de Amorim Ana Laura Benevenuto, Rodrigues Ester Ferreira, Sussi Elizandra Lopes, Neri Lenycia de Cassya Lopes
Nutrition Department, Santos Metropolitan University, Santos, SP, Brazil; Children's Institute of Faculty of Medicine, Department of Pediatrics, University of São Paulo, São Paulo, Brazil.
Children's Institute of Faculty of Medicine, Department of Pediatrics, University of São Paulo, São Paulo, Brazil.
Nutr Res. 2024 May;125:91-100. doi: 10.1016/j.nutres.2024.02.007. Epub 2024 Feb 29.
The quality of a mother's diet is important to ensure child growth and development and keep women healthy. This systematic review aimed to identify the outcomes of a carbohydrate-restricted diet during lactation. PubMed, EMBASE, Scopus, Web of Science, and LILACS were searched for studies published between 2012 and 2023; 16 studies were selected, all of them case reports or care series. The carbohydrate restriction described in the papers mainly was ketogenic, low-carb, low-carbohydrate and high-fat, and modified ketogenic diets. The main goal of women undertaking these diets was weight loss, with therapeutic purposes (monitored and supervised by health professionals) in only 2 cases: (1) ketogenic diet therapy for treatment of seizures in the infant and (2) to reduce symptoms of mother's gastroesophageal reflux. Most articles reported that lactating women were hospitalized, experiencing symptoms such as vomiting, muscle weakness, nausea, abdominal pain, general malaise, and fatigue. However, articles did not mention poor outcomes for the infants. Most of the studies in this review were published in the past 3 years, indicating a possible increase in cases of women practicing carbohydrate restriction during lactation for weight loss caused by body dissatisfaction. In conclusion, carbohydrate restriction during lactation may be harmful to the lactating woman and contribute to the state of lactational ketoacidosis, but infant outcomes are mainly a change in feeding patterns. Thus, education on food and nutrition is necessary for this population.
母亲的饮食质量对于确保儿童生长发育以及维持女性健康至关重要。本系统评价旨在确定哺乳期碳水化合物限制饮食的结果。检索了PubMed、EMBASE、Scopus、Web of Science和LILACS中2012年至2023年发表的研究；共筛选出16项研究，均为病例报告或病例系列。论文中描述的碳水化合物限制主要是生酮饮食、低碳水化合物饮食、低碳水高脂肪饮食和改良生酮饮食。采用这些饮食的女性的主要目标是减肥，仅有2例具有治疗目的（由健康专业人员监测和监督）：（1）生酮饮食疗法用于治疗婴儿癫痫，（2）减轻母亲胃食管反流症状。大多数文章报道哺乳期女性住院，出现呕吐、肌肉无力、恶心、腹痛、全身不适和疲劳等症状。然而，文章未提及婴儿的不良结局。本评价中的大多数研究发表于过去3年，表明因身体不满意而在哺乳期进行碳水化合物限制以减肥的女性病例可能有所增加。总之，哺乳期碳水化合物限制可能对哺乳期女性有害，并导致哺乳期酮症酸中毒状态，但婴儿结局主要是喂养模式的改变。因此，对这一人群进行食物和营养教育是必要的。
