I'm exhausted from this project, so I'll make this short. This meta-analysis is my attempt to bring some sanity and clarity to online and academic discussions/debates regarding ketogenic diets and health. There are many claims made without references, or claims made with references to cherry-picked studies. Fuck that bullshit. I've had enough of it.
This blog article may be educational for anyone looking to learn about how ketogenic diets relate to health. As well as whether or not those health outcomes are independent of duration or weight loss. There are many common effects of low carbohydrate or ketogenic diets that some people just take for granted, such as lower triglycerides or lower blood glucose. However, it is unclear whether or not these effects are independent of weight loss or duration of time spent on the diet.
It is also true that some people expect negative things to happen on a ketogenic diet, like elevated low density lipoprotein cholesterol or impaired thyroid function. It is likewise unclear whether or not these effects are independent of weight loss or time spent on the diet. Hopefully the data below will help settle, or at least inform, some of these potential misconceptions, debates and discussions.
I will also not be including any interpretations of any data, because I lack the expertise and knowledge to be able to do that credibly or accurately.
Results will be stratified five ways:
- Low carbohydrate ketogenic diets vs low carbohydrate non-ketogenic diets.
- Ketogenic diets stratified by duration, compared to control.
- Ketogenic diets stratified by duration, compared to baseline.
- Ketogenic diets stratified by weight loss, compared to control.
- Ketogenic diets stratified by weight loss, compared to baseline.
Inclusion Criteria:
- Interventional trials involving low carbohydrate or ketogenic diets (definitions below).
- In the case of trials involving low carbohydrate diets versus low carbohydrate diets or ketogenic diets versus ketogenic diets, change from baseline data will substitute for between group results.
- Studies must report any relevant biomarkers, carbohydrate intake, duration, and weight changes.
Criteria for low carbohydrate diets:
- Less than 50% of daily energy derived from carbohydrates.
- A difference of at least 10% between the low carbohydrate diet and the comparator diet.
- When a study contains multiple comparator diets, comparator diets are selected such that the contrast in carbohydrate intake is maximized.
Criteria for ketogenic diets:
- Less than 75g of carbohydrates per day.
- Less than 14% of daily energy derived from carbohydrates.
- Comparator diets must be non-ketogenic.
Disclaimer:
This is not a peer-reviewed publication. This blog article is for educational and/or entertainment purposes only. This blog article is not an academic reference, nor does it stand in place of current or future peer reviewed, academic research into ketogenic diets and health. There are multiple methodological limitations that make credible interpretation challenging in many cases. Thank you for your time! Enjoy!
Table of Contents
Cardiovascular
Chemistry
Endocrine
Inflammation
Kidney Function
Lipids/Lipoproteins
Liver Function
Thyroid Function
- Triiodothyronine
- Thyroxine
- Free Triiodothyronine
- Free Thyroxine
- Reverse Triiodothyronine
- Triiodothyronine Resin Uptake
- Thyroid Stimulating Hormone
Energetics
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Anthropometrics
Body Weight
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Body Fat Mass
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Fat Free Mass
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Body Mass Index
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Waist Hip Ratio
Keto vs Non-Keto
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Visceral Adipose Tissue
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Bone Mineral Density
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Cardiovascular
Systolic Blood Pressure
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Diastolic Blood Pressure
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Flow-Mediated Dilation
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Heart Rate
Keto vs Non-Keto
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Chemistry
Hemoglobin A1C
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Blood Glucose
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Uric Acid
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Fibrinogen
Keto vs Non-Keto
Homocysteine
Keto vs Non-Keto
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Methylglyoxal
Keto vs Non-Keto
Proprotein Convertase Subtilisin/Kexin Type 9
Keto vs Non-Keto
Peptide YY
Keto vs Non-Keto
White Blood Cell Count
Keto vs Non-Keto
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Endocrine
Insulin
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Leptin
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Adiponectin
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Cortisol
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Epinephrine
Keto vs Non-Keto
Ghrelin
Keto vs Non-Keto
Insulin-Like Growth Factor 1
Keto vs Non-Keto
Testosterone
Keto vs Non-Keto
Keto by Duration (vs Control)
Inflammation
C-Reactive Protein
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Tumor Necrosis Factor
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Intercellular Adhesion Molecule 1
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Vascular Cell Adhesion Molecule 1
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Monocyte Chemoattractant Protein-1
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Interleukin 1 Beta
Keto vs Non-Keto
Interleukin 1 Receptor Antagonist
Keto vs Non-Keto
Interleukin 6
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Interleukin 8
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Interleukin 10
Keto vs Non-Keto
Kidney Function
Creatinine
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Urea
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Estimated Glomerular Filtration Rate
Keto vs Non-Keto
Lipids/Lipoproteins
Low Density Lipoprotein Cholesterol
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
High Density Lipoprotein Cholesterol
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Triglycerides
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Apolipoprotein B
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Apolipoprotein A1
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Apolipoprotein C-III
Keto vs Non-Keto
Low Density Lipoprotein Particle Count
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Low Density Lipoprotein Particle Size
Keto vs Non-Keto
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Lipoprotein (a)
Keto vs Non-Keto
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Liver Function
Aspartate Aminotransferase
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Alanine Aminotransferase
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Alkaline Phosphatase
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Gamma-Glutamyl Transferase
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Bilirubin
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Thyroid Function
Triiodothyronine
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Thyroxine
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Free Triiodothyronine
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Free Thyroxine
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Reverse Triiodothyronine
Keto vs Non-Keto
Keto by Weight Loss (vs Control)
Triiodothyronine Resin Uptake
Keto vs Non-Keto
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Thyroid Stimulating Hormone
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
Energetics
Energy Expenditure
Keto vs Non-Keto
Keto by Duration (vs Control)
Keto by Duration (vs Baseline)
Keto by Weight Loss (vs Control)
Keto by Weight Loss (vs Baseline)
