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Despite the fact that genes and the environment are known to play a central role in islet function, our knowledge of how these parameters interact to modulate insulin secretory function remains relatively poor. Presently, we performed ex vivo glucose-stimulated insulin secretion and insulin content assays in islets of 213 mice from 13 inbred mouse strains on chow, Western diet (WD), and a high-fat, carbohydrate-free (KETO) diet. Strikingly, among these 13 strains, islets from the commonly used C57BL/6J mouse strain were the least glucose responsive. Using matched metabolic phenotyping data, we performed correlation analyses of isolated islet parameters and found a positive correlation between basal and glucose-stimulated insulin secretion, but no relationship between insulin secretion and insulin content. Using in vivo metabolic measures, we found that glucose tolerance determines the relationship between ex vivo islet insulin secretion and plasma insulin levels. Finally, we showed that islet glucose-stimulated insulin secretion decreased with KETO in almost all strains, concomitant with broader phenotypic changes, such as increased adiposity and glucose intolerance. This is an important finding as it should caution against the application of KETO diet for beta-cell health. Together these data offer key insights into the intersection of diet and genetic background on islet function and whole body glucose metabolism. NEW & NOTEWORTHY: Thirteen strains of mice on chow, Western diet, and high-fat, carbohydrate-free (KETO), correlating whole body phenotypes to ex vivo pancreatic islet functional measurements, were used. The study finds a huge spectrum of functional islet responses and insulin phenotypes across all strains and diets, with the ubiquitous C57Bl/6J mouse exhibiting the lowest secretory response of all strains, highlighting the overall importance of considering genetic background when investigating islet function. Ex vivo basal and stimulated insulin secretion are correlated in the islet, and KETO imparts widescale downregulation of islet insulin secretion. [ABSTRACT FROM AUTHOR]

Starvation ketoacidosis represents one of the three forms of metabolic acidosis caused by the accumulation of ketone bodies within the blood stream. It can be easily missed in patients who present acutely and are found to have an unexplained or profound metabolic acidosis. Here, we present a life-threatening case of severe ketoacidosis in a breast-feeding mother without diabetes who was on a strict ketogenic diet. Although a ketogenic diet has been previously considered to be safe in non-pregnant individuals, its safety in breast-feeding mothers in the post-partum period is less known and may be associated with greater harm. Health professionals and mothers should be aware of the potential risks associated with a strict ketogenic diet when combined with breast-feeding, especially in the earlier stages of the post-partum period. Prompt investigation, diagnosis and immediate management is vital to avoid life-threatening complications. We report a case admitted on the acute medical take with starvation ketoacidosis associated with ketogenic diet and adequate calorie consumption who was breast-feeding at the time of admission.

PurposeAnorexia nervosa (AN) is a severe psychiatric disorder, and shape and weight concerns are often chronic despite weight normalization. No specific treatments exist for those preoccupations that interfere with recovery and trigger relapse. A case study using a ketogenic diet followed by ketamine infusions led to sustained remission in one patient with chronic AN. Here we conducted an open-label trial to test whether this response could be replicated.MethodsFive adults weight recovered from AN but with persistent eating disorder thoughts and behaviors adopted a therapeutic ketogenic diet (TKD) aimed at maintaining weight. After sustaining nutritional ketosis, participants received six ketamine infusions and were followed over 6 months.ResultsAll participants completed the study protocol without significant adverse effects. Two participants maintained TKD for 8 weeks prior to ketamine infusions due to good behavioral response and remained on TKD. Three participants received TKD for 4 weeks prior to and during ketamine, then tapered off after the final infusion. The group showed significant improvements on the Clinical Impairment Assessment (p = 0.008), Eating Disorder Examination Questionnaire (EDEQ) Global score (p = 0.006), EDEQ-Eating Concerns (p = 0.005), EDEQ-Shape Concerns (p = 0.016), EDEQ-Weight Concerns (p = 0.032), Eating Disorders Recovery Questionnaire (EDRQ) Acceptance of Self and Body (0.027) and EDRQ-Social and Emotional Connection (p = 0.001). Weight remained stable, except for one participant who relapsed 4 months after treatment and off TKD.ConclusionThis novel treatment appears to be safe and effective for adults with chronic AN-related psychopathology. The results from this open trial support that there are specific neurobiological underpinnings of AN that can be normalized using TKD and ketamine.Level of evidenceLevel IV, multiple time series with intervention.

The ketogenic diet (KD) is recognized as minimum carbohydrate and maximum fat intakes, which leads to ketosis stimulation, a state that is thought to metabolize fat more than carbohydrates for energy supply. KD has gained more interest in recent years and is for many purposes, including weight loss and managing serious diseases like type 2 diabetes. On the other hand, many believe that KD has safety issues and are uncertain about the health drawbacks. Thus, the outcomes of the effect of KD on metabolic and non‐metabolic disease remain disputable. The current narrative review aims to evaluate the effect of KD on several diseases concerning the human health. To our best knowledge, the first report aims to investigate the efficacy of KD on multiple human health issues including type 2 diabetes and weight loss, cardiovascular disease, kidney failure and hypertension, non‐alcoholic fatty liver, mental problem, oral health, libido, and osteoporosis. The literature searches were performed in Databases, PubMed, Scopus, and web of Science looking for both animal and human model designs. The results heterogeneity seems to be explained by differences in diet composition and duration. Also, the available findings may show that proper control of carbohydrates, a significant reduction in glycemic control and glycated hemoglobin, and weight loss by KD can be an approach to improve diabetes and obesity, hypertension, non‐alcoholic fatty liver, PCOS, libido, oral health, and mental problem if isocaloric is considered. However, for some other diseases like cardiovascular disease and osteoporosis, more robust data are needed. Therefore, there is robust data to support the notion that KD can be effective for some metabolic and non‐metabolic diseases but not for all of them. So they have to be followed cautiously and under the supervision of health professionals. [ABSTRACT FROM AUTHOR]

Epilepsy is a central nervous system disorder involving spontaneous and recurring seizures that affects 50 million individuals globally. Because approximately one-third of patients with epilepsy do not respond to drug therapy, the development of new therapeutic strategies against epilepsy could be beneficial. Oxidative stress and mitochondrial dysfunction are frequently observed in epilepsy. Additionally, neuroinflammation is increasingly understood to contribute to the pathogenesis of epilepsy. Mitochondrial dysfunction is also recognized for its contributions to neuronal excitability and apoptosis, which can lead to neuronal loss in epilepsy. This review focuses on the roles of oxidative damage, mitochondrial dysfunction, NAPDH oxidase, the blood–brain barrier, excitotoxicity, and neuroinflammation in the development of epilepsy. We also review the therapies used to treat epilepsy and prevent seizures, including anti-seizure medications, anti-epileptic drugs, anti-inflammatory therapies, and antioxidant therapies. In addition, we review the use of neuromodulation and surgery in the treatment of epilepsy. Finally, we present the role of dietary and nutritional strategies in the management of epilepsy, including the ketogenic diet and the intake of vitamins, polyphenols, and flavonoids. By reviewing available interventions and research on the pathophysiology of epilepsy, this review points to areas of further development for therapies that can manage epilepsy. [ABSTRACT FROM AUTHOR]

To reduce the health complications of obesity, safe therapies and effective weight loss processes must be identified with preventing weight regain at the same time.Humans have metabolic flexibility and the potential to utilise ketones as an energy source by reducing carbohydrate intake in the diet, this reduces insulin levels, and ketogenesis occurs . These conditions promote the release of excess stored fat, avoid muscle weakness, and improve insulin sensitivity. Losing weight by diet causes appetite feeling and a rise in ghrelin release , that raises the likelihood of regaining weight and is thus counterproductive to goals for weight reduction . A study's aim is to review evidence on a ketogenic diet for weight loss and metabolic illnesses like insulin resistance, lipid disorders, cardiovascular disease, fatty liver disease development, and Polycystic Ovarian Syndrome. We present a foundational understanding of dietary ketones and how they are formed.

Obesity is a chronic, complex multifactorial disease associated with a wide range of complications affecting many different aspects of physiology. The ketogenic diet, the norm caloric diet is regarded as the most widely followed diet on the planet. As a result, short for ketogenic, the keto diet emphasizes a high-fat, moderate-protein and low-carbohydrate diet. This study is conducted at Baghdad University of Baghdad, College of Science for Women, Chemistry Department, Al-Numan Hospital (Baghdad, Adhamiya) and Al-Batool Hospital Education Feminine and Pediatric (Diyala -Baqubah) from January 2021 till May 2021. The results and findings of the current study were based on analyses of ninety (90) subjects who were enrolled and chosen randomly from the study population. The subjects were subdivided into twenty (20) normal subjects, twenty (20) subjects suffering from obesity, twenty-five (25) subjects of keto diet subjects and twenty-five (25) subjects left keto diet. The results of the current study showed the highest level of BMI was recorded among individuals of the obesity study group; the Mean ±Std. deviation was (30.6720± 2.17667), while other groups recorded less results. Obesity groups whose ages ranged (27-60) years recorded the highest Mean ± Std. deviation with (45.5000± 10.53565). The vitamin D levels were high in both the left keto diet group and keto diet group and Mean ±Std. deviation was (21.4508± 9.39564) and (19.1068± 8.58309) respectively. The Mean ± Std. Deviation of highest level of the atherogenic index of plasma(AIP) among the study groups recorded obesity group with (0.2380 ± .06439). [ABSTRACT FROM AUTHOR]

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Although high carbohydrate intake (>60%) is generally recommended for athletes, nowadays many experiments involve a low carbohydrate diet. Carbohydrate restriction leads to significant hormonal changes as well as reduced glucose utilization and increased utilization of free fatty acids and ketone bodies as energy sources. This narrative review aimed to discuss the physiological basis of low carbohydrate ketogenic diets (LCKD) and their both positive and negative effects on body composition, power, strength, aerobic capacity and anaerobic performance of athletes and physically active subjects. We searched and analyzed earlier and recently published papers on the subject. Research results showed that LCKD facilitates a reduction of body mass and fat mass while promoting maintenance of lean body mass (LBM). However, compared to a diet with a high carbohydrate content, it is challenging to increase LBM. Despite significant metabolic changes and increased fat oxidation LCKD did not show clear and convincing effects on endurance ability. While LCKD can preserve endurance performance in sports where intensity does not exceed 65-70% VO2max, it is not superior compared to a diet high in carbohydrates. Also negative effects on aerobic capacity can be manifested, especially in women, which may be related to a lower status and transport of iron and due to the difference in fat oxidation between genders. Reduced availability of glucose, decreased glycolytic enzyme activity and metabolic inefficiency (higher oxygen consumption for fat oxidation compared to glucose oxidation) might impair anaerobic performance where the intensity exceeds 70-80%. It seems that LCKD has no particular effects on maximum strength, power and anaerobic lactate abilities because they depend on the phosphagen energy system. [ABSTRACT FROM AUTHOR]

The multi-faceted process of aging encompasses various human pathologies such as diabetes, hypertension, neurological and cardiovascular diseases and cancer among many others. The hallmarks of aging has broadened the scope of eligible interventions aimed at delaying aging. Among the scores of anti-aging strategies, dietary restriction (DR) intervention has opened gamut of physiological benefits for humans. In this review, we elucidate briefly the two strict DR approaches practiced among humans especially for weight loss, but additionally for its metabolic benefits and lifespan elongating effects. Calorie restriction has been tried in diverse model organisms including humans, but CR has been challenging for humans due to its adverse effect. We discuss the metabolic pathways operating in case of intermittent fasting (IF) and calorie restriction (CR). Lastly we review a vital mechanism observed during fasting, ketogenesis, and scrutinize the latest emerging dieting trend keto diet with reference to IF. [ABSTRACT FROM AUTHOR]

Obesity is undoubtedly one of the leading health problems today. According to some authors, the main cause of obesity is a high intake of carbohydrates. This hypothesis has contributed to the creation of a large number of diets with limited carbohydrate intake, including the keto diet. Considering the great popularity of this diet and the large number of contradictory attitudes related to it, the aim of this paper is to review the effectiveness of a ketogenic diet in the treatment of obesity and associated comorbidities. A search of databases (KoBSON, Google Scholar, MEDLINE, PEDro, DOAJ, PubMed) has identified 1197 studies on the relevant topic, and a further application of the set criteria, the final analysis included 37 studies. Using a descriptive and analytical method for processing the selected literature, we found that a ketogenic diet compared to a diet high in carbohydrates and low in fat, leads to initially greater weight loss, but in the long run, later results are equalized. Moreover, most studies show the positive effects of this diet on the cardiovascular system and lipid profile in terms of lowering systolic and diastolic blood pressure, as well as the values of triglycerides and cholesterol and increasing high-density lipoprotein cholesterol levels. In addition, the results show a positive effect in the treatment of insulin resistance and type 2 diabetes. On the other hand, a ketogenic diet can also lead to vitamin, mineral and dietary fiber deficiencies, electrolyte imbalances, dehydration, increased uric acid and the risk of gout, metabolic acidosis, as well as cognitive impairment. Overall, the ketogenic diet has its place in diet therapy, but its proper indication and implementation is very important in order to minimize the side effects. [ABSTRACT FROM AUTHOR]

It takes material as well as immaterial elements to have a good life. Among some upper middle-class Iranians, there is a growing interest in having a healthy lifestyle and increase one's quality of life to the extent that we can talk about a culture of health and wellbeing in which different rituals and body management practices are employed to help people follow their sense of the good life. This is studied in this paper from a "resource culture" perspective wherein resources are the means to create, sustain, and alter social relations, units, and identities within the framework of cultural ideas and practices. This paper examines how undertaking a new health-based lifestyle transforms people's social network, sense of identity, or group memberships, providing them with new opportunities to pursue what they think is the good life. Participants of the study include 30 members of a social media group named "Our keto Lives" in Tehran who were interviewed in two intensive, online focus group sessions. The result of the study indicates that as an increasingly popular dietary movement, Keto is capable of inspiring its followers to significantly change their life circumstances through a variety of body management practices. [ABSTRACT FROM AUTHOR]

Background: A variety of dietary adjuncts are known to affect the pathophysiology of glioma, making them a potential therapeutic adjunct to standard of care. We systematically reviewed clinical outcomes in glioma patients treated with one or more nutritional adjunct and/or an antimetabolite drug., Methodology: A systematic review of the literature following PRISMA guidelines was performed using Pubmed from inception till February 2023. In total, 22 manuscripts on nutrition representing 828 patients were included in the review. Statistical analyses were performed to compare the outcomes of various adjuncts., Results: The median overall survival (OS) increased for newly diagnosed (21 months) and recurrent cases (10 months) when compared to historical data. For newly diagnosed cases, a ketogenic diet had the highest median OS of all the adjuncts (42.6 months) while in recurrent cases, a low copper diet coupled with 1 g penicillamine had the highest median OS (18.5 months). However, no statistically significant difference was observed in OS or progression-free survival (PFS) of newly diagnosed or recurrent gliomas., Conclusion: While nutritional adjuncts may offer a therapeutic benefit in the treatment of glioma, more human subject research is needed to derive meaningful conclusions., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Carbon footprints of vegetarian, pescatarian, and other popular diets have been studied previously, but mostly as idealized versions modeled to meet dietary recommendations. Less is known about the footprints of popular diets as they are consumed by US adults, and thus the potential trade-offs with diet quality for free-living individuals., Objectives: This study estimated the carbon footprint and diet quality of popular diets as selected by a nationally representative sample of US consumers, including the recently trending keto- and paleo-style diets., Methods: The 2005-2010 NHANES 24-h recall data were used to categorize individual adult diets (n = 16,412) into 6 types: vegan, vegetarian, pescatarian, paleo, keto, and all other diets, referred to here as omnivore diets. Average daily greenhouse gas emissions in kilograms of carbon dioxide equivalents per 1000 kcal (kg CO 2 -eq/1000 kcal) were calculated for each diet by matching our previously developed database to NHANES individual diet data. Diet quality was determined using the Healthy Eating Index (HEI) and the Alternate Healthy Eating Index. Survey-weighted ordinary least-squares regression was used to assess mean differences in diets., Results: The average carbon footprints of vegan (0.69 ± 0.05 kg CO 2 -eq/1000 kcal) and vegetarian (1.16 ± 0.02) diets were lower (P < 0.05) than those of the pescatarian (1.66 ± 0.04), omnivore (2.23 ± 0.01), paleo (2.62 ± 0.33), or keto (2.91 ± 0.27) diets. Mean HEI scores were highest for pescatarian diets (58.76 ± 0.79) and higher (P < 0.05) for vegetarian (51.89 ± 0.74) than for omnivore (48.92 ± 0.33) or keto (43.69 ± 1.61) diets., Conclusions: Our results highlight the nuances when evaluating the nutritional quality of diets and their carbon footprints. On average, pescatarian diets may be the healthiest, but plant-based diets have lower carbon footprints than other popular diets, including keto- and paleo-style diets., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Keto diet is defined as a high-fat, adequate-protein, and low-carbohydrate nutrition which forces the body to burn fats and use an alternative metabolic fuel resource by stimulating endogenous ketone production. The standard range of ketones in ketosis is up to 3.00mmol/L, and anything beyond this level can result in serious medical conditions. This diet's most common and easily reversible consequences are constipation, low-grade acidosis, hypoglycemia, kidney stones, and increased lipid in the blood. We present a case of a 36-year-old female who presented with pre-renal azotemia after starting a keto diet regimen., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Ayele et al.)

Prurigo pigmentosa (PP) is a rare pruritic condition with idiopathic etiology that affects mostly females. It most commonly presents as a rash on the neck and trunk. We report the occurrence of PP in a young woman on two separate occasions; her first episode was following a ketogenic diet and second after undergoing a laparoscopic gastric sleeve surgery. This presents as a unique case because, to our knowledge, PP has only been reported in a small number of cases in the Western world. This presentation could be suggestive of a stronger relationship between PP and the metabolic state of the body. It also outlines the effectiveness of treatment options currently in use for treating PP., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Alkhouri et al.)

The ketogenic diet (keto diet) has become an increasingly popular approach for both weight loss and as an alternative diet for type 2 diabetes mellitus (T2DM). Owing to the nature of the keto diet, patients are at risk of developing hypertriglyceridemia (HTG) due to the high amount of triglycerides consumed by individuals during the initiation of this diet. Acute pancreatitis can result from HTG. We present a case of a 19-year-old African American male with well-controlled T2DM and no history of HTG who developed severe necrotizing HTG-induced pancreatitis after an unsupervised three-month trial of the keto diet., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Chan et al.)

Background: The antidepressant Mianserin has been shown to extend the lifespan of Caenorhabditis elegan (C. elegan), a well-established model organism used in ageing research. The extension of lifespan in C. elegan was shown to be dependent on increased expression of the scaffolding protein (ANK3/unc-44). In contrast, antidepressant use in humans is associated with an increased risk of death. The C. elegan elegan in the laboratory are fed Escherichia coli (E. coli), a diet high in protein and low in carbohydrate, whereas a typical human diet is high in carbohydrates. We hypothesized that dietary carbohydrates might mitigate the lifespan-extension effect of mianserin., Objective: To investigate the effect of glucose added to the diet of C. elegan on the lifespan-extension effect of mianserin., Methods: Wild-type Bristol N2 and ANK3/unc-44 inactivating mutants were cultured on agar plates containing nematode growth medium and fed E. coli. Treatment groups included (C) control, (M50) 50 μM mianserin, (G) 73 mM glucose, and (M50G) 50 μM mianserin and 73 mM glucose. Lifespan was determined by monitoring the worms until they died. Statistical analysis was performed using the Kaplan-Meier version of the log-rank test., Results: Mianserin treatment resulted in a 12% increase in lifespan (P<0.05) of wild-type Bristol N2 worms but reduced lifespan by 6% in ANK3/unc-44 mutants, consistent with previous research. The addition of glucose to the diet reduced the lifespan of both strains of worms and abolished the lifespan-extension by mianserin., Conclusion: The addition of glucose to the diet of C. elegan abolishes the lifespan-extension effects of mianserin., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Diabetic ketoacidosis (DKA) is one of the serious complications of diabetes, especially type 1. It is defined by the triad of hyperglycemia (>250 mg/dL [>13.9 mmol/L]), high anion-gap metabolic acidosis, and increased plasma ketones. Euglycemic ketoacidosis is characterized by DKA without hyperglycemia. We present a rare case of a 28-year-old type 1 diabetic male, presenting with abdominal pain, fatigue, and dizziness after one week of starting a keto diet. He was diagnosed with euglycemic DKA, managed with DKA protocol and given detailed dietary counselling to avoid the keto diet in future., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Shaikh et al.)