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. 2024 Oct 1;14(1):22805.
doi: 10.1038/s41598-024-73384-x.

The ketogenic diet has the potential to decrease all-cause mortality without a concomitant increase in cardiovascular-related mortality

Xiaolong Qu  1 , Lei Huang  2 , Jiacheng Rong  3
Affiliations

The ketogenic diet has the potential to decrease all-cause mortality without a concomitant increase in cardiovascular-related mortality

Xiaolong Qu et al. Sci Rep. .

Abstract

The impact of the ketogenic diet (KD) on overall mortality and cardiovascular disease (CVD) mortality remains inconclusive.This study enrolled a total of 43,776 adults from the National Health and Nutrition Examination Survey (NHANES) conducted between 2001 and 2018 to investigate the potential association between dietary ketogenic ratio (DKR) and both all-cause mortality as well as cardiovascular disease(CVD) mortality.Three models were established, and Cox proportional hazards regression analysis was employed to examine the correlation. Furthermore, a restricted cubic spline function was utilized to assess the non-linear relationship. In addition, subgroup analysis and sensitivity analysis were performed.In the adjusted Cox proportional hazards regression model, a significant inverse association was observed between DKR and all-cause mortality (HR = 0.76, 95% CI = 0.63-0.9, P = 0.003). However, no significant association with cardiovascular mortality was found (HR = 1.13; CI = 0.79-1.6; P = 0.504). Additionally, a restricted cubic spline(RCS) analysis demonstrated a linear relationship between DKR and all-cause mortality risk. In the adult population of the United States, adherence to a KD exhibits potential in reducing all-cause mortality risk while not posing an increased threat of CVD-related fatalities.

Keywords: Cohort study; Ketogenic diet; Mortality; NHANES.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the study participant selection. NHANES, National Health and Nutrition Examination Survey; CVD, cardiovascular diseases.
Fig. 2
Fig. 2
RCS analysis on the association between the DKR and the risk of all-cause mortality and CVD mortality. (A) RCS curve of the association between the DKR and all-cause mortality, (B) RCS curve of the association between the DKR and CVD mortality. RCS: restricted cubic spline; CVD, Cardiovascular Disease; DKR, Dietary ketogenic ratio.
Fig. 3
Fig. 3
Stratified analysis of the DKR and risk of all-cause mortality. DKR, dietary ketogenic ratio; BMI, Body Mass Index.
Fig. 4
Fig. 4
Stratified analysis of the DKR and risk of cardiovascular mortality. DKR, dietary ketogenic ratio; BMI, Body Mass Index.
See this image and copyright information in PMC

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