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

Bolla, Andrea Mario; Caretto, Amelia; Laurenzi, Andrea; Scavini, Marina; Piemonti, Lorenzo

doi:10.3390/nu11050962

Cited by 148 publications

(124 citation statements)

References 101 publications

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“…However, this largely occurs at the expense of making the diet high in carbohydrates. The literature supports that LFD may be detrimental [69][70][71]. While we were unable to find literature supporting the impact of LFD specifically on ERGs, the systemic consequences of LFD may indirectly affect the retina, for example by reduced availability of fat-soluble vitamins or changing retinal cholesterol metabolism.…”

Section: Discussionmentioning

confidence: 63%

Characterizing the Retinal Phenotype in the High-Fat Diet and Western Diet Mouse Models of Prediabetes

Asare-Bediako

Noothi

Calzi

et al. 2020

Cells

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We sought to delineate the retinal features associated with the high-fat diet (HFD) mouse, a widely used model of obesity. C57BL/6 mice were fed either a high-fat (60% fat; HFD) or low-fat (10% fat; LFD) diet for up to 12 months. The effect of HFD on body weight and insulin resistance were measured. The retina was assessed by electroretinogram (ERG), fundus photography, permeability studies, and trypsin digests for enumeration of acellular capillaries. The HFD cohort experienced hypercholesterolemia when compared to the LFD cohort, but not hyperglycemia. HFD mice developed a higher body weight (60.33 g vs. 30.17g, p < 0.0001) as well as a reduced insulin sensitivity index (9.418 vs. 62.01, p = 0.0002) compared to LFD controls. At 6 months, retinal functional testing demonstrated a reduction in a-wave and b-wave amplitudes. At 12 months, mice on HFD showed evidence of increased retinal nerve infarcts and vascular leakage, reduced vascular density, but no increase in number of acellular capillaries compared to LFD mice. In conclusion, the HFD mouse is a useful model for examining the effect of prediabetes and hypercholesterolemia on the retina. The HFD-induced changes appear to occur slower than those observed in type 2 diabetes (T2D) models but are consistent with other retinopathy models, showing neural damage prior to vascular changes.

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Section: Discussionmentioning

confidence: 63%

Characterizing the Retinal Phenotype in the High-Fat Diet and Western Diet Mouse Models of Prediabetes

Asare-Bediako

Noothi

Calzi

et al. 2020

Cells

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“…Apart from cognitive impairment, comorbidities are likely to modulate the efficacy or the adhesion to KD or KS. For instance, in patients with type 2 diabetes, very stringent KD may not be sustainable over long-term, although there is no formal contraindication to it [44]. Besides inflammatory diseases, mood disorders, chronic pain and polypharmacy may change the nutritional status of the individuals, as well as the safety of a high-fat diet.…”

Section: Clinical Studiesmentioning

confidence: 99%

Are ketogenic diets promising for Alzheimer’s disease? A translational review

et al. 2020

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Background: Brain amyloid deposition and neurofibrillary tangles in Alzheimer's disease (AD) are associated with complex neuroinflammatory reactions such as microglial activation and cytokine production. Glucose metabolism is closely related to neuroinflammation. Ketogenic diets (KDs) include a high amount of fat, low carbohydrate and medium-chain triglyceride (MCT) intake. KDs lead to the production of ketone bodies to fuel the brain, in the absence of glucose. These nutritional interventions are validated treatments of pharmacoresistant epilepsy, consequently leading to a better intellectual development in epileptic children. In neurodegenerative diseases and cognitive decline, potential benefits of KD were previously pointed out, but the published evidence remains scarce. The main objective of this review was to critically examine the evidence regarding KD or MCT intake effects both in AD and ageing animal models and in humans. Main body: We conducted a review based on a systematic search of interventional trials published from January 2000 to March 2019 found on MEDLINE and Cochrane databases. Overall, 11 animal and 11 human studies were included in the present review. In preclinical studies, this review revealed an improvement of cognition and motor function in AD mouse model and ageing animals. However, the KD and ketone supplementation were also associated with significant weight loss. In human studies, most of the published articles showed a significant improvement of cognitive outcomes (global cognition, memory and executive functions) with ketone supplementation or KD, regardless of the severity of cognitive impairments previously detected. Both interventions seemed acceptable and efficient to achieve ketosis. Conclusion: The KD or MCT intake might be promising ways to alter cognitive symptoms in AD, especially at the prodromal stage of the disease. The need for efficient disease-modifying strategies suggests to pursue further KD interventional studies to assess the efficacy, the adherence to this diet and the potential adverse effects of these nutritional approaches.

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“…Overconsumption of simple sugars, refined carbohydrates, and poor-quality refined oils are believed to increase the risk of developing NCDs [4,6]. Furthermore, there is now much clinical evidence that dietary carbohydrate restriction, and particularly sugar restriction, can improve markers of metabolic health, including obesity, hyperlipidaemia and hyperglycaemia [7][8][9]. Current guidelines for a healthy diet in South Africa recommend carbohydrate intake to be 45-65% of calories and fat intake to be 20-35% of calories [10].…”

Section: Introductionmentioning

confidence: 99%

Exploring the Perceptions of Women from Under-Resourced South African Communities about Participating in a Low-Carbohydrate High-Fat Nutrition and Health Education Program: A Qualitative Focus Group Study

et al. 2020

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Scientific evidence suggests that low-carbohydrate high-fat (LCHF) diets may be effective for managing non-communicable diseases (NCDs). Eat Better South Africa (EBSA) is an organization that runs LCHF nutrition education programs for women from low-income communities. Three focus group discussions (FGDs) were held with 18 women who had taken part in an EBSA program between 2015 and 2017, to explore their perceptions and to identify the facilitators and barriers they faced in implementing and sustaining dietary changes. Thematic analysis of the focus groups was conducted using NVivo 12 software. Women reported that they decided to enroll in the program because they suffered from NCDs. Most women said that the EBSA diet made them feel less hungry, more energetic and they felt that their health had improved. Most women spoke of socioeconomic challenges which made it difficult for them to follow EBSA’s recommendations, such as employment status, safety issues in the community, and lack of support from relatives and doctors. Hence, women felt they needed more support from EBSA after the program. The social determinants that affected these women’s ability to change their health behavior are also NCD risk factors, and these should be assessed to improve the program for other communities.

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

Cited by 148 publications

References 101 publications

Characterizing the Retinal Phenotype in the High-Fat Diet and Western Diet Mouse Models of Prediabetes

Characterizing the Retinal Phenotype in the High-Fat Diet and Western Diet Mouse Models of Prediabetes

Are ketogenic diets promising for Alzheimer’s disease? A translational review

Exploring the Perceptions of Women from Under-Resourced South African Communities about Participating in a Low-Carbohydrate High-Fat Nutrition and Health Education Program: A Qualitative Focus Group Study

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