Ketogenic diet but not free-sugar restriction alters glucose tolerance, lipid metabolism, peripheral tissue phenotype, and gut microbiome: RCT

Aaron Hengist, Russell G Davies, Jean-Philippe Walhin, Jariya Buniam, Lucy H Merrell, Lucy Rogers, Louise Bradshaw, Alfonso Moreno-Cabañas, Peter J Rogers, Jeff M Brunstrom, Leanne Hodson, Luc J C van Loon, Wiley Barton, Ciara O'Donovan, Fiona Crispie, Orla O'Sullivan, Paul D Cotter, Kathryn Proctor, James A Betts, Françoise KoumanovDylan Thompson, Javier T Gonzalez*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Restricted sugar and ketogenic diets can alter energy balance/metabolism, but decreased energy intake may be compensated by reduced expenditure. In healthy adults, randomization to restricting free sugars or overall carbohydrates (ketogenic diet) for 12 weeks reduces fat mass without changing energy expenditure versus control. Free-sugar restriction minimally affects metabolism or gut microbiome but decreases low-density lipoprotein cholesterol (LDL-C). In contrast, a ketogenic diet decreases glucose tolerance, increases skeletal muscle PDK4, and reduces AMPK and GLUT4 levels. By week 4, the ketogenic diet reduces fasting glucose and increases apolipoprotein B, C-reactive protein, and postprandial glycerol concentrations. However, despite sustained ketosis, these effects are no longer apparent by week 12, when gut microbial beta diversity is altered, possibly reflective of longer-term adjustments to the ketogenic diet and/or energy balance. These data demonstrate that restricting free sugars or overall carbohydrates reduces energy intake without altering physical activity, but with divergent effects on glucose tolerance, lipoprotein profiles, and gut microbiome.
Original languageEnglish
Article number101667
JournalCell Reports Medicine
Volume5
Issue number8
Early online date1 Aug 2024
DOIs
Publication statusPublished - 20 Aug 2024

Keywords

  • body fat
  • diet
  • energy balance
  • energy intake
  • ketogenic
  • lipoprotein
  • low carbohydrate
  • metabolism
  • physical activity
  • sugar

Fingerprint

Dive into the research topics of 'Ketogenic diet but not free-sugar restriction alters glucose tolerance, lipid metabolism, peripheral tissue phenotype, and gut microbiome: RCT'. Together they form a unique fingerprint.

Cite this