{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T08:46:44Z","timestamp":1785833204314,"version":"3.56.0"},"reference-count":46,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Whether ketogenic diets provide greater weight-loss benefits than higher-carbohydrate diets when prescribed energy intake or targeted energy deficit are comparable remains uncertain. This systematic review and meta-analysis evaluated their effects on body weight change in adults with overweight or obesity. Methods: Following PRISMA 2020, PubMed, Scopus, and Web of Science were searched for randomized controlled trials comparing ketogenic diets with higher-carbohydrate diets under matched energy prescriptions. Ketogenic diets were defined as providing \u226450 g carbohydrate\/day or \u226410% of total energy from carbohydrate. A random-effects meta-analysis used restricted maximum likelihood estimation and the Hartung\u2013Knapp adjustment. Risk of bias and certainty of evidence were assessed using RoB 2 and GRADE, respectively. Results: Eight reports representing seven studies were included in the systematic review; six studies comprising 259 participants contributed to the meta-analysis. Ketogenic diets were associated with slightly greater weight loss than higher-carbohydrate diets (MD = \u22121.49 kg; 95% CI: \u22122.41 to \u22120.58; p = 0.008; I2 = 0%). Estimates remained similar after alternative imputations of change-score standard deviations, exclusion of the trial at high risk of bias, and leave-one-out analyses. In three trials meeting the prescribed protein-matching criterion, the effect remained directionally consistent but was imprecise and compatible with no difference. Certainty of evidence was low because of risk of bias and imprecision. Conclusions: Under comparable prescribed energy conditions, ketogenic diets may produce a small additional reduction in body weight. However, predominantly short-term evidence, uncertainty regarding achieved energy and protein intakes, the absence of a synthesis of body composition, and low certainty of evidence limit confidence in the magnitude, durability, and clinical significance of this advantage.<\/jats:p>","DOI":"10.3390\/nu18152525","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T08:02:19Z","timestamp":1785830539000},"page":"2525","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Do Ketogenic Diets Produce Greater Weight Loss than Higher-Carbohydrate Diets Under Comparable Prescribed Energy Conditions? A Systematic Review and Meta-Analysis of Randomized Controlled Trials"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9253-573X","authenticated-orcid":false,"given":"Tomasz","family":"\u017burawski","sequence":"first","affiliation":[{"name":"University of Rzesz\u00f3w, Collegium Medicum, Faculty of Health Sciences and Psychology, 35-959 Rzesz\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2359-7818","authenticated-orcid":false,"given":"Anna","family":"Bartosiewicz","sequence":"additional","affiliation":[{"name":"University of Rzesz\u00f3w, Collegium Medicum, Faculty of Health Sciences and Psychology, 35-959 Rzesz\u00f3w, Poland"},{"name":"University Center for Research and Development in Health Sciences, 35-310 Rzesz\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.metabol.2018.09.005","article-title":"The epidemiology of obesity","volume":"92","author":"Chooi","year":"2019","journal-title":"Metabolism"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/164_2022_581","article-title":"Epidemiology of Obesity","volume":"Volume 274","author":"Eckel","year":"2022","journal-title":"From Obesity to Diabetes"},{"key":"ref_3","unstructured":"Chamarthi, V.S., and Daley, S.F. 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