Review

European Journal of Clinical Nutrition (2013) 67, 789–796; doi:10.1038/ejcn.2013.116; published online 26 June 2013

There is a Corrigendum (7 May 2014) associated with this article.

Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets

A Paoli1, A Rubini1, J S Volek2 and K A Grimaldi3

  1. 1The Physiological Laboratory, Department of Biomedical Sciences, University of Padova, Padova, Italy
  2. 2Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT, USA
  3. 3Biomedical Engineering Laboratory, Institute of Communication and Computer Systems, National Technical University of Athens, Athens, Greece

Correspondence: Professor A Paoli, The Physiological Laboratory, Department of Biomedical Sciences, University of Padova, via Marzolo 3, Padova 35131, Italy. E-mail: antonio.paoli@unipd.it

Received 20 January 2013; Revised 27 May 2013; Accepted 29 May 2013
Advance online publication 26 June 2013

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Abstract

Very-low-carbohydrate diets or ketogenic diets have been in use since the 1920s as a therapy for epilepsy and can, in some cases, completely remove the need for medication. From the 1960s onwards they have become widely known as one of the most common methods for obesity treatment. Recent work over the last decade or so has provided evidence of the therapeutic potential of ketogenic diets in many pathological conditions, such as diabetes, polycystic ovary syndrome, acne, neurological diseases, cancer and the amelioration of respiratory and cardiovascular disease risk factors. The possibility that modifying food intake can be useful for reducing or eliminating pharmaceutical methods of treatment, which are often lifelong with significant side effects, calls for serious investigation. This review revisits the meaning of physiological ketosis in the light of this evidence and considers possible mechanisms for the therapeutic actions of the ketogenic diet on different diseases. The present review also questions whether there are still some preconceived ideas about ketogenic diets, which may be presenting unnecessary barriers to their use as therapeutic tools in the physician’s hand.

Keywords:

ketogenic diet; cancer; diabetes; neurological diseases; obesity; cardiovascular diseases

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