Ketogenic Diets and Cardio-Metabolic Diseases.

Weiyue Zhang,Chaodong Wu,Xin Guo,Jiayu Yu,Ting Chen,Lulu Chen,Juan Zheng

doi:10.3389/fendo.2021.753039

Abstract

While the prevalence of cardio-metabolic diseases (CMDs) has become a worldwide epidemic, much attention is paid to managing CMDs effectively. A ketogenic diet (KD) constitutes a high-fat and low-carbohydrate diet with appropriate protein content and calories. KD has drawn the interests of clinicians and scientists regarding its application in the management of metabolic diseases and related disorders; thus, the current review aimed to examine the evidences surrounding KD and the CMDs to draw the clinical implications. Overall, KD appears to play a significant role in the therapy of various CMDs, which is manifested by the effects of KDs on cardio-metabolic outcomes. KD therapy is generally promising in obesity, heart failure, and hypertension, though different voices still exist. In diabetes and dyslipidemia, the performance of KD remains controversial. As for cardiovascular complications of metabolic diseases, current evidence suggests that KD is generally protective to obese related cardiovascular disease (CVD), while remaining contradictory to diabetes and other metabolic disorder related CVDs. Various factors might account for the controversies, including genetic background, duration of therapy, food composition, quality, and sources of KDs. Therefore, it’s crucial to perform more rigorous researches to focus on clinical safety and appropriate treatment duration and plan of KDs.

Highlights

Cardio-metabolic diseases (CMDs) have become a worldwide epidemic, as demonstrated by an increased prevalence of obesity, diabetes mellitus (DM), metabolic syndrome, cardiovascular disease (CVD), and chronic kidney disease (CKD), and culpable to a significant global financial burden [1]
The results indicated that under very-low-calorie ketogenic diet (VLCKD), the participants had a significant reduction in body weight, TAG, and diastolic blood pressure, while increased highdensity lipoprotein (HDL)-C and low-density lipoprotein (LDL)-C levels were observed
Based on the currently available evidence, ketogenic diet (KD) appears to play a significant role in treating various cardio-metabolic diseases and reveals remarkable effects on cardiovascular function

Summary

INTRODUCTION

Cardio-metabolic diseases (CMDs) have become a worldwide epidemic, as demonstrated by an increased prevalence of obesity, diabetes mellitus (DM), metabolic syndrome, cardiovascular disease (CVD), and chronic kidney disease (CKD), and culpable to a significant global financial burden [1]. Cicero et al [55] evaluated the effect of a very low carbohydrate ketogenic diet (VLCKD) on overweight-related risk factors of CVD such as blood pressure, lipid levels, and glucose metabolism, and the study found that VLCKD intervention for 3 months was generally safe and found effective in inducing weight loss and improved CV risk factors levels. Similar results were observed by a 2-year randomized clinical trial study [39] that investigated the effect of an LC diet with high unsaturated fat and low saturated fat on glycemic control and CVD risk factors in overweight or obese patients with T2DM. Studies have found that individuals with pre-diabetes or diabetes who received an earlier LCHF diet revealed several beneficial outcomes, including weight loss, improved insulin sensitivity, glucose homeostasis, and lower fasting blood glucose levels These outcome improvements decreased the risks of cardiovascular diseases development [38, 84]. While future studies are warranted to confirm and elucidate whether and how KD causes potential safety concerns, it would be important to consider to modifying KD or combining KD with other healthy diets for managing CMDs

DISCUSSION

CONCLUSION