Nutritional ketosis as therapeutic regimen for metabolic disorders: Perspectives and challenges

Nutritional ketosis involves attaining a metabolic shift from glucose to fats for the purpose of energy production and is achieved through low-carbohydrate and high-fat intake. Ketone bodies serve as alternative energy sources during fasting, intense exercise or intake of ketogenic diet and exhibit a range of health benefits. Ketogenic diet (KD), a well-established treatment intervention for refractory epilepsy, is re-emerging as a potential adjunctive management strategy to alleviate a multitude of metabolic disorders. The ketogenic diet enhances anthropometric, glycemic, lipid and endocrinological parameters thus highlighting its multifaceted therapeutic potential. Since the etiology and pathophysiology of many metabolic disorders are interconnected, KD may be an effective and viable approach to manage multiple metabolic disorders simultaneously. Hereby, this review explores the therapeutic potential of KD to mitigate several metabolic disorders including obesity, diabetes mellitus, dyslipidemia, fatty liver disease, congenital hyperinsulinism and polycystic ovary syndrome as evidenced by recent research. Moreover, it also addresses side effects associated with the intervention of different types of ketogenic diets. However, forthcoming research should comprise of studies that delve into the underlying mechanisms associated with the potential of a ketogenic diet to manage metabolic disorders. Furthermore, there is a mounting need to conduct studies to test the safety and tolerability of different types of ketogenic diets in long-term clinical settings. • Nutritional ketosis shifts energy production from glucose to fats, using ketone bodies as an alternative source. • Ketogenic diets (KD) show promise in managing metabolic disorders like obesity, diabetes mellitus, dyslipidemia, fatty liver disease, congenital hyperinsulinism and polycystic ovary syndrome. • KD improves various health parameters, including glycemic control, lipid profiles, and endocrine function. • Further studies are needed to understand KD's mechanisms and assess long-term safety and tolerability.