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Therapies for insulin resistance

Comparison of ketogenic diet, low-carb diet, and intermittent fasting

Feature Keto Diet Low-Carb Diet Intermittent Fasting
Definition Very low-carb, high-fat diet (typically <50g carbs/day) that induces ketosis. Moderately reduces carbohydrate intake (50–150g carbs/day) without necessarily inducing ketosis. Eating pattern alternating between periods of fasting and eating (e.g., 16:8).
Primary Mechanism Lowers insulin levels by minimising carb intake and shifting metabolism to fat/ketone use. Reduces insulin spikes by lowering carb load but still allows some carbs. Prolonged fasting lowers insulin levels and improves insulin sensitivity during fasting periods.
Impact Strong evidence for improving insulin sensitivity and lowering blood sugar, especially in type 2 diabetes. Improves insulin sensitivity, but effects may be milder compared to keto. Can significantly improve insulin sensitivity by extending periods of low insulin.
Ease of Adoption Often challenging due to strict carb restriction and diet change. Easier to maintain long term than keto because it is less restrictive. Variable; easier for some, but fasting periods may be hard for others.
Typical Side Effects Keto flu, nutrient deficiencies if poorly planned, potential lipid changes. Fewer side effects, but may still cause fatigue or nutrient imbalance if not balanced. Hunger, irritability, risk of overeating during eating windows, not suitable for everyone.
Sustainability Difficult for many people to sustain long term. More sustainable than keto for most individuals. Sustainability varies; may be easier than keto for some.
Best Suited For Those who can adhere to strict carb restriction and want rapid metabolic improvements. Individuals seeking moderate carb reduction with fewer dietary restrictions. People comfortable with meal timing changes rather than strict food restrictions.
Scientific Evidence Substantial evidence for short-term benefits in blood sugar control; long-term data are limited and mixed. Good evidence for improving metabolic health; long-term outcomes generally favourable if diet quality is high. Growing evidence supports benefits for insulin sensitivity and weight loss; long-term effects still under investigation.
Effects on Weight and Health Often leads to rapid weight loss initially, but maintaining weight loss long term is challenging; long-term cardiovascular effects are debated. Promotes steady weight loss with better long-term adherence; associated with improved metabolic health if done with whole foods. Can support weight loss and metabolic health, but effectiveness depends heavily on diet quality during eating windows and consistency.