The Summary
In a 12-week randomized controlled trial, researchers evaluated 90 adults with obesity and prediabetes across three dietary protocols: a ketogenic-caloric-restricted (KD+CR) diet, a standard caloric-restricted diet, and an unrestricted normal diet. The KD+CR group achieved the greatest reductions in body weight (-10.5%) and body fat (-21.7%), alongside significant improvements in insulin sensitivity and interleukin-6 levels. Surprisingly, the KD+CR group also experienced a significant rise in serum lipopolysaccharides (LPS), a marker of metabolic endotoxemia, highlighting a complex physiological trade-off during ketogenic dieting.
Why this is interesting
This study presents a striking paradox: while the ketogenic diet is highly effective for weight loss and blood sugar control, it also increases metabolic endotoxemia (LPS), which is typically associated with systemic inflammation and gut barrier leakage. Previously, researchers assumed keto's anti-inflammatory benefits extended across all markers. This finding suggests that high-fat, low-carb eating might alter gut permeability or lipid transport in ways that release bacterial toxins into the bloodstream. For readers, it emphasizes that weight loss does not automatically mean perfect internal health, and long-term keto safety warrants closer inspection.