A study published in Cell Metabolism suggests that the ketogenic (keto) diet may offer specific benefits for cardiometabolic health compared to the Mediterranean diet and a low-fat, plant-based diet. The keto diet, characterized by high fat and very low carbohydrates, has gained popularity not just for weight loss but also for its metabolic effects.
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Researchers conducted a randomized clinical trial involving 42 adults with obesity, prediabetes, and fatty liver disease, assessing the impacts of three different diets. Each group lost approximately 10% of their body weight while adhering to their assigned dietary patterns. The participants received all meals from the research team and met weekly with a dietitian.
The macronutrient breakdown of the diets was significantly different: the keto diet consisted of about 73% calories from fat and 4% from carbohydrates, the Mediterranean diet included 35% calories from fat and 50% from carbohydrates, while the plant-forward diet contained 15% of calories from fat and 70% from carbohydrates.
Findings revealed that while weight loss was similar across all groups, the keto diet was linked to enhanced hepatic insulin sensitivity and reductions in liver fat. Participants on the keto diet also saw better improvements in blood sugar levels, with greater reductions in hemoglobin A1c and overall insulin levels. Notably, half of those on the keto diet no longer qualified as prediabetic post-intervention, compared to 29% of the Mediterranean diet group and 7% of the plant-based diet group.
However, the study noted that the keto diet did not show significant advantages for other health markers such as LDL cholesterol levels or apolipoprotein B. The small sample size and focus on weight loss limit the ability to assess the long-term sustainability of these benefits.
While the keto diet had certain advantages in this study, dietitian Madeline Peck emphasizes the importance of considering the long-term viability of any dietary approach. The keto diet's restriction of carbohydrates can prove challenging for some individuals and may impact nutritional diversity. The Mediterranean and plant-based diets, which permit a wider variety of carbohydrate-rich foods, may offer a more sustainable approach to healthy eating.
Ultimately, the best diet is one that aligns with individual preferences and promotes overall health while being practical to maintain.