PDF(Pubmed)
Abstract：
BACKGROUND: There is a growing consensus that fasting-induced ketosis has beneficial effects on human physiology. Despite these compelling benefits, fasting-induced ketosis raises concerns in some clinicians because it is often inappropriately compared with the pathologic uncontrolled ketone production in diabetic ketoacidosis. The determinants of the inter-individual differences in the intensity of ketosis during long-term fasting is unknown.
METHODS: We monitored daily variations in fasting ketonemia, as well as ketonuria, which is less invasive, in a large cohort of 1610 subjects, fasting between 4 and 21 days with the Buchinger Wilhelmi program, minimally supplemented with ~75-250 kcal (daily fruit juice, vegetable soup, and honey).
RESULTS: Ketonuria was detected in more than 95% of fasting subjects from day 4 onwards. Subjects consuming only soups, without fruit juice or honey, exhibited reduced caloric intake (72 kcal instead of 236 kcal) and carbohydrate intake (15.6 g instead of 56.5 g), leading to more intense ketonuria. Participants with high ketonuria were, in the majority, males, young, had a higher body weight, and had lower HDL-C and urea values. They had a larger decrease in blood glucose, glycated haemoglobin levels, body weight, and waist circumference. Furthermore, in the high-ketonuria group, a larger increase in blood uric acid concentration was observed.
CONCLUSIONS: Our study showed that long-term fasting triggered ketosis, never reaching pathological levels, and that ketosis is influenced by age, gender, health, and the level of physical activity. Furthermore, it is modulated but not suppressed by minimal carbohydrate intake. Our study paves the way for better understanding how supplementation can modulate the therapeutic effects and tolerability of long-term fasting.
METHODS: We monitored daily variations in fasting ketonemia, as well as ketonuria, which is less invasive, in a large cohort of 1610 subjects, fasting between 4 and 21 days with the Buchinger Wilhelmi program, minimally supplemented with ~75-250 kcal (daily fruit juice, vegetable soup, and honey).
RESULTS: Ketonuria was detected in more than 95% of fasting subjects from day 4 onwards. Subjects consuming only soups, without fruit juice or honey, exhibited reduced caloric intake (72 kcal instead of 236 kcal) and carbohydrate intake (15.6 g instead of 56.5 g), leading to more intense ketonuria. Participants with high ketonuria were, in the majority, males, young, had a higher body weight, and had lower HDL-C and urea values. They had a larger decrease in blood glucose, glycated haemoglobin levels, body weight, and waist circumference. Furthermore, in the high-ketonuria group, a larger increase in blood uric acid concentration was observed.
CONCLUSIONS: Our study showed that long-term fasting triggered ketosis, never reaching pathological levels, and that ketosis is influenced by age, gender, health, and the level of physical activity. Furthermore, it is modulated but not suppressed by minimal carbohydrate intake. Our study paves the way for better understanding how supplementation can modulate the therapeutic effects and tolerability of long-term fasting.
摘要：
背景：人们越来越一致认为，空腹诱发的酮症对人体生理具有有益作用。尽管有这些令人信服的好处，空腹诱发酮症引起了一些临床医生的担忧,因为与糖尿病酮症酸中毒的病理性不受控酮产生相比,空腹诱发酮症常不适当.长期禁食期间酮症强度的个体差异的决定因素尚不清楚。
方法：我们监测了空腹酮血症的每日变化，以及酮尿症，侵入性较小，在1610名受试者的大队列中，用BuchingerWilhelmi计划禁食4到21天，最低限度补充~75-250千卡(每日果汁，蔬菜汤,和蜂蜜）。
结果：从第4天开始，在超过95%的空腹受试者中检测到酮尿。受试者只吃汤，没有果汁或蜂蜜，表现出减少的热量摄入量（72千卡而不是236千卡）和碳水化合物摄入量（15.6克而不是56.5克），导致更强烈的酮尿症。高酮尿症的参与者是，在大多数情况下，男性,年轻,体重较高，HDL-C和尿素值较低。他们的血糖下降幅度更大，糖化血红蛋白水平，体重,和腰围。此外，在高酮尿症组，观察到血尿酸浓度增加较大.
结论：我们的研究表明，长期禁食引发的酮症，从未达到病理水平，酮症受年龄的影响，性别,健康,以及身体活动的水平。此外，它被调节，但不被最低限度的碳水化合物摄入量所抑制。我们的研究为更好地理解补充剂如何调节长期禁食的治疗效果和耐受性铺平了道路。
方法：我们监测了空腹酮血症的每日变化，以及酮尿症，侵入性较小，在1610名受试者的大队列中，用BuchingerWilhelmi计划禁食4到21天，最低限度补充~75-250千卡(每日果汁，蔬菜汤,和蜂蜜）。
结果：从第4天开始，在超过95%的空腹受试者中检测到酮尿。受试者只吃汤，没有果汁或蜂蜜，表现出减少的热量摄入量（72千卡而不是236千卡）和碳水化合物摄入量（15.6克而不是56.5克），导致更强烈的酮尿症。高酮尿症的参与者是，在大多数情况下，男性,年轻,体重较高，HDL-C和尿素值较低。他们的血糖下降幅度更大，糖化血红蛋白水平，体重,和腰围。此外，在高酮尿症组，观察到血尿酸浓度增加较大.
结论：我们的研究表明，长期禁食引发的酮症，从未达到病理水平，酮症受年龄的影响，性别,健康,以及身体活动的水平。此外，它被调节，但不被最低限度的碳水化合物摄入量所抑制。我们的研究为更好地理解补充剂如何调节长期禁食的治疗效果和耐受性铺平了道路。
