Ketogenic Diet and Multiple Health Outcomes: An Umbrella Review of Meta-Analysis
Numerous studies have examined the effects of ketogenic diets (KD) on health-related outcomes through meta-analyses. However, the presence of biases may compromise the reliability of conclusions. Therefore, we conducted an umbrella review to collate and appraise the strength of evidence on the effic...
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-09-01
|
| Series: | Nutrients |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6643/15/19/4161 |
| _version_ | 1797575355076182016 |
|---|---|
| author | Shiyun Chen Xin Su Yonghui Feng Ruojie Li Minqi Liao Laina Fan Jiazi Liu Shasha Chen Shiwen Zhang Jun Cai Sui Zhu Jianxiang Niu Yanbin Ye Kenneth Lo Fangfang Zeng |
| author_facet | Shiyun Chen Xin Su Yonghui Feng Ruojie Li Minqi Liao Laina Fan Jiazi Liu Shasha Chen Shiwen Zhang Jun Cai Sui Zhu Jianxiang Niu Yanbin Ye Kenneth Lo Fangfang Zeng |
| author_sort | Shiyun Chen |
| collection | DOAJ |
| description | Numerous studies have examined the effects of ketogenic diets (KD) on health-related outcomes through meta-analyses. However, the presence of biases may compromise the reliability of conclusions. Therefore, we conducted an umbrella review to collate and appraise the strength of evidence on the efficacy of KD interventions. We conducted a comprehensive search on PubMed, EMBASE, and the Cochrane Database until April 2023 to identify meta-analyses that investigated the treatment effects of KD for multiple health conditions, which yielded 23 meta-analyses for quantitative analyses. The evidence suggests that KD could increase the levels of low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C), the respiratory exchange rate (RER), and could decrease total testosterone and testosterone levels (all <i>p</i>-random effects: <0.05). The combination of KD and physical activity can significantly reduce body weight and increase the levels of LDL-C and cortisol. In addition, KD was associated with seizure reduction in children, which can be explained by the ketosis state as induced by the diet. Furthermore, KD demonstrated a better alleviation effect in refractory childhood epilepsy, in terms of median effective rates for seizure reduction of ≥50%, ≥90%, and seizure freedom. However, the strength of evidence supporting the aforementioned associations was generally weak, thereby challenging their credibility. Consequently, future studies should prioritize stringent research protocols to ascertain whether KD interventions with longer intervention periods hold promise as a viable treatment option for various diseases. |
| first_indexed | 2024-03-10T21:38:24Z |
| format | Article |
| id | doaj.art-18baa7ae058c4167ab48403ecec2a933 |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-10T21:38:24Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-18baa7ae058c4167ab48403ecec2a9332023-11-19T14:51:02ZengMDPI AGNutrients2072-66432023-09-011519416110.3390/nu15194161Ketogenic Diet and Multiple Health Outcomes: An Umbrella Review of Meta-AnalysisShiyun Chen0Xin Su1Yonghui Feng2Ruojie Li3Minqi Liao4Laina Fan5Jiazi Liu6Shasha Chen7Shiwen Zhang8Jun Cai9Sui Zhu10Jianxiang Niu11Yanbin Ye12Kenneth Lo13Fangfang Zeng14Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Road West, Guangzhou 510632, ChinaDepartment of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Road West, Guangzhou 510632, ChinaDepartment of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Road West, Guangzhou 510632, ChinaDepartment of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Road West, Guangzhou 510632, ChinaInstitute of Epidemiology, Helmholtz Zentrum Munich-German Research Center for Environmental Health, Ingolstadt Landstr. 1, 85764 Neuherberg, GermanyDepartment of Clinical Medicine, International School, Jinan University, No. 601 Huangpu Road West, Guangzhou 510632, ChinaDepartment of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Road West, Guangzhou 510632, ChinaDepartment of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Road West, Guangzhou 510632, ChinaDepartment of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Road West, Guangzhou 510632, ChinaDepartment of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Road West, Guangzhou 510632, ChinaDepartment of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Road West, Guangzhou 510632, ChinaGeneral Surgery, The Affiliated Hospital of Inner Mongolia Medical University, No. 1 Tongdao North Road, Hohhot 010000, ChinaDepartment of Clinical Nutrition, The First Affiliated Hospital, Jinan University, Guangzhou 510630, ChinaDepartment of Food Science and Nutrition, The Hong Kong Polytechnic University, Kowloon, Hong Kong 100872, ChinaDepartment of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Road West, Guangzhou 510632, ChinaNumerous studies have examined the effects of ketogenic diets (KD) on health-related outcomes through meta-analyses. However, the presence of biases may compromise the reliability of conclusions. Therefore, we conducted an umbrella review to collate and appraise the strength of evidence on the efficacy of KD interventions. We conducted a comprehensive search on PubMed, EMBASE, and the Cochrane Database until April 2023 to identify meta-analyses that investigated the treatment effects of KD for multiple health conditions, which yielded 23 meta-analyses for quantitative analyses. The evidence suggests that KD could increase the levels of low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C), the respiratory exchange rate (RER), and could decrease total testosterone and testosterone levels (all <i>p</i>-random effects: <0.05). The combination of KD and physical activity can significantly reduce body weight and increase the levels of LDL-C and cortisol. In addition, KD was associated with seizure reduction in children, which can be explained by the ketosis state as induced by the diet. Furthermore, KD demonstrated a better alleviation effect in refractory childhood epilepsy, in terms of median effective rates for seizure reduction of ≥50%, ≥90%, and seizure freedom. However, the strength of evidence supporting the aforementioned associations was generally weak, thereby challenging their credibility. Consequently, future studies should prioritize stringent research protocols to ascertain whether KD interventions with longer intervention periods hold promise as a viable treatment option for various diseases.https://www.mdpi.com/2072-6643/15/19/4161ketogenic dietsobesityoverweightseizure reductioncancerumbrella review |
| spellingShingle | Shiyun Chen Xin Su Yonghui Feng Ruojie Li Minqi Liao Laina Fan Jiazi Liu Shasha Chen Shiwen Zhang Jun Cai Sui Zhu Jianxiang Niu Yanbin Ye Kenneth Lo Fangfang Zeng Ketogenic Diet and Multiple Health Outcomes: An Umbrella Review of Meta-Analysis Nutrients ketogenic diets obesity overweight seizure reduction cancer umbrella review |
| title | Ketogenic Diet and Multiple Health Outcomes: An Umbrella Review of Meta-Analysis |
| title_full | Ketogenic Diet and Multiple Health Outcomes: An Umbrella Review of Meta-Analysis |
| title_fullStr | Ketogenic Diet and Multiple Health Outcomes: An Umbrella Review of Meta-Analysis |
| title_full_unstemmed | Ketogenic Diet and Multiple Health Outcomes: An Umbrella Review of Meta-Analysis |
| title_short | Ketogenic Diet and Multiple Health Outcomes: An Umbrella Review of Meta-Analysis |
| title_sort | ketogenic diet and multiple health outcomes an umbrella review of meta analysis |
| topic | ketogenic diets obesity overweight seizure reduction cancer umbrella review |
| url | https://www.mdpi.com/2072-6643/15/19/4161 |
| work_keys_str_mv | AT shiyunchen ketogenicdietandmultiplehealthoutcomesanumbrellareviewofmetaanalysis AT xinsu ketogenicdietandmultiplehealthoutcomesanumbrellareviewofmetaanalysis AT yonghuifeng ketogenicdietandmultiplehealthoutcomesanumbrellareviewofmetaanalysis AT ruojieli ketogenicdietandmultiplehealthoutcomesanumbrellareviewofmetaanalysis AT minqiliao ketogenicdietandmultiplehealthoutcomesanumbrellareviewofmetaanalysis AT lainafan ketogenicdietandmultiplehealthoutcomesanumbrellareviewofmetaanalysis AT jiaziliu ketogenicdietandmultiplehealthoutcomesanumbrellareviewofmetaanalysis AT shashachen ketogenicdietandmultiplehealthoutcomesanumbrellareviewofmetaanalysis AT shiwenzhang ketogenicdietandmultiplehealthoutcomesanumbrellareviewofmetaanalysis AT juncai ketogenicdietandmultiplehealthoutcomesanumbrellareviewofmetaanalysis AT suizhu ketogenicdietandmultiplehealthoutcomesanumbrellareviewofmetaanalysis AT jianxiangniu ketogenicdietandmultiplehealthoutcomesanumbrellareviewofmetaanalysis AT yanbinye ketogenicdietandmultiplehealthoutcomesanumbrellareviewofmetaanalysis AT kennethlo ketogenicdietandmultiplehealthoutcomesanumbrellareviewofmetaanalysis AT fangfangzeng ketogenicdietandmultiplehealthoutcomesanumbrellareviewofmetaanalysis |