Purpose: This narrative review explores the ketogenic diet (KD) as a unified therapeutic approach for a variety of neurological disorders. Instead of focusing solely on seizure control, the authors assess whether ketosis and associated metabolic changes could address shared pathogenic mechanisms across diseases.

Methods: The review synthesises pre‑clinical and clinical research on ketogenic diets and related metabolic interventions. The authors examine animal experiments and small human studies, focusing on how elevated ketone bodies, reduced glycolytic flux and increased polyunsaturated fatty acid intake influence neuronal energy metabolism, mitochondrial function, oxidative stress and inflammation. They summarise clinical reports and pilot trials in epilepsy, neurodegenerative diseases, brain cancers, autism, pain syndromes and sleep disorders.

Results: Mechanistic findings show that ketone bodies enhance ATP production, reduce reactive oxygen species, stimulate mitochondrial biogenesis and stabilise synaptic function. Reduced blood glucose mimics calorie restriction, down‑regulating excitatory pathways and neuroinflammation. Clinically, the KD remains a proven therapy for drug‑resistant epilepsy, and preliminary evidence hints at benefits in Alzheimer’s and Parkinson’s disease models, brain tumours (when combined with calorie restriction), traumatic brain injury, autism and chronic pain. However, most data come from animal studies or small case series.

Conclusion: The ketogenic diet offers a promising metabolic therapy that could benefit diverse neurological disorders by improving mitochondrial efficiency and reducing oxidative stress and inflammation. While robust human data are limited, the mechanistic rationale supports further controlled trials. For athletes and health‑conscious consumers, ketosis via diet or supplementation may enhance cognitive resilience and neuroprotection, but guidance is needed to ensure safety and nutritional adequacy.