Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
The New South Wales Ministry of Health (NSW Health), Sydney, Australia.
Nutr Res Rev. 2023 Dec;36(2):295-319. doi: 10.1017/S0954422422000087. Epub 2022 Apr 19.
Dietary restriction of carbohydrate has been demonstrated to be beneficial for nervous system dysfunction in animal models and may be beneficial for human chronic pain. The purpose of this review is to assess the impact of a low-carbohydrate/ketogenic diet on the adult nervous system function and inflammatory biomarkers to inform nutritional research for chronic pain. An electronic database search was carried out in May 2021. Publications were screened for prospective research with dietary carbohydrate intake <130 g per day and duration of ≥2 weeks. Studies were categorised into those reporting adult neurological outcomes to be extracted for analysis and those reporting other adult research outcomes. Both groups were screened again for reported inflammatory biomarkers. From 1548 studies, there were 847 studies included. Sixty-four reported neurological outcomes with 83% showing improvement. Five hundred and twenty-three studies had a different research focus (metabolic = 394, sport/performance = 51, cancer = 33, general = 30, neurological with non-neuro outcomes = 12, or gastrointestinal = 4). The second screen identified sixty-three studies reporting on inflammatory biomarkers, with 71% reporting a reduction in inflammation. The overall results suggest a favourable outcome on the nervous system and inflammatory biomarkers from a reduction in dietary carbohydrates. Both nervous system sensitisation and inflammation occur in chronic pain, and the results from this review indicate it may be improved by low-carbohydrate nutritional therapy. More clinical trials within this population are required to build on the few human trials that have been done.
限制碳水化合物的饮食已被证明对动物模型的神经系统功能有益，并且可能对人类慢性疼痛有益。本综述的目的是评估低碳水化合物/生酮饮食对成人神经系统功能和炎症生物标志物的影响，为慢性疼痛的营养研究提供信息。 2021 年 5 月进行了电子数据库搜索。筛选了前瞻性研究出版物，这些出版物的饮食碳水化合物摄入量<130g/天，持续时间≥2 周。将研究分为报告成人神经学结果以供提取分析的研究和报告其他成人研究结果的研究。两组均再次筛选报告的炎症生物标志物。从 1548 项研究中，有 847 项研究被纳入。其中 64 项报告了神经学结果，其中 83%显示改善。523 项研究有不同的研究重点（代谢 = 394，运动/表现 = 51，癌症 = 33，一般 = 30，神经学伴有非神经结果 = 12，或胃肠道 = 4）。第二轮筛选确定了 63 项报告炎症生物标志物的研究，其中 71%报告炎症减轻。总体结果表明，通过减少碳水化合物的饮食，对神经系统和炎症生物标志物有良好的影响。慢性疼痛中既存在神经系统敏化又存在炎症，本综述的结果表明，低碳水化合物营养疗法可能改善这种情况。需要在该人群中进行更多的临床试验，以建立已完成的少数人类试验的基础。
