Zeitschrift für Komplementärmedizin 2018; 10(02): 22-29
DOI: 10.1055/a-0584-5311
Praxis
Ketogene Ernährung
© Karl F. Haug Verlag in MVS Medizinverlage Stuttgart GmbH & Co. KG

Die ketogene Diät – was sie kann, wie sie wirkt und wie sie gelingt

Lina Samira Bahr
,
Judith Bellmann-Strobl
,
Andreas Michalsen

Verantwortlicher Herausgeber dieser Rubrik:
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
16. April 2018 (online)

Zusammenfassung

Ketogene Diät bedeutet Kohlenhydratverzicht. Bei Epilepsie ist sie seit 100 Jahren etabliert. Bei Diabetes Typ 2 kann sie eine echte Alternative sein, da sie schnell zur Gewichtsreduktion führt, der Blutzucker konstant bleibt und Insulinspitzen vermieden werden. Vielversprechende Ergebnisse haben aktuelle Forschungsarbeiten ergeben bei Multipler Sklerose, Alzheimer und Krebs als begleitende Therapiemaßnahme.

Die Autoren geben einen überblick zu den möglichen Wirkmechanismen, den Indikationen sowie zur Umsetzung in der Praxis.

 
  • Literatur

  • 1 Paoli A, Rubini A. et al Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets.. Eur J Clin Nutr 2014; 67 (08) 789-796
  • 2 Gasior M, Rogawski MA. et al Neuroprotective and disease-modifying effects of the ketogenic diet.. Behav Pharmacol 2006; 17 (5-6) 431-439
  • 3 Krebs HA. The regulation of the release of ketone bodies by the liver. Adv.. Enzyme Regul 1966; 339: 354
  • 4 Fine EJ, Feinman RD. Thermodynamics of weight loss diets.. Nutr Metab (Lond) 2004; 1 (01) 15
  • 5 Boden G, Sargrad K. et al Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes.. Ann Intern Med 2005; 142 (06) 403-411
  • 6 Kessler SK, Neal EG, Camfield CS. et al Dietary therapies for epilepsy: future research.. Epilepsy Behav 2011; 22 (01) 17-22
  • 7 Hartman AL, Gasior M. et al The neuropharmacology of the ketogenic diet.. Pediatr Neurol 2007; 36 (05) 281-292
  • 8 McDaniel SS, Rensing NR. et al The ketogenic diet inhibits the mammalian target of rapamycin (mTOR) pathway.. Epilepsia 2011; 52 (03) e7-11
  • 9 Kessler SK, Neal EG. et al Dietary therapies for epilepsy: future research.. Epilepsy Behav 2011; 22: 17-22
  • 10 Klepper J, Leiendecker B. Ketogene Diät bei refraktärer Epilepsie im Kindesalter.. Monatsschr Kinderheilkd 2011 739. https://doi.org/10.1007/s00112-011–2396–4
  • 11 Bakshi R, Miletich RS. et al High-resolution fluorodeoxyglucose positron emission tomography shows both global and regional cerebral hypometabolism in multiple sclerosis.. J Neuroimaging 1998; 8 (04) 228-234
  • 12 Castellano CA. et al Lower brain 18F-fluorodeoxyglucose uptake but normal 11C-acetoacetate metabolism in mild Alzheimer’s disease dementia.. J Alzheimers Dis 2015; 43 (04) 1343-1353
  • 13 Akdemir ÜÖ. Brain 18F-FDG PET imaging in the differential diagnosis of parkinsonism.. Nucl Med 2014; 39 (03) e220-6 doi: 10.1097/RLU.0000000000000315
  • 14 de la Monte SM. Type 3 diabetes is sporadic Alzheimer’s disease: Mini-review.. Eur Neuropsychopharmacol 2014; 24 (12) 1954-1960
  • 15 Grant WB. Dietary links to Alzheimer’s disease: 1999 update.. J Alzheimers Dis 1999; 1 (4-5) 197-201
  • 16 Van der Auwera I, Wera S. et al. A ketogenic diet reduces amyloid beta 40 and 42 in a mouse model of Alzheimer’s disease. Nutr Metab (Lond.) 2005; 2: 28
  • 17 Henderson ST, Vogel JL. et al. Study of the ketogenic agent AC-1202 in mild to moderate Alzheimer’s disease: a randomized, double-blind, placebo-controlled, multicenter trial.. Nutr Metab (Lond.) 2009; 6: 31 doi: 10.1186/1743-7075-6-31
  • 18 Reger MA, Henderson ST, Hale C. et al Effects of beta-hydroxybutyrate on cognition in memory-impaired adults.. Neurobiol Aging 2004; 25 (03) 311-314
  • 19 Storoni M, Plant GT. The therapeutic potential of the ketogenic diet in treating progressive multiple sclerosis.. Mult Scler Int 2015; 681: 289 doi: 10.1155/2015/681289
  • 20 Kim DY, Hao J, Liu R. et al Inflammation-mediated memory dysfunction and effects of a ketogenic diet in a murine model of multiple sclerosis.. PLoS ONE 2012; 7 (05) e35476 doi: 10.1371/journal.pone.0035476
  • 21 Choi IY, Michalsen A, Longo VD. et al A diet mimicking fasting promotes regeneration and reduces autoimmunity and multiple sclerosis symptoms.. Cell Rep 2016; 15 (10) 2136-2146
  • 22 Bock M, Michalsen A, Paul F. Ketogenic diet and prolonged fasting improve health-related quality of life and lipid profiles in multiple sclerosis – A randomized controlled trial.. ECTRIMS Online Library 2015; 2015 Barcelona
  • 23 Warburg O, Wind F, Negelein E. The metabolism of tumors in the body.. J Gen Physiol 1927; 519: 530
  • 24 Khodadadi S, Sobhani N. et al Tumor cells growth and survival time with the ketogenic diet in animal models: a systematic review.. Int J Prev Med 2017; 8: 35 doi: 10.4103/2008-7802.207035
  • 25 Rieger J, Bähr O, Maurer GD. et al ERGO: a pilot study of ketogenic diet in recurrent glioblastoma.. Int J Oncol 2014; 44 (06) 1843-1852
  • 26 Schwartz K. et al Treatment of glioma patients with ketogenic diets: report of two cases treated with an IRB-approved energy-restricted ketogenic diet protocol and review of the Literature.. Cancer Metab 2015; 3: 3 doi: 10.1186/s40170-015–0129–1
  • 27 Klement RJ, Kämmerer U. Kann eine kohlenhydratarme/ketogene Ernährung das Tumorwachstum verzoägern?. Aktuel Ernahrungsmed 2016; 41: 95-102
  • 28 Woolf EC, Scheck AC. The ketogenic diet for the treatment of malignant glioma.. J Lipid Res 2014; 56 (01) 5-10
  • 29 Cunnane SC, Courchesne-Loyer A. et al Can ketones compensate for deteriorating brain glucoseuptake during aging? Implications for the riskand treatment of Alzheimer’s disease.. Ann N Y Acad Sci 2016; 12: 17
  • 30 Dupuis N, Curatolo N, Benoist JF. et al Ketogenic diet exhibits anti-inflammatory properties.. Epilepsia 2015; 56 (07) e95-98
  • 31 Haider L, Fischer MT, Frischer JM. et al Oxidative damage in multiple sclerosis lesions.. Brain 2011; 134 (Pt 7) 1914-1924
  • 32 Amorini AM, Nociti V, Petzold A. et al Serum lactate as a novel potential biomarker in multiple sclerosis.. Biochim Biophys Acta 2014; 1842 (07) 1137-1143
  • 33 Choudhari SK, Chaudhary M, Gadbail AR. et al Oxidative and antioxidative mechanisms in oral cancer and precancer: a review.. Oral Oncol 2014; 50 (01) 10-18
  • 34 Søndergaard ES, Gögenur I. Oxidative stress may cause metastatic disease in patients with colorectal cancer.. Ugeskr Laeger 2015; 177 (18) 857-860
  • 35 Doherty JR, Clevenland JL. Targeting lactate metabolism for cancer therapeutics.. J Clin Invest 2013; 123 (09) 3685-3692
  • 36 Paoli A. Ketogenic Diet for Obesity: Friend or Foe?. Int J Environ Res Public Health 2014; 11 (02) 2092-2107
  • 37 Kosinski C, Jornayvaz FR. Effects of ketogenic diets on cardiovascular risk factors: evidence from animal and human studies.. Nutrients 2017; 9 (05) E517 doi: 10.3390/nu9050517
  • 38 Westerterp-Plantenga MS, Nieuwenhuizen A. et al Dietary protein, weight loss, and weight maintenance.. Annu Rev Nutr 2009; 29: 21-41
  • 39 Ułamek-Kozioł M, Pluta R. et al To treat or not to treat drug-refractory epilepsy by the ketogenic diet? That is the question.. Ann Agric Environ Med 2016; 23 (04) 533-536
  • 40 Cullingford TE. The ketogenic diet; fatty acids, fatty acid-activated receptors and neurological disorders.. Prostaglandins Leukot Essent Fatty Acids 2004; 70 (03) 253-264
  • 41 Kim DY, Davis LM, Sullivan PG. et al Ketone bodies are protective against oxidative stress in neocortical neurons.. J Neurochem 2007; 101 (05) 1316-1326
  • 42 Shimazu T, Hirschey MD, Newman J. et al Suppression of oxidative stress by β-hydroxybutyrate, an endogenous histone deacetylase inhibitor.. Science 2013; 339 6116 211-214
  • 43 Sullivan PG, Rippy NA, Dorenbos K. et al The ketogenic diet increases mitochondrial uncoupling protein levels and activity.. Ann Neurol 2004; 55 (04) 576-580
  • 44 Milder JB, Liang LP, Patel M. Acute oxidative stress and systemic Nrf2 activation by the ketogenic diet.. Neurobiol Dis 2010; 40 (01) 238-244
  • 45 Youm YH, Nguyen KY, Grant RW. et al The ketone metabolite β-hydroxybutyrate blocks NLRP3 inflammasome—mediated inflammatory disease.. Nat Med 2015; 21 (03) 263-269
  • 46 Erecińska M, Nelson D, Daikhin Y. et al Regulation of GABA level in rat brain synaptosomes: fluxes through enzymes of the GABA shunt and effects of glutamate, calcium, and ketone bodies.. J Neurochem 1996; 67 (06) 2325-2334