NHANES data are irrelevant for ketogenic diet research – Comment on “Ketogenic diets are associated with an elevated risk of hypertension: Insights from a cross-sectional analysis of the NHANES 2007–2018″

In a recent study titled "Ketogenic diets are associated with an elevated risk of hypertension: Insights from a cross-sectional analysis of the NHANES 2007-2018", Qu et al. have used data from the NHANES, a large survey of American citizens, to correlate the participants' dietary ketogenic ratio (DKR) to hypertension. They find a significant positive correlation and conclude, as the title of their article suggests, that ketogenic diets (KDs) are associated to hypertension risk. However, their basic assumption that the participants' DKR has anything to do with a KD constitutes a serious mistake, as I argue in this Commentary. The reason is that even the highest quartile of DKR corresponds to a non-ketogenic diet. In conclusion, the data utilized by Qu et al. are irrelevant to their research question and cannot be used to support the hypothesis that KDs increase the risk of hypertension.