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Cited by 4Diet and metabolism studiesDietary Effects on HealthLipoproteins and Cardiovascular Health

The Impact of the Ketogenic Diet on the Lipid Profile in Adults: A Comprehensive Review and Meta-Regression Analysis of Randomized Controlled Trials

Chang, Chaoyue, Liu, Yuxia, Rohani, Pejman, Khodadadi, Navideh, Prabahar, Kousalya, Sohouli, Mohammad Hassan·2026·Endocrine Practice
DOI 10.1016/j.eprac.2026.01.009
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Abstract

Objectives The impact of the ketogenic diet (KD) on lipid metabolism remains inconclusive. To address this gap, we conducted a meta-regression analysis of randomized controlled trials to evaluate the overall influence of KD on lipid profile parameters in adults.Methods A comprehensive search of 5 major electronic databases was carried out using predefined keywords to identify randomized controlled trials assessing the effects of KD on lipid outcomes. Pooled weighted mean differences with 95% confidence intervals were calculated employing a random-effects model.Results Sixty-two studies were analyzed. The meta-analysis results from the included randomized controlled trials indicated a significant decrease in triglyceride levels (weighted mean difference [WMD]: -19.96 mg/dl, 95% CI: -26.10 to -13.81) and the triglyceride/high-density lipoprotein-cholesterol (HDL-C) ratio (WMD: -0.31, 95% CI: -0.49 to -0.12), despite a notable increase in HDL-C (WMD: 3.61 mg/dl, 95% CI: 1.44 to 5.57), low-density lipoprotein-cholesterol (LDL-C) (WMD: 8.49 mg/dl, 95% CI: 5.45 to 11.52), and total cholesterol (WMD: 8.14 mg/dl, 95% CI: 3.41 to 12.88) concentrations following KD compared to the control group. However, LDL-C levels increased by 8.49 mg/dL, which may carry potential adverse implications. Furthermore, the findings indicated a linear correlation between alterations in HDL-C and the duration of KD intervention.Conclusions The ketogenic diet significantly improves triglycerides and HDL-C but also leads to modest increases in LDL-C. Given the lack of long-term cardiovascular outcome data, these findings should be interpreted with caution.

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Authors
Chang, C., Liu, Y., Rohani, P., Khodadadi, N., Prabahar, K., & Sohouli, M. H.
Affiliations
  • First Hospital of China Medical University (CN)
  • Children's Medical Center (IR)
  • University of Tabuk (SA)
Corresponding author
  • Liu, Yuxia
  • Sohouli, Mohammad Hassan
ORCID
Venue
Endocrine Practice
Publisher
Elsevier BV
Published
2026-01
Volume
32
Issue
5
Pages
819-828
ISSN
1530-891X (ISSN-L)
DOI
10.1016/j.eprac.2026.01.009
OpenAlex
W7126194234
Cited by
4
References
30
Citations by year
2026: 4
FWCI
4.16
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Endocrine Practice (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Diet and metabolism studies
  • Health Sciences › Medicine › Physiology › Dietary Effects on Health
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
Keywords
ketogenic diet, lipid profile, triglycerides, HDL cholesterol, LDL cholesterol, total cholesterol, lipid metabolism, dietary intervention, adults
MeSH terms
Adult, Humans, Lipids, Cholesterol, HDL, Cholesterol, LDL, Regression Analysis, Triglycerides, Randomized Controlled Trials as Topic, Lipid Metabolism, Diet, Ketogenic

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