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Scientific evidence underlying contraindications to the ketogenic diet: An update
Author(s) -
Watanabe Mikiko,
Tuccinardi Dario,
Ernesti Ilaria,
Basciani Sabrina,
Mariani Stefania,
Genco Alfredo,
Manfrini Silvia,
Lubrano Carla,
Gnessi Lucio
Publication year - 2020
Publication title -
obesity reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.845
H-Index - 162
eISSN - 1467-789X
pISSN - 1467-7881
DOI - 10.1111/obr.13053
Subject(s) - ketogenic diet , medicine , intervention (counseling) , de facto , intensive care medicine , popularity , evidence based medicine , medical literature , scientific evidence , medline , evidence based practice , clinical practice , epilepsy , alternative medicine , psychiatry , family medicine , psychology , pathology , social psychology , philosophy , epistemology , political science , law
Summary First identified as a feasible treatment for intractable epilepsy, the ketogenic diet (KD) has recently gained popularity thanks to growing evidence on applications such as weight loss, most importantly, but also NAFLD, cancer, neurologic conditions and chronic pain. As with any treatment, whether pharmacologic or not, the KD might not be an appropriate intervention for every individual, and a number of contraindications have been proposed, now deeply rooted into clinical practice, excluding de facto many patients that could benefit from its use. However, many of these concerns were expressed due to the absence of clinical studies conducted on fragile populations, and an assessment of lately emerged evidence relative to KD safety is currently lacking and much needed. We herein provide a critical revision of the literature behind each safety alert, in order to guide through the treatment options in the case of subjects with an indication to the KD and a borderline safe situation. Based on available evidence, the possible use of this diet as a therapeutic intervention should be assessed on a patient‐to‐patient basis by adequately skilled medical doctors, keeping in mind current recommendations, but reading them through the knowledge of the current state of the art.