Ketogenic diet and metabolic health: A review of its impact on type 2 diabetes and obesity. Analysis of research on the ketogenic diet in the context of treating metabolic disorders
DOI:
https://doi.org/10.12775/JEHS.2024.71.55923Keywords
Ketogenic diet, ketosis, ketone bodies, obesity, type 2 diabetes, metabolism, insulin sensitivity, glucose control, insulin resistance, biological mechanisms, metabolic processes, long-term use, inflammation, gut microbiota, neuroprotection, therapeutic effects, dietary changes, fat intake, carbohydrates, scientific research, lipid profile, side effects, supplementation, weight management, physical activity, dietary programs, patient education, dietary interventionsAbstract
This paper aims to review current research on the ketogenic diet as a potential therapeutic approach for obesity and type 2 diabetes. This diet is characterized by high fat intake, moderate protein, and minimal carbohydrates, leading to a state of ketosis in which the body utilizes ketone bodies as its primary energy source. Studies indicate that the ketogenic diet may positively influence blood glucose control, enhance insulin sensitivity, and facilitate weight reduction, particularly relevant in the context of insulin resistance. The paper discusses the biological mechanisms underlying these effects, as well as potential risks associated with long-term adherence to the diet. It underscores that, despite promising results, further research is necessary to better understand the long-term effects of the ketogenic diet and its applicability across various patient populations. Conclusions highlight the need for patient monitoring during the dietary regimen and the potential for integrating the ketogenic diet into a broader strategy for managing metabolic diseases
References
O'Neill, B., & Raggi, P. (2020). The ketogenic diet: Pros and cons. Atherosclerosis, 292, 119–126. https://doi.org/10.1016/j.atherosclerosis.2019.11.021
Di Raimondo, D., Buscemi, S., Musiari, G., Rizzo, G., Pirera, E., Corleo, D., Pinto, A., & Tuttolomondo, A. (2021). Ketogenic Diet, Physical Activity, and Hypertension-A Narrative Review. Nutrients, 13(8), 2567. https://doi.org/10.3390/nu13082567
Masino, S. A., & Rho, J. M. (2012). Mechanisms of Ketogenic Diet Action. In J. L. Noebels (Eds.) et. al., Jasper's Basic Mechanisms of the Epilepsies. (4th ed.). National Center for Biotechnology Information (US).
Nylen, K., Likhodii, S., & Burnham, W. M. (2009). The ketogenic diet: proposed mechanisms of action. Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 6(2), 402–405. https://doi.org/10.1016/j.nurt.2009.01.021
Tiulganova, D. A., Nasaev, S. S., Chugreev, I. A., Rodionova, M. A., & Zavyalov, G. A. (2018). Mekhanizmy deĭstviia ketogennoĭ diety [Mechanisms of ketogenic diet action]. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova, 118(10. Vyp. 2), 72–75. https://doi.org/10.17116/jnevro201811810272
Chandrasekaran, P., & Weiskirchen, R. (2024). The Role of Obesity in Type 2 Diabetes Mellitus-An Overview. International journal of molecular sciences, 25(3), 1882. https://doi.org/10.3390/ijms25031882
Ruze, R., Liu, T., Zou, X., Song, J., Chen, Y., Xu, R., Yin, X., & Xu, Q. (2023). Obesity and type 2 diabetes mellitus: connections in epidemiology, pathogenesis, and treatments. Frontiers in endocrinology, 14, 1161521. https://doi.org/10.3389/fendo.2023.1161521
Tinajero, M. G., & Malik, V. S. (2021). An Update on the Epidemiology of Type 2 Diabetes: A Global Perspective. Endocrinology and metabolism clinics of North America, 50(3), 337–355. https://doi.org/10.1016/j.ecl.2021.05.013
Sandouk, Z., & Lansang, M. C. (2017). Diabetes with obesity--Is there an ideal diet?. Cleveland Clinic journal of medicine, 84(7 Suppl 1), S4–S14. https://doi.org/10.3949/ccjm.84.s1.02
Bales, C. W., & Porter Starr, K. N. (2018). Obesity Interventions for Older Adults: Diet as a Determinant of Physical Function. Advances in nutrition (Bethesda, Md.), 9(2), 151–159. https://doi.org/10.1093/advances/nmx016
Aaseth, J., Ellefsen, S., Alehagen, U., Sundfør, T. M., & Alexander, J. (2021). Diets and drugs for weight loss and health in obesity - An update. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 140, 111789. https://doi.org/10.1016/j.biopha.2021.111789
Martín-Peláez, S., Fito, M., & Castaner, O. (2020). Mediterranean Diet Effects on Type 2 Diabetes Prevention, Disease Progression, and Related Mechanisms. A Review. Nutrients, 12(8), 2236. https://doi.org/10.3390/nu12082236
Hemmingsen, B., Gimenez-Perez, G., Mauricio, D., Roqué I Figuls, M., Metzendorf, M. I., & Richter, B. (2017). Diet, physical activity or both for prevention or delay of type 2 diabetes mellitus and its associated complications in people at increased risk of developing type 2 diabetes mellitus. The Cochrane database of systematic reviews, 12(12), CD003054. https://doi.org/10.1002/14651858.CD003054.pub4
Esposito, K., Maiorino, M. I., Bellastella, G., Chiodini, P., Panagiotakos, D., & Giugliano, D. (2015). A journey into a Mediterranean diet and type 2 diabetes: a systematic review with meta-analyses. BMJ open, 5(8), e008222. https://doi.org/10.1136/bmjopen-2015-008222
Zhou, C., Wang, M., Liang, J., He, G., & Chen, N. (2022). Ketogenic Diet Benefits to Weight Loss, Glycemic Control, and Lipid Profiles in Overweight Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trails. International journal of environmental research and public health, 19(16), 10429. https://doi.org/10.3390/ijerph191610429
Dashti, H. M., Mathew, T. C., & Al-Zaid, N. S. (2021). Efficacy of Low-Carbohydrate Ketogenic Diet in the Treatment of Type 2 Diabetes. Medical principles and practice : international journal of the Kuwait University, Health Science Centre, 30(3), 223–235. https://doi.org/10.1159/000512142
Yuan, X., Wang, J., Yang, S., Gao, M., Cao, L., Li, X., Hong, D., Tian, S., & Sun, C. (2020). Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: a systematic review and meta-analysis. Nutrition & diabetes, 10(1), 38. https://doi.org/10.1038/s41387-020-00142-z
Paoli, A., Bianco, A., Moro, T., Mota, J. F., & Coelho-Ravagnani, C. F. (2023). The Effects of Ketogenic Diet on Insulin Sensitivity and Weight Loss, Which Came First: The Chicken or the Egg?. Nutrients, 15(14), 3120. https://doi.org/10.3390/nu15143120
Jing, T., Zhang, S., Bai, M., Chen, Z., Gao, S., Li, S., & Zhang, J. (2023). Effect of Dietary Approaches on Glycemic Control in Patients with Type 2 Diabetes: A Systematic Review with Network Meta-Analysis of Randomized Trials. Nutrients, 15(14), 3156. https://doi.org/10.3390/nu15143156
Skow, S. L., & Jha, R. K. (2023). A Ketogenic Diet is Effective in Improving Insulin Sensitivity in Individuals with Type 2 Diabetes. Current diabetes reviews, 19(6), e250422203985. https://doi.org/10.2174/1573399818666220425093535
Cunha, G. M., Guzman, G., Correa De Mello, L. L., Trein, B., Spina, L., Bussade, I., Marques Prata, J., Sajoux, I., & Countinho, W. (2020). Efficacy of a 2-Month Very Low-Calorie Ketogenic Diet (VLCKD) Compared to a Standard Low-Calorie Diet in Reducing Visceral and Liver Fat Accumulation in Patients With Obesity. Frontiers in endocrinology, 11, 607. https://doi.org/10.3389/fendo.2020.00607
Choi, Y. J., Jeon, S. M., & Shin, S. (2020). 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, 12(7), 2005. https://doi.org/10.3390/nu12072005
Murphy, E. A., & Jenkins, T. J. (2019). A ketogenic diet for reducing obesity and maintaining capacity for physical activity: hype or hope?. Current opinion in clinical nutrition and metabolic care, 22(4), 314–319. https://doi.org/10.1097/MCO.0000000000000572
Lambadiari, V., Katsimbri, P., Kountouri, A., Korakas, E., Papathanasi, A., Maratou, E., Pavlidis, G., Pliouta, L., Ikonomidis, I., Malisova, S., Vlachos, D., & Papadavid, E. (2024). The Effect of a Ketogenic Diet versus Mediterranean Diet on Clinical and Biochemical Markers of Inflammation in Patients with Obesity and Psoriatic Arthritis: A Randomized Crossover Trial. International journal of molecular sciences, 25(5), 2475. https://doi.org/10.3390/ijms25052475
Santangelo, A., Corsello, A., Spolidoro, G. C. I., Trovato, C. M., Agostoni, C., Orsini, A., Milani, G. P., & Peroni, D. G. (2023). The Influence of Ketogenic Diet on Gut Microbiota: Potential Benefits, Risks and Indications. Nutrients, 15(17), 3680. https://doi.org/10.3390/nu15173680
Batch, J. T., Lamsal, S. P., Adkins, M., Sultan, S., & Ramirez, M. N. (2020). Advantages and Disadvantages of the Ketogenic Diet: A Review Article. Cureus, 12(8), e9639. https://doi.org/10.7759/cureus.9639
Rafiullah, M., Musambil, M., & David, S. K. (2022). Effect of a very low-carbohydrate ketogenic diet vs recommended diets in patients with type 2 diabetes: a meta-analysis. Nutrition reviews, 80(3), 488–502. https://doi.org/10.1093/nutrit/nuab040
Merovci, A., Finley, B., Hansis-Diarte, A., Neppala, S., Abdul-Ghani, M. A., Cersosimo, E., Triplitt, C., & DeFronzo, R. A. (2024). Effect of weight-maintaining ketogenic diet on glycemic control and insulin sensitivity in obese T2D subjects. BMJ open diabetes research & care, 12(5), e004199. https://doi.org/10.1136/bmjdrc-2024-004199
Berk, K. A., van der Louw, E. J. T. M., Olieman, J. F., & van der Lely, A. J. (2021). Comment on Moriconi et al. Very-Low-Calorie Ketogenic Diet as a Safe and Valuable Tool for Long-Term Glycemic Management in Patients with Obesity and Type 2 Diabetes. Nutrients 2021, 13, 758. Nutrients, 13(10), 3613. https://doi.org/10.3390/nu13103613
Zhang, X., Qin, J., Zhao, Y., Shi, J., Lan, R., Gan, Y., Ren, H., Zhu, B., Qian, M., & Du, B. (2016). Long-term ketogenic diet contributes to glycemic control but promotes lipid accumulation and hepatic steatosis in type 2 diabetic mice. Nutrition research (New York, N.Y.), 36(4), 349–358. https://doi.org/10.1016/j.nutres.2015.12.002
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Paweł Nojek, Monika Zawół, Mariusz Zimonczyk, Wiktoria Pawlik, Agnieszka Nowotarska, Gustaw Błaszczyński
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: 96
Number of citations: 0