Higher dietary ketogenic ratio is associated with accelerated biological aging among US adults: analysis from NHANES 2005-2018

Each 1-unit increase in dietary ketogenic ratio is associated with a 5.65-year increase in biological age acceleration.

• Biological age acceleration is measured using four indices: biological age acceleration, phenotypic age acceleration, homeostatic dysregulation, and serum Klotho concentrations.
• A 1-unit increase in dietary ketogenic ratio also corresponds to a 0.88-year increase in phenotypic age acceleration and a 67.67 pg/mL decrease in Klotho concentrations.
• A linear positive association exists between biological age acceleration and dietary ketogenic ratio, with significant effects noted at higher dietary ratios.
• Phenotypic age acceleration and homeostatic dysregulation show positive associations with dietary ketogenic ratio, indicating potential nonlinearity in their relationships.
• Klotho concentrations are negatively associated with dietary ketogenic ratio, demonstrating a decreasing trend as the ratio increases.

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