Summary:
The ketogenic diet (KD) has a vast history of use and has recently gained substantial interest due to its potentially positive impact on epilepsy and other diseases such as obesity and malignancies. The KD is considered as high-fat, very low carbohydrate and adequate protein. This paper is a comprehensive summary of the KD, including the therapeutic benefits, mechanisms of action and current evidence on the application of the KD in multiple diseases. The paper discusses its role in metabolism, the gut microbiota, endocrine disorders, obesity, non-alcoholic fatty liver disease, polycystic ovarian syndrome, neurodegenerative diseases such as Alzheimer’s disease, depression, cancer and cardiovascular health. The authors conclude that the KD functions through multiple mechanisms, which still need to be thoroughly explored. Randomized-controlled trials isolating the KD with particular disease states are warranted, however this paper is still a thorough summary of the application of the KD in modern diseases.
Abstract:
The ketogenic diet (KD) is a high-fat, adequate-protein, and very-low-carbohydrate diet regimen that mimics the metabolism of the fasting state to induce the production of ketone bodies. The KD has long been established as a remarkably successful dietary approach for the treatment of intractable epilepsy and has increasingly garnered research attention rapidly in the past decade, subject to emerging evidence of the promising therapeutic potential of the KD for various diseases, besides epilepsy, from obesity to malignancies. In this review, we summarize the experimental and/or clinical evidence of the efficacy and safety of the KD in different diseases, and discuss the possible mechanisms of action based on recent advances in understanding the influence of the KD at the cellular and molecular levels. We emphasize that the KD may function through multiple mechanisms, which remain to be further elucidated. The challenges and future directions for the clinical implementation of the KD in the treatment of a spectrum of diseases have been discussed. We suggest that, with encouraging evidence of therapeutic effects and increasing insights into the mechanisms of action, randomized controlled trials should be conducted to elucidate a foundation for the clinical use of the KD.
Article Publication Date: 17/01/2022
DOI: 10.1038/s41392-021-00831-w
