Anyone considering getting on the latest dietary fad train should think twice; strict adherence to a modified dietary regime without monitoring by medical professionals can lead to unintended consquences. Often, the promoters of such diets use a handful of scientific studies to gain followers (hence revenue), even if such studies (such as the one in this article) aren't applicable for the general public. If you want to get on the train regardless, or are already on it, I suggest reading this entire review (2013) (it's dense, a chatbot can help).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3625904/

It covers everything from basic biochemistry to unusual disease states, here's the diet-relevant bit:

> "Ketogenic diets are often unpalatable, which leads to poor patient compliance. Additionally, such diets raise blood cholesterol and free fatty acids, increase the risk of nephrolithiasis, and cause constipation (23, 116, 201). Therefore, Veech and Clarke developed and tested ingestible ketone ester compounds, which can rapidly generate ketoses exceeding 5 mM in rats and humans (37, 103, 195), while sparing the adverse consequences of high-fat diets."

Now these ketone esters are being marketed direct to consumers when they really should only be used under medical supervision as part of a coherent treatment program for specific issues:

https://www.businessinsider.com/ketone-ester-drinks-claim-ke...