Ketogenic Diet Intervention for Obesity Weight-Loss- A Narrative Review, Challenges, and Open Questions

Area of Science:

• Metabolic Health
• Nutritional Science
• Obesity Research

Background:

• The ketogenic diet (KD), characterized by carbohydrate restriction, mimics fasting and shifts metabolism towards ketone body (KB) utilization.
• KD shows promise for weight loss and metabolic syndrome, but its effects on various weight-loss indicators are debated.
• Challenges include monitoring adherence, defining optimal macronutrient ratios, and ensuring long-term sustainability.

Purpose of the Study:

• To review weight-loss outcomes of KD interventions for obesity.
• To assess KD effectiveness using ketone bodies (KB) as an indicator of adherence.
• To identify challenges and areas for improvement in KD application for obesity management.

Main Methods:

• Systematic review of current literature on KD interventions for obesity.
• Analysis of studies monitoring adherence through KB levels.
• Evaluation of changes in body weight, body mass index, body composition, and appetite regulation.

Main Results:

• KD interventions significantly reduce body weight, BMI, waist circumference, visceral adipose tissue, fat mass, and body fat percentage.
• Minor decreases in lean body mass were observed without concurrent resistance training.
• Variability in adherence markers (KB), carbohydrate intake (7-27%), diet duration (28 days-12 months), and follow-up frequency was noted.

Conclusions:

• KD interventions improve weight-related outcomes in individuals with obesity.
• Challenges include potential lean body mass reduction without resistance exercise and inconsistent adherence.
• Standardizing methodologies, refining interventions, and establishing clear KB adherence markers are crucial for optimizing KD effectiveness.