Mechanisms by Which the Ketogenic Diet Reverses Obesity and Diabetes

Abstract

Since the beginning of the 20th century, when low-carbohydrate diets were first implemented to treat Type 1 diabetes, the role of dietary composition in regulating glucose homeostasis and, increasingly, energy balance, has been the subject of great interest to both biomedical researchers and, increasingly, to the public. In fairly extreme circumstances (e.g., Type 1 diabetes untreated with insulin) low-carbohydrate diets (which are generally high-fat diets) can be useful to reduce blood glucose, but since the advent of insulin therapy, and increasing appreciation of the cardiovascular consequences of hyperlipidemia, clinical practice has dramatically favored highcarbohydrate, low-fat diets for diabetes (especially Type 2 diabetes, largely associated with obesity). This clinical advice, at the time, seemed fairly radical. In a famous treatise, "The Physiology of Taste" published in 1825, Brillat-Savarin, argue that consumption of "natural" diets (e.g., meat and vegetables) promote health, whereas "cultivated" diet (e.g., derived from rice and wheat) increasingly led to deterioration of health associated with affluence.Similarly, in 1837 Sylvester Graham published "A treatise on bread and breadmaking", essentially a tirade against food with grains (as well as meat), which were not suited to the assumption that gluttony was among the greatest sins (clearly a theme in subsequent American diet fads). Similarly throughout the 20th century popular diets (including those promotes by Adelle Davis in the 1950s, Robert Atkins in the 1970s, the paleo diet, and increasingly many more) have emphasized lowcarbohydrate, high-fat diets especially for weight loss (viewed by the public as a more compelling concern than glucose homeostasis). While these diets have little if any clinical evidence for efficacy, low-calorie, low-protein diets that produce ketogenesis are extremely effective to reverse obesity, hyperglycemia, and diabetic complications. The mini-review examines possible mechanisms mediating these remarkable effects, particularly focusing on epigenetic effects on hypothalamic neurons.

Manfaat Diet Ketogenik pada Tata Laksana Obesitas

“…Dikhawatirkan bahwa pola makan tinggi lemak justru dapat menyebabkan obesitas dan berisiko beragam penyakit, seperti diabetes, kanker, dan penyakit arteri koroner. 18,26 Berikut dugaan beberapa mekanisme diet ketogenik dalam menurunkan berat badan: 15,18,27 Efek Diuretik. Dalam kondisi ketosis, pengurangan asupan kalori secara keseluruhan dapat meningkatkan penurunan berat badan.…”

Efek Diet Ketogenik Pada Diabetes Mellitus Tipe 2: Scoping Review

“…Pernyataan tersebut selaras dengan hasil penelitian Choi et al 21 yang membuktikan adanya penurunan Homeostasis Model Assessment Insulin Resistance (HOMA-IR) pada subjek DMT2 yang diberikan DK dengan cara meningkatkan fungsi sel beta pankreas 22 . Secara in vitro, DK dapat menurunkan metabolisme glukosa secara keseluruhan melalui mekanisme keton-3-beta-hidroksibutirat yang bekerja dengan menghambat efek molekuler glukosa sehingga menyebabkan adanya penurunan glukosa darah pada subjek DMT2 23 . Hal tersebut didukung oleh pernyataan dari Sainsbury et al dan Snorgaard et al 24,25 dalam Laporan Konsensus American Diabetes Association (ADA) yang menyatakan bahwa diet rendah karbohidrat 20-50 g/hari (termasuk ketosis nutrisi) terbukti dapat menurunkan HbA1c dan kebutuhan obat anti diabetes (OAD).…”

The Effects of A Short Period of A Ketogenic Diet on Blood Biochemistry and Immunological Status in Overweight Thai Subjects

“…Some of them are the South Beach diet, Atkins diet, and Ketogenic dietary patterns [9]. The Ketogenic Diet (KD) includes consuming a high fat, moderate protein, and low carbohydrate [10][11][12][13]. Dr. Russell Morse Wilder coined the term in 1921 to describe foods increasing levels of body blood ketone by higher fat and lower carbohydrate intake [9].…”