ketogenic diet long term

Researchers studied the success rates of ketogenic and low glycemic index diets, to see which keeps weight off long term.

In 2016, 39% of adults worldwide were overweight. Poor health conditions such as high blood pressure, high cholesterol, heart disease, type 2 diabetes, and heart attack are more common in the overweight. While bad for the individual, obesity also places a heavy burden on healthcare systems. 

Many weight loss programs and systems have been developed with mixed results. The number of diets available can be overwhelming – ketogenic diet, macro diet, personalized nutrigenetic diet – it is hard to know which one to choose. Keeping the weight off afterwards is often the biggest hurdle. 

Ketogenic diets are high fat and characterized by low to no carbohydrate consumption. The macro diet focuses on maintaining a certain level of carbohydrates, proteins, and fats (the macronutrients) to achieve weight loss. The nutrigenetic diet is based on personal genetic testing results, creating a diet which tailors micronutrient requirements to the individual based on their genetic test results.

To determine the better long-term weight loss rates, researchers from Iuliu Hatieganu University of Medicine and Pharmacy in Romania recently conducted a study of the ketogenic diet compared to a low glycemic index / nutrigenetic diet. Their results were published in the journal BMC Nutrition.

The study followed 114 overweight or obese patients enrolled at a weight management clinic. The patients could choose a ketogenic diet or a low-GI nutrigenetic diet. Fifty-three patients chose the ketogenic diet and sixty-one patients chose the low-GI nutrigenetic diet. The patients followed the diet plans for 24 weeks. 

Patients in the ketogenic diet group ate no more than 35 grams of carbohydrates, no more than 10% total calories from fat, and protein intake between 1.2 g/kg bodyweight for women, and 1.5 g/kg bodyweight for men. 

Patients in the low-GI nutrigenetic diet group were DNA tested, and a diet plan was specifically developed based on the DNA testing. However, limits were placed on carbohydrates and saturated fat intake.

Both groups participated in 30-45 minutes of exercise per day, five days per week. During the first 24 weeks, body measurements were taken, and diet diaries were kept. Patients in the low-GI nutrigenetic diet also measured the amount of ketone bodies in their urine. After the initial 24 weeks, the patients were monitored for another 18 months to determine the long-term effects of the diets.

After the first 24 weeks, the ketogenic diet group lost more weight than the low-GI nutrigenetic diet. However, after 18 months, the ketogenic diet group gained more weight back than the low-GI nutrigenetic group. 

Study results suggest that while the ketogenic diet is better for weight loss initially, in the long term sustained weight loss and health benefits are better using a low-GI nutrigenetic diet. 

Written by Rebecca Blankenship, B.Sc.


1. Overweight and obesity. World Health Organization. Published 2020. Accessed October 5, 2020.

2. Vranceanu M, Pickering C, Filip L et al. A comparison of a ketogenic diet with a LowGI/nutrigenetic diet over 6 months for weight loss and 18-month follow-up. BMC Nutr. 2020;6(1). doi:10.1186/s40795-020-00370-7

3. The Ketogenic Diet: A Detailed Beginner’s Guide to Keto. Healthline. Published 2020. Accessed October 5, 2020.

4. Why You Should Count Macros (Not Calories!) If You Want to Lose Weight. Prevention. Published 2020. Accessed October 5, 2020.

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