Ketogenic diets, physical activity and body composition: a review.
Ketogenic diets, physical activity and body composition: a review.
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DOI：
10.1017/s0007114521002609
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发表时间：
2022-06-28
影响因子：
3.6
通讯作者：
Paoli, Antonio
中科院分区：
文献类型：
--
作者：
Ashtary-Larky, Damoon;Bagheri, Reza;Bavi, Hoda;Baker, Julien S.;Moro, Tatiana;Mancin, Laura;Paoli, Antonio
关键词：
肥胖症仍然是一个严重的相关公共卫生问题在世界各地，尽管相关的对策被很好地理解（即主要是体育活动和调整饮食）。在不同的营养方法中，对生酮饮食（KD）的兴趣越来越大，以控制体重（BM）并提高脂肪量的减少。KD大幅减少每日碳水化合物的摄入量。这导致脂肪酸利用增加，导致血液酮体（乙酰乙酸酯、3-β-羟基丁酸酯和丙酮）增加，从而导致代谢性酮症。多年来，营养干预研究一直专注于减少膳食脂肪，长期来看几乎没有或相互矛盾的积极结果。此外，目前的运动员营养指南建议以碳水化合物为基础的饮食，以增强肌肉的适应性。这篇综述讨论了KD的生理基础及其对肥胖者和运动员中久坐者结合不同类型的运动（阻力训练或耐力训练）减少BM和改善身体成分的影响。最后，我们讨论了这些营养干预措施的优点和缺点，以及在肥胖和运动人群中应该观察到的预防措施。使用Medline、Google Scholar、PubMed、Web of Science、Scopus和Sportdisc数据库检索了1921年至2021年4月的文献，以识别相关研究。总之，根据目前的证据，KD是减少肥胖个体和运动员BM和体脂的有效方法。然而，这些积极的影响主要是因为KD的食欲抑制作用，可以减少每日能量摄入。因此，在等能情况下，在肥胖个体和运动人群中，KD在BM和体脂减少方面没有任何优于非KD的上级益处。在久坐不动的肥胖患者中，似乎无脂肪质量（FFM）的变化与低脂饮食后的下降一样大，如果不是更大的话。在瘦体重方面，似乎KD后会导致阻力训练个体的FFM损失。相比之下，KD的FFM保留效果在抵抗训练的个体中比在抵抗训练的个体中更有效。
Obesity remains a serious relevant public health concern throughout the world despite related countermeasures being well understood (i.e. mainly physical activity and an adjusted diet). Among different nutritional approaches, there is a growing interest in ketogenic diets (KD) to manipulate body mass (BM) and to enhance fat mass loss. KD reduce the daily amount of carbohydrate intake drastically. This results in increased fatty acid utilisation, leading to an increase in blood ketone bodies (acetoacetate, 3-β-hydroxybutyrate and acetone) and therefore metabolic ketosis. For many years, nutritional intervention studies have focused on reducing dietary fat with little or conflicting positive results over the long term. Moreover, current nutritional guidelines for athletes propose carbohydrate-based diets to augment muscular adaptations. This review discusses the physiological basis of KD and their effects on BM reduction and body composition improvements in sedentary individuals combined with different types of exercise (resistance training or endurance training) in individuals with obesity and athletes. Ultimately, we discuss the strengths and the weaknesses of these nutritional interventions together with precautionary measures that should be observed in both individuals with obesity and athletic populations. A literature search from 1921 to April 2021 using Medline, Google Scholar, PubMed, Web of Science, Scopus and Sportdiscus Databases was used to identify relevant studies. In summary, based on the current evidence, KD are an efficient method to reduce BM and body fat in both individuals with obesity and athletes. However, these positive impacts are mainly because of the appetite suppressive effects of KD, which can decrease daily energy intake. Therefore, KD do not have any superior benefits to non-KD in BM and body fat loss in individuals with obesity and athletic populations in an isoenergetic situation. In sedentary individuals with obesity, it seems that fat-free mass (FFM) changes appear to be as great, if not greater, than decreases following a low-fat diet. In terms of lean mass, it seems that following a KD can cause FFM loss in resistance-trained individuals. In contrast, the FFM-preserving effects of KD are more efficient in endurance-trained compared with resistance-trained individuals.