VITAMIN D STATUS AND METABOLIC IMPLICATIONS IN PATIENTS FOLLOWING A KETOGENIC DIET

Abstract

The ketogenic diet (KD), a very-low carbohydrate, high-fat nutritional strategy, has received increasing attention due to its therapeutic uses in epilepsy and more broadly for weight management in obesity. Simultaneously, vitamin D deficiency is a worldwide health problem closely correlated with obesity and several metabolic disorders. Our narrative review investigates this complex and reciprocal relationship between KD and vitamin D metabolism. New evidence from the clinical setting suggests that KD, particularly during weight reduction, often increases the serum 25-hydroxyvitamin D [25(OH)D] contents of circulating plasma. Several mechanisms are associated with vitamin D release from adipose tissue stores in weight-related reduction, high fat concentrations of the diet increase absorption, and ketone bodies, especially β-hydroxybutyrate (BHB), are newly identified signaling molecules that could epigenetically reprogram genes for vitamin D metabolism. This review examines both the biochemical mechanisms underlying such interactions and the downstream metabolic implications, including implications for insulin signaling, lipid metabolism, inflammation and calcium-phosphate homeostasis with directly relevant effects for bone health. Knowledge of this intricate interplay is necessary for medical students and clinician provision of holistic nutritional guidance