Evidence mapPaperPMID 41715236Full record

SynthesisBMC nutrition2026

Adverse events and tolerability of ketogenic diets - a systematic literature analysis.

Carolin Schopf, Marc Assmann, Nadja Wolke, Marius Frenser, Thorsten Marquardt, Tobias Fischer

Abstract readSystematic Review
In one paragraph

Synthesis in BMC nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
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

6 authors.

Carolin SchopfCenter for Nutrition and Therapy (NuT), University of Applied Sciences Muenster, Corrensstraße 25, Muenster, 48149, Germany.
Marc AssmannCenter for Nutrition and Therapy (NuT), University of Applied Sciences Muenster, Corrensstraße 25, Muenster, 48149, Germany.
Nadja WolkeCenter for Nutrition and Therapy (NuT), University of Applied Sciences Muenster, Corrensstraße 25, Muenster, 48149, Germany.
Marius FrenserCenter for Nutrition and Therapy (NuT), University of Applied Sciences Muenster, Corrensstraße 25, Muenster, 48149, Germany.
Thorsten MarquardtDepartment of Pediatrics, University Hospital Muenster, Albert-Schweitzer-Campus 1, Muenster, 48149, Germany.
Tobias FischerCenter for Nutrition and Therapy (NuT), University of Applied Sciences Muenster, Corrensstraße 25, Muenster, 48149, Germany. tobias.fischer@fh-muenster.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundKetogenic diets (KDs) are becoming increasingly popular in the treatment of various diseases, not just pharmacoresistant epilepsy. Despite the growing use of this dietary approach and its economic rationale, a systematic overview of the associated adverse events remains conspicuously absent.

methodsA systematic literature search was conducted in accordance with PRISMA guidelines in the electronic database PubMed. Prospective interventional studies documenting adverse events associated with ketogenic diets published between 2019 and 2024 were included. The recorded adverse events were categorized according to CTCAE criteria and analyzed based on frequency and diversity by diet type.

resultsA total of 36 studies involving 42 ketogenic interventions (classic KD, modified Atkins diet, MCT-based KD, LGIT) were evaluated. The included studies covered a wide range of age groups and conditions. At least one adverse event was documented in 43% of the participants (0-89%, 0.91 ± 0.71 adverse events per person). The most prevalent adverse events were gastrointestinal (40%), followed by neurological (17%), and metabolic and nutritional (12%) disorders. Constipation (24%) was the most commonly reported individual adverse event. A higher rate and severity of adverse events was observed in patients following stricter diets. The tolerability of the intervention was influenced by several factors, including age, the presence of underlying diseases, and the duration of the intervention.

conclusionsThe analysis indicates that adverse events frequently occur alongside KD and encompass a broad spectrum, with gastrointestinal complaints predominating. However, the significance of the findings is limited by the heterogeneity of dietary regimens, the lack of standardization, and the occasional inadequate documentation of adverse events. In clinical practice, it is recommended that adverse events are recorded systematically and monitored regularly.

Indexed as

Adverse effectsAdverse eventsDatabase analysisKetogenic dietLiterature analysisTolerance

Identifiers

PMID41715236
PMCPMC12930977

What Socratic holds

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LicenceCC BY
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Registered trials

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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.