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Pradeepkiran JA, Islam MA, Sehar U, Reddy AP, Vijayan M, Reddy PH. Impact of diet and exercise on mitochondrial quality and mitophagy in Alzheimer's disease. Ageing Res Rev 2025; 108:102734. [PMID: 40120948 DOI: 10.1016/j.arr.2025.102734] [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: 09/10/2024] [Revised: 11/26/2024] [Accepted: 03/15/2025] [Indexed: 03/25/2025]
Abstract
Alzheimer's disease (AD) is a devastating neurodegenerative disorder that affects millions of people worldwide. It is characterized by the accumulation of beta-amyloid and phosphorylated tau, synaptic damage, and mitochondrial abnormalities in the brain, leading to the progressive loss of cognitive function and memory. In AD, emerging research suggests that lifestyle factors such as a healthy diet and regular exercise may play a significant role in delaying the onset and progression of the disease. Mitochondria are often referred to as the powerhouse of the cell, as they are responsible for producing the energy to cells, including neurons to maintain cognitive function. Our article elaborates on how mitochondrial quality and function decline with age and AD, leading to an increase in oxidative stress and a decrease in ATP production. Decline in mitochondrial quality can impair cellular functions contributing to the development and progression of disease with the loss of neuronal functions in AD. This article also covered mitophagy, the process by which damaged or dysfunctional mitochondria are selectively removed from the cell to maintain cellular homeostasis. Impaired mitophagy has been implicated in the progression and pathogenesis of AD. We also discussed the impact of impaired mitophagy implicated in AD, as the accumulation of damaged mitochondria can lead to increased oxidative stress. We expounded how dietary interventions and exercise can help to improve mitochondrial quality, and mitochondrial function and enhance mitophagy in AD. A diet rich in antioxidants, polyphenols, and mitochondria-targeted small molecules has been shown to enhance mitochondrial function and protect against oxidative stress, particularly in neurons with aged and mild cognitively impaired subjects and AD patients. Promoting a healthy lifestyle, mainly balanced diet and regular exercise that support mitochondrial health, in an individual can potentially delay the onset and progression of AD. In conclusion, a healthy diet and regular exercise play a crucial role in maintaining mitochondrial quality and mitochondrial function, in turn, enhancing mitophagy and synaptic activities that delay AD in the elderly populations.
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Affiliation(s)
| | - Md Ariful Islam
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Ujala Sehar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Arubala P Reddy
- Nutritional Sciences Department, College Human Sciences, Texas Tech University, Lubbock, TX, USA
| | - Murali Vijayan
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - P Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA; Nutritional Sciences Department, College Human Sciences, Texas Tech University, Lubbock, TX, USA; Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX, USA; Department of Neurology, Texas Tech University Health Sciences Center, Lubbock, TX, USA; Department of Public Health, Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA; Department of Speech, Language, and Hearing Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
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Bachar A, Birk R. Ketogenic Diet Intervention for Obesity Weight-Loss- A Narrative Review, Challenges, and Open Questions. Curr Nutr Rep 2025; 14:43. [PMID: 40056334 DOI: 10.1007/s13668-025-00634-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2025] [Indexed: 03/10/2025]
Abstract
PURPOSE OF REVIEW The ketogenic diet (KD) has gained clinical attention for its potential benefits in weight loss and metabolic syndrome. By mimicking fasting through carbohydrate (CHO) restriction, KD shifts energy utilization to ketone bodies (KB) instead of glucose. Despite promising results, the effects on different weight loss indicators remain controversial, with challenges in monitoring adherence standards, optimal macronutrient composition, potential risks, and long-term sustainability. This article aims to review the different weight-loss outcomes of KD interventions for obesity, monitored by KB (adherence indication). RECENT FINDINGS Current literature on KD interventions for obesity weight loss monitored by KB show reduction in different outcomes, including body weight, body mass index, waist circumference, visceral adipose tissue, fat mass, and body fat percentage. Minor decreases in lean body mass and skeletal muscle mass were noted without resistance training. Variability existed in adherence (KB markers), CHO intake (7-27% of daily energy), diet duration (28 days to 12 months), and follow-up frequency (weekly to biannual). KD, particularly accompanied by exercise, positively influenced appetite regulation. KD interventions improves weight-related outcomes in participants with obesity but presents challenges in lean body mass reduction without resistance training and adherence variability. Standardizing methodologies, refining interventions and suitability to sub-populations, setting KB markers, and defining clinical relevance are essential for optimizing KD effectiveness.
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Affiliation(s)
- Adina Bachar
- Nutrition Department, Health Sciences Faculty, Ariel University, Ariel, Israel
| | - Ruth Birk
- Nutrition Department, Health Sciences Faculty, Ariel University, Ariel, Israel.
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Wei DX, Chen Z. Current situation and challenge of exogenous 3-hydroxybutyrate derived from polyhydroxyalkanoates for elderly health: A review. Int J Biol Macromol 2025; 285:138328. [PMID: 39631604 DOI: 10.1016/j.ijbiomac.2024.138328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2024] [Revised: 11/14/2024] [Accepted: 12/02/2024] [Indexed: 12/07/2024]
Abstract
3-Hydroxybutyrate (3HB), predominantly found in the liver, muscles, and brain, is the most important endogenous ketone body in humans. During prolonged fasting and starvation, 3HB can partially replace glucose to meet some of the body's energy needs. In recent years, the resurgence of the ketogenic diet (KD) and systematic exploration of the favorable biocompatibility of polyhydroxyalkanoates (PHAs), the precursor polymer to 3HB, have led to numerous reports indicating that the benefits of exogenous 3HB supplementation outweigh the drawbacks, particularly for middle-aged and elderly individuals. In this review, the physicochemical properties, physiological functions, and biosafety of 3HB in the elderly population are introduced. The effects of exogenous 3HB supplements, including KD, ketone esters, 1,3-butanediol, and ketone salts, on the elderly are compared. It is proposed that exogenous 3HB derived from PHAs is optimal for this population. Exogenous 3HB supplementation for elderly health maintenance and disease treatment is summarized, with an outline of four challenges related to the mechanistic and clinical research of exogenous 3HB supplementation for elderly health. This aims to explore its novel therapeutic potential as a small molecule in the context of aging.
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Affiliation(s)
- Dai-Xu Wei
- Clinical Medical College and Affiliated Hospital of Chengdu University, Chengdu University, Chengdu, Sichuan 610081, China.
| | - Zongcun Chen
- Department of Endocrinology, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, China.
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Lim SL, Tay M, Ang SM, Wai SN, Ong KW, Neo WJ, Yap QV, Chan YH, Khoo CM. Development and Pragmatic Randomized Controlled Trial of Healthy Ketogenic Diet Versus Energy-Restricted Diet on Weight Loss in Adults with Obesity. Nutrients 2024; 16:4380. [PMID: 39771001 PMCID: PMC11677078 DOI: 10.3390/nu16244380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2024] [Revised: 12/13/2024] [Accepted: 12/15/2024] [Indexed: 01/11/2025] Open
Abstract
Introduction: The ketogenic diet (KD) is widely used for weight management by reducing appetite, enhancing fat oxidation, and facilitating weight loss. However, the high content of total and saturated fats in a conventional KD may elevate low-density lipoprotein (LDL)-cholesterol levels, a known risk factor for cardiovascular diseases, highlighting the need for healthier alternatives. This study aimed to investigate the effect of a newly developed Healthy Ketogenic Diet (HKD) versus an Energy-Restricted Diet (ERD) on weight loss and metabolic outcomes among adults with obesity. Methods: Multi-ethnic Asian adults (n = 80) with body mass index ≥ 27.5 kg/m2 were randomized either to HKD (n = 41) or ERD (n = 39) for 6 months. Both groups followed an energy-restricted healthy diet, emphasizing on reducing saturated and trans fats. The HKD group additionally limited net carbohydrate intake to no more than 50 g per day. Dietary adherence was supported via the Nutritionist Buddy app with dietitian coaching. The primary outcome was weight change from baseline at 6 months. Secondary outcomes included weight change at 3 months and 1 year, along with changes in metabolic profiles. Data were analyzed using linear regression with an intention-to-treat approach. Results: The HKD group achieved significantly greater mean weight loss at 6 months than the ERD group (-7.8 ± 5.2 kg vs. -4.2 ± 5.6 kg, p = 0.01). The mean weight loss percentage at 6 months was 9.3 ± 5.9% and 4.9 ± 5.8% for the HKD and ERD groups, respectively (p = 0.004). Improvements in metabolic profiles were also significantly better in the HKD group [glycated hemoglobin (-0.3 ± 0.3% vs. -0.1 ± 0.2%, p = 0.008), systolic blood pressure (-7.7 ± 8.9 mmHg vs. -2.6 ± 12.2 mmHg, p = 0.005), and aspartate transaminase (-7.6 ± 15.5 IU/L vs. 0.6 ± 11.5 IU/L, p = 0.01)], with no increase in LDL-cholesterol (-0.12 ± 0.60 mmol/L vs. -0.04 ± 0.56 mmol/L, p = 0.97) observed in either group. Conclusions: The HKD was more effective than the ERD in promoting weight loss and improving cardiometabolic outcomes without elevation in LDL-cholesterol. It can be recommended for therapeutic intervention in patients with obesity.
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Affiliation(s)
- Su Lin Lim
- Office of Allied Health & Pharmacy, National University Hospital, Singapore 119228, Singapore
| | - Melissa Tay
- Department of Dietetics, National University Hospital, Singapore 119074, Singapore; (M.T.); (S.M.A.); (S.N.W.); (K.W.O.); (W.J.N.)
| | - Siew Min Ang
- Department of Dietetics, National University Hospital, Singapore 119074, Singapore; (M.T.); (S.M.A.); (S.N.W.); (K.W.O.); (W.J.N.)
| | - Shu Ning Wai
- Department of Dietetics, National University Hospital, Singapore 119074, Singapore; (M.T.); (S.M.A.); (S.N.W.); (K.W.O.); (W.J.N.)
| | - Kai Wen Ong
- Department of Dietetics, National University Hospital, Singapore 119074, Singapore; (M.T.); (S.M.A.); (S.N.W.); (K.W.O.); (W.J.N.)
| | - Wen Joo Neo
- Department of Dietetics, National University Hospital, Singapore 119074, Singapore; (M.T.); (S.M.A.); (S.N.W.); (K.W.O.); (W.J.N.)
| | - Qai Ven Yap
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University Singapore, Singapore 117597, Singapore; (Q.V.Y.); (Y.H.C.)
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University Singapore, Singapore 117597, Singapore; (Q.V.Y.); (Y.H.C.)
| | - Chin Meng Khoo
- Department of Medicine, National University Hospital, Singapore 119074, Singapore;
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Eshaghhosseiny N, Ahmadi M, Izadi B, Vali M, Akbari M, Azari I, Akbari H. The effects of ketogenic diet on metabolic and hormonal parameters in patients with polycystic ovary syndrome: a systematic review and meta-analysis of clinical trials. J Diabetes Metab Disord 2024; 23:1573-1587. [PMID: 39610476 PMCID: PMC11599545 DOI: 10.1007/s40200-024-01441-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 04/30/2024] [Indexed: 11/30/2024]
Abstract
Purpose In recent years, using the ketogenic diet (KD) as a potential intervention for polycystic ovary syndrome (PCOS) has gained attention. Therefore, this study aimed to conduct a meta-analysis to determine the effects of KD on sexual hormones, glycemic and lipid parameters in women diagnosed with PCOS. Methods A comprehensive literature search was performed using online databases such as Medline/PubMed, Scopus, Web of Science (ISI), Embase, and the Cochrane Library and clinical trials were selected based on the inclusion criteria. Data extraction and quality assessment were conducted independently by two investigators using appropriate tools. The effects of a KD on metabolic biomarkers and hormonal parameters were pooled using a random-effects model and were considered as the weighted mean difference (WMD) with corresponding 95% confidence intervals (CIs). Heterogeneity across studies was assessed using Cochran's Q test and the I-square test. Results Ten studies including 408 women were analyzed in this analysis. Findings showed that KD significantly decreased triglycerides levels (WMD = -44.03 mg/dL; 95% CI, -56.29, -31.76), total cholesterol (-18.95 mg/dL; -29.06, -8.83), and low-density lipoprotein cholesterol (LDL) (-18.11 mg/dL; -29.56, -6.67) compared to the control groups. KD also led to a notable reduction in fasting glucose (-10.30 mg/dL; -14.10, -6.50) and HOMA-IR (-1.93; -3.66, -0.19). Also, this diet led to a significant decrease in luteinizing hormone (LH) levels (-3.75 mIU/mL; -3.84, -3.65) and total testosterone levels (-7.71 ng/dL); -12.08, -3.35), while follicle-stimulating hormone (FSH) increased (0.43 mIU/mL; 0.29, 0.57). Conclusion The KD demonstrated promising outcomes in improving metabolic and hormonal parameters in women diagnosed with PCOS.
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Affiliation(s)
| | - Mohammad Ahmadi
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahareh Izadi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohebat Vali
- Epidemiology Department, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Akbari
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Isaac Azari
- Yasuj University of Medical Sciences, Yasuj, Iran
| | - Hamed Akbari
- Cardiovascular Research Centre, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta Canada
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Walaszek M, Kachlik Z, Cubała WJ. Low-carbohydrate diet as a nutritional intervention in a major depression disorder: focus on relapse prevention. Nutr Neurosci 2024; 27:1185-1198. [PMID: 38245881 DOI: 10.1080/1028415x.2024.2303218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
OBJECTIVES Mood disorders are trending to be among the leading causes of years lived with disability. Despite multiple treatment options, around 30% patients with major depressive disorder (MDD) develop treatment resistant depression (TRD) and fail to respond to current pharmacological therapies. This study aimed to explore the potential benefits of nutritional treatment strategies, along with their molecular mechanisms of action, focusing especially on low-carbohydrate diet (LCHD), ketogenic diet (KD) and other strategies based on carbohydrates intake reduction. METHODS A comprehensive literature review was conducted to determine the impact of LCHD on alleviating depressive symptoms in patients with MDD, along with an explanation of its mode of action. RESULTS The study revealed significant impact of nutritional interventions based on restriction in carbohydrate intake such as LCHD, KD or sugar-sweetened beverages (SSB) exclusion on anxiety or depression symptoms reduction, mood improvement and lower risk of cognitive impairment or depression. The efficacy of these approaches is further substantiated by their underlying molecular mechanisms, mainly brain-derived neurotrophic factor (BDNF) which is a potential key target of sugar restriction diets in terms of neuroplasticity. DISCUSSION Healthcare professionals may consider implementing LCHD strategies for MDD and TRD patients to modify the disease process, maintain euthymia, and prevent depressive episode relapses. Ranging from the exclusion of SSB to the adherence to rigorous LCHD regimens, these nutritional approaches are safe, straightforward to implement, and may confer benefits for well-being and relapse prevention in this specific patient population.
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Affiliation(s)
- Michał Walaszek
- Department of Psychiatry, Faculty of Medicine, Medical University of Gdansk, Gdańsk, Poland
| | - Zofia Kachlik
- Department of Psychiatry, Faculty of Medicine, Medical University of Gdansk, Gdańsk, Poland
| | - Wiesław Jerzy Cubała
- Department of Psychiatry, Faculty of Medicine, Medical University of Gdansk, Gdańsk, Poland
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Laurent N, Bellamy EL, Hristova D, Houston A. Ketogenic diets in clinical psychology: examining the evidence and implications for practice. Front Psychol 2024; 15:1468894. [PMID: 39391844 PMCID: PMC11464436 DOI: 10.3389/fpsyg.2024.1468894] [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: 07/22/2024] [Accepted: 09/17/2024] [Indexed: 10/12/2024] Open
Abstract
Introduction The application of ketogenic dietary interventions to mental health treatments is increasingly acknowledged within medical and psychiatric fields, yet its exploration in clinical psychology remains limited. This article discusses the potential implications of ketogenic diets, traditionally utilized for neurological disorders, within broader mental health practices. Methods This article presents a perspective based on existing ketogenic diet research on historical use, biological mechanisms, and therapeutic benefits. It examines the potential application of these diets in mental health treatment and their relevance to clinical psychology research and practice. Results The review informs psychologists of the therapeutic benefits of ketogenic diets and introduces to the psychology literature the underlying biological mechanisms involved, such as modulation of neurotransmitters, reduction of inflammation, and stabilization of brain energy metabolism, demonstrating their potential relevance to biopsychosocial practice in clinical psychology. Conclusion By considering metabolic therapies, clinical psychologists can broaden their scope of biopsychosocial clinical psychology practice. This integration provides a care model that incorporates knowledge of the ketogenic diet as a treatment option in psychiatric care. The article emphasizes the need for further research and training for clinical psychologists to support the effective implementation of this metabolic psychiatry intervention.
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Paoli A, Campa F. Problems and Opportunities in the use of Bioelectrical Impedance Analysis for Assessing Body Composition During Ketogenic Diets: A Scoping Review. Curr Obes Rep 2024; 13:496-509. [PMID: 38802722 PMCID: PMC11306364 DOI: 10.1007/s13679-024-00573-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE OF THE REVIEW The use of bioelectrical impedance analysis (BIA) for monitoring body composition during the ketogenic diet has experienced a rapid surge. This scoping review aimed to assess the validity of procedures applying BIA in the ketogenic diet and to suggest best practices for optimizing its utilization. RECENT FINDINGS We conducted a systematic scoping review of peer-reviewed literature involving BIA for assessing body composition in individuals adhering to a ketogenic diet. Searches of international databases yielded 1609 unique records, 72 of which met the inclusion criteria and were reviewed. Thirty-five studies used foot-to-hand technology, 34 used standing position technology, while 3 did not declare the technology used. Raw bioelectrical parameters were reported in 21 studies. A total of 196 body mass components were estimated, but predictive equations were reported in only four cases. Most research on BIA during ketogenic diets did not report the equations used for predicting body composition, making it impossible to assess the validity of BIA outputs. Furthermore, the exceedingly low percentage of studies reporting and analyzing raw data makes it challenging to replicate methodologies in future studies, highlighting that BIA is not being utilized to its full potential. There is a need for more precise technology and device characteristics descriptions, full report of raw bioelectrical data, and predictive equations utilized. Moreover, evaluating raw data through vectorial analysis is strongly recommended. Eventually, we suggest best practices to enhance BIA outcomes during ketogenic diets.
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Affiliation(s)
- Antonio Paoli
- Department of Biomedical Sciences, University of Padua, Padua, Italy.
| | - Francesco Campa
- Department of Biomedical Sciences, University of Padua, Padua, Italy
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Ari C, D'Agostino DP, Cha BJ. Neuroregeneration Improved by Sodium-D,L-Beta-Hydroxybutyrate in Primary Neuronal Cultures. Pharmaceuticals (Basel) 2024; 17:1160. [PMID: 39338322 PMCID: PMC11435142 DOI: 10.3390/ph17091160] [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] [Received: 07/16/2024] [Revised: 08/25/2024] [Accepted: 08/28/2024] [Indexed: 09/30/2024] Open
Abstract
Ketone bodies are considered alternative fuels for the brain when glucose availability is limited. To determine the neuroregenerative potential of D,L-sodium-beta-hydroxybutyrate (D/L-BHB), Sprague Dawley rat primary cortical neurons were exposed to simulated central nervous system injury using a scratch assay. The neuronal cell migration, cell density and degree of regeneration in the damaged areas (gaps) in the absence (control) and presence of BHB (2 mM) were documented with automated live-cell imaging by the CytoSMART system over 24 h, which was followed by immunocytochemistry, labeling synapsin-I and β3-tubulin. The cell density was significantly higher in the gaps with BHB treatment after 24 h compared to the control. In the control, only 1.5% of the measured gap areas became narrower over 24 h, while in the BHB-treated samples 49.23% of the measured gap areas became narrower over 24 h. In the control, the gap expanded by 63.81% post-injury, while the gap size decreased by 10.83% in response to BHB treatment, compared to the baseline. The cell density increased by 97.27% and the gap size was reduced by 74.64% in response to BHB, compared to the control. The distance travelled and velocity of migrating cells were significantly higher with BHB treatment, while more synapsin-I and β3-tubulin were found in the BHB-treated samples after 24 h, compared to the control. The results demonstrate that D/L-BHB enhanced neuronal migration and molecular processes associated with neural regeneration and axonogenesis. These results may have clinical therapeutic applications in the future for nervous system injuries, such as for stroke, concussion and TBI patients.
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Affiliation(s)
- Csilla Ari
- Behavioral Neuroscience Laboratory, Department of Psychology, University of South Florida, Tampa, FL 33620, USA
- Ketone Technologies LLC, Tampa, FL 33612, USA
| | - Dominic P D'Agostino
- Ketone Technologies LLC, Tampa, FL 33612, USA
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL 33620, USA
- Institute for Human and Machine Cognition, Ocala, FL 34471, USA
| | - Byeong J Cha
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL 33620, USA
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O'Hearn LA. Signals of energy availability in sleep: consequences of a fat-based metabolism. Front Nutr 2024; 11:1397185. [PMID: 39267859 PMCID: PMC11390529 DOI: 10.3389/fnut.2024.1397185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 08/05/2024] [Indexed: 09/15/2024] Open
Abstract
Humans can flexibly switch between two primary metabolic modes, usually distinguished by whether substrate supply from glucose can meet energy demands or not. However, it is often overlooked that when glucose use is limited, the remainder of energy needs may still be met more or less effectively with fat and ketone bodies. Hence a fat-based metabolism marked by ketosis is often conflated with starvation and contexts of inadequate energy (including at the cellular level), even when energy itself is in ample supply. Sleep and satiation are regulated by common pathways reflecting energy metabolism. A conceptual analysis that distinguishes signals of inadequate energy in a glucose-dominant metabolism from signals of a fat-based metabolism that may well be energy sufficient allows a reexamination of experimental results in the study of sleep that may shed light on species differences and explain why ketogenic diets have beneficial effects simultaneously in the brain and the periphery. It may also help to distinguish clinically when a failure of a ketogenic diet to resolve symptoms is due to inadequate energy rather than the metabolic state itself.
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Monda A, La Torre ME, Messina A, Di Maio G, Monda V, Moscatelli F, De Stefano M, La Marra M, Padova MD, Dipace A, Limone P, Casillo M, Monda M, Messina G, Polito R. Exploring the ketogenic diet's potential in reducing neuroinflammation and modulating immune responses. Front Immunol 2024; 15:1425816. [PMID: 39188713 PMCID: PMC11345202 DOI: 10.3389/fimmu.2024.1425816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 07/30/2024] [Indexed: 08/28/2024] Open
Abstract
The ketogenic diet (KD) is marked by a substantial decrease in carbohydrate intake and an elevated consumption of fats and proteins, leading to a metabolic state referred to as "ketosis," where fats become the primary source of energy. Recent research has underscored the potential advantages of the KD in mitigating the risk of various illnesses, including type 2 diabetes, hyperlipidemia, heart disease, and cancer. The macronutrient distribution in the KD typically entails high lipid intake, moderate protein consumption, and low carbohydrate intake. Restricting carbohydrates to below 50 g/day induces a catabolic state, prompting metabolic alterations such as gluconeogenesis and ketogenesis. Ketogenesis diminishes fat and glucose accumulation as energy reserves, stimulating the production of fatty acids. Neurodegenerative diseases, encompassing Alzheimer's disease, Parkinson's disease are hallmarked by persistent neuroinflammation. Evolving evidence indicates that immune activation and neuroinflammation play a significant role in the pathogenesis of these diseases. The protective effects of the KD are linked to the generation of ketone bodies (KB), which play a pivotal role in this dietary protocol. Considering these findings, this narrative review seeks to delve into the potential effects of the KD in neuroinflammation by modulating the immune response. Grasping the immunomodulatory effects of the KD on the central nervous system could offer valuable insights into innovative therapeutic approaches for these incapacitating conditions.
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Affiliation(s)
- Antonietta Monda
- Department of Human Sciences and Quality of Life Promotion of the Telematic University “San Raffaele”, Rome, Italy
| | - Maria Ester La Torre
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonietta Messina
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Girolamo Di Maio
- Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetics and Sports Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Vincenzo Monda
- Department of Exercise Sciences and Well-Being, University of Naples “Parthenope”, Naples, Italy
| | - Fiorenzo Moscatelli
- Department of Wellbeing, Nutrition and Sport, Pegaso Telematic University, Naples, Italy
| | - Marida De Stefano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Marco La Marra
- Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetics and Sports Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | | | - Anna Dipace
- Department of Wellbeing, Nutrition and Sport, Pegaso Telematic University, Naples, Italy
| | - Pierpaolo Limone
- Department of Wellbeing, Nutrition and Sport, Pegaso Telematic University, Naples, Italy
| | - Maria Casillo
- Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetics and Sports Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Marcellino Monda
- Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetics and Sports Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Giovanni Messina
- Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetics and Sports Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Rita Polito
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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Qiu X, Kuang J, Huang Y, Wei C, Zheng X. The association between Weight-adjusted-Waist Index (WWI) and cognitive function in older adults: a cross-sectional NHANES 2011-2014 study. BMC Public Health 2024; 24:2152. [PMID: 39118100 PMCID: PMC11308487 DOI: 10.1186/s12889-024-19332-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] [Received: 09/20/2023] [Accepted: 07/01/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND The impact of obesity on cognitive function has engendered considerable interest. Weight-adjusted waist index (WWI) has emerged as a novel and innovative marker of obesity that reflects weight-independent abdominal obesity. However, the association between WWI and cognitive function remains unclear. To address this gap, the present study aims to explore the relationship between weight-adjusted waist index (WWI) and cognitive performance in older adults. METHODS We conducted a cross-sectional investigation using datasets from the National Health and Nutrition Examination Survey (NHANES) 2011-2014. The study included 3,472 participants (48.59% male, 51.41% female) of various races (Mexican American, Other Hispanic, Non-Hispanic White, Non-Hispanic Black, and Other), with a mean age of 69.95 years (SD = 6.94). Multivariate regression and smoothing curve fitting were used to investigate the linear and nonlinear relationship between WWI and cognitive performance in the following domains: learning and memory, verbal fluency, and processing speed, as measured by Consortium to Establish a Registry for Alzheimer's Disease Word Learning subtest (CERAD-WL), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST), respectively. Subgroup analysis and interaction tests were conducted to examine the stability of this relationship across groups. Machine learning models based on random forests were used to analyze the predictive performance of WWI for cognitive function. RESULTS A total of 3,472 participants were included in the analysis. The results revealed significant negative associations between WWI and low scores on the CERAD-WL [-0.96 (-1.30, -0.62)], AFT [-0.77 (-1.05, -0.49)], and DSST [-3.67 (-4.55, -2.79)]. This relationship remained stable after converting WWI to a categorical variable. In addition, this significant negative association was more pronounced in men than women and diminished with advancing age. Non-linear threshold effects were observed, with correlations intensifying between WWI and CERAD-WL when WWI surpassed 12.25, AFT when WWI surpassed 11.54, and DSST when WWI surpassed 11.66. CONCLUSIONS A higher WWI, indicating increased abdominal obesity, was associated with deficits in learning, memory, verbal fluency, and processing speed among older adults. These findings suggest that abdominal obesity may play a crucial role in cognitive decline in this population. The stronger relationship observed between WWI and cognition in men highlights the need for gender-specific considerations in interventions targeting abdominal obesity. The results demonstrate the importance of interventions targeting abdominal obesity to preserve cognitive performance in older adults.
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Affiliation(s)
- Xichenhui Qiu
- Health Science Center, Shenzhen University, No. 1066, Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong Province, 518060, People's Republic of China
| | - Jiahao Kuang
- Health Science Center, Shenzhen University, No. 1066, Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong Province, 518060, People's Republic of China
| | - Yiqing Huang
- Health Science Center, Shenzhen University, No. 1066, Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong Province, 518060, People's Republic of China
| | - Changning Wei
- School of Tech X Academy, Shenzhen Polytechnic University, No. 7098, Liuxian Avenue Nanshan District, Shenzhen, Guangdong Province, 518118, People's Republic of China
| | - Xujuan Zheng
- Health Science Center, Shenzhen University, No. 1066, Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong Province, 518060, People's Republic of China.
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13
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Garner S, Davies E, Barkus E, Kraeuter AK. Ketogenic diet has a positive association with mental and emotional well-being in the general population. Nutrition 2024; 124:112420. [PMID: 38669832 DOI: 10.1016/j.nut.2024.112420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 01/26/2024] [Accepted: 03/05/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES A ketogenic diet reduces pathologic stress and improves mood in neurodegenerative and neurodevelopmental disorders. However, the effects of a ketogenic diet for people from the general population have largely been unexplored. A ketogenic diet is increasingly used for weight loss. Research in healthy individuals primarily focuses on the physical implications of a ketogenic diet. It is important to understand the holistic effects of a ketogenic diet, not only the physiological but also the psychological effects, in non-clinical samples. The aim of this cross-sectional study with multiple cohorts was to investigate the association of a ketogenic diet with different aspects of mental health, including calmness, contentedness, alertness, cognitive and emotional stress, depression, anxiety, and loneliness, in a general healthy population. METHODS Two online surveys were distributed: cohort 1 used Bond-Lader visual analog scales and Perceived Stress Scale (n = 147) and cohort 2 the Depression Anxiety Stress Scale and revised UCLA Loneliness Scale (n = 276). RESULTS A ketogenic diet was associated with higher self-reported mental and emotional well-being behaviors, including calmness, contentedness, alertness, cognitive and emotional stress, depression, anxiety, and loneliness, compared with individuals on a non-specific diet in a general population. CONCLUSION This research found that a ketogenic diet has potential psychological benefits in the general population.
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Affiliation(s)
- Sarah Garner
- Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Evan Davies
- Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK; Brain, Performance and Nutrition Research Centre, Northumbria University, Newcastle upon Tyne, UK
| | - Emma Barkus
- Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Ann-Katrin Kraeuter
- Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK; Brain, Performance and Nutrition Research Centre, Northumbria University, Newcastle upon Tyne, UK; NUTRAN, Northumbria University, Newcastle upon Tyne, UK.
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14
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Baldelli S, Aiello G, Mansilla Di Martino E, Campaci D, Muthanna FMS, Lombardo M. The Role of Adipose Tissue and Nutrition in the Regulation of Adiponectin. Nutrients 2024; 16:2436. [PMID: 39125318 PMCID: PMC11313710 DOI: 10.3390/nu16152436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 07/21/2024] [Accepted: 07/25/2024] [Indexed: 08/12/2024] Open
Abstract
Adipose tissue (AT), composed mainly of adipocytes, plays a critical role in lipid control, metabolism, and energy storage. Once considered metabolically inert, AT is now recognized as a dynamic endocrine organ that regulates food intake, energy homeostasis, insulin sensitivity, thermoregulation, and immune responses. This review examines the multifaceted role of adiponectin, a predominant adipokine released by AT, in glucose and fatty acid metabolism. We explore the regulatory mechanisms of adiponectin, its physiological effects and its potential as a therapeutic target for metabolic diseases such as type 2 diabetes, cardiovascular disease and fatty liver disease. Furthermore, we analyze the impact of various dietary patterns, specific nutrients, and physical activities on adiponectin levels, highlighting strategies to improve metabolic health. Our comprehensive review provides insights into the critical functions of adiponectin and its importance in maintaining systemic metabolic homeostasis.
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Affiliation(s)
- Sara Baldelli
- Department for the Promotion of Human Science and Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy (E.M.D.M.)
- IRCCS San Raffaele Roma, 00166 Rome, Italy
| | - Gilda Aiello
- Department for the Promotion of Human Science and Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy (E.M.D.M.)
| | - Eliana Mansilla Di Martino
- Department for the Promotion of Human Science and Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy (E.M.D.M.)
| | - Diego Campaci
- Department for the Promotion of Human Science and Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy (E.M.D.M.)
| | - Fares M. S. Muthanna
- Pharmacy Department, Faculty of Medicine and Health Sciences, University of Science and Technology-Aden, Alshaab Street, Enmaa City 22003, Yemen
| | - Mauro Lombardo
- Department for the Promotion of Human Science and Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy (E.M.D.M.)
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15
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Acuña-Catalán D, Shah S, Wehrfritz C, Nomura M, Acevedo A, Olmos C, Quiroz G, Huerta H, Bons J, Ampuero E, Wyneken U, Sanhueza M, Arancibia F, Contreras D, Cárdenas JC, Morales B, Schilling B, Newman JC, González-Billault C. Ketogenic diet administration later in life improves memory by modifying the synaptic cortical proteome via the PKA signaling pathway in aging mice. Cell Rep Med 2024; 5:101593. [PMID: 38843842 PMCID: PMC11228662 DOI: 10.1016/j.xcrm.2024.101593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 02/26/2024] [Accepted: 05/14/2024] [Indexed: 06/21/2024]
Abstract
Aging compromises brain function leading to cognitive decline. A cyclic ketogenic diet (KD) improves memory in aged mice after long-term administration; however, short-term effects later in life and the molecular mechanisms that govern such changes remain unclear. Here, we explore the impact of a short-term KD treatment starting at elderly stage on brain function of aged mice. Behavioral testing and long-term potentiation (LTP) recordings reveal that KD improves working memory and hippocampal LTP. Furthermore, the synaptosome proteome of aged mice fed a KD long-term evidence changes predominantly at the presynaptic compartment associated to the protein kinase A (PKA) signaling pathway. These findings were corroborated in vivo by western blot analysis, with high BDNF abundance and PKA substrate phosphorylation. Overall, we show that a KD modifies brain function even when it is administered later in life and recapitulates molecular features of long-term administration, including the PKA signaling pathway, thus promoting synaptic plasticity at advanced age.
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Affiliation(s)
- Diego Acuña-Catalán
- Center for Geroscience, Brain Health, and Metabolism (GERO), Santiago, Chile; Department of Biology, Faculty of Sciences, Universidad de Chile, Santiago, Chile
| | - Samah Shah
- The Buck Institute for Research on Aging, Novato, CA, USA
| | | | | | - Alejandro Acevedo
- Institute of Nutrition and Food Technology (INTA), Universidad de Chile, Santiago, Chile
| | - Cristina Olmos
- Center for Geroscience, Brain Health, and Metabolism (GERO), Santiago, Chile; Department of Biology, Faculty of Sciences, Universidad de Chile, Santiago, Chile
| | - Gabriel Quiroz
- Center for Geroscience, Brain Health, and Metabolism (GERO), Santiago, Chile; Department of Biology, Faculty of Sciences, Universidad de Chile, Santiago, Chile
| | - Hernán Huerta
- Center for Geroscience, Brain Health, and Metabolism (GERO), Santiago, Chile; Center for Integrative Biology, Faculty of Sciences, Universidad Mayor, Santiago, Chile
| | - Joanna Bons
- The Buck Institute for Research on Aging, Novato, CA, USA
| | - Estibaliz Ampuero
- Neurobiology of Behavior Laboratory, Department of Biology, Universidad de Santiago de Chile, Santiago, Chile
| | - Ursula Wyneken
- IMPACT, Center for Interventional Medicine for Precision and Advanced Cellular Therapy, and Faculty of Medicine, Universidad de Los Andes, Santiago, Chile
| | - Magdalena Sanhueza
- Department of Biology, Faculty of Sciences, Universidad de Chile, Santiago, Chile
| | - Felipe Arancibia
- Department of Biology, Faculty of Sciences, Universidad de Chile, Santiago, Chile
| | - Darwin Contreras
- Laboratory of Neuroscience, Faculty of Chemistry and Biology, Universidad de Santiago de Chile, Santiago, Chile
| | - Julio César Cárdenas
- Center for Geroscience, Brain Health, and Metabolism (GERO), Santiago, Chile; Department of Biology, Faculty of Sciences, Universidad de Chile, Santiago, Chile; The Buck Institute for Research on Aging, Novato, CA, USA; Center for Integrative Biology, Faculty of Sciences, Universidad Mayor, Santiago, Chile; Department of Chemistry and Biochemistry and Center for Aging and Longevity Studies University of California, Santa Barbara, CA, USA
| | - Bernardo Morales
- Laboratory of Neuroscience, Faculty of Chemistry and Biology, Universidad de Santiago de Chile, Santiago, Chile
| | | | - John C Newman
- The Buck Institute for Research on Aging, Novato, CA, USA
| | - Christian González-Billault
- Center for Geroscience, Brain Health, and Metabolism (GERO), Santiago, Chile; Department of Biology, Faculty of Sciences, Universidad de Chile, Santiago, Chile; The Buck Institute for Research on Aging, Novato, CA, USA; Institute of Nutrition and Food Technology (INTA), Universidad de Chile, Santiago, Chile; Department of Neurosciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile.
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16
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Kachlik Z, Walaszek M, Cubała WJ. Low-carbohydrate diet as a disease modifier for relapse prevention of treatment-resistant depression. Spotlight on neuroplasticity and brain-derived neurotrophic factor. Med Hypotheses 2024; 187:111356. [DOI: 10.1016/j.mehy.2024.111356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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17
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Jiménez-Morcillo J, Ramos-Campo DJ, Rodríguez-Besteiro S, Clemente-Suárez VJ. The Association of Body Image Perceptions with Behavioral and Health Outcomes among Young Adults. Nutrients 2024; 16:1281. [PMID: 38732530 PMCID: PMC11085562 DOI: 10.3390/nu16091281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/24/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
This study was conducted on 5 March 2024, by the Universidad Europea de Madrid. This study aims to explore how body image perceptions influence health behaviors and mental and physical health outcomes among a specific group of 605 young adults aged 20 to 35 engaged in strength training regimes. To measure these perceptions, the Multidimensional Body-Self Relations Questionnaire (MBSRQ) was employed, an advanced tool that assesses multiple dimensions of body image through its subscales, including feelings of physical attractiveness, investment in one's appearance, and satisfaction with different body areas. Participants were segmented into two groups based on a median split of their self-reported body image. The survey assessed a diverse array of variables, including demographic details, physiological data, resistance training routines, and psychological attributes. In this revision, we consistently use the term 'dietary habits' to ensure clear and uniform language when discussing eating patterns. Notable differences were observed in dietary habits and exercise engagement, influenced significantly by body image perceptions. Negative body image was linked to less healthy dietary habits, diminished physical activity, and worse psychological outcomes, such as increased anxiety and depression. Conversely, a positive body image was associated with healthier dietary habits, more frequent physical activity, and better psychological health. The findings suggest that interventions aimed at improving body image could be crucial for enhancing overall health within this specific demographic. Due to the non-representative nature of the study group, conclusions are cautiously presented as applicable only to similar populations engaged in strength training. This study underscores the need for holistic strategies that encourage positive body image to improve both physical and psychological health outcomes in young adults.
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Affiliation(s)
- Jorge Jiménez-Morcillo
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (J.J.-M.); (S.R.-B.); (V.J.C.-S.)
| | - Domingo Jesús Ramos-Campo
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Stephanie Rodríguez-Besteiro
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (J.J.-M.); (S.R.-B.); (V.J.C.-S.)
| | - Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (J.J.-M.); (S.R.-B.); (V.J.C.-S.)
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
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18
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Ma K, Zhou T, Pu C, Cheng Z, Han X, Yang L, Yu X. The Bidirectional Relationship between Weight Gain and Cognitive Function in First-Episode Schizophrenia: A Longitudinal Study in China. Brain Sci 2024; 14:310. [PMID: 38671962 PMCID: PMC11048552 DOI: 10.3390/brainsci14040310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 03/13/2024] [Accepted: 03/17/2024] [Indexed: 04/28/2024] Open
Abstract
Patients with schizophrenia often encounter notable weight gain during their illness, heightening the risk of metabolic diseases. While previous studies have noted a correlation between obesity and cognitive impairment in schizophrenia, many were cross-sectional, posing challenges in establishing a causal relationship between weight gain and cognitive function. The aim of this longitudinal study is to examine the relationship between weight gain and cognitive function in patients with first-episode schizophrenia (FES) during the initial 6-month antipsychotic treatments. Employing linear and logistic regression analyses, the study involved 337 participants. Significantly, baseline scores in processing speed (OR = 0.834, p = 0.007), working memory and attention (OR = 0.889, p = 0.043), and executive function (OR = 0.862, p = 0.006) were associated with clinically relevant weight gain (CRW, defined as an increase in body weight > 7%) at the 6-month endpoint. On the other hand, CRW correlated with improvements in the Brief Visuospatial Memory Test (p = 0.037). These findings suggest that patients with lower baseline cognitive performance undergo more substantial weight gain. Conversely, weight gain was correlated with cognitive improvements, particularly in the domain of visual learning and memory. This suggested a potential bidirectional relationship between weight gain and cognitive function in first-episode schizophrenia patients.
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Affiliation(s)
- Ke Ma
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Tianhang Zhou
- Peking University Sixth Hospital, Beijing 100191, China
- Institute of Mental Health, Peking University Sixth Hospital, Beijing 100191, China
- NHC Key Laboratory of Mental Health, Peking University, Beijing 100191, China
- National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing 100191, China
| | - Chengcheng Pu
- Peking University Sixth Hospital, Beijing 100191, China
- Institute of Mental Health, Peking University Sixth Hospital, Beijing 100191, China
- NHC Key Laboratory of Mental Health, Peking University, Beijing 100191, China
- National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing 100191, China
| | - Zhang Cheng
- Peking University Sixth Hospital, Beijing 100191, China
- Institute of Mental Health, Peking University Sixth Hospital, Beijing 100191, China
- NHC Key Laboratory of Mental Health, Peking University, Beijing 100191, China
- National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing 100191, China
| | - Xue Han
- Peking University Sixth Hospital, Beijing 100191, China
- Institute of Mental Health, Peking University Sixth Hospital, Beijing 100191, China
- NHC Key Laboratory of Mental Health, Peking University, Beijing 100191, China
- National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing 100191, China
| | - Lei Yang
- Peking University Sixth Hospital, Beijing 100191, China
- Institute of Mental Health, Peking University Sixth Hospital, Beijing 100191, China
- NHC Key Laboratory of Mental Health, Peking University, Beijing 100191, China
- National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing 100191, China
| | - Xin Yu
- Peking University Sixth Hospital, Beijing 100191, China
- Institute of Mental Health, Peking University Sixth Hospital, Beijing 100191, China
- NHC Key Laboratory of Mental Health, Peking University, Beijing 100191, China
- National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing 100191, China
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19
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Wang X, Jiang B. Letter-to-the-editor on "A low-carbohydrate diet induces hepatic insulin resistance and metabolic associated fatty liver disease in mice". Mol Metab 2024; 81:101898. [PMID: 38360108 PMCID: PMC10928363 DOI: 10.1016/j.molmet.2024.101898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 02/06/2024] [Indexed: 02/17/2024] Open
Affiliation(s)
- Xin Wang
- Beijing Tiantan Hospital, Capital Medical University, China; Beijing Shijitan Hospital, Capital Medical University, China
| | - Bo Jiang
- Beijing Tiantan Hospital, Capital Medical University, China.
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20
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Iyer SH, Yeh MY, Netzel L, Lindsey MG, Wallace M, Simeone KA, Simeone TA. Dietary and Metabolic Approaches for Treating Autism Spectrum Disorders, Affective Disorders and Cognitive Impairment Comorbid with Epilepsy: A Review of Clinical and Preclinical Evidence. Nutrients 2024; 16:553. [PMID: 38398876 PMCID: PMC10893388 DOI: 10.3390/nu16040553] [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: 12/24/2023] [Revised: 02/09/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
Epilepsy often occurs with other neurological disorders, such as autism, affective disorders, and cognitive impairment. Research indicates that many neurological disorders share a common pathophysiology of dysfunctional energy metabolism, neuroinflammation, oxidative stress, and gut dysbiosis. The past decade has witnessed a growing interest in the use of metabolic therapies for these disorders with or without the context of epilepsy. Over one hundred years ago, the high-fat, low-carbohydrate ketogenic diet (KD) was formulated as a treatment for epilepsy. For those who cannot tolerate the KD, other diets have been developed to provide similar seizure control, presumably through similar mechanisms. These include, but are not limited to, the medium-chain triglyceride diet, low glycemic index diet, and calorie restriction. In addition, dietary supplementation with ketone bodies, polyunsaturated fatty acids, or triheptanoin may also be beneficial. The proposed mechanisms through which these diets and supplements work to reduce neuronal hyperexcitability involve normalization of aberrant energy metabolism, dampening of inflammation, promotion of endogenous antioxidants, and reduction of gut dysbiosis. This raises the possibility that these dietary and metabolic therapies may not only exert anti-seizure effects, but also reduce comorbid disorders in people with epilepsy. Here, we explore this possibility and review the clinical and preclinical evidence where available.
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Affiliation(s)
| | | | | | | | | | | | - Timothy A. Simeone
- Department of Pharmacology & Neuroscience, Creighton University School of Medicine, Omaha, NE 68178, USA; (S.H.I.); (K.A.S.)
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21
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Fila M, Chojnacki J, Pawlowska E, Sobczuk P, Chojnacki C, Blasiak J. The Ketogenic Diet in the Prevention of Migraines in the Elderly. Nutrients 2023; 15:4998. [PMID: 38068855 PMCID: PMC10707997 DOI: 10.3390/nu15234998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 11/23/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
Migraines display atypical age dependence, as the peak of their prevalence occurs between the ages of 20-40 years. With age, headache attacks occur less frequently and are characterized by a lower amplitude. However, both diagnosis and therapy of migraines in the elderly are challenging due to multiple comorbidities and polypharmacy. Dietary components and eating habits are migraine triggers; therefore, nutrition is a main target in migraine prevention. Several kinds of diets were proposed to prevent migraines, but none are commonly accepted due to inconsistent results obtained in different studies. The ketogenic diet is featured by very low-carbohydrate and high-fat contents. It may replace glucose with ketone bodies as the primary source of energy production. The ketogenic diet and the actions of ketone bodies are considered beneficial in several aspects of health, including migraine prevention, but studies on the ketogenic diet in migraines are not standardized and poorly evidenced. Apart from papers claiming beneficial effects of the ketogenic diet in migraines, several studies have reported that increased levels of ketone bodies may be associated with all-cause and incident heart failure mortality in older adults and are supported by research on mice showing that the ketogenic diets and diet supplementation with a human ketone body precursor may cause life span shortening. Therefore, despite reports showing a beneficial effect of the ketogenic diet in migraines, such a diet requires further studies, including clinical trials, to verify whether it should be recommended in older adults with migraines.
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Affiliation(s)
- Michal Fila
- Department of Developmental Neurology and Epileptology, Polish Mother’s Memorial Hospital—Research Institute, 93-338 Lodz, Poland;
| | - Jan Chojnacki
- Department of Clinical Nutrition and Gastroenterological Diagnostics, Medical University of Lodz, 90-647 Lodz, Poland; (J.C.), (C.C.)
| | - Elzbieta Pawlowska
- Department of Pediatric Dentistry, Medical University of Lodz, 92-217 Lodz, Poland;
| | - Piotr Sobczuk
- Emergency Medicine and Disaster Medicine Department, Medical University of Lodz, 92-209 Lodz, Poland;
- Department of Orthopaedics and Traumatology, Polish Mother’s Memorial Hospital—Research Institute, Rzgowska 281, 93-338 Lodz, Poland
| | - Cezary Chojnacki
- Department of Clinical Nutrition and Gastroenterological Diagnostics, Medical University of Lodz, 90-647 Lodz, Poland; (J.C.), (C.C.)
| | - Janusz Blasiak
- Faculty of Medicine, Collegium Medicum, The Mazovian Academy in Plock, 09-402 Plock, Poland
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22
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Field R, Field T, Pourkazemi F, Rooney K. Low-carbohydrate and ketogenic diets: a scoping review of neurological and inflammatory outcomes in human studies and their relevance to chronic pain. Nutr Res Rev 2023; 36:295-319. [PMID: 35438071 DOI: 10.1017/s0954422422000087] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Dietary restriction of carbohydrate has been demonstrated to be beneficial for nervous system dysfunction in animal models and may be beneficial for human chronic pain. The purpose of this review is to assess the impact of a low-carbohydrate/ketogenic diet on the adult nervous system function and inflammatory biomarkers to inform nutritional research for chronic pain. An electronic database search was carried out in May 2021. Publications were screened for prospective research with dietary carbohydrate intake <130 g per day and duration of ≥2 weeks. Studies were categorised into those reporting adult neurological outcomes to be extracted for analysis and those reporting other adult research outcomes. Both groups were screened again for reported inflammatory biomarkers. From 1548 studies, there were 847 studies included. Sixty-four reported neurological outcomes with 83% showing improvement. Five hundred and twenty-three studies had a different research focus (metabolic n = 394, sport/performance n = 51, cancer n = 33, general n = 30, neurological with non-neuro outcomes n = 12, or gastrointestinal n = 4). The second screen identified sixty-three studies reporting on inflammatory biomarkers, with 71% reporting a reduction in inflammation. The overall results suggest a favourable outcome on the nervous system and inflammatory biomarkers from a reduction in dietary carbohydrates. Both nervous system sensitisation and inflammation occur in chronic pain, and the results from this review indicate it may be improved by low-carbohydrate nutritional therapy. More clinical trials within this population are required to build on the few human trials that have been done.
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Affiliation(s)
- Rowena Field
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Tara Field
- The New South Wales Ministry of Health (NSW Health), Sydney, Australia
| | | | - Kieron Rooney
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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23
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Chinna-Meyyappan A, Gomes FA, Koning E, Fabe J, Breda V, Brietzke E. Effects of the ketogenic diet on cognition: a systematic review. Nutr Neurosci 2023; 26:1258-1278. [PMID: 36354157 DOI: 10.1080/1028415x.2022.2143609] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Ketogenic diet (KD) therapy has been used as a dietary intervention in drug-resistant epilepsy for several years. Research currently suggests that KD therapy may carry neuroprotective and cognition enhancing effects for individuals with non-epileptic conditions as well as for healthy individuals. Therefore, KD may have potential as a non-invasive, nutritional treatment approach for difficult to manage conditions such as neurodegenerative illnesses or mood disorders. The aim of this review is to summarize the available evidence on ketogenic interventions and the resulting cognitive outcomes. MATERIALS AND METHODS The paper was based on PRISMA 2020 guidelines. The search was conducted in June 2021 on the following databases: CENTRAL, PubMed, EMBASE, PsycInfo, Web of Science. The search yielded 2014 studies, of which 49 were included. RESULTS There were 22 animal studies assessing murine models and 27 studies on humans. The primary indications in these studies were epileptic conditions, neurodegenerative disorders, cognitive impairment, and healthy populations. DISCUSSION Administration of KD seems to confer cognitive-enhancing effects in areas such as working memory, reference memory and attention. Studies found that KD treatment in animals has the potential to alleviate age-related cognitive decline. Over 80% of the 27 human studies reported a favourable effect of intervention, and none reported a detrimental effect of KD. While these findings suggest that KD may improve the functioning of certain cognitive domains, definitive conclusions were limited by studies with small sample sizes, the absence of controls and randomization, and the lack of objective measures of cognition.
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Affiliation(s)
| | - Fabiano Alves Gomes
- Department of Psychiatry, Queen's University School of Medicine, Kingston, Canada
- Centre for Neuroscience Studies (CNS), Queen's University, Kingston, Canada
| | - Elena Koning
- Department of Psychiatry, Queen's University School of Medicine, Kingston, Canada
| | | | - Vitor Breda
- Department of Psychiatry, Queen's University School of Medicine, Kingston, Canada
- Centre for Neuroscience Studies (CNS), Queen's University, Kingston, Canada
| | - Elisa Brietzke
- Department of Psychiatry, Queen's University School of Medicine, Kingston, Canada
- Centre for Neuroscience Studies (CNS), Queen's University, Kingston, Canada
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Jenko Pražnikar Z, Šik Novak K, Bogataj Jontez N, Petelin A, Mohorko N, Kenig S. Inflammatory and intestinal permeability biomarkers in healthy participants on long term vegan, vegetarian, omnivore and low-carbohydrate high-fat diet. Sci Rep 2023; 13:17286. [PMID: 37828090 PMCID: PMC10570364 DOI: 10.1038/s41598-023-44233-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 10/05/2023] [Indexed: 10/14/2023] Open
Abstract
Vegan, vegetarian and low-carbohydrate high fat (LCHF) diets can all offer several health benefits, if food choices are appropriate. In most studies examining their effects on systemic inflammation, participants were either overweight, on a weight loss programme or not matched for BMI, or had a pre-existing condition such as type 2 diabetes mellitus or hypertension. Little is known about the effects of dietary patterns on healthy and normal weight individuals. The aim of the present study was therefore to assess and directly compare inflammatory and intestinal permeability status in healthy participants following aforementioned or omnivore diet for at least 6 months. In this cross-sectional study, we measured the inflammatory biomarkers IL-6, TNF-α and CRP, and the markers of intestinal permeability LBP and zonulin, along with the analysis of lifestyle aspects, dietary intakes and physical activity, in 89 healthy participants. The groups were matched for sex, age and BMI. There were no differences in any of the measured parameters between the four groups and we found no strong correlations with dietary intakes. Using cluster analysis, participants were divided into eight clusters with more or less favourable inflammatory profiles; all clusters contained representatives of all patterns and all patterns were represented in each cluster. Significant differences between clusters were in the intake of mono-unsaturated fatty acids, ω-3/ω-6 ratio, phase angle and working two shifts. In healthy, normal-weight individuals, inflammatory status therefore does not depend on the dietary pattern itself, but is rather more complexly regulated and associated with dietary and non-dietary factors.
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Affiliation(s)
- Zala Jenko Pražnikar
- University of Primorska, Faculty of Health Sciences, Polje 42, 6310, Izola, Slovenia
| | - Karin Šik Novak
- University of Primorska, Faculty of Health Sciences, Polje 42, 6310, Izola, Slovenia
| | - Nives Bogataj Jontez
- University of Primorska, Faculty of Health Sciences, Polje 42, 6310, Izola, Slovenia
| | - Ana Petelin
- University of Primorska, Faculty of Health Sciences, Polje 42, 6310, Izola, Slovenia
| | - Nina Mohorko
- University of Primorska, Faculty of Health Sciences, Polje 42, 6310, Izola, Slovenia
| | - Saša Kenig
- University of Primorska, Faculty of Health Sciences, Polje 42, 6310, Izola, Slovenia.
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Halma MTJ, Tuszynski JA, Marik PE. Cancer Metabolism as a Therapeutic Target and Review of Interventions. Nutrients 2023; 15:4245. [PMID: 37836529 PMCID: PMC10574675 DOI: 10.3390/nu15194245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/20/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
Cancer is amenable to low-cost treatments, given that it has a significant metabolic component, which can be affected through diet and lifestyle change at minimal cost. The Warburg hypothesis states that cancer cells have an altered cell metabolism towards anaerobic glycolysis. Given this metabolic reprogramming in cancer cells, it is possible to target cancers metabolically by depriving them of glucose. In addition to dietary and lifestyle modifications which work on tumors metabolically, there are a panoply of nutritional supplements and repurposed drugs associated with cancer prevention and better treatment outcomes. These interventions and their evidentiary basis are covered in the latter half of this review to guide future cancer treatment.
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Affiliation(s)
- Matthew T. J. Halma
- Department of Physics and Astronomy, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
- EbMC Squared CIC, Bath BA2 4BL, UK
| | - Jack A. Tuszynski
- Department of Physics, University of Alberta, 11335 Saskatchewan Dr NW, Edmonton, AB T6G 2M9, Canada
- Department of Data Science and Engineering, The Silesian University of Technology, 44-100 Gliwice, Poland
- DIMEAS, Politecnico di Torino, Corso Duca degli Abruzzi 24, I-1029 Turin, Italy
| | - Paul E. Marik
- Frontline COVID-19 Critical Care Alliance, Washington, DC 20036, USA
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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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Mentzelou M, Dakanalis A, Vasios GK, Gialeli M, Papadopoulou SK, Giaginis C. The Relationship of Ketogenic Diet with Neurodegenerative and Psychiatric Diseases: A Scoping Review from Basic Research to Clinical Practice. Nutrients 2023; 15:2270. [PMID: 37242153 PMCID: PMC10220548 DOI: 10.3390/nu15102270] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/09/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The ketogenic diet (KD) has become widespread for the therapy of epileptic pathology in childhood and adulthood. In the last few decades, the current re-emergence of its popularity has focused on the treatment of obesity and diabetes mellitus. KD also exerts anti-inflammatory and neuroprotective properties, which could be utilized for the therapy of neurodegenerative and psychiatric disorders. PURPOSE This is a thorough, scoping review that aims to summarize and scrutinize the currently available basic research performed in in vitro and in vivo settings, as well as the clinical evidence of the potential beneficial effects of KD against neurodegenerative and psychiatric diseases. This review was conducted to systematically map the research performed in this area as well as identify gaps in knowledge. METHODS We thoroughly explored the most accurate scientific web databases, e.g., PubMed, Scopus, Web of Science, and Google Scholar, to obtain the most recent in vitro and in vivo data from animal studies as well as clinical human surveys from the last twenty years, applying effective and characteristic keywords. RESULTS Basic research has revealed multiple molecular mechanisms through which KD can exert neuroprotective effects, such as neuroinflammation inhibition, decreased reactive oxygen species (ROS) production, decreased amyloid plaque deposition and microglial activation, protection in dopaminergic neurons, tau hyper-phosphorylation suppression, stimulating mitochondrial biogenesis, enhancing gut microbial diversity, restoration of histone acetylation, and neuron repair promotion. On the other hand, clinical evidence remains scarce. Most existing clinical studies are modest, frequently uncontrolled, and merely assess the short-term impacts of KD. Moreover, several clinical studies had large dropout rates and a considerable lack of compliance assessment, as well as an increased level of heterogeneity in the study design and methodology. CONCLUSIONS KD can exert substantial neuroprotective effects via multiple molecular mechanisms in various neurodegenerative and psychiatric pathological states. Large, long-term, randomized, double-blind, controlled clinical trials with a prospective design are strongly recommended to delineate whether KD may attenuate or even treat neurodegenerative and psychiatric disease development, progression, and symptomatology.
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Affiliation(s)
- Maria Mentzelou
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece; (M.M.); (G.K.V.); (M.G.)
| | - Antonios Dakanalis
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
| | - Georgios K. Vasios
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece; (M.M.); (G.K.V.); (M.G.)
| | - Maria Gialeli
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece; (M.M.); (G.K.V.); (M.G.)
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece;
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece; (M.M.); (G.K.V.); (M.G.)
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Šik Novak K, Bogataj Jontez N, Petelin A, Hladnik M, Baruca Arbeiter A, Bandelj D, Pražnikar J, Kenig S, Mohorko N, Jenko Pražnikar Z. Could Gut Microbiota Composition Be a Useful Indicator of a Long-Term Dietary Pattern? Nutrients 2023; 15:2196. [PMID: 37432336 DOI: 10.3390/nu15092196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/01/2023] [Accepted: 05/03/2023] [Indexed: 07/12/2023] Open
Abstract
Despite the known effects of diet on gut microbiota composition, not many studies have evaluated the relationship between distinct dietary patterns and gut microbiota. The aim of our study was to determine whether gut microbiota composition could be a useful indicator of a long-term dietary pattern. We collected data from 89 subjects adhering to omnivorous, vegetarian, vegan, and low-carbohydrate, high-fat diet that were equally distributed between groups and homogenous by age, gender, and BMI. Gut microbiota composition was analyzed with a metabarcoding approach using V4 hypervariable region of the 16S rRNA gene. K-means clustering of gut microbiota at the genus level was performed and the nearest neighbor classifier was applied to predict microbiota clustering classes. Our results suggest that gut microbiota composition at the genus level is not a useful indicator of a subject's dietary pattern, with the exception of a vegan diet that is represented by a high abundance of Prevotella 9. Based on our model, a combination of 26 variables (anthropometric measurements, serum biomarkers, lifestyle factors, gastrointestinal symptoms, psychological factors, specific nutrients intake) is more important to predict an individual's microbiota composition cluster, with 91% accuracy, than the dietary intake alone. Our findings could serve to develop strategies to educate individuals about changes of some modifiable lifestyle factors, aiming to classify them into clusters with favorable health markers, independent of their dietary pattern.
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Affiliation(s)
- Karin Šik Novak
- Faculty of Health Sciences, University of Primorska, Polje 42, 6310 Izola, Slovenia
| | - Nives Bogataj Jontez
- Faculty of Health Sciences, University of Primorska, Polje 42, 6310 Izola, Slovenia
| | - Ana Petelin
- Faculty of Health Sciences, University of Primorska, Polje 42, 6310 Izola, Slovenia
| | - Matjaž Hladnik
- Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, Glagoljaška 8, 6000 Koper, Slovenia
| | - Alenka Baruca Arbeiter
- Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, Glagoljaška 8, 6000 Koper, Slovenia
| | - Dunja Bandelj
- Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, Glagoljaška 8, 6000 Koper, Slovenia
| | - Jure Pražnikar
- Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, Glagoljaška 8, 6000 Koper, Slovenia
| | - Saša Kenig
- Faculty of Health Sciences, University of Primorska, Polje 42, 6310 Izola, Slovenia
| | - Nina Mohorko
- Faculty of Health Sciences, University of Primorska, Polje 42, 6310 Izola, Slovenia
| | - Zala Jenko Pražnikar
- Faculty of Health Sciences, University of Primorska, Polje 42, 6310 Izola, Slovenia
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Bogataj Jontez N, Kenig S, Šik Novak K, Petelin A, Jenko Pražnikar Z, Mohorko N. Habitual low carbohydrate high fat diet compared with omnivorous, vegan, and vegetarian diets. Front Nutr 2023; 10:1106153. [PMID: 37125046 PMCID: PMC10133707 DOI: 10.3389/fnut.2023.1106153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/23/2023] [Indexed: 05/02/2023] Open
Abstract
Background Dietary patterns which exclude whole food groups, such as vegetarian, vegan and low carbohydrate high fat diet (LCHF), are increasingly popular in general public. When carefully planned, all these diets have some known benefits for health, but concerns are also raised in particular for LCHF. The quality of LCHF diet which individuals follow in real life without supervision is not known. Methods One hundred thirty healthy individuals with stable body mass following LCHF, vegan, vegetarian and omnivorous diet for at least six months, were compared in a cross-sectional study. Diet was analyzed through 3-day food records and FFQ, anthropometric measurements were performed and serum metabolic biomarkers determined from fasting blood. Results Participants on LCHF diet had the intakes of micronutrients comparable to other groups, while the intakes of macronutrients differed in line with the definition of each diet. The intakes of saturated fats, cholesterol and animal proteins were significantly higher and the intakes of sugars and dietary fibers were lower compared to other groups. Healthy eating index 2015 in this group was the lowest. There were no differences in the levels of glucose, triacylglycerols and CRP among groups. Total and LDL cholesterol levels were significantly higher in LCHF group, in particular in participants with higher ketogenic ratio. Fatty acids intakes and intakes of cholesterol, dietary fibers and animal proteins explained 40% of variance in total cholesterol level, with saturated fatty acids being the strongest positive predictor and monounsaturated fatty acids a negative predictor. Conclusion None of the self-advised diets provided all the necessary nutrients in optimal levels. Due to the detected increased levels of serum cholesterols, selection of healthy fat sources, higher intake of dietary fibers and partial replacing of animal sources with plant sources of foods should be recommended to the individuals selecting LCFH dietary pattern.Clinical Trial Registration: ClinicalTrials.gov, identifier NCT04347213.
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Affiliation(s)
| | | | | | | | | | - Nina Mohorko
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
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Nasrollahzadeh J, Khandouzi N, Maroofi M. Effect of a Reduced-Calorie Diet on Plasma Levels of Inflammatory and Metabolic Factors in Overweight/Obese Patients with Cardiovascular Risk Factors. Int J Endocrinol Metab 2023; 21:e135216. [PMID: 37654524 PMCID: PMC10467581 DOI: 10.5812/ijem-135216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/16/2023] [Accepted: 05/01/2023] [Indexed: 09/02/2023] Open
Abstract
Background Calorie restriction without malnutrition is likely to improve cardiovascular risk factors. Objectives The aim of this study was to investigate calorie restriction on markers of cardiometabolic risk in overweight/obese adults with cardiovascular risk factors. Methods In a parallel controlled trial, patients with overweight or obesity and one or more cardiovascular risk factor were randomized to a modest reduced-calorie diet (75% of the total calculated energy requirements) or control (no calorie restriction) groups and followed up for two months. Body weight, dietary intake, fasting plasma levels of C-reactive protein (CRP), monocyte chemoattractant protein-1 (MCP-1), intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), brain-derived neurotrophic factor (BDNF), neuropeptide Y (NPY), lipids, and glycemic factors were measured at baseline, and after two months. The differences were analyzed with analysis of covariance (ANCOVA). Results Sixty-six participants (33 in each group) completed the study. Body weight changed in the reduced-calorie diet group (- 3.05 ± 2.65 kg), and blood pressure was improved (systolic -6.96 ± 12.04 and diastolic - 3.90 ± 8.97 mmHg). The reduced-calorie diet improved plasma ICAM-1 (change from baseline - 0.45 ± 1.99 ng/mL, P = 0.033, ANCOVA), MCP-1 (change from baseline - 0.50 pg/mL, P = 0.011, ANCOVA), low-density lipoprotein cholesterol (change from baseline - 9.35 ± 19.61 mg/dL, P < 0.001, ANCOVA), and triglyceride (change from baseline -33.66 ± 49.08, P = 0.001, ANCOVA), but BDNF, NPY, and other cardiometabolic factors were not different. Conclusions In overweight/obese subjects with cardiovascular risk factors which have been under medical treatment with risk-reducing medications, a modest weight loss induced by a reduced-calorie diet improved lipid profile, blood pressure, and reduced ICAM-1 and MCP-1 levels but had no effect on plasma BDNF or glycemic factors.
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Affiliation(s)
- Javad Nasrollahzadeh
- Department of Clinical Nutrition & Dietetics, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nafiseh Khandouzi
- Department of Clinical Nutrition & Dietetics, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Maroofi
- Department of Clinical Nutrition & Dietetics, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Schmidt T, Harmon DM, Kludtke E, Mickow A, Simha V, Kopecky S. Dramatic elevation of LDL cholesterol from ketogenic-dieting: A Case Series. Am J Prev Cardiol 2023; 14:100495. [PMID: 37096158 PMCID: PMC10121782 DOI: 10.1016/j.ajpc.2023.100495] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/24/2023] [Accepted: 04/01/2023] [Indexed: 04/08/2023] Open
Abstract
High-fat, low carb dieting, also known as the "ketogenic diet," has increased in popularity as a rapid weight-loss tool. Previous studies describe a modest elevation in cholesterol in the average keto-diet participant without specific cardiovascular impact. We hypothesize that patients with a genetic predisposition to cholesterol metabolism dysregulation may have a disproportionate elevation in cholesterol in response to ketogenic dieting.
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Ayele GM, Atalay RT, Mamo RT, Hussien S, Nigussie B, Fissha A, Michael MB. Is Losing Weight Worth Losing Your Kidney: Keto Diet Resulting in Renal Failure. Cureus 2023; 15:e36546. [PMID: 37095796 PMCID: PMC10121483 DOI: 10.7759/cureus.36546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/14/2023] [Indexed: 04/26/2023] Open
Abstract
Keto diet is defined as a high-fat, adequate-protein, and low-carbohydrate nutrition which forces the body to burn fats and use an alternative metabolic fuel resource by stimulating endogenous ketone production. The standard range of ketones in ketosis is up to 3.00mmol/L, and anything beyond this level can result in serious medical conditions. This diet's most common and easily reversible consequences are constipation, low-grade acidosis, hypoglycemia, kidney stones, and increased lipid in the blood. We present a case of a 36-year-old female who presented with pre-renal azotemia after starting a keto diet regimen.
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Affiliation(s)
- Girma M Ayele
- Internal Medicine, Howard University Hospital, Washington D.C., USA
| | | | - Ruth T Mamo
- General Medicine, Nordic Medical Center, Addis Ababa, ETH
| | - Siham Hussien
- Internal Medicine, University of Maryland Midtown Campus, Baltimore, USA
| | | | - Abel Fissha
- Internal Medicine, International Cardiovascular and Medical Center (iCMC) Hospital, Addis Ababa, ETH
| | - Miriam B Michael
- Internal Medicine, Howard University Hospital, Washington D.C., USA
- Internal Medicine, University of Maryland, Baltimore, USA
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Effect of Low-Carbohydrate Diet on Beta-Hydroxybutyrate Ketogenesis Metabolic Stimulation and Regulation of NLRP3 Ubiquitination in Obese Saudi Women. Nutrients 2023; 15:nu15040820. [PMID: 36839178 PMCID: PMC9958539 DOI: 10.3390/nu15040820] [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: 01/12/2023] [Revised: 01/25/2023] [Accepted: 02/03/2023] [Indexed: 02/08/2023] Open
Abstract
The effects of a ketogenic diet (KD) on anthropometric indices, the lipid profile, and the benefits of the ketone body beta-hydroxybutyrate (BHB) as an inhibitor of the NOD-like receptor pyrin domain-containing 3 (NLRP3) inflammasome in obese women were investigated in this study. From January to March 2021, 23 obese adult women (n = 23) with an average age of 35.30 years and BMI of 33.96 kg/m2 followed a KD. Instructions for the KD were given to eligible participants, with a typical plan and a menu for all the main meals, snacks, and drinks permitted over seven days. They were also free to change meals according to their preferences provided that they followed the plan. The participants attended six times throughout the intervention for measurements of their anthropometric indices, BHB levels, interleukin-1beta (1L-1β) levels, and completion of a questionnaire (pre-intervention, mid-intervention, and post-intervention). Following the KD caused significant weight loss, a reduction in waist circumference and BHB levels, as well as a reduction in BMI and appetite. Cholesterol, triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) increased slightly. However, low-density lipoprotein cholesterol (LDL-C) in serum increased significantly (p < 0.05), and 1L-1β decreased significantly (p < 0.0001). The results show that the KD effectively encouraged weight loss and NLRP3 inflammasome inhibition. Based on the questionnaire results, it was found that a variety of physical symptoms, including overall energy, physical activity, mood, sleep, focus, skin conditions, and menstruation, had significantly improved.
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Černelič-Bizjak M, Kenig S, Petelin A, Jenko-Pražnikar Z, Mohorko N. Link between emotional and external eating behaviors, peripheral neuropeptide Y, and β-hydroxybutyrate in participants with obesity on 12-week ketogenic diet. Nutr Health 2023:2601060231154464. [PMID: 36734124 DOI: 10.1177/02601060231154464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Objective: Understanding the impact of stress on emotional and external eating behaviors and the psychological and the associated metabolic factors can help in designing subsequent interventions to protect health. In particular, psychological trait-like construct related to eating has been shown to be an important target for intervention. Methods and measures: This study aimed to investigate the biochemical variables associated with a decrease in emotional and external eating behaviors due to 12-week ketogenic diet (12KD) in 35 adult participants (12 males) with obesity. Results: Absolute changes in emotional and external eating were independent of changes in body mass, nutritional intake, and Δ cortisol, but were predicted with increases in serum β-hydroxybutyrate (BHB) and decreases in serum peripheral neuropeptide Y (pNPY) (all p's < 0.050). Decrease in pNPY was also associated with an increase in BHB but was independent of anthropometrical changes, Δ fasting glucose, and Δ insulin. Conclusion: The reductions in emotional and external eating behaviors in participants with obesity were uniquely predicted by an increase in BHB and a decrease in pNPY after 12KD. In ketosis, emotional and external eating dropped independently of body mass change. Change in pNPY predicted changes in emotional and external eating. The role of BHB in modulating eating behavior should be further explored.
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Affiliation(s)
| | - Saša Kenig
- Faculty of Health Sciences, 68960University of Primorska, Izola, Slovenia
| | - Ana Petelin
- Faculty of Health Sciences, 68960University of Primorska, Izola, Slovenia
| | | | - Nina Mohorko
- Faculty of Health Sciences, 68960University of Primorska, Izola, Slovenia
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Long F, Bhatti MR, Kellenberger A, Sun W, Modica S, Höring M, Liebisch G, Krieger JP, Wolfrum C, Challa TD. A low-carbohydrate diet induces hepatic insulin resistance and metabolic associated fatty liver disease in mice. Mol Metab 2023; 69:101675. [PMID: 36682412 PMCID: PMC9900440 DOI: 10.1016/j.molmet.2023.101675] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES Metabolic-associated fatty liver disease (MAFLD) is the most common chronic liver disease that can range from hepatic steatosis to non-alcoholic steatohepatitis (NASH), which can lead to fibrosis and cirrhosis. Recently, ketogenic diet (KD), a low carbohydrate diet, gained popularity as a weight-loss approach, although it has been reported to induce hepatic insulin resistance and steatosis in animal model systems via an undefined mechanism. Herein, we investigated the KD metabolic benefits and its contribution to the pathogenesis of NASH. METHODS Using metabolic, biochemical and omics approaches, we identified the effects of a KD on NASH and investigated the mechanisms by which KD induces hepatic insulin resistance and steatosis. RESULTS We demonstrate that KD can induce fibrosis and NASH regardless of body weight loss compared to high-fat diet (HFD) fed mice at thermoneutrality. At ambient temperature (23 °C), KD-fed mice develop a severe hepatic injury, inflammation, and steatosis. In addition, KD increases liver cholesterol, IL-6, and p-JNK and aggravates diet induced-glucose intolerance and hepatic insulin resistance compared to HFD. Pharmacological inhibition of IL-6 and JNK reverses KD-induced glucose intolerance, and hepatic steatosis and restores insulin sensitivity. CONCLUSIONS Our studies uncover a new mechanism for KD-induced hepatic insulin resistance and NASH potentially via IL-6-JNK signaling and provide a new NASH mouse model.
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Affiliation(s)
- Fen Long
- Institute of Food Nutrition and Health and Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zürich (ETH), CH-8603 Schwerzenbach, Switzerland
| | - Memoona R. Bhatti
- Université catholique de Louvain, de Duve Institute, Avenue Hippocrate 75/B1-7503, Brussels 1200, Belgium
| | - Alexandra Kellenberger
- Institute of Food Nutrition and Health and Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zürich (ETH), CH-8603 Schwerzenbach, Switzerland
| | - Wenfei Sun
- Institute of Food Nutrition and Health and Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zürich (ETH), CH-8603 Schwerzenbach, Switzerland
| | - Salvatore Modica
- Institute of Food Nutrition and Health and Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zürich (ETH), CH-8603 Schwerzenbach, Switzerland
| | - Marcus Höring
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital of Regensburg, 93053 Regensburg, Germany
| | - Gerhard Liebisch
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital of Regensburg, 93053 Regensburg, Germany
| | - Jean-Philippe Krieger
- Department of Metabolic Physiology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Christian Wolfrum
- Institute of Food Nutrition and Health and Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zürich (ETH), CH-8603 Schwerzenbach, Switzerland.
| | - Tenagne D. Challa
- Institute of Food Nutrition and Health and Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zürich (ETH), CH-8603 Schwerzenbach, Switzerland,Corresponding author. Eidgenössische Technische Hochschule Zürich (ETH, Zürich), Department of Health Sciences and Technology, Schorenstrasse 16, CH-8603 Schwerzenbach, Switzerland.
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Drabińska N, Romaszko J, White P. The effect of isocaloric, energy-restrictive, KETOgenic diet on metabolism, inflammation, nutrition deficiencies and oxidative stress in women with overweight and obesity (KETO-MINOX): Study protocol. PLoS One 2023; 18:e0285283. [PMID: 37155645 PMCID: PMC10166534 DOI: 10.1371/journal.pone.0285283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 04/12/2023] [Indexed: 05/10/2023] Open
Abstract
Obesity is considered one of the biggest health problems of the 21st century, becoming a worldwide epidemic, leading to the development of many diseases and increasing the risk of premature death. The first step in reducing body weight is a calorie-restricted diet. To date, there are many different diet types available, including the ketogenic diet (KD) which is recently gaining a lot of attention. However, all the physiological consequences of KD in the human body are not fully understood. Therefore, this study aims to evaluate the effectiveness of an eight-week, isocaloric, energy-restricted, KD as a weight management solution in women with overweight and obesity compared to a standard, balanced diet with the same calorie content. The primary outcome is to evaluate the effects of a KD on body weight and composition. The secondary outcomes are to evaluate the effect of KD-related weight loss on inflammation, oxidative stress, nutritional status, profiles of metabolites in breath, which informs about the metabolic changes in the body, obesity and diabetes-associated parameters, including a lipid profile, status of adipokines and hormones. Notably, in this trial, the long-term effects and efficiency of the KD will be studied. In summary, the proposed study will fill the gap in knowledge about the effects of KD on inflammation, obesity-associated parameters, nutritional deficiencies, oxidative stress and metabolism in a single study. ClinicalTrail.gov registration number: NCT05652972.
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Affiliation(s)
- Natalia Drabińska
- Department of Chemistry and Biodynamics of Food, Institute of Animal Reproduction and Food Research of Polish Academy of Sciences, Olsztyn, Poland
| | - Jerzy Romaszko
- Department of Family Medicine and Infectious Diseases, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Paul White
- Department of Mathematics and Data Science, University of the West of England, Bristol, United Kingdom
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Yu BJ, Oz RS, Sethi S. Ketogenic diet as a metabolic therapy for bipolar disorder: Clinical developments. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023. [DOI: 10.1016/j.jadr.2022.100457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Du Y, Oh C, No J. Effects of the ketogenic diet on components of the metabolic syndrome: A systematic review and meta-analysis. NUTR CLIN METAB 2023. [DOI: 10.1016/j.nupar.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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ERTAL E, ÖZKAYA V. Düşük veya Yüksek Karbonhidratlı Diyetlerin Beyin, Beyin-Bağırsak Aksı ve Bilişsel İşlevler Üzerine Etkisi. İSTANBUL GELIŞIM ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2022. [DOI: 10.38079/igusabder.1140592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
İntestinal mikrobiyota sağlığın korunmasında anahtar bir rol oynamaktadır. Mikrobiyota üzerine önemli etkileri olan beslenme, beyin-bağırsak aksındaki bozuklukları hafifletmek, nöroinflamasyonu ve bilişsel bozulmayı iyileştirmek için büyük önem taşımaktadır. Bağırsak bakterileri, diyetle alınan besin ögelerini kullanarak çeşitli metabolitleri (örn., kısa zincirli yağ asitleri, amino asitler, vitaminler) üretebilme yeteneğine sahiptir. Üretilen bu metabolitler, periferik sinir sistemi, enteroendokrin hücreler ve merkezi sinir sistemine sinyal gönderen immün hücreler aracılığıyla beyin fonksiyonlarını ve bilişsel davranış değişikliğini etkilemektedir. Karbonhidratlar, çoğu durumda intestinal mikrobiyota tarafından substrat olarak kullanılmakta ve fermente edilmektedir. Karbonhidratların bu etkileri kimyasal yapılarına, sindirilmeden kolona ulaşıp ulaşamamalarına ve konağın karbonhidratı enerji kaynağı olarak kullanabilme yeteneğine bağlıdır. Karbonhidratın türü ve miktarı mikrobiyota, beyin bağırsak aksı ve bilişsel işlevlerdeki etkiyi belirleyen ana faktörlerden biridir. Bu derlemede, düşük veya yüksek karbonhidrat içeren diyetlerin beyin-bağırsak aksı ve bilişsel fonksiyonlara olan etkilerinin güncel literatür verileri ışığında değerlendirilmesi amaçlanmıştır.
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Affiliation(s)
- Ezgi ERTAL
- BİRUNİ ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ FAKÜLTESİ, BESLENME VE DİYETETİK BÖLÜMÜ
| | - Volkan ÖZKAYA
- İSTANBUL MEDİPOL ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ FAKÜLTESİ, BESLENME VE DİYETETİK BÖLÜMÜ
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Tao Y, Leng SX, Zhang H. Ketogenic Diet: An Effective Treatment Approach for Neurodegenerative Diseases. Curr Neuropharmacol 2022; 20:2303-2319. [PMID: 36043794 PMCID: PMC9890290 DOI: 10.2174/1570159x20666220830102628] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 06/13/2022] [Accepted: 07/03/2022] [Indexed: 12/29/2022] Open
Abstract
This review discusses the effects and mechanisms of a ketogenic diet on neurodegenerative diseases on the basis of available evidence. A ketogenic diet refers to a high-fat, mediumprotein, and low-carbohydrate diet that leads to a metabolic shift to ketosis. This review systematically summarizes the scientific literature supporting this effective treatment approach for neurodegenerative diseases, including effects on mitochondrial function, oxidative stress, neuronal apoptosis, neuroinflammation, and the microbiota-gut-brain axis. It also highlights the clinical evidence for the effects of the ketogenic diet in the treatment of Alzheimer's disease, Parkinson's disease, and motor neuron disease. Finally, it discusses the common adverse effects of ketogenic therapy. Although the complete mechanism of the ketogenic diet in the treatment of neurodegenerative diseases remains to be elucidated, its clinical efficacy has attracted many new followers. The ketogenic diet is a good candidate for adjuvant therapy, but its specific applicability depends on the type and the degree of the disease.
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Affiliation(s)
- Ye Tao
- Department of Geriatrics, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - Sean X Leng
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, 5501 Hopkins Bayview Circle - Room 1A.38A, Baltimore, MD, 21224, USA
| | - Haiyan Zhang
- Department of Geriatrics, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
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Valinejad A, Khodaei K. Does exercise during a ketogenic diet effectively alter appetite sensation, appetite-regulating hormones, and body composition? Exp Biol Med (Maywood) 2022; 247:1898-1906. [PMID: 35920294 PMCID: PMC9742743 DOI: 10.1177/15353702221113862] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Exercise and diet are two essential interventions in weight control. The purpose of this study was to compare the effectiveness of two exercise training types during a ketogenic diet (KD) on appetite sensation, appetite-regulating hormones, and body composition in overweight or obese man. Thirty-six men, overweight or with obesity, voluntarily participated in this study. The participants were randomly assigned into three groups, including KD (n = 12), aerobic training during KD (AT-KD) (n = 12), and resistance training during KD (RT-KD) (n = 12) groups. The participants followed a low-carbohydrate diet for 6 weeks. Exercise training programs consisted of three sessions per week over 6 weeks. Appetite sensation was analyzed using a visual analogue scale (VAS) in fasting and postprandial states. The Enzyme-Linked Immunosorbent Assay (ELISA) method analyzed appetite-regulating hormones, including spexin, leptin, and acylated ghrelin, in a fasting state. Body composition was measured using bioelectrical impedance analysis (BIA). Furthermore, the ketosis state was monitored by measuring urinary ketones weekly. The results indicated that in both AT-KD and RT-KD groups, spexin and acylated ghrelin increased while leptin decreased without any between-group differences. Hunger and prospective food consumption (PFC) declined while satiety and fullness increased in all groups. The AT-KD group experienced a significant decrease in hunger and PFC, while fullness increased compared with the KD group. Fat mass, weight, and body mass index (BMI) decreased in all groups. Lean body mass increased in the RT-KD group (+2.66 kg) compared with both AT-KD and KD groups (-1.71 and -1.33 kg, respectively). This study demonstrated that AT-KD and RT-KD effectively altered appetite-regulating hormones and suppressed appetite sensation. In addition, both interventions had a favorable effect on weight loss and body fat reduction, with a more pronounced effect of RT-KD on maintaining lean body mass in overweight or obese men.
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Dolan LC, Karikachery AR, Thipe VC, Arceneaux BG, Katti KK, Katti KV, Chesne AM. Toxicity Investigations of (R)-3-Hydroxybutyrate Glycerides In Vitro and in Male and Female Rats. Nutrients 2022; 14:nu14204426. [PMID: 36297110 PMCID: PMC9610502 DOI: 10.3390/nu14204426] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/19/2022] [Accepted: 10/19/2022] [Indexed: 11/05/2022] Open
Abstract
TCN006, a formulation of (R)-3-Hydroxybutyrate glycerides, is a promising ingredient for enhancing ketone intake of humans. Ketones have been shown to have beneficial effects on human health. To be used by humans, TCN006 must be determined safe in appropriately designed safety studies. The results of a bacterial reverse mutation assay, an in vitro mammalian micronucleus study, and 14-and 90-day repeat dose toxicity studies in rats are reported herein. In the 14- and 90-day studies, male and female Wistar rats had free access to drinking water containing 0, 75,000, 125,000 or 200,000 ppm TCN006 for 92 and 93 days, respectively. TCN006 tested negative for genotoxicity and the no observed adverse effect level (NOAEL) for toxicity in the 14- and 90-day studies was 200,000 ppm, the highest dose administered. In the longer term study, the mean overall daily intake of TCN006 in the 200,000 ppm groups was 14,027.9 mg/kg bw/day for males and 20,507.0 mg/kg bw/day for females. At this concentration, palatability of water was likely affected, which led to a decrease in water consumption in both males and females compared to respective controls. This had no effect on the health of the animals. Although the rats were administered very high levels of (R)-3-Hydroxybutyrate glycerides, there were no signs of ketoacidosis.
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Affiliation(s)
- Laurie C. Dolan
- GRAS Associates, LLC., 11810 Grand Park Avenue, Suite 500, North Bethesda, MD 20852, USA
| | - Alice Raphael Karikachery
- Department of Radiology, Institute of Green Nanotechnology, University of Missouri, Columbia, MO 65212, USA
| | - Velaphi C. Thipe
- Department of Radiology, Institute of Green Nanotechnology, University of Missouri, Columbia, MO 65212, USA
| | - Benjamin G. Arceneaux
- GRAS Associates, LLC., 11810 Grand Park Avenue, Suite 500, North Bethesda, MD 20852, USA
| | - Kavita K. Katti
- Department of Radiology, Institute of Green Nanotechnology, University of Missouri, Columbia, MO 65212, USA
| | - Kattesh V. Katti
- Department of Radiology, Institute of Green Nanotechnology, University of Missouri, Columbia, MO 65212, USA
| | - Alton M. Chesne
- Tecton Group, LLC., 370 River Rd., Alexandria, LA 71302, USA
- Correspondence:
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Fakhoury M, Eid F, El Ahmad P, Khoury R, Mezher A, El Masri D, Haddad Z, Zoghbi Y, Ghayad LM, Sleiman SF, Stephan JS. Exercise and Dietary Factors Mediate Neural Plasticity Through Modulation of BDNF Signaling. Brain Plast 2022; 8:121-128. [DOI: 10.3233/bpl-220140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2022] [Indexed: 11/15/2022] Open
Abstract
The term “neural plasticity” was first used to describe non-pathological changes in neuronal structure. Today, it is generally accepted that the brain is a dynamic system whose morphology and function is influenced by a variety of factors including stress, diet, and exercise. Neural plasticity involves learning and memory, the synthesis of new neurons, the repair of damaged connections, and several other compensatory mechanisms. It is altered in neurodegenerative disorders and following damage to the central or peripheral nervous system. Understanding the mechanisms that regulate neural plasticity in both healthy and diseased states is of significant importance to promote cognition and develop rehabilitation techniques for functional recovery after injury. In this minireview, we will discuss the mechanisms by which environmental factors promote neural plasticity with a focus on exercise- and diet-induced factors. We will highlight the known circulatory factors that are released in response to exercise and discuss how all factors activate pathways that converge in part on the activation of BDNF signaling. We propose to harness the therapeutic potential of exercise by using BDNF as a biomarker to identify novel endogenous factors that promote neural plasticity. We also discuss the importance of combining exercise factors with dietary factors to develop a lifestyle pill for patients afflicted by CNS disorders.
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Affiliation(s)
- Marc Fakhoury
- Biological Sciences Program, Lebanese American University, Byblos, Lebanon
| | - Fady Eid
- Biological Sciences Program, Lebanese American University, Byblos, Lebanon
| | - Perla El Ahmad
- Biological Sciences Program, Lebanese American University, Byblos, Lebanon
| | - Reine Khoury
- Biological Sciences Program, Lebanese American University, Byblos, Lebanon
| | - Amar Mezher
- Biological Sciences Program, Lebanese American University, Byblos, Lebanon
| | - Diala El Masri
- Biological Sciences Program, Lebanese American University, Byblos, Lebanon
| | - Zena Haddad
- Biological Sciences Program, Lebanese American University, Byblos, Lebanon
| | - Yara Zoghbi
- Biological Sciences Program, Lebanese American University, Byblos, Lebanon
| | - Litsa Maria Ghayad
- Biological Sciences Program, Lebanese American University, Byblos, Lebanon
| | - Sama F. Sleiman
- Biological Sciences Program, Lebanese American University, Byblos, Lebanon
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Kackley ML, Brownlow ML, Buga A, Crabtree CD, Sapper TN, O’Connor A, Volek JS. The effects of a 6-week controlled, hypocaloric ketogenic diet, with and without exogenous ketone salts, on cognitive performance and mood states in overweight and obese adults. Front Neurosci 2022; 16:971144. [PMID: 36248655 PMCID: PMC9563373 DOI: 10.3389/fnins.2022.971144] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background Ketogenic diets are a commonly used weight loss method, but little is known how variations in sodium content and ketones influence cognition and mood during the early keto-adaptation period. Objectives To investigate the effects of an exogenous ketone salt (KS) as part of a hypocaloric KD on mood and cognitive outcomes in overweight and obese adults. A secondary objective was to evaluate changes in biochemical markers associated with inflammatory and cognitive responses. Materials and methods Adults who were overweight or obese participated in a 6-week controlled-feeding intervention comparing hypocaloric diets (∼75% of energy expenditure). KD groups received twice daily ketone salt (KD + KS; n = 12) or a flavor-matched placebo, free of minerals (KD + PL; n = 13). A separate group of age and BMI matched adults were later assigned to an isoenergetic low-fat diet (LFD; n = 12) as comparison to KD. Mood was assessed by shortened Profile of Mood States and Visual Analog Mood Scale surveys. Cognitive function was determined by the Automated Neuropsychological Assessment Metrics mental test battery. Results Both KD groups achieved nutritional ketosis. Fasting serum glucose decreased in both KD groups, whereas glucose was unaffected in the LFD. Insulin decreased at week 2 and remained lower in all groups. At week 2, depression scores in the KD + PL group were higher compared to KD + KS. Performance in the math processing and go/no-go cognitive tests were lower for KD + PL and LFD participants, respectively, compared to KD + KS. Serum leptin levels decreased for all groups throughout the study but were higher for KD + KS group at week 6. Serum TNF-α steadily increased for LFD participants, reaching significance at week 6. Conclusion During a short-term hypocaloric diet, no indication of a consistent decline in mood or cognitive function were seen in participants following either KD, despite KD + PL being relatively low in sodium. WK2 scores of “anger” and “depression” were higher in the LFD and KD + PL groups, suggesting that KS may attenuate negative mood parameters during the early intervention stages.
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Affiliation(s)
- Madison L. Kackley
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Milene L. Brownlow
- Research and Development Department, Metagenics Inc., Gig Harbor, WA, United States
| | - Alex Buga
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Chris D. Crabtree
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Teryn N. Sapper
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Annalouise O’Connor
- Research and Development Department, Metagenics Inc., Gig Harbor, WA, United States
| | - Jeff S. Volek
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
- *Correspondence: Jeff S. Volek,
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Cecchini AL, Biscetti F, Rando MM, Nardella E, Pecorini G, Eraso LH, Dimuzio PJ, Gasbarrini A, Massetti M, Flex A. Dietary Risk Factors and Eating Behaviors in Peripheral Arterial Disease (PAD). Int J Mol Sci 2022; 23:10814. [PMID: 36142725 PMCID: PMC9504787 DOI: 10.3390/ijms231810814] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 11/17/2022] Open
Abstract
Dietary risk factors play a fundamental role in the prevention and progression of atherosclerosis and PAD (Peripheral Arterial Disease). The impact of nutrition, however, defined as the process of taking in food and using it for growth, metabolism and repair, remains undefined with regard to PAD. This article describes the interplay between nutrition and the development/progression of PAD. We reviewed 688 articles, including key articles, narrative and systematic reviews, meta-analyses and clinical studies. We analyzed the interaction between nutrition and PAD predictors, and subsequently created four descriptive tables to summarize the relationship between PAD, dietary risk factors and outcomes. We comprehensively reviewed the role of well-studied diets (Mediterranean, vegetarian/vegan, low-carbohydrate ketogenic and intermittent fasting diet) and prevalent eating behaviors (emotional and binge eating, night eating and sleeping disorders, anorexia, bulimia, skipping meals, home cooking and fast/ultra-processed food consumption) on the traditional risk factors of PAD. Moreover, we analyzed the interplay between PAD and nutritional status, nutrients, dietary patterns and eating habits. Dietary patterns and eating disorders affect the development and progression of PAD, as well as its disabling complications including major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Nutrition and dietary risk factor modification are important targets to reduce the risk of PAD as well as the subsequent development of MACE and MALE.
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Affiliation(s)
- Andrea Leonardo Cecchini
- Internal Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Federico Biscetti
- Cardiovascular Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Maria Margherita Rando
- Cardiovascular Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Elisabetta Nardella
- Cardiovascular Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Giovanni Pecorini
- Internal Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Luis H. Eraso
- Division of Vascular and Endovascular Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Paul J. Dimuzio
- Division of Vascular and Endovascular Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Antonio Gasbarrini
- Internal Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Massimo Massetti
- Internal Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Andrea Flex
- Internal Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Cardiovascular Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
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Kackley ML, Buga A, Crabtree CD, Sapper TN, McElroy CA, Focht BC, Kraemer WJ, Volek JS. Influence of Nutritional Ketosis Achieved through Various Methods on Plasma Concentrations of Brain Derived Neurotropic Factor. Brain Sci 2022; 12:brainsci12091143. [PMID: 36138878 PMCID: PMC9496887 DOI: 10.3390/brainsci12091143] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 11/29/2022] Open
Abstract
Brain-Derived Neurotropic Factor (BDNF) expression is decreased in conditions associated with cognitive decline as well as metabolic diseases. One potential strategy to improve metabolic health and elevate BDNF is by increasing circulating ketones. Beta-Hydroxybutyrate (BHB) stimulates BDNF expression, but the association of circulating BHB and plasma BDNF in humans has not been widely studied. Here, we present results from three studies that evaluated how various methods of inducing ketosis influenced plasma BDNF in humans. Study 1 determined BDNF responses to a single bout of high-intensity cycling after ingestion of a dose of ketone salts in a group of healthy adults who were habitually consuming either a mixed diet or a ketogenic diet. Study 2 compared how a ketogenic diet versus a mixed diet impacts BDNF levels during a 12-week resistance training program in healthy adults. Study 3 examined the effects of a controlled hypocaloric ketogenic diet, with and without daily use of a ketone-salt, on BDNF levels in overweight/obese adults. We found that (1) fasting plasma BDNF concentrations were lower in keto-adapted versus non keto-adapted individuals, (2) intense cycling exercise was a strong stimulus to rapidly increase plasma BDNF independent of ketosis, and (3) clinically significant weight loss was a strong stimulus to decrease fasting plasma BDNF independent of diet composition or level of ketosis. These results highlight the plasticity of plasma BDNF in response to lifestyle factors but does not support a strong association with temporally matched BHB concentrations.
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Affiliation(s)
- Madison L. Kackley
- Department of Kinesiology, The Ohio State University, Columbus, OH 43210, USA
| | - Alex Buga
- Department of Kinesiology, The Ohio State University, Columbus, OH 43210, USA
| | - Chris D. Crabtree
- Department of Kinesiology, The Ohio State University, Columbus, OH 43210, USA
| | - Teryn N. Sapper
- Department of Kinesiology, The Ohio State University, Columbus, OH 43210, USA
| | - Craig A. McElroy
- Department of Medicinal Chemistry and Pharmacognosy, 06 The Ohio State University, Columbus, OH 43210, USA
| | - Brian C. Focht
- Department of Kinesiology, The Ohio State University, Columbus, OH 43210, USA
| | - William J. Kraemer
- Department of Kinesiology, The Ohio State University, Columbus, OH 43210, USA
| | - Jeff S. Volek
- Department of Kinesiology, The Ohio State University, Columbus, OH 43210, USA
- Correspondence:
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Hu M, Shi Q, Sun S, Hong HI, Zhang H, Qi F, Zou L, Nie J. Effect of a Low-Carbohydrate Diet With or Without Exercise on Anxiety and Eating Behavior and Associated Changes in Cardiometabolic Health in Overweight Young Women. Front Nutr 2022; 9:894916. [PMID: 35873416 PMCID: PMC9298497 DOI: 10.3389/fnut.2022.894916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background The effectiveness of low-carbohydrate diets (LCDs) on weight loss and exercise for improving cardiometabolic fitness have been well documented in the literature, but the effects of LCDs and whether adding exercise to a LCD regime could additionally benefit mental health (e. g., by lowering the level of anxiety) and associated changes in eating behavior are less clear in overweight and obese populations. Therefore, this study aimed to investigate the effects of a 4-week LCD with or without exercise on anxiety and eating behavior, and to explore the associations between changes in the psychological state and physiological parameters (i.e., body composition, aerobic fitness, blood pressure, lipid profile, and metabolic hormones). Methods Seventy-four overweight Chinese women [age: 20.8 ± 3.0 years, body mass index (BMI): 25.3 ± 3.3 kg·m-2] completed the 4-week randomized controlled trial, which included a LCD group (i.e., ~50 g daily carbohydrate intake) with exercise training 5 days/week (LC-EXE, n = 26), a LCD group without exercise training (LC-CON, n = 25) and a control group that did not modify their habitual diets and physical activity (CON, n = 23). Levels of anxiety, eating behavior scores and physiological parameters (i.e., body weight, V̇O2peak, blood pressure, fasting glucose, blood lipids, and serum metabolic hormones including insulin, C-peptide, leptin, and ghrelin) were measured before and after the intervention. Results There were significant reductions in anxiety levels in the LC-EXE compared with the LC-CON group, while no statistical changes were found in eating behaviors in any conditions after the 4-week intervention. Significant reduction in weight (~3.0 kg or 4%, p < 0.01) and decreases in insulin (~30% p < 0.01), C-peptide (~20% p < 0.01), and leptin (~40%, p < 0.01) were found in both LC-CON and LC-EXE groups, but adding exercise to a LCD regime generated no additional effects. There were significant improvements in V̇O2peak (~15% p < 0.01) and anxiety (~25% p < 0.01) in the LC-EXE compared with the LC-CON group, while no statistical differences were found between CON and LC-CON treatments. Further analysis revealed a negative association (r = -0.32, p < 0.01) between changes in levels of anxiety and changes in V̇O2peak in all participates, no other correlations were found between changes in psychological and physiological parameters. Conclusion Although the combination of a LCD and exercise may not induce additional reductions in body weight in overweight young females, exercise could be a useful add-on treatment along with a LCD to improve cardiometabolic health and lower anxiety levels.
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Affiliation(s)
- Mingzhu Hu
- Faculty of Education, University of Macau, Macao, Macao SAR, China
| | - Qingde Shi
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, Macao SAR, China
| | - Shengyan Sun
- Institute of Physical Education, Huzhou University, Huzhou, China
| | - Hin Ieong Hong
- Chan Sui Ki Perpetual Help College, Macao, Macao SAR, China
| | - Haifeng Zhang
- College of Physical Education, Hebei Normal University, Shijiazhuang, China
| | - Fengxue Qi
- Sports, Exercise and Brain Sciences Laboratory, Beijing Sport University, Beijing, China
| | - Liye Zou
- Exercise Psychophysiology Laboratory, Institute of KEEP Collaborative Innovation, School of Psychology, Shenzhen University, Shenzhen, China
| | - Jinlei Nie
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, Macao SAR, China
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Abedelmalek S, Aloui K, Denguezli Bouzgarou M, Adam H, Souissi N, Chtourou H. Exergaming During Ramadan Intermittent Fasting Improve Body Composition as Well as Physiological and Psychological Responses to Physical Exercise in Adolescents With Obesity. Front Nutr 2022; 9:851054. [PMID: 35836586 PMCID: PMC9274190 DOI: 10.3389/fnut.2022.851054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 06/03/2022] [Indexed: 11/24/2022] Open
Abstract
The effects of exergaming on biochemical responses has been investigated; however, no data is available for this effect during Ramadan intermittent fasting (RIF). RIF is a daily fasting characterized by abstaining from eating and drinking from sunrise to sunset for 29-30 days. The purpose of this study was to investigate the effect of exergaming during RIF on body composition, physical performance and hematological parameters in overweight and adolescents with obesity. Twenty-four adolescents with obesity were divided into two groups [control group (CG), n = 12, or cooperative sport exergaming group (EG), n = 12: 45 min per session during five days per week)]. Participants completed a 6-min walking test (6MWT), a squat jump test and a 10 and a 30m sprint tests in four different occasions: before Ramadan (T0), the second week of Ramadan (T1), the fourth week of Ramadan (T2), and after Ramadan (T3). Blood pressure, rating of perceived exertion (RPE), body composition, central obesity index, dietary intake and profile of mood states (POMS) were, also, assessed over the four periods. The results showed that body weight, body mass index and body fat percentage were significantly lower at T2 compared to T0 and T1 in the EG. After RIF, body composition returned to the values recorded before RIF. The POMS score was significantly lower during T2 compared to T0, T1 and T3 in the EG. The vertical jump and the 6MWT distance were significantly higher (i) at T2 compared to T0, T1 and T3 in the EG and (ii) in EG compared to CG at T2. RPE was significantly lower (i) at T2 compared to T0, T1 and T3 in the EG and (ii) in EG compared to CG at T2. Blood pressure was lower during T2 compared to the other periods in EG. The EG experienced significant decreases in total cholesterol and triglycerides during T2. However, no significant changes between groups and periods was reported for all the other parameters. In conclusion, exergaming during RIF has a positive effect on body composition and physiological and psychological responses in adolescents with obesity.
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Affiliation(s)
- Salma Abedelmalek
- Department of Sport Science and Physical Activity, College of Education, University of Ha'il, Ha'il, Saudi Arabia
- Laboratory of Physiology and Functional Explorations, Faculty of Medicine, Sousse, Tunisia
| | - Khouloud Aloui
- High Institute of Sport and Physical Education, Ksar-Saïd, Manouba University, Manouba, Tunisia
| | | | - Halima Adam
- Department of Psychology, College of Education, University of Ha'il, Ha'il, Saudi Arabia
| | - Nizar Souissi
- Department of Psychology, College of Education, University of Ha'il, Ha'il, Saudi Arabia
- Research Unit: Physical Activity, Sport, and Health (UR18JS01), National Observatory of Sports, Tunis, Tunisia
| | - Hamdi Chtourou
- Research Unit: Physical Activity, Sport, and Health (UR18JS01), National Observatory of Sports, Tunis, Tunisia
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
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Abstract
Obesity remains a serious relevant public health concern throughout the world despite related countermeasures being well understood (i.e. mainly physical activity and an adjusted diet). Among different nutritional approaches, there is a growing interest in ketogenic diets (KD) to manipulate body mass (BM) and to enhance fat mass loss. KD reduce the daily amount of carbohydrate intake drastically. This results in increased fatty acid utilisation, leading to an increase in blood ketone bodies (acetoacetate, 3-β-hydroxybutyrate and acetone) and therefore metabolic ketosis. For many years, nutritional intervention studies have focused on reducing dietary fat with little or conflicting positive results over the long term. Moreover, current nutritional guidelines for athletes propose carbohydrate-based diets to augment muscular adaptations. This review discusses the physiological basis of KD and their effects on BM reduction and body composition improvements in sedentary individuals combined with different types of exercise (resistance training or endurance training) in individuals with obesity and athletes. Ultimately, we discuss the strengths and the weaknesses of these nutritional interventions together with precautionary measures that should be observed in both individuals with obesity and athletic populations. A literature search from 1921 to April 2021 using Medline, Google Scholar, PubMed, Web of Science, Scopus and Sportdiscus Databases was used to identify relevant studies. In summary, based on the current evidence, KD are an efficient method to reduce BM and body fat in both individuals with obesity and athletes. However, these positive impacts are mainly because of the appetite suppressive effects of KD, which can decrease daily energy intake. Therefore, KD do not have any superior benefits to non-KD in BM and body fat loss in individuals with obesity and athletic populations in an isoenergetic situation. In sedentary individuals with obesity, it seems that fat-free mass (FFM) changes appear to be as great, if not greater, than decreases following a low-fat diet. In terms of lean mass, it seems that following a KD can cause FFM loss in resistance-trained individuals. In contrast, the FFM-preserving effects of KD are more efficient in endurance-trained compared with resistance-trained individuals.
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Swimming Suppresses Cognitive Decline of HFD-Induced Obese Mice through Reversing Hippocampal Inflammation, Insulin Resistance, and BDNF Level. Nutrients 2022; 14:nu14122432. [PMID: 35745162 PMCID: PMC9228449 DOI: 10.3390/nu14122432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/04/2022] [Accepted: 06/06/2022] [Indexed: 02/01/2023] Open
Abstract
Obesity is an important public health problem nowadays. Long-term obesity can trigger a series of chronic diseases and impair the learning and memory function of the brain. Current studies show that scientific exercise can effectively improve learning and memory capacity, which also can provide benefits for obese people. However, the underlying mechanisms for the improvement of cognitive capacity under the status of obesity still need to be further explored. In the present study, the obesity-induced cognition-declined model was established using 4-week-old mice continuously fed with a high-fat diet (HFD) for 12 weeks, and then the model mice were subjected to an 8-week swimming intervention and corresponding evaluation of relevant indicators, including cognitive capacity, inflammation, insulin signal pathway, brain-derived neurotrophic factor (BNDF), and apoptosis, for exploring potential regulatory mechanisms. Compared with the mice fed with regular diets, the obese mice revealed the impairment of cognitive capacity; in contrast, swimming intervention ameliorated the decline in cognitive capacity of obese mice by reducing inflammatory factors, inhibiting the JNK/IRS-1/PI3K/Akt signal pathway, and activating the PGC-1α/BDNF signal pathway, thereby suppressing the apoptosis of neurons. Therefore, swimming may be an important interventional strategy to compensate for obesity-induced cognitive impairment.
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