West-German Centre of Diabetes and Health, Düsseldorf Catholic Hospital Group, 40591 Dusseldorf, Germany.
Medical Faculty and University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, 40225 Dusseldorf, Germany.
Nutrients. 2024 Oct 18;16(20):3531. doi: 10.3390/nu16203531.
Due to the increasing prevalence of obesity and type 2 diabetes, effective dietary recommendations are needed. Previously, we developed the low-insulin method: by avoiding insulinogenic, i.e., insulin-release-triggering foods, insulin secretion becomes reduced, lipolysis is stimulated, and energy production is shifted to ketosis with excess ketone bodies exhaled in the form of acetone. Now, we investigate how quickly stable ketosis (defined as fasting breath acetone concentration ≥ 7.0 ppm) is achieved, whether and for how long a carbohydrate meal inhibits ketosis, and whether the responses differ in healthy adults with different insulin levels.
An oral glucose tolerance test was conducted, and body composition and fasting insulin were determined at the beginning and end of the 14-day study. Participants ( = 10) followed a ketogenic diet and performed continuous glucose monitoring. Ketosis levels were determined by measuring breath acetone concentrations. On day 8, two white bread rolls with jam (72 g carbohydrates) were consumed for breakfast.
After seven days, all participants achieved stable ketosis (defined as fasting breath acetone concentration ≥ 7.0 ppm), which dropped from 8.2 to 5.7 ppm ( = 0.0014) after the carbohydrate meal. It took five days to achieve stable ketosis again. The stratification of participants into tertiles according to their fasting insulin levels demonstrated that individuals with low fasting insulin levels achieved stable ketosis again after two days and those with medium insulin levels after five days, while those with high baseline values did not reach stable ketosis by the end of the study.
By carbohydrate restriction, stable ketosis can be achieved within one week. However, a single carbohydrate meal inhibits ketosis for several days. This effect is pronounced in individuals with elevated fasting insulin levels.
由于肥胖症和 2 型糖尿病的发病率不断上升，需要有效的饮食建议。此前，我们开发了低胰岛素法：通过避免胰岛素触发的食物，减少胰岛素分泌，刺激脂肪分解，并将能量产生转移到酮症，多余的酮体以丙酮的形式呼出。现在，我们研究了稳定酮症（定义为空腹呼吸丙酮浓度≥7.0ppm）的速度，碳水化合物餐是否以及持续多长时间抑制酮症，以及健康成年人的胰岛素水平不同时，这些反应是否存在差异。
进行口服葡萄糖耐量试验，并在研究开始和结束时测定身体成分和空腹胰岛素。参与者（n=10）遵循生酮饮食，并进行连续血糖监测。通过测量呼吸丙酮浓度来确定酮症水平。第 8 天，早餐吃两个果酱白面包卷（72 克碳水化合物）。
七天后，所有参与者均达到稳定的酮症（定义为空腹呼吸丙酮浓度≥7.0ppm），碳水化合物餐后从 8.2ppm 降至 5.7ppm（p=0.0014）。再次达到稳定酮症需要五天。根据空腹胰岛素水平将参与者分层为三分位数，结果表明空腹胰岛素水平较低的个体在两天后再次达到稳定酮症，胰岛素水平中等的个体在五天后达到稳定酮症，而基线值较高的个体在研究结束时未达到稳定酮症。
通过限制碳水化合物摄入，可在一周内达到稳定的酮症。然而，一顿碳水化合物餐可抑制酮症数天。这种影响在空腹胰岛素水平升高的个体中更为明显。
