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Suarez R, Chapela S, Llobera ND, Montalván M, Vásquez CA, Martinuzzi ALN, Katsanos CS, Verde L, Frias-Toral E, Barrea L, Muscogiuri G. Very Low Calorie Ketogenic Diet: What Effects on Lipid Metabolism? Curr Nutr Rep 2024:10.1007/s13668-024-00556-6. [PMID: 39008211 DOI: 10.1007/s13668-024-00556-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2024] [Indexed: 07/16/2024]
Abstract
PURPOSE OF REVIEW This review aims to critically examine how VLCKD affects plasma lipoprotein, lipid and cholesterol metabolism. Cardiovascular disease is a worldwide health problem affecting millions of people and leading to high rates of mortality and morbidity. There is a well-established association between cardiovascular disease and circulating cholesterol. Various dietary recommendations are currently available for the management of dyslipidemia. RECENT FINDINGS The very low-calorie ketogenic diet (VLCKD) is becoming increasingly popular as a treatment option for several pathological conditions, including dyslipidemia. In addition to being low in calories, the VLCKD's main feature is its unique calorie distribution, emphasizing a reduction in carbohydrate consumption in favor of fat as the primary calorie source. Lowering calorie intake through a VLCKD can reduce the endogenous production of cholesterol. However, if the foods consumed are from animal sources, dietary cholesterol intake may increase due to the higher fat content of animal products. When combined, these dietary practices may have opposing effects on plasma cholesterol levels. Studies investigating the impact of VLCKD on plasma cholesterol and low-density lipoprotein cholesterol levels report contradictory findings. While some studies found an increase in low-density lipoprotein cholesterol levels, others showed a decrease in total cholesterol and low-density lipoprotein cholesterol, along with an increase in high-density lipoprotein cholesterol.
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Affiliation(s)
- Rosario Suarez
- School of Medicine, Universidad Técnica Particular de Loja, Calle Paris, San Cayetano Alto, Loja 110107, Ecuador
| | - Sebastián Chapela
- Facultad de Medicina, Departamento de Bioquímica Humana, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
- Equipo de Soporte Nutricional, Hospital Británico de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Natalia Daniela Llobera
- Equipo de Soporte Nutricional, Hospital Británico de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Martha Montalván
- Universidad Católica Santiago de Guayaquil, Av. Pdte. Carlos Julio Arosemena Tola, Guayaquil, 090615, Ecuador
- Facultad de Ciencias Médicas, Universidad de Guayaquil, Guayaquil, Ecuador
| | - Celina Andrade Vásquez
- School of Medicine, Universidad Técnica Particular de Loja, Calle Paris, San Cayetano Alto, Loja 110107, Ecuador
| | | | | | - Ludovica Verde
- Department of Public Health, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Evelyn Frias-Toral
- School of Medicine, Universidad Espíritu Santo - Samborondón, 0901952 Samborondón , Ecuador
| | - Luigi Barrea
- Department of Wellbeing, Nutrition and Sport, Pegaso Telematic University, Centro Direzionale Isola F2, Via Porzio, 80143 Naples, Italy
| | - Giovanna Muscogiuri
- Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
- Centro Italiano per la cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy.
- Cattedra Unesco Educazione Alla Salute E Allo Sviluppo Sostenibile, University Federico II, 80131 Naples, Italy.
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Burén J, Svensson M, Liv P, Sjödin A. Effects of a Ketogenic Diet on Body Composition in Healthy, Young, Normal-Weight Women: A Randomized Controlled Feeding Trial. Nutrients 2024; 16:2030. [PMID: 38999778 PMCID: PMC11243114 DOI: 10.3390/nu16132030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 06/13/2024] [Accepted: 06/24/2024] [Indexed: 07/14/2024] Open
Abstract
This study investigates the effects of a ketogenic low-carbohydrate high-fat (LCHF) diet on body composition in healthy, young, normal-weight women. With the increasing interest in ketogenic diets for their various health benefits, this research aims to understand their impact on body composition, focusing on women who are often underrepresented in such studies. Conducting a randomized controlled feeding trial with a crossover design, this study compares a ketogenic LCHF diet to a Swedish National Food Agency (NFA)-recommended control diet over four weeks. Seventeen healthy, young, normal-weight women adhered strictly to the provided diets, with ketosis confirmed through blood β-hydroxybutyrate concentrations. Dual-energy X-ray absorptiometry (DXA) was utilized for precise body composition measurements. To avoid bias, all statistical analyses were performed blind. The findings reveal that the ketogenic LCHF diet led to a significant reduction in both lean mass (-1.45 kg 95% CI: [-1.90;-1.00]; p < 0.001) and fat mass (-0.66 kg 95% CI: [-1.00;-0.32]; p < 0.001) compared to the control diet, despite similar energy intake and physical activity levels. This study concludes that while the ketogenic LCHF diet is effective for weight loss, it disproportionately reduces lean mass over fat mass, suggesting the need for concurrent strength training to mitigate muscle loss in women following this diet.
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Affiliation(s)
- Jonas Burén
- Department of Food, Nutrition and Culinary Science, Umeå University, 90187 Umeå, Sweden
- Umeå School of Sport Sciences, Umeå University, 90187 Umeå, Sweden
| | - Michael Svensson
- Umeå School of Sport Sciences, Umeå University, 90187 Umeå, Sweden
- Department of Community Medicine and Rehabilitation, Section of Sports Medicine, Umeå University, 90187 Umeå, Sweden
| | - Per Liv
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, 90187 Umeå, Sweden
| | - Anna Sjödin
- Department of Food, Nutrition and Culinary Science, Umeå University, 90187 Umeå, Sweden
- Umeå School of Sport Sciences, Umeå University, 90187 Umeå, Sweden
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Wu Z, Ma Y, Chen S, Liu Y, Liu X, Cao H, Jin T, Li L, Huang M, Yang F, Dong W. Arginine Biosynthesis Mediates Wulingzhi Extract Resistance to Busulfan-Induced Male Reproductive Toxicity. Int J Mol Sci 2024; 25:6320. [PMID: 38928028 PMCID: PMC11203605 DOI: 10.3390/ijms25126320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/01/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
Busulfan, an indispensable medicine in cancer treatment, can cause serious reproductive system damage to males as a side effect of its otherwise excellent therapeutic results. Its widespread use has also caused its accumulation in the environment and subsequent ecotoxicology effects. As a Chinese medicine, Wulingzhi (WLZ) has the effects of promoting blood circulation and improving female reproductive function. However, the potential effects of WLZ in male reproduction and in counteracting busulfan-induced testis damage, as well as its probable mechanisms, are still ambiguous. In this study, busulfan was introduced in a mouse model to evaluate its production of the testicular damage. The components of different WLZ extracts were compared using an untargeted metabolome to select extracts with greater efficacy, which were further confirmed in vivo. Here, we demonstrate abnormal spermatogenesis and low sperm quality in busulfan-injured testes. The WLZ extracts showed a strong potential to rehabilitate the male reproductive system; this effect was more prominent in room-temperature extracts. Additionally, both water and ethanol WLZ extracts at room temperature alleviated various busulfan-induced adverse effects. In particular, WLZ recovered spermatogenesis, re-activated arginine biosynthesis, and alleviated the increased oxidative stress and inflammation in the testis, ultimately reversing the busulfan-induced testicular injury. Collectively, these results suggest a promising approach to protecting the male reproductive system from busulfan-induced adverse side effects, as well as those of other similar anti-cancer drugs.
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Affiliation(s)
- Zifang Wu
- College of Animal Science and Technology, Northwest A&F University, Xianyang 712100, China; (Z.W.); (Y.M.); (S.C.); (Y.L.); (H.C.); (T.J.); (L.L.); (M.H.)
| | - Yuxuan Ma
- College of Animal Science and Technology, Northwest A&F University, Xianyang 712100, China; (Z.W.); (Y.M.); (S.C.); (Y.L.); (H.C.); (T.J.); (L.L.); (M.H.)
| | - Shaoxian Chen
- College of Animal Science and Technology, Northwest A&F University, Xianyang 712100, China; (Z.W.); (Y.M.); (S.C.); (Y.L.); (H.C.); (T.J.); (L.L.); (M.H.)
| | - Yuyan Liu
- College of Animal Science and Technology, Northwest A&F University, Xianyang 712100, China; (Z.W.); (Y.M.); (S.C.); (Y.L.); (H.C.); (T.J.); (L.L.); (M.H.)
| | - Xianglin Liu
- College of Forestry, Northwest A&F University, Xianyang 712100, China;
| | - Heran Cao
- College of Animal Science and Technology, Northwest A&F University, Xianyang 712100, China; (Z.W.); (Y.M.); (S.C.); (Y.L.); (H.C.); (T.J.); (L.L.); (M.H.)
| | - Tianqi Jin
- College of Animal Science and Technology, Northwest A&F University, Xianyang 712100, China; (Z.W.); (Y.M.); (S.C.); (Y.L.); (H.C.); (T.J.); (L.L.); (M.H.)
| | - Long Li
- College of Animal Science and Technology, Northwest A&F University, Xianyang 712100, China; (Z.W.); (Y.M.); (S.C.); (Y.L.); (H.C.); (T.J.); (L.L.); (M.H.)
| | - Mengqi Huang
- College of Animal Science and Technology, Northwest A&F University, Xianyang 712100, China; (Z.W.); (Y.M.); (S.C.); (Y.L.); (H.C.); (T.J.); (L.L.); (M.H.)
| | - Fangxia Yang
- College of Forestry, Northwest A&F University, Xianyang 712100, China;
| | - Wuzi Dong
- College of Animal Science and Technology, Northwest A&F University, Xianyang 712100, China; (Z.W.); (Y.M.); (S.C.); (Y.L.); (H.C.); (T.J.); (L.L.); (M.H.)
- College of Forestry, Northwest A&F University, Xianyang 712100, China;
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Chapela SP, Simancas-Racines A, Ceriani F, Martinuzzi ALN, Russo MP, Zambrano AK, Simancas-Racines D, Verde L, Muscogiuri G, Katsanos CS, Frias-Toral E, Barrea L. Obesity and Obesity-Related Thyroid Dysfunction: Any Potential Role for the Very Low-Calorie Ketogenic Diet (VLCKD)? Curr Nutr Rep 2024; 13:194-213. [PMID: 38526760 PMCID: PMC11133069 DOI: 10.1007/s13668-024-00528-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2024] [Indexed: 03/27/2024]
Abstract
PURPOSE OF REVIEW This review aims to explore in-depth the different aspects of the association between very low-calorie ketogenic diet (VLCKD), obesity and obesity-related thyroid dysfunction. RECENT FINDINGS The VLCKD, proposed as a non-pharmacological strategy for the management of certain chronic diseases, is becoming increasingly popular worldwide. Initially used to treat epilepsy, it has been shown to be effective in controlling body weight gain and addressing various pathophysiological conditions. Research has shown that a low-calorie, high-fat diet can affect thyroid hormone levels. Weight loss can also influence thyroid hormone levels. Studies have suggested that long-term use of VLCKD for refractory epilepsy may be related to the development of hypothyroidism, with an effect seen in various populations. In particular, women with obesity following VLCKD tend to have reduced T3 levels. We propose further research to unravel the underlying mechanisms linking VLCKD to obesity and obesity-related thyroid dysfunction.
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Affiliation(s)
- Sebastián Pablo Chapela
- Facultad de Medicina, Departamento de Bioquímica Humana, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
- Equipo de Soporte Nutricional, Hospital Británico de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Alison Simancas-Racines
- Facultad de, Ciencias Agropecuarias y Recursos Naturales, Carrera de Medicina Veterinaria, Universidad Técnica de Cotopaxi, Latacunga, 050108, Ecuador
- Centro de Investigación de Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Veterinaria y Agronomía, Universidad UTE, Santo Domingo, Ecuador
| | - Florencia Ceriani
- Escuela de Nutrición, Universidad de la República Uruguay, Montevideo, Uruguay
| | | | - María Paula Russo
- Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Ana Karina Zambrano
- Centro de Investigación Genética y Genómica, Universidad UTE, Facultad de Ciencias de la Salud Eugenio Espejo, Quito, Ecuador
| | - Daniel Simancas-Racines
- Centro de Investigación de Salud Pública y Epidemiología Clínica (CISPEC), Universidad UTE, Facultad de Ciencias de la Salud Eugenio Espejo, Quito, 170129, Ecuador
| | - Ludovica Verde
- Department of Public Health, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Giovanna Muscogiuri
- Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
- Cattedra Unesco "Educazione Alla Salute E Allo Sviluppo Sostenibile", University Federico II, 80131, Naples, Italy.
| | | | - Evelyn Frias-Toral
- School of Medicine, Universidad Espíritu Santo - Samborondón, 0901952, Samborondón, Ecuador
| | - Luigi Barrea
- Dipartimento di Benessere, Nutrizione e Sport, Università Telematica Pegaso, Centro Direzionale Isola F2, Via Porzio, 80143, Naples, Italy
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Gonzatti MB, Goldberg EL. Ketone bodies as chemical signals for the immune system. Am J Physiol Cell Physiol 2024; 326:C707-C711. [PMID: 38189135 PMCID: PMC11193451 DOI: 10.1152/ajpcell.00478.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/03/2024] [Accepted: 01/03/2024] [Indexed: 01/09/2024]
Abstract
Ketone bodies are short-chain fatty acids produced by the liver during periods of limited glucose availability, such as during fasting or low carbohydrate feeding. Recent studies have highlighted important nonmetabolic functions of the most abundant ketone body, β-hydroxybutyrate (BHB). Notably, many of these functions, including limiting specific sources of inflammation, histone deacetylase inhibition, NFκB inhibition, and GPCR stimulation, are particularly important to consider in immune cells. Likewise, dietary manipulations like caloric restriction or ketogenic diet feeding have been associated with lowered inflammation, improved health outcomes, and improved host defense against infection. However, the underlying mechanisms of the broad benefits of ketosis remain incompletely understood. In this Perspective, we contextualize the current state of the field of nonmetabolic functions of ketone bodies specifically in the immune system and speculate on the molecular explanations and broader physiological significance.
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Affiliation(s)
- Michelangelo B Gonzatti
- Department of Physiology, University of California, San Francisco, California, United States
| | - Emily L Goldberg
- Department of Physiology, University of California, San Francisco, California, United States
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6
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Dušková M. The Effects of Different Types of Diets on Steroid Hormone Concentrations. Physiol Res 2023; 72:S323-S337. [PMID: 38116769 DOI: 10.33549/physiolres.935209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
The great popularity of various diets in recent years has led us to reflect on their suitability for our health. The aim of this communication is to review current knowledge on the influence of the most well-known diets on the concentrations of the main steroids and to consider possible mechanisms. The influence of diet on hormone concentrations is expected, but the literature data on this topic are inconsistent and yield conflicting results. The main problem in evaluating these influences is the change in weight that a change in diet induces. This effect needs to be filtered out in order to discover interesting associations between diet and steroid hormones. This is illustrated by the example of the effects of ketogenic diets on testosterone levels in men, where the direct effect of the diet is to reduce testosterone levels, but a number of papers have described increases that are due to diet-related weight loss and the modification of obesity-induced changes. A second major driver is the change in circadian rhythm, and it is necessary to assess hormonal changes induced by changing the time of day of the diet. Such shifts within the circadian rhythm rather than due to a particular type of diet itself are documented by changes in the circadian rhythm of cortisol.
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Affiliation(s)
- M Dušková
- Institute of Endocrinology, Prague, Czech Republic
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Alkhorayef N, Almutery FT, Rasheed Z, Althwab SA, Aljohani AS, Alhawday YA, Salem T, Alharbi AM, Wahaq AA, Alharbi FS, Alghanem AS, Al Abdulmonem W. Regulatory effects of ketogenic diet on the inflammatory response in obese Saudi women. J Taibah Univ Med Sci 2023; 18:1101-1107. [PMID: 37009396 PMCID: PMC10050637 DOI: 10.1016/j.jtumed.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 01/07/2023] [Accepted: 03/12/2023] [Indexed: 04/04/2023] Open
Abstract
Objective In recent years, the use of a ketogenic diet (KD) against obesity has gained popularity in KSA. This study was designed to determine the impact of KD on anthropometric indices and on the abnormal regulation of inflammatory activities in obese Saudi women. Moreover, we investigated the potential of beta-hydroxybutyrate (BHB) supplementation on the inhibition of pro-inflammatory activities. Methods We enrolled 31 Saudi women (aged, 35.3 ± 8.4 years) with an average BMI of 33.96 ± 4.44 kg/m2 underwent an 8-week KD (8KD) from January to March 2021. Changes in anthropometric measurements were collected at baseline and after 4-8 weeks of intervention. Compliance with the dietary regimen was monitored weekly by plasma BHB level. Results Twenty-nine females commenced the diets and 23 completed the study (a 79% completion rate). In comparison to pre-intervention, the 8KD resulted in a significant increase in the levels of plasma BHB (P < 0.001) throughout the duration of the trial. This was accompanied by a significant reduction in weight loss (7.7 kg ± 11.3; P < 0.001), BMI, waist circumference (P < 0.001), and levels of the inflammatory cytokine IL-1β (P < 0.001). Conclusions An 8-week KD was found to be useful in producing a positive impact on anthropometric indices, biochemical and inflammatory processes. This study indicated that the intake of a KD by obese Saudi women induced the release of BHB in the blood without stimulation of an overall starvation response. This may be useful to alleviate the severity of chronic inflammatory disorders associated with obesity.
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Affiliation(s)
- Nada Alkhorayef
- Laboratory Department, College of Applied Medical Sciences, Al-Quway'iyah, Shaqra University, Riyadh, KSA
| | - Fatimah T. Almutery
- General Directorate of Health Affairs, Qassim Region, Public Health Department, KSA
| | - Zafar Rasheed
- Department of Pathology, College of Medicine, Qassim University, Buraidah, KSA
| | - Sami A. Althwab
- Department of Food Science and Human Nutrition, College of Agriculture and Veterinary Medicine, Qassim University, Buraidah, KSA
| | - Abdullah S.M. Aljohani
- Department of Veterinary Medicine, College of Agricultural and Veterinary Medicine, Qassim University, Buraidah, KSA
| | | | - Tarek Salem
- Department of Pathology, College of Medicine, Qassim University, Buraidah, KSA
| | - Abdulaziz M. Alharbi
- Department of Public Health, Directorate of Health Affairs in Al-Qassim, Buraidah, KSA
| | - Abdulrahman A.A.B. Wahaq
- Riyadh Second Health Cluster, Department of Public Health, Al-Kahleej 1 Primary Healthcare Centre, Riyadh, KSA
| | | | | | - Waleed Al Abdulmonem
- Department of Pathology, College of Medicine, Qassim University, Buraidah, KSA
- Corresponding address: Department of Pathology, College of Medicine, Qassim University, Buraidah, KSA.
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Patel PR, Armistead-Jehle P, Eltman NR, Heath KM, Cifu DX, Swanson RL. Brain Injury: How Dietary Patterns Impact Long-Term Outcomes. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2023; 11:367-376. [PMID: 37732170 PMCID: PMC10506931 DOI: 10.1007/s40141-023-00413-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2023] [Indexed: 09/22/2023]
Abstract
Purpose of Review Individuals with a history of traumatic brain injury (TBI) are at a much greater risk for developing cardiovascular disease (CVD) compared to the general population. This review discusses dietary patterns as a means of addressing modifiable risk factors following TBI exposure. Evidence-based resources for practicing Physiatrists and Brain Injury Medicine specialists pertaining to nutrition education and counseling are also provided. Recent Findings We examined Mediterranean, Dietary Approaches to Stop Hypertension, plant-based, ketogenic, and intermittent fasting dietary patterns through publications of clinical trials and systematic reviews. While many reviews had significant positive findings, some were limited by generalizability. Summary While there is extensive literature on the immediate nutrition goals in the inpatient setting following an acute TBI exposure, there is limited literature discussing the nature of diet and nutrition in the post-acute setting. Fortunately, most individuals with TBI exposure survive their initial injury and continue into the recovery phase. The scientific literature supports increased morbidity and mortality with chronic TBI exposure compared to matched counterparts, most notably with CVD. A diet rich in fiber and nutrients but limited in added sugars, saturated fats, and excess calories would likely have the greatest cardiovascular and related neurologic protection. Future studies are needed to assess the specific impact of dietary interventions in the chronic phase of brain injury recovery.
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Affiliation(s)
- Palak R. Patel
- Department of Physical Medicine and Rehabilitation, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
| | | | - Nicholas R. Eltman
- Corporal Michael J. Crescenz VA Medical Center, Center for Neurotrauma, Neurodegeneration, and Restoration, Philadelphia, PA USA
- Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ USA
| | - Kelly M. Heath
- Department of Physical Medicine and Rehabilitation, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
- Rehab Medicine Service, Corporal Michael J. Crescenz VA Medical Center, 3900 Woodland Avenue, Mail Stop #117, Philadelphia, PA 19104 USA
| | - David X. Cifu
- Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, USA
- Physical Medicine and Rehabilitation, Central Virginia Veterans Health Care System, Richmond, USA
| | - Randel L. Swanson
- Department of Physical Medicine and Rehabilitation, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
- Corporal Michael J. Crescenz VA Medical Center, Center for Neurotrauma, Neurodegeneration, and Restoration, Philadelphia, PA USA
- Rehab Medicine Service, Corporal Michael J. Crescenz VA Medical Center, 3900 Woodland Avenue, Mail Stop #117, Philadelphia, PA 19104 USA
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Wang Y, Zhang J, Zhang Y, Yao J. Bibliometric analysis of global research profile on ketogenic diet therapies in neurological diseases: Beneficial diet therapies deserve more attention. Front Endocrinol (Lausanne) 2023; 13:1066785. [PMID: 36686482 PMCID: PMC9846225 DOI: 10.3389/fendo.2022.1066785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/12/2022] [Indexed: 01/05/2023] Open
Abstract
Background The protective effects of Ketogenic Diet Therapies (KDTs) on neurological diseases have been extensively studied over the past two decades. The purpose of this study was to quantitatively and qualitatively analyze the publication of KDTs in the neurological field from 2000 to 2021. Methods A literature search was performed on June 7th, 2022, using the search terms: (("ketone" OR "ketogenic" OR "*hydroxybuty*") AND ("neuro*")) in the WoSCC database. Collected data were further analyzed using VOSviewer, CiteSpace and other online bibliometric websites. The annual publication volume and citation trends were summarized. The collaborations among highly cited countries, institutions, authors and journals were visualized. The co-citation analysis of highly cited references and journals were also visualized. Moreover, the research focuses and fronts were revealed by co-occurrence analysis and burst keywords detection. Results A total of 2808 publications with 88,119 citations were identified. From 2000-2021, the number of publications and citations presented rising trends. The United States was the country with an overwhelming number of publications and cited times. Johns Hopkins University was the most contributory institution. Kossoff Eric H was the author with the largest number of publications. And Epilepsia was both the largest publisher and the most frequently cited journal. The keywords of intense interest involved "Modified Atkins Diet", "Temporal Lobe Epilepsy", "Alzheimer's Disease", "Parkinson's Disease", "Cerebral Blood Flow", "Neuroinflammation", "Oxidative Stress", "Metabolism" and "Mitochondria". Conclusion We presented the global trend of KDTs in neurological diseases and provided important information for relevant researchers in a bibliometric way. This bibliometric study revealed that treating epilepsy, neuroprotection and functional effects of KDTs on mitochondria and oxidative stress have been the spotlight from 2000 to 2021. These have emerged as the basis for transformation from basic research to clinical application of KDTs.
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Affiliation(s)
| | | | | | - Junyan Yao
- Department of Anesthesiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Tsunemi S, Nakamura Y, Yokota K, Nakagawa T, Tsukiyama H, Kubo Y, Oyanagi T, Takemoto A, Nagai Y, Tanaka Y, Sone M. Correlation between blood ketones and exhaled acetone measured with a semiconducting gas sensor. J Breath Res 2022; 16. [PMID: 35868249 DOI: 10.1088/1752-7163/ac836a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 07/22/2022] [Indexed: 11/11/2022]
Abstract
Breath acetone (BrAce) has been reported to be useful for monitoring the pathophysiology of patients with diabetes. However, devices that measure BrAce are expensive, complex and uncommon. The FM-001, originally designed to monitor a marker of weight loss in healthy people, is a device for measuring BrAce. The FM-001 is a loading semiconducting gas sensor that is a simple and reusable device. The aim of this study was to evaluate the correlation between blood total ketone bodies (TKB) and BrAce measured with the FM-001 in patients with diabetes. Furthermore, through evaluation of that correlation, we sought to detect patients at high risk of developing diabetic ketoacidosis (DKA). Thirty-five participants (Age 52 [40-57], T2DM 32, T1DM 3) were enrolled. Scatter plots and linear regression lines relating BrAce to TKB and the correlation coefficients were calculated. Receiver-operating characteristic (ROC) analysis was performed to determine the cut-off for predicting patients prone to DKA. The results showed that BrAce strongly correlates with TKB (R=0.828), and the correlation was stronger in patients whose serum C-peptide was not low. The optimal BrAce cut-off for predicting risk of developing DKA was 3,400 ppb (AUC 0.924, sensitivity 73.3%, specificity 100%), which corresponds to a TKB ≥ 1,000 µmol/L. BrAce also weakly correlated with free fatty acid. Thus, BrAce levels measured with the FM-001 strongly correlate with TKB, even in patients with diabetes. This suggests the FM-001 is a simple and potentially useful method for detecting diabetic ketosis. (UMIN-ID: UMIN000038086).
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Affiliation(s)
- Shingo Tsunemi
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku,, Kawasaki, Kanagawa, 216-8511, JAPAN
| | - Yuta Nakamura
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku,, Kawasaki, Kanagawa, 216-8511, JAPAN
| | - Kenichi Yokota
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku,, Kawasaki, Kanagawa, 216-8511, JAPAN
| | - Tomoko Nakagawa
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku,, Kawasaki, Kanagawa, 216-8511, JAPAN
| | - Hidekazu Tsukiyama
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku,, Kawasaki, Kanagawa, 216-8511, JAPAN
| | - Yui Kubo
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku,, Kawasaki, Kanagawa, 216-8511, JAPAN
| | - Takeshi Oyanagi
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku,, Kawasaki, Kanagawa, 216-8511, JAPAN
| | - Ayaka Takemoto
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku,, Kawasaki, Kanagawa, 216-8511, JAPAN
| | - Yoshio Nagai
- Division of Diabetes and Endocrinology, Kanto Rosai Hospital, 1-1, Kizukisumiyoshi, Nakahara-ku,, Yokohama, Kanagawa, 211-8510, JAPAN
| | - Yasushi Tanaka
- Department of Internal Medicine, Yokohama General Hospital, 2201-5, Kurogane-cho, Aoba-ku,, Yokohama, Kanagawa, 225-0025, JAPAN
| | - Masakatsu Sone
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku,, Kawasaki, Kanagawa, 216-8511, JAPAN
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11
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Valinskas S, Aleknavicius K, Jonusas J. KetoCycle mobile app for ketogenic diet: a retrospective study of weight loss and engagement. BMC Nutr 2022; 8:40. [PMID: 35501935 PMCID: PMC9063366 DOI: 10.1186/s40795-022-00539-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/27/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The ketogenic diet is one of the oldest diets that has been used for more than a centennial in the clinical setting, and it is gaining popularity as a measure to fight obesity, which is a major predisposing factor for many diseases to manifest, including diabetes mellitus, chronic heart disease, cancer, and others. Thus, we designed this retrospective investigation to determine if users of the mobile application KetoCycle achieved statistically significant weight loss outcomes. METHODS The initial study cohort comprised 12,965 consecutive users who started using KetoCycle between January 2020 and December 2020. The final cohort comprised 10,269 users. The main parameters obtained from the database containing all self-reported data were gender, number of active days (AD), total time of use (TT), height, initial weight, and last recorded weight. The primary outcome of the study was weight loss. Statistical analyses were performed using IBM SPSS Statistics, version 26 (IBM Corp., Armonk, NY, USA). In addition, a standard multiple regression model was created to predict weight loss from significant actions. RESULTS A retrospective analysis of KetoCycle user data showed that 87.3% of KetoCycle users lost some of their initial weight. Of those, 1645 users (18.3%) lost more than 10% of their initial body weight, 3528 (39.3%) users lost between 5 and 10% of their initial body weight, and 3796 (42.3%) users lost less than 5% of their body weight. When user activity was taken into account, it was found that active users lost statistically significantly more weight than non-active users (p < 0.05). App engagement was also associated with losing > 5% of initial weight. Using water tracking, weight tracking, and creation of a meals list within KetoCycle statistically significantly predicted weight loss in a multiple regression model. CONCLUSIONS We concluded that KetoCycle appeared as a promising mobile application suited for weight loss and weight control. TRIAL REGISTRATION This retrospective chart review study was approved by BRANY IRB in January 2022 (registration ID.: 21-08-564-939).
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Affiliation(s)
- Sarunas Valinskas
- Faculty of Medicine, Vilnius University, M. K. Čiurlonio Str. 21, 03101, Vilnius, Lithuania
- Kilo.Health, Antakalnio g. 17, LT 10312, Vilnius, Lithuania
| | | | - Justinas Jonusas
- Kilo.Health, Antakalnio g. 17, LT 10312, Vilnius, Lithuania.
- Lithuania Business University of Applied Sciences, Turgaus st. 21, LT 91249, Klaipeda, Lithuania.
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12
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Иванникова ЕВ, Алташина МВ, Трошина ЕА. [The ketogenic diet: history, mechanism of action, indications and contraindications]. PROBLEMY ENDOKRINOLOGII 2021; 68:49-72. [PMID: 35262297 PMCID: PMC9761873 DOI: 10.14341/probl12724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 10/20/2021] [Accepted: 11/01/2021] [Indexed: 01/09/2023]
Abstract
Low-carb diets have been successfully used to alleviate a number of severe neurological diseases for about 100 years. The publication of the results of new studies suggesting that this type of diet may play a therapeutic role in other pathologies such as diabetes, obesity, polycystic ovary syndrome, and oncology is of particular interest for both doctors and the public. However, the long-term safety of using a low-carb or ketogenic diet, as well as its impact, primarily on the risks of developing cardiovascular diseases, remains poorly studied. This article presents the results of observation of patients against the background of a low-carbohydrate diet, both in the short-term perspective as well as provides an assessment of its long-term consequences.
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Affiliation(s)
| | - М. В. Алташина
- Национальный медицинский исследовательский центр
эндокринологии
| | - Е. А. Трошина
- Национальный медицинский исследовательский центр
эндокринологии
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13
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Che X, Chen Z, Liu M, Mo Z. Dietary Interventions: A Promising Treatment for Polycystic Ovary Syndrome. ANNALS OF NUTRITION AND METABOLISM 2021; 77:313-323. [PMID: 34610596 DOI: 10.1159/000519302] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 08/30/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Dietary interventions as a first-line treatment for patients with polycystic ovary syndrome (PCOS) have been evaluated, but the optimal diet has not been determined. Proper diet and the maintenance of adequate nutritional status are of great importance in the prevention of this disorder, and therapeutics and dietary habits play an important role in the recovery of patients with PCOS. SUMMARY A range of dietary patterns have been shown to impact weight loss and insulin resistance (IR) and improve reproductive function, including the Mediterranean diet, the ketogenic diet, Dietary Approaches to Stop Hypertension, and other dietary patterns. Key Messages: Diets that can reduce rates of obesity and IR are beneficial to women with PCOS, the status of obesity and IR should be determined at the early stage of the disease, so as to develop individualized and sustainable dietary intervention. The long-term efficacy, safety, and health benefits of diet management in patients with PCOS need to be tested by further researches.
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Affiliation(s)
- Xuan Che
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, China, .,Guangxi Key Laboratory of Diabetic Systems Medicine, Guilin Medical University, Guilin, China,
| | - Zhuo Chen
- Guangxi Province Postgraduate Cotraining Base for Cooperative Innovation in Basic Medicine (Guilin Medical University and Yueyang Women & Children's Medical Center), Yueyang, China
| | - Mingqi Liu
- Guangxi Key Laboratory of Diabetic Systems Medicine, Guilin Medical University, Guilin, China
| | - Zhongcheng Mo
- Guangxi Key Laboratory of Diabetic Systems Medicine, Guilin Medical University, Guilin, China.,Guangxi Province Postgraduate Cotraining Base for Cooperative Innovation in Basic Medicine (Guilin Medical University and Yueyang Women & Children's Medical Center), Yueyang, China
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14
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Sourbron J, Thevissen K, Lagae L. The Ketogenic Diet Revisited: Beyond Ketones. Front Neurol 2021; 12:720073. [PMID: 34393987 PMCID: PMC8363000 DOI: 10.3389/fneur.2021.720073] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 06/29/2021] [Indexed: 12/25/2022] Open
Affiliation(s)
- Jo Sourbron
- Department of Development and Regeneration, Section Pediatric Neurology, University Hospital Katholieke Universiteit Leuven, Leuven, Belgium
| | - Karin Thevissen
- Centre of Microbial and Plant Genetics, Department of Microbial and Molecular Systems, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Lieven Lagae
- Department of Development and Regeneration, Section Pediatric Neurology, University Hospital Katholieke Universiteit Leuven, Leuven, Belgium
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15
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Ketogenic Diet, Physical Activity, and Hypertension-A Narrative Review. Nutrients 2021; 13:nu13082567. [PMID: 34444726 PMCID: PMC8398985 DOI: 10.3390/nu13082567] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/22/2021] [Accepted: 07/26/2021] [Indexed: 12/12/2022] Open
Abstract
Several studies link cardiovascular diseases (CVD) with unhealthy lifestyles (unhealthy dietary habits, alcohol consumption, smoking, and low levels of physical activity). Therefore, the strong need for CVD prevention may be pursued through an improved control of CVD risk factors (impaired lipid and glycemic profiles, high blood pressure, and obesity), which is achievable through an overall intervention aimed to favor a healthy lifestyle. Focusing on diet, different recommendations emphasize the need to increase or avoid consumption of entire classes of food, with only partly known and only partly foreseeable consequences on the overall level of health. In recent years, the ketogenic diet (KD) has been proposed to be an effective lifestyle intervention for metabolic syndrome, and although the beneficial effects on weight loss and glucose metabolism seems to be well established, the effects of a prolonged KD on the ability to perform different types of exercise and the influence of KD on blood pressure (BP) levels, both in normotensives and in hypertensives, are not so well understood. The objective of this review is to analyze, on the basis of current evidence, the relationship between KD, regular physical activity, and BP.
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16
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Yılmaz Ü, Nalbantoğlu Ö, Güzin Y, Edizer S, Akışin Z, Pekuz S, Kırkgöz HH, Yavuz M, Ünalp A, Özkan B. The effect of ketogenic diet on thyroid functions in children with drug-resistant epilepsy. Neurol Sci 2021; 42:5261-5269. [PMID: 33846882 DOI: 10.1007/s10072-021-05225-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 03/24/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Ketogenic diet (KD) remains a valuable treatment option for children with drug-resistant epilepsy. However, it may cause many well-known adverse effects such as dyslipidemia or kidney stones. But, its effects on thyroid functions are largely unknown. PURPOSE The aim of this study was to investigate the effects of the KD on thyroid functions in children with drug-resistant epilepsy. METHOD A total of 66 children (35 females) aged 3-193 months (median, 52 months) with drug-resistant epilepsy who received a KD for at least 12 months were enrolled in the study. All children were started on KD with 3:1 ratio which was then adjusted as clinically necessary. Serum free-thyroxine (FT4) and thyroid stimulating hormone (TSH) concentrations were measured before starting treatment and at the first, sixth and twelfth months of treatment. Changes in FT4 and TSH concentrations over 12 months were analyzed. RESULTS Median serum FT4 and TSH concentrations, and the frequencies of patients with low FT4 and high TSH concentrations did not change significantly in the study sample over the 12-month study period. Serum FT4 levels increased significantly and TSH concentrations decreased insignificantly in four patients receiving L-thyroxine replacement therapy. During the 12-month treatment period, BMI-SDS increased, and the number of antiepileptic drugs decreased significantly. CONCLUSION It appears that KD therapy does not impair thyroid functions in children with drug-resistant epilepsy. KD can be used safely along with L-thyroxine replacement even in children with pre-existing subclinical hypothyroidism.
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Affiliation(s)
- Ünsal Yılmaz
- Pediatric Neurology Department, Health Sciences University Dr. Behçet Uz Children's Education and Research Hospital, Alsancak, 35210, Izmir, Turkey.
| | - Özlem Nalbantoğlu
- Pediatric Endocrinology Department, Health Sciences University Dr. Behçet Uz Children's Education and Research Hospital, Izmir, Turkey
| | - Yiğithan Güzin
- Pediatric Neurology Department, Health Sciences University Dr. Behçet Uz Children's Education and Research Hospital, Alsancak, 35210, Izmir, Turkey
| | - Selvinaz Edizer
- Pediatric Neurology Department, Health Sciences University Dr. Behçet Uz Children's Education and Research Hospital, Alsancak, 35210, Izmir, Turkey
| | - Zeynep Akışin
- Nutrition and Dietetics Department, Health Sciences University Dr. Behçet Uz Children's Education and Research Hospital, Izmir, Turkey
| | - Serdar Pekuz
- Pediatric Neurology Department, Health Sciences University Dr. Behçet Uz Children's Education and Research Hospital, Alsancak, 35210, Izmir, Turkey
| | - Hatice Hilal Kırkgöz
- Pediatric Neurology Department, Health Sciences University Dr. Behçet Uz Children's Education and Research Hospital, Alsancak, 35210, Izmir, Turkey
| | - Merve Yavuz
- Pediatric Neurology Department, Health Sciences University Dr. Behçet Uz Children's Education and Research Hospital, Alsancak, 35210, Izmir, Turkey
| | - Aycan Ünalp
- Pediatric Neurology Department, Health Sciences University Dr. Behçet Uz Children's Education and Research Hospital, Alsancak, 35210, Izmir, Turkey
| | - Behzat Özkan
- Pediatric Endocrinology Department, Health Sciences University Dr. Behçet Uz Children's Education and Research Hospital, Izmir, Turkey
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