Bostock Emmanuelle C S, Kirkby Kenneth C, Taylor Bruce V, Hawrelak Jason A
Menzies Institute for Medical Research, Hobart, TAS, Australia.
Psychiatry, University of Tasmania, Hobart, TAS, Australia.
Front Nutr. 2020 Mar 13;7:20. doi: 10.3389/fnut.2020.00020. eCollection 2020.
The ketogenic diet (KD) is a high-fat, low-carbohydrate diet that limits glucose and results in the production of ketones by the liver and their uptake as an alternative energy source by the brain. KD is an evidence-based treatment for intractable epilepsy. KD is also self-administered, with limited evidence of efficacy, for conditions including weight loss, cognitive and memory enhancement, type II diabetes, cancer, neurological and psychiatric disorders. A commonly discussed side effect of KD in media and online forums is "keto flu," a cluster of transient symptoms generally reported as occurring within the first few weeks of KD. This study aimed to characterize the pattern of symptoms, severity and time course of keto flu as related by users of online forums. Online forums referring to "keto flu," "keto-induction," or "keto-adaptation" in the URL were identified in Google. Passages describing personal experiences of keto flu were categorized manually with reference to pattern of symptoms, severity, time course, and remedies proposed. The search criteria identified 75 online forums, 43 met inclusion criteria and contained 448 posts from 300 unique users. Seventy-three made more than one post (mean 3.12, range 2-11). Descriptors of personal experience of keto flu, reported by 101 of 300 users, included 256 symptom descriptions involving 54 discrete symptoms. Commonest symptoms were "flu," headache, fatigue, nausea, dizziness, "brain fog," gastrointestinal discomfort, decreased energy, feeling faint and heartbeat alterations. Symptom reports peaked in the first and dwindled after 4 weeks. Resolution of keto flu symptoms was reported by eight users between days 3 and 30 (median 4.5, IQR 3-15). Severity of symptoms, reported by 60 users in 40 forums, was categorized as mild ( = 15), moderate ( = 23), or severe ( = 22). Eighteen remedies were proposed by 121 individual users in 225 posts. Typically, individual posts provided fragmentary descriptions related to the flow of forum conversations. A composite picture emerged across 101 posts describing personally experienced symptoms. User conversations were generally supportive, sharing remedies for keto flu reflecting assumptions of physiological effects of KD.
生酮饮食（KD）是一种高脂肪、低碳水化合物的饮食，它限制葡萄糖摄入，导致肝脏产生酮类，并被大脑作为替代能源摄取。KD是一种针对难治性癫痫的循证治疗方法。KD也被用于自我治疗一些病症，如减肥、增强认知和记忆力、治疗II型糖尿病、癌症、神经和精神疾病，但疗效证据有限。在媒体和在线论坛上，KD常见的一个副作用被称为“酮流感”，这是一组通常在生酮饮食的头几周内出现的短暂症状。本研究旨在描述在线论坛用户所提及的酮流感的症状模式、严重程度和时间进程。在谷歌中识别URL中提及“酮流感”“生酮诱导”或“生酮适应”的在线论坛。参考症状模式、严重程度、时间进程和所提出的补救措施，对描述酮流感个人经历的段落进行人工分类。搜索标准确定了75个在线论坛，43个符合纳入标准，包含来自300名不同用户的448个帖子。73人发布了不止一个帖子（平均3.12个，范围2 - 11个）。300名用户中有101人报告了酮流感的个人经历描述，其中包括256个症状描述，涉及54种不同症状。最常见的症状是“流感”、头痛、疲劳、恶心、头晕、“脑雾”、胃肠道不适、精力下降、感觉虚弱和心跳改变。症状报告在第一周达到峰值，4周后逐渐减少。8名用户报告在第3天至30天之间酮流感症状得到缓解（中位数4.5，四分位间距3 - 15）。40个论坛中的60名用户报告了症状严重程度，分为轻度（= 15）、中度（= 23）或重度（= 22）。121名用户在225个帖子中提出了18种补救措施。通常，单个帖子提供的是与论坛对话流程相关的零散描述。在101个描述个人经历症状的帖子中呈现出一幅综合图景。用户对话通常相互支持，分享酮流感的补救措施，反映了对生酮饮食生理效应的假设。
