School of Nursing, UT Health San Antonio, San Antonio, TX, USA.
Center for Precision Medicine, Long School of Medicine, UT Health San Antonio, San Antonio, TX, USA.
Nutr Diabetes. 2023 Sep 14;13(1):16. doi: 10.1038/s41387-023-00246-2.
BACKGROUND/OBJECTIVES: Despite the evidence supporting the efficacy of the ketogenic diet (KD) on weight and type 2 diabetes (T2D) management, adherence to the KD is challenging. Additionally, no studies have reported changes in PA among individuals with overweight/obesity and T2D who have followed KD. We mapped out the methods used to assess adherence to the KD and level of physical activity (PA) in lifestyle interventions for weight and T2D management in individuals with overweight/obesity and T2D and compared levels of KD adherence and PA in these interventions.
Articles published between January 2005 and March 2022 were searched in MEDLINE, CINAHL, and Scopus. Studies that included KD in lifestyle interventions for adults with T2D and overweight/obesity and measured ketone levels were included.
The eleven included studies comprised eight randomized controlled trials. They mainly used self-reported measures to evaluate adherence to the KD and level of PA. We found studies reported higher carbohydrate intake and lower fat intake than the KD regimen. Great inconsistencies were found among studies on the measurement and reporting of ketone and PA levels.
Our results demonstrated the need to develop intervention strategies to improve adherence to the KD, as well as the necessity of developing standardized diet and PA assessment tools to establish a stronger evidence base for including KD in lifestyle interventions for weight and T2D management among adults with overweight/obesity and T2D.
背景/目的：尽管有证据支持生酮饮食（KD）在体重和 2 型糖尿病（T2D）管理方面的疗效，但坚持 KD 饮食具有挑战性。此外，尚无研究报告超重/肥胖和 T2D 患者遵循 KD 饮食后身体活动（PA）的变化。我们制定了方法来评估超重/肥胖和 T2D 患者的 KD 饮食依从性和生活方式干预中 PA 水平，并比较了这些干预措施中 KD 饮食依从性和 PA 水平。
在 MEDLINE、CINAHL 和 Scopus 中搜索了 2005 年 1 月至 2022 年 3 月期间发表的文章。纳入了将 KD 纳入超重/肥胖和 T2D 成年人生活方式干预中并测量酮水平的研究。
纳入的 11 项研究包括 8 项随机对照试验。它们主要使用自我报告的措施来评估 KD 饮食依从性和 PA 水平。我们发现研究报告的碳水化合物摄入量高于 KD 方案，脂肪摄入量低于 KD 方案。关于酮和 PA 水平的测量和报告，研究之间存在很大的不一致。
我们的研究结果表明，需要制定干预策略来提高 KD 饮食的依从性，同时需要开发标准化的饮食和 PA 评估工具，以在超重/肥胖和 T2D 成年人的体重和 T2D 管理的生活方式干预中纳入 KD 饮食方面建立更强的证据基础。
