Fat not so bad? The role of ketone bodies and ketogenic diet in the treatment of endothelial dysfunction and hypertension

Pirola, Luciano; Ciesielski, Oskar; Balcerczyk, Aneta

doi:10.1016/j.bcp.2022.115346

Cited by 4 publications

(2 citation statements)

References 73 publications

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“…The present study discovered that children and adolescents in the highest quintile tend to have lower intakes of carbohydrates, while higher intakes of energy, protein, and micro-nutrients, including those we regarded as response variables. This indicated that children and adolescents who have greater adherence to the protective dietary pattern could be getting energy mainly through fat and protein rather than carbohydrates, which is consistent with the principles of the ketogenic diet to some extent [37,38]. Nevertheless, during the essential period of development, appropriate intake of energy and nutrients and a balanced diet are important for children and adolescents.…”

Section: Discussionmentioning

confidence: 62%

Association of the Protective Dietary Pattern for Blood Pressure with Elevated Blood Pressure and Hypertension among Chinese Children and Adolescents Aged 6–17 Years Old: Data from China Nutrition and Health Surveillance (2015–2017)

Li,

Yang,

et al. 2023

Nutrients

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Studies focused on the association between dietary patterns and elevated blood pressure (BP) and hypertension (HTN) among children and adolescents remain insufficient. This study aimed to explore a dietary pattern that could be helpful for the prevention of abnormal BP and to investigate the association between this dietary pattern and elevated BP and HTN among Chinese children and adolescents. A total of 52,080 Chinese children and adolescents aged 6~17 years old from the China Nutrition and Health Surveillance (CNHS) 2015–2017 were included in the current study. The reduced rank regression (RRR) method was applied to derive a dietary pattern that is associated with BP. Multivariable logistic regression was used to assess the association between dietary pattern (DP) and elevated BP and HTN. The Dietary Approach to Stop Hypertension (DASH) score was also calculated for each participant as a comparative method to validate the dietary pattern derived with the RRR method. A protective dietary pattern (PDP) for BP among Chinese children and adolescents was derived, which was characterized by high intakes of dairy products, mushrooms/edible fungi, fresh vegetables, fresh fruits, fresh eggs, aquatic products, mixed legumes, soybeans and related products, offal, dried fruits, and coarse cereals, with low intakes of refined grains. After multiple adjustments, there were significant inverse associations between PDP scores and the odds of elevated BP and HTN (elevated BP: Q5 vs. Q1, OR = 0.849, 95%CI = 0.755–0.931, P-trend < 0.05; HTN: Q5 vs. Q1, OR = 0.795, 95%CI = 0.694–0.911, P-trend < 0.05). The DASH diet was also observed to have protective effects on elevated BP in model I (Q5 vs. Q1, OR = 0.899, 95%CI = 0.828–0.975, P-trend < 0.05), but was not observed to have protective effects on HTN (HTN: Q5 vs. Q1, OR = 0.958, 95%CI = 0.876–1.048, P-trend > 0.05). The current study suggested that greater adherence to the PDP for BP among Chinese children and adolescents might be associated with lower odds of elevated BP and HTN.

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Section: Discussionmentioning

confidence: 62%

Association of the Protective Dietary Pattern for Blood Pressure with Elevated Blood Pressure and Hypertension among Chinese Children and Adolescents Aged 6–17 Years Old: Data from China Nutrition and Health Surveillance (2015–2017)

Li,

Yang,

et al. 2023

Nutrients

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“…In this context, in normal-weight individuals, a non-calorie-restricted ketogenic diet can produce a modest reduction in body mass and percent fat and can maintain fat-free mass while it leads to increased use of fat as fuel [ 101 ]. Furthermore, ketones have a potential benefit in patients with CVD; particularly in patients with HF [ 102 ], they might offset senescent changes leading to apoptosis-induced myocardial atrophy and failure [ 103 ]; they may benefit patients with hypertension and endothelial dysfunction [ 104 ], they can enhance cardiac endothelial cell proliferation [ 33 ], upregulate anti-oxidative and anti-inflammatory activities, and they can finally improve mitochondrial function and growth, DNA repair, and autophagy [ 32 ]. In the heart, the adaptive response to increased ketolysis ameliorates resistance to damage after ischemic episodes or to cardiotoxic effects of chemotherapeutic agents, like doxorubicin [ 32 ].…”

Section: Ketone Therapymentioning

confidence: 99%

Ketone Bodies and Cardiovascular Disease: An Alternate Fuel Source to the Rescue

Manolis

2023

IJMS

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The increased metabolic activity of the heart as a pump involves a high demand of mitochondrial adenosine triphosphate (ATP) production for its mechanical and electrical activities accomplished mainly via oxidative phosphorylation, supplying up to 95% of the necessary ATP production, with the rest attained by substrate-level phosphorylation in glycolysis. In the normal human heart, fatty acids provide the principal fuel (40–70%) for ATP generation, followed mainly by glucose (20–30%), and to a lesser degree (<5%) by other substrates (lactate, ketones, pyruvate and amino acids). Although ketones contribute 4–15% under normal situations, the rate of glucose use is drastically diminished in the hypertrophied and failing heart which switches to ketone bodies as an alternate fuel which are oxidized in lieu of glucose, and if adequately abundant, they reduce myocardial fat delivery and usage. Increasing cardiac ketone body oxidation appears beneficial in the context of heart failure (HF) and other pathological cardiovascular (CV) conditions. Also, an enhanced expression of genes crucial for ketone break down facilitates fat or ketone usage which averts or slows down HF, potentially by avoiding the use of glucose-derived carbon needed for anabolic processes. These issues of ketone body utilization in HF and other CV diseases are herein reviewed and pictorially illustrated.

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The role of low-carbohydrate, high-fat diet in modulating autophagy and endoplasmic reticulum stress in aortic endothelial dysfunction of metabolic syndrome animal model

Eldakhakhny,

Bima,

Alamoudi

et al. 2024

Front. Nutr.

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BackgroundEndothelial dysfunction (ED) is induced by insulin resistance, mediated by endoplasmic reticulum (ER) stress and disturbed autophagy. This study investigates the protective role of a low-carbohydrate, high-fat (LCHF) diet on ED, ER stress, and autophagy dysregulation in an experimental animal model of metabolic syndrome.MethodsForty male Sprague–Dawley rats were divided into four groups: a Control group (standard diet) and three Dexamethasone (DEX) treated groups. Group II continued the standard diet, Group III received an LCHF diet, and Group IV received a high-carbohydrate, low-fat (HCLF) diet. At the end of the experiment, aortic tissue samples were obtained and used for histological, immunohistochemical (Endothelin and PCNA, biochemical MDA, TCA, NO, 8-OH-dG, and Nrf2/ARE protein) and molecular (Endothelin, eNOS, Nrf-2 α, p62, LC3, BECN-1, PINK1, CHOP, BNIP3, PCNA) analysis.ResultsOxidative stress, autophagy markers, and ED markers are increased in the metabolic syndrome group. LCHF diet mitigates the adverse effects of DEX on endothelial dysfunction and oxidative stress, as evidenced by reduced BMI, HOMA-IR, and improved histological and molecular parameters.ConclusionOxidative stress, autophagy dysregulation, and ER stress play crucial roles in the pathogenesis of insulin resistance-induced endothelial dysfunction. An LCHF diet offers protective benefits against insulin resistance and related comorbidities, including endothelial dysfunction.

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Fat not so bad? The role of ketone bodies and ketogenic diet in the treatment of endothelial dysfunction and hypertension

Cited by 4 publications

References 73 publications

Association of the Protective Dietary Pattern for Blood Pressure with Elevated Blood Pressure and Hypertension among Chinese Children and Adolescents Aged 6–17 Years Old: Data from China Nutrition and Health Surveillance (2015–2017)

Association of the Protective Dietary Pattern for Blood Pressure with Elevated Blood Pressure and Hypertension among Chinese Children and Adolescents Aged 6–17 Years Old: Data from China Nutrition and Health Surveillance (2015–2017)

Ketone Bodies and Cardiovascular Disease: An Alternate Fuel Source to the Rescue

The role of low-carbohydrate, high-fat diet in modulating autophagy and endoplasmic reticulum stress in aortic endothelial dysfunction of metabolic syndrome animal model

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