Alteraciones metabólicas en mujeres adultas obesas como efecto del uso de dietas cetogénicas
Resumen
La obesidad se ha tornado una epidemia creciente a nivel mundial, y a pesar de ser un factor modificable, es altamente prevalente, destacándose aún más en la población femenina, este trastorno es el patrón clave para desarrollar la mayoría de enfermedades crónicas, principales razones de mortalidad.La dieta cetogénica es caracterizada por una marcada restricción de carbohidratos con un aumento en grasa y proteínas, desde hace años atrás ha sido recomendada como tratamiento para trastornos neurológicos, sin embargo, en la actualidad es un instrumento eficaz y muy utilizado puesto que, no solo presenta efectos terapéuticos en el control lipídico y glucémico, sino que aporta con el rápido descenso de peso corporal en pacientes con obesidad, e incluso se ha visto beneficios en pacientes con “diabetes mellitus tipo 2”, “enfermedad de hígado graso no alcohólico”, “insuficiencia renal leve”, síndrome de ovario poliquístico, cáncer de endometrio, etc. La duración de la dieta cetogénica en cada paciente sigue causando controversia e incertidumbre, sin embargo, en esta revisión bibliográfica en la mayoría de casos no se evidencian efectos secundarios a corto plazo, por lo que se considera una opción terapéutica segura en estos períodos, sin embargo, se desconoce los efectos secundarios a largo plazo. Además, la mala adherencia a esta opción de tratamiento por su poco porcentaje de carbohidratos y sus elevados costos, hace que los pacientes opten por abordajes distintos con los que se pueda llevar un mejor estilo de vida.
Descargas
Citas
A. Lyngstad et al., “Investigating the effect of sex and ketosis on weight-loss-induced changes in appetite,” Am. J. Clin. Nutr., vol. 109, no. 6, pp. 1511–1518, 2019, doi: 10.1093/ajcn/nqz002.
R. J. Klement et al., “Impact of a ketogenic diet intervention during radiotherapy on body composition: III - Final results of the KETOCOMP study for breast cancer patients,” Breast Cancer Res., vol. 22, no. 1, pp. 1–14, 2020, doi: 10.1186/s13058-020-01331-5.
E. Sánchez et al., “Randomized clinical trial to evaluate the morphological changes in the adventitial vasa vasorum density and biological markers of endothelial dysfunction in subjects with moderate obesity undergoing a very low-calorie ketogenic diet,” Nutrients, vol. 14, no. 1, 2022, doi: 10.3390/nu14010033.
A. I. Castro et al., “Effect of a very low-calorie ketogenic diet on food and alcohol cravings, physical and sexual activity, sleep disturbances, and quality of life in obese patients,” Nutrients, vol. 10, no. 10, 2018, doi: 10.3390/nu10101348.
Y. J. Choi, S. M. Jeon, and S. Shin, “Impact of a ketogenic diet on metabolic parameters in patients with obesity or overweight and with or without type 2 diabetes: A meta-analysis of randomized controlled trials,” Nutrients, vol. 12, no. 7, pp. 1–19, 2020, doi: 10.3390/nu12072005.
G. M. Cunha et al., “Efficacy of a 2-Month Very Low-Calorie Ketogenic Diet (VLCKD) Compared to a Standard Low-Calorie Diet in Reducing Visceral and Liver Fat Accumulation in Patients With Obesity,” Front. Endocrinol. (Lausanne)., vol. 11, no. September, pp. 1–10, 2020, doi: 10.3389/fendo.2020.00607.
F. Vinciguerra, M. Graziano, M. Hagnäs, L. Frittitta, and A. Tumminia, “Influence of the mediterranean and ketogenic diets on cognitive status and decline: A narrative review,” Nutrients, vol. 12, no. 4, pp. 1–22, 2020, doi: 10.3390/nu12041019.
A. Bruci et al., “Very low-calorie ketogenic diet: A safe and effective tool for weight loss in patients with obesity and mild kidney failure,” Nutrients, vol. 12, no. 2, pp. 1–10, 2020, doi: 10.3390/nu12020333.
G. Muscogiuri et al., “The management of very low-calorie ketogenic diet in obesity outpatient clinic: A practical guide,” J. Transl. Med., vol. 17, no. 1, pp. 1–9, 2019, doi: 10.1186/s12967-019-2104-z.
K. C. Schreck et al., “Feasibility and Biological Activity of a Ketogenic/Intermittent-Fasting Diet in Patients With Glioma,” Neurology, vol. 97, no. 9, pp. e953–e963, 2021, doi: 10.1212/WNL.0000000000012386.
C. Di Lorenzo et al., “A randomized double-blind, cross-over trial of very low-calorie diet in overweight migraine patients: A possible role for ketones?,” Nutrients, vol. 11, no. 8, pp. 1–13, 2019, doi: 10.3390/nu11081742.
S. Razeghi Jahromi, Z. Ghorbani, P. Martelletti, C. Lampl, and M. Togha, “Association of diet and headache,” J. Headache Pain, vol. 20, no. 1, pp. 1–11, 2019, doi: 10.1186/s10194-019-1057-1.
X. Yuan et al., “Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: a systematic review and meta-analysis,” Nutr. Diabetes, vol. 10, no. 1, 2020, doi: 10.1038/s41387-020-00142-z.
V. Garofalo, F. Barbagallo, R. Cannarella, A. E. Calogero, S. La Vignera, and R. A. Condorelli, “Effects of the ketogenic diet on bone health: A systematic review,” Front. Endocrinol. (Lausanne)., vol. 14, no. February, pp. 1–7, 2023, doi: 10.3389/fendo.2023.1042744.
K. Falkenhain et al., “Keyto app and device versus WW app on weight loss and metabolic risk in adults with overweight or obesity: A randomized trial,” Obesity, vol. 29, no. 10, pp. 1606–1614, 2021, doi: 10.1002/oby.23242.
M. M. Michalczyk, G. Klonek, A. Maszczyk, and A. Zajac, “The effects of a low calorie ketogenic diet on glycaemic control variables in hyperinsulinemic overweight/obese females,” Nutrients, vol. 12, no. 6, pp. 1–14, 2020, doi: 10.3390/nu12061854.
T. J. W. Mcdonald and M. C. Cervenka, “Lessons learned from recent clinical trials of ketogenic diet therapies in adults,” Curr. Opin. Clin. Nutr. Metab. Care, vol. 6, pp. 418–424, 2019, doi: 10.1097/MCO.0000000000000596.Lessons.
S. Li et al., “The effect of periodic ketogenic diet on newly diagnosed overweight or obese patients with type 2 diabetes,” BMC Endocr. Disord., vol. 22, no. 1, pp. 4–9, 2022, doi: 10.1186/s12902-022-00947-2.
M. Á. López-Espinoza, S. Chacón-Moscoso, S. Sanduvete-Chaves, M. J. Ortega-Maureira, and T. Barrientos-Bravo, “Effect of a ketogenic diet on the nutritional parameters of obese patients: A systematic review and meta-analysis,” Nutrients, vol. 13, no. 9, pp. 1–21, 2021, doi: 10.3390/nu13092946.
M. D’abbondanza et al., “Very low-carbohydrate ketogenic diet for the treatment of severe obesity and associated non-alcoholic fatty liver disease: The role of sex differences,” Nutrients, vol. 12, no. 9, pp. 1–14, 2020, doi: 10.3390/nu12092748.
A. Paoli, L. Mancin, M. C. Giacona, A. Bianco, and M. Caprio, “Effects of a ketogenic diet in overweight women with polycystic ovary syndrome,” J. Transl. Med., vol. 18, no. 1, pp. 1–11, 2020, doi: 10.1186/s12967-020-02277-0.
L. Barrea et al., “Ketogenic Diet as Medical Prescription in Women with Polycystic Ovary Syndrome (PCOS),” Curr. Nutr. Rep., vol. 12, no. 1, pp. 56–64, 2023, doi: 10.1007/s13668-023-00456-1.
X. Che, Z. Chen, M. Liu, and Z. Mo, “Dietary Interventions: A Promising Treatment for Polycystic Ovary Syndrome,” Ann. Nutr. Metab., vol. 77, no. 6, pp. 313–323, 2021, doi: 10.1159/000519302.
C. W. Cohen et al., “A ketogenic diet reduces central obesity and serum insulin in women with ovarian or endometrial cancer,” J. Nutr., vol. 148, no. 8, pp. 1253–1260, 2018, doi: 10.1093/jn/nxy119.
J. Burén, M. Ericsson, N. R. T. Damasceno, and A. Sjödin, “A ketogenic low‐carbohydrate high‐fat diet increases ldl cholesterol in healthy, young, normal‐weight women: A randomized controlled feeding trial,” Nutrients, vol. 13, no. 3, pp. 1–12, 2021, doi: 10.3390/nu13030814.
S. Vargas-Molina et al., “Effects of a ketogenic diet on body composition and strength in trained women,” J. Int. Soc. Sports Nutr., vol. 17, no. 1, pp. 1–10, 2020, doi: 10.1186/s12970-020-00348-7.
J. L. Coleman, C. T. Carrigan, and L. M. Margolis, “Body composition changes in physically active individuals consuming ketogenic diets: a systematic review,” J. Int. Soc. Sports Nutr., vol. 18, no. 1, pp. 1–11, 2021, doi: 10.1186/s12970-021-00440-6.
K. Durkalec-Michalski, P. M. Nowaczyk, and K. Siedzik, “Effect of a four-week ketogenic diet on exercise metabolism in CrossFit-trained athletes,” J. Int. Soc. Sports Nutr., vol. 16, no. 1, pp. 1–15, 2019, doi: 10.1186/s12970-019-0284-9.
K. Durkalec-Michalski, P. M. Nowaczyk, N. Główka, A. Ziobrowska, and T. Podgórski, “Is a four-week ketogenic diet an effective nutritional strategy in crossfit-trained female and male athletes?,” Nutrients, vol. 13, no. 3, pp. 1–19, 2021, doi: 10.3390/nu13030864.
J. Cao, S. Lei, X. Wang, and S. Cheng, “The effect of a ketogenic low-carbohydrate, high-fat diet on aerobic capacity and exercise performance in endurance athletes: A systematic review and meta-analysis,” Nutrients, vol. 13, no. 8, 2021, doi: 10.3390/nu13082896.
Derechos de autor 2023 Doris Elizabeth Aucay Yunga, Gina Fabiola Mora Domínguez
Esta obra está bajo licencia internacional Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0.
