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Review
. 2021 Aug 16;13(8):2805.
doi: 10.3390/nu13082805.

Metabolic Derangement in Pediatric Patient with Obesity: The Role of Ketogenic Diet as Therapeutic Tool

Valeria Calcaterra  1   2 , Elvira Verduci  2   3 , Martina Chiara Pascuzzi  2   4 , Vittoria Carlotta Magenes  2   4 , Giulia Fiore  2   3 , Elisabetta Di Profio  2   4 , Elisavietta Tenuta  1 , Alessandra Bosetti  2 , Carolina Federica Todisco  2   4 , Enza D'Auria  2   4 , Gianvincenzo Zuccotti  2   4
Affiliations
Review

Metabolic Derangement in Pediatric Patient with Obesity: The Role of Ketogenic Diet as Therapeutic Tool

Valeria Calcaterra et al. Nutrients. .

Abstract

Obesity is defined as a condition characterized by an excessive fat accumulation that has negative health consequences. Pediatric obesity is associated with an increased risk for many diseases, including impaired glycemic and lipidic control that may lead to the development of chronic, and potentially disabling, pathologies, such as type 2 diabetes mellitus (T2DM) and cardiovascular events, in adult life. The therapeutic strategy initially starts with interventions that are aimed at changing lifestyle and eating behavior, to prevent, manage, and potentially reverse metabolic disorders. Recently, the ketogenic diet (KD) has been proposed as a promising dietary intervention for the treatment of metabolic and cardiovascular risk factors related to obesity in adults, and a possible beneficial role has also been proposed in children. KD is very low in carbohydrate, high in fat, and moderate to high in protein that may have the potential to promote weight loss and improve lipidic derangement, glycemic control, and insulin sensitivity. In this review, we present metabolic disorders on glycemic and lipidic control in children and adolescents with obesity and indication of KD in pediatrics, discussing the role of KD as a therapeutic tool for metabolic derangement. The results of this review may suggest the validity of KD and the need to further research its potential to address metabolic risk factors in pediatric obesity.

Keywords: diabetes; insulin resistance; ketogenic diet; lipids; obesity.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Obesity-related complications. T2DM = type 2 diabetes mellitus; PCOS = polycystic ovarian syndrome; NAFLD = nonalcoholic fatty liver disease; NASH = nonalcoholic steatohepatitis.
Figure 2
Figure 2
The ketogenic plate.
Figure 3
Figure 3
Mechanisms of ketogenic diet action. ROS = reactive oxygen species; GABA = gamma-aminobutyric acid; GSH = glutathione; G-protein-coupled receptor (GPCR); HCA2 = hydroxycarboxylic acid receptor 2; HDAC = histone deacetylase; Th = T helper; TNF-α = tumor necrosis factor alpha; NPY = neuropeptide Y; CCK = cholecystokinin; CNS = central nervous system; AMPK = AMP-activated protein kinase.
See this image and copyright information in PMC

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