In the quest for effective dietary strategies for weight management and diabetes control, the ketogenic diet has emerged as a compelling approach. A recent meta-analysis conducted by Chong Zhou, Meng-die Wang, Jiling Liang, Guomin He, and Ning Chen, published on August 1, 2022, in the International Journal of Environmental Research and Public Health, sheds light on the ketogenic diet’s efficacy in overweight patients with type 2 diabetes mellitus (T2DM). This article delves into the study’s methodology, findings, and the practical implications for nutrition coaches working with clients aiming to control diabetes and lose weight.

Study Overview

The meta-analysis aimed to evaluate the ketogenic diet’s impact on body weight, glycaemic control, and lipid profiles in overweight individuals with T2DM. The researchers systematically reviewed articles from Embase, PubMed, Web of Science, and Cochrane Library databases, selecting eight randomised controlled trials (RCTs) for in-depth analysis.


The selected RCTs compared the effects of a ketogenic diet (low carbohydrate, high fat, and adequate protein) with various control diets on overweight T2DM patients. The primary outcomes measured were changes in body weight, waist circumference, glycated haemoglobin (HbA1c), triglycerides, and high-density lipoprotein (HDL) cholesterol levels.


  • Weight Loss: Participants on the ketogenic diet experienced a substantial reduction in body weight compared to those on control diets.
  • Waist Circumference: A notable decrease in waist circumference was observed, indicating a reduction in abdominal fat.
  • Glycaemic Control: The ketogenic diet led to significant improvements in HbA1c levels, reflecting better blood sugar control.
  • Lipid Profiles: There was a marked reduction in triglycerides and an increase in HDL cholesterol levels, signalling improved cardiovascular health.

The findings underscore the ketogenic diet’s potential as an effective dietary intervention for weight management, glycaemic control, and lipid profile improvement in overweight T2DM patients. The diet’s ability to induce weight loss and enhance metabolic health parameters suggests its suitability as a therapeutic strategy for this population.

Practical Tips for Nutrition Coaches

Nutrition coaches can play a pivotal role in guiding clients through the ketogenic diet, especially those with T2DM aiming for weight loss. Here are practical tips to offer:

  1. Educate on Macronutrient Distribution: Emphasise the importance of adhering to the ketogenic diet’s macronutrient ratios—low carbohydrate, moderate protein, and high fat intake.
  2. Focus on Whole Foods: Encourage the consumption of whole, unprocessed foods rich in healthy fats, such as avocados, nuts, and olive oil, while limiting saturated fats.
  3. Monitor Carbohydrate Intake: Advise clients to track their carbohydrate intake meticulously to ensure they stay within the ketogenic threshold and achieve ketosis.
  4. Hydration and Electrolytes: Stress the importance of staying hydrated and maintaining electrolyte balance, as the ketogenic diet can lead to increased water and mineral loss.
  5. Personalise the Plan: Tailor dietary recommendations to each client’s preferences, lifestyle, and metabolic health status, ensuring the plan is sustainable and effective.
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Sample Eating Plan

Here’s a basic structure of a meal plan for clients aiming to control diabetes and lose weight on the ketogenic diet:

  • Breakfast: Scrambled eggs with spinach and avocado, cooked in olive oil.
  • Lunch: Grilled chicken salad with mixed greens, cherry tomatoes, cucumber, feta cheese, and olive oil dressing.
  • Snack: A handful of almonds or celery sticks with almond butter.
  • Dinner: Baked salmon with asparagus and a side of cauliflower rice.
  • Dessert (Optional): A small serving of berries with whipped coconut cream.


Zhou, C., Wang, M.-d., Liang, J., He, G., & Chen, N. (2022). Ketogenic Diet Benefits to Weight Loss, Glycaemic Control, and Lipid Profiles in Overweight Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Randomised Controlled Trails. International Journal of Environmental Research and Public Health, 19(16), 10429. Click here to review the full research article