Research progress of the ketogenic diet for treatment of heart diseases
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摘要:
生酮饮食作为新型饮食辅助治疗心脏疾病的研究方向之一, 具有改善危险因素、抑制心室重构、保护心脏等优势。本综述归纳整理生酮饮食对心脏疾病及处于心血管危险因素状态作用的研究成果, 从多角度阐述心脏相关作用机制, 分析其在减少心血管疾病危险因素、治疗心脏相关疾病等方面的积极影响, 总结了生酮饮食的不良反应与禁忌证, 为心脏疾病的预防和治疗提供新思路。
Abstract:As one of the research directions of novel dietary adjuvant treatment for heart diseases, ketogenic diet has the advantages of improving risk factors, inhibiting ventricular remodeling, and protecting the heart. This paper reviews and summarizes the research achievements of the effect of ketogenic diet on heart diseases and cardiovascular risk factors, elaborates the heart-related mechanism from multiple perspectives, analyzes its positive impacts on reducing cardiovascular disease risk factors and treating heart-related diseases, and summarizes the adverse reactions and contraindications of ketogenic diet, so as to provide new ideas for the prevention and treatment of heart diseases.
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Keywords:
- ketogenic diet /
- heart diseases /
- dietary therapy /
- mechanism /
- risk factors
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[1] 阿丽娅, 李子华, 吕金艳, 等. 小分子, 大作为: 酮体D-β羟基丁酸在医疗领域的应用与展望[J]. 生物工程学报, 2022, 38(3): 976-989. https://www.cnki.com.cn/Article/CJFDTOTAL-SHWU202203010.htm [2] 江波, 邹大进, 马向华, 等. 生酮饮食干预2型糖尿病中国专家共识(2019年版)[J]. 实用临床医药杂志, 2019, 23(3): 1-6. https://www.cnki.com.cn/Article/CJFDTOTAL-XYZL201903001.htm [3] NAKAMURA M, ODANOVIC N, NAKADA Y, et al. Dietary carbohydrates restriction inhibits the development of cardiac hypertrophy and heart failure[J]. Cardiovasc Res, 2021, 117(11): 2365-2376. doi: 10.1093/cvr/cvaa298
[4] GUO Y Z, WANG X W, JIA P, et al. Ketogenic diet aggravates hypertension via NF-κB-mediated endothelial dysfunction in spontaneously hypertensive rats[J]. Life Sci, 2020, 258: 118124. doi: 10.1016/j.lfs.2020.118124
[5] GUO Y Z, ZHANG C, SHANG F F, et al. Ketogenic diet ameliorates cardiac dysfunction via balancing mitochondrial dynamics and inhibiting apoptosis in type 2 diabetic mice[J]. Aging Dis, 2020, 11(2): 229-240. doi: 10.14336/AD.2019.0510
[6] 刘志强, 崔利德. 生酮饮食对兔心肌缺血再灌注损伤的保护[J]. 职业与健康, 2011, 27(15): 1736-1737. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJK201115028.htm [7] SNOREK M, HODYC D, SEDIVY V, et al. Short-term fasting reduces the extent of myocardial infarction and incidence of reperfusion arrhythmias in rats[J]. Physiol Res, 2012, 61(6): 567-574.
[8] ZOU Z T, SASAGURI S, RAJESH K G, et al. Dl-3-Hydroxybutyrate administration prevents myocardial damage after coronary occlusion in rat hearts[J]. Am J Physiol Heart Circ Physiol, 2002, 283(5): H1968-H1974. doi: 10.1152/ajpheart.00250.2002
[9] AL-ZAID N S, DASHTI H M, MATHEW T C, et al. Low carbohydrate ketogenic diet enhances cardiac tolerance to global ischaemia[J]. Acta Cardiol, 2007, 62(4): 381-389. doi: 10.2143/AC.62.4.2022282
[10] 董爱巧, 张晓亮, 林思朴, 等. β-羟基丁酸抑制细胞焦亡减轻心肌缺血再灌注损伤[J]. 心脏杂志, 2022, 34(1): 12-17. https://www.cnki.com.cn/Article/CJFDTOTAL-XGNZ202201003.htm [11] TAGGART A K, KERO J, GAN X D, et al. (D)-beta-Hydroxybutyrate inhibits adipocyte lipolysis via the nicotinic acid receptor PUMA-G[J]. J Biol Chem, 2005, 280(29): 26649-26652. doi: 10.1074/jbc.C500213200
[12] GUO Y Z, WANG Z, QIN X H, et al. Enhancing fatty acid utilization ameliorates mitochondrial fragmentation and cardiac dysfunction via rebalancing optic atrophy 1 processing in the failing heart[J]. Cardiovasc Res, 2018, 114(7): 979-991. doi: 10.1093/cvr/cvy052
[13] DUDA M K, O'SHEA K M, LEI B, et al. Low-carbohydrate/high-fat diet attenuates pressure overload-induced ventricular remodeling and dysfunction[J]. J Card Fail, 2008, 14(4): 327-335. doi: 10.1016/j.cardfail.2007.11.003
[14] CHONG D Y, GU Y Y, ZHANG T Y, et al. Neonatal ketone body elevation regulates postnatal heart development by promoting cardiomyocyte mitochondrial maturation and metabolic reprogramming[J]. Cell Discov, 2022, 8(1): 106. doi: 10.1038/s41421-022-00447-6
[15] TAN Y Z, LI M, WU G L, et al. Short-term but not long-term high fat diet feeding protects against pressure overload-induced heart failure through activation of mitophagy[J]. Life Sci, 2021, 272: 119242. doi: 10.1016/j.lfs.2021.119242
[16] JI L W, HE Q Q, LIU Y H, et al. Ketone body β-hydroxybutyrate prevents myocardial oxidative stress in septic cardiomyopathy[J]. Oxid Med Cell Longev, 2022, 2022: 2513837.
[17] ZHU H Y, BI D X, ZHANG Y H, et al. Ketogenic diet for human diseases: the underlying mechanisms and potential for clinical implementations[J]. Signal Transduct Target Ther, 2022, 7(1): 11. doi: 10.1038/s41392-021-00831-w
[18] BINOBEAD M A, ALDAKHILALLAH A H, ALSEDAIRY S A, et al. Effect of low-carbohydrate diet on beta-hydroxybutyrate ketogenesis metabolic stimulation and regulation of NLRP3 ubiquitination in obese Saudi women[J]. Nutrients, 2023, 15(4): 820. doi: 10.3390/nu15040820
[19] IVAN C R, MESSINA A, CIBELLI G, et al. Italian ketogenic Mediterranean diet in overweight and obese patients with prediabetes or type 2 diabetes[J]. Nutrients, 2022, 14(20): 4361. doi: 10.3390/nu14204361
[20] ZHOU C, WANG M, LIANG J L, et al. Ketogenic diet benefits to weight loss, glycemic control, and lipid profiles in overweight patients with type 2 diabetes mellitus: a meta-analysis of randomized controlled trails[J]. Int J Environ Res Public Health, 2022, 19(16): 10429. doi: 10.3390/ijerph191610429
[21] FALKENHAIN K, ROACH L A, MCCREARY S, et al. Effect of carbohydrate-restricted dietary interventions on LDL particle size and number in adults in the context of weight loss or weight maintenance: a systematic review and meta-analysis[J]. Am J Clin Nutr, 2021, 114(4): 1455-1466. doi: 10.1093/ajcn/nqab212
[22] SCHAEFER E J, IKEZAKI H, DIFFENDERFER M R, et al. Atherosclerotic cardiovascular disease risk and small dense low-density lipoprotein cholesterol in men, women, African Americans and non-African Americans: The pooling project[J]. Atherosclerosis, 2023, 367: 15-23. doi: 10.1016/j.atherosclerosis.2023.01.015
[23] LIOU L, KAPTOGE S. Association of small, dense LDL-cholesterol concentration and lipoprotein particle characteristics with coronary heart disease: a systematic review and meta-analysis[J]. PLoS One, 2020, 15(11): e0241993. doi: 10.1371/journal.pone.0241993
[24] DURAN E K, ADAY A W, COOK N R, et al. Triglyceride-rich lipoprotein cholesterol, small dense LDL cholesterol, and incident cardiovascular disease[J]. J Am Coll Cardiol, 2020, 75(17): 2122-2135. doi: 10.1016/j.jacc.2020.02.059
[25] QI Y, LIU J, WANG W, et al. High sdLDL cholesterol can be used to reclassify individuals with low cardiovascular risk for early intervention: findings from the Chinese multi-provincial cohort study[J]. J Atheroscler Thromb, 2020, 27(7): 695-710. doi: 10.5551/jat.49841
[26] ATHINARAYANAN S J, HALLBERG S J, MCKENZIE A L, et al. Impact of a 2-year trial of nutritional ketosis on indices of cardiovascular disease risk in patients with type 2 diabetes[J]. Cardiovasc Diabetol, 2020, 19(1): 208. doi: 10.1186/s12933-020-01178-2
[27] KEMPER M F, SRIVASTAVA S, TODD KING M, et al. An ester of β-hydroxybutyrate regulates cholesterol biosynthesis in rats and a cholesterol biomarker in humans[J]. Lipids, 2015, 50(12): 1185-1193. doi: 10.1007/s11745-015-4085-x
[28] MICHALCZYK M M, KLONEK G, MASZCZYK A, et al. The effects of a low calorie ketogenic diet on glycaemic control variables in hyperinsulinemic overweight/obese females[J]. Nutrients, 2020, 12(6): 1854. doi: 10.3390/nu12061854
[29] LIM E L, HOLLINGSWORTH K G, ARIBISALA B S, et al. Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol[J]. Diabetologia, 2011, 54(10): 2506-2514. doi: 10.1007/s00125-011-2204-7
[30] 郭琴. 生酮饮食对超重/肥胖症患者影响效果的meta分析[D]. 太原: 山西医科大学, 2021. [31] GE L, SADEGHIRAD B, BALL G D C, et al. Comparison of dietary macronutrient patterns of 14 popular named dietary programmes for weight and cardiovascular risk factor reduction in adults: systematic review and network meta-analysis of randomised trials[J]. BMJ, 2020, 369: m696.
[32] 张耀元, AYAZ ALI SAMO, 桂庆军, 等. 生酮饮食改善糖尿病心肌病的机制研究进展[J]. 江苏大学学报: 医学版, 2021, 31(3): 196-199. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJYZ202103003.htm [33] OKA S I, TANG F, CHIN A, et al. β-hydroxybutyrate, a ketone body, potentiates the antioxidant defense via thioredoxin 1 upregulation in cardiomyocytes[J]. Antioxidants, 2021, 10(7): 1153. doi: 10.3390/antiox10071153
[34] NIELSEN R, MØLLER N, GORMSEN L C, et al. Cardiovascular effects of treatment with the ketone body 3-hydroxybutyrate in chronic heart failure patients[J]. Circulation, 2019, 139(18): 2129-2141. doi: 10.1161/CIRCULATIONAHA.118.036459
[35] BYRNE N J, SONI S, TAKAHARA S, et al. Chronically elevating circulating ketones can reduce cardiac inflammation and blunt the development of heart failure[J]. Circ Heart Fail, 2020, 13(6): e006573. doi: 10.1161/CIRCHEARTFAILURE.119.006573
[36] WEIS E M, PUCHALSKA P, NELSON A B, et al. Ketone body oxidation increases cardiac endothelial cell proliferation[J]. EMBO Mol Med, 2022, 14(4): e14753. doi: 10.15252/emmm.202114753
[37] MARUSIC T, TANSEK M Z, CAMPA A S, et al. Data highlighting effects of Ketogenic diet on cardiomyopathy and hepatopathy in Glycogen storage disease Type ⅢA[J]. Data Brief, 2020, 32: 106205. doi: 10.1016/j.dib.2020.106205
[38] FRANCINI-PESENTI F, TRESSO S, VITTURI N. Modified Atkins ketogenic diet improves heart and skeletal muscle function in glycogen storage disease type Ⅲ[J]. Acta Myol, 2019, 38(1): 17-20.
[39] DEBERLES E, MARAGNES P, PENNIELLO-VALETTE M J, et al. Reversal of cardiac hypertrophy with a ketogenic diet in a child with mitochondrial disease and hypertrophic cardiomyopathy[J]. Can J Cardiol, 2020, 36(10): 1690. e1-1690. e3.
[40] NUWAYLATI D, ELDAKHAKHNY B, BIMA A, et al. Low-carbohydrate high-fat diet: a SWOC analysis[J]. Metabolites, 2022, 12(11): 1126.
[41] RAIMONDO D D, BUSCEMI S, MUSIARI G, et al. Ketogenic diet, physical activity, and hypertension-a narrative review[J]. Nutrients, 2021, 13(8): 2567.
[42] OH S W, WOOD A C, HWANG S S, et al. Racial and ethnic differences in the association of low-carbohydrate diet with mortality in the multi-ethnic study of atherosclerosis[J]. JAMA Netw Open, 2022, 5(10): e2237552.
[43] 薛长勇, 刘英华, 王觐, 等. 中长链脂肪酸食用油对高甘油三酯血症患者脂代谢的影响[J]. 营养学报, 2008, 30(4): 363-368. https://www.cnki.com.cn/Article/CJFDTOTAL-YYXX200804014.htm [44] KALAFUT K C, MITCHELL S J, MACARTHUR M R, et al. Short-term ketogenic diet induces a molecular response that is distinct from dietary protein restriction[J]. Front Nutr, 2022, 9: 839341.
[45] ZHANG Y F, XU J W, ZHANG K, et al. The anticonvulsant effects of ketogenic diet on epileptic seizures and potential mechanisms[J]. Curr Neuropharmacol, 2018, 16(1): 66-70.
[46] 岳月仪, 韩晓菁, 鲁燕. 生酮饮食的利与弊[J]. 实用临床医药杂志, 2023, 27(4): 123-126, 132. doi: 10.7619/jcmp.20222300 [47] TAN Y Z, LI M, WU G L, et al. Short-term but not long-term high fat diet feeding protects against pressure overload-induced heart failure through activation of mitophagy[J]. Life Sci, 2021, 272: 119242.
[48] HOLLOWAY C J, COCHLIN L E, EMMANUEL Y, et al. A high-fat diet impairs cardiac high-energy phosphate metabolism and cognitive function in healthy human subjects[J]. Am J Clin Nutr, 2011, 93(4): 748-755.
[49] TAO J, CHEN H, WANG Y J, et al. Ketogenic diet suppressed T-regulatory cells and promoted cardiac fibrosis via reducing mitochondria-associated membranes and inhibiting mitochondrial function[J]. Oxid Med Cell Longev, 2021, 2021: 5512322.
[50] XU S, TAO H, CAO W, et al. Ketogenic diets inhibit mitochondrial biogenesis and induce cardiac fibrosis[J]. Signal Transduct Target Ther, 2021, 6(1): 54.
[51] 江波. 生酮减脂法[J]. 肿瘤代谢与营养电子杂志, 2017, 4(3): 263-266. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLDX201703004.htm [52] 裴陈琳, 鲁丁强, 庞广昌. 生酮饮食(KD)在临床营养辅助治疗中的研究进展[J]. 食品工业科技, 2022, 8(16): 467-475. https://www.cnki.com.cn/Article/CJFDTOTAL-SPKJ202216056.htm -
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