Metabolic impact of a ketogenic diet compared to a hypocaloric diet in obese children and adolescents

J Pediatr Endocrinol Metab. 2012;25(7-8):697-704. doi: 10.1515/jpem-2012-0131.


Background: The effects of carbohydrate-restricted (ketogenic) diets on metabolic parameters in children have been incompletely assessed.

Objective: To compare the efficacy and metabolic impact of ketogenic and hypocaloric diets in obese children and adolescents.

Subjects: Fifty-eight obese subjects were placed on one of the two diets for 6 months.

Methods: Anthropometric measurements, body composition, oral glucose/insulin tolerance test, lipidemic profile, high molecular weight (HMW) adiponectin, whole-body insulin sensitivity index (WBISI), and homeostatic model assessment-insulin resistance (HOMA-IR) were determined before and after each diet.

Results: Both groups significantly reduced their weight, fat mass, waist circumference, fasting insulin, and HOMA-IR (p = 0.009 for ketogenic and p = 0.014 for hypocaloric), but the differences were greater in the ketogenic group. Both groups increased WBISI significantly, but only the ketogenic group increased HMW adiponectin significantly (p = 0.025).

Conclusions: The ketogenic diet revealed more pronounced improvements in weight loss and metabolic parameters than the hypocaloric diet and may be a feasible and safe alternative for children's weight loss.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Body Mass Index
  • Caloric Restriction
  • Child
  • Cholesterol, HDL / blood
  • Combined Modality Therapy
  • Diet, Ketogenic*
  • Diet, Reducing*
  • Exercise Therapy
  • Female
  • Humans
  • Insulin / blood
  • Male
  • Obesity / diet therapy*
  • Obesity / metabolism*
  • Obesity / therapy
  • Treatment Outcome
  • Weight Loss / physiology


  • Cholesterol, HDL
  • Insulin