生酮减脂法

Ketogenic diet and fat loss

生酮饮食疗法应用于儿童癫痫已有近百年的历史,充分证明了其安全性和有效性。生酮饮食疗法在体重管理领域具有较强的可实践性,易于操作和长期坚持。由于生酮饮食疗法中的高脂饮食和传统营养认知存在偏颇,需要进行从基础理论到临床实践的规范化培训,建立标准操作流程。本文就生酮饮食减脂的背景、生物化学理论基础、适应证、禁忌证、不良反应和对策进行较为初步阐述。节食、运动、手术分别通过减少摄入、增加能量消耗的方式减肥,而生酮饮食减脂模拟饥饿状态,通过限制碳水化合物的摄入,构成饥饿性酮症,将甘油三酯分解转化为可溶的酮体从尿中排出,同时升高的血酮浓度还有抑制食欲的作用,可进一步减少食物及能量的摄入。考虑到相关专业人员数量不足,生酮饮食减脂疗法目前不宜全面推广,其适应证暂定为:BMI>28、肝肾功能正常的单纯性肥胖人群。生酮饮食减脂疗法的禁忌证包括脂肪代谢途径中关键酶的缺陷和功能丧失。生酮饮食减脂过程中,需进行基线评估,制定合理膳食计划,定期监测血酮和尿酮水平、体重变化,补充维生素和膳食纤维,生酮减脂常见不良反应包括:低血糖反应、饥饿感、面色潮红、便秘、皮肤瘙痒等,可对症处理。

Ketogenic diet was used in children to remedy epilepsy nearly 100 years. Such long history fully proved its safety and effectiveness. In the field of weight management, ketogenic diet had strong practicality, easy operation and long persistence. Due to the high fat diet in ketogenic diet existed cognitive bias with traditional nutrition knowledge, either theory or the of clinical practice needed standardized training. This paper introdused the background, biochemistry, indications, contraindications, adverse reactions of the ketogenic diet, as preliminary exposition and base, ready for co-authoring specialist consensus with other experts. Diet, exercise, or operation are frequency-used methods in loss weight by limiting energy intake or increasing energy consumption, while ketogenic diet was another mechanism differing these methods. Ketogenic diet simulated starvation by controlling carbohydrate intake, transforming triglyceride into ketone, then excreting ketone from the urine. Elevatory ketone also can suppress appetite to reduce food and energy intake. The indications of ketogenic diet were： BMI〉28; with normal liver and kidney functions. Contraindications were patients whose lack functional key enzyme for fat metabolism, and failure of liver and kidney functions. Baseline assessment is necessary before initiating ketogenic diet, Blood and urine ketone should to be monitored during whole ketogenic diets loss procession.