared to low-fat diets. This was demonstrated by a significant reduction in HA1c levels and homeostatic model assessment (HOMA) values for diabetic patients. Similar effects were seen with both diets in nondiabetic patients. In addition, ketogenic diets for 4 weeks to 12 months demonstrated a significant weight reduction in both diabetic and nondiabetic patients. Also, lipid profiles were improved including an increase in HDL cholesterol and lower triglyceride levels in diabetic patients.

As a result, this study showed that ketogenic diets are more effective in improving metabolic biomarkers associated with glycemic, weight, and lipid controls in patients whom are overweight, especially those with diabetes compared to low-fat diets.

This is the first study to perform a meta-analysis with randomized controlled trials to investigate the impact of ketogenic diets on glycemic control, weight loss, lipid control and cardiovascular and renal risk markers over varied low-fat diets.

Ketogenic diets are an effective strategy for weight loss, however, transitioning to a ketogenic diet can be challenge as the body is switching from burning glucose to fat for fuel. Many individuals often experience fatigue, nausea, dizziness, and irritability during this transition.

Perceived hunger is also a common barrier to weight loss. Based upon this recent research exogenous ketones are a great adjunct to a ketogenic diet, intermittent fasting, or for an individual transitioning to a ketogenic diet for weight loss. Exogenous ketone supplementation Increase blood ketone levels which may directly suppress appetite as they lower plasma ghrelin levels reduce cravings.

Source: Choi Y, Jeon S, and Shin S. Impact of a Ketogenic Diet on Metabolic Parameters in Patients with Obesity or Overweight and with or without Type 2 Diabetes: A Meta-Analysis of Randomized Controlled Trials. Nutrients. 6 July 2020, 12(7), 2005.

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