Moreno-Sepúlveda José, Capponi Magdalena
Clínica de la Mujer Medicina Reproductiva, Viña del Mar, Chile.
Unidad de Endocrinología, Fundación Neuropsiquiátrica de Santiago, Santiago, Chile.
Rev Med Chil. 2020 Nov;148(11):1630-1639. doi: 10.4067/S0034-98872020001101630.
With low carbohydrate diets glucose becomes unavailable as a source of energy for our body, leading to the production of ketones from fatty acids in the liver. The increase in plasma ketones is known as nutritional ketosis. The available evidence from basic and clinical studies indicates that both low carbohydrate and high fat low carbohydrate diets are effective for weight loss and are better than non-intervention. However, low carbohydrate diet and ketogenic diets induce unique metabolic changes and consistently improve some markers of cardiovascular risk, lowering elevated blood glucose, insulin, triglycerides, ApoB and saturated fat concentrations, reducing small dense LDL particle numbers, glycated hemoglobin levels, blood pressure and body weight while increasing HDL-cholesterol concentrations and reversing non-alcoholic fatty liver disease. Low carbohydrate diets are an efficient strategy for the management of obesity and metabolic syndrome. They may also benefit patients with polycystic ovary syndrome. They must be prescribed by trained professionals to balance the risks and benefits for each individual patient. Future research is required to improve the knowledge about individual responses to dietary interventions, their safety, tolerance, efficacy and long-term effects.
采用低碳水化合物饮食时，葡萄糖无法作为我们身体的能量来源，从而导致肝脏中脂肪酸生成酮类物质。血浆酮类物质增加即所谓的营养性酮症。基础研究和临床研究的现有证据表明，低碳水化合物饮食和高脂肪低碳水化合物饮食对减肥均有效，且优于不干预措施。然而，低碳水化合物饮食和生酮饮食会引发独特的代谢变化，并持续改善一些心血管风险指标，降低血糖、胰岛素、甘油三酯、载脂蛋白B和饱和脂肪浓度，减少小而密的低密度脂蛋白颗粒数量、糖化血红蛋白水平、血压和体重，同时提高高密度脂蛋白胆固醇浓度，并逆转非酒精性脂肪性肝病。低碳水化合物饮食是管理肥胖和代谢综合征的有效策略。它们可能对多囊卵巢综合征患者也有益处。必须由经过培训的专业人员开出处方，以平衡每位患者的风险和益处。未来需要开展研究，以增进对个体对饮食干预的反应、其安全性、耐受性、疗效和长期影响的了解。
