케토제닉 다이어트(저탄수화물 고지방식)의 치료효과

[문형철]

beyond reason

chapter 14. 저탄수화물 고지방식의 치료효과

에릭 웨스터먼

'무지에서 비롯된 오해는 공포를 낳는다. 저탄수화물 고지방식이는 1980년대부터 2002년까지 이 주제를 연구하는 것은 금기시 되어옴. 하지만 지난 20년간 이 식이요법은 엄청난 연구가 진행되었고 놀라운 치료효과를 보이기 시작함'

테리 휠 다발성경화증 완치

데일 브레드슨 알츠하이머 치매 완치

토마스 사이프리드의 암세포 굶기기 치유법

모두 케토제닉 다이어트를 기반으로 시작함. 

1) 뇌전증(epilepsy)

저탄수화물 고지방 케토제닉 다이어트는 19세기 초반 간질치료법으로 재발견됨. 

2) 제 2형 당뇨병

수만년동안 인간의 식단에 탄수화물이 포함되지 않았다는 사실을 고려하면 당뇨병 치료를 위한 저탄수화물, 고지방식단에 공포심을 갖는 것은 말이 되지 않음. 1800년대와 1920년까지 저탄수화물, 고지방식단이 당뇨병 치료의 기본이었음. 

1921년 인슐린이 발견된 이후 ...

론 로즈데일(의사)

'많은 수의 2형 당뇨병 환자들이 케토제닉 다이어트로 당뇨약을 끊어도 될 정도로 회복됨'

Low-Carb and Ketogenic Diets in Type 1 and Type 2 Diabetes

Andrea Mario Bolla, Amelia Caretto, [...], and Lorenzo Piemonti

Additional article information

Abstract

Low-carb and ketogenic diets are popular among clinicians and patients, but the appropriateness of reducing carbohydrates intake in obese patients and in patients with diabetes is still debated. Studies in the literature are indeed controversial, possibly because these diets are generally poorly defined; this, together with the intrinsic complexity of dietary interventions, makes it difficult to compare results from different studies. Despite the evidence that reducing carbohydrates intake lowers body weight and, in patients with type 2 diabetes, improves glucose control, few data are available about sustainability, safety and efficacy in the long-term. In this review we explored the possible role of low-carb and ketogenic diets in the pathogenesis and management of type 2 diabetes and obesity. Furthermore, we also reviewed evidence of carbohydrates restriction in both pathogenesis of type 1 diabetes, through gut microbiota modification, and treatment of type 1 diabetes, addressing the legitimate concerns about the use of such diets in patients who are ketosis-prone and often have not completed their growth.

Keywords: carbohydrates, ketogenic, diabetes, dietary patterns, nutritional intervention

3) 체중감량

윌리엄 데이비스(의사)

케토제닉 다이어트의 체중감량 효과는 탄수화물 제한만으로 얻어지는 감량효과를 넘어섬. 케톤상태가 되면 포만감이 증가하고 정신이 또렷해지며 집중력과 집중시간이 향상되고 기운이 나기 때문임.

앳킨스 박사의 '앳킨스 박사의 다이어트 혁명'에서 수많은 사람들이 체중감량에 성공함. 

4) 혈관질환과 대사증후군

론 로즈데일

'20년 넘게 저탄수화물, 고지방식단을 이용해서 매우 중한 당뇨병, 심혈관 질환을 치료해 왔음. 이 식이요법을 이용해서 당뇨병, 심혈관질환, 비만환자들이 거의 모두 크게 호전됨'

Effects of Ketogenic Diets on Cardiovascular Risk Factors: Evidence from Animal and Human Studies

Christophe Kosinski and François R. Jornayvaz

Additional article information

Abstract

The treatment of obesity and cardiovascular diseases is one of the most difficult and important challenges nowadays. Weight loss is frequently offered as a therapy and is aimed at improving some of the components of the metabolic syndrome. Among various diets, ketogenic diets, which are very low in carbohydrates and usually high in fats and/or proteins, have gained in popularity. Results regarding the impact of such diets on cardiovascular risk factors are controversial, both in animals and humans, but some improvements notably in obesity and type 2 diabetes have been described. Unfortunately, these effects seem to be limited in time. Moreover, these diets are not totally safe and can be associated with some adverse events. Notably, in rodents, development of nonalcoholic fatty liver disease (NAFLD) and insulin resistance have been described. The aim of this review is to discuss the role of ketogenic diets on different cardiovascular risk factors in both animals and humans based on available evidence.

Keywords: ketogenic diets, obesity, NAFLD, fibroblast growth factor (FGF21), insulin resistance, type 2 diabetes, cardiovascular risk factors

5) 다낭성 난소증후군(PCOS, polycystic ovary syndrome)

가임기 여성에게 흔한 불임의 원인 질환이며 흔한 호르몬 장애임. 불규칙한 생리, 무월경, 과도한 체모, 비만, 2형당뇨병이 함께 나타남. PCOS는 흔히 인슐린 저항성을 동반함. 

The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: A pilot study

John C Mavropoulos, William S Yancy, [...], and Eric C Westman

Additional article information

Abstract

Background

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age and is associated with obesity, hyperinsulinemia, and insulin resistance. Because low carbohydrate diets have been shown to reduce insulin resistance, this pilot study investigated the six-month metabolic and endocrine effects of a low-carbohydrate, ketogenic diet (LCKD) on overweight and obese women with PCOS.

Results

Eleven women with a body mass index >27 kg/m2 and a clinical diagnosis of PCOS were recruited from the community. They were instructed to limit their carbohydrate intake to 20 grams or less per day for 24 weeks. Participants returned every two weeks to an outpatient research clinic for measurements and reinforcement of dietary instruction. In the 5 women who completed the study, there were significant reductions from baseline to 24 weeks in body weight (-12%), percent free testosterone (-22%), LH/FSH ratio (-36%), and fasting insulin (-54%). There were non-significant decreases in insulin, glucose, testosterone, HgbA1c, triglyceride, and perceived body hair. Two women became pregnant despite previous infertility problems.

Conclusion

In this pilot study, a LCKD led to significant improvement in weight, percent free testosterone, LH/FSH ratio, and fasting insulin in women with obesity and PCOS over a 24 week period.

6) 과민성 대장증후군

설사형과 변비형이 있는데 저탄수화물 고지방식이를 하면 처음에는 설사가 더 심해짐. 하지만 얼마안가서 증상은 곧 회복됨

The Impact of Low-FODMAPs, Gluten-Free, and Ketogenic Diets on Gut Microbiota Modulation in Pathological Conditions

Sofia Reddel, Lorenza Putignani, and Federica Del Chierico

Additional article information

Abstract

The gut microbiota performs several essential protective, structural, and metabolic functions for host health. The maintenance of a beneficial microbiota requires a homeostatic equilibrium within microbial communities, and between the microorganisms and the host. The gut microbiota composition may be affected by external factors, among them diet habits may be considered most important. In some pathological conditions such as irritable bowel syndrome (IBS), celiac disease (CD), or neurological disorders (ND), specific dietary regimens as low-fermentable, oligo-, di-, mono-saccharides and polyols (FODMAPs), ketogenic (KD), and gluten-free (GFD) diets are considered therapeutic. These kinds of diets are characterized by a reduction or exclusion of a specific nutrient from the entire dietary pattern. Despite these alimentary regimens showing beneficial effects on disease symptoms, they can affect microbiota composition, especially if they are protracted for a long time. To date, only a few studies have reported the effects of these diets on gut microbiota. In this review, we discuss the effects of low-FODMAPs, KD, and GFD on gut microbiota modulation in pathological conditions, advancing the possibility of depicting a balanced diet and developing personalized dietary intervention protocols.

7) 위식도 역류와 속쓰림

위식도역류는 미국인의 20-30%가 적어도 일주일에 한번씩 경험하는 흔한 질환임. 통곡물과 당분은 위식도 역류의 흔한 원인임. 1주일이내에 케토제닉 다이어트로 증상이 바로 개선됨. 

수많은 환자들이 넥시움과 같은 위산분비억제제를 복용하고 있는데 ... 간단한 식습관만 바꾸면 해결됨.

The Effect of Dietary Carbohydrate on Gastroesophageal Reflux Disease

Keng-Liang Wu 1, Chung-Mou Kuo 2, Chih-Chien Yao 3, Wei-Chen Tai 2, Seng-Kee Chuah 2, Chee-Sang Lim 4, Yi-Chun Chiu 5

Affiliations expand

• PMID: 29339035
 
• DOI: 10.1016/j.jfma.2017.11.001

Abstract

Background: Acid changes in gastroesophageal reflux with vary component in the food have less been studied, especially carbohydrate. We plan to clarify the effect of different carbohydrate density on low esophageal acid and reflux symptoms of patients with gastroesophgeal reflux disease.

Methods: Twelve patients (52 ± 12 years old; five female) with gastroesophageal reflux disease were recruited for the prospective crossover study. Each patient was invited for panendoscope, manometry and 24 h pH monitor. The two formulated liquid meal, test meal A: 500 ml liquid meal (containing 84.8 g carbohydrate) and B: same volume liquid meal (but 178.8 g carbohydrate) were randomized supplied as lunch or dinner. Reflux symptoms were recorded.

Results: There are significant statistic differences in more Johnson-DeMeester score (p = 0.019), total reflux time (%) (p = 0.028), number of reflux periods (p = 0.026) and longest reflux (p = 0.015) after high carbohydrate diet than low carbohydrate. Total reflux time and number of long reflux periods more than 5 min are significant more after high carbohydrate diet.

Conclusion: More acid reflux symptoms are found after high carbohydrate diet. High carbohydrate diet could induce more acid reflux in low esophagus and more reflux symptoms in patients with gastroesophageal reflux disease.

Keywords: Ambulatory esophageal pH monitoring; Carbohydrate; Diet; Esophagitis; Gastroesophgeal reflux disease.

A Very Low-Carbohydrate Diet Improves Gastroesophageal Reflux and Its Symptoms

Gregory L Austin 1, Michelle T Thiny, Eric C Westman, William S Yancy Jr, Nicholas J Shaheen

Affiliations expand

• PMID: 16871438
 
• DOI: 10.1007/s10620-005-9027-7

Abstract

Obese patients with gastroesophageal reflux disease (GERD) may experience resolution of symptoms utilizing a very low-carbohydrate diet. The mechanism of this improvement is unknown. This studied aimed to prospectively assess changes in distal esophageal acid exposure and GERD symptoms among obese adults initiating a very low-carbohydrate diet. We studied obese individuals with GERD initiating a diet containing less than 20 g/day of carbohydrates. Symptom severity was assessed using the GERD Symptom Assessment Scale--Distress Subscale (GSAS-ds). Participants underwent 24-hr esophageal pH probe testing and initiated the diet upon its completion. Within 6 days, a second pH probe test was performed. Outcomes included changes in the Johnson-DeMeester score, percentage total time with a pH<4 in the distal esophagus, and GSAS-ds scores. Eight participants were enrolled. Mean Johnson-DeMeester score decreased from 34.7 to 14.0 (P=0.023). Percentage time with pH<4 decreased from 5.1% to 2.5% (P=0.022). Mean GSAS-ds score decreased from 1.28 to 0.72 (P=0.0004). These data suggest that a very low-carbohydrate diet in obese individuals with GERD significantly reduces distal esophageal acid exposure and improves symptoms.

8) 비알콜성 지방간

간의 지방은 탄수화물때문에 발생함. 간은 음식으로 섭취한 탄수화물을 중성지방이라는 혈중지방으로 바꿔 간에 저장함. 

저탄수화물 고지방식이를 하면 지방간이 금세 호전됨. 

The effect of a low-carbohydrate, ketogenic diet on nonalcoholic fatty liver disease: a pilot study.

Published

Journal Article

Nonalcoholic fatty liver disease is an increasingly common condition that may progress to hepatic cirrhosis. This pilot study eval‎uated the effects of a low-carbohydrate, ketogenic diet on obesity-associated fatty liver disease. Five patients with a mean body mass index of 36.4 kg/m(2) and biopsy evidence of fatty liver disease were instructed to follow the diet (<20 g/d of carbohydrate) with nutritional supplementation for 6 months. Patients returned for group meetings biweekly for 3 months, then monthly for the second 3 months. The mean weight change was -12.8 kg (range 0 to -25.9 kg). Four of 5 posttreatment liver biopsies showed histologic improvements in steatosis (P=.02) inflammatory grade (P=.02), and fibrosis (P=.07). Six months of a low-carbohydrate, ketogenic diet led to significant weight loss and histologic improvement of fatty liver disease. Further research is into this approach is warranted.

9) 알츠하이머 치매, 파킨슨병

데이비드 펄머터(의사)

알츠하이머 환자가 케톤이 많으면 인지기능이 향상된다고 밝혀져 FDA에서는 케톤생성을 늘리는 식품을알츠하이머 치료하는 의료식품으로 승인함

인간의 뇌가 적절하게 기능하려면 지방과 콜레스테롤이 필요함. 저탄수화물 고지방식이로 케톤이 생성되면 뇌는 대부분의 에너지를 케톤체에서 얻음. 케톤이 생성되면 만성염증수준이 낮아지고 인슐린 생성이 감소함. 

알츠하이머병이 더 진행되는 것을 막기 위해 실시하는 저탄수화물, 고지방 식단이 이론적으로 근거가 확실한 이유는 글루텐과 탄수화물로 인한 염증과 고혈당이 알츠하이머 병에 일조하기 때문임. 

Axona라는 의료식품이 개발됨

A Brief Review of Caprylidene (Axona) and Coconut Oil as Alternative Fuels in the Fight Against Alzheimer's Disease

Monica Chintapenta 1, Justin Spence, Hyanggi Irene Kwon, Amie Taggart Blaszczyk

Affiliations expand

• PMID: 29467067
 
• DOI: 10.4140/TCP.n.2017.748

Abstract

Type 3 diabetes mellitus has been coined to describe an alternative pathologic pathway of Alzheimer's disease (AD). The insulin resistance and impaired insulin signaling seen on positron-emission tomography scans in the brain of those affected by AD support this disease hypothesis. Two products-the medical food caprylidene (Axona) and coconut oil-seek to target the underlying pathology of type 3 diabetes mellitus by providing an alternative fuel source in the brain. Rather than improving glucose utilization, these two products seek to supply ketone bodies in sufficient quantities to pass through the blood-brain barrier and provide an alternative energy source to glucose. This review will provide an overview of the research behind these two modalities, as well as information necessary to ensure the safe use of these supplements.

메리 뉴포트(의사)

데일 브레드슨 알츠하이머 치매치료법 논문 발표

10) 조현병, 양극성 장애, 자폐증 등

브라이언 빅스데일(신경과학자)

'신경과학자로서 나는 케톤상태의 유익한 측면중에서 인지 기능개선이 가장 흥미롭다고 생각한다. 케톤상태에서는 단기기억, 언어기억, 기분과 같은 것들이 모두 향상된다. 케톤은 신경을 보호하는 기능이 있는데 이는 뇌세포를 보호하다는 의미다. 케톤은 깨끗하게 연소하는 연료원을 제공하고 항산화 물질을 증가시키며 염증을 줄인다'

A Ketogenic Diet Improves Cognition and Has Biochemical Effects in Prefrontal Cortex That Are Dissociable From Hippocampus

Abbi R. Hernandez, Caesar M. Hernandez, [...], and Sara N. Burke

Additional article information

Abstract

Age-related cognitive decline has been linked to a diverse set of neurobiological mechanisms, including bidirectional changes in proteins critical for neuron function. Importantly, these alterations are not uniform across the brain. For example, the hippocampus (HPC) and prefrontal cortex (PFC) show distinct patterns of dysfunction in advanced age. Because higher cognitive functions require large–scale interactions across prefrontal cortical and hippocampal networks, selectively targeting an alteration within one region may not broadly restore function to improve cognition. One mechanism for decline that the PFC and HPC share, however, is a reduced ability to utilize glucose for energy metabolism. Although this suggests that therapeutic strategies bypassing the need for neuronal glycolysis may be beneficial for treating cognitive aging, this approach has not been empirically tested. Thus, the current study used a ketogenic diet (KD) as a global metabolic strategy for improving brain function in young and aged rats. After 12 weeks, rats were trained to perform a spatial alternation task through an asymmetrical maze, in which one arm was closed and the other was open. Both young and aged KD-fed rats showed resilience against the anxiogenic open arm, training to alternation criterion performance faster than control animals. Following alternation testing, rats were trained to perform a cognitive dual task that required working memory while simultaneously performing a bi-conditional association task (WM/BAT), which requires PFC–HPC interactions. All KD-fed rats also demonstrated improved performance on WM/BAT. At the completion of behavioral testing, tissue punches were collected from the PFC for biochemical analysis. KD-fed rats had biochemical alterations within PFC that were dissociable from previous results in the HPC. Specifically, MCT1 and MCT4, which transport ketone bodies, were significantly increased in KD-fed rats compared to controls. GLUT1, which transports glucose across the blood brain barrier, was decreased in KD-fed rats. Contrary to previous observations within the HPC, the vesicular glutamate transporter (VGLUT1) did not change with age or diet within the PFC. The vesicular GABA transporter (VGAT), however, was increased within PFC similar to HPC. These data suggest that KDs could be optimal for enhancing large-scale network function that is critical for higher cognition.

Keywords: anxiety, GABA, glucose, glutamate, metabolism, monocarboxylate, transporter

흥미롭게도 많은 정신질환이 뇌가 아닌 장에서 비롯된다는 이론이 제시됨. 장 건강이 나쁜 것은 탄수화물이 많은 곡물위주의 식단, 항생제 남용, 약물 등이 원인임. 케토제닉 다이어트를 하면 장이 변화해 뇌화학물질이 안정되어 뇌신경 기능이 개선됨. 

11) 기면증과 기타 수면장애

케톤상태에서 사람들은 대부분 잠을 더 잘자고 식후에 피곤함을 느끼지 않음. 

Abstract

The effects of a low-carbohydrate, ketogenic diet (LCKD) on sleepiness and other narcolepsy symptoms were studied. Nine patients with narcolepsy were asked to adhere to the Atkins’ diet plan, and their symptoms were assessed using the Narcolepsy Symptom Status Questionnaire (NSSQ). The NSSQ–Total score decreased by 18% from 161.9 to 133.5 (p = 0.0019) over 8 weeks. Patients with narcolepsy experienced modest improvements in daytime sleepiness on an LCKD.

12) 운동능력

케토제닉 다이어트를 하면 운동능력이 극적으로 향상됨 

처음 1-2주 동안은 운동선수들의 운동능력이 저하될 수 있으므로 그 기간을 반드시 넘어가야 함. 

Ketogenic Diets and Physical Performance

Stephen D Phinney 1

Affiliations expand

• PMID: 15507148
 
• PMCID: PMC524027
 
• DOI: 10.1186/1743-7075-1-2

Abstract

Impaired physical performance is a common but not obligate result of a low carbohydrate diet. Lessons from traditional Inuit culture indicate that time for adaptation, optimized sodium and potassium nutriture, and constraint of protein to 15-25 % of daily energy expenditure allow unimpaired endurance performance despite nutritional ketosis.

 Impact Of Ketogenic Diet On Athletes: Current Insights

Fionn T McSwiney, Lorna Doyle, [...], and Caryn Zinn

Additional article information

Associated Data

Data Citations

Abstract

The impact of a ketogenic diet (KD) (<50 g/d carbohydrate, >75% fat) on athletic performance has sparked much interest and self-experimentation in the past 3–4 years. Evidence shows 3–4-week adaptations to a KD in endurance-trained athletes were associated with maintenance of moderate (46–63% VO2max) and vigorous intensity (64–90% VO2max) endurance exercise, while at intensities >70% VO2max, increases in fat oxidation were associated with decreased economy (increased oxygen consumption), and in some cases, increased ratings of perceived exertion and heart rate. Two investigations in recreationally active endurance athletes noted no vigorous intensity exercise decrement following 3- and 12-week adaptations. Moderate (70–85% one repetition maximum) and near-maximal to maximal intensity (>85% 1RM) strength performance experienced no decrement following a 3-12-week KD adaptation. Beneficial effects were noted for 2000 m sprint and critical power test completed for short duration at vigorous intensity, while two additional tests noted no decrement. For sprint, near-maximal exercise (>91% VO2max), benefit of the KD was observed for six-second sprint, while no decrement in performance was noted for two additional maximal tests. When protein is equated (grams per kilogram), one investigation noted no decrement in muscle hypertrophy, while one noted a decrement. One investigation with matched protein noted the KD group lost more body fat. In conclusion, moderate-to-vigorous intensity exercise experiences no decrement following adaptation to a KD. Decreases in exercise economy are observed >70% VO2max in trained endurance athletes which may negate performance within field settings. Beneficial effects of the KD during short duration vigorous, and sprint bouts of exercises are often confounded by greater weight loss in the KD group. With more athletes pursuing carbohydrate-restricted diets (moderate and strict (KD)) for their proposed health benefits, more work is needed in the area to address both performance and health outcomes.

Keywords: keto-adaptation, performance, endurance, strength, high intensity, low carbohydrate

벤 그린필드 철인 3종경기 선수로 2013년 캐나다 철인 3종경기 케토제닉 다이어트로 놀라운 성과

1) 대사효율이 향상되고 지방연소가 강화되어 시간이 갈수록 힘이 좋아짐

2) 저장된 글리코겐을 아낄 수 있어 지구력이 향상됨. 지방을 더 효율적으로 태울 수 있기 때문에 근육과 간의 탄수화물을 덜 사용함

3) 많은 양의 당분섭취로 인한 자유라디칼(활성산소)과 반응성 산소가 덜 만들어지므로 염증이 줄어들고 운동후 회복이 빠름

4) 에너지 수준이 안정화됨. 혈당치가 탄수화물 식사때보다 등락이 심하지 않음. 

빌 라카코스

'케톤체는 다른 대사성 연료보다 산소 단위당 제공하는 에너지가 많기 때문에 수퍼 연료로 알려짐'

# 케톤체의 암치유 효과

노라 겟가다우스 

'케톤식은 단일 식이요법 가운데 모든 형태의 암 및 기타면역관련 질병에 가장 효과적임. 암에 필요한 연료(당분)을 제거하고 케톤과 유리지방산을 사용함으로써 암을 억제하는 내외적 환경을 만들 수 있음. 환경독소가 증가하고 암발병율이 급등하는 상황에서 케토제닉 다이어트는 최고의 식이요법이 될 것임'

존 키이퍼

'4기 여성암 환자가 3개월 시한부 선고를 받았으나 케토제닉 다이어트로 유럽여행을 계획하고 있음. 케톤식의 위력은 놀랍기만 함. 더 정확하게 탄수화물이 해롭다는 것이 정말 놀라움'

토마스 사이프리드

'암은 대사질환이다라는 책을 통해 케토제닉 다이어트가 암치료의 새로운 방향으로 이끌고 있음'

# 자폐증

메리 뉴포트

'일부 자폐아는 저탄수화물 고지방식단, MCT오일 요법에 효과를 보임'

# 섬유근육통, 만성통증, 편두통

Ketogenic Diets and Pain

Susan A. Masino, Ph.D. and David N. Ruskin, Ph.D.

Additional article information

Abstract

Ketogenic diets are well-established as a successful anticonvulsant therapy. Based on overlap between mechanisms postulated to underlie pain and inflammation, and mechanisms postulated to underlie therapeutic effects of ketogenic diets, recent studies have explored the ability for ketogenic diets to reduce pain. Here we review clinical and basic research thus far exploring the impact of a ketogenic diet on thermal pain, inflammation, and neuropathic pain.

Keywords: chronic constriction injury, hypoalgesia, inflammation, neuropathic pain, Taxol

# 외상성 뇌손상과 뇌졸중

Ketogenic Diet Provides Neuroprotective Effects against Ischemic Stroke Neuronal Damages

Sheyda Shaafi, Javad Mahmoudi, [...], and Hossein Akbari

Additional article information

Abstract

Ischemic stroke is a leading cause of death and disability in the world. Many mechanisms contribute in cell death in ischemic stroke. Ketogenic diet which has been successfully used in the drug-resistant epilepsy has been shown to be effective in many other neurologic disorders. The mechanisms underlying of its effects are not well studied, but it seems that its neuroprotective ability is mediated at least through alleviation of excitotoxicity, oxidative stress and apoptosis events. On the basis of these mechanisms, it is postulated that ketogenic diet could provide benefits to treatment of cerebral ischemic injuries.

Keywords: Stroke, Ketogenic diet, Excitotoxicity, Oxidative stress, Apoptosis

# 잇몸질환과 충치

케톤식단에는 곡물이나 당분이 없기 때문에 잇몸질환과 충치가 거의 사라짐. 인류 조상들의 치아를 연구해보니 매우 건강했음. 

An oral health optimized diet can reduce gingival and periodontal inflammation in humans - a randomized controlled pilot study

J. P. Woelber, K. Bremer, [...], and C. Tennert

Additional article information

Associated Data

Data Availability Statement

Abstract

Background

The aim of this pilot study was to investigate the effects of four weeks of an oral health optimized diet on periodontal clinical parameters in a randomized controlled trial.

Methods

The experimental group (n = 10) had to change to a diet low in carbohydrates, rich in Omega-3 fatty acids, and rich in vitamins C and D, antioxidants and fiber for four weeks. Participants of the control group (n = 5) did not change their dietary behavior. Plaque index, gingival bleeding, probing depths, and bleeding upon probing were assessed by a dentist with a pressure-sensitive periodontal probe. Measurements were performed after one and two weeks without a dietary change (baseline), followed by a two week transitional period, and finally performed weekly for four weeks.

Results

Despite constant plaque values in both groups, all inflammatory parameters decreased in the experimental group to approximately half that of the baseline values (GI: 1.10 ± 0.51 to 0.54 ± 0.30; BOP: 53.57 to 24.17 %; PISA: 638 mm2to 284 mm2). This reduction was significantly different compared to that of the control group.

Conclusion

A diet low in carbohydrates, rich in Omega-3 fatty acids, rich in vitamins C and D, and rich in fibers can significantly reduce gingival and periodontal inflammation.

# 여드름

여드름은 인슐린 저항성 징후

Nutrition and Acne: Therapeutic Potential of Ketogenic Diets

A Paoli 1, K Grimaldi, L Toniolo, M Canato, A Bianco, A Fratter

Affiliations expand

• PMID: 22327146
 
• DOI: 10.1159/000336404

Abstract

The influence of nutrition on skin health is a growing research area but the findings of various studies on the effect of diet on the development of acne have often been contradictory. The general opinion among researchers has oscillated between two different, opposing positions: that diet either is or is not a key factor for acne development. This review examines the evidence supporting an influence of various dietary components on the development of acne particularly focusing on the role played by carbohydrates. The physiological and biochemical effects of the ketogenic diet are examined from this perspective and mechanisms will be proposed via which this type of diet could have a role in the treatment of acne.

# 시력

케토제닉 다이어트를 하고 시력이 개선되었다는 체험담은 널려 있음.

# 루게릭 병

High-Fat and Ketogenic Diets in Amyotrophic Lateral Sclerosis

Sabrina Paganoni, MD, PhD and Anne-Marie Wills, MD, MPH

Additional article information

Abstract

Amyotrophic lateral sclerosis is a fatal neurodegenerative disease. Epidemiologic data suggest that malnutrition is a common feature in amyotrophic lateral sclerosis and being overweight or obese confers a survival advantage in this patient population. In amyotrophic lateral sclerosis mouse models, a high-fat diet has been shown to lead to weight gain and prolonged survival. However, little research has been conducted to test whether nutritional interventions might ameliorate the disease course in humans. Here we review the currently available evidence supporting the potential role of dietary interventions as a therapeutic tool for amyotrophic lateral sclerosis. Ultimately, determining whether a high-fat or ketogenic diet could be beneficial in amyotrophic lateral sclerosis will require large randomized, placebo-controlled clinical trials.

Keywords: ketogenic, fat, diet, amyotrophic lateral sclerosis, ALS

REVIEW ARTICLE

Front. Mol. Neurosci., 26 January 2018 | https://doi.org/10.3389/fnmol.2018.00015

How Can a Ketogenic Diet Improve Motor Function?

Charlotte Veyrat-Durebex^1,2, Pascal Reynier^1,2, Vincent Procaccio^1,2, Rudolf Hergesheimer³, Philippe Corcia^3,4, Christian R. Andres^3,5 and Hélène Blasco^2,3,5*

• ¹Département de Biochimie et Génétique, Centre Hospitalier Universitaire, Angers, France
• ²INSERM 1083, CNRS, Equipe Mitolab, Institut MITOVASC, UMR 6015, Université d’Angers, Angers, France
• ³INSERM U930, Université François Rabelais de Tours, Tours, France
• ⁴Service de Neurologie, Centre Hospitalier Universitaire de Tours, Tours, France
• ⁵Laboratoire de Biochimie et Biologie Moléculaire, Centre Hospitalier Universitaire de Tours, Tours, France

A ketogenic diet (KD) is a normocaloric diet composed by high fat (80–90%), low carbohydrate, and low protein consumption that induces fasting-like effects. KD increases ketone body (KBs) production and its concentration in the blood, providing the brain an alternative energy supply that enhances oxidative mitochondrial metabolism. In addition to its profound impact on neuro-metabolism and bioenergetics, the neuroprotective effect of specific polyunsaturated fatty acids and KBs involves pleiotropic mechanisms, such as the modulation of neuronal membrane excitability, inflammation, or reactive oxygen species production. KD is a therapy that has been used for almost a century to treat medically intractable epilepsy and has been increasingly explored in a number of neurological diseases. Motor function has also been shown to be improved by KD and/or medium-chain triglyceride diets in rodent models of Alzheimer’s disease, Parkinson’s disease, amyotrophic lateral sclerosis, and spinal cord injury. These studies have proposed that KD may induce a modification in synaptic morphology and function, involving ionic channels, glutamatergic transmission, or synaptic vesicular cycling machinery. However, little is understood about the molecular mechanisms underlying the impact of KD on motor function and the perspectives of its use to acquire the neuromuscular effects. The aim of this review is to explore the conditions through which KD might improve motor function. First, we will describe the main consequences of KD exposure in tissues involved in motor function. Second, we will report and discuss the relevance of KD in pre-clinical and clinical trials in the major diseases presenting motor dysfunction.

# 다발성 경화증과 헌팅턴 병

테리 휠은 다발성 경화증을 스스로 치료함. 

대규모 연구 준비중!!

Review Article | Open Access

Volume 2014 |Article ID 474296 | 10 pages | https://doi.org/10.1155/2014/474296

Ketogenic Diet in Neuromuscular and Neurodegenerative Diseases

---

Antonio Paoli,¹ Antonino Bianco,² Ernesto Damiani,¹ and Gerardo Bosco¹

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Academic Editor: Giuseppe D’Antona

Received24 Apr 2014

Accepted30 May 2014

Published03 Jul 2014

Abstract

An increasing number of data demonstrate the utility of ketogenic diets in a variety of metabolic diseases as obesity, metabolic syndrome, and diabetes. In regard to neurological disorders, ketogenic diet is recognized as an effective treatment for pharmacoresistant epilepsy but emerging data suggests that ketogenic diet could be also useful in amyotrophic lateral sclerosis, Alzheimer, Parkinson’s disease, and some mitochondriopathies. Although these diseases have different pathogenesis and features, there are some common mechanisms that could explain the effects of ketogenic diets. These mechanisms are to provide an efficient source of energy for the treatment of certain types of neurodegenerative diseases characterized by focal brain hypometabolism; to decrease the oxidative damage associated with various kinds of metabolic stress; to increase the mitochondrial biogenesis pathways; and to take advantage of the capacity of ketones to bypass the defect in complex I activity implicated in some neurological diseases. These mechanisms will be discussed in this review.

# 노화

칼로리를 제한하면 수명이 연장됨. 인슐린 수치가 낮으면 세포를 해독하고 회복하는 능력을 낮추는 항산화 스트레스가 감소하기 때문임. 따라서 이론상으로는 케토제닉 다이어트를 하면 수명이 연장됨. 

# 신장병

신경과학자이자 내분비학자인 찰스 몹스 박사는 케토제닉 다이어트를 이용하여 투석 쥐를 치료함. 

# 하지불안 증후군

# 관절염

케톤상태에서는 염증이 억제되므로 관절염치료에 효과가 있을 것으로 추정됨

Managing Rheumatoid Arthritis with Dietary Interventions

Shweta Khanna, Kumar Sagar Jaiswal, and Bhawna Gupta

Additional article information

Abstract

Self-help by means of dietary interventions can help in management of various disorders including rheumatoid arthritis (RA), a debilitating autoimmune disease. Dietary interventions necessitate a widespread appeal for both patients as well as clinicians due to factors including affordability, accessibility, and presence of scientific evidences that demonstrate substantial benefits in reducing disease symptoms such as pain, joint stiffness, swelling, tenderness and associated disability with disease progression. However, there is still an uncertainty among the community about the therapeutic benefits of dietary manipulations for RA. In the present review, we provide an account of different diets and their possible molecular mechanism of actions inducing observed therapeutic benefits for remission and management of RA. We further indicate food that can be a potential aggravating factor for the disease or may help in symptomatic relief. We thereafter summarize and thereby discuss various diets and food which help in reducing levels of inflammatory cytokines in RA patients that may play an effective role in management of RA following proper patient awareness. We thus would like to promote diet management as a tool that can both supplement and complement present treatment strategies for a better patient health and recovery.

Keywords: rheumatoid arthritis, diets, foods, essential fatty acids, synbiotics

# 탈모

마리아 에머리치는 수년간 탈모로 고생하다가 케톤식을 하면서 갑자기 머리숱이 풍성해진 고객이 수백명에 이른다고 말함.