What’s Up with Ketogenic Diets: An Update

steak, eggs and vegetables on a plate
Photo Credit: Eduardo Roda Lopes, via Unsplash

The CDC found that over 73% of Americans 20 and older were clinically overweight (2017-2018).1 Overweight (BMI 25-29.9) leads to various life-threatening chronic diseases such as heart disease, stroke, type 2 diabetes, and certain types of cancer. It is evident that many Americans are in need of a weight loss solution. Many are wondering, is the ketogenic diet an effective way to lose weight? If so, can it help reduce risk for chronic diseases that are associated with overweight and obesity? Let’s take a look at current evidence to decipher if the ketogenic diet can be a good solution.

Take a Glance at Current Evidence

Type 2 Diabetes

A randomized controlled trial found that greater than half of the participants following a very low carbohydrate ketogenic diet (intervention) had seen greater improvements in their glycemic control and had lost more weight than the control group.2 The participants were all adults(>18 years old) with type 2 diabetes and are overweight. Major drawbacks of this study include a small number of participants (25 total) and a short amount of time (32 weeks).2

Non-Alcoholic Fatty Liver Disease

Many assume that increasing dietary fats in one’s diet will directly lead to fatty liver. One intervention using a high-fat keto diet demonstrated that its participants who followed this diet achieved increased weight loss and reduced fat content in the blood.3 The major drawbacks of this study again are a small number of participants (18 total) and a short amount of time (6 weeks).3

Keto at a Glance

Individuals with metabolic syndrome, insulin resistance, and type 2 diabetes who follow a low carbohydrate ketogenic diet might see the following benefits:4

    • Improved insulin sensitivity
    • Improved glucose “blood sugar” control
    • Weight loss
    • Improved blood pressure
    • Improved triglyceride levels
    • Improved HDL “good fat” levels
    • Has been associated as a positive treatment method for neurological disorders such as epilepsy

What are the potential risks (long-term)?4

    • Increased LDL “bad fat” levels
    • Unsustainable for a long period of time
    • Countless studies show this diet is associated with complications that lead to emergency room visits for electrolyte disturbances, dehydration, and hypoglycemia (low blood sugar levels)
    • Vitamin and mineral deficiencies
    • Kidney stones 

Ketogenic Dietitian, Jessica M. Lowe, MPH, RD, CSP tells University of Southern California Health News, “It[ketogenic diet] is not dangerous. We just do not have an understanding as to what the long term impact of ketosis is on one’s long-term health”.5 It seems there are a lot of potential short-term benefits related to weight loss and blood sugar control from following a low carb keto diet. There is a need for more long-term studies with a greater number of participants to determine the sustainability of this diet. It is best to consult a registered dietitian before experimenting with this diet.


  1. Centers for Disease Control and Prevention. (2021, February 8). Products – Health E Stats – Prevalence of Overweight, Obesity, and Extreme Obesity Among Adults Aged 20 and Over: United States, 1960–1962 Through 2017–2018. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/data/hestat/obesity-adult-17-18/obesity-adult.htm.
  2. Masood W, Annamaraju P, Uppaluri KR. Ketogenic Diet. In: StatPearls. Treasure Island (FL): StatPearls Publishing; December 14, 2020.
  3. Lundsgaard AM, Holm JB, Sjøberg KA, et al. Mechanisms Preserving Insulin Action during High Dietary Fat Intake [published correction appears in Cell Metab. 2019 Jan 8;29(1):229]. Cell Metab. 2019;29(1):50-63.e4. doi:10.1016/j.cmet.2018.08.022
  4. Masood W, Annamaraju P, Uppaluri KR. Ketogenic Diet. In: StatPearls. Treasure Island (FL): StatPearls Publishing; December 14, 2020.
  5. Is the keto diet safe? USC experts have some serious concerns. HSC News. (2019, February 20). https://hscnews.usc.edu/is-the-keto-diet-safe-usc-experts-have-some-serious-concerns.
United States Department of Defense logo, a partner of OneOp
United States Department of Agriculture logo, a partner of OneOp