Abstract
With low carbohydrate diets glucose becomes unavailable as a source of energy for our body, leading to the production of ketones from fatty acids in the liver. The increase in plasma ketones is known as nutritional ketosis. The available evidence from basic and clinical studies indicates that both low carbohydrate and high fat low carbohydrate diets are effective for weight loss and are better than non-intervention. However, low carbohydrate diet and ketogenic diets induce unique metabolic changes and consistently improve some markers of cardiovascular risk, lowering elevated blood glucose, insulin, triglycerides, ApoB and saturated fat concentrations, reducing small dense LDL particle numbers, glycated hemoglobin levels, blood pressure and body weight while increasing HDL-cholesterol concentrations and reversing non-alcoholic fatty liver disease. Low carbohydrate diets are an efficient strategy for the management of obesity and metabolic syndrome. They may also benefit patients with polycystic ovary syndrome. They must be prescribed by trained professionals to balance the risks and benefits for each individual patient. Future research is required to improve the knowledge about individual responses to dietary interventions, their safety, tolerance, efficacy and long-term effects.
Highlights
Recibido el 22 de agosto de 2019, aceptado el 3 de julio de Correspondencia a: José Moreno Sepulveda Clínica de la Mujer Medicina
With low carbohydrate diets glucose becomes unavailable as a source of energy for our body, leading to the production of ketones from fatty acids in the liver
The available evidence from basic and clinical studies indicates that both low carbohydrate and high fat low carbohydrate diets are effective for weight loss and are better than non-intervention
Summary
Desde su divulgación en 1920, como tratamiento para la epilepsia, y más tarde para la obesidad, diversos estudios han intentado entender los mecanismos de las dietas bajas en carbohidratos (DBC) y su posible aplicación en diversas situaciones clínicas[1,2,3,4,5]. La dieta baja en carbohidratos (DBC) determina una inadecuada disponibilidad de glucosa como fuente energética, lo que hace necesario. El hígado convierte la grasa en ácidos grasos y produce los cuerpos cetónicos a partir de ésta, reemplazando a la glucosa como primera fuente energética. En períodos de baja ingesta de carbohidratos, como en las DBC o ayunos prolongados, se genera una falla en la glucólisis y una derivación de la CoA hacia la cetogénesis, resultando en una acumulación de cuerpos cetónicos[9].
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