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Based on a sensitivity analysis with a maximum 5-year follow-up time, exposure misclassification introduced by long follow-up times might explain only partly this null association

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It has been shown that the KD may be more bioenergetically efficient than other dietary strategies, inter alia owing to its effect on curtailing hunger, improving satiety and decreasing appetite (influence on hunger and satiety hormones and the sensation of hunger), inducing faster initial weight loss (associated with lower glycogen levels and reduced water retention), and controlling glycaemia and insulinemia (directly attributable to the low-carbohydrate nature of KD and indirectly to the other areas described)

These changes are not dangerous but can impact self-esteem and body image

We acknowledge Mart Sillen (KU Leuven) for providing protocols for microscopic biofilm analysis

Li S, Ji X, Chao C, Liu Z, Zhu J, Peng H