Effects of ketogenic diet on health outcomes: an umbrella review of meta-analyses of randomized clinical trials
Patikorn C, Saidoung P, Pham T, Phisalprapa P, Lee YY, Varady KA, Veettil SK, Chaiyakunapruk N
BMC medicine · 79 citas
Etiquetas de revisión
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Cómo se estudió
- Diseño
- Revisión sistemática (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
- Consumo medido con
- No se indica
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2023-05-25 · BMC Med · vol. 21 · número 1 · pág. 196
- Editorial
- BioMed Central
- Citado
- 100 citas · más que el 99% de estudios similares · 14.5× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 69 trabajos
- Acceso
- Acceso abierto (revista) · CC-BY
- Áreas de investigación
- Diet and metabolism studies · Dietary Effects on Health · Nutritional Studies and Diet
- Palabras clave
- ketogenic diet, very low-calorie ketogenic diet, epilepsy, seizure frequency, cardiometabolic outcomes, LDL cholesterol, triglycerides, body weight, body fat percentage, muscle mass, quality of evidence, GRADE, obesity, overweight adults, health outcomes, respiratory exchange ratio
- MeSH
- humans, seizures, cardiovascular diseases, obesity, body weight, adult, overweight, cholesterol, ldl, meta-analysis as topic, randomized controlled trials as topic, diet, ketogenic
8 autores
- Chanthawat Patikorn🇹🇭🇺🇸Chulalongkorn University; University of Utah
- Pantakarn Saidoung🇺🇸University of Utah
- Tuan Anh Pham🇺🇸University of Utah
- Pochamana Phisalprapa🇹🇭Siriraj Hospital; Mahidol University
- Yeong Yeh Lee🇲🇾Universiti Sains Malaysia; Hospital Universiti Sains Malaysia
- Krista A Varady🇺🇸University of Illinois Chicago
- Sajesh Kalkandi Veettil🇺🇸 · autor de correspondenciaUniversity of Utah
- Nathorn Chaiyakunapruk🇺🇸 · autor de correspondenciaUniversity of Utah; VA Salt Lake City Healthcare System
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Systematic reviews and meta-analyses of randomized clinical trials (RCTs) have reported the benefits of ketogenic diets (KD) in various participants such as patients with epilepsy and adults with overweight or obesity. Nevertheless, there has been little synthesis of the strength and quality of this evidence in aggregate.
Methods
To grade the evidence from published meta-analyses of RCTs that assessed the association of KD, ketogenic low-carbohydrate high-fat diet (K-LCHF), and very low-calorie KD (VLCKD) with health outcomes, PubMed, EMBASE, Epistemonikos, and Cochrane database of systematic reviews were searched up to February 15, 2023. Meta-analyses of RCTs of KD were included. Meta-analyses were re-performed using a random-effects model. The quality of evidence per association provided in meta-analyses was rated by the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) criteria as high, moderate, low, and very low.
Results
We included 17 meta-analyses comprising 68 RCTs (median [interquartile range, IQR] sample size of 42 [20-104] participants and follow-up period of 13 [8-36] weeks) and 115 unique associations. There were 51 statistically significant associations (44%) of which four associations were supported by high-quality evidence (reduced triglyceride (n = 2), seizure frequency (n = 1) and increased low-density lipoprotein cholesterol (LDL-C) (n = 1)) and four associations supported by moderate-quality evidence (decrease in body weight, respiratory exchange ratio (RER), hemoglobin A1c, and increased total cholesterol). The remaining associations were supported by very low (26 associations) to low (17 associations) quality evidence. In overweight or obese adults, VLCKD was significantly associated with improvement in anthropometric and cardiometabolic outcomes without worsening muscle mass, LDL-C, and total cholesterol. K-LCHF was associated with reduced body weight and body fat percentage, but also reduced muscle mass in healthy participants.
Conclusions
This umbrella review found beneficial associations of KD supported by moderate to high-quality evidence on seizure and several cardiometabolic parameters. However, KD was associated with a clinically meaningful increase in LDL-C. Clinical trials with long-term follow-up are warranted to investigate whether the short-term effects of KD will translate to beneficial effects on clinical outcomes such as cardiovascular events and mortality.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial (CC BY).
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