Prediabetes and type 2 diabetes mellitus (T2DM) affect 60% of adults in the United States (Centers for Disease Control and Prevention, 2024). Ketogenic diet interventions demonstrate benefit for glycemic management among people with diabetes. The carnivore diet (CD) is a ketogenic diet characterized by exclusive consumption of animal-sourced foods and has not been systematically evaluated. The purpose of this study was to evaluate the direction and magnitude of within-subject changes in glycated hemoglobin (HbA1c) following adoption of a CD and to assess feasibility of recruitment, data collection procedures, and measurement approaches.

An experimental pilot design using a within-subject pre-post analysis was conducted. Adults with HbA1c levels of 5.7% or greater who adhered to a carnivore diet for at least 6 months were recruited through online carnivore communities and social media. Previously collected pre- and post-CD HbA1c values were utilized to evaluate glycemic outcomes. Participants completed a digital survey to self-report health history, diabetes management and medication use, and perceived changes in health status. A carnivore diet-specific food-frequency questionnaire was used to assess dietary adherence and characterize intake patterns. HbA1c was analyzed using paired-samples t tests, while descriptive statistics were used to summarize secondary and feasibility outcomes.

Final analysis included 12 participants. The mean difference in HbA1c decreased 1.47% (SD ± 2.44) p = 0.061, 95% CI (–0.08–3.01). Improvement in HbA1c was reported in 11 people, 41.7% of participants achieved a normal level HbA1c, and 71% discontinued use of diabetes medications during the intervention time frame. Daily red meat intake was reported by 75% of participants.

The findings suggest an association between adopting a carnivore diet and improved glycemic management among adults with prediabetes or T2DM. Sample size and self-reported data limit generalizability and clinical interpretation. Observed changes in HbA1c provide preliminary foundational evidence warranting future prospective investigations evaluating the therapeutic potential of the carnivore diet.

Langlois, Courtney E. "The Carnivore Diet as a Nutritional Intervention for Glycemic Management in Adults With Prediabetes and Type 2 Diabetes." PhD diss., Saybrook University, 2026.

https://www.proquest.com/openview/d29cae668094aa4b36923a433bc9b89c

Abstract

Metabolic reprogramming has been firmly established as a core hallmark of cancer, representing a fundamental shift in cellular physiology that is as critical to tumorigenesis as uncontrolled proliferation and evasion of apoptosis. This chapter provides a comprehensive examination of this complex phenomenon, dissecting the intricate web of factors that trigger, sustain, and can be targeted within the altered metabolic landscape of malignant cells. The discussion begins by elucidating the primary drivers of metabolic rewiring, establishing that this transformation is not a mere adaptation but a direct, programmed consequence of the same genetic lesions that define cancer. The activation of oncogenes such as MYC and RAS and the inactivation of tumor suppressor genes, including TP53 and LKB1, constitute a genetic blueprint for metabolic change. This genetic predisposition is further shaped by the harsh realities of the tumor microenvironment (TME), where hypoxia and nutrient deprivation act as powerful selective pressures, primarily through the master regulator hypoxia-inducible factor 1-alpha. Furthermore, cancer cells engage in a form of metabolic warfare, creating an immunosuppressive TME by depleting essential nutrients and secreting inhibitory metabolites like lactate, thereby crippling antitumor immune responses. The chapter then provides a detailed mechanistic analysis of the key metabolic alterations themselves, including the iconic Warburg effect, the dynamic plasticity between glycolysis and oxidative phosphorylation, and the profound dependency on glutamine. Following this, it surveys the advanced technologies, such as mass spectrometry and nuclear magnetic resonance-based metabolomics, that enable the assessment of these changes, with a special focus on their application in developing noninvasive liquid biopsies and predictive biomarkers. Finally, the chapter explores the therapeutic landscape, covering both clinically approved metabolic drugs, such as isocitrate dehydrogenase inhibitors and antifolates, and the promising pipeline of investigational agents, alongside a critical evaluation of nutritional interventions like caloric restriction and ketogenic diets. By integrating molecular biology, immunology, and clinical oncology, this chapter frames cancer metabolism as a central, targetable vulnerability, paving the way for the next generation of personalized cancer therapies.

Singh, Sapna, Urja Desai, Dweipayan Goswami, Ankesh Barnwal, Dharmesh Domadia, Suresh Thakur, and Sanjay Premi. "Metabolic Reprogramming in Cancer and Therapeutic Implications." In Redefining Cancer Therapeutics with Emerging Drug Strategies and Molecular Insights, pp. 131-165. Singapore: Springer Nature Singapore, 2026.

https://link.springer.com/chapter/10.1007/978-981-92-0477-9_5

Abstract

Obesity represents a major global public health challenge, particularly among women, and is associated with adverse metabolic and endocrine outcomes. his study evaluated the effects of ketogenic, intermittent fasting (IF), and semi-vegetarian diets, alone or combined with home-based exercise, on anthropometric, metabolic, and hormonal parameters in women with obesity. The study employed a pretest–posttest controlled experimental design with 108 women aged 19–45 years, comprising 96 participants with obesity and 12 with normal body weight. Participants were assigned to nine groups: control (C), obese (O), obese with exercise (OE), obese with exercise plus semi-vegetarian diet (OEVD), obese with semi-vegetarian diet (OVD), obese with exercise plus intermittent fasting (OEIF), obese with intermittent fasting (OIF), obese with exercise plus ketogenic diet (OEKD), and obese with ketogenic diet (OKD). Participants completed ketogenic, intermittent fasting (IF), or semi-vegetarian dietary interventions, either alone or combined with home-based exercise, for 6 weeks. Anthropometric parameters were assessed using bioelectrical impedance analysis, while biochemical markers (adiponectin, insulin-like growth factor 1 (IGF-1), irisin, myostatin, glucose, and insulin) were analyzed via ELISA. Statistical analyses were performed using mixed-design ANOVA, Pearson’s correlation, and principal component analysis. The C and O groups exhibited no significant changes, whereas intervention groups showed reductions in body mass, body mass index (BMI), and body fat (p < 0.001). Single interventions were associated with changes in anthropometric measures (OIF:10.42% body mass,7.61% BMI, 9.86% body fat; OE: 9.49%, 6.65%, 13.49%; OVD: 9.07%, 8.17%, 6.21%; OKD: 8.12%, 6.91%, 9.78%). Diet-plus-exercise intervention groups generally exhibited larger changes, with OEVD achieving the greatest reductions (12.69, 13.46, 13.95%), followed by OEKD (10.68, 9.16, 11.17%) and OEIF (8.76, 9.64, 12.04%). Moreover, adiponectin, irisin, IGF-1, and myostatin levels changed significantly in exercise-only and diet-plus-exercise groups compared with those of the C and O groups. Additionally, intervention groups exhibited significant alterations in glucose and insulin concentrations, whereas no significant changes were observed in the C and O groups. Lifestyle modifications integrating dietary strategies with home-based exercise are associated with changes in metabolic and hormonal parameters in women with obesity.

https://www.nature.com/articles/s41598-026-65060-z_reference.pdf

Çınar, Fidan, Fatih Mehmet Uğurlu, Vedat Çınar, Taner Akbulut, Yavuz Yasul, Salih Öner, Elif Subaşı et al. "Metabolic responses of diet–exercise combinations in women with obesity: a comparative lifestyle intervention study with different diet types." Scientific Reports (2026).

Abstract

Introduction

Multidrug-resistant Klebsiella pneumoniae (MDR Kp) is a global health threat, causing persistent, subacute airway infections that are often fatal in healthcare settings. The failure of antimicrobials underscores an urgent need for alternative host-targeted therapies. Kp evades airway immune responses by perturbing host metabolism, inducing mitochondrial oxidative phosphorylation (OXPHOS) and oxidative stress, thus establishing a disease-tolerant microenvironment. We hypothesized that a ketogenic diet (KD), which improves OXPHOS efficiency via ketone production, would restore immune control of Kp by enhancing the bioenergetics and function of innate immune cells.

Methods

C57BL/6 mice were fed a KD or control diet prior to intranasal Kp infection. Airway bacterial burden was enumerated and immunometabolic changes were assessed by scRNA-seq, flow cytometry, and spatial metabolomics.

Results

KD significantly enhanced Kp airway clearance and host survival. ScRNA-seq of lung tissue revealed markedly higher numbers of neutrophils and alveolar macrophages at day 2 post-infection in KD-fed mice, as well as an upregulation in phagolysosome signaling. By day 7 in the KD group, the neutrophil population contracted while B and T cells concomitantly expanded. Notably, IFN-γ-responsive genes were upregulated across all immune cell subsets. Exogenous ketones or drug-induced ketone accumulation bypassed the need for dietary intervention, likewise, conferring protection against Kp airway infection.

Conclusion

Ketones promote effective immunity to Kp by sustaining cellular energy production, thereby supporting immune cell survival and effector function. The ketone-enhanced innate immune response is followed by adaptive immune cell expansion and a broad IFN-γ transcriptional signature. Together, these findings suggest a novel therapeutic strategy for energetically demanding bacterial infections via diet-induced metabolic reprogramming

Tang, Eric, Ridhima Wadhwa, Ariful Islam, Arthur VanValkenburg, Xutao Wang, Alice Prince, Evan Johnson, and Tania Wong. "Ketogenic diet-mediated immunometabolic regulation improves airway clearance of Klebsiella pneumoniae 2253582." The Journal of Immunology 215, no. Supplement_1 (2026): vkag141-181.

https://academic.oup.com/jimmunol/article/215/Supplement_1/vkag141.181/8745885

Abstract

Hypertension (HTN) is one of the greatest public health challenges of the 21st century. Its prevalence has reached alarming levels in recent decades. The search for effective prevention and treatment strategies includes lifestyle choices, such as dietary interventions. Although not applicable to everyone, particularly interesting in this context is the ketogenic diet (KD), known to clinicians and also applied in epilepsy treatment for over a century. Its possible beneficial effects are increasingly often reported in many other conditions, including HTN. The aim of the present study is to analyse the effect of a KD on blood pressure, and the mechanisms that may modulate that effect. Based on the available literature, key potential pathways of the influence of a KD on blood pressure regulation have been identified: (1) reduced body weight; (2) reduced visceral adipose tissue; (3) improved insulin sensitivity; (4) improved water and electrolyte balance; and (5) anti-inflammatory effect. Meta-analyses and randomised controlled trials consistently indicate that ketogenic dietary interventions are associated with reductions in blood pressure, although the magnitude of the effect varies considerably depending on the ketogenic diet model, study population, and comparator. In light of these observations, it has been found that in patients undergoing pharmacological treatment, it may be necessary to appropriately reduce antihypertensive medication dosage in advance. To maximise the hypotensive effect of a KD, the need to ensure an adequate supply of potassium, magnesium, and high-quality products, as well as proper hydration has been emphasised. Further studies are needed, with the effect of a KD on systolic and diastolic blood pressure as the primary endpoint, taking into account the role of the qualitative composition of the diet in the observed effects.

Rodzeń, Łukasz, Damian Dyńka, Mateusz Rodzeń, Hanna Karakuła-Juchnowicz, Dorota Łojko, Sebastian Kraszewski, Żaneta Grzywacz et al. "The Ketogenic Diet in the Prevention and Treatment of Hypertension (HTN)." Biomedicines 14, no. 8 (2026): 1728.

https://www.mdpi.com/2227-9059/14/8/1728

Abstract

Introduction

This study evaluates the effect of simultaneous application of plant-rich ketogenic diet and intermittent fasting as an individualized adjunct to standard treatment on cognitive function in early/mid-stage Alzheimer’s patients.

Methods

This assessor-blinded, randomized controlled trial enrolled 60 Alzheimer’s disease (AD) patients (CDR 1–2; aged 55–85), randomized to intervention (n = 30; intervention + standard care) or control (n = 30; standard care). Cognition and brain structure were assessed at baseline and 6 months. Individual cognitive changes were analyzed using Reliable Change Index (RCI).

Results

Cognitive change scores differed significantly between groups (p < 0.001). The mean Mini Mental State Examination (MMSE) score increased by +0.9 in the intervention group, while a decrease of −1.5 points was observed in the control group. RCI analysis indicated stability in 93% of intervention and 70% of control participants, with cognitive improvement in 7% and 3.3%, respectively.

Discussion

The intervention method has the potential to stabilize cognitive decline in AD and promote improvement at the individual level. The response to the intervention is closely related to the individual's metabolic phenotype and structural brain integrity.

Tağraf, Beyza, Dilara Kaygusuz, Deniz Yerlikaya, Özden Erkan Oğul, and Lütfü Hanoğlu. "The effect of simultaneous application of plant-rich ketogenic diet and intermittent fasting on early-to-mid-stage Alzheimer's disease: a randomised controlled trial." The Journal of nutrition, health and aging 30, no. 9 (2026): 100930.

https://www.sciencedirect.com/science/article/pii/S1279770726001636

Abstract:

Aging in the immune system leads to increased susceptibility to infections, exacerbated autoimmunity, and decreased responsiveness to vaccinations. While many interventions are being studied to ameliorate aspects of aging, none are currently established for immune aging. Ketogenic diets and fasting have shown promise against aging and age-related diseases, working in part by raising circulating levels of ketone bodies. $\beta$-hydroxybutyrate (BHB), the primary ketone body produced, has anti-inflammatory properties and can enhance T cell function. However, these nutritional interventions are highly restrictive and difficult to adhere to long-term. Exogenous ketone supplementation, such as ketone esters, offers a more accessible alternative by directly delivering ketone bodies without major dietary changes. Yet, it remains unclear how ketone esters impact the immune system, especially in the context of aging.

In this dissertation, I evaluated the ketone ester bis-octanoyl (R)-1,3-butanediol as an intervention for age-related immune decline in parallel mouse and human studies. In aged mice, a diet supplemented with the ketone ester diet decreased activation of B cells in the spleen, particularly age-associated B cells. Despite this decrease in activation, antibody production during immunization was maintained, demonstrating preserved B cell function. Mechanistically, the ketone ester diet suppressed translation and glucose dependence of age-associated B cells, and BHB alone was sufficient to inhibit B cell translation, likely through mTOR signaling.

Translating these findings to humans, the Buck Institute Ketone Ester (BIKE) study showed that 12 weeks of daily ketone ester supplementation in healthy older adults (> 65 years old) decreased $\text{CD56}^{\text{low}}$ natural killer cell subsets and $\text{CD38}^{\text{high}}$ non-classical monocytes, suggesting a reduction in age-related chronic inflammation. The ketone ester also increased HLA-DR expression on T cells and decreased KLRG1 expression on naïve CD8 T cells, pointing to enhanced effector and potentially immunoregulatory function. These immune changes corresponded with a decrease in predicted biological age by an immune composition clock.

Interestingly, the ketone ester preferentially affected B cells in mice and T cells and innate immune cells in humans, which may reflect species-specific differences in immune composition and immune aging. Together, these findings position ketone esters as a promising and accessible intervention for immune aging by selectively inhibiting inflammaging while improving adaptive immune function. This work highlights the potential of ketone esters as treatments for autoimmune diseases and age-related immune dysfunction.

Adkisson-Floro, Ariel. "Evaluating Ketone Esters as an Intervention for Age-Related Immune Decline." PhD diss., University of Southern California, 2026.

https://www.proquest.com/openview/ec9de7f452988557bd13359e9933a666

My hardboard center fin hit a tree stump and broke the front edge where it screws down to the US box. I;m on the road now and wondered if getting some superglue at a walmart might be enough to keep it workable for a few more paddles or would I just be wasting my time. The walmart is 45min drive in the opposite direction of the 30min drive to the lake. If it won't work I'll just hikes locally.

edit: Doing more research via Google, it's clear superglue won't work as it eventually dissolves in water. Epoxy might but even that is iffy. But I still have 2 side fins so maybe I'll just try without a center fin and see how straight it tracks anf it not I'll just hike around the lake.

Abstract

As an alternative or supplement to traditional pharmaceutical treatments, intermittent fasting (IF) has become a viable dietary approach for the management of type 2 diabetes mellitus (T2DM). Improved insulin sensitivity and blood glucose management are the outcomes of various IF patterns, such as time-restricted eating, alternate-day fasting and the 5:2 diet, which encourage a metabolic shift from glucose to fat utilisation. Even in patients on insulin therapy, research indicates that IF may help lower fasting blood sugar, glycated haemoglobin (HbA1 c) and insulin resistance with no risk of hypoglycaemia when appropriately monitored. Physiological benefits of IF include enhanced circadian rhythm alignment, increased autophagy, reduced oxidative stress and improved lipid metabolism. Comparisons with other dietary approaches, such as the Mediterranean, Palaeolithic, ketogenic and fasting-mimicking diets, indicate that IF offers flexibility and long-term sustainability for many individuals. However, consistent adherence and personalised strategies are essential for optimal results. Overall, IF presents a valuable complementary approach for managing T2DM and promoting better metabolic health.

Mustafa, Faheem, Asifa Murtaza, Razzia Batool, Samra Faisal, Binti Umar Rabiatul Adawiyah, Muniba Khaliq, Wan Rohani Wan Taib, and Binti Che Taha Che Suhaili. "Intermittent fasting as a complementary strategy to manage type II diabetes and metabolic health: A review." Scripta Medica 57, no. 3 (2026): 689-700.

https://scindeks.ceon.rs/article.aspx?artid=2490-33292603689M

Abstract

We report the case of a 23-year-old woman with Autosomal Dominant Polycystic Kidney Disease (ADPKD) and preserved kidney function who was followed with a supervised plant-based ketogenic diet for 11 months. The intervention was associated with a marked reduction in albuminuria (from 80 to 10 mg/g) and a stable estimated glomerular filtration rate (eGFR), with no clinically relevant metabolic or electrolyte disturbances; whereas total kidney volume increased from 617 to 709 cc during follow-up. This case highlights the feasibility, safety, and possible association with favorable renal biomarker changes, warranting further investigation in controlled studies in early-stage ADPKD.

Alvarado‐Pelayo, Paola Azucena, Xunaxi Nahomi García‐Rodríguez, Erika Fabiola Gómez‐García, and Ari Cisneros‐Hernández. "Plant‐based ketogenic nutritional intervention in a young woman with autosomal dominant polycystic kidney disease: A case report." Nutrition in Clinical Practice.

https://aspenjournals.onlinelibrary.wiley.com/doi/10.1002/ncp.70150

Abstract

Diet composition shapes tissue function and disease risk by modulating nutrient availability, metabolic state and cellular dynamics^(1). In the gastrointestinal tract, obesogenic high-fat diets enhance small-intestinal stem cell activity and tumorigenesis^(2). However, the impact of ketogenic diets (KDs), which contain even higher lipid content but reduce circulating insulin and induce ketogenesis, remains poorly understood^(3). This is particularly relevant for patients with familial adenomatous polyposis who face a high risk of small-intestinal tumours^(4). Here we combine dietary, genetic and metabolic manipulations in mouse models of spontaneous intestinal adenoma formation to dissect the role of systemic and epithelial ketogenesis in intestinal cancer. We show that KD accelerates tumour burden and shortens survival, independent of ketone metabolites. Through genetic manipulation of the ketogenic pathway, we modulate the production of local and systemic ketone metabolites; however, neither inhibition nor augmentation of the ketogenic enzyme 3-hydroxy-3-methylglutaryl-coenzyme A synthase 2 nor disruption of ketolysis altered tumorigenesis. Combined intestinal loss of PPARα/δ/γ attenuates KD-driven intestinal stem cell expansion, proliferation and clonogenicity, whereas inhibition of downstream fatty acid oxidation through CPT1A loss limits adenoma formation specifically under KD, linking tumour initiation to fatty acid oxidation of dietary lipids rather than lipid accumulation. These findings reveal that dietary lipid content, through fatty acid oxidation rather than ketone metabolism, influences intestinal tumorigenesis and highlight the need for nuanced consideration of dietary strategies for cancer prevention in genetically susceptible populations.

Shay, Jessica ES, Fangtao Chi, Constantine N. Tzouanas, Shixun Han, Xiao Zhang, Johanna Ten Hoeve, Kevin J. Williams et al. "Ketogenic diet mediates intestinal tumorigenesis through lipids not ketones." Nature (2026): 1-10.

https://www.nature.com/articles/s41586-026-10779-y

Abstract

Background

Rheumatoid arthritis (RA), psoriasis (PsO), and psoriatic arthritis (PsA) cause substantial disability and cardiometabolic risk. Ketogenic diets (KDs), including very-low-calorie ketogenic diets (VLCKDs), may influence disease-relevant immunometabolism, but the clinical evidence remains preliminary.

Objective

To map mechanistic and clinical evidence for KD/VLCKD across RA, PsO, and PsA and to distinguish direct KD/VLCKD evidence from ketosis-adjacent background evidence.

Methods

Using the Population-Concept-Context (PCC) framework and PRISMA-ScR guidance, MEDLINE/PubMed, Embase, ClinicalTrials.gov, WHO ICTRP, and reference lists were searched from inception to 30 July 2025. Search strategies are provided in Supplementary Table S1. Eligible direct evidence comprised adult human KD/VLCKD studies in RA, PsO, or PsA with a ketogenic protocol and reported or protocol-defined nutritional ketosis. Fasting or low-carbohydrate studies without verified KD/VLCKD were summarized separately. Data charting was duplicated, and no formal risk-of-bias appraisal was performed.

Results

After reassessment, 29 direct KD/VLCKD studies were retained, while 3 ketosis-adjacent records were treated as contextual evidence. Mechanistic data support plausible effects of β-hydroxybutyrate on NLRP3 inflammasome signaling, cytokine pathways, immune-cell metabolism, oxidative stress, the gut-skin/gut-joint axes, and adiposity-related inflammation. Human signals are strongest in psoriatic disease, particularly among participants with obesity or metabolic dysregulation. However, most studies are short, small, heterogeneous, and strongly confounded by weight loss.

Conclusions

Current evidence suggests that KD/VLCKD may be a supervised adjunctive dietary approach for selected people with psoriatic disease and obesity, but it is not yet sufficient to support efficacy claims. RA evidence is mainly mechanistic or ketosis-adjacent. Adequately powered, at least 24-week randomized trials with verified ketosis, active comparators, and weight-independent endpoints are needed before routine clinical implementation.

Conforti, Alessandro, Vincenzo Russo, Linda Lucchetti, Emanuele Fiorino, Filippo Messina, Davide Francomano, Nicolo Merendino, and Marco Marchetti. "Ketogenic diet in rheumatoid arthritis, psoriatic arthritis and psoriasis: A scoping review of clinical and mechanistic evidence." Autoimmunity Reviews (2026): 104137.

https://www.sciencedirect.com/science/article/abs/pii/S1568997226001515

Abstract

Background

The ketogenic diet (KD) is a widely used nutritional intervention for weight loss. The beneficial effects of the KD are intrinsically linked to the state of physiological ketosis, where ketone bodies (KBs) raise, even though minimal effective threshold of blood ketone concentration that correlates with significant weight loss remains unclear. Therefore, the main purpose of this study was to identify the optimal β-hydroxybutyrate (βHB) threshold associated with weight loss in individuals with overweight or obesity undergoing a KD.

Methods

This secondary analysis included 217 participants (111 males and 106 females) with overweight or obesity, who followed a KD for 14 days. Time to Ketosis (TtK)—defined as the number of days needed to reach and maintain a given ketone concentration—was calculated for each threshold.

Results

Regression analysis showed that a βHB concentration of ≥0.5 mmol/L was the most associated with significant weight loss. Moreover, body weight and gender significantly influenced TtK, suggesting interindividual variability in achieving effective ketosis.

Conclusions

Achieving and maintaining a ketonemia of at least 0.5 mmol/L may represent a clinically meaningful threshold to optimize weight loss in individuals undergoing a KD. Monitoring βHB levels and reducing TtK may improve individual responsiveness to KD-based interventions.

Paoli, Antonio, Giuseppe Cerullo, Samuele Paoli, Davide Charrier, Jacopo Givralli, Antonino Bianco, Giovanna Boccuzzo, Pietro Belloni, Lorenzo Cenci, and Tatiana Moro. "Defining a ketone threshold for weight loss: evidence from 14 day daily β-hydroxybutyrate monitoring in 217 subjects on a ketogenic diet." Nutrition & Diabetes (2026).

https://www.nature.com/articles/s41387-026-00454-6

https://www.nature.com/articles/s41387-026-00454-6_reference.pdf

Abstract

The ketogenic diet, a high-fat, low-carb diet, is being researched for treating conditions like epilepsy, cancer, neurological conditions, metabolic syndromes, and cognitive impairments. Ketone salts and exogenous ketone salt supplementation are also being studied for treating neurologic conditions like gliomas, Alzheimer's, and seizure disorders. The diet may also improve depression and brain health by reducing inflammation and oxidative stress. KDs have neuroprotective properties in epilepsy, induction of aging, neurodegenerative and dementia in animals. Treatment with ketosis decreases the induced seizures and anxiety-like behaviors through handling, according to Morris water maze tests. Mood and cognitive function are positively impacted by the ketogenic diet. Blood glucose levels are stabilized and the inflammatory response is improved by a ketogenic diet. The ketogenic diet has a significant impact on body weight as well as hunger reduction and satiety stimulation. Improved problem-solving abilities, quicker thinking, and better recall. Long-term brain health and a lower chance of cognitive decline brought on by ageing.

shaq, A., Abubakar, M., Mumtaz, M. S., & Nadeem, Z. (2026). Effects of Ketogenic Diet on Brain Functions and Behaviors. Medical and Life Sciences, 5(1), 65–74. Retrieved from https://journals.smarcons.com/index.php/mls/article/view/464

https://journals.smarcons.com/index.php/mls/article/view/464/512

ABSTRAT

Background  

No study has directly compared intermittent fasting alone, a clean ketogenic diet alone, and their combination in a single three-arm design. The purpose of this study was to compare the effects of these three dietary conditions on body composition, cardiometabolic markers, grip strength, and glycemic control over 30 days.  

Methods  

A cross-study analysis combined data from two sequential pre-post intervention studies at the University of Tennessee at Martin, yielding a three-arm design: intermittent fasting alone (n=16), clean ketogenic diet alone (n=22), and combined clean ketogenic diet with intermittent fasting (n=41). The clean ketogenic diet restricted carbohydrates to 20 grams per day from whole unprocessed sources and eliminated refined sugars, high-fructose corn syrup, and ultra-processed foods. The intermittent fasting protocol employed a 16:8 time-restricted eating window. Paired-samples t-tests examined within-group changes; one-way ANOVAs with Tukey post-hoc comparisons examined between-group differences. Effect sizes are reported as Hedges’ g and eta squared. An independent samples t-test compared glycosylated hemoglobin changes between the intermittent fasting and combined groups, and Spearman and Kendall correlations examined associations between fat mass and cardiometabolic change.  

Results  

All three conditions produced significant within-group reductions in body weight, body fat percentage, fat mass percentage, waist circumference, and hip circumference. Carbohydrate restriction produced significantly greater weight reduction than intermittent fasting alone, F(2,76)=12.003, p<.001, η2=.240, and greater fat mass reduction (p=.002, η2=.144). Both fasting-containing conditions produced significantly greater bilateral grip strength improvement than the ketogenic diet alone (p<.05). The combined protocol produced significantly greater glycosylated hemoglobin reduction than fasting alone, t(30)=2.141, p=.041, g=0.738. Fat mass reduction correlated significantly with triglyceride-to-HDL ratio improvement across all 79 participants (rs​=−.250,p=.026).  

Conclusions  

Carbohydrate restriction produced the greatest weight loss and cardiometabolic improvements, while the addition of a 16:8 fasting window contributed independently to glycemic control and grip strength. These findings support the clean ketogenic diet as a first-line strategy for metabolic syndrome management, with the combined protocol offering additive benefits.  

MacKewn, Angie, Julie Floyd, Todd Sherman, Alison Ellis, Anna Dunn, and Diana Sanford. "Comparing Intermittent Fasting, Clean Ketogenic Diet, and Their Combined Effects on Body Composition, Cardiometabolic Markers, and Metabolic Health: A Three-Arm Randomized Pre-Post Study." (2026).

https://www.researchsquare.com/article/rs-10085509/latest.pdf

Abstract

Background and Hypothesis

Psychiatric medications contribute to high rates of metabolic dysfunction in psychotic disorders. Ketogenic diets reduce metabolic syndrome, have anticonvulsant effects in epilepsy, and may improve symptoms of schizophrenia and bipolar disorder. We report the first randomized controlled trial to assess effects of ketogenic diets on metabolism, psychiatric symptoms, and cognition in people with schizophrenia-spectrum and bipolar-1 disorders.

Study Methods

Participants were randomized to a ketogenic diet (KETO; n = 28) or diet-as-usual (DAU; n = 30) for 1 month. Partway through the trial, a KETO extension was offered to both groups, resulting in a sub-group who completed the diet for 4 months (n = 25). We assessed changes in metabolic health, clinical symptoms, and cognition after 1 month (KETO versus DAU) and after 4 months (KETO versus baseline).

Study Results

KETO participants’ daily ketone levels surpassed the standard ketosis threshold. Relative to DAU, KETO participants showed reductions in weight (Padj <  .001), hemoglobin A1c (Padj = .05), and insulin resistance (Padj = .05). Clinical symptoms (positive, negative, depression) and cognitive performance improved after 4 months on the KETO (all P-values < .001). Increased blood ketone levels in KETO participants correlated with improvements in pre-diabetic markers and depressive symptoms (all P-values < .001). Reduced weight following the KETO was unrelated to metabolic and symptom improvements.

Conclusions

We demonstrate feasibility of administering a KETO in outpatients with schizophrenia and bipolar-1 disorder. Participants showed improvement in metabolic health, cognitive performance, and clinical symptoms. Improvement in depressive symptoms was associated with ketosis rather than weight loss, implicating ketosis as the therapeutic mechanism.

Samantha V Abram, Juliette M Kyner, An Vu, Zanib Naeem, Shebani Sethi, Michael S Jacob, Susanna L Fryer, Daniel H Mathalon, Judith M Ford, Metabolic Improvements with a Ketogenic Diet Correlate with Symptom Improvement in Psychosis: A Randomized Controlled Trial, Schizophrenia Bulletin, Volume 52, Issue 4, July 2026, sbag082, https://doi.org/10.1093/schbul/sbag08

Also see https://www.youtube.com/watch?v=wsR4wKoPCfs

Edit: here is an an open access version

https://watermark02.silverchair.com/sbag082.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAA4owggOGBgkqhkiG9w0BBwagggN3MIIDcwIBADCCA2wGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMkHP5OkuGroyDForSAgEQgIIDPQ7-4bMhjeIT3RhX1NA_-wGIMHAbAKeq4RDWHOUuBuZz8MliaTFn-rO02Yy6Zn4v-sZEbpGKW34Sr1IjfEJq9n_3xLRui_PY-XkUAePeAS539KCur63OZwq6AfHuYc-k-44TETo2JTi6jMLm3OGvYXg8lofry6HYX62Gp-LBkTe42HMOH75NfZlv9lfeNrKeQQG5Ycvd-dZAnAP0OwZ2lLTewVzB6szpI769L6gaKAkKXNWJUAFL4mhDTHxJ-au0A_6x89iQ3ArDogBD_Ns0xdb-JHS2Yka8UgXhyaNakBXppMWP72zvEYHvExD05hmyUZPf_nG0r1G9td3cYCizTq_ruaMHUatdGyCwqxFvrlqK3Omqmed_AX8Qx2kRrJu0VyTEZuFzCR36tEUHQ7M1qhmbZxrYycF-cvOCgMEUi1xGCPEkpUa0irCDYB4iqPNgWYc1dM4Ty3ZtDjY0NQxu8jbYr_P8llIYLKHFa8J-pKZw6JBnkQKTcMfAhMYMr6_gW73gl8CVEAxBxG5wIJo1pld0sblo3g9NxYhESuJVShEFPF-iQdnw0SqJLd6d8j1y4dH7ZB810T99D7V6EHXgMcP0gFbfPUdRnSk7R6acFfCDy43lZhxLj0cNvIizBwMoK5-x6_1p-l4qhaLGDau1WI61QHeFz8RhzWl2MmLSObo7dGJ-SQsZjXo7ruY24XLDSssVlSAxElqKDmkhFjhTHnscICw5BIhcdOpf98sJij51qVxC3jwT4TiKdJaqzXGX05hDkUTnI4JF7vlALL2lwSL6sZbl2fjqo7z2tzG6-K1jxQ8jp0SjCa9yKe5C4kY_SepfHCEd8KBXPgfeLZJ-iIYpHxPjG1jaX3HyZJTeudFRMpPpmq6f5oH9_xqBLJlIwb0YkokDyWoVIgMZN2-5EF3FtJgANlN4ZyTUfDF66Z6bJqSK8O0FyNPA2ozDsYmgQW6fXEbuz90W-2M0rPgp-rTTvMOj5gz-qlsYkId4mDwVWuGIP8DF2E9rHeTXZqNbQrh887Ry2R-U9ZOnipnrQJeMprTv5VYN3C1uZy9w5tBeNw1IHIUZEgsXzktSya8mNX94lRDRqE8vSSwigPM

though not sure how long the token will be good, so might need to visit https://neurosciencenews.com/ketogenic-diet-schizophrenia-bipolar-31018/

to get a new one