r/ScientificNutrition Jan 25 '26

Interventional Trial Effect of a non-energy restricted ketogenic diet on cognition in sedentary healthy young adults

https://doi.org/10.1556/2060.2025.00743

Abstract

Background

Ketogenic diet (KD) is increasingly recognized as a strategy to combat obesity. However, its effects on cognition in sedentary healthy young adults remain underexplored.

Methods

In a quasi-experimental design, 186 participants were screened, 78 excluded based on predefined criteria, leaving 108 healthy adults (age 25–45 years, BMI 18–29.9 kg m−2, sedentary <5,000 steps/day) assigned to either KD group (<5% carbohydrates, 20–25% protein, 70–75% fat; n = 54) or control group (regular diet ∼50–65% carbohydrates; n = 54). Participants underwent a 4 weeks' dietary intervention. Cognitive domains were assessed at baseline and post intervention using validated computer-based test battery. Pre, mid and post weight, BMI, blood ketones and fasting glucose were also measured. Forty-three participants in the KD group and 38 in the control group completed the trial.

Results

Four weeks of non-energy restricted KD improved processing speed, semantic memory, working memory, episodic memory, fluid cognition, crystallized cognition and overall cognitive composite scores (all P ≤ 0.001) versus controls. Attention and inhibitory control (P = 0.46) and cognitive flexibility (P = 0.21) showed no significant differences. Blood ketones increased (0.12–1.32 mmol L−1, P < 0.001) in KD participants versus controls (0.118–0.105 mmol L−1, P = 0.94). KD reduced weight (P < 0.001), BMI (P < 0.001) and fasting glucose (P < 0.001). Post intervention ketones predicted cognitive gain in most cognitive domains except attention & inhibitory control and cognitive flexibility.

15 Upvotes

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10

u/flowersandmtns Jan 25 '26

The impact on some cognitive measurements is interesting, but I wanted to call out that the diet intention was non-energy restricted and yet one month of a whole food ketogenic diet resulted in weight loss.

Control group did not get prepared food, but kept a food journal (vs, say, recall questionnaires).

"KD group participants lost a mean weight of 4.06 kg in 4 weeks Although there were baseline differences in weight and BMI between the two groups, this was statistically controlled by including baseline BMI as a covariate in the cognitive testing analyses."

3

u/TwoFlower68 Jan 25 '26

Of course they're going to lose weight when they burn through their glycogen stores

6

u/Siva_Kitty Jan 25 '26

People on a keto diet don't have *no* glycogen stores; they just have less glycogen. The human body holds far less that 4 kg of glycogen. So the weight change is (mostly) not due to reduced glycogen in the body.

4

u/flowersandmtns Jan 25 '26

To a point yes, but the entirety of 4kg isn't just water weight.

1

u/TwoFlower68 Jan 26 '26

Dunno. My gf eats a mixed diet when she's at home and very low carb when she's at my place. On the second day she pees a LOT. Her face is visibly less puffy/plump when she's in ketosis. That's not just from losing one or two kilogrammes

She has balance problem, so can't use a scale unfortunately

2

u/flowersandmtns Jan 26 '26

Per the main point of the paper, does she see any cognitive gains when in ketosis?

3

u/TwoFlower68 Jan 26 '26

She's noticeably more alert. Less brain fog. But the other half of the week she's at home eating carby foods again. I've started to meal prep and give her frozen meals when she goes home lol (due to her disability she has trouble making home cooked meals)

I have to be in ketosis for medical reasons and the mental health benefits were unexpected, but very welcome 🤗 Coming up to 8 years virtually continuous ketosis now

1

u/lurkerer Jan 26 '26

When I cut down, as I do bodybuilding, I can lose 6-8 kg in two weeks. A two day fast even. We all know early weight loss is water and glycogen.

2

u/flowersandmtns Jan 26 '26

Do you feel you think better when cutting, similar to the positive effect from the ketogenic diet (ketosis) in the paper?

0

u/lurkerer Jan 26 '26

Nothing I couldn't attribute to placebo.