Ketogenic diet for epilepsy and obesity: Is it the same?

Area of Science:

• Nutrition Science
• Metabolic Research
• Neurology

Background:

• The term 'ketogenic diet' (KD) encompasses diverse dietary protocols with varied applications, leading to confusion among patients and healthcare professionals.
• Current terminology fails to differentiate between KDs for neurological diseases and those for weight management, despite distinct metabolic effects and mechanisms.

Purpose of the Study:

• To clarify the terminology surrounding ketogenic diets and propose standardized nomenclature.
• To differentiate between ketogenic dietary therapy (KDT) for neurological conditions and other low-carbohydrate diets used for weight loss.

Main Methods:

• A viewpoint analysis of existing literature and clinical practices regarding ketogenic diets.
• Proposal for revised abbreviations: Very Low Carbohydrate Ketogenic Diet (VLCHKD) and Very Low Energy Ketogenic Diet (VLEKD).

Main Results:

• Ketogenic diets for epilepsy and other neurological diseases (KDT) have established mechanisms involving ketosis.
• Diets for weight loss, often low-fat and low-carbohydrate, may only induce mild ketosis, especially with calorie restriction, and are not inherently ketogenic.
• Current KD terminology is imprecise and hinders clear communication regarding efficacy and side effects.

Conclusions:

• The term ketogenic dietary therapy (KDT) should be exclusively used for diets targeting neurological diseases where ketosis is a key mechanism.
• Standardized nomenclature, including revised abbreviations like VLCHKD and VLEKD, is crucial for precise scientific communication.
• Researchers should clearly specify the dietary protocol and ketosis levels when reporting KD efficacy or side effects.