The dark side of the spoon - glucose, ketones and COVID-19: a possible role for ketogenic diet? - PubMed (original) (raw)

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The dark side of the spoon - glucose, ketones and COVID-19: a possible role for ketogenic diet?

Antonio Paoli et al. J Transl Med. 2020.

Abstract

The novel coronavirus disease (COVID-19) is posing a serious challenge to the health-care systems worldwide, with an enormous impact on health conditions and loss of lives. Notably, obesity and its related comorbidities are strictly related with worse clinical outcomes of COVID-19 disease. Recently, there is a growing interest in the clinical use of ketogenic diets (KDs), particularly in the context of severe obesity with related metabolic complications. KDs have been proven effective for a rapid reduction of fat mass, preserving lean mass and providing an adequate nutritional status. In particular, the physiological increase in plasma levels of ketone bodies exerts important anti-inflammatory and immunomodulating effects, which may reveal as precious tools to prevent infection and potential adverse outcomes of COVID-19 disease. We discuss here the importance of KDs for a rapid reduction of several critical risk factors for COVID-19, such as obesity, type 2 diabetes and hypertension, based on the known effects of ketone bodies on inflammation, immunity, metabolic profile and cardiovascular function. We do believe that a rapid reduction of all modifiable risk factors, especially obesity with its metabolic complications, should be a pillar of public health policies and interventions, in view of future waves of SARS-CoV-2 infection.

Keywords: Diabetes; Hyperglycaemia; Inflammation; Metabolic rehabilitation; Obesity; Sars-CoV-2; VLCKD.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1

Fig. 1

Ketone bodies and NLRP3/inflammasome activation. Protective effects of ketogenic diet and ßOHB on risk conditions associated with serious COVID-19 disease. ßOHB: Beta-hydroxybutyrate, AcAc: AcetoAcetate, MAVS: mitochondrial antiviral signalling protein, LPS: lipopolysaccharide, NLP3: NOD-, LRR- and pyrin domain-containing protein 3, ASC: Adaptor apoptosis associated Speck-like protein containing a Caspase Recruitment Domain (CARD), Pro-IL-1ß: pro-interleukin 1 beta, Pro-IL-18: pro-interleukin 18, DAMPs: damage-associated molecular patterns; PAMPs: pathogen-associated molecular patterns

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