Weight loss, improved physical performance, cognitive function, eating behavior, and metabolic profile in a 12-week ketogenic diet in obese adults

Nutr Res. 2019 Feb:62:64-77. doi: 10.1016/j.nutres.2018.11.007. Epub 2018 Nov 12.


The ketogenic diet (KD) is being increasingly promoted as a strategy to fight obesity. Although the KD is effective for weight loss and weight control, comprehensive determination of its relationship with biochemical, physiological and psychological changes is still largely unexplored. We hypothesized that a 12-week KD (12KD) would significantly affect body weight, physical performance, cognitive function, eating behaviors, the metabolic and hormonal profile in obese adults, although differently in men and women. In an uncontrolled intervention, 35 sedentary obese adults (13 men, 25 women), aged 37 ± 7 years with a BMI 36.1 ± 5.6 kg/m2 underwent a 12KD between March 2017 and June 2017 at the University of Primorska. The 12KD resulted in decreased appetite, significant weight loss of participants (-18 ± 9 kg men vs. -11 ± 3 kg women; P < .001), decreased emotional and external eating (P < .001 for both), increased body image satisfaction (P < .001) and improved physical performance (P < .001). Biochemically, a significant drop in glucose (P = .026), and a significant increase in LDL-cholesterol (P = .031), CRP (P = .007), and BDNF (P = .035) were observed in the first 2 weeks; then, all listed parameters returned to baseline. On the other hand, a significant reduction in insulin (P < .001) and leptin levels (P < .001), and a significant increase in adiponectin (P = .008) and NPY (P = .009) were detected throughout the duration of the 12KD. Our results show the efficacy of the 12KD on weight loss, physical performance, cognitive function, eating behaviors and metabolic profile. However, the long-term effects of a KD on these outcomes needs to be further studied before general recommendations can be made.

Keywords: Cognitive function; Glycemic control; Inflammation; Ketogenic diet; Nutritional intervention; Physical performance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Glucose / drug effects
  • Blood Glucose / metabolism
  • Cholesterol, LDL / drug effects
  • Cholesterol, LDL / metabolism
  • Cognition / physiology*
  • Diet, Ketogenic / methods*
  • Feeding Behavior / physiology*
  • Female
  • Humans
  • Insulin / metabolism
  • Leptin / metabolism
  • Male
  • Obesity / diet therapy*
  • Obesity / metabolism*
  • Physical Functional Performance*
  • Weight Loss / physiology*


  • Blood Glucose
  • Cholesterol, LDL
  • Insulin
  • Leptin