From Neurological Therapy to a Class-Conditioned Health Resource: The Ketogenic Diet, Food Economics, and Global Inequalities

The ketogenic diet, originally developed as a neurological therapy for refractory epilepsy, has evolved into a widely discussed dietary approach for metabolic health. While evidence supports its efficacy in weight management, glycemic control, and neurological outcomes, its accessibility remains highly unequal. In low- and middle-income countries (LMICs), reliance on inexpensive carbohydrate staples and limited consumption of animal-source foods make ketogenic diets structurally costly and often unattainable. This editorial explores the economic and political factors shaping ketogenic diet accessibility, contrasts global dietary patterns with Western high-carbohydrate diets, and highlights the tension between therapeutic potential and structural inequity. Understanding these dynamics positions the ketogenic diet as both a clinical tool and a lens through which global nutrition inequalities can be examined.