Maternal ketogenic diet linked to altered glucose tolerance in pregnant mice and modest offspring metabolic changes
Research Analysis
In a controlled mouse experiment, females fed a high‑fat, low‑carbohydrate ketogenic diet before and throughout pregnancy showed higher body weight, impaired glucose tolerance and lower circulating insulin in late gestation, while their fetuses were smaller. Offspring exposed in utero displayed a modest improvement in glucose tolerance at 12 weeks, with sex‑specific reductions in serum insulin.
Study and findings
Female Swiss Webster mice (n = 20 per group) were assigned to either a control diet (20 % protein, 70 % carbohydrate, 10 % fat) or a ketogenic diet (20 % protein, 5 % carbohydrate, 75 % fat) for six weeks before mating and remained on the same diet through pregnancy and lactation. In the maternal cohort (3 keto dams, 5 control dams), glucose tolerance tests at gestational day 16.5 revealed significantly higher blood glucose excursions in keto dams, and urinary ketone strips confirmed ketosis. At gestational day 17.5, keto dams weighed more, had lower serum insulin, and their fetuses were lighter, although placental weight and efficiency were unchanged. In the offspring cohort (7 keto dams, 9 control dams), one male and one female per litter were followed to 12 weeks. Body‑weight trajectories did not differ overall, but at 12 weeks keto‑exposed offspring showed a modest but statistically significant reduction in glucose‑tolerance test area under the curve. Male keto offspring had lower serum insulin than male controls; leptin levels were similar across groups, but the typical sex difference in leptin seen in controls was absent in keto offspring.
Clinical interpretation
The data indicate that continuous exposure to a ketogenic macronutrient profile during murine pregnancy perturbs maternal glucose homeostasis, leading to higher glycaemia and reduced insulin despite the presence of ketosis. The associated reduction in fetal weight suggests that altered maternal metabolism can limit nutrient delivery to the conceptus. In the adult offspring, the observed modest improvement in glucose tolerance, together with lower insulin in males, may reflect a programmed shift toward enhanced insulin sensitivity, although the effect size is small and confined to a single time point. These findings illustrate that maternal dietary fat‑to‑carbohydrate ratios can have divergent acute effects on the mother and delayed, sex‑specific metabolic outcomes in the progeny.
Limitations and open questions
The study used a limited number of pregnant dams (n = 3 keto, n = 5 control) and independent cohorts for maternal and offspring measurements, preventing direct correlation of maternal and offspring phenotypes. Litter size, sex ratio, and neonatal survival were not recorded, which restricts assessment of broader developmental impacts. Only one offspring per litter was followed, reducing statistical power for detecting subtle sex‑specific effects. The mouse model may not fully recapitulate human pregnancy physiology, and the ketogenic diet composition (75 % fat, 5 % carbohydrate) differs from many human regimens. Future work should include larger sample sizes, standardized litter handling, and mechanistic investigations of placental nutrient transport to clarify how maternal ketosis influences fetal growth and long‑term metabolic programming.
Source
Ruano AH et al. Effects of a maternal ketogenic diet on maternal and offspring metabolic health in mice. PLoS One. 2026;21(10):e0356015.