Eminyakeni yamuva nje, ukudla kwe-ketogenic kungene engxoxweni mayelana nokwehlisa isisindo kanye nempilo ye-metabolic, kwaphonsela inselelo izinhlelo ezisunguliwe njengokudla kwaseMedithera noma ukudla okunamafutha aphansi. Ngaphandle kwezitayela, isivivinyo sezokwelapha esilawulwayo sinikeze ukuqonda okusha ngezinga izindlela zokwehlisa isisindo ezingashintsha ngalo okwenzekayo emzimbeni.
Ithimba elivela eWashington University School of Medicine eSt. Louis liqhathanise izindlela ezintathu zokudla ezihluke kakhulu kubantu abanokukhuluphala ngokweqile, isifo sikashukela esingakafiki, kanye namafutha amaningi esibindini. Nakuba bonke ababambiqhaza belahlekelwe cishe yisisindo esifanayo, imiphumela iphakamisa ukuthi ukusatshalaliswa kwama-carbohydrate namafutha kwenza umehluko ocacile empilweni yesibindi kanye nengozi yokuqhubekela phambili kusifo sikashukela sohlobo 2.
Isivivinyo somtholampilo sokuqhathanisa izindlela ezintathu zokudla
Lolu cwaningo, olwanyatheliswa kuyi- Cell Metabolism , luhlanganisa abantu abadala abanesimo esithile: ukukhuluphala, isifo sikashukela esingaphambi kwesikhathi, kanye nesifo sesibindi esinamafutha (manje esibizwa ngokuthi i-MASLD). Lesi simo, ngezinye izikhathi esibizwa ngokuthi ukukhuluphala okungenampilo ngokwe-metabolically , sihlotshaniswa nengozi eyengeziwe yesifo sikashukela sohlobo 2, isifo senhliziyo, kanye nezinkinga zesibindi ezifana ne-fibrosis noma i-cirrhosis.
Sekukonke, abacwaningi babela ngokungahleliwe abantu abacishe babe amashumi amane (inani liyahlukahluka kuye ngomthombo, kusukela kwabangu-42 kuya kwabangaphezudlwana kuka-50) kwenye yezinhlobo ezintathu zokudla: ukudla okunama-carbohydrate aphansi kakhulu, ukudla kwaseMedithera, kanye nokudla okunamafutha aphansi kakhulu okusekelwe kakhulu ekudleni okusekelwe ezitshalweni. Kuzo zonke izimo, ithimba locwaningo linikeze konke ukudla, futhi kwaba nokulandelela kwamasonto onke nochwepheshe bezokudla ukuqinisekisa ukunamathela eziqondisweni.
Inhloso kwakungekona ukubona ukuthi ubani olahlekelwe isisindo esiningi, kodwa ukunquma ukuthi, ngokulahlekelwa isisindo okufanayo , ukusatshalaliswa kwezakhamzimba ezinkulu kushintshe yini indlela umzimba osabela ngayo. Ngenxa yalokhu, ukudla amandla kwalungiswa ngamunye ngenhloso yokuthi umhlanganyeli ngamunye alahlekelwe cishe yi-10% yesisindo somzimba wakhe esikhathini esiyizinyanga ezine kuya kwezinhlanu, kungakhathaliseki ukuthi badla ukudla okungakanani.
Zonke izindlela ezintathu zaklanywa ngokwakheka kwezakhamzimba ezikhethekile kakhulu. Ukudla kwe-ketogenic kuhlinzeka ngo-4% kuphela wamakhalori avela kuma-carbohydrate kanye no-73% ovela emafutheni. Ukudla kwaseMedithera kwakuqukethe cishe u-50% wamandla avela kuma-carbohydrate kanye no-35% ovela emafutheni, iphethini eyaziwayo ekudleni kwendabuko kwaseNingizimu Yurophu. Ekudleni okunamafutha aphansi, okusekelwe kakhulu ezitshalweni , u-70% wamakhalori avela kuma-carbohydrate kanti u-15% kuphela avela emafutheni.
Ukuze kuqiniswe ukuthembeka kwedatha, kwenziwa izivivinyo eziphelele ze-metabolic ngaphambi nangemva kokungenelela: ukulinganiswa kokwakheka komzimba, ukunqunywa kwe-glucose nama-insulin amahora angama-24, ucwaningo lokuzwela kwe-insulin emisipheni nasesibindini, ukuhlaziywa kwe-de novo lipogenesis (ukukhiqizwa kwama-fatty acid amasha yisibindi) kanye nokulinganiswa kwamafutha esibindi.
Kuyini ngempela ukudla kwe-ketogenic?
Ukudla kwe-ketogenic, okwaziwa nangokuthi ukudla kwe-keto , akuyona into entsha esungulwe muva nje, yize sekuthandwa kakhulu ezinkundleni zokuxhumana eminyakeni eyishumi edlule. Kwaqala ukusetshenziswa eminyakeni engaphezu kwekhulu edlule njengokwelapha isifo sokuwa ezigulini ezingasabelanga kahle emithini. Isici saso esiyisisekelo ukunqunyelwa okukhulu kwama-carbohydrate , ngokuvamile kube ngaphansi kwamagremu angu-20-50 ngosuku, okuphoqa umzimba ukuthi ushintshe umthombo wawo oyinhloko wamandla.
Uma ukudla ama-carbohydrate kwehla kakhulu, amazinga kashukela egazini ayehla futhi umzimba wandise ukukhiqizwa kwemizimba ye-ketone evela emafutheni. Lawa ma-compound, njenge-beta-hydroxybutyrate, angasetshenziswa njengamafutha yizicubu ezahlukahlukene, kufaka phakathi ubuchopho, futhi ayingxenye yempendulo yomzimba ekuzileni ukudla isikhathi eside noma ekulambeni.
Kulolu cwaningo, leli phethini lihunyushwe ekudleni okunama-calories amaningi avela kumafutha kanye nokuba khona okulinganiselwe kakhulu kokudla okucebile ngama-starch noma ushukela. Ukudla kwe-ketogenic kungafaka kokubili amafutha anempilo (amafutha omnqumo, amantongomane, i-avocado, inhlanzi enamafutha) kanye namafutha angadingeki kangako (inyama enamafutha, imikhiqizo ecutshunguliwe enamafutha agcwele), futhi yilapho ochwepheshe begxila khona ukunaka kwabo.
Abacwaningi bezokudla esifundeni sethu basikhumbuza ukuthi inkinga ngokudla okunamafutha amaningi akuyona nje inani, kodwa ikhwalithi yalawo mafutha . Akufani nokulandela ukudla okucebile ngokudla okucutshunguliwe kanye nenyama enamafutha njengokudla okucebile ngamafutha omnqumo angenasici, amantongomane, noma inhlanzi enamafutha amaningi e-omega-3 . Kwenzeka okufanayo ngama-carbohydrate: ingxenye enkulu ingavela kokusanhlamvu okuphelele, izithelo, imifino, kanye nemifino… noma ezintweni ezibhakiwe ezicutshunguliwe kanye neziphuzo ezinoshukela.
Eqinisweni, izifundo zangaphambilini ezenziwa amaqembu aseSpain ziphawulile ukuthi, lapho kubikezelwa ingozi yezifo ezingamahlalakhona ekugugeni, akwanele ukubheka nje iphesenti eliphelele lamafutha noma ama-carbohydrate ekudleni. Okwenza umehluko ukuthi iphethini iyonke yayinempilo noma ayiphilile, kuye ngohlobo lwamafutha nama-carbohydrate adliwayo. Kulezi zifundo, labo abalandela ukudla okuseqophelweni eliphansi babenengozi ephezulu efinyelela ku-11% yokuthola izifo ezahlukahlukene eminyakeni edlule.
Imiphumela evamile: ukwehla kwesisindo okufanayo, ukuthuthuka okwabelana ngakho
Omunye wemiyalezo ecacile evela esivivinyweni sase-University of Washington ukuthi, kubantu abanokukhuluphala okungenampilo ngokwe-metabolic, ukulahlekelwa cishe yi-10% yesisindo somzimba kubonisa intuthuko enkulu, kungakhathaliseki uhlobo lokudla. Kuwo wonke amaqembu amathathu, kwabonakala ukwehla okukhulu kwamafutha kanye nokwanda kokuzwela kwe-insulin emisipheni, okubonisa ukuthi umzimba wawulawula i-glucose ngempumelelo enkulu.
Ngokuphathelene nesisindo nokwakheka komzimba, amaphrofayili e-lipid egazini (i-cholesterol iyonke, i-LDL, i-HDL, ama-triglycerides) ngokuvamile ayefana kuzo zonke lezi zindlela ezintathu zokungenelela . Lokhu kususa okunye kokukhathazeka okuvamile mayelana nokudla kwe-ketogenic: umqondo wokuthi, ngoba kunamafutha amaningi kakhulu, kuzodala amazinga e-cholesterol egazini abe mandundu. Kulesi simo esithile, nangohlelo olulawulwayo, lo mphumela omubi awuzange ubonwe.
Ukudla kwaseMedithera, ngakolunye uhlangothi, kubonise umehluko othakazelisayo: ukuhlaziywa okuningana kubonisa ukuthi labo abalandela le ndlela balahlekelwa amafutha amaningi kodwa balondoloza kangcono isisindo sabo esinciphile —okungukuthi, imisipha nezinye izicubu ezingezona amafutha. Ukugcina isisindo semisipha kubalulekile ekusebenzeni kwe-metabolism isikhathi eside, ukuze kuqiniswe amandla ebudaleni, kanye nokunciphisa ingozi yobuthakathaka, ngakho-ke lokhu okutholakele kusikisela ukuthi akekho “onqobayo” oyedwa ophelele.
Abacwaningi bagcizelela ukuthi izinzuzo ezibonwe ngeziqondiso zokudla ezintathu azikwazi ukuhlukaniswa nokunqunywa kwamakhalori kanye nesiqondiso sobungcweti. Bonke abahlanganyeli bathole ukudla okulungisiwe kanye nokusekelwa kwamasonto onke, okuhluke kakhulu empilweni yansuku zonke, lapho ukunamathela ekudleni kuvame ukuba phansi kakhulu.
Ukuthuthuka okuvamile kubonwe nasezimpawini ezifana ne-glycated hemoglobin (HbA1c), ehlobene nokulawulwa kwe-glucose yesikhathi esimaphakathi, yize izinga lokushintsha lalilikhulu eqenjini lokudla kwe-ketogenic. Noma kunjalo, abalobi bagcizelela ukuthi ukwehlisa isisindo nje kwakunemiphumela emihle evamile kungakhathaliseki ukuthi kukhethwe ukudla okukhethiwe.
Izinzuzo ezithile zokudla kwe-ketogenic esibindini esinamafutha kanye ne-prediabetes
Lapho kwavela khona umehluko ocacile kwakusekusebenzeni kwesibindi kanye nokuqhubeka kwesifo sikashukela. Ngemva kokufinyelela ukwehla kwesisindo okuqondiwe, inani lamafutha aqoqwe esibindini lancipha, ngokwesilinganiso, cishe ngo- 67% eqenjini le-ketogenic , uma kuqhathaniswa cishe no-45% kulabo abalandela ukudla kwaseMedithera, kanye namaphesenti afanayo ekudleni okunamafutha aphansi, okusekelwe ezitshalweni.
Ngaphezu kokuncipha kokudla amafutha, ukuzwela kwesibindi ku-insulin kuthuthuke kakhulu eqenjini le-keto. Lesi sitho sasabela kangcono ezimpawini zamahomoni ezilawula ukugcinwa nokukhululwa kwe-glucose namafutha, okuyisici esibalulekile ekuvimbeleni izifo zesibindi ezinamafutha ukuthi zingathuthuki ziye ezigabeni ezithuthukile. I-De novo lipogenesis, inqubo lapho isibindi sikhiqiza khona ama-fatty acid amasha avela ku-glucose, nayo yehle kakhulu ngokudla okunama-carbohydrate aphansi kakhulu.
Ngokuphathelene nesifo sikashukela sangaphambi kwesifo sikashukela, idatha yayimangalisa: cishe ingxenye yabantu abalandela ukudla kwe-ketogenic babengasahlangabezani nezindinganiso zesifo sikashukela sangaphambi kwesifo ngasekupheleni kocwaningo. Eqenjini laseMedithera, isilinganiso sasicishe sibe ngu-29%, kanti ekudleni okusekelwe kakhulu ezitshalweni, okunamafutha aphansi, kwakungafiki ku-7%, naphezu kokulahlekelwa isisindo esifanayo.
Abacwaningi baphinde babona izinguquko zamahomoni ezihambisana nale miphumela. Eqenjini le-ketogenic, amazinga e-glucagon akhuphuke kakhulu ; i-glucagon iyi-hormone ekhuthaza ukuhlanganiswa nokusetshenziswa kwamafutha agciniwe, kufaka phakathi lawo agcinwe esibindini. Ngesikhathi esifanayo, kube nokwehla okukhulu kwe-insulin egazini uma kuqhathaniswa nezinye izinhlobo ezimbili zokudla.
Umbono weqembu uwukuthi ukuvinjelwa okukhulu kwama-carbohydrate kwagcina amazinga kashukela egazini kanye ne-insulin ephansi usuku lonke, kunciphisa isignali eqhuba isibindi ukuthi sikhiqize futhi sigcine amafutha. Lokhu kuhlanganiswa bekuyosiza "ekuhlanzweni" okukhulu kwamafutha esibindi kanye nokuthuthuka okucacile kuphrofayili ye-glycemic, okuhambisana nesilinganiso esiphezulu sokuxolelwa kwe-prediabetes.
I-cholesterol, ikhwalithi yamafutha, kanye nemikhawulo yokutadisha
Enye yezinto ezitholwe ezimangaze kakhulu ababhali ukuthi abahlanganyeli ekudleni kwe -ketogenic abazange bazizwe bekhuphuka ngamafutha noma i-cholesterol egazini, naphezu kokudla ingxenye enkulu yamandla avela kumafutha, okuhlanganisa namafutha agcwele. Amaphrofayili abo e-lipid ahlala efana nalawo amanye amaqembu, okungenani esikhathini esifushane sokuhlolwa.
Lo mphumela awusho ukuthi noma yikuphi ukudla okunamafutha amaningi ngeke kube yingozi kwi-cholesterol, kodwa kunalokho, kulesi simo esilawulwa kakhulu sokunciphisa isisindo, imiphumela emibi eyesabekayo ayizange ibonwe. Nalapha futhi, ikhwalithi iyonke yokudla iyaqala ukusebenza : uhlobo luni lwamafutha oludliwayo, ukuthi kungakanani ukudla okucutshunguliwe okukhona ekudleni, nokuthi amaqembu okudla ahlukene ahlanganiswa kanjani.
Abalobi balolu cwaningo, okuhlanganisa uSamuel Klein noMax Petersen, bagcizelela ukuthi idatha yabo ayikuvumeli ukumemezela ukudla kwe-ketogenic "njengokudla okungcono kakhulu" kwawo wonke umuntu . Kuyisilingo esincane kakhulu, esinqunyelwe ezinyangeni ezimbalwa, futhi sigxile kubantu abanesimo esithile (ukukhuluphala ngokweqile, isifo sikashukela sangaphambi kwesikhathi, nesifo sesibindi esinamafutha). Ngaphezu kwalokho, ukuhlinzekwa kwakho konke ukudla kanye nokusekelwa okuseduze okuvela kochwepheshe bezokudla akubonisi izimo zokuphila ezivamile zansuku zonke.
Ochwepheshe bangaphandle abaphawule ngalolu cwaningo bagcizelela ukuthi ucwaningo lwesikhathi eside luyadingeka ukuze kuqondwe ukuthi kwenzekani uma ukudla okunjalo okunama-carbohydrate aphansi kugcinwa iminyaka eminingi, ukuthi kuthinta kanjani ukunamathela, i-gut microbiota, kanye nengozi yenhliziyo nemithambo yegazi iyonke. Baphinde baveze ukuthi abanye abasekeli bokudla kwe-keto bangase babe nokungqubuzana kwezintshisekelo kwezentengiselwano, isici okufanele sicatshangelwe lapho kuhlolwa ukuhumusha okunentshiseko ngokweqile.
EYurophu, iziqondiso zokudla, njengalezo zaseSpain, ngokuvamile zincoma ukudla okulinganiselayo okunokudla okunempilo okuphakathi kuya kokuphezulu (ikakhulukazi uwoyela womnqumo namantongomane), ukudla okuphakathi kuya kokuphezulu kwama-carbohydrate asezingeni eliphezulu (okusanhlamvu okuphelele, ubhontshisi, izithelo, nemifino), inani eliphakathi lamaprotheni ezilwane, kanye nokugcizelela kakhulu imithombo yamaprotheni asekelwe ezitshalweni . Le ndlela, efana kakhulu nokudla kwaseMedithera, isalokhu iyisincomo esiyinhloko kubantu bonke.
Ucwaningo lwase-University of Washington lunezela ezinye izici eziwusizo: kubantu abanamafutha esibindi amaningi kanye ne-prediabetes , ukunciphisa kakhulu ama-carbohydrate kunganikeza izinzuzo ezengeziwe ngale kokulahlekelwa isisindo uqobo, ikakhulukazi maqondana nokulawulwa kwamafutha esibindi kanye noshukela. Kodwa-ke, ukukhetha indlela yokudla efanele kakhulu kufanele kwenziwe ngabanye, kucatshangelwa isimo sempilo yomuntu ngamunye, imithi yakhe (kufaka phakathi izidakamizwa ezisekelwe ku-GLP-1, ezishintshe ukwelashwa kokukhuluphala), futhi, okubaluleke kakhulu, ikhono labo langempela lokugcina leyo ndlela yokudla isikhathi eside.
Isithombe esidwetshwe yile datha asiyona nje umjaho wokuwina ukudla kodwa sikhumbuza ukuthi lokho esikudlayo kubalulekile nokuthi kungakanani . Kubantu abanokukhuluphala ngokweqile, isifo sikashukela sangaphambi kwesifo sikashukela, nesibindi esinamafutha, ukwehla kwesisindo ngo-10% kuthuthukisa impilo ngamaphethini ahlukene, kodwa ukuhlukahluka kokusatshalaliswa kanye nekhwalithi yamafutha nama-carbohydrate kungenza kube ngcono kwezinye izimpawu ezithile, ngakho isu elihle kakhulu lihlala liyilelo elihlanganisa ukusebenza kahle, ukuphepha, futhi lifanelana nendlela yokuphila yesiguli ngasinye.
