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We believe that a ketogenic diet has the potential to alter the gut microbiota composition and function, thereby promoting alpha diversity but also the production of beneficial microbial metabolites. These trials are needed in different populations (i.e., healthy, obese, diabetic, or epileptic patients) in order to gain more insight in the (patho)physiological response of a ketogenic diet on gut microbiota and metabolic health. However, currently there are no clinical studies that have studied the effects of a ketogenic diet on dyslipidaemia and gut microbiota composition and/or function. Such a study, with an antibiotic arm, is warranted to elucidate the causal role of the gut microbiota in the seizure diminishing effects of the ketogenic diet. To date, no clinical trial has been performed which investigates the effects of a ketogenic diet on gut microbiota composition and function in patients suffering epileptic seizures. Moreover, the authors showed that the seizure protective effects of the ketogenic diet were mediated via the gut microbiota as germ-free mice and antibiotic-treated mice had increased seizure activities, despite following a ketogenic diet . A comparison between these effects and the specific effects of a ketogenic diet on gut microbiota modulation is interesting, but beyond the scope of this review. A ketogenic diet affects the gut microbiota and with it also multiple domains of human health. Results of this trial therefore need to be interpreted as pilot results and larger, better defined dietary trials are needed to study the role of a ketogenic diet on gut microbiota composition/function and metabolic health. To date, however, no clinical studies investigated the effects of a ketogenic diet on both the blood lipid levels and gut microbiota. Despite the reduction of seizure frequency, gut microbiota composition showed a reduction in healthy bacteria upon a ketogenic diet. Interestingly, the role of the gut microbiota with regards to the anti-seizure effects of a ketogenic diet has also been established in human studies [34,35,36,37,38,39]. A systematic search (Supplementary Table S1) was carried out in PubMed, Medline and Embase in order to summarize the current state of knowledge regarding the metabolic effects of a ketogenic diet and the role of gut microbiota in these effects. The exact mechanism by which a ketogenic diet promotes its beneficial metabolic effects regarding seizure activity, obesity, dyslipidaemia, and insulin resistance remains unknown, but recent evidence points towards a crucial role for the gut microbiota [16,17,18]. The goal of this review is to summarize the current state of knowledge regarding the beneficial metabolic effects of the ketogenic diet and the role of gut microbiota in these effects. Reviewing Keto ACV Gummies by effectiveness for weight loss, I’m giving it an F. 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