Department of Food, Nutrition, and Facilities, FH Muenster, University of Applied Sciences Muenster, 48149 Muenster, Germany.
Department of General Pediatrics, Metabolic Diseases, University Hospital Muenster, 48149 Muenster, Germany.
Nutrients. 2024 Jul 29;16(15):2456. doi: 10.3390/nu16152456.
The ketogenic diet is used worldwide to treat various diseases, especially drug-resistant epilepsies. Medium-chain triglycerides or medium-chain fatty acids, primarily the major ketogenic compound caprylic acid (C8; C8:0), can significantly support ketogenesis. This review examines the effects of concurrent carbohydrate intake on C8-induced ketogenesis. A systematic literature search (PubMed and Web of Science) with subsequent data extraction was performed according to PRISMA guidelines and the Cochrane Handbook. Studies investigating the metabolic response to C8-containing MCT interventions with carbohydrate intake were included. The studies did not include a ketogenic diet. Three intervention groups were created. The quality of the studies was assessed using the RoB II tool, and the meta-analysis was performed using the Cochrane RevMan software. A total of 7 trials, including 4 RCTs, met the inclusion criteria. Ketone production was lower when C8 was combined with carbohydrates compared to MCT intake alone. The lower C8 dose group (11 g) did not show a significantly lower ketogenic effect than the higher dose group (19 g). Forest plot analysis showed heterogeneous data. The data suggest a non-linear relationship between C8, carbohydrate intake and ketone production. Further studies are needed to investigate the influence of different carbohydrates on C8-induced ketogenesis. Limitations include heterogeneous intervention conditions, such as different types of dispersions, caffeine intake, limited number of studies and variability in study design.
生酮饮食在全球范围内用于治疗各种疾病，特别是耐药性癫痫。中链甘油三酯或中链脂肪酸，主要是主要的生酮化合物辛酸（C8；C8：0），可以显著支持酮体生成。这篇综述考察了碳水化合物摄入对 C8 诱导的酮体生成的影响。根据 PRISMA 指南和 Cochrane 手册进行了系统的文献搜索（PubMed 和 Web of Science），并随后进行了数据提取。纳入了研究 C8 含量的 MCT 干预与碳水化合物摄入对代谢反应的研究。这些研究不包括生酮饮食。创建了三个干预组。使用 RoB II 工具评估研究的质量，并使用 Cochrane RevMan 软件进行荟萃分析。共有 7 项试验符合纳入标准，其中包括 4 项 RCT。与单独摄入 MCT 相比，C8 与碳水化合物结合时酮的产生较低。C8 低剂量组（11 克）与高剂量组（19 克）相比，酮生成效果没有明显降低。森林图分析显示数据存在异质性。数据表明 C8、碳水化合物摄入和酮体生成之间存在非线性关系。需要进一步研究不同碳水化合物对 C8 诱导的酮体生成的影响。限制因素包括干预条件的异质性，例如不同类型的分散体、咖啡因摄入、研究数量有限以及研究设计的变异性。
