Abstract
Morbid obese people are more likely to contract SARS-CoV-2 infection and its most severe complications, as need for mechanical ventilation. Ketogenic Diet (KD) is able to induce a fast weight loss preserving lean mass and is particularly interesting as a preventive measure in obese patients. Moreover, KD has anti-inflammatory and immune-modulating properties, which may help in preventing the cytokine storm in infected patients. Respiratory failure is actually considered a contraindication for VLCKD, a very-low calorie form of KD, but in the literature there are some data reporting beneficial effects on respiratory parameters from ketogenic and low-carbohydrate high-fat diets. KD may be helpful in reducing ventilatory requirements in respiratory patients, so it should be considered in specifically addressed clinical trials as an adjuvant therapy for obese patients infected with SARS-CoV-2.
Highlights
Obesity and COVID-19: An Emergency in the EmergencyThe pandemic of SARS-CoV-2 infection has been challenging the world for over a year
The aim of our study is to review the literature on ketogenic diets in respiratory patients, to consider the possibility of their safe use, from a respiratory point of view, in COVID-19 obese patients
A study on 7 well-trained male cyclists consuming a low-carbohydrate high-fat diet (15–82 g of CHO/day), for a long-time, showed that these athletes had a similar gluconeogenesis rate and reduced glycogenolysis respect to the 7 athletes fed with a mixed diet [46]. These findings suggest that after a long-term adaptation to a low-carbohydrate high-fat diet, liver glycogen contributes to endogenous glucose production during exercise, and that glucose may be preferentially obtained from glycerol derived from lipolysis of intramuscular triglycerides [47], configuring an hypothetical difference among about subjects accustomed to a low-carbohydrate high-fat diet and “newbies.”
Summary
Received: 05 September 2021 Accepted: 17 November 2021 Published: 09 December 2021. Citation: Gangitano E, Tozzi R, Mariani S, Lenzi A, Gnessi L and Lubrano C (2021) Ketogenic Diet for Obese COVID-19 Patients: Is Respiratory. A Narrative Review of the Literature on Ketogenic Diet and Respiratory Function. Morbid obese people are more likely to contract SARS-CoV-2 infection and its most severe complications, as need for mechanical ventilation. Ketogenic Diet (KD) is able to induce a fast weight loss preserving lean mass and is interesting as a preventive measure in obese patients. KD has anti-inflammatory and immunemodulating properties, which may help in preventing the cytokine storm in infected patients. Respiratory failure is considered a contraindication for VLCKD, a verylow calorie form of KD, but in the literature there are some data reporting beneficial effects on respiratory parameters from ketogenic and low-carbohydrate high-fat diets. KD may be helpful in reducing ventilatory requirements in respiratory patients, so it should be considered in addressed clinical trials as an adjuvant therapy for obese patients infected with SARS-CoV-2
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