SynthesisNutrients2026
Effects of the Mediterranean Diet, Ketogenic Diet, and Intermittent Fasting on Iron Metabolism and Iron Deficiency Risk in Adults with Obesity: A Systematic Literature Review.
Synthesis in Nutrients, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND/
objectivesObesity is paradoxically associated with iron deficiency despite adequate dietary intake, driven by chronic inflammation and elevated hepcidin. Different dietary patterns may differentially affect iron metabolism in obese individuals, yet comparative evidence remains limited.
methodsWe conducted a systematic literature review following PRISMA 2020 guidelines. Four databases (SciSpace, Google Scholar, PubMed) were searched through 2025 using terms related to obesity, iron deficiency, and three dietary patterns: Mediterranean diet, ketogenic diet, and intermittent fasting. Studies were screened using seven predefined criteria (three inclusion, four exclusion) with thresholds of ≥4.0/5.0 for abstract screening and ≥4.5/5.0 for full-text screening.
resultsFrom 396 identified records (SciSpace
conclusionsAmong the three dietary patterns examined, the Mediterranean diet appears most protective for iron status in obese individuals. The ketogenic diet may pose the highest risk due to restricted dietary iron diversity and potential hepcidin-independent absorption impairment. Direct comparative randomized controlled trials are urgently needed. Clinicians should routinely monitor iron biomarkers, including hepcidin, in obese patients undertaking any dietary intervention. Quantitative biomarker data from the 38 included studies showed serum ferritin reductions of 8-28%, hemoglobin levels remaining within clinically stable ranges, and IL-6 decreases of 15-42% across dietary patterns.
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