The DOI matches its Crossref record; 59 of the 59 references it cites were found in a registry or an index.
The ketogenic diet: Pros and cons
Abstract
Diets have been at the center of animated debates for decades and many claims have been made in one direction or the other by supporters of opposite camps, often with limited evidence. At times emphasis has been put on a single new aspect that the previous diets had overlooked and the new one was to embrace in order to improve weight loss and well-being. Unfortunately, very few randomized clinical trials involving diets have addressed the combined question of weight loss and cardiovascular outcomes. The recently introduced ketogenic diet requires a rigorous limitation of carbohydrates while allowing a liberal ingestion of fats (including saturated fats) and has generated a flurry of interest with many taking the pro position and as many taking the cons position. The ketogenic diet causes a rapid and sensible weight loss along with favourable biomarker changes, such as a reduction in serum hemoglobin A1c in patients with diabetes mellitus type 2. However, it also causes a substantial rise in low density lipoprotein cholesterol levels and many physicians are therefore hesitant to endorse it. In view of the popular uptake of the keto diet even among subjects not in need of weight loss, there is some preoccupation with the potential long-term consequences of a wide embrace of this diet by large segments of the population. On the contrary, numerous lines of evidence show that plant-based diets are associated with reduction in oncological and cardiovascular diseases and a prolonged life span. The debate reproduced in this article took place during a continuous medical education program between two cardiologists with largely differing views on the matter of effectiveness, sustainability, and safety of the ketogenic diet compared to alternative options.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Furthermore, weight loss induced by KD is relatively modest and appears comparable to other dietary interventions that are effective for short-term weight loss, e.g., intermittent fastingand Mediterranean diet [55–57].”
From Effects of ketogenic diet on health outcomes: an umbrella review of meta-analyses of randomized clinical trials (2023) · cites this paper as [55]
In the citing paper
“These dietary patterns and practices tend to be high in saturated fat consumption which can increase plasma LDL-C and risk for premature cardiovascular disease [34, 35].”
From Benefits of low carbohydrate diets: a settled question or still controversial? (2021) · cites this paper as [34]
Citations
Cites
1 retracted
Estruch, R., Martínez-González, M. A., Corella, D., Salas-Salvadó, J., Fitó, M., Chiva-Blanch, G., Fiol, M., Gómez-Gracia, E., Arós, F., Lapetra, J., et al. (2019) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(19)30074-9 · Cited by 147
RetractedFerence, B. A., Ginsberg, H. N., Graham, I., Ray, K. K., Packard, C. J., Bruckert, E., Hegele, R. A., Krauss, R. M., Raal, F. J., Schunkert, H., et al. (2017) · European Heart Journal · doi:10.1093/eurheartj/ehx144 · Cited by 3,962
Estruch, R., Ros, E., Salas-Salvadó, J., Covas, M.-I., Corella, D., Arós, F., Gómez-Gracia, E., Ruiz-Gutiérrez, V., Fiol, M., Lapetra, J., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1800389 · Cited by 3,616
Bariatric Surgery versus Intensive Medical Therapy for Diabetes — 5-Year Outcomes
Schauer, P. R., Bhatt, D. L., Kirwan, J. P., Wolski, K., Aminian, A., Brethauer, S. A., Navaneethan, S. D., Singh, R. P., Pothier, C. E., Nissen, S. E., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1600869 · Cited by 2,934
de Lorgeril, M., Salen, P., Martin, J.-L., Monjaud, I., Delaye, J., & Mamelle, N. (1999) · Circulation · doi:10.1161/01.cir.99.6.779 · Cited by 2,910
Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease
de Lorgeril, M., Renaud, S., Salen, P., Monjaud, I., Mamelle, N., Martin, J. L., Guidollet, J., Touboul, P., & Delaye, J. (1994) · The Lancet · doi:10.1016/s0140-6736(94)92580-1 · Cited by 2,122
THE DIET AND 15-YEAR DEATH RATE IN THE SEVEN COUNTRIES STUDY
KEYS, A., MIENOTTI, A., KARVONEN, M. J., ARAVANIS, C., BLACKBURN, H., BUZINA, R., DJORDJEVIC, B. S., DONTAS, A. S., FIDANZA, F., KEYS, M. H., et al. (1986) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a114480 · Cited by 1,790
Siri-Tarino, P. W., Sun, Q., Hu, F. B., & Krauss, R. M. (2010) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.2009.27725 · Cited by 1,253
Martínez-González, M. A., García-Arellano, A., Toledo, E., Salas-Salvadó, J., Buil-Cosiales, P., Corella, D., Covas, M. I., Schröder, H., Arós, F., Gómez-Gracia, E., et al. (2012) · PLoS ONE · doi:10.1371/journal.pone.0043134 · Cited by 1,150
Dehghan, M., Mente, A., Zhang, X., Swaminathan, S., Li, W., Mohan, V., Iqbal, R., Kumar, R., Wentzel-Viljoen, E., Rosengren, A., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(17)32252-3 · Cited by 1,101
Research works printed but not linked: 1
- Toth, 2014, Cardiovascular risk in patients achieving low-density lipoprotein cholesterol and particle targets, Atherosclerosis, 235, 585, 10.1016/j.atherosclerosis.2014.05.914 · DOI
Cited by
Sorted by citations
Ten things to know about ten cardiovascular disease risk factors
Bays, H. E., Taub, P. R., Epstein, E., Michos, E. D., Ferraro, R. A., Bailey, A. L., Kelli, H. M., Ferdinand, K. C., Echols, M. R., Weintraub, H., et al. (2021) · American Journal of Preventive Cardiology · doi:10.1016/j.ajpc.2021.100149 · Cited by 274
Food as medicine: targeting the uraemic phenotype in chronic kidney disease
Mafra, D., Borges, N. A., Lindholm, B., Shiels, P. G., Evenepoel, P., & Stenvinkel, P. (2021) · Nature Reviews Nephrology · doi:10.1038/s41581-020-00345-8 · Cited by 238
3-Hydroxybutyrate as a Metabolite and a Signal Molecule Regulating Processes of Living Organisms
Mierziak, J., Burgberger, M., & Wojtasik, W. (2021) · Biomolecules · doi:10.3390/biom11030402 · Cited by 206
A Heart-Healthy Diet for Cardiovascular Disease Prevention: Where Are We Now?
Diab, A., Dastmalchi, L. N., Gulati, M., & Michos, E. D. (2023) · Vascular Health and Risk Management · doi:10.2147/vhrm.s379874 · Cited by 221
Implicating the effect of ketogenic diet as a preventive measure to obesity and diabetes mellitus
Kumar, S., Behl, T., Sachdeva, M., Sehgal, A., Kumari, S., Kumar, A., Kaur, G., Yadav, H. N., & BUNGAU, S. G. (2020) · Life Sciences · doi:10.1016/j.lfs.2020.118661 · Cited by 181
Metadata
- Authors
- O'Neill, B., & Raggi, P.
- Affiliations
- University of Alberta (CA)
- Corresponding author
- Raggi, Paolo
- ORCID
- Raggi, Paolo
- Venue
- Atherosclerosis
- Publisher
- Elsevier BV
- Published
- 2020-01
- Volume
- 292
- Pages
- 119-126
- ISSN
- 0021-9150 (ISSN-L)
- OpenAlex
- W2990060012
- Cited by
- 219
- References
- 59
- Citations by year
- 2026: 17 · 2025: 37 · 2024: 45 · 2023: 45 · 2022: 31 · 2021: 29 · 2020: 15
- FWCI
- 2.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Atherosclerosis (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Diet and metabolism studies
- Health Sciences › Medicine › Physiology (medical) › Dietary Effects on Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- ketogenic diet, weight loss, cardiovascular risk, LDL cholesterol, type 2 diabetes, glycemic control, saturated fat, plant-based diet, diet sustainability, diet safety
- MeSH terms
- Diet, Reducing, Humans, Diet, Ketogenic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review