Ketogenic Diet and Vitamin D Metabolism: A Review of Evidence

Detopoulou, Paraskevi; Papadopoulou, Sousana K.; Voulgaridou, Gavriela; Dedes, Vasileios; Tsoumana, Despoina; Gioxari, Aristea; Gerostergios, George; Detopoulou, Maria; Panoutsopoulos, Georgios I.

doi:10.3390/metabo12121288

Cited by 6 publications

(6 citation statements)

References 88 publications

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“…Firstly, our research is cross-sectional, and studies conducted in other research designs are required. Secondly, although our study included 533 patients with T2DM, more data is required, especially for T2DM patients with high levels of vitamin D. Finally, although the 35 clinical variables listed in Table 1 have been included in our study for model adjustments, some factors that may affect vitamin D levels (such as sun exposure 40 and dietary habits 41 ) have not been considered due to a lack of data.…”

Section: Discussionmentioning

confidence: 99%

Association Between the Water Distribution in the Human Body and 25-Hydroxyvitamin D Among the Type 2 Diabetes Mellitus Population: A Possible Pathway Between Vitamin D and Diabetic Nephropathy

Xu,

Zhang,

Xiang

et al. 2024

DMSO

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Purpose To explore the association between the water distribution in the human body and 25-hydroxyvitamin D among patients with type 2 diabetes mellitus (T2DM), and to analyze whether water distribution is a mediator between vitamin D and T2DM complications. Patients and Methods In total, 533 T2DM inpatients were included from August 1, 2016 to April 1, 2023. Water distribution indicators, whether from the whole body, arms, trunk, or legs, were measured to calculate the association with vitamin D using linear regression analysis. Subgroups based on age, sex, body mass index, and macrovascular complications were established to clarify changes in the association between vitamin D and water distribution in different populations. Mediation analysis was applied to evaluate the correlation between vitamin D, water distribution, and T2DM complications. Results There was a negative correlation between 25-hydroxyvitamin D and the ratio of extracellular water (ECW)/total body water (TBW) both in the whole body ( P =0.045, β =−0.008) and in certain parts. A U-shaped restricted cubic spline curve further presented an inflection point (approximately 23 ng/mL 25-hydroxyvitamin D) in the relationship between 25-hydroxyvitamin D and the ECW/TBW of the whole body. A negative correlation was observed between ECW/TBW and vitamin D in the obese subgroup ( P =0.015, β =−0.038). In the total effect of vitamin D on diabetic nephropathy (DN), the mediation effect of ECW/TBW accounted for 15.44%. Conclusion A correlation between vitamin D and water distribution was observed, and a high ECW/TBW was one of the pathways through which low vitamin D levels might affect DN.

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Section: Discussionmentioning

confidence: 99%

Association Between the Water Distribution in the Human Body and 25-Hydroxyvitamin D Among the Type 2 Diabetes Mellitus Population: A Possible Pathway Between Vitamin D and Diabetic Nephropathy

Xu,

Zhang,

Xiang

et al. 2024

DMSO

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“…Moreover, it is possible that the total diet and/or dietary protein may be important in addressing this issue, since sarcopenia often co-exists with osteoporosis (osteosarcopenia) [ 70 ]. In this case, animal protein may be a key factor for modifying body composition and sarcopenia, such as in the case of cancer, which is also related to sarcopenia [ 71 , 72 ]. In addition, inflammatory indices, such as platelet activating factor, are related to OF [ 73 ], and an antioxidant-rich diet and/or fatty acid profile may lessen its deleterious actions [ 74 , 75 ].…”

Section: Discussionmentioning

confidence: 99%

“…Besides environmental factors, the genetic background may also influence the effects of supplementation [ 71 ]. For example, 35 genes and several single-nucleotide polymorphisms (SNPs) have been connected to vitamin D status, which could potentially alter individual 25(OH)D responses to supplementation [ 84 ].…”

Section: Discussionmentioning

confidence: 99%

“…For example, 35 genes and several single-nucleotide polymorphisms (SNPs) have been connected to vitamin D status, which could potentially alter individual 25(OH)D responses to supplementation [ 84 ]. In parallel, dietary habits may influence vitamin D status [ 71 , 85 ],while gene–diet interactions may also take place [ 86 ], although they may not at last largely affect BMD [ 87 , 88 ]. In addition, concomitant calcium supplementation may reduce compliance with vitamin D, due to calcium-induced digestive problems, which probably supported the decision in some trials to try vitamin D supplementation alone [ 89 ].…”

Section: Discussionmentioning

confidence: 99%

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Vitamin D and Calcium in Osteoporosis, and the Role of Bone Turnover Markers: A Narrative Review of Recent Data from RCTs

et al. 2023

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Osteoporosis is a common disease, defined primarily by a low measured bone density, which is associated with an increased risk of fragility fractures. Low calcium intake and vitamin D deficiency seem to be positively correlated with the prevalence of osteoporosis. Although they are not suitable for the diagnosis of osteoporosis, the biochemical markers of bone turnover can be measured in serum and/or urine, enabling the assessment of the dynamic bone activity and the short-term effectiveness of the osteoporosis treatment. Calcium and vitamin D are essential for maintaining bone health. The aim of this narrative review is to summarize the effects of vitamin D and calcium supplementation separately and in combination, on bone density and circulating serum and blood plasma vitamin D, calcium, parathyroid hormone levels, markers of bone metabolism concentrations, and clinical outcomes, such as falls and osteoporotic fractures. We searched the PubMed online database to find clinical trials from the last five years (2016–April 2022). A total of 26 randomized clinical trials (RCTs) were included in this review. The present reviewed evidence suggests that vitamin D alone or in combination with calcium increases circulating 25(OH)D. Calcium with concomitant vitamin D supplementation, but not vitamin D alone, leads to an increase in BMD. In addition, most studies did not detect significant changes in circulating levels of plasma bone metabolism markers, nor in the incidence of falls. Instead, there was a decrease in blood serum PTH levels in the groups receiving vitamin D and/or Ca supplementation. The plasma vitamin D levels at the beginning of the intervention, and the dosing regimen followed, may play a role in the observed parameters. However, further study is needed to determine an appropriate dosing regimen for the treatment of osteoporosis and the role of bone metabolism markers.

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“…Despite that, however, the loss in bone mineral density (BMD) was reported at approximately 2% during CR at clinically prevalent sites of osteoporotic fractures ( 60 , 66 ). Some dietary intervention may affect the active hormone 1,25-(OH)2D3 through modulating cytochrome P450 27B1 (CYP27B1) expression in the kidney, leading to an increase in circulating 25OHD and a decline in 1,25-(OH)2D3 ( 67 ). As neither 1,25-(OH)2D3 nor CYP27B1 was measured, the precise mechanism is unknown.…”

Section: Micronutrient Requirements During Calorie Restrictionmentioning

confidence: 99%

Requirements for essential micronutrients during caloric restriction and fasting

Zhang,

Chen,

Huo

et al. 2024

Front. Nutr.

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Caloric restriction (CR) or energy restriction, when carefully designed, monitored, and implemented in self-motivated and compliant individuals, proves to be a viable non-pharmacologic strategy for human weight control and obesity management. Beyond its role in weight management, CR has the potential to impede responses involved not only in the pathogenesis of various diseases but also in the aging process in adults, thereby being proposed to promote a healthier and longer life. The core objective of implementing caloric restriction is to establish a balance between energy intake and expenditure, typically involving a reduction in intake and an increase in expenditure—a negative balance at least initially. It may transition toward and maintain a more desired equilibrium over time. However, it is essential to note that CR may lead to a proportional reduction in micronutrient intake unless corresponding supplementation is provided. Historical human case reports on CR have consistently maintained adequate intakes (AI) or recommended dietary allowances (RDA) for essential micronutrients, including vitamins and minerals. Similarly, longevity studies involving non-human primates have upheld micronutrient consumption levels comparable to control groups or baseline measures. Recent randomized controlled trials (RCTs) have also endorsed daily supplementation of multivitamins and minerals to meet micronutrient needs. However, aside from these human case reports, limited human trials, and primate experiments, there remains a notable gap in human research specifically addressing precise micronutrient requirements during CR. While adhering to AI or RDA for minerals and vitamins appears sensible in the current practice, it’s important to recognize that these guidelines are formulated for generally healthy populations under standard circumstances. The adequacy of these guidelines in the setting of prolonged and profound negative energy balance remains unclear. From perspectives of evidence-based medicine and precision nutrition, this field necessitates comprehensive exploration to uncover the intricacies of absorption, utilization, and metabolism and the requirement of each hydrophilic and lipophilic vitamin and mineral during these special periods. Such investigations are crucial to determine whether existing daily dietary recommendations for micronutrients are quantitatively inadequate, excessive, or appropriate when energy balance remains negative over extended durations.

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Ketogenic Diet and Vitamin D Metabolism: A Review of Evidence

Cited by 6 publications

References 88 publications

Association Between the Water Distribution in the Human Body and 25-Hydroxyvitamin D Among the Type 2 Diabetes Mellitus Population: A Possible Pathway Between Vitamin D and Diabetic Nephropathy

Association Between the Water Distribution in the Human Body and 25-Hydroxyvitamin D Among the Type 2 Diabetes Mellitus Population: A Possible Pathway Between Vitamin D and Diabetic Nephropathy

Vitamin D and Calcium in Osteoporosis, and the Role of Bone Turnover Markers: A Narrative Review of Recent Data from RCTs

Requirements for essential micronutrients during caloric restriction and fasting

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