Reacción a "The ketogenic diet may be more beneficial in the short term than other diets for people with obesity, according to a small clinical trial"

The article describes a randomised clinical trial, so it is of high quality in terms of design; however, it should be noted that only 14 participants completed the trial in each group, meaning the sample size is very small, and they only underwent the dietary intervention for five months.

We were already aware that the ketogenic diet has interesting metabolic effects in the short term; my own research group has published several papers on this topic. It should also be noted that all three dietary intervention groups showed metabolic improvements, meaning that any dietary intervention that leads to weight loss improves the patient’s metabolism; in this study, the ketogenic diet group performed marginally better than the other two interventions. The major concern with the ketogenic diet is its safety and long-term effects; there are no reliable studies assessing its long-term effects, for example, on cardiovascular disease. The Mediterranean diet, on the other hand, has been shown to be safe in the long term and to significantly reduce the incidence of cardiovascular events. We must interpret these results with caution. The long-term effect of a diet so high in fat and so low in carbohydrates restricts the intake of certain foods that have been shown to provide significant cardiovascular benefits. At present, the evidence regarding the long-term health benefits of the Mediterranean diet is indisputable, and it should therefore continue to be the recommended diet for all individuals.

The sample size is very small and the inclusion criteria are very restrictive: only subjects with hepatic steatosis were included, and these results cannot be generalised to the general population or to those with other conditions, such as diabetes.

The only thing this study demonstrates, like others carried out previously, is that the ketogenic diet in the short term (less than six months’ intervention) improves metabolic health in obese individuals. However, it is incorrect to conclude that it is better than other diets and, above all, in the long term – which is how individuals suffering from obesity should be treated.