Evidence mapPaperPMID 40598397Full record

Trial reportBMC medicine2025

Effect of a ketogenic diet, time-restricted eating, or alternate-day fasting on weight loss in adults with obesity: a randomized clinical trial.

José Ignacio Martínez-Montoro, Borja Bandera, Mario Gutiérrez-Bedmar, Ana María Gómez-Pérez, Manuel Macías-González, Isabel Moreno-Indias, Francisco J Tinahones

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04453150 (Ketone Bodies and Gut Microbiota Role in the Dietetic Approach of Obesity), which is not on this map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04453150 nacompletednot on this map

Ketone Bodies and Gut Microbiota Role in the Dietetic Approach of Obesity

TypeinterventionalSponsorFundación Pública Andaluza para la Investigación de Málaga en Biomedicina y SaludRan2020 to 2022Enrolled150ConditionsObesityArmsStandard hypocaloric die, Intermittent fasting 16/8 (early fasting), Intermittent fasting 16/8 (late fasting), Alternate-day fasting, Ketogenic diet
3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Trial
  2. Review
  3. Review
  4. Article
  5. Review
  6. Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

José Ignacio Martínez-Montoro *Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain. joseimartinezmontoro@gmail.com.
Borja Bandera *Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain.
Mario Gutiérrez-BedmarInstituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, Spain.
Ana María Gómez-PérezDepartment of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain.
Manuel Macías-GonzálezDepartment of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain.
Isabel Moreno-IndiasDepartment of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain. isabel.moreno@ibima.eu.
Francisco J TinahonesDepartment of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain.

Funding

Instituto de Salud Carlos III CM22/00217Instituto de Salud Carlos III CPII21/00013
6 · The paper itself

Abstract

backgroundStudies evaluating the effects of novel, alternative dietary approaches for weight loss compared with the Mediterranean diet (MedDiet) are lacking. We aimed to evaluate the effects of diets with varying ketogenic potential, i.e., a very-low carbohydrate diet (ketogenic diet, KD), time-restricted eating (TRE), and modified alternate-day fasting (mADF) on weight loss in obesity, compared with a MedDiet.

methodsThree-month, parallel-arm, randomized clinical trial including 160 adults with obesity. Participants were randomized to 1 of 5 groups: control (MedDiet), KD, early TRE (eTRE), late TRE (lTRE), or mADF. All diets were calorie-restricted. The primary outcome was differences in weight loss from baseline to 3 months between a calorie-restricted MedDiet and each of the four remaining calorie-restricted dietary interventions. Secondary outcomes included change in body mass index, body composition, and cardiometabolic risk factors.

resultsThe mean age was 45.7 years (SD 10.7), and 70.6% were women. One hundred forty participants completed the study. Significant differences in weight loss from baseline to 3 months were found between KD and the control group [- 3.78 kg (- 5.65 to - 1.91 kg)], between mADF and the control group [- 3.14 kg (- 4.98 to - 1.30 kg)], and between lTRE and the control group [- 2.27 kg (- 4.13 to - 0.40 kg)], but not between eTRE and the control group [- 1.22 kg (- 3.07 to 0.64 kg)].

conclusionsThese results suggest that a calorie-restricted KD, mADF, or lTRE may be more effective for weight loss than a calorie-restricted MedDiet in obesity. Further research is needed to evaluate the long-term feasibility and efficacy of these dietary interventions compared with the MedDiet.

trial registrationClinicalTrials.gov (NCT04453150).

Indexed as

Diet, KetogenicFastingObesityWeight LossAdultBody Mass IndexCaloric RestrictionFemaleHumansMaleMiddle AgedTreatment OutcomeAlternate-day fastingKetogenic dietMediterranean dietTime-restricted eatingWeight loss

Identifiers

PMID40598397
PMCPMC12220164

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.