Ketogenic diet and intermittent fasting - impact on body weight and various diseases
DOI:
https://doi.org/10.12775/JEHS.2024.70.55560Keywords
intermittent fasting, weight loss, ketogenic diet, cardiovascular diseases, glycemiaAbstract
Introduction and purpose: Obesity affects every age group and is associated with many negative health effects. Various diets are used to remove excess body weight. Recently, popular became two diets - intermittent fasting and ketogenic diet.
Material and Method: This paper reviews various types of research documents published since 2018. Its main aim is to summarize the latest knowledge of ketogenic diet and intermittent fasting, including contraindications, side effects, impact on body weight and many diseases. It is also aimed to highlight the need for future research of the effects of both diets on various diseases and body weight reduction.
Results: Both diets may be effective in weight loss and show other health benefits. Both ketogenic diet and intermittent fasting have proven to be effective in weight reduction. In the case of intermittent fasting the biggest impact on weight loss is calorie restriction. Ketogenic diet is effective as a result of calorie restriction, increased gluconeogenesis and loss of free water through increased diuresis. They can be used in the prevention and treatment of many diseases, including cardiovascular disorders, neurological disorders or potentially cancer. However, they cannot be administered by everyone and may cause dangerous side effects.
Conclusion: Ketogenic diet and intermittent fasting are successful strategies for body weight reduction. Moreover, both of them may be used as an additional therapy for various diseases. However, patients should be under supervision.
References
Ruze R, Liu T, Zou X, Song J, Chen Y, Xu R, et al. Obesity and type 2 diabetes mellitus: connections in epidemiology, pathogenesis, and treatments. Front Endocrinol (Lausanne) 2023;14. https://doi.org/10.3389/FENDO.2023.1161521.
Tutor AW, Lavie CJ, Kachur S, Milani R V., Ventura HO. Updates on obesity and the obesity paradox in cardiovascular diseases. Prog Cardiovasc Dis 2023;78:2–10. https://doi.org/10.1016/J.PCAD.2022.11.013.
Nussbaumerova B, Rosolova H. Obesity and Dyslipidemia. Curr Atheroscler Rep 2023;25:947–55. https://doi.org/10.1007/S11883-023-01167-2.
Muscogiuri G, Barrea L, Laudisio D, Pugliese G, Salzano C, Savastano S, et al. The management of very low-calorie ketogenic diet in obesity outpatient clinic: a practical guide. J Transl Med 2019;17. https://doi.org/10.1186/S12967-019-2104-Z.
McGaugh E, Barthel B. A Review of Ketogenic Diet and Lifestyle. Mo Med 2022;119:84.
Varady KA, Cienfuegos S, Ezpeleta M, Gabel K. Clinical application of intermittent fasting for weight loss: progress and future directions. Nat Rev Endocrinol 2022;18:309–21. https://doi.org/10.1038/S41574-022-00638-X.
Nowosad K, Sujka M. Effect of Various Types of Intermittent Fasting (IF) on Weight Loss and Improvement of Diabetic Parameters in Human. Curr Nutr Rep 2021;10:146–54. https://doi.org/10.1007/S13668-021-00353-5.
Liu J, Yi P, Liu F. The Effect of Early Time-Restricted Eating vs Later Time-Restricted Eating on Weight Loss and Metabolic Health. J Clin Endocrinol Metab 2023;108:1824–34. https://doi.org/10.1210/CLINEM/DGAD036.
Varady KA, Cienfuegos S, Ezpeleta M, Gabel K. Cardiometabolic Benefits of Intermittent Fasting. Annu Rev Nutr 2021;41:333–61. https://doi.org/10.1146/ANNUREV-NUTR-052020-041327.
Arbour MW, Stec M, Walker KC, Wika JC. Clinical Implications for Women of a Low-Carbohydrate or Ketogenic Diet With Intermittent Fasting. Nurs Womens Health 2021;25:139–51. https://doi.org/10.1016/J.NWH.2021.01.009.
Basolo A, Magno S, Santini F, Ceccarini G. Ketogenic Diet and Weight Loss: Is There an Effect on Energy Expenditure? Nutrients 2022;14. https://doi.org/10.3390/NU14091814.
Masood W, Annamaraju P, Suheb MZK, Uppaluri KR. Ketogenic Diet. StatPearls 2023.
Rusek M, Pluta R, Ułamek-Kozioł M, Czuczwar SJ. Ketogenic Diet in Alzheimer’s Disease. Int J Mol Sci 2019;20. https://doi.org/10.3390/IJMS20163892.
Ramesh R, Kanagasingam A, Sabrina S, Anushanth U. Starvation Ketoacidosis in a Young Healthy Female After Prolonged Religious Fasting. Cureus 2023;15. https://doi.org/10.7759/CUREUS.39962.
Baumeister A, Gardemann J, Fobker M, Spiegler V, Fischer T. Short-Term Influence of Caffeine and Medium-Chain Triglycerides on Ketogenesis: A Controlled Double-Blind Intervention Study. J Nutr Metab 2021;2021. https://doi.org/10.1155/2021/1861567.
Jamshed H, Beyl RA, Manna DLD, Yang ES, Ravussin E, Peterson CM. Early Time-Restricted Feeding Improves 24-Hour Glucose Levels and Affects Markers of the Circadian Clock, Aging, and Autophagy in Humans. Nutrients 2019;11. https://doi.org/10.3390/NU11061234.
Choi A, Hallett M, Ehrlich D. Nutritional Ketosis in Parkinson’s Disease — a Review of Remaining Questions and Insights. Neurotherapeutics 2021;18:1637. https://doi.org/10.1007/S13311-021-01067-W.
Elortegui Pascual P, Rolands MR, Eldridge AL, Kassis A, Mainardi F, Kim-Anne L, et al. A meta-analysis comparing the effectiveness of alternate day fasting, the 5:2 diet, and time-restricted eating for weight loss. Obesity (Silver Spring) 2023;31 Suppl 1:9–21. https://doi.org/10.1002/OBY.23568.
Patikorn C, Saidoung P, Pham T, Phisalprapa P, Lee YY, Varady KA, et al. Effects of ketogenic diet on health outcomes: an umbrella review of meta-analyses of randomized clinical trials. BMC Med 2023;21:1–12. https://doi.org/10.1186/S12916-023-02874-Y/FIGURES/2.
Mohammadifard N, Haghighatdoost F, Rahimlou M, Rodrigues APS, Gaskarei MK, Okhovat P, et al. The Effect of Ketogenic Diet on Shared Risk Factors of Cardiovascular Disease and Cancer. Nutrients 2022;14. https://doi.org/10.3390/NU14173499.
Arciero PJ, Poe M, Mohr AE, Ives SJ, Arciero A, Sweazea KL, et al. Intermittent fasting and protein pacing are superior to caloric restriction for weight and visceral fat loss. Obesity (Silver Spring) 2023;31 Suppl 1:139–49. https://doi.org/10.1002/OBY.23660.
Weber DD, Aminzadeh-Gohari S, Tulipan J, Catalano L, Feichtinger RG, Kofler B. Ketogenic diet in the treatment of cancer - Where do we stand? Mol Metab 2020;33:102–21. https://doi.org/10.1016/J.MOLMET.2019.06.026.
Norwitz NG, Sethi S, Palmer CM. Ketogenic diet as a metabolic treatment for mental illness. Curr Opin Endocrinol Diabetes Obes 2020;27:269–74. https://doi.org/10.1097/MED.0000000000000564.
Brietzke E, Mansur RB, Subramaniapillai M, Balanza-Martínez V, Vinberg M, González-Pinto A, et al. Ketogenic diet as a metabolic therapy for mood disorders: Evidence and developments. Neurosci Biobehav Rev 2018;94:11–6. https://doi.org/10.1016/J.NEUBIOREV.2018.07.020.
Stockman MC, Thomas D, Burke J, Apovian CM. Intermittent Fasting: Is the Wait Worth the Weight? Curr Obes Rep 2018;7:172–85. https://doi.org/10.1007/S13679-018-0308-9.
Morales-Suarez-varela M, Sánchez EC, Peraita-Costa I, Llopis-Morales A, Soriano JM. Intermittent Fasting and the Possible Benefits in Obesity, Diabetes, and Multiple Sclerosis: A Systematic Review of Randomized Clinical Trials. Nutrients 2021;13. https://doi.org/10.3390/NU13093179.
Jamshed H, Steger FL, Bryan DR, Richman JS, Warriner AH, Hanick CJ, et al. Effectiveness of Early Time-Restricted Eating for Weight Loss, Fat Loss, and Cardiometabolic Health in Adults With Obesity: A Randomized Clinical Trial. JAMA Intern Med 2022;182:953–62. https://doi.org/10.1001/JAMAINTERNMED.2022.3050.
Watanabe M, Tuccinardi D, Ernesti I, Basciani S, Mariani S, Genco A, et al. Scientific evidence underlying contraindications to the ketogenic diet: An update. Obes Rev 2020;21. https://doi.org/10.1111/OBR.13053.
Dowis K, Banga S. The Potential Health Benefits of the Ketogenic Diet: A Narrative Review. Nutrients 2021;13. https://doi.org/10.3390/NU13051654.
Zarnowska IM. Therapeutic Use of the Ketogenic Diet in Refractory Epilepsy: What We Know and What Still Needs to Be Learned. Nutrients 2020;12:1–23. https://doi.org/10.3390/NU12092616.
Corsello A, Trovato CM, Di Profio E, Cardile S, Campoy C, Zuccotti G, et al. Ketogenic diet in children and adolescents: The effects on growth and nutritional status. Pharmacol Res 2023;191. https://doi.org/10.1016/J.PHRS.2023.106780.
Dressler A, Trimmel-Schwahofer P. The ketogenic diet for infants: How long can you go? Epilepsy Res 2020;164. https://doi.org/10.1016/J.EPLEPSYRES.2020.106339.
Barry D, Ellul S, Watters L, Lee D, Haluska R, White R. The ketogenic diet in disease and development. Int J Dev Neurosci 2018;68:53–8. https://doi.org/10.1016/J.IJDEVNEU.2018.04.005.
Saris CGJ, Timmers S. Ketogenic diets and Ketone suplementation: A strategy for therapeutic intervention. Front Nutr 2022;9. https://doi.org/10.3389/FNUT.2022.947567.
Roekenes J, Martins C. Ketogenic diets and appetite regulation. Curr Opin Clin Nutr Metab Care 2021;24:359–63. https://doi.org/10.1097/MCO.0000000000000760.
Horner K, Hopkins M, Finlayson G, Gibbons C, Brennan L. Biomarkers of appetite: is there a potential role for metabolomics? Nutr Res Rev 2020;33:271–86. https://doi.org/10.1017/S0954422420000062.
Sukkar SG, Muscaritoli M. A Clinical Perspective of Low Carbohydrate Ketogenic Diets: A Narrative Review. Front Nutr 2021;8:642628. https://doi.org/10.3389/FNUT.2021.642628.
Batch JT, Lamsal SP, Adkins M, Sultan S, Ramirez MN. Advantages and Disadvantages of the Ketogenic Diet: A Review Article. Cureus 2020;12. https://doi.org/10.7759/CUREUS.9639.
Murugan M, Boison D. Ketogenic diet, neuroprotection, and antiepileptogenesis. Epilepsy Res 2020;167. https://doi.org/10.1016/J.EPLEPSYRES.2020.106444.
Ko A, Kwon HE, Kim HD. Updates on the ketogenic diet therapy for pediatric epilepsy. Biomed J 2022;45:19–26. https://doi.org/10.1016/J.BJ.2021.11.003.
McDonald TJW, Cervenka MC. Ketogenic Diet Therapies for Seizures and Status Epilepticus. Semin Neurol 2020;40:719–29. https://doi.org/10.1055/S-0040-1719077.
Fila M, Chojnacki J, Pawlowska E, Sobczuk P, Chojnacki C, Blasiak J. The Ketogenic Diet in the Prevention of Migraines in the Elderly. Nutrients 2023;15. https://doi.org/10.3390/NU15234998.
Barbanti P, Fofi L, Aurilia C, Egeo G, Caprio M. Ketogenic diet in migraine: rationale, findings and perspectives. Neurol Sci 2017;38:111–5. https://doi.org/10.1007/S10072-017-2889-6.
Hayes MT. Parkinson’s Disease and Parkinsonism. Am J Med 2019;132:802–7. https://doi.org/10.1016/J.AMJMED.2019.03.001.
Dyńka D, Kowalcze K, Paziewska A. The Role of Ketogenic Diet in the Treatment of Neurological Diseases. Nutrients 2022;14. https://doi.org/10.3390/NU14235003.
Bahr LS, Bock M, Liebscher D, Bellmann-Strobl J, Franz L, Prüß A, et al. Ketogenic diet and fasting diet as Nutritional Approaches in Multiple Sclerosis (NAMS): protocol of a randomized controlled study. Trials 2020;21. https://doi.org/10.1186/S13063-019-3928-9.
Brockhoff JD, Bereswill S, Heimesaat MM. The impact of ketogenic diet on the onset and progression of multiple sclerosis. Eur J Microbiol Immunol (Bp) 2023;13:29–36. https://doi.org/10.1556/1886.2023.00020.
Phillips MCL, Deprez LM, Mortimer GMN, Murtagh DKJ, McCoy S, Mylchreest R, et al. Randomized crossover trial of a modified ketogenic diet in Alzheimer’s disease. Alzheimers Res Ther 2021;13. https://doi.org/10.1186/S13195-021-00783-X.
Tao Y, Leng SX, Zhang H. Ketogenic Diet: An Effective Treatment Approach for Neurodegenerative Diseases. Curr Neuropharmacol 2022;20:2303–19. https://doi.org/10.2174/1570159X20666220830102628.
Davis JJ, Fournakis N, Ellison J. Ketogenic Diet for the Treatment and Prevention of Dementia: A Review. J Geriatr Psychiatry Neurol 2021;34:3–10. https://doi.org/10.1177/0891988720901785.
Weber DD, Aminazdeh-Gohari S, Kofler B. Ketogenic diet in cancer therapy. Aging 2018;10:164–5. https://doi.org/10.18632/AGING.101382.
Barrea L, Caprio M, Tuccinardi D, Moriconi E, Di Renzo L, Muscogiuri G, et al. Could ketogenic diet “starve” cancer? Emerging evidence. Crit Rev Food Sci Nutr 2022;62:1800–21. https://doi.org/10.1080/10408398.2020.1847030.
Adak A, Khan MR. An insight into gut microbiota and its functionalities. Cell Mol Life Sci 2019;76:473–93. https://doi.org/10.1007/S00018-018-2943-4.
Paoli A, Mancin L, Bianco A, Thomas E, Mota JF, Piccini F. Ketogenic Diet and Microbiota: Friends or Enemies? Genes (Basel) 2019;10. https://doi.org/10.3390/GENES10070534.
Mengoli M, Conti G, Fabbrini M, Candela M, Brigidi P, Turroni S, et al. Microbiota-gut-brain axis and ketogenic diet: how close are we to tackling epilepsy? Microbiome Research Reports 2023;2. https://doi.org/10.20517/MRR.2023.24.
Santos HO, Macedo RCO. Impact of intermittent fasting on the lipid profile: Assessment associated with diet and weight loss. Clin Nutr ESPEN 2018;24:14–21. https://doi.org/10.1016/J.CLNESP.2018.01.002.
Fanti M, Mishra A, Longo VD, Brandhorst S. Time-Restricted Eating, Intermittent Fasting, and Fasting-Mimicking Diets in Weight Loss. Curr Obes Rep 2021;10:70–80. https://doi.org/10.1007/S13679-021-00424-2.
Wang Y, Wu R. The Effect of Fasting on Human Metabolism and Psychological Health. Dis Markers 2022;2022. https://doi.org/10.1155/2022/5653739.
Malinowski B, Zalewska K, Węsierska A, Sokołowska MM, Socha M, Liczner G, et al. Intermittent Fasting in Cardiovascular Disorders-An Overview. Nutrients 2019;11. https://doi.org/10.3390/NU11030673.
Zhang Q, Zhang C, Wang H, Ma Z, Liu D, Guan X, et al. Intermittent Fasting versus Continuous Calorie Restriction: Which Is Better for Weight Loss? Nutrients 2022;14. https://doi.org/10.3390/NU14091781.
Poggiogalle E, Jamshed H, Peterson CM. Circadian regulation of glucose, lipid, and energy metabolism in humans. Metabolism 2018;84:11–27. https://doi.org/10.1016/J.METABOL.2017.11.017.
Chair SY, Cai H, Cao X, Qin Y, Cheng HY, Timothy MNG. Intermittent Fasting in Weight Loss and Cardiometabolic Risk Reduction: A Randomized Controlled Trial. J Nurs Res 2022;30:E185. https://doi.org/10.1097/JNR.0000000000000469.
Sundfør TM, Svendsen M, Tonstad S. Effect of intermittent versus continuous energy restriction on weight loss, maintenance and cardiometabolic risk: A randomized 1-year trial. Nutr Metab Cardiovasc Dis 2018;28:698–706. https://doi.org/10.1016/J.NUMECD.2018.03.009.
Jospe MR, Roy M, Brown RC, Haszard JJ, Meredith-Jones K, Fangupo LJ, et al. Intermittent fasting, Paleolithic, or Mediterranean diets in the real world: exploratory secondary analyses of a weight-loss trial that included choice of diet and exercise. Am J Clin Nutr 2020;111:503–14. https://doi.org/10.1093/AJCN/NQZ330.
Welton S, Minty R, O’Driscoll T, Willms H, Poirier D, Madden S, et al. Intermittent fasting and weight loss: Systematic review. Canadian Family Physician 2020;66:117.
Pérez-Gerdel T, Camargo M, Alvarado M, Ramírez JD. Impact of Intermittent Fasting on the Gut Microbiota: A Systematic Review. Adv Biol 2023;7. https://doi.org/10.1002/ADBI.202200337.
Stanislawski MA, Frank DN, Borengasser SJ, Ostendorf DM, Ir D, Jambal P, et al. The Gut Microbiota during a Behavioral Weight Loss Intervention. Nutrients 2021;13. https://doi.org/10.3390/NU13093248.
Templeman I, Smith HA, Chowdhury E, Chen YC, Carroll H, Johnson-Bonson D, et al. A randomized controlled trial to isolate the effects of fasting and energy restriction on weight loss and metabolic health in lean adults. Sci Transl Med 2021;13. https://doi.org/10.1126/SCITRANSLMED.ABD8034.
Thomas EA, Zaman A, Sloggett KJ, Steinke S, Grau L, Catenacci VA, et al. Early time-restricted eating compared with daily caloric restriction: A randomized trial in adults with obesity. Obesity (Silver Spring) 2022;30:1027–38. https://doi.org/10.1002/OBY.23420.
Kim BH, Joo Y, Kim MS, Choe HK, Tong Q, Kwon O. Effects of Intermittent Fasting on the Circulating Levels and Circadian Rhythms of Hormones. Endocrinol Metab (Seoul) 2021;36:745–56. https://doi.org/10.3803/ENM.2021.405.
Poggiogalle E, Jamshed H, Peterson CM. Circadian regulation of glucose, lipid, and energy metabolism in humans. Metabolism 2018;84:11–27. https://doi.org/10.1016/J.METABOL.2017.11.017.
Freire R. Scientific evidence of diets for weight loss: Different macronutrient composition, intermittent fasting, and popular diets. Nutrition 2020;69. https://doi.org/10.1016/J.NUT.2019.07.001.
Arciero PJ, Arciero KM, Poe M, Mohr AE, Ives SJ, Arciero A, et al. Intermittent fasting two days versus one day per week, matched for total energy intake and expenditure, increases weight loss in overweight/obese men and women. Nutr J 2022;21. https://doi.org/10.1186/S12937-022-00790-0.
Sutton EF, Beyl R, Early KS, Cefalu WT, Ravussin E, Peterson CM. Early Time-Restricted Feeding Improves Insulin Sensitivity, Blood Pressure, and Oxidative Stress Even without Weight Loss in Men with Prediabetes. Cell Metab 2018;27:1212-1221.e3. https://doi.org/10.1016/J.CMET.2018.04.010.
Varady KA, Runchey MC, Reutrakul S, Vidmar AP, Chow LS. Clinical potential of fasting in type 1 diabetes. Trends Endocrinol Metab 2024;35:413–24. https://doi.org/10.1016/J.TEM.2024.01.007.
He Z, Xu H, Li C, Yang H, Mao Y. Intermittent fasting and immunomodulatory effects: A systematic review. Front Nutr 2023;10. https://doi.org/10.3389/FNUT.2023.1048230.
Kim BH, Joo Y, Kim MS, Choe HK, Tong Q, Kwon O. Effects of Intermittent Fasting on the Circulating Levels and Circadian Rhythms of Hormones. Endocrinol Metab (Seoul) 2021;36:745–56. https://doi.org/10.3803/ENM.2021.405.
Patikorn C, Roubal K, Veettil SK, Chandran V, Pham T, Lee YY, et al. Intermittent Fasting and Obesity-Related Health Outcomes: An Umbrella Review of Meta-analyses of Randomized Clinical Trials. JAMA Netw Open 2021;4. https://doi.org/10.1001/JAMANETWORKOPEN.2021.39558.
Mohr AE, Sweazea KL, Bowes DA, Jasbi P, Whisner CM, Sears DD, et al. Gut microbiome remodeling and metabolomic profile improves in response to protein pacing with intermittent fasting versus continuous caloric restriction. Nat Commun 2024;15. https://doi.org/10.1038/S41467-024-48355-5.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Julia Kuźniar, Patrycja Kozubek, Magdalena Czaja, Hanna Sitka, Cezary Wegenko
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 393
Number of citations: 0