The dark side of the spoon - glucose, ketones and COVID-19: a possible role for ketogenic diet?
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(2020) 18:441 Paoli et al. J Transl Med https://doi.org/10.1186/s12967-020-02600-9
Open Access
REVIEW
The dark side of the spoon ‑ glucose, ketones and COVID‑19: a possible role for ketogenic diet? Antonio Paoli1 , Stefania Gorini2 and Massimiliano Caprio2,3*
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: Sars-CoV-2, VLCKD, Obesity, Diabetes, Hyperglycaemia, Inflammation, Metabolic rehabilitation Introduction Data from World Health Organization (WHO) indicate that seasonal influenza causes about 3 to 5 million cases of severe illness, 290,000 to 650,000 deaths from respiratory causes and 99,000–200,000 deaths from lower respiratory tract infections [1]. In general, acute respiratory infections are one of the leading causes of morbidity around the world and, more specifically, lower respiratory tract infections are the leading infectious cause of death and the fifth-leading cause of death overall. In consideration of the relative low effectiveness of influenza vaccination, public health practices have been
*Correspondence: [email protected] 2 Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele Pisana, Via di Val Cannuta, 247, 00166 Rome, Italy Full list of author information is available at the end of the article
implemented by health authorities in order to limit the spread of respiratory viruses. Common suggested health practices are related to peoples’ behaviors as hand washing, use of face masks and eye protection, social distancing, and were encouraged during the pandemic spread of Coronavirus 2019 disease (COVID-19), caused by a virus (SARS-CoV-2) for which there is not yet a vaccine [2], nor effective pharmacological treatments, so far.
Risk factors for COVID‑19: role of
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