A 12-week low-energy ketogenic diet in adults with obesity significantly reduced systolic blood pressure by 8.2 mmHg (p=0.050) and diastolic blood pressure by 9.2 mmHg (p=0.010).
Does a low-energy ketogenic diet improve blood pressure, arterial stiffness, and endothelial function in adults with obesity?
A 12-week low-energy ketogenic diet significantly reduces blood pressure and improves vascular function in adults with obesity, with benefits extending beyond weight reduction alone.
Mean Difference: -8.2
Absolute Event Rate: 118.2% vs 126.4%
p-value: p=0.050
Objective: Ketogenic diets (KD) are effective tools for weight loss and cardiometabolic risk reduction. Evidence suggests that very-low-energy ketogenic diets can reduce blood pressure (BP) by approximately 7–8/6–7 mmHg. These effects may be weight-independent, potentially mediated by improved endothelial function and the anti-inflammatory properties of ketone bodies. However, real-world clinical data remain limited. This study evaluated the impact of a low-energy ketogenic diet (LEKD) on Blood Pressure, arterial stiffness, and endothelial function in adults with obesity.Design and method: A total of 27 adults with obesity were enrolled in a 12-week LEKD protocol. Office Blood pressure was monitored. Arterial stiffness was assessed via Pulse Wave Velocity (PWV), while endothelial function was measured through Flow-Mediated Dilatation (FMD). Body composition and metabolic markers were tracked throughout the intervention. Results: The LEKD intervention resulted in a significant reduction in systolic (126.4 ± 9.8 mmHg to 118.2 ± 10.4 mmHg, a reduction of 8.2 mmHg, p = 0.050) and diastolic (79.5 ± 9.6 to 70.4 ± 5.1 mmHg, a reduction of 9.2 mmHg, p = 0.010) blood pressure. We observed a clinically meaningful improvement in arterial stiffness, with PWV decreasing. Endothelial function showed a marked enhancement (FMD: +2.6%). Notably, these cardiovascular improvements were only partially correlated with the total weight loss (97.9 ± 18.7 to 86.3 ± 17.4 kg, a reduction of 11.6 kg, p < 0.001), suggesting a direct metabolic effect of nutritional ketosis. Conclusions: LEKD effectively reduces office blood pressure and improves vascular function in patients with obesity. The observed enhancements in arterial stiffness and endothelial function support the role of nutritional ketosis as a vasoprotective strategy that extends beyond the benefits of weight reduction alone. These findings highlight LEKD as a potent clinical tool for cardiovascular risk management.
Carducci et al. (2026) studied Obesity (n=27). Low-energy ketogenic diet (LEKD) was evaluated on Systolic blood pressure (reduction of 8.2 mmHg, p=0.050). A 12-week low-energy ketogenic diet in adults with obesity significantly reduced systolic blood pressure by 8.2 mmHg (p=0.050) and diastolic blood pressure by 9.2 mmHg (p=0.010).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: