The Interplay between the Gut and Ketogenic Diets in Health and Disease

This review synthesizes current knowledge on how the ketogenic diet interacts with the gut, covering gut physiology, intestinal immunity, and processes such as mitochondrial function, stem cell fate and intestinal circadian rhythm. It gives special focus to the gut microbiome, including bacterial and fungal communities, and how the diet modulates them in epilepsy, obesity, traumatic brain injury and multiple sclerosis. It also examines ways of tailoring the diet, including alternative formulations, ketone esters, prebiotics and probiotics, and strategies to reduce side effects.