Cardiometabolic diseases (CMDs) are a group of metabolic abnormalities that increase the risk of diseases such as type 2 diabetes, cardiovascular diseases, insulin resistance, non-alcoholic fatty liver disease (NAFLD), dyslipidemia, and abdominal obesity. The study of CMDs’ comorbidity is an emerging field. In the quest to reduce the cost and side effects of drugs, fasting therapies like ketogenic diet (KD) have been proposed for treating seizure disorders, cancer, and chronic diseases. Recently, it has been reported to improve the quality of life of patients with cardiometabolic-related diseases. KD is a very low carbohydrate, high protein, very high-fat diet which induces ketogenesis, eliciting molecular signals. Intake of KD produces inhibition of histone deacetylase and 3-hydroxy-3-methyl glutaryl coA (HMG-CoA) reductase. It also increases the particulate size of low density lipoprotein cholesterol (LDL-C), lipolysis, HMG-CoA synthase 2, cataplerotic activity and high-density lipoprotein, and sirtuins production, which results in improved health status for patients with NAFLD, diabetes, and cardiovascular diseases when KD is consumed for a minimum of two weeks. There are usually mild side effects that are experienced with this therapy but these can be overcome after four (4) weeks of continuous intake of KD and with certain interventions like vitamins, minerals and calcium. There is, therefore, a need to explore ways of incorporating KD into the clinical management and treatment of cardiometabolic diseases globally.
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