Ketogenic diets and cardiovascular health balancing metabolic benefits against lipid-related risk
Liu H, Wu W, He N, Wang X, Pan S, Zhu L, Ma S, Zhang Y, Liu Z
BMC cardiovascular disorders · 0 citas
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 independiente
- Gobierno
- Shaanxi Provincial Innovation Capacity Support Program - Science and Technology Innovation Team Project
Según 1 financiador declarado y la declaración de financiación del texto completo.
Publicación
- Publicado
- 2026-07-07 · BMC Cardiovasc Disord · vol. 26 · número 1
- Editorial
- BioMed Central
- Citado
- 0 citas · más que el 51% de estudios similares · 0.0× el promedio de su campo
- Referencias
- 0 trabajos
- Acceso
- Acceso abierto (revista) · CC-BY-NC-ND
- Áreas de investigación
- Diet and metabolism studies · Dietary Effects on Health · Nutritional Studies and Diet
- Palabras clave
- ketogenic diet, cardiovascular health, LDL cholesterol, lipid profile, triglycerides, glycemic control, blood pressure, body weight, atherosclerosis, all-cause mortality, nutritional ketosis, carbohydrate restriction, risk-benefit assessment
- MeSH
- humans, cardiovascular diseases, blood glucose, lipids, treatment outcome, risk assessment, risk factors, adult, aged, middle aged, female, male, dyslipidemias, diet, carbohydrate-restricted, protective factors, biomarkers, diet, ketogenic, heart disease risk factors
9 autores
- Hanxiu Liu🇨🇳Shaanxi Provincial People's Hospital
- Wei Wu🇨🇳Shaanxi Provincial People's Hospital
- Ni He🇨🇳Shaanxi Provincial People's Hospital
- Xiqiang Wang🇨🇳Shaanxi Provincial People's Hospital
- Shuo Pan🇨🇳Shaanxi Provincial People's Hospital
- Ling Zhu🇨🇳Shaanxi Provincial People's Hospital
- Sen Ma🇨🇳Shaanxi Provincial People's Hospital
- Yuming Zhang🇨🇳 · autor de correspondenciaShaanxi Provincial People's Hospital
- Zhongwei Liu🇨🇳 · autor de correspondenciaShaanxi Provincial People's Hospital
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
The cardiovascular impact of ketogenic diets (KD) remains debated. In this review, KD refers to adult dietary interventions intended to induce nutritional ketosis through marked carbohydrate restriction, while acknowledging that ketogenic diet therapy (KDT) is a broader umbrella term encompassing several protocol variants.
Methods
We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library from inception to March 2026, and we additionally searched gray literature sources (ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform, medRxiv, conference proceedings, and reference lists). Eligible studies included randomized controlled trials (RCTs), prospective cohorts, and observational studies of adult KD interventions (generally < 10% of energy from carbohydrate or < 50 g/day). Primary outcomes were lipid changes; secondary outcomes included glycemia, anthropometrics, and blood pressure; exploratory outcomes were mortality and atherosclerosis. Random-effects meta-analyses generated pooled estimates. The protocol was not prospectively registered.
Results
Twenty-four studies (20 RCTs, 2 prospective cohorts, 1 non-randomized clinical trial, and 1 pilot intervention; >47,000 participants) were included. Compared with control diets, KD increased low-density lipoprotein cholesterol (LDL-C) (mean difference [MD] + 12.2 mg/dL, 95% CI 7.5 to 16.9; I2 = 67.7%) and total cholesterol, while high-density lipoprotein cholesterol (HDL-C) rose modestly. Triglycerides decreased overall (MD -16.1 mg/dL, 95% CI -20.3 to -11.8; I2 = 17.1%). KD also improved fasting glucose, glycated hemoglobin, body weight, body mass index, and systolic blood pressure. Cohort evidence suggested lower all-cause mortality but no clear reduction in cardiovascular mortality. Imaging evidence for atherosclerosis was limited and mixed.
Conclusions
KD was associated with improvements in adiposity, glycemic control, and blood pressure, but also with higher LDL-C and total cholesterol. Evidence for clinical cardiovascular endpoints remains limited, mixed, and mostly low certainty, supporting individualized risk-benefit assessment rather than universal adoption of KD.
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