A wider use of the ketogenic diet may be limited by the number of early adverse effects (gastrointestinal distress, acidosis, hypoglycaemia, dehydration and lethargy), and late adverse effects (hyperu

The gap

Consensus across the literature

Supporting evidence — 3 representative gaps

• Efficacy and safety of ketogenic diet in glioblastoma: an updated systematic review and meta-analysis (2026) · doi

  The present body of evidence is limited by small cohort numbers, lack of blinding, and variability in diet composi- tion, treatment length, and levels of diet compliance. Most trials were conducted in an observational fashion, making it difficult to establish causality and rendering these trials vulnerable to selection bias. Moreover, the long-term fea- sibility of following very low carbohydrate diets is likely to remain a challenge for patients. The availability of only limited registered dietitians competent in ketogenic treat- ment and varying levels of patient compliance have been other challenges. Additionally, there is no common set of biomarkers for the following treatment response.

  Keywords: limited diet treatment levels compliance trials following present body evidence small cohort numbers lack blinding
• To treat or not to treat drug-refractory epilepsy by the ketogenic diet? That is the question (2016) · doi

  A wider use of the ketogenic diet may be limited by the number of early adverse effects (gastrointestinal distress, acidosis, hypoglycaemia, dehydration and lethargy), and late adverse effects (hyperuricaemia, hyperlipidaemia, kidney stones, easy bruising, and decreases in height and weight).

  Keywords: adverse effects wider ketogenic diet limited number early gastrointestinal distress acidosis hypoglycaemia dehydration lethargy late
• The impact of the ketogenic diet on the health of patients with metabolic syndrome: a scoping review (2026) · doi

  Conflict of interest Research on the effects of the ketogenic diet on metabolic syn- drome has significant limitations that make it difficult to unequivo- cally assess its effectiveness. They often include small groups of participants, which limits the ability to generalize the results to the entire population. In addition, many studies take a short time, making it difficult to assess the long-term effects and safety of such a diet. The results also vary due to differences in the composition of the ketogenic diet used in individual studies. Another important problem is the lack of standardization of methods for assessing metabolic parameters, which makes it difficult to compare results. Finally, some studies do not take into account factors such as physical activity or individual genetic predispositions, which can significantly affect the course of metabolic syndrome. The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

  Keywords: diet metabolic difficult conflict interest effects ketogenic assess take individual drome significant limitations make unequivo