Effects of the Mediterranean Diet, Ketogenic Diet, and Intermittent Fasting on Iron Metabolism and Iron Deficiency Risk in Adults with Obesity: A Systematic Literature Review
La Vignera S, Condorelli R
Nutrients · 0 citas
Cómo se estudió
- Diseño
- Revisión sistemática (indexado por PubMed)
- Estudiado en
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- Resultado principal
- Marcadores de salud y funcionamiento
- Consumo medido con
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Quién lo pagó
- Financiación
- Financiación independiente
Según la declaración de financiación del texto completo.
Publicación
- Publicado
- 2026-08-17 · Nutrients · vol. 18 · número 16 · pág. 2681
- Editorial
- Multidisciplinary Digital Publishing Institute
- Citado
- 0 citas · más que el 52% de estudios similares · 0.0× el promedio de su campo
- Referencias
- 32 trabajos
- Acceso
- Acceso abierto (revista) · CC-BY
- Áreas de investigación
- Iron Metabolism and Disorders · Dietary Effects on Health · Nutritional Studies and Diet
- Palabras clave
- Mediterranean diet, ketogenic diet, intermittent fasting, iron metabolism, iron deficiency, obesity, hepcidin, iron absorption, serum ferritin, transferrin, inflammation, weight loss, omega-3 fatty acids, polyphenols
- MeSH
- humans, anemia, iron-deficiency, obesity, iron, fasting, diet, mediterranean, adult, female, male, hepcidins, diet, ketogenic, iron deficiencies, intermittent fasting
2 autores
- Sandro La Vignera🇮🇹 · autor de correspondenciaUniversity of Catania
- Rosita Angela Condorelli🇮🇹University of Catania
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background/objectives
Obesity is paradoxically associated with iron deficiency despite adequate dietary intake, driven by chronic inflammation and elevated hepcidin. Different dietary patterns may differentially affect iron metabolism in obese individuals, yet comparative evidence remains limited.
Methods
We conducted a systematic literature review following PRISMA 2020 guidelines. Four databases (SciSpace, Google Scholar, PubMed) were searched through 2025 using terms related to obesity, iron deficiency, and three dietary patterns: Mediterranean diet, ketogenic diet, and intermittent fasting. Studies were screened using seven predefined criteria (three inclusion, four exclusion) with thresholds of ≥4.0/5.0 for abstract screening and ≥4.5/5.0 for full-text screening.
Results
From 396 identified records (SciSpace n = 325, Google Scholar n = 57, PubMed n = 14), 38 studies were included after removing 62 duplicates and screening 334 unique records. Studies without accessible full text were excluded.The Mediterranean diet appears most protective for iron status due to its anti-inflammatory profile (omega-3 fatty acids, polyphenols, vitamin C) and bioavailable iron sources. Ketogenic diets may impair duodenal iron absorption through hepcidin-independent mechanisms and restrict dietary iron diversity. Intermittent fasting shows complex effects, remodeling iron metabolism with increased transferrin and decreased ferritin within physiological ranges. Weight loss per se consistently improves iron status by reducing adipose-driven inflammation and lowering hepcidin.
Conclusions
Among the three dietary patterns examined, the Mediterranean diet appears most protective for iron status in obese individuals. The ketogenic diet may pose the highest risk due to restricted dietary iron diversity and potential hepcidin-independent absorption impairment. Direct comparative randomized controlled trials are urgently needed. Clinicians should routinely monitor iron biomarkers, including hepcidin, in obese patients undertaking any dietary intervention. Quantitative biomarker data from the 38 included studies showed serum ferritin reductions of 8-28%, hemoglobin levels remaining within clinically stable ranges, and IL-6 decreases of 15-42% across dietary patterns.
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