EFEKTIVITAS DIET KETOGENIK DALAM MANAJEMEN PENYAKIT KARDIOMETABOLIK: TINJAUAN PUSTAKA
Abstrak
Introduction: Cardiometabolic disease has become a common disease in Indonesian society and also globally. There are several diet programs that can be used to improve the quality of life of cardiometabolic patients, one of the most popular is the ketogenic diet (DK). Various literature shows the potential effectiveness of DK in reducing body weight and sugar levels in cardiometabolic patients. However, several other reports also show that DK can cause hypoglycemia and hypercholesterolemia in these patients. This literature review was created to broadly explain the benefits and risks of DK in the management and improvement of quality of life for cardiometabolic patients.
Discussion: DK is a dietary pattern with very low carbohydrate content, but with high fat content. In obesity management, DK has been proven to be effective in reducing body weight and body fat content. Regarding diabetes mellitus, several studies have stated that DK has proven effective in controlling the body's glycemic levels even when compared with a standard hypocaloric diet. DK has also been proven to be effective in preventing heart disease through controlling total fat content, glycemic load, and body mass index (BMI). Several reports state that DK can cause side effects including ketoacidosis, hypoglycemia and dyslipidemia. There are no definite reports that state the relationship between increased levels of unsaturated fat due to DK and cardiovascular risk.
Conclusion: DK can be an option for management of several cardiometabolic diseases. However, further studies need to be carried out to determine safe consumption levels and other risks that may arise from the DK program
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Referensi
1. Vincent GE, Jay SM, Sargent C, Vandelanotte C, Ridgers ND, Ferguson SA. Improving Cardiometabolic Health with Diet, Physical Activity, and Breaking Up Sitting: What about Sleep? Front Physiol. 2017;8:865.
2. Shmerling RH. How good is your cardiometabolic health — and what is that, anyway? Harvard Health Publishing. 2022.
3. ACC. Cardiometabolic Initiative. American College of Cardiology. 2023.
4. Zhang W, Guo X, Chen L, Chen T, Yu J, Wu C, et al. Ketogenic Diets and Cardio-Metabolic Diseases. Front Endocrinol (Lausanne). 2021;12:753039.
5. Tarmizi SN. Penyakit Jantung Penyebab Utama Kematian, Kemenkes Perkuat Layanan Primer [Internet]. Sehat Negeriku. 2022 [cited 2023 Feb 2]. Available from: https://sehatnegeriku.kemkes.go.id/baca/rilis-media/20220929/0541166/penyakit-jantung-penyebab-utama-kematian-kemenkes-perkuat-layanan-primer/
6. BPS. Prevalensi Obesitas Pada Penduduk Umur > 18 Tahun Menurut Jenis Kelamin 2013-2018. Badan Pusat Statistik. 2023.
7. BPJS. Tangkis Risiko Kardiometabolik dengan Optimalisasi PROLANS. BPJS Kesehatan. 2017.
8. Marques M do C, Pires R, Perdigão M, Sousa L, Fonseca C, Pinho LG, et al. Patient-Centered Care for Patients with Cardiometabolic Diseases: An Integrative Review. J Pers Med. 2021 Dec;11(12).
9. Gardner CD, Landry MJ, Perelman D, Petlura C, Durand LR, Aronica L, et al. Effect of a ketogenic diet versus Mediterranean diet on glycated hemoglobin in individuals with prediabetes and type 2 diabetes mellitus: The interventional Keto-Med randomized crossover trial. Am J Clin Nutr [Internet]. 2022 Sep 1;116(3):640–52. Available from: https://doi.org/10.1093/ajcn/nqac154
10. Leow ZZX, Guelfi KJ, Davis EA, Jones TW, Fournier PA. The glycaemic benefits of a very-low-carbohydrate ketogenic diet in adults with Type 1 diabetes mellitus may be opposed by increased hypoglycaemia risk and dyslipidaemia. Diabet Med. 2018 May;
11. Olsson R. What Is the Ketogenic (Keto) Diet? A Beginner’s Guide [Internet]. Banner Health. 2022 [cited 2023 Jul 20]. Available from: https://www.bannerhealth.com/healthcareblog/teach-me/ketogenic-diet
12. Healthline. The Ketogenic Diet: A Detailed Beginner’s Guide to Keto. Healthline. 2020.
13. WHO. Obesity. World Health Organization. 2023.
14. Saslow LR, Kim S, Daubenmier JJ, Moskowitz JT, Phinney SD, Goldman V, et al. A randomized pilot trial of a moderate carbohydrate diet compared to a very low carbohydrate diet in overweight or obese individuals with type 2 diabetes mellitus or prediabetes. PLoS One. 2014;9(4):e91027.
15. Li S, Lin G, Chen J, Chen Z, Xu F, Zhu F, et al. The effect of periodic ketogenic diet on newly diagnosed overweight or obese patients with type 2 diabetes. BMC Endocr Disord [Internet]. 2022;22(1):34. Available from: https://doi.org/10.1186/s12902-022-00947-2
16. Al Aamri KS, Alrawahi AH, Al Busaidi N, Al Githi MS, Al Jabri K, Al Balushi F, et al. The effect of low-carbohydrate ketogenic diet in the management of obesity compared with low caloric, low-fat diet. Clin Nutr ESPEN [Internet]. 2022;49:522–8. Available from: https://www.sciencedirect.com/science/article/pii/S2405457722001590
17. Ernesti I, Baratta F, Watanabe M, Risi R, Camajani E, Persichetti A, et al. Predictors of weight loss in patients with obesity treated with a Very Low-Calorie Ketogenic Diet. Front Nutr. 2023;10(January):1–9.
18. Perticone M, Maio R, Sciacqua A, Suraci E, Pinto A, Pujia R, et al. Ketogenic Diet-Induced Weight Loss is Associated with an Increase in Vitamin D Levels in Obese Adults. Vol. 24, Molecules. 2019.
19. WHO. Diabetes [Internet]. World Health Organization. 2023 [cited 2023 Jul 21]. Available from: https://www.who.int/health-topics/diabetes#tab=tab_1
20. Li F, Shen Y, Chen Q, Li X, Yang H, Zhang C, et al. Therapeutic effect of ketogenic diet treatment on type 2 diabetes. J Futur Foods [Internet]. 2022;2(2):177–83. Available from: https://www.sciencedirect.com/science/article/pii/S2772566922000179
21. Goday A, Bellido D, Sajoux I, Crujeiras AB, Burguera B, García-Luna PP, et al. Short-term safety, tolerability and efficacy of a very low-calorie-ketogenic diet interventional weight loss program versus hypocaloric diet in patients with type 2 diabetes mellitus. Nutr Diabetes. 2016 Sep;6(9):e230.
22. Aylward NM, Shah N, Sellers EA. The ketogenic diet for the treatment of myoclonic astatic epilepsy in a child with type 1 diabetes mellitus. Can J diabetes. 2014 Aug;38(4):223–4.
23. Gavidia K, Kalayjian T. Treating Diabetes Utilizing a Low Carbohydrate Ketogenic Diet and Intermittent Fasting Without Significant Weight Loss: A Case Report. Vol. 8, Frontiers in nutrition. Switzerland; 2021. p. 687081.
24. Lichtash C, Fung J, Ostoich KC, Ramos M. Therapeutic use of intermittent fasting and ketogenic diet as an alternative treatment for type 2 diabetes in a normal weight woman: a 14-month case study. BMJ Case Rep [Internet]. 2020 Jul 1;13(7):e234223. Available from: http://casereports.bmj.com/content/13/7/e234223.abstract
25. WHO. The top 10 causes of death [Internet]. World Health Organization. 2020 [cited 2023 Jul 22]. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
26. Dehghan M, Mente A, Zhang X, Swaminathan S, Li W, Mohan V, et al. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Lancet (London, England). 2017 Nov;390(10107):2050–62.
27. Luo W, Zhang J, Xu D, Zhou Y, Qu Z, Yang Q, et al. Low carbohydrate ketogenic diets reduce cardiovascular risk factor levels in obese or overweight patients with T2DM: A meta-analysis of randomized controlled trials [Internet]. Vol. 9, Frontiers in Nutrition . 2022. Available from: https://www.frontiersin.org/articles/10.3389/fnut.2022.1092031
28. Patikorn C, Saidoung P, Pham T, Phisalprapa P, Lee YY, Varady KA, et al. Effects of ketogenic diet on health outcomes: an umbrella review of meta-analyses of randomized clinical trials. BMC Med [Internet]. 2023;21(1):1–12. Available from: https://doi.org/10.1186/s12916-023-02874-y
29. Whalen C, Mattie F, Bach E, Bottiglieri T, Ross AC, Neuberger T, et al. A Ketogenic Diet Is Protective Against Atherosclerosis in Apolipoprotein E Knockout Mice. Vol. 4, Current Developments in Nutrition. 2020. p. 87.
30. White-Cotsmire AJ, Healy AM. Ketogenic Diet as a Trigger for Diabetic Ketoacidosis in a Misdiagnosis of Diabetes: A Case Report. Vol. 38, Clinical diabetes : a publication of the American Diabetes Association. United States; 2020. p. 318–21.
31. Shaikh S, Mohamed MM, Mujeeb A, Shaikh F, Harris B. Euglycemic Diabetic Ketoacidosis Precipitated by a Keto Diet: Importance of Dietary History in Diagnosis. Vol. 12, Cureus. United States; 2020. p. e10199.
2. Shmerling RH. How good is your cardiometabolic health — and what is that, anyway? Harvard Health Publishing. 2022.
3. ACC. Cardiometabolic Initiative. American College of Cardiology. 2023.
4. Zhang W, Guo X, Chen L, Chen T, Yu J, Wu C, et al. Ketogenic Diets and Cardio-Metabolic Diseases. Front Endocrinol (Lausanne). 2021;12:753039.
5. Tarmizi SN. Penyakit Jantung Penyebab Utama Kematian, Kemenkes Perkuat Layanan Primer [Internet]. Sehat Negeriku. 2022 [cited 2023 Feb 2]. Available from: https://sehatnegeriku.kemkes.go.id/baca/rilis-media/20220929/0541166/penyakit-jantung-penyebab-utama-kematian-kemenkes-perkuat-layanan-primer/
6. BPS. Prevalensi Obesitas Pada Penduduk Umur > 18 Tahun Menurut Jenis Kelamin 2013-2018. Badan Pusat Statistik. 2023.
7. BPJS. Tangkis Risiko Kardiometabolik dengan Optimalisasi PROLANS. BPJS Kesehatan. 2017.
8. Marques M do C, Pires R, Perdigão M, Sousa L, Fonseca C, Pinho LG, et al. Patient-Centered Care for Patients with Cardiometabolic Diseases: An Integrative Review. J Pers Med. 2021 Dec;11(12).
9. Gardner CD, Landry MJ, Perelman D, Petlura C, Durand LR, Aronica L, et al. Effect of a ketogenic diet versus Mediterranean diet on glycated hemoglobin in individuals with prediabetes and type 2 diabetes mellitus: The interventional Keto-Med randomized crossover trial. Am J Clin Nutr [Internet]. 2022 Sep 1;116(3):640–52. Available from: https://doi.org/10.1093/ajcn/nqac154
10. Leow ZZX, Guelfi KJ, Davis EA, Jones TW, Fournier PA. The glycaemic benefits of a very-low-carbohydrate ketogenic diet in adults with Type 1 diabetes mellitus may be opposed by increased hypoglycaemia risk and dyslipidaemia. Diabet Med. 2018 May;
11. Olsson R. What Is the Ketogenic (Keto) Diet? A Beginner’s Guide [Internet]. Banner Health. 2022 [cited 2023 Jul 20]. Available from: https://www.bannerhealth.com/healthcareblog/teach-me/ketogenic-diet
12. Healthline. The Ketogenic Diet: A Detailed Beginner’s Guide to Keto. Healthline. 2020.
13. WHO. Obesity. World Health Organization. 2023.
14. Saslow LR, Kim S, Daubenmier JJ, Moskowitz JT, Phinney SD, Goldman V, et al. A randomized pilot trial of a moderate carbohydrate diet compared to a very low carbohydrate diet in overweight or obese individuals with type 2 diabetes mellitus or prediabetes. PLoS One. 2014;9(4):e91027.
15. Li S, Lin G, Chen J, Chen Z, Xu F, Zhu F, et al. The effect of periodic ketogenic diet on newly diagnosed overweight or obese patients with type 2 diabetes. BMC Endocr Disord [Internet]. 2022;22(1):34. Available from: https://doi.org/10.1186/s12902-022-00947-2
16. Al Aamri KS, Alrawahi AH, Al Busaidi N, Al Githi MS, Al Jabri K, Al Balushi F, et al. The effect of low-carbohydrate ketogenic diet in the management of obesity compared with low caloric, low-fat diet. Clin Nutr ESPEN [Internet]. 2022;49:522–8. Available from: https://www.sciencedirect.com/science/article/pii/S2405457722001590
17. Ernesti I, Baratta F, Watanabe M, Risi R, Camajani E, Persichetti A, et al. Predictors of weight loss in patients with obesity treated with a Very Low-Calorie Ketogenic Diet. Front Nutr. 2023;10(January):1–9.
18. Perticone M, Maio R, Sciacqua A, Suraci E, Pinto A, Pujia R, et al. Ketogenic Diet-Induced Weight Loss is Associated with an Increase in Vitamin D Levels in Obese Adults. Vol. 24, Molecules. 2019.
19. WHO. Diabetes [Internet]. World Health Organization. 2023 [cited 2023 Jul 21]. Available from: https://www.who.int/health-topics/diabetes#tab=tab_1
20. Li F, Shen Y, Chen Q, Li X, Yang H, Zhang C, et al. Therapeutic effect of ketogenic diet treatment on type 2 diabetes. J Futur Foods [Internet]. 2022;2(2):177–83. Available from: https://www.sciencedirect.com/science/article/pii/S2772566922000179
21. Goday A, Bellido D, Sajoux I, Crujeiras AB, Burguera B, García-Luna PP, et al. Short-term safety, tolerability and efficacy of a very low-calorie-ketogenic diet interventional weight loss program versus hypocaloric diet in patients with type 2 diabetes mellitus. Nutr Diabetes. 2016 Sep;6(9):e230.
22. Aylward NM, Shah N, Sellers EA. The ketogenic diet for the treatment of myoclonic astatic epilepsy in a child with type 1 diabetes mellitus. Can J diabetes. 2014 Aug;38(4):223–4.
23. Gavidia K, Kalayjian T. Treating Diabetes Utilizing a Low Carbohydrate Ketogenic Diet and Intermittent Fasting Without Significant Weight Loss: A Case Report. Vol. 8, Frontiers in nutrition. Switzerland; 2021. p. 687081.
24. Lichtash C, Fung J, Ostoich KC, Ramos M. Therapeutic use of intermittent fasting and ketogenic diet as an alternative treatment for type 2 diabetes in a normal weight woman: a 14-month case study. BMJ Case Rep [Internet]. 2020 Jul 1;13(7):e234223. Available from: http://casereports.bmj.com/content/13/7/e234223.abstract
25. WHO. The top 10 causes of death [Internet]. World Health Organization. 2020 [cited 2023 Jul 22]. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
26. Dehghan M, Mente A, Zhang X, Swaminathan S, Li W, Mohan V, et al. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Lancet (London, England). 2017 Nov;390(10107):2050–62.
27. Luo W, Zhang J, Xu D, Zhou Y, Qu Z, Yang Q, et al. Low carbohydrate ketogenic diets reduce cardiovascular risk factor levels in obese or overweight patients with T2DM: A meta-analysis of randomized controlled trials [Internet]. Vol. 9, Frontiers in Nutrition . 2022. Available from: https://www.frontiersin.org/articles/10.3389/fnut.2022.1092031
28. Patikorn C, Saidoung P, Pham T, Phisalprapa P, Lee YY, Varady KA, et al. Effects of ketogenic diet on health outcomes: an umbrella review of meta-analyses of randomized clinical trials. BMC Med [Internet]. 2023;21(1):1–12. Available from: https://doi.org/10.1186/s12916-023-02874-y
29. Whalen C, Mattie F, Bach E, Bottiglieri T, Ross AC, Neuberger T, et al. A Ketogenic Diet Is Protective Against Atherosclerosis in Apolipoprotein E Knockout Mice. Vol. 4, Current Developments in Nutrition. 2020. p. 87.
30. White-Cotsmire AJ, Healy AM. Ketogenic Diet as a Trigger for Diabetic Ketoacidosis in a Misdiagnosis of Diabetes: A Case Report. Vol. 38, Clinical diabetes : a publication of the American Diabetes Association. United States; 2020. p. 318–21.
31. Shaikh S, Mohamed MM, Mujeeb A, Shaikh F, Harris B. Euglycemic Diabetic Ketoacidosis Precipitated by a Keto Diet: Importance of Dietary History in Diagnosis. Vol. 12, Cureus. United States; 2020. p. e10199.
Diterbitkan
2024-04-30
##submission.howToCite##
WIRA ABDI SUPUTRA, Putu; DWINANDA PRABAWA MAHARDANA, Made.
EFEKTIVITAS DIET KETOGENIK DALAM MANAJEMEN PENYAKIT KARDIOMETABOLIK: TINJAUAN PUSTAKA.
Essence of Scientific Medical Journal, [S.l.], v. 21, n. 2, p. 83 - 89, apr. 2024.
ISSN 2655-6472.
Tersedia pada: <http://103.29.196.112/index.php/essential/article/view/109748>. Tanggal Akses: 04 mar. 2026
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