Ketogenic diet - a literature review
DOI:
https://doi.org/10.12775/JEHS.2023.13.04.014Keywords
ketogenic diet, obesity, type 2 diabetes, epilepsy, dementia, cancerAbstract
Introduction: The ketogenic diet, originally used in the treatment of epilepsy, has recently attracted increasing interest from scientists. There are more and more reports about the possible benefits of using KD.
Aim of the study: The aim of the study is to present the assumptions of the ketogenic diet and the effects of its use in weight reduction, treatment of type 2 diabetes and the treatment of cancer and dementia.
Description of the state of knowledge: Beneficial effects of the use of a ketogenic diet related to weight reduction and improvement of the lipid profile have been described. The ketogenic diet also allows to reduce the intake of antidiabetic drugs and reduce or discontinue insulin therapy. Animal studies also suggest benefits of using KD in the treatment of cancer. However, studies involving humans are lacking. There are also reports of the effect of KD on delaying the onset of dementia symptoms.
Summary: Despite very promising scientific reports, there are no long-term studies on the impact of the ketogenic diet on cardiovascular risk. Therefore, it should be used after weighing the pros and cons.
References
Wheless JW. History of the ketogenic diet. Epilepsia,49(Suppl. 8):3–5, 2008. doi: 10.1111/j.1528-1167.2008.01821.x.
Bąk-Sosnowska M, Białkowska M, Bogdański P, Chomiuk T, Gałązka-Sobotka M, Holecki M, Jarosińska A, Jezierska M, Kamiński P, Kłoda K, Kręgielska-Narożna M, Lech M, Mamcarz A, Mastalerz-Migas A, Matyjaszek-Matuszek B, Ostrowska L, Płaczkiewicz-Jankowska E, Stachowska E, Stelmach-Mardas M, Szeliga J, Szulińska M, Walczak M, Wyleżoł M. Zalecenia kliniczne dotyczące postępowania u chorych na otyłość 2022 – stanowisko Polskiego Towarzystwa Leczenia Otyłości. Med. Prakt. wyd. specj.; maj 2022: 1–87. https://www.mp.pl/nadwaga-i-otylosc/wytyczne/303527,3-powiklania-otylosci
Accurso A, Bernstein RK, Dahlqvist A, Draznin B, Feinman RD, Fine EJ, Gleed A, Jacobs DB, Larson G, Lustig RH, Manninen AH, McFarlane SI, Morrison K, Nielsen JV, Ravnskov U, Roth KS, Silvestre R, Sowers JR, Sundberg R, Volek JS, Westman EC, Wood RJ, Wortman J, Vernon MC. Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal. Nutr Metab (Lond).2008 Apr 8;5:9. doi: 10.1186/1743-7075-5-9.
Paoli A. Ketogenic diet for obesity: friend or foe? Int J Environ Res Public Health. 2014 Feb 19;11(2):2092-107. doi: 10.3390/ijerph110202092
Hartman AL, Gasior M, Vining EP, Rogawski MA. The neuropharmacology of the ketogenic diet. Pediatr. Neurol. 2007, 36, 281–292. doi: 10.1016/j.pediatrneurol.2007.02.008.
Paoli A, Rubini A, Volek JS, Grimaldi KA. Beyond weight loss: A review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. Eur. J. Clin. Nutr. 2013, 67, 789–796. doi: 10.1038/ejcn.2013.116.
Allen BG, Bhatia SK, Anderson CM, Eichenberger-Gilmore JM, Sibenaller ZA, Mapuskar KA, Schoenfeld JD, Buatti JM, Spitz DR, Fath MA. Ketogenic diets as an adjuvant cancer therapy: History and potential mechanism. Redox Biol. 2014;2:963-70. doi: 10.1016/j.redox.2014.08.002. Epub 2014 Aug 7. PMID: 25460731; PMCID: PMC4215472.
Di Lorenzo C, Ballerini G, Barbanti P, Bernardini A, D'Arrigo G, Egeo G, Frediani F, Garbo R, Pierangeli G, Prudenzano MP, Rebaudengo N, Semeraro G, Sirianni G, Valente M, Coppola G, Cervenka MC, Spera G. Applications of Ketogenic Diets in Patients with Headache: Clinical Recommendations. Nutrients. 2021 Jul 5;13(7):2307. doi: 10.3390/nu13072307. PMID: 34371817; PMCID: PMC8308539.
Martuscello RT, Vedam-Mai V, McCarthy DJ, Schmoll ME, Jundi MA, Louviere CD, Griffith BG, Skinner CL, Suslov O, Deleyrolle LP, Reynolds BA. A Supplemented High-Fat Low-Carbohydrate Diet for the Treatment of Glioblastoma. Clin Cancer Res. 2016 May 15;22(10):2482-95. doi: 10.1158/1078-0432.CCR-15-0916. Epub 2015 Dec 2. PMID: 26631612.
Sumithran P, Proietto J. Ketogenic diets for weight loss: a review of their principles, safety and efficacy. Obes Res Clin Pract.2008;2:1–3. doi: 10.1016/j.orcp.2007.11.003.
Ballaban-Gil K, Callahan C, O’Dell C, Pappo M, Moshe S, Shinnar S. Complications of the ketogenic diet. Epilepsia. 1998;39:744–8. doi: 10.1111/j.1528-1157.1998.tb01160.x.
Zarnowska IM. Therapeutic Use of the Ketogenic Diet in Refractory Epilepsy: What We Know and What Still Needs to Be Learned. Nutrients. 2020 Aug 27;12(9):2616. doi: 10.3390/nu12092616. PMID: 32867258; PMCID: PMC7551948.
Wells J, Swaminathan A, Paseka J, Hanson C. Efficacy and Safety of a Ketogenic Diet in Children and Adolescents with Refractory Epilepsy-A Review. Nutrients. 2020 Jun 17;12(6):1809. doi: 10.3390/nu12061809. PMID: 32560503; PMCID: PMC7353240.
Annemiek A. van Berkel, Dominique M. IJff, Jan Martin Verkuyl, Cognitive benefits of the ketogenic diet in patients with epilepsy: A systematic overview, Epilepsy & Behavior, Volume 87, 2018, Pages 69-77, ISSN 1525-5050.
Hallböök, T.; Lundgren, J.; Rosén, I. Dieta ketogeniczna poprawia jakość snu u dzieci z padaczką oporną na leczenie. Padaczka 2007 , 48 , 59–65.
IJff DM, Postulart D, Lambrechts DAJE, Majoie MHJM, de Kinderen RJA, Hendriksen JGM, Evers SMAA, Aldenkamp AP. Cognitive and behavioral impact of the ketogenic diet in children and adolescents with refractory epilepsy: A randomized controlled trial. Epilepsy Behav. 2016 Jul;60:153-157. doi: 10.1016/j.yebeh.2016.04.033. Epub 2016 May 18. PMID: 27206235.
Krzyż, JH; Caraballo, RH; Nabbout, R.; Vigevano, F.; Guerrini R.; Lagae, Dravet syndrome. Treatment options and menagement of prolonged seizures. Padaczka 2019 , 60 (Suppl. 3), S39–S48.
Kossoff, EH; Żupec-Kania, BA; Auvin, S.; Ballaban-Gil, KR; Bergquist, AGC; Blackford, R.; Buchalter, JR; Caraballo, RH; Krzyż, JH; Dahlin, MG; i in. Optimal clinical management of children receiving dietary therapies for epilepsy: Updated recommendations of the International Ketogenic Diet Study Group . Epilepsia Open 2018, 3(2) , 175–192. doi: 10.1002/epi4.12225.
Cervenka MC, Henry BJ, Felton EA, Patton K, Kossoff EH. Establishing an Adult Epilepsy Diet Center: Experience, efficacy and challenges. Epilepsy Behav. 2016 May;58:61-8. doi: 10.1016/j.yebeh.2016.02.038. Epub 2016 Apr 6. PMID: 27060389.
Kim JA, Yoon JR, Lee EJ, Lee JS, Kim JT, Kim HD, Kang HC. Efficacy of the classic ketogenic and the modified Atkins diets in refractory childhood epilepsy. Epilepsia. 2016 Jan;57(1):51-8. doi: 10.1111/epi.13256. Epub 2015 Dec 10. PMID: 26662710.
Paleologou E, Ismayilova N, Kinali M. Use of the Ketogenic Diet to Treat Intractable Epilepsy in Mitochondrial Disorders. J Clin Med. 2017 May 26;6(6):56. doi: 10.3390/jcm6060056. PMID: 28587136; PMCID: PMC5483866.
Freeman, JM; Vining, PE; Pillas, DJ; Pyzik, PL; Casey JC; Kelly, The Efficacy of the Ketogenic Diet-1998. A Prospective Evaluation od Intervention in 150 Children. Pediatrics 1998, 102, 1358-1363.
Martin-McGill KJ, Jackson CF, Bresnahan R, Levy RG, Cooper PN. Ketogenic diets for drug-resistant epilepsy. Cochrane Database Syst Rev. 2018 Nov 7;11(11):CD001903. doi: 10.1002/14651858.CD001903.pub4. Update in: Cochrane Database Syst Rev. 2020 Jun 24;6:CD001903. PMID: 30403286; PMCID: PMC6517043.
Sourbron J, Klinkenberg S, van Kuijk SMJ, Lagae L, Lambrechts D, Braakman HMH, Majoie M. Ketogenic diet for the treatment of pediatric epilepsy: review and meta-analysis. Childs Nerv Syst. 2020 Jun;36(6):1099-1109. doi: 10.1007/s00381-020-04578-7. Epub 2020 Mar 16. PMID: 32173786.
Chen H., Chen YH, Liu L., Wang Y. Effects of ketogenic diet on lipid metabolism in children with intractable epilepsy. Zhongguo Dang Dai Er Ke Za Zhi. 2019; 21 :450–453
Howrie DL, Kraisinger M, McGhee HW, Crumrine PK, Katyal N. The ketogenic diet: the need for a multidisciplinary approach. Ann Pharmacother. 1998 Mar;32(3):384-5. doi: 10.1345/aph.17201. PMID: 9533070.
Hartman AL, Gasior M, Vining EP, Rogawski MA. The neuropharmacology of the ketogenic diet. Pediatr Neurol. 2007 May;36(5):281-92. doi: 10.1016/j.pediatrneurol.2007.02.008. PMID: 17509459; PMCID: PMC1940242.
Bueno NB, de Melo IS, de Oliveira SL, da Rocha Ataide T. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. Br. J. Nutr., 110 (2013), pp. 1178-1187. doi: 10.1017/S0007114513000548.
Ebbeling CB, Swain JF, Feldman HA, Wong WW, Hachey DL, Garcia-Lago E, Ludwig DS. Effects of dietary composition on energy expenditure during weight-loss maintenance. JAMA. 2012 Jun 27;307(24):2627-34. doi: 10.1001/jama.2012.6607.
Purnell JQ, Kahn SE, Samuels MH, Brandon D, Loriaux DL, Brunzell JD. Enhanced cortisol production rates, free cortisol, and 11beta-HSD-1 expression correlate with visceral fat and insulin resistance in men: effect of weight loss. Am J Physiol Endocrinol Metab. 2009;296(2):E351-E35719050176. doi: 10.1152/ajpendo.90769.2008.
Dashti HM, Mathew TC, Khadada M, Al-Mousawi M, Talib H, Asfar SK, Behbahani AI, Al-Zaid NS. Beneficial effects of ketogenic diet in obese diabetic subjects. Mol Cell Biochem. 2007 Aug;302(1-2):249-56. doi: 10.1007/s11010-007-9448-z. Epub 2007 Apr 20. PMID: 17447017.
Saslow LR, Daubenmier JJ, Moskowitz JT, Kim S, Murphy EJ, Phinney SD, Ploutz-Snyder R, Goldman V, Cox RM, Mason AE, Moran P, Hecht FM. Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes. Nutr Diabetes. 2017 Dec 21;7(12):304. doi: 10.1038/s41387-017-0006-9.
Hallberg SJ, McKenzie AL, Williams PT, Bhanpuri NH, Peters AL, Campbell WW, et al. Effectiveness and safety of a novel care model for the management of type 2 diabetes at 1 year: an open-label, non-randomized, controlled study. Diabetes Ther. 2018;9(2):583–612. doi: 10.1007/s13300-018-0373-9.
Wong K, Raffray M, Roy-Fleming A, Blunden S, Brazeau AS. Ketogenic diet as a normal way of eating in adults with type 1 and type 2 diabetes: a qualitative study. Can J Diabetes. 2021;45(2):137–43.e1. doi: 10.1016/j.jcjd.2020.06.016.
Retterstøl K, Svendsen M, Narverud I, Holven KB. Effect of low carbohydrate high fat diet on LDL cholesterol and gene expression in normal-weight, young adults: a randomized controlled study. Atherosclerosis, 279 (2018), pp. 52-61. doi: 10.1016/j.atherosclerosis.2018.10.013.
Dashti HM, Mathew TC, Khadada M, Al-Mousawi M, Talib H, Asfar SK. Beneficial effects of ketogenic diet in obese diabetic subjects. Mol Cell Biochem. 2007;302(1–2):249–56. doi: 10.1007/s11010-007-9448-z.
Hussain TA, Mathew TC, Dashti AA, Asfar S, Al-Zaid N, Dashti HM. Effect of low-calorie versus low-carbohydrate ketogenic diet in type 2 diabetes. Nutrition. 2012;28(10):1016–21. doi: 10.1016/j.nut.2012.01.016.
Pinto A, Bonucci A, Maggi E, Corsi M, Businaro R. Anti-oxidant and anti-inflammatory activity of ketogenic diet: new perspectives for neuroprotection in Alzheimer’s disease. Antioxidants (Basel). 2018;7(5). doi: 10.3390/antiox7050063.
Krzysztofiak A, Krajka-Kuźniak V. Kiedy obrona staje się niebezpieczna – czynnik transkrypcyjny Nrf2 a nowotwory. Postepy Hig Med Dosw (online), 2015; 69: 140-152. https://phmd.pl/api/files/view/116224.pdf
Devaraj S, Dasu MR, Jialal I. Diabetes is a proinflammatory state: a translational perspective. Expert Rev Endocrinol Metab. 2010;5(1):19–28. doi: 10.1586/eem.09.44.
Otto AM. Warburg effect(s)-a biographical sketch of Otto Warburg and his impacts on tumor metabolism. Cancer Metab. 2016 Mar 8;4:5. doi: 10.1186/s40170-016-0145-9. PMID: 26962452; PMCID: PMC4784299.
Warburg O. On the Origin of Cancer Cells. Science. 1956;123:309–314. doi: 10.1126/science.123.3191.309.
Trabold O., Wagner S., Wicke C., Bs H.S., Hussain M.Z., Rosen N., Bs A.S., Becker H.D., Hunt T.K. Lactate and oxygen constitute a fundamental regulatory mechanism in wound healing. Wound Repair Regen. 2003;11:504–509. doi: 10.1046/j.1524-475X.2003.11621.x.
Hanahan D., Weinberg R.A. Hallmarks of Cancer: The Next Generation. Cell. 2011;144:646–674. doi: 10.1016/j.cell.2011.02.013.
Vidali S., Aminzadeh S., Lambert B., Rutherford T., Sperl W., Kofler B., Feichtinger R.G. Mitochondria: The ketogenic diet—A metabolism-based therapy. Int. J. Biochem. Cell Biol. 2015;63:55–59. doi: 10.1016/j.biocel.2015.01.022.
Allen BG, Bhatia SK, Buatti JM, Brandt KE, Lindholm KE, Button AM, Szweda LI, Smith BJ, Spitz DR, Fath MA. Ketogenic diets enhance oxidative stress and radio-chemo-therapy responses in lung cancer xenografts. Clin Cancer Res. 2013 Jul 15;19(14):3905-13. doi: 10.1158/1078-0432.CCR-12-0287. Epub 2013 Jun 6. PMID: 23743570; PMCID: PMC3954599.
Yang YF, Mattamel PB, Joseph T, Huang J, Chen Q, Akinwunmi BO, Zhang CJP, Ming WK. Efficacy of Low-Carbohydrate Ketogenic Diet as an Adjuvant Cancer Therapy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2021 Apr 21;13(5):1388. doi: 10.3390/nu13051388. PMID: 33918992; PMCID: PMC8142992.
Weber DD, Aminzadeh-Gohari S, Tulipan J, Catalano L, Feichtinger RG, Kofler B. Ketogenic diet in the treatment of cancer - Where do we stand? Mol Metab. 2020 Mar;33:102-121. doi: 10.1016/j.molmet.2019.06.026. Epub 2019 Jul 27. PMID: 31399389; PMCID: PMC7056920.
Otto C, Kaemmerer U, Illert B, Muehling B, Pfetzer N, Wittig R, Voelker HU, Thiede A, Coy JF. Growth of human gastric cancer cells in nude mice is delayed by a ketogenic diet supplemented with omega-3 fatty acids and medium-chain triglycerides. BMC Cancer. 2008 Apr 30;8:122. doi: 10.1186/1471-2407-8-122. PMID: 18447912; PMCID: PMC2408928.
Lussier DM, Woolf EC, Johnson JL, Brooks KS, Blattman JN, Scheck AC. Enhanced immunity in a mouse model of malignant glioma is mediated by a therapeutic ketogenic diet. BMC Cancer. 2016 May 13;16:310. doi: 10.1186/s12885-016-2337-7. PMID: 27178315; PMCID: PMC4866042.
Hopkins BD, Pauli C, Du X, Wang DG, Li X, Wu D, Amadiume SC, Goncalves MD, Hodakoski C, Lundquist MR, Bareja R, Ma Y, Harris EM, Sboner A, Beltran H, Rubin MA, Mukherjee S, Cantley LC. Suppression of insulin feedback enhances the efficacy of PI3K inhibitors. Nature. 2018 Aug;560(7719):499-503. doi: 10.1038/s41586-018-0343-4. Epub 2018 Jul 4. Erratum in: Nature. 2018 Aug 29;: PMID: 30051890; PMCID: PMC6197057.
Liśkiewicz AD, Kasprowska D, Wojakowska A, Polański K, Lewin-Kowalik J, Kotulska K, Jędrzejowska-Szypułka H. Long-term High Fat Ketogenic Diet Promotes Renal Tumor Growth in a Rat Model of Tuberous Sclerosis. Sci Rep. 2016 Feb 19;6:21807. doi: 10.1038/srep21807. PMID: 26892894; PMCID: PMC4759602.
Xia S, Lin R, Jin L, Zhao L, Kang HB, Pan Y, Liu S, Qian G, Qian Z, Konstantakou E, Zhang B, Dong JT, Chung YR, Abdel-Wahab O, Merghoub T, Zhou L, Kudchadkar RR, Lawson DH, Khoury HJ, Khuri FR, Boise LH, Lonial S, Lee BH, Pollack BP, Arbiser JL, Fan J, Lei QY, Chen J. Prevention of Dietary-Fat-Fueled Ketogenesis Attenuates BRAF V600E Tumor Growth. Cell Metab. 2017 Feb 7;25(2):358-373. doi: 10.1016/j.cmet.2016.12.010. Epub 2017 Jan 12. PMID: 28089569; PMCID: PMC5299059.
Talib WH, Mahmod AI, Kamal A, Rashid HM, Alashqar AMD, Khater S, Jamal D, Waly M. Ketogenic Diet in Cancer Prevention and Therapy: Molecular Targets and Therapeutic Opportunities. Curr Issues Mol Biol. 2021 Jul 3;43(2):558-589. doi: 10.3390/cimb43020042. PMID: 34287243; PMCID: PMC8928964.
Fine EJ, Segal-Isaacson CJ, Feinman RD, Herszkopf S, Romano MC, Tomuta N, Bontempo AF, Negassa A, Sparano JA. Targeting insulin inhibition as a metabolic therapy in advanced cancer: a pilot safety and feasibility dietary trial in 10 patients. Nutrition. 2012 Oct;28(10):1028-35. doi: 10.1016/j.nut.2012.05.001. Epub 2012 Jul 26. PMID: 22840388.
Noh HS, Lee HP, Kim DW, Kang SS, Cho GJ, Rho JM, Choi WS. A cDNA microarray analysis of gene expression profiles in rat hippocampus following a ketogenic diet. Brain Res Mol Brain Res. 2004 Oct 22;129(1-2):80-7. doi: 10.1016/j.molbrainres.2004.06.020. PMID: 15469884.
Hussain TA, Mathew TC, Dashti AA, Asfar S, Al-Zaid N, Dashti HM. Effect of low-calorie versus low-carbohydrate ketogenic diet in type 2 diabetes. Nutrition. 2012 Oct;28(10):1016-21. doi: 10.1016/j.nut.2012.01.016. Epub 2012 Jun 5. PMID: 22673594.
Hughes SD, Kanabus M, Anderson G, Hargreaves IP, Rutherford T, O'Donnell M, Cross JH, Rahman S, Eaton S, Heales SJ. The ketogenic diet component decanoic acid increases mitochondrial citrate synthase and complex I activity in neuronal cells. J Neurochem. 2014 May;129(3):426-33. doi: 10.1111/jnc.12646. Epub 2014 Jan 25. PMID: 24383952.
Broom GM, Shaw IC, Rucklidge JJ. The ketogenic diet as a potential treatment and prevention strategy for Alzheimer's disease. Nutrition. 2019 Apr;60:118-121. doi: 10.1016/j.nut.2018.10.003. Epub 2018 Oct 10. PMID: 30554068.
Ruskin DN, Kawamura M, Masino SA. Reduced pain and inflammation in juvenile and adult rats fed a ketogenic diet. PLoS One. 2009 Dec 23;4(12):e8349. doi: 10.1371/journal.pone.0008349. PMID: 20041135; PMCID: PMC2796387.
. Seneff S, Wainwright G, Mascitelli L. Nutrition and Alzheimer's disease: the detrimental role of a high carbohydrate diet. Eur J Intern Med. 2011 Apr;22(2):134-40. doi: 10.1016/j.ejim.2010.12.017. Epub 2011 Jan 26. PMID: 21402242.
Haces ML, Hernández-Fonseca K, Medina-Campos ON, Montiel T, Pedraza-Chaverri J, Massieu L. Antioxidant capacity contributes to protection of ketone bodies against oxidative damage induced during hypoglycemic conditions. Exp Neurol. 2008 May;211(1):85-96. doi: 10.1016/j.expneurol.2007.12.029. Epub 2008 Jan 26. PMID: 18339375.
Ferris SH, de Leon MJ, Wolf AP, Farkas T, Christman DR, Reisberg B, Fowler JS, Macgregor R, Goldman A, George AE, Rampal S. Positron emission tomography in the study of aging and senile dementia. Neurobiol Aging. 1980 Winter;1(2):127-31. doi: 10.1016/0197-4580(80)90005-6. PMID: 24279935.
Foster NL, Chase TN, Fedio P, Patronas NJ, Brooks RA, Di Chiro G. Alzheimer's disease: focal cortical changes shown by positron emission tomography. Neurology. 1983 Aug;33(8):961-5. doi: 10.1212/wnl.33.8.961. PMID: 6603596.
Hasselbalch SG, Knudsen GM, Jakobsen J, Hageman LP, Holm S, Paulson OB. Blood-brain barrier permeability of glucose and ketone bodies during short-term starvation in humans. Am J Physiol. 1995 Jun;268(6 Pt 1):E1161-6. doi: 10.1152/ajpendo.1995.268.6.E1161. PMID: 7611392.
Castellano CA, Nugent S, Paquet N, Tremblay S, Bocti C, Lacombe G, Imbeault H, Turcotte É, Fulop T, Cunnane SC. Lower brain 18F-fluorodeoxyglucose uptake but normal 11C-acetoacetate metabolism in mild Alzheimer's disease dementia. J Alzheimers Dis. 2015;43(4):1343-53. doi: 10.3233/JAD-141074. PMID: 25147107.
Xie G, Zhou Q, Qiu CZ, Dai WK, Wang HP, Li YH, Liao JX, Lu XG, Lin SF, Ye JH, Ma ZY, Wang WJ. Ketogenic diet poses a significant effect on imbalanced gut microbiota in infants with refractory epilepsy. World J Gastroenterol. 2017 Sep 7;23(33):6164-6171. doi: 10.3748/wjg.v23.i33.6164. PMID: 28970732; PMCID: PMC5597508.
63. Ota M, Matsuo J, Ishida I, Hattori K, Teraishi T, Tonouchi H, Ashida K, Takahashi T, Kunugi H. Effect of a ketogenic meal on cognitive function in elderly adults: potential for cognitive enhancement. Psychopharmacology (Berl). 2016 Oct;233(21-22):3797-3802. doi: 10.1007/s00213-016-4414-7. Epub 2016 Aug 27. PMID: 27568199.
64. Witte AV, Fobker M, Gellner R, Knecht S, Flöel A. Caloric restriction improves memory in elderly humans. Proc Natl Acad Sci U S A. 2009 Jan 27;106(4):1255-60. doi: 10.1073/pnas.0808587106. Epub 2009 Jan 26. PMID: 19171901; PMCID: PMC2633586.
Delgado-Lista J, Alcala-Diaz JF, Torres-Peña JD, Quintana-Navarro GM, Fuentes F, Garcia-Rios A, Ortiz-Morales AM, Gonzalez-Requero AI, Perez-Caballero AI, Yubero-Serrano EM, Rangel-Zuñiga OA, Camargo A, Rodriguez-Cantalejo F, Lopez-Segura F, Badimon L, Ordovas JM, Perez-Jimenez F, Perez-Martinez P, Lopez-Miranda J. Long-term secondary prevention of cardiovascular disease with a Mediterranean diet and a low-fat diet (CORDIOPREV): a randomised controlled trial. Lancet. 2022 May 14;399(10338):1876-1885. doi: 10.1016/S0140-6736(22)00122-2.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Iwona Cuber, Ewelina Dybała, Artur Aghadi, Edyta Białowąs, Magdalena Mazurek, Marta Górna
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 1614
Number of citations: 0
