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During a shortage of glucose, the energy focus switches from glycolysis to the breakdown of fatty acids . It has been hypothesized that the increased systemic levels of βOHB induced during KD may lessen the importance of microbial butyrate production (126), and thus, the potential negative impact on colonic health from reduced butyrate may be lessened. Their central fermentation pathway, the fructose-6-phosphoketolase or “bifid shunt,” provides them with an ecological advantage in the presence of carbohydrates, because it produces more energy compared with the fermentation pathways of other bacterial species (87, 88). The terms used to locate literature relevant to the research objectives were “Low-carbohydrate” OR “low carbohydrate” OR “low carb” OR “carbohydrate restricted” OR “carbohydrate-restricted” OR ketogenic AND microbiome OR microbiota OR flora OR microbial. During a KD, however, diminishing glucose blood levels and reserves instigate two processes to provide glucose and FAs for energy production; gluconeogenesis in the liver and lipolysis of FAs from adipose tissue (19). This systematic review examined the diet’s impact on the human gut microbiota to identify potential consequent health outcomes. Pimentel-Suarez LI, Soto-Mota A. Evaluation of the safety and tolerability of exogenous ketosis induced by orally administered free beta-hydroxybutyrate in healthy adult subjects. Rabast U, Vornberger KH, Ehl M. Loss of weight, sodium and water in obese persons consuming a high- or low-carbohydrate diet. I weight loss, electrolyte excretion, and fatigue. Alterations in carbohydrate metabolism in response to short-term dietary carbohydrate restriction. Low carbohydrate, high fat diet impairs exercise economy and negates the performance benefit from intensified training in elite race walkers. 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