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极低卡路里生酮饮食:对脂代谢有何影响?

Very Low Calorie Ketogenic Diet: What Effects on Lipid Metabolism?

机构信息

School of Medicine, Universidad Técnica Particular de Loja, Calle Paris, San Cayetano Alto, Loja 110107, Ecuador.

Facultad de Medicina, Departamento de Bioquímica Humana, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.

出版信息

Curr Nutr Rep. 2024 Sep;13(3):516-526. doi: 10.1007/s13668-024-00556-6. Epub 2024 Jul 15.

DOI:10.1007/s13668-024-00556-6
PMID:39008211
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11327205/
Abstract

PURPOSE OF REVIEW

This review aims to critically examine how VLCKD affects plasma lipoprotein, lipid and cholesterol metabolism. Cardiovascular disease is a worldwide health problem affecting millions of people and leading to high rates of mortality and morbidity. There is a well-established association between cardiovascular disease and circulating cholesterol. Various dietary recommendations are currently available for the management of dyslipidemia.

RECENT FINDINGS

The very low-calorie ketogenic diet (VLCKD) is becoming increasingly popular as a treatment option for several pathological conditions, including dyslipidemia. In addition to being low in calories, the VLCKD's main feature is its unique calorie distribution, emphasizing a reduction in carbohydrate consumption in favor of fat as the primary calorie source. Lowering calorie intake through a VLCKD can reduce the endogenous production of cholesterol. However, if the foods consumed are from animal sources, dietary cholesterol intake may increase due to the higher fat content of animal products. When combined, these dietary practices may have opposing effects on plasma cholesterol levels. Studies investigating the impact of VLCKD on plasma cholesterol and low-density lipoprotein cholesterol levels report contradictory findings. While some studies found an increase in low-density lipoprotein cholesterol levels, others showed a decrease in total cholesterol and low-density lipoprotein cholesterol, along with an increase in high-density lipoprotein cholesterol.

摘要

目的综述

本综述旨在批判性地考察极低卡路里生酮饮食(VLCKD)如何影响血浆脂蛋白、脂质和胆固醇代谢。心血管疾病是一个全球性的健康问题,影响着数百万人,并导致高死亡率和发病率。心血管疾病与循环胆固醇之间存在着明确的关联。目前有多种饮食建议可用于血脂异常的管理。

最近的发现

极低卡路里生酮饮食(VLCKD)作为多种病理状况的治疗选择,包括血脂异常,越来越受到欢迎。除了热量低之外,VLCKD 的主要特点是其独特的热量分布,强调减少碳水化合物的摄入,转而以脂肪作为主要热量来源。通过 VLCKD 减少热量摄入可以减少内源性胆固醇的产生。然而,如果食用的食物来自动物来源,由于动物产品的脂肪含量较高,膳食胆固醇的摄入量可能会增加。当这些饮食实践结合在一起时,它们可能对血浆胆固醇水平产生相反的影响。研究 VLCKD 对血浆胆固醇和低密度脂蛋白胆固醇水平影响的研究报告得出了相互矛盾的结果。虽然一些研究发现低密度脂蛋白胆固醇水平升高,但其他研究显示总胆固醇和低密度脂蛋白胆固醇降低,同时高密度脂蛋白胆固醇升高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4d4/11327205/d5750babc398/13668_2024_556_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4d4/11327205/d5750babc398/13668_2024_556_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4d4/11327205/d5750babc398/13668_2024_556_Fig1_HTML.jpg

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Diabetes Ther. 2024 Jan;15(1):77-97. doi: 10.1007/s13300-023-01492-4. Epub 2023 Nov 15.
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Very Low-Calorie Ketogenic Diet (VLCKD) as Pre-Operative First-Line Dietary Therapy in Patients with Obesity Who Are Candidates for Bariatric Surgery.极低卡路里生酮饮食(VLCKD)作为肥胖症患者行减重手术的一线术前饮食治疗。
Nutrients. 2023 Apr 14;15(8):1907. doi: 10.3390/nu15081907.
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Efficacy of very low-calorie ketogenic diet with the Pronokal® method in obese women with polycystic ovary syndrome: a 16-week randomized controlled trial.
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BMC Cardiovasc Disord. 2025 Mar 26;25(1):222. doi: 10.1186/s12872-025-04666-z.
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Preoperative Nutrition in Bariatric Surgery: A Narrative Review on Enhancing Surgical Success and Patient Outcomes.减重手术中的术前营养:关于提高手术成功率和患者预后的叙述性综述
Nutrients. 2025 Feb 2;17(3):566. doi: 10.3390/nu17030566.
采用普诺卡尔(Pronokal®)方法的极低热量生酮饮食对肥胖多囊卵巢综合征女性的疗效:一项为期16周的随机对照试验。
Endocr Connect. 2023 Jun 12;12(7). doi: 10.1530/EC-22-0536. Print 2023 Jul 1.
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