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Ketogenic Diet in COVID-19 Management

Yıl 2023, Cilt: 7 Sayı: 2, 440 - 446, 31.05.2023
https://doi.org/10.46237/amusbfd.1060681

Öz

Cases of pneumonia of unknown etiology were reported on 31 December 2019 in Wuhan, China. These cases have been recognized as COVID-19 disease. Prevention and management of complications related to COVID-19 and methods to protect against COVID-19 are the subjects of research. Adequate and balanced nutrition also comes to the fore at this point. However, the role of the ketogenic diet (KD) in the prevention and management of COVID-19 is also of interest. Respiratory distress and pneumonia are among the complications of COVID-19. Since the respiratory coefficient of carbohydrates is high, there are current recommendations for the restriction of some respiratory system diseases before COVID-19. Factors such as the existence of various mechanisms by which it can act on serious viral infections such as COVID-19, and the loss of fat mass by KD support the idea of KD in COVID-19. On the other hand, factors such as the immune-enhancing effect of a healthy and balanced diet may be deprived as a result of KD application, and the unknown how the human immune system and lung cell functions are affected by ketosis, cause a distant approach to KD. Clinical studies are needed to determine the place of KD in the prevention and management of this epidemic, about which there are many unknowns.

Kaynakça

  • 1. T.C. Sağlık Bakanlığı. (2020). COVID-19 (Sars-Cov2 Enfeksiyonu) Rehberi.Ankara: T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. (Erişim tarihi: 15 Mayıs 2021.)
  • 2. Wu, Z., & McGoogan, J. M. (2020). Characteristics of and important lessons from the Coronavirus Disease 2019 (COVID-19) outbreak in China: Summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA, 323(13), 1239– 1242.
  • 3. South, A. M., Diz, D. I., & Chappell, M. C. (2020). COVID-19, ACE2, and the cardiovascular consequences. Am J Physiol Heart Circ Physiol, 318(5), 1084–1090.
  • 4. Narici, M., Vito, G., Franchi, M., Paoli, A., Moro, T., Marcolin, G., et al. (2021). Impact of sedentarism due to the COVID-19 home confinement on neuromuscular, cardiovascular and metabolic health: Physiological and pathophysiological implications and recommendations for physical and nutritional countermeasures. Eur J Sport Sci, 21(4), 614–635.
  • 5. Özen Barut, B., & Güçlü Altun, İ. (2020). COVID-19 ile ilişkili nörolojik komplikasyonlar. South Clin Ist Euras, 31 ,26-30.
  • 6. Ahmad, I., & Rathore, F. A. (2020). Neurological manifestations and complications of COVID-19: A literature review. J Clin Neurosci, 77, 8–12.
  • 7. Türkiye Diyetisyenler Derneği (TDD). COVID-19 beslenme önerileri. http://www.tdd.org.tr/index.php/duyurular/69-COVID-19-beslenme-onerileri (Erişim tarihi: 15 Mayıs 2021.)
  • 8. T.C. Sağlık Bakanlığı. (2022). Türkiye'ye Özgü Besin ve Beslenme Rehberi. Ankara: Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi Beslenme ve Diyetetik Bölümü.(Erişim tarihi: 22 Ocak 2023.)
  • 9. Armeno, M., Caraballo, R., Vaccarezza, M., Alberti, M. J., Ríos, V., & Galicchio, S. (2014). National consensus on the ketogenic diet. Rev Neurol, 59(5),213-223.
  • 10. Akbulut, G. (2018). Tıbbi Beslenme Tedavisinde Güncel Uygulamalar. Ankara: Nobel Tıp Kitabevleri.
  • 11. Kumada, T., Imai, K., Takahashi, Y., Nabatame, S., & Oguni, H. (2018). Ketogenic diet using a Japanese ketogenic milk for patients with epilepsy: A multi-institutional study. Brain Dev, 40(3), 188– 195.
  • 12. Zhu, D., Wang, M., Wang, J., Yuan, J., Niu, G., Zhang, G., et al. (2016). Ketogenic diet effects on neurobehavioral development of children with intractable epilepsy: A prospective study. Epilepsy Behav, 55, 87–91.
  • 13. Baby, N., Vinayan, K. P., Pavithran, N., & Grace Roy, A. (2018). A pragmatic study on efficacy, tolerability and long term acceptance of ketogenic diet therapy in 74 South Indian children with pharmacoresistant epilepsy. Seizure, 58, 41–46.
  • 14. Liu, H., Yang, Y., Wang, Y., Tang, H., Zhang, F., Zhang, Y., et al. (2018). Ketogenic diet for treatment of intractable epilepsy in adults: A meta-analysis of observational studies. Epilepsia Open, 3(1), 9–17.
  • 15. Masood, W., Annamaraju, P., & Uppaluri, K. R. (2020). Ketogenic Diet. Treasure Island: StatPearls Publishing.
  • 16. Paoli, A., Gorini, S., & Caprio, M. (2020). The dark side of the spoon - glucose, ketones and COVID-19: a possible role for ketogenic diet?. J Transl Med, 18(1), 441.
  • 17. Codo, A. C., Davanzo, G. G., Monteiro, L. B., de Souza, G. F., Muraro, S. P., Virgilio-da- Silva, J. V., et al. (2020). Elevated glucose levels favor SARS-CoV-2 infection and monocyte response through a HIF-1α/glycolysis-dependent axis. Cell Metab, 32(3), 498– 499.
  • 18. Bowie, A. G., & Unterholzner, L. (2008). Viral evasion and subversion of pattern- recognition receptor signalling. Nat Rev Immunol, 8(12), 911–922.
  • 19. Franchi, L., & Núñez, G. (2012). Immunology. Orchestrating inflammasomes. Science (New York, N.Y.), 337(6100), 1299–1300.
  • 20. Swanson, K. V., Deng, M., & Ting, J. P. (2019). The NLRP3 inflammasome: molecular activation and regulation to therapeutics. Nat Rev Immunol, 19(8), 477–489.
  • 21. Chen, I. Y., Moriyama, M., Chang, M. F., & Ichinohe, T. (2019). Severe acute respiratory syndrome coronavirus viroporin 3a activates the NLRP3 inflammasome. Front Microbiol, 10, 50.
  • 22. Horng T. (2014). Calcium signaling and mitochondrial destabilization in the triggering of the NLRP3 inflammasome. Trends Immunol, 35(6), 253–261.
  • 23. Paoli, A., Moro, T., Bosco, G., Bianco, A., Grimaldi, K. A., Camporesi, E., et al. (2015). Effects of n-3 polyunsaturated fatty acids (ω-3) supplementation on some cardiovascular risk factors with a ketogenic Mediterranean diet. Mar Drugs, 13(2), 996–1009.
  • 24. Youm, Y. H., Nguyen, K. Y., Grant, R. W., Goldberg, E. L., Bodogai, M., Kim, D., et al. (2015). The ketone metabolite β-hydroxybutyrate blocks NLRP3 inflammasome-mediated inflammatory disease. Nat Med, 21(3), 263–269.
  • 25. Sukkar, S. G., & Bassetti, M. (2020). Induction of ketosis as a potential therapeutic option to limit hyperglycemia and prevent cytokine storm in COVID-19. Nutrition, 79-80, 110967.
  • 26. Bradshaw, P. C., Seeds, W. A., Miller, A. C., Mahajan, V.R., & Curtis, W.M. (2020). COVID- 19: Proposing a ketone-based metabolic therapy as a treatment to blunt the cytokine storm. Oxid Med Cell Longev, 2020, 6401341.
  • 27. Hussain, A., Mahawar, K., Xia, Z., Yang, W., & El-Hasani, S. (2020). Obesity and mortality of COVID-19. Meta-analysis. Obes Res Clin Pract, 14(4), 295–300.
  • 28. Zhou, Y., Chi, J., Lv, W., & Wang, Y. (2021). Obesity and diabetes as high-risk factors for severe coronavirus disease 2019 (Covid-19). Diabetes Metab Res Rev, 37(2), 3377.
  • 29. Gangitano, E., Tozzi, R., Gandini, O., Watanabe, M., Basciani, S. & Mariani, S., (2021). Ketogenic diet as a preventive and supportive care for COVID-19 patients. Nutrients, 13(3), 1004.
  • 30. Mao, L., Jin, H., Wang, M., Hu, Y., Chen, S., He, Q., et al. (2020). Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol, 77(6), 683–690.
  • 31. Desforges, M., Le Coupanec, A., Dubeau, P., Bourgouin, A., Lajoie, L., Dubé, M., et al. (2019). Human coronaviruses and other respiratory viruses: Underestimated opportunistic pathogens of the central nervous system?. Viruses, 12(1), 14.
  • 32. Hamming, I., Timens, W., Bulthuis, M. L., Lely, A. T., Navis, G., & van Goor, H. (2004). Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol, 203(2), 631–637.
  • 33. Li, H., Xue, Q., & Xu, X. (2020). Involvement of the nervous system in SARS-CoV-2 infection. Neurotox Res, 38(1), 1–7.
  • 34. Dubé, M., Le Coupanec, A., Wong, A., Rini, J. M., Desforges, M., & Talbot, P.J. (2018). Axonal Transport Enables Neuron-to-Neuron Propagation of Human Coronavirus OC43. J Virol, 92(17), e00404- 18.
  • 35. Berger J. R. (2020). COVID-19 and the nervous system. J Neurovirol, 26(2), 143-148.
  • 36. World Health Organization. Epilepsy. https://www.who.int/news-room/fact- sheets/detail/epilepsy (Erişim tarihi: 10 Mayıs 2021).
  • 37. Özdağ Acarlı, A.N., Samancı, B., Ekizoğlu, E., Çakar, A., Görkem Şirin N, Gündüz T, ve ark. (2020). Nörolog Gözüyle Koronavirüs Hastalığı 2019 (COVID-19): Pandemi ile Mücadele Sırasında Dikkat Edilmesi Gereken Nörolojik Bulgu ve Semptomlar. Nöro Psikiyatri Arşivi. 1-6.

COVID-19 Yönetiminde Ketojenik Diyet Uygulamaları

Yıl 2023, Cilt: 7 Sayı: 2, 440 - 446, 31.05.2023
https://doi.org/10.46237/amusbfd.1060681

Öz

Çin'in Wuhan şehrinde 31 Aralık 2019 tarihinde etiyolojisi bilinmeyen pnömoni vakaları bildirilmiştir. Bu vakalar COVID-19 hastalığı olarak kabul edilmiştir. COVID-19’a bağlı komplikasyonların önlenmesi, yönetimi ve COVID-19’dan korunmayı sağlayacak yöntemler araştırmalara konu olmaktadır. Yeterli ve dengeli beslenme de bu noktada gündeme gelmektedir. Bununla birlikte ketojenik diyetin (KD), COVID-19’un önlenmesi ve yönetimindeki rolü de merak edilmektedir. Solunum sıkıntısı ve pnömoni, COVID-19’un komplikasyonları arasında yer alan durumlardandırlar. Karbonhidratların solunum katsayısı yüksek olduğu için COVID-19’dan önce de bazı solunum sistemi hastalıklarında kısıtlanmasına yönelik halihazırda önerilerin bulunması, keton cisimlerinin COVID-19 gibi ciddi viral enfeksiyonlar üzerine etki gösterebileceği çeşitli mekanizmaların mevcudiyeti, KD’nin yağ kütlesi kaybı sağlaması gibi faktörler COVID-19’da KD fikrini desteklemektedir. Öte yandan, KD uygulaması sonucu, sağlıklı ve dengeli beslenmenin bağışıklık güçlendirici etkinliğinden mahrum kalınabileceği, insan bağışıklık sisteminin ve akciğer hücre fonksiyonlarının ketozisten nasıl etkilendiğinin bilinmemesi gibi etkenler, KD’ye mesafeli yaklaşmaya sebep olmaktadır. Hakkında birçok bilinmezin bulunduğu bu salgının önlenmesi, yönetilmesi hususlarında KD’nin yerini belirlemek için klinik çalışmalara ihtiyaç vardır.

Kaynakça

  • 1. T.C. Sağlık Bakanlığı. (2020). COVID-19 (Sars-Cov2 Enfeksiyonu) Rehberi.Ankara: T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. (Erişim tarihi: 15 Mayıs 2021.)
  • 2. Wu, Z., & McGoogan, J. M. (2020). Characteristics of and important lessons from the Coronavirus Disease 2019 (COVID-19) outbreak in China: Summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA, 323(13), 1239– 1242.
  • 3. South, A. M., Diz, D. I., & Chappell, M. C. (2020). COVID-19, ACE2, and the cardiovascular consequences. Am J Physiol Heart Circ Physiol, 318(5), 1084–1090.
  • 4. Narici, M., Vito, G., Franchi, M., Paoli, A., Moro, T., Marcolin, G., et al. (2021). Impact of sedentarism due to the COVID-19 home confinement on neuromuscular, cardiovascular and metabolic health: Physiological and pathophysiological implications and recommendations for physical and nutritional countermeasures. Eur J Sport Sci, 21(4), 614–635.
  • 5. Özen Barut, B., & Güçlü Altun, İ. (2020). COVID-19 ile ilişkili nörolojik komplikasyonlar. South Clin Ist Euras, 31 ,26-30.
  • 6. Ahmad, I., & Rathore, F. A. (2020). Neurological manifestations and complications of COVID-19: A literature review. J Clin Neurosci, 77, 8–12.
  • 7. Türkiye Diyetisyenler Derneği (TDD). COVID-19 beslenme önerileri. http://www.tdd.org.tr/index.php/duyurular/69-COVID-19-beslenme-onerileri (Erişim tarihi: 15 Mayıs 2021.)
  • 8. T.C. Sağlık Bakanlığı. (2022). Türkiye'ye Özgü Besin ve Beslenme Rehberi. Ankara: Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi Beslenme ve Diyetetik Bölümü.(Erişim tarihi: 22 Ocak 2023.)
  • 9. Armeno, M., Caraballo, R., Vaccarezza, M., Alberti, M. J., Ríos, V., & Galicchio, S. (2014). National consensus on the ketogenic diet. Rev Neurol, 59(5),213-223.
  • 10. Akbulut, G. (2018). Tıbbi Beslenme Tedavisinde Güncel Uygulamalar. Ankara: Nobel Tıp Kitabevleri.
  • 11. Kumada, T., Imai, K., Takahashi, Y., Nabatame, S., & Oguni, H. (2018). Ketogenic diet using a Japanese ketogenic milk for patients with epilepsy: A multi-institutional study. Brain Dev, 40(3), 188– 195.
  • 12. Zhu, D., Wang, M., Wang, J., Yuan, J., Niu, G., Zhang, G., et al. (2016). Ketogenic diet effects on neurobehavioral development of children with intractable epilepsy: A prospective study. Epilepsy Behav, 55, 87–91.
  • 13. Baby, N., Vinayan, K. P., Pavithran, N., & Grace Roy, A. (2018). A pragmatic study on efficacy, tolerability and long term acceptance of ketogenic diet therapy in 74 South Indian children with pharmacoresistant epilepsy. Seizure, 58, 41–46.
  • 14. Liu, H., Yang, Y., Wang, Y., Tang, H., Zhang, F., Zhang, Y., et al. (2018). Ketogenic diet for treatment of intractable epilepsy in adults: A meta-analysis of observational studies. Epilepsia Open, 3(1), 9–17.
  • 15. Masood, W., Annamaraju, P., & Uppaluri, K. R. (2020). Ketogenic Diet. Treasure Island: StatPearls Publishing.
  • 16. Paoli, A., Gorini, S., & Caprio, M. (2020). The dark side of the spoon - glucose, ketones and COVID-19: a possible role for ketogenic diet?. J Transl Med, 18(1), 441.
  • 17. Codo, A. C., Davanzo, G. G., Monteiro, L. B., de Souza, G. F., Muraro, S. P., Virgilio-da- Silva, J. V., et al. (2020). Elevated glucose levels favor SARS-CoV-2 infection and monocyte response through a HIF-1α/glycolysis-dependent axis. Cell Metab, 32(3), 498– 499.
  • 18. Bowie, A. G., & Unterholzner, L. (2008). Viral evasion and subversion of pattern- recognition receptor signalling. Nat Rev Immunol, 8(12), 911–922.
  • 19. Franchi, L., & Núñez, G. (2012). Immunology. Orchestrating inflammasomes. Science (New York, N.Y.), 337(6100), 1299–1300.
  • 20. Swanson, K. V., Deng, M., & Ting, J. P. (2019). The NLRP3 inflammasome: molecular activation and regulation to therapeutics. Nat Rev Immunol, 19(8), 477–489.
  • 21. Chen, I. Y., Moriyama, M., Chang, M. F., & Ichinohe, T. (2019). Severe acute respiratory syndrome coronavirus viroporin 3a activates the NLRP3 inflammasome. Front Microbiol, 10, 50.
  • 22. Horng T. (2014). Calcium signaling and mitochondrial destabilization in the triggering of the NLRP3 inflammasome. Trends Immunol, 35(6), 253–261.
  • 23. Paoli, A., Moro, T., Bosco, G., Bianco, A., Grimaldi, K. A., Camporesi, E., et al. (2015). Effects of n-3 polyunsaturated fatty acids (ω-3) supplementation on some cardiovascular risk factors with a ketogenic Mediterranean diet. Mar Drugs, 13(2), 996–1009.
  • 24. Youm, Y. H., Nguyen, K. Y., Grant, R. W., Goldberg, E. L., Bodogai, M., Kim, D., et al. (2015). The ketone metabolite β-hydroxybutyrate blocks NLRP3 inflammasome-mediated inflammatory disease. Nat Med, 21(3), 263–269.
  • 25. Sukkar, S. G., & Bassetti, M. (2020). Induction of ketosis as a potential therapeutic option to limit hyperglycemia and prevent cytokine storm in COVID-19. Nutrition, 79-80, 110967.
  • 26. Bradshaw, P. C., Seeds, W. A., Miller, A. C., Mahajan, V.R., & Curtis, W.M. (2020). COVID- 19: Proposing a ketone-based metabolic therapy as a treatment to blunt the cytokine storm. Oxid Med Cell Longev, 2020, 6401341.
  • 27. Hussain, A., Mahawar, K., Xia, Z., Yang, W., & El-Hasani, S. (2020). Obesity and mortality of COVID-19. Meta-analysis. Obes Res Clin Pract, 14(4), 295–300.
  • 28. Zhou, Y., Chi, J., Lv, W., & Wang, Y. (2021). Obesity and diabetes as high-risk factors for severe coronavirus disease 2019 (Covid-19). Diabetes Metab Res Rev, 37(2), 3377.
  • 29. Gangitano, E., Tozzi, R., Gandini, O., Watanabe, M., Basciani, S. & Mariani, S., (2021). Ketogenic diet as a preventive and supportive care for COVID-19 patients. Nutrients, 13(3), 1004.
  • 30. Mao, L., Jin, H., Wang, M., Hu, Y., Chen, S., He, Q., et al. (2020). Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol, 77(6), 683–690.
  • 31. Desforges, M., Le Coupanec, A., Dubeau, P., Bourgouin, A., Lajoie, L., Dubé, M., et al. (2019). Human coronaviruses and other respiratory viruses: Underestimated opportunistic pathogens of the central nervous system?. Viruses, 12(1), 14.
  • 32. Hamming, I., Timens, W., Bulthuis, M. L., Lely, A. T., Navis, G., & van Goor, H. (2004). Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol, 203(2), 631–637.
  • 33. Li, H., Xue, Q., & Xu, X. (2020). Involvement of the nervous system in SARS-CoV-2 infection. Neurotox Res, 38(1), 1–7.
  • 34. Dubé, M., Le Coupanec, A., Wong, A., Rini, J. M., Desforges, M., & Talbot, P.J. (2018). Axonal Transport Enables Neuron-to-Neuron Propagation of Human Coronavirus OC43. J Virol, 92(17), e00404- 18.
  • 35. Berger J. R. (2020). COVID-19 and the nervous system. J Neurovirol, 26(2), 143-148.
  • 36. World Health Organization. Epilepsy. https://www.who.int/news-room/fact- sheets/detail/epilepsy (Erişim tarihi: 10 Mayıs 2021).
  • 37. Özdağ Acarlı, A.N., Samancı, B., Ekizoğlu, E., Çakar, A., Görkem Şirin N, Gündüz T, ve ark. (2020). Nörolog Gözüyle Koronavirüs Hastalığı 2019 (COVID-19): Pandemi ile Mücadele Sırasında Dikkat Edilmesi Gereken Nörolojik Bulgu ve Semptomlar. Nöro Psikiyatri Arşivi. 1-6.
Toplam 37 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Derleme Makaleler
Yazarlar

Gizem Alaca Bu kişi benim 0000-0001-6991-8344

Gülşah Kaner 0000-0001-5882-6049

Çağla Ayer 0000-0001-6124-7339

Yayımlanma Tarihi 31 Mayıs 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 7 Sayı: 2

Kaynak Göster

APA Alaca, G., Kaner, G., & Ayer, Ç. (2023). COVID-19 Yönetiminde Ketojenik Diyet Uygulamaları. Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 7(2), 440-446. https://doi.org/10.46237/amusbfd.1060681