Journal of Shanghai Jiao Tong University (Medical Science) ›› 2022, Vol. 42 ›› Issue (4): 545-550.doi: 10.3969/j.issn.1674-8115.2022.04.018

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Research progress of ketogenic diet regulating intestinal microbiome in the treatment of diseases

WU Ya1(), YIN Jun1,2()   

  1. 1.Department of Endocrinology, Shanghai Eighth People's Hospital, Shanghai 200235, China
    2.Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Clinical Center for Endocrinology and Metabolic Diseases, Shanghai 200233, China
  • Received:2021-12-31 Accepted:2021-03-25 Online:2022-04-28 Published:2022-04-28
  • Contact: YIN Jun;
  • Supported by:
    National Natural Science Foundation of China(82070885);Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support(20172025)


Ketogenic diet is a high-fat, very low-carbohydrate, appropriate amount of protein and other nutrients diet. It was first used to treat children's epilepsy. With the continuous development of medicine, ketogenic diet has been gradually used in the adjuvant treatment of other diseases, but its specific mechanism is not clear. Recent studies have shown that ketogenic diet can affect the diversity and quantity of intestinal flora, which is of great significance to the health of the host. Studies have also shown that ketogenic diet can increase the abundance of Akkermansia muciniphila (A. muciniphila) and Parabacteroides in mouse intestine, resulting in decreased subset of gamma-glutamylated amino acids and increased ratio of hippocampal gamma-aminobutyric acid and glutamate, which could reduce the frequency of seizures. Elevated abundance of A. muciniphila can also improve cerebrovascular function, and then reduce the risk of Alzheimer's disease. Besides, ketogenic diet can also decrease the abundance of Bifidobacterium in mouse intestine, resulting in the decrease of intestinal lactic acid level and pro-inflammatory T helper 17 cell (Th17 cell) level, which could improve cognitive and memory function and treat obesity, respectively. This article reviews the therapeutic effects and possible mechanisms of ketogenic diet on the regulation of intestinal flora in neurological diseases (epilepsy, Alzheimer's disease, multiple sclerosis and autism), metabolic diseases (diabetes mellitus and obesity), and tumors.

Key words: ketogenic diet, Akkermansia muciniphilaA. muciniphila), Bifidobacterium, diabetes mellitus, obesity

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