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Low-carb and ketogenic diets are popular among clinicians and patients, but the appropriateness of reducing carbohydrates intake in obese patients and in patients with diabetes is still debated. However, the effects of ketogenic diets on cardiovascular risk factors could help validate the effects of low-carbohydrate ketogenic diets on clinical cardiovascular event endpoints. Our meta-analysis confirmed that ketogenic diets significantly reduced FPG and HbA1c levels in obese/overweight patients with T2DM. These diets provide energy via fat oxidation, and when the body experiences extreme hunger or limited carbohydrate levels, ketone bodies are produced and released into the circulation via fatty acid conversion in the liver (43). In this meta-analysis of 21 RCTs which included 1,074 participants, we investigated the efficacy of ketogenic diets when compared with non-ketogenic diets toward cardiovascular risk factor control in overweight or obese patients. Forest plot showing weighted mean difference and 95% confidence intervals (CIs) for low carbohydrate ketogenic diet effects on blood pressure. Subgroup analyses of obese/overweight patients with or without T2DM on ketogenic diet showed no statistically significant changes in systolic and diastolic blood pressure levels when compared with non-ketogenic diet (Figure 5). Obese/overweight patients on ketogenic diet showed no statistically significant changes in Uric acid (UA), blood urea nitrogen (BUN), and creatinine levels when compared with those on non-ketogenic diet (Figure 4). Forest plot showing weighted mean difference and 95% confidence intervals (CIs) for low carbohydrate ketogenic diet effects on glucose metabolism. Therefore, appropriateness and potential risks of low-carbohydrate ketogenic diets in obese patients remain controversial. Previous studies have proposed many different dietary approaches, including low-carbohydrate ketogenic diets which includes ~60% fat intake, 25% protein intake, and 15% carbohydrate intake, but without limiting caloric intake (7, 8). Keto gummies, which are designed to support the ketogenic diet, can help individuals achieve a state of ketosis, in which the body burns fat for energy instead of carbohydrates. The ketogenic diet, which involves drastically reducing carbohydrate intake and increasing fat consumption, has been shown to have a significant impact on blood sugar levels and insulin sensitivity. Unlike a ketogenic diet, a ketogenic diet does not rely on endogenous fatty acids or glucose and can rapidly increase ketone levels without the process of fatty acid β-oxidation. Utilizing body composition assessments, investigators noted a substantial reduction in weight due to free water loss early in the study.12 It is important to look at length of duration in ketogenic diet studies as early, dramatic weight loss may be due to diuresis. 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