28 Keto Diet Benefits Backed by Science

There is much debate about whether keto is another fad diet or can provide lasting health benefits.

In this article, I explain the numerous benefits of the ketogenic diet in simple terms and supported by 90 recent studies.

Keto Diet | Health Benefits | Practical Benefits | FAQ | Studies

What Is the Keto Diet?

The keto diet is a low-carb, healthy-fat (LCHF) diet.

It reduces carbohydrates and maximizes healthy fats while keeping protein consumption moderate. Keto aims to burn fat as the primary energy source.

Because it is more readily available, the body uses energy from carbohydrates first. Only then can the body attack fat reserves.

Because we eat carbohydrates around the clock today, the average person can no longer burn fat for energy.

Few people know hormones also control fat burning. Ketogenic diets take advantage of this fact.

When you eat carbohydrates, the body converts them into glucose. As a result, blood sugar and insulin levels rise.

Insulin is the primary storage hormone of our body. Its function is to store excess glucose as glycogen and body fat. In addition, insulin has an antilipolytic effect (Jensen et al. 1989¹).

Simply put, it blocks fat breakdown and promotes fat gain (Meijssen et al. 2001²).

As long as carbohydrates are in your glycogen stores, the body burns them preferentially for energy.

Only when glycogen stores are empty, and insulin levels are low can the body break down fat and convert it into ketones.

Once these fat energy sources predominantly feed the energy intake, the metabolic state of ketosis is reached.

Because ketogenic diets and interval fasting can permanently lower insulin levels, they are the most effective methods to lose body fat sustainably (Kong et al. 2013³).

But weight loss is only one of countless benefits of the keto diet. Research can now attest to an enormously vast range of health benefits of the ketogenic diet.

Health Benefits of the Keto Diet

The staggering health benefits of the keto diet show that it is more than just a weight loss trend.

1. Improves Cognition

Our brain requires more energy than other organs. However, few people know that ketone bodies and glucose can feed it.

Ketones can cross the blood-brain barrier (Hallböök et al. 2014⁴).

Compared to glucose, ketone bodies are a cleaner, more efficient, healthier fuel for the brain.

The modern Western diet of processed foods, refined grains, sugar, and beer provides vast amounts of glucose.

This diet promotes inflammation, oxidative stress, and insulin resistance in the brain, which can cause depression, among other things (Jacka et al. 2010⁵, Harrison et al. 2015⁶).

In contrast, ketone bodies reduce oxidative stress and inflammation in the brain (Achanta et al. 2017⁷).

Moreover, the neuroprotective properties of keto boost memory and cognitive reasoning (Hallböök et al. 2014⁸).

Neurologists conclude that healthy fats are crucial to brain health in old age (Chianese et al. 2018⁹).

Additionally, ketogenic diets increase brain-derived neurotrophic factor (BDNF) (Hu et al. 2018¹⁰).

BDNF is a neuronal growth hormone responsible for the formation of new neurons. High BDNF levels are associated with increased intelligence, mood, and memory.

For this reason, many people report being able to think more clearly in ketosis.

2. Boosts Well-Being

In addition to BDNF, another neurotransmitter is instrumental in mood.

The keto diet promotes gamma-aminobutyric acid (GABA), a neurotransmitter that reduces brain functions for anxiety and stress and improves sleep (Calderon et al. 2017¹¹).

Because ketogenic diets also combat oxidative stress, insulin resistance, and inflammation, they have a mood-stabilizing effect (Brietzke et al. 2018¹²).

In addition, ketosis reduces sodium concentrations in cells. This is an effect shared by all effective mood stabilizers (El-Mallakh et al. 2001¹³).

3. Heals Brain Cells

The keto diet is prime for treating complications that originate in the brain.

One of the first clinical applications of the ketogenic diet was the treatment of epilepsy. The keto diet has been used successfully since the 1920s to treat children with drug-resistant epilepsy (Neal et al. 2008¹⁴).

Keto helps children with epilepsy reduce the number of seizures (Ulamek-Koziol et al. 2019¹⁵).

In addition, recent research suggests that ketones are generally the better energy sources for healing traumatic brain injury (Prins et al. 2014¹⁶).

4. Alleviates Parkinson’s

The keto diet positively affects Parkinson’s disease (Phillips et al. 2018¹⁷).

According to a brand-new study, the ketogenic diet can improve mood, mobility, and processing speed in Parkinson’s patients.

Keto consistently shows improvement in learning and memory function in neurodegenerative diseases such as Alzheimer’s and Parkinson’s disease. Ketone bodies and improved insulin signaling in the brain are the reason (Choi et al. 2021¹⁸).

5. Fights Alzheimer’s

Alzheimer’s disease is the #1 cause of dementia.

Depending on the duration and intensity of ketosis, keto helps fight this neurodegenerative disease (Rusek et al. 2019¹⁹).

Because Alzheimer’s, like type 2 diabetes, is based on insulin resistance, keto may help against it. For this reason, scientists call Alzheimer’s disease type 3 diabetes (de la Monte 2014²⁰).

6. Regulates Blood Sugar

High blood sugar and insulin levels trigger numerous ailments and modern civilization diseases.

The keto diet reduces blood sugar and insulin levels (Noakes et al. 2006²¹).

The modern Western diet not only harms the body due to high blood sugar (Ramasarma et al. 2016²²), but inevitably leads to insulin resistance.

7. Reverses Insulin Resistance

Insulin resistance is the starting point for most chronic diseases that plague us today.

Insulin resistance occurs when the body needs to protect itself from dangerously high insulin levels, usually caused by high blood sugar. The significant side effect is the buildup of adipose tissue (Corkey 2012²³).

Ketogenic diets can reduce blood glucose and insulin resistance significantly better than conventional calorie reduction diets (Westman et al. 2008²⁴; Hussain et al. 2012²⁵).

This effect is also critical in the fight against diabetes.

8. Prevents Diabetes

Because the ketogenic diet fights the root of type 2 diabetes, it is so effective against it.

With the help of keto, people with type 2 diabetes can reduce or stop 95% of their blood sugar-lowering medications in six months.

Studies show that people with diabetes must cut their insulin dose in half when starting a low-carb diet (Westman et al. 2008²⁶).

9. Combats Metabolic Syndrome

Metabolic syndrome is closely related to type 2 diabetes and is composed of the following significant contemporary health risks (Huang et al. 2009²⁷):

• High blood glucose (due to insulin resistance).
• High blood fat levels (triglycerides)
• High blood pressure (hypertension)
• Low HDL levels (high-density lipoprotein, good cholesterol)
• Obesity (adiposity)

All of these factors contribute significantly to those diseases of civilization that are responsible for increased mortality.

A keto diet, which is low in carbohydrates, can reverse these five symptoms sustainably (Volek et al. 2005²⁸).

10. Fights PCOS

The keto diet also offers benefits in fighting another common metabolic disorder.

Polycystic ovarian syndrome (PCOS) is characterized by the development of cysts on the ovaries due to a hormonal imbalance.

Lowering insulin levels also effectively treats PCOS (Paoli et al. 2020²⁹).

Women suffering from PCOS successfully reduced insulin levels, body weight, and the ratio of testosterone to fertility hormones in just 24 weeks with keto (Mavropoulos et al. 2005³⁰).

11. Alleviates PMS

Premenstrual syndrome (PMS) symptoms are promoted by inflammation in the body (Gold et al. 2016³¹).

According to recent studies, the keto diet’s blood sugar-regulating and anti-inflammatory properties can relieve pain and symptoms of premenstrual syndrome (Masino et al. 2013³²; Schmelzer et al. 2015³³).

Numerous studies have shown that consuming sugary drinks and foods is closely related to PMS (Rossignol et al. 1991³⁴; Cheng et al. 2013³⁵; Bu et al. 2020³⁶).

12. Reduces Inflammation

Sweetened foods and beverages and other refined carbohydrates promote inflammation in the body (Buyken et al. 2014³⁷).

Unlike low-fat diets, keto can effectively reduce inflammation in the body (Forsythe et al. 2008³⁸), since ketones have antioxidant properties that reduce oxidative stress in our cells (Greco et al. 2015³⁹).

Thus, they can even reverse oxidative damage in the brain (Achanta et al. 2017⁴⁰).

This property can also help relieve skin diseases and pain in general (Fomin et al. 2017⁴¹).

13. Fights Acne

In women, I have been privileged to witness time and time again how quickly the switch to a ketogenic diet has a positive effect on the skin.

Studies show that carbohydrates play an essential role in the development of acne (Paoli et al. 2012⁴²).

Due to its anti-inflammatory effects, the keto diet is now considered a beacon of hope against blemished skin (Fomin et al. 2020⁴³).

In particular, the positive effects on the microbiome in our gut could be responsible for this.

14. Boosts Gut Health

Inflammation levels and gut health go hand in hand. The ketogenic diet reduces pro-inflammatory gut bacteria (Ang et al. 2020⁴⁴).

Brand new research suggests that keto’s beneficial metabolic effects are partly due to the gut microbiome (Attaye et al. 2022⁴⁵).

Therefore, the keto diet may also improve abdominal pain and quality of life in people with irritable bowel syndrome (Austin et al. 2009⁴⁶).

15. Slows Aging

Because biological aging is driven by inflammation, researchers have coined the term inflammaging (Franceschi et al. 2014⁴⁷).

In addition to reducing inflammation, specifically positive effects on the brain can slow aging.

Studies show that the keto diet can improve age-related cognitive function and life expectancy (Astrup et al. 2017⁴⁸).

The increased quality of life in old age due to keto has been noted through positive effects on working memory, visual attention, and task switching (Ota et al. 2016⁴⁹).

16. Fights Hypertension

High blood pressure increases the risk of cardiovascular disease.

Studies show that low-carb diets are significantly more effective than other diets in lowering blood pressure(Gardner et al. 2007⁵⁰).

Thus, they can help reduce the risk of strokes, heart attacks, and mortality in general.

17. Reduces Triglycerides

Triglycerides are fat molecules in the blood. They are the major measurable risk factor for cardiovascular disease (McBride 2008⁵¹).

Few people realize that triglycerides do not come from fat but are predominantly from carbohydrates in the diet.

When glycogen stores in the liver are full, it initiates de novo lipogenesis.

This process converts excess glucose, such as from starch in potatoes, into triglycerides.

But the liver is even more efficient at converting the second sugar molecule besides glucose in table sugar – fructose – into triglycerides. Therefore, fructose is also the primary driver of fatty liver disease worldwide (Ter Horst et al. 2017⁵²).

Finally, fructose is closely related to alcohol. The critical difference is that fructose is 100% metabolized in the liver and not in the brain, sparing us from hangovers (Lustig 2013⁵³).

When people limit carbohydrate consumption, triglyceride and other blood lipid levels improve tremendously (Wood et al. 2006⁵⁴).

In contrast, science can now clearly show that low-fat diets increase blood triglycerides (Parks et al. 1999⁵⁵).

18. Improves Cholesterol Levels

You most likely know high-density lipoprotein (HDL) as good cholesterol.

The higher the HDL level relative to triglycerides, the lower your risk for heart disease (Marotta et al. 2010⁵⁶).

Studies show that HDL levels increase with a high-fat, low-carbohydrate diet while triglyceride levels decrease (Foster et al. 2003⁵⁷).

In contrast, if fat, especially saturated fat, is reduced in the diet, good cholesterol drops markedly (Berglund et al. 1999⁵⁸).

You probably know low-density lipoprotein (LDL) as bad cholesterol.

Current research shows that the particle size of LDL is critical in determining whether it is associated with an increased risk for heart disease.

Smaller particles are associated with increased risk, and larger particles are associated with lower risk (Lamarche et al. 1997⁵⁹; Campos et al. 1992⁶⁰).

Studies show that low-carbohydrate diets increase the size of LDL particles while decreasing their number in the bloodstream (Wood et al. 2006⁶¹).

Therefore, heart health benefits enormously from low-carbohydrate diets like keto.

19. Promotes Heart Health

Ketogenic diets help control widespread risk factors such as body fat, blood lipids, blood pressure, and blood sugar (Paoli et al. 2013⁶²).

The keto diet is one of the most effective natural methods to prevent cardiovascular disease.

20. Fights Cancer

The ketogenic diet has been the focus of cancer research for quite some time, as it can significantly slow tumor growth (Weber et al. 2018⁶³).

Glucose is the substance that drives cancer cell growth (Zheng 2012⁶⁴).

Accordingly, it is beneficial to restrict carbohydrate intake to deprive cancer cells of their fuel.

The keto diet offers many health benefits because it drastically lowers insulin levels. This fact equally supports the prevention and fight against cancer.

Insulin is a hormone that promotes glucose uptake into cells, reduces the release of fat from cells, prevents ketone production in the liver, and stimulates fat and glycogen storage (Bolla et al. 2019⁶⁵).

Therefore, persistently elevated insulin levels promote cancer growth (DeCensi et al. 2014⁶⁶).

Moreover, a ketogenic diet increases the effectiveness of cancer treatments while protecting healthy cells (Dowis et al. 2021⁶⁷).

21. Accelerates Weight Loss

Its tremendous effectiveness in weight loss is why keto is so healthy and popular (Paoli et al. 2014⁶⁸).

Since keto forces your body to deplete glycogen stores, you can use it to lose several pounds quickly. Glycogen consists of one part carbohydrate and three parts water.

A ketogenic diet causes you to lose this stored water weight. But initial weight loss is not the end of the story.

A clinical trial compared the effectiveness of low-carb and low-fat diets over six months. 132 men and women participated.

Not only did the overweight individuals lose more weight on the low-carb diet, but unlike the low-fat diet, they also improved blood lipid levels and insulin sensitivity (Samaha et al. 2003⁶⁹).

Further research confirms ketogenic diets are safe to lose weight successfully, especially over extended periods.

Doing so improves body fat and blood lipid levels without noticeable side effects (Dashti et al. 2004⁷⁰).

22. Maximizes Fat-Burning

The ketogenic diet relearns the body to burn fat instead of sugar for energy. As a result, it gains metabolic flexibility.

You are fat-adapted when your body uses fat as its primary energy source. This metabolic state is established after the first few weeks of the keto diet. How long this takes individually depends on the preload of your hormonal system.

The higher the level of insulin resistance when you change your diet, the longer it may take for you to become fat-adapted and in ketosis.

The result is improved cellular metabolism. Clinical studies show that the keto diet significantly increases cell fat burning (Gano et al. 2014⁷¹).

Further studies show that keto-adapted people can burn more fat than others (Purdom et al. 2018⁷²).

This advantage of the keto diet is also noticeable in the increased effectiveness of exercise (McSwiney et al. 2018⁷³).

23. Reduces Dangerous Fat

More dangerous than subcutaneous fat just under the skin on the abdomen is fat in and around organs.

This so-called visceral fat increases the risk of metabolic syndrome, fatty liver, type 2 diabetes, and cardiovascular disease regardless of body mass index (Shah et al. 2014⁷⁴).

Therefore, people with normal BMI can develop type 2 diabetes (Taylor et al. 2015⁷⁵).

Studies show that keto helps burn straight visceral fat successfully (Volek et al. 2004⁷⁶).

24. Improves Performance

The keto diet can also have benefits for female athletes.

Researchers have repeatedly shown that keto helps use fat more efficiently as a muscle substrate, improving endurance performance (Phinney et al. 1983⁷⁷).

25. Increases Growth Hormones

Research shows that diets particularly low in carbohydrates increase growth hormone release (Manninen et al. 2006⁷⁸).

This aspect of the keto diet benefits muscle recovery and muscle development, organ health, and life expectancy in general  (Besson et al. 2003⁷⁹).

Practical Benefits of a Keto Diet

Even though most people try the keto diet to lose weight and get healthy, they stick with it for lesser-known benefits.

Many features of the ketogenic diet indirectly make the diet work in the long run. That’s why keto is more of a lifestyle that makes you sustainably healthy than a short-term diet.

1. Prevents Yo-Yo-Dieting

Unlike conventional diets, ketosis protects your muscles.

The low insulin levels ensure that fat is burned instead of lean mass, even when in a calorie deficit. Even researchers were astonished to discover this fact.

Their obese subjects lost body fat and weight quickly and permanently on the keto diet. What was absent was the expected reduction in basal metabolic rate.

The researchers concluded that the yo-yo effect was absent because ketogenic diets protect muscle mass (Gomez-Arbelaez et al. 2018⁸⁰).

Losing weight with conventional diets is accompanied by a compensatory effect, which increases appetite and thus promotes weight regains.

Unlike conventional diets, ketogenic diets can suppress the increase in the hunger hormone ghrelin caused by weight loss (Sumithran et al. 2013⁸¹).

2. Fights Cravings

One of the worst properties of sugar is that it makes you crave even more carbohydrates (Teff et al. 2004⁸²).

In contrast, eating fats inhibits the release of hunger hormones (Beck 2006⁸³).

In contrast, the consumption of healthy fats, such as olive oil or grass-fed butter, stimulates the release of satiety hormones (Dockray et al. 2012⁸⁴).

Some satiety hormones even increase in proportion to the number of fatty acids consumed in the diet (Pironi et al. 1993⁸⁵).

Unlike carbohydrates, fats cannot permanently throw your hormonal system off track if you eat high amounts (Dirlewanger et al. 2000⁸⁶).

In short, keto sets your hormonal system up for effective satiety and fat burning.

3. Works Without Calorie Counting

Keto is not a fad diet that will be forgotten the day after tomorrow. The main reason why Keto is enormously different from conventional diets is the end of calorie counting.

Studies show that people who reduce carbohydrates and eat more protein and fat automatically eat less daily (McClernon et al. 2007⁸⁷).

A meta-analysis confirms that even without calorie counting, keto produces better results than conventional diets that involve abstaining (Sackner-Bernstein et al. 2015⁸⁸).

What you eat is more important than how much you eat. The reason for this is the hormonal system.

Food and fitness industries persist with the outdated idea of calorie counting because it makes them more money.

World-renowned endocrinologist Dr. Robert Lustig showed more than 20 years ago that the obesity pandemic is due to a hormonal imbalance, not a caloric one (Lustig 2001⁸⁹).

Too many carbohydrates raise blood sugar and insulin levels, making you hungry, sick, and fat, even if you restrict yourself.

Accordingly, 99.5% of 99,791 overweight women and 76,704 overweight men failed to lose weight successfully through a calorie deficit in a dedicated study (Fildes et al. 2015⁹⁰).

The Bottom Line

Although mass media still classify keto as a short-term weight loss trend, current research tells a different story.

Rarely has anything been proven as watertight as the comprehensive health benefits of keto diets. These effects go far beyond weight loss.

A keto diet generally benefits the brain, heart, skin, gut, and hormone balance.

The welcome side effect is weight loss. Best of all, you can lose weight healthily without counting calories.

A ketogenic diet minimizes hunger and maximizes fat burning via your hormone balance.

Whether you want to live long or get fit fast, the keto diet will lead you to health benefits sustainably.

Frequently Asked Questions (FAQ)

What are 5 benefits of the keto diet?

Stunning weight loss results and improved metabolic, brain, gut, and heart health are the five major benefits of keto.

What are the negative effects of a keto diet?

Keto side effects include weight loss, satiety, urinary urgency, muscle cramps, mental clarity, increased energy, and the keto flu.

Is keto good for health?

Keto is fantastic for metabolic, brain, gut, and heart health.

Is keto good for belly fat?

Since keto aims to burn fat for energy, it is remarkable for shedding belly fat.

Studies

#1-6

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⁸Hallböök T, Ji S, Maudsley S, Martin B. The effects of the ketogenic diet on behavior and cognition. Epilepsy Res. 2012 Jul;100(3):304-9. doi: 10.1016/j.eplepsyres.2011.04.017. Epub 2011 Aug 27. Review. PubMed PMID: 21872440; PubMed Central PMCID: PMC4112040. 

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¹⁰Hu E, Du H, Zhu X, Wang L, Shang S, Wu X, Lu H, Lu X. Beta-hydroxybutyrate Promotes the Expression of BDNF in Hippocampal Neurons under Adequate Glucose Supply. Neuroscience. 2018 Aug 21;386:315-325. doi: 10.1016/j.neuroscience.2018.06.036. Epub 2018 Jun 30. PubMed PMID: 29966721.

¹¹Calderón N, Betancourt L, Hernández L, Rada P. A ketogenic diet modifies glutamate, gamma-aminobutyric acid and agmatine levels in the hippocampus of rats: A microdialysis study. Neurosci Lett. 2017 Mar 6;642:158-162. doi: 10.1016/j.neulet.2017.02.014. Epub 2017 Feb 8. PubMed PMID: 28189745.

¹²Brietzke E, Mansur RB, Subramaniapillai M, Balanzá-Martínez V, Vinberg M, González-Pinto A, Rosenblat JD, Ho R, McIntyre RS. Ketogenic diet as a metabolic therapy for mood disorders: Evidence and developments. Neurosci Biobehav Rev. 2018 Nov;94:11-16. doi: 10.1016/j.neubiorev.2018.07.020. Epub 2018 Jul 31. Review. PubMed PMID: 30075165.

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#14-20

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¹⁵Ułamek-Kozioł M, Czuczwar SJ, Januszewski S, Pluta R. Ketogenic Diet and Epilepsy. Nutrients. 2019 Oct 18;11(10). doi: 10.3390/nu11102510. Review. PubMed PMID: 31635247; PubMed Central PMCID: PMC6836058. 

¹⁶Prins ML, Matsumoto JH. The collective therapeutic potential of cerebral ketone metabolism in traumatic brain injury. J Lipid Res. 2014 Dec;55(12):2450-7. doi: 10.1194/jlr.R046706. Epub 2014 Apr 10. Review. PubMed PMID: 24721741; PubMed Central PMCID: PMC4242438. 

¹⁷Phillips MCL, Murtagh DKJ, Gilbertson LJ, Asztely FJS, Lynch CDP. Low-fat versus ketogenic diet in Parkinson’s disease: A pilot randomized controlled trial. Mov Disord. 2018 Aug;33(8):1306-1314. doi: 10.1002/mds.27390. Epub 2018 Aug 11. PubMed PMID: 30098269; PubMed Central PMCID: PMC6175383. 

¹⁸Choi A, Hallett M, Ehrlich D. Nutritional Ketosis in Parkinson’s Disease – a Review of Remaining Questions and Insights. Neurotherapeutics. 2021 Jul;18(3):1637-1649. doi: 10.1007/s13311-021-01067-w. Epub 2021 Jul 7. Review. PubMed PMID: 34235637; PubMed Central PMCID: PMC8608995.

¹⁹Rusek M, Pluta R, Ułamek-Kozioł M, Czuczwar SJ. Ketogenic Diet in Alzheimer’s Disease. Int J Mol Sci. 2019 Aug 9;20(16). doi: 10.3390/ijms20163892. Review. PubMed PMID: 31405021; PubMed Central PMCID: PMC6720297.

²⁰de la Monte SM. Type 3 diabetes is sporadic Alzheimer׳s disease: mini-review. Eur Neuropsychopharmacol. 2014 Dec;24(12):1954-60. doi: 10.1016/j.euroneuro.2014.06.008. Epub 2014 Jun 28. Review. PubMed PMID: 25088942; PubMed Central PMCID: PMC4444430.

#21-27

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²⁴Westman EC, Yancy WS Jr, Mavropoulos JC, Marquart M, McDuffie JR. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutr Metab (Lond). 2008 Dec 19;5:36. doi: 10.1186/1743-7075-5-36. PubMed PMID: 19099589; PubMed Central PMCID: PMC2633336.

²⁵Hussain TA, Mathew TC, Dashti AA, Asfar S, Al-Zaid N, Dashti HM. Effect of low-calorie versus low-carbohydrate ketogenic diet in type 2 diabetes. Nutrition. 2012 Oct;28(10):1016-21. doi: 10.1016/j.nut.2012.01.016. Epub 2012 Jun 5. PubMed PMID: 22673594.

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²⁸Volek JS, Feinman RD. Carbohydrate restriction improves the features of Metabolic Syndrome. Metabolic Syndrome may be defined by the response to carbohydrate restriction. Nutr Metab (Lond). 2005 Nov 16;2:31. doi: 10.1186/1743-7075-2-31. PubMed PMID: 16288655; PubMed Central PMCID: PMC1323303.

²⁹Paoli A, Mancin L, Giacona MC, Bianco A, Caprio M. Effects of a ketogenic diet in overweight women with polycystic ovary syndrome. J Transl Med. 2020 Feb 27;18(1):104. doi: 10.1186/s12967-020-02277-0. PubMed PMID: 32103756; PubMed Central PMCID: PMC7045520.

³⁰Mavropoulos JC, Yancy WS, Hepburn J, Westman EC. The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: a pilot study. Nutr Metab (Lond). 2005 Dec 16;2:35. doi: 10.1186/1743-7075-2-35. PubMed PMID: 16359551; PubMed Central PMCID: PMC1334192.

³¹Gold EB, Wells C, Rasor MO. The Association of Inflammation with Premenstrual Symptoms. J Womens Health (Larchmt). 2016 Sep;25(9):865-74. doi: 10.1089/jwh.2015.5529. Epub 2016 May 2. PubMed PMID: 27135720; PubMed Central PMCID: PMC5311461.

³²Masino SA, Ruskin DN. Ketogenic diets and pain. J Child Neurol. 2013 Aug;28(8):993-1001. doi: 10.1177/0883073813487595. Epub 2013 May 16. Review. PubMed PMID: 23680946; PubMed Central PMCID: PMC4124736. 

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³⁵Cheng SH, Shih CC, Yang YK, Chen KT, Chang YH, Yang YC. Factors associated with premenstrual syndrome – a survey of new female university students. Kaohsiung J Med Sci. 2013 Feb;29(2):100-5. doi: 10.1016/j.kjms.2012.08.017. Epub 2013 Jan 3. PubMed PMID: 23347812.

³⁶Bu L, Lai Y, Deng Y, Xiong C, Li F, Li L, Suzuki K, Ma S, Liu C. Negative Mood Is Associated with Diet and Dietary Antioxidants in University Students During the Menstrual Cycle: A Cross-Sectional Study from Guangzhou, China. Antioxidants (Basel). 2019 Dec 26;9(1). doi: 10.3390/antiox9010023. PubMed PMID: 31888014; PubMed Central PMCID: PMC7023165.

³⁷Buyken AE, Goletzke J, Joslowski G, Felbick A, Cheng G, Herder C, Brand-Miller JC. Association between carbohydrate quality and inflammatory markers: systematic review of observational and interventional studies. Am J Clin Nutr. 2014 Apr;99(4):813-33. doi: 10.3945/ajcn.113.074252. Epub 2014 Feb 19. Review. PubMed PMID: 24552752.

³⁸Forsythe CE, Phinney SD, Fernandez ML, Quann EE, Wood RJ, Bibus DM, Kraemer WJ, Feinman RD, Volek JS. Comparison of low fat and low carbohydrate diets on circulating fatty acid composition and markers of inflammation. Lipids. 2008 Jan;43(1):65-77. doi: 10.1007/s11745-007-3132-7. Epub 2007 Nov 29. PubMed PMID: 18046594.

³⁹Greco T, Glenn TC, Hovda DA, Prins ML. Ketogenic diet decreases oxidative stress and improves mitochondrial respiratory complex activity. J Cereb Blood Flow Metab. 2016 Sep;36(9):1603-13. doi: 10.1177/0271678X15610584. Epub 2015 Oct 13. PubMed PMID: 26661201; PubMed Central PMCID: PMC5012517.

⁴⁰Achanta LB, Rae CD. β-Hydroxybutyrate in the Brain: One Molecule, Multiple Mechanisms. Neurochem Res. 2017 Jan;42(1):35-49. doi: 10.1007/s11064-016-2099-2. Epub 2016 Nov 8. Review. PubMed PMID: 27826689.

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⁴¹ Fomin DA, McDaniel B, Crane J. The promising potential role of ketones in inflammatory dermatologic disease: a new frontier in treatment research. J Dermatolog Treat. 2017 Sep;28(6):484-487. doi: 10.1080/09546634.2016.1276259. Epub 2017 Jan 24. PubMed PMID: 28043175.

⁴²Paoli A, Grimaldi K, Toniolo L, Canato M, Bianco A, Fratter A. Nutrition and acne: therapeutic potential of ketogenic diets. Skin Pharmacol Physiol. 2012;25(3):111-7. doi: 10.1159/000336404. Epub 2012 Feb 11. Review. PubMed PMID: 22327146.

⁴³Fomin DA, Handfield K. The ketogenic diet and dermatology: a primer on current literature. Cutis. 2020 Jan;105(1):40-43. Review. PubMed PMID: 32074146.

⁴⁴Ang QY, Alexander M, Newman JC, Tian Y, Cai J, Upadhyay V, Turnbaugh JA, Verdin E, Hall KD, Leibel RL, Ravussin E, Rosenbaum M, Patterson AD, Turnbaugh PJ. Ketogenic Diets Alter the Gut Microbiome Resulting in Decreased Intestinal Th17 Cells. Cell. 2020 Jun 11;181(6):1263-1275.e16. doi: 10.1016/j.cell.2020.04.027. Epub 2020 May 20. PubMed PMID: 32437658; PubMed Central PMCID: PMC7293577.

⁴⁵Attaye I, van Oppenraaij S, Warmbrunn MV, Nieuwdorp M. The Role of the Gut Microbiota on the Beneficial Effects of Ketogenic Diets. Nutrients. 2021 Dec 31;14(1). doi: 10.3390/nu14010191. PubMed PMID: 35011071; PubMed Central PMCID: PMC8747023.

⁴⁶Austin GL, Dalton CB, Hu Y, Morris CB, Hankins J, Weinland SR, Westman EC, Yancy WS Jr, Drossman DA. A very low-carbohydrate diet improves symptoms and quality of life in diarrhea-predominant irritable bowel syndrome. Clin Gastroenterol Hepatol. 2009 Jun;7(6):706-708.e1. doi: 10.1016/j.cgh.2009.02.023. Epub 2009 Mar 10. PubMed PMID: 19281859; PubMed Central PMCID: PMC2693479.

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⁴⁷Franceschi C, Campisi J. Chronic inflammation (inflammaging) and its potential contribution to age-associated diseases. J Gerontol A Biol Sci Med Sci. 2014 Jun;69 Suppl 1:S4-9. doi: 10.1093/gerona/glu057. Review. PubMed PMID: 24833586.

⁴⁸Astrup A, Hjorth MF. Ageing: Improvement in age-related cognitive functions and life expectancy by ketogenic diets. Nat Rev Endocrinol. 2017 Nov 9;13(12):695-696. doi: 10.1038/nrendo.2017.142. PubMed PMID: 29118350.

⁴⁹Ota M, Matsuo J, Ishida I, Hattori K, Teraishi T, Tonouchi H, Ashida K, Takahashi T, Kunugi H. Effect of a ketogenic meal on cognitive function in elderly adults: potential for cognitive enhancement. Psychopharmacology (Berl). 2016 Oct;233(21-22):3797-3802. doi: 10.1007/s00213-016-4414-7. Epub 2016 Aug 27. PubMed PMID: 27568199.

⁵⁰Gardner CD, Kiazand A, Alhassan S, Kim S, Stafford RS, Balise RR, Kraemer HC, King AC. Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study: a randomized trial. JAMA. 2007 Mar 7;297(9):969-77. doi: 10.1001/jama.297.9.969. PubMed PMID: 17341711.

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⁵²Ter Horst KW, Serlie MJ. Fructose Consumption, Lipogenesis, and Non-Alcoholic Fatty Liver Disease. Nutrients. 2017 Sep 6;9(9). doi: 10.3390/nu9090981. Review. PubMed PMID: 28878197; PubMed Central PMCID: PMC5622741.

⁵³Lustig RH. Fructose: it’s “alcohol without the buzz”. Adv Nutr. 2013 Mar 1;4(2):226-35. doi: 10.3945/an.112.002998. PubMed PMID: 23493539; PubMed Central PMCID: PMC3649103.

#54-60

⁵⁴Wood RJ, Volek JS, Liu Y, Shachter NS, Contois JH, Fernandez ML. Carbohydrate restriction alters lipoprotein metabolism by modifying VLDL, LDL, and HDL subfraction distribution and size in overweight men. J Nutr. 2006 Feb;136(2):384-9. doi: 10.1093/jn/136.2.384. PubMed PMID: 16424116.

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⁵⁷Foster GD, Wyatt HR, Hill JO, McGuckin BG, Brill C, Mohammed BS, Szapary PO, Rader DJ, Edman JS, Klein S. A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med. 2003 May 22;348(21):2082-90. doi: 10.1056/NEJMoa022207. PubMed PMID: 12761365.

⁵⁸Berglund L, Oliver EH, Fontanez N, Holleran S, Matthews K, Roheim PS, Ginsberg HN, Ramakrishnan R, Lefevre M. HDL-subpopulation patterns in response to reductions in dietary total and saturated fat intakes in healthy subjects. Am J Clin Nutr. 1999 Dec;70(6):992-1000. doi: 10.1093/ajcn/70.6.992. PubMed PMID: 10584043.

⁵⁹Mauger JF, Lichtenstein AH, Ausman LM, Jalbert SM, Jauhiainen M, Ehnholm C, Lamarche B. Effect of different forms of dietary hydrogenated fats on LDL particle size. Am J Clin Nutr. 2003 Sep;78(3):370-5. doi: 10.1093/ajcn/78.3.370. PubMed PMID: 12936917.

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#61-67

⁶¹Wood RJ, Volek JS, Liu Y, Shachter NS, Contois JH, Fernandez ML. Carbohydrate restriction alters lipoprotein metabolism by modifying VLDL, LDL, and HDL subfraction distribution and size in overweight men. J Nutr. 2006 Feb;136(2):384-9. doi: 10.1093/jn/136.2.384. PubMed PMID: 16424116.

⁶²Paoli A, Rubini A, Volek JS, Grimaldi KA. Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. Eur J Clin Nutr. 2013 Aug;67(8):789-96. doi: 10.1038/ejcn.2013.116. Epub 2013 Jun 26. Review. PubMed PMID: 23801097; PubMed Central PMCID: PMC3826507. 

⁶³Weber DD, Aminazdeh-Gohari S, Kofler B. Ketogenic diet in cancer therapy. Aging (Albany NY). 2018 Feb 11;10(2):164-165. doi: 10.18632/aging.101382. PubMed PMID: 29443693; PubMed Central PMCID: PMC5842847. 

⁶⁴Zheng J. Energy metabolism of cancer: Glycolysis versus oxidative phosphorylation (Review). Oncol Lett. 2012 Dec;4(6):1151-1157. doi: 10.3892/ol.2012.928. Epub 2012 Sep 20. PubMed PMID: 23226794; PubMed Central PMCID: PMC3506713.

⁶⁵Bolla AM, Caretto A, Laurenzi A, Scavini M, Piemonti L. Low-Carb and Ketogenic Diets in Type 1 and Type 2 Diabetes. Nutrients. 2019 Apr 26;11(5). doi: 10.3390/nu11050962. Review. PubMed PMID: 31035514; PubMed Central PMCID: PMC6566854.

⁶⁶DeCensi A, Puntoni M, Gandini S, Guerrieri-Gonzaga A, Johansson HA, Cazzaniga M, Pruneri G, Serrano D, Schwab M, Hofmann U, Mora S, Aristarco V, Macis D, Bassi F, Luini A, Lazzeroni M, Bonanni B, Pollak MN. Differential effects of metformin on breast cancer proliferation according to markers of insulin resistance and tumor subtype in a randomized presurgical trial. Breast Cancer Res Treat. 2014 Nov;148(1):81-90. doi: 10.1007/s10549-014-3141-1. Epub 2014 Sep 25. PubMed PMID: 25253174; PubMed Central PMCID: PMC4196136.

⁶⁷Dowis K, Banga S. The Potential Health Benefits of the Ketogenic Diet: A Narrative Review. Nutrients. 2021 May 13;13(5). doi: 10.3390/nu13051654. Review. PubMed PMID: 34068325; PubMed Central PMCID: PMC8153354.

#68-74

⁶⁸Paoli A. Ketogenic diet for obesity: friend or foe?. Int J Environ Res Public Health. 2014 Feb 19;11(2):2092-107. doi: 10.3390/ijerph110202092. Review. PubMed PMID: 24557522; PubMed Central PMCID: PMC3945587.

⁶⁹Samaha FF, Iqbal N, Seshadri P, Chicano KL, Daily DA, McGrory J, Williams T, Williams M, Gracely EJ, Stern L. A low-carbohydrate as compared with a low-fat diet in severe obesity. N Engl J Med. 2003 May 22;348(21):2074-81. doi: 10.1056/NEJMoa022637. PubMed PMID: 12761364.

⁷⁰Dashti HM, Mathew TC, Hussein T, Asfar SK, Behbahani A, Khoursheed MA, Al-Sayer HM, Bo-Abbas YY, Al-Zaid NS. Long-term effects of a ketogenic diet in obese patients. Exp Clin Cardiol. 2004 Fall;9(3):200-5. PubMed PMID: 19641727; PubMed Central PMCID: PMC2716748. 

⁷¹Gano LB, Patel M, Rho JM. Ketogenic diets, mitochondria, and neurological diseases. J Lipid Res. 2014 Nov;55(11):2211-28. doi: 10.1194/jlr.R048975. Epub 2014 May 20. Review. PubMed PMID: 24847102; PubMed Central PMCID: PMC4617125.

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⁷⁴Dockray GJ. Cholecystokinin. Curr Opin Endocrinol Diabetes Obes. 2012 Feb;19(1):8-12. doi: 10.1097/MED.0b013e32834eb77d. Review. PubMed PMID: 22157397.

#75-80

⁷⁵Pironi L, Stanghellini V, Miglioli M, Corinaldesi R, De Giorgio R, Ruggeri E, Tosetti C, Poggioli G, Morselli Labate AM, Monetti N. Fat-induced ileal brake in humans: a dose-dependent phenomenon correlated to the plasma levels of peptide YY. Gastroenterology. 1993 Sep;105(3):733-9. doi: 10.1016/0016-5085(93)90890-o. PubMed PMID: 8359644.

⁷⁶Dirlewanger M, di Vetta V, Guenat E, Battilana P, Seematter G, Schneiter P, Jéquier E, Tappy L. Effects of short-term carbohydrate or fat overfeeding on energy expenditure and plasma leptin concentrations in healthy female subjects. Int J Obes Relat Metab Disord. 2000 Nov;24(11):1413-8. doi: 10.1038/sj.ijo.0801395. PubMed PMID: 11126336.

⁷⁷Phinney SD, Bistrian BR, Evans WJ, Gervino E, Blackburn GL. The human metabolic response to chronic ketosis without caloric restriction: preservation of submaximal exercise capability with reduced carbohydrate oxidation. Metabolism. 1983 Aug;32(8):769-76. doi: 10.1016/0026-0495(83)90106-3. PubMed PMID: 6865776. 

⁷⁸Manninen AH. Very-low-carbohydrate diets and preservation of muscle mass. Nutr Metab (Lond). 2006 Jan 31;3:9. doi: 10.1186/1743-7075-3-9. PubMed PMID: 16448570; PubMed Central PMCID: PMC1373635.

⁷⁹Besson A, Salemi S, Gallati S, Jenal A, Horn R, Mullis PS, Mullis PE. Reduced longevity in untreated patients with isolated growth hormone deficiency. J Clin Endocrinol Metab. 2003 Aug;88(8):3664-7. doi: 10.1210/jc.2002-021938. PubMed PMID: 12915652.

⁸⁰Gomez-Arbelaez D, Crujeiras AB, Castro AI, Martinez-Olmos MA, Canton A, Ordoñez-Mayan L, Sajoux I, Galban C, Bellido D, Casanueva FF. Resting metabolic rate of obese patients under very low calorie ketogenic diet. Nutr Metab (Lond). 2018;15:18. doi: 10.1186/s12986-018-0249-z. eCollection 2018. PubMed PMID: 29467800; PubMed Central PMCID: PMC5816424.

#81-86

⁸¹Sumithran P, Prendergast LA, Delbridge E, Purcell K, Shulkes A, Kriketos A, Proietto J. Ketosis and appetite-mediating nutrients and hormones after weight loss. Eur J Clin Nutr. 2013 Jul;67(7):759-64. doi: 10.1038/ejcn.2013.90. Epub 2013 May 1. PubMed PMID: 23632752.

⁸²Teff KL, Elliott SS, Tschöp M, Kieffer TJ, Rader D, Heiman M, Townsend RR, Keim NL, D’Alessio D, Havel PJ. Dietary fructose reduces circulating insulin and leptin, attenuates postprandial suppression of ghrelin, and increases triglycerides in women. J Clin Endocrinol Metab. 2004 Jun;89(6):2963-72. doi: 10.1210/jc.2003-031855. PubMed PMID: 15181085.

⁸³Beck B. Neuropeptide Y in normal eating and in genetic and dietary-induced obesity. Philos Trans R Soc Lond B Biol Sci. 2006 Jul 29;361(1471):1159-85. doi: 10.1098/rstb.2006.1855. Review. PubMed PMID: 16874931; PubMed Central PMCID: PMC1642692.

⁸⁴Dockray GJ. Cholecystokinin. Curr Opin Endocrinol Diabetes Obes. 2012 Feb;19(1):8-12. doi: 10.1097/MED.0b013e32834eb77d. Review. PubMed PMID: 22157397.

⁸⁵Pironi L, Stanghellini V, Miglioli M, Corinaldesi R, De Giorgio R, Ruggeri E, Tosetti C, Poggioli G, Morselli Labate AM, Monetti N. Fat-induced ileal brake in humans: a dose-dependent phenomenon correlated to the plasma levels of peptide YY. Gastroenterology. 1993 Sep;105(3):733-9. doi: 10.1016/0016-5085(93)90890-o. PubMed PMID: 8359644.

⁸⁶Dirlewanger M, di Vetta V, Guenat E, Battilana P, Seematter G, Schneiter P, Jéquier E, Tappy L. Effects of short-term carbohydrate or fat overfeeding on energy expenditure and plasma leptin concentrations in healthy female subjects. Int J Obes Relat Metab Disord. 2000 Nov;24(11):1413-8. doi: 10.1038/sj.ijo.0801395. PubMed PMID: 11126336.

#87-90

⁸⁷McClernon FJ, Yancy WS Jr, Eberstein JA, Atkins RC, Westman EC. The effects of a low-carbohydrate ketogenic diet and a low-fat diet on mood, hunger, and other self-reported symptoms. Obesity (Silver Spring). 2007 Jan;15(1):182-7. doi: 10.1038/oby.2007.516. PubMed PMID: 17228046.

⁸⁸Sackner-Bernstein J, Kanter D, Kaul S. Dietary Intervention for Overweight and Obese Adults: Comparison of Low-Carbohydrate and Low-Fat Diets. A Meta-Analysis. PLoS One. 2015;10(10):e0139817. doi: 10.1371/journal.pone.0139817. eCollection 2015. PubMed PMID: 26485706; PubMed Central PMCID: PMC4618935.

⁸⁹Lustig RH. The neuroendocrinology of childhood obesity. Pediatr Clin North Am. 2001 Aug;48(4):909-30. doi: 10.1016/s0031-3955(05)70348-5. Review. PubMed PMID: 11494643.

⁹⁰Fildes A, Charlton J, Rudisill C, Littlejohns P, Prevost AT, Gulliford MC. Probability of an Obese Person Attaining Normal Body Weight: Cohort Study Using Electronic Health Records. Am J Public Health. 2015 Sep;105(9):e54-9. doi: 10.2105/AJPH.2015.302773. Epub 2015 Jul 16. PubMed PMID: 26180980; PubMed Central PMCID: PMC4539812.