JOURNAL

REVIEW
ABOUT
KETOGENIC
DIET
BY GROUP 2
ISU MUTAKHIR GIZI MASYARAKAT
 GROUP 2

DWI SETIANINGSIH INDAH AYU FAQIH SRI RAHAYU

200741022 200741015 200741004

1 3 5
2 4

HANIFAH SOBARKAH SELLA ANJELI

200741008 200741007
JOURNAL 1
KETOGENIC DIET WITH OBESE
JOURNAL REFERENCE
 JOURNAL IDENTITY
Regulatory effects of ketogenic diet on the inflammatory response in obese Saudi
TITLE women
Nada Alkhorayef, PhD, Fatimah T. Almutery, PhD, Zafar Rasheed, PhD, Sami A.
Althwab, PhD, Abdullah S.M. Aljohani, PhD, Yasser A.N. Alhawday, PhD, Tarek
Salem, PhD, Abdulaziz M. Alharbi, PhD, Abdulrahman A.A.B. Wahaq, PhD,
Fawaz S. Alharbi, PhD, Abdulrhman S. Alghanem, PhD and Waleed Al
AUTHOR Abdulmonem, PhD.

YEAR 2023
JOURNAL NAME Journal of Taibah University Medical Sciences
VOLUME 18(5)
PAGE 1101-1107
 INTRODUCTION
1 2
Obesitas → tantangan paling signifikan Ketosis adalah salah satu faktor kunci dalam
karena prevalensinya meningkat secara keefektifan diet sangat rendah energi (VLED)
global, termasuk Kerajaan Arab Saudi dan yang terpenting KD dilaporkan menekan
(KSA). dorongan untuk makan, sehingga mengarah
pada peningkatan Indeks Massa Tubuh (BMI)
Dalam beberapa tahun terakhir, dan mengurangi kemungkinan kelebihan berat
pengelolaan kalori dengan diet ketogenik badan dan obesitas
(KD) telah diusulkan dan mendapat
perhatian signifikan dari orang-orang
gemuk karena terbukti efektif untuk
3
menurunkan berat badan.
KD meningkatkan produksi beta-hidroksibutirat
3
(BHB), yang dikenal untuk meningkatkan berat
Keton dapat melindungi dari badan dan penurunan lemak.19BHB adalah
gangguan kognitif yang disebabkan produk metabolisme yang disintesis oleh tubuh
oleh penambahan berat badan dan dan diketahui menyediakan energi dalam kondisi
obesitas. kelaparan.
RESEARCH
QUESTION  Apakah ada dampak KD pada
berbagai indeks antropometrik dan
pada regulasi aktivitas inflamasi
yang abnormal pada wanita obesitas
di Saudi?

 Bagaimana potensi BHB sebagai

suplemen untuk melawan timbulnya
atau perkembangan aktivitas pro-
inflamasi pada wanita obesitas?
Design study Population Sampel Time Place
Wanita Saudi (rentang
usia: 20-50 tahun) dengan
Tidak BMI > 30 kg/m2 direkrut Januari-Maret Rumah Sakit
40 peserta
disebutkan dari kota Buraidah KSA 2021 Pusat Buraidah
melalui iklan di
WhatsApp

METHOD
Statistical Analysis Exposure Outcome

Menggunakan SPSS versi 23.

Analisis : Frekuensi dasar dan Penurunan BB
Diet ketogenic
persentase, SD, Rata-rata dan Wanita obesitas
uji t-test berpasangan, Analisis dan BHB
varians (pengukuran berulang).
RESULT
Setelah bulan pertama,
berat badan menurun
secara progresif. BMI dan
lingkar pinggang juga
menurun secara progresif
selama periode penelitian
(p < 0,001).

Analisis menunjukkan bahwa ada perbedaan yang signifikan dalam

Usia rata-rata peserta adalah 35,3 - 8,4 tahun dan sebagian
besar kelebihan berat badan, dengan rata-rata berat badan 84,7
- 12,26 kg dengan rata-rata BMI 33,96 - 4,44 kg/m2. Subjek
dalam keadaan sehat dan tidak memiliki alergi makanan yang
mungkin mengganggu diet.
tingkat serum BHB antara awal dan minggu keempat, menunjukkan
bahwa semua peserta berkomitmen untuk KD. Setelah minggu
keenam, sedikit penurunan BHB diamati; namun, tingkat BHB
meningkat lagi pada minggu ke-8 dan peserta masih mengalami
ketosis.
RESULT

Tidak ada perubahan kolesterol total yang signifikan jika Tingkat sitokin inflamasi IL-1b menurun secara signifikan pada
dibandingkan sebelum dan sesudah intervensi. akhir penelitian jika dibandingkan dengan pada awal penelitian.
Hasil menunjukkan bahwa kadar sitokin proinflamasi menurun
karena peningkatan BHB.
 DISCUSSION
Penelitian ini menunjukkan bahwa intervensi KD menghasilkan penurunan berat badan yang cukup besar,
penurunan BMI, dan penurunan lingkar pinggang pada subjek, serta penurunan IL-1.B. Karena mekanisme
badan keton yang dihasilkan dari penguraian lemak yang disimpan untuk diproduksi sebagai energi bagi
tubuh, sebuah penelitian terbaru menemukan bahwa ada korelasi penurunan berat badan dan lingkar pinggang
dengan peningkatan badan keton dalam tubuh selama ketogenik.

Penelitian ini menunjukkan bahwa kadar kolesterol total, TG dan HDL membaik setelah diet KD; namun,
kadar LDL meningkat pada akhir penelitian. Hal ini mungkin disebabkan sensitivitas kadar LDL darah
terhadap asupan lemak yang lebih tinggi.

Hasil penelitian ini juga menunjukkan bahwa peningkatan kadar BHB pada peserta menghasilkan beberapa
hasil positif, termasuk penurunan berat badan, pengurangan lingkar pinggang, dan kelegaan dari berbagai
gejala. Khususnya, intervensi mengurangi tingkat IL-1B, sitokin yang mengaktifkan sistem kekebalan
menyebabkan berbagai gangguan peradangan ketika kadarnya meningkat.
Studi ini menunjukkan bahwa intervensi KD
menghasilkan penurunan berat badan yang cukup besar,
peningkatan BMI, pengurangan lingkar pinggang, dan
juga penurunan tingkat aktivitas inflamasi pada wanita
Saudi yang obesitas.

Secara khusus, selama periode 8 minggu, KD berguna

untuk mendeteksi dampak positif KD pada indeks CONCLUSION
antropometrik, bersamaan dengan proses biokimia dan
inflamasi. Studi ini juga mendukung keyakinan bahwa
asupan diet KD oleh wanita gemuk menginduksi
pelepasan BHB dalam darah. Tanpa stimulasi respon
kelaparan secara keseluruhan. Hal ini berguna untuk
meringankan keparahan gangguan peradangan kronis yang
terkait dengan obesitas.
JOURNAL 2
KETOGENIC DIET WITH OBESE
JOURNAL REFERENCE
 JOURNAL IDENTITY
Effects of Very Low Calorie Ketogenic Diet on the Orexinergic System, Visceral
TITLE
Adipose Tissue, and ROS Production

Anna Valenzano 1, Rita Polito 1, Valentina Trimigno 1, Antonella Di Palma 1,

Fiorenzo Moscatelli 1, Gaetano Corso 1, Francesco Sessa 1, Monica Salerno 2,
AUTHOR Angelo Montana 2, Nunzio Di Nunno 3, Marinella Astuto 4, Aurora Daniele 5,
Marco Carotenuto 6, Giovanni Messina 1, Giuseppe Cibelli 1, and Vincenzo
Monda 7.

YEAR 2019
JOURNAL NAME MDPI
VOLUME 8
PAGE 643
 INTRODUCTION
OBESITAS JENIS OBESITAS
Obesitas adalah penyakit kronis multifaktorial • sentral (jaringan adiposa di sekitar
jangka panjang yang ditandai dengan
perut daripada akumulasi
ketidakseimbangan energi akibat kelebihan
apendikular)
asupan kalori dibandingkan dengan • visceral.
pengeluaran energi dan deregulasi parameter
Jaringan adiposa sentral yang
metabolik lainnya, seperti profil lipid yang
dihasilkan terdiri dari kompartemen :
berubah, peningkatan resistensi insulin, dan • jaringan adiposa subkutan (SAT)
keadaan proinflamasi kronis • jaringan adiposa visceral (VAT).
INTRODUCTIO
TANDA OBESITAS
N
Obesitas juga ditandai dengan DIET KETOSIS
ketidakseimbangan dalam jalur neurokimia, ketosis diet ringan adalah mekanisme
khususnya orexin-A/hypocretin-1 (ORX1) fisiologis; diet ketogenik, menginduksi
yang disintesis di hipotalamus lateral dan produksi badan keton dalam jumlah
terlibat dalam pengaturan nafsu makan, laju besar, dapat menjadi strategi terapeutik
metabolisme, pengeluaran energi, pada penyakit terkait obesitas dan
perkembangan sosial, dan pengaturan nyeri kardiovaskular
dan tidur.
Research Question

Untuk mengevaluasi efek diet

ketogenik kalori sangat rendah
(VLCKD) pada populasi pasien
obesitas
 METHOD
Statistical Analysis 3 Outcome 5

Menggunakan paket Obesitas

perangkat lunak StatView
5.0.1.0 (SAS Institute Inc.,
Cary, USA)

Place 2
di Laboratorium Exposure 4
Fisiologi, Departemen Diet ketosis
Kedokteran Klinis dan
Eksperimental,
Universitas Foggia
Sample 1
20 subjek obesitas
 Result
Parameter Antropometri dan Biokimia Pasien Obesitas VLCKD

ada penurunan yang signifikan

secara statistik dari low-density
lipoprotein (LDL), trigliserida,
insulinemia, aspartat
transaminase/glutamic
oxaloacetic transaminase
(AST/GOT), alanine
transaminase/glutamic pyruvic
transaminase (ALT/GPT), dan
gamma glutamil transferase
(GT) ), menunjukkan modulasi
yang kuat dan modifikasi profil
glikemik dan lipid dengan terapi
VLCKD pada subjek ini.
 Result Modifikasi komposisi tubuh
dan parameter biokimia
Parameter Antropometri dan Biokimia Pasien Obesitas VLCKD
juga mempengaruhi
modifikasi parameter
jantung, seperti tekanan
arteri diastolik dan sistolik
serta frekuensi jantung,
sebelum dan sesudah 8
minggu VLCKD

ada pengurangan FM
dan PPN yang
signifikan
 Result
Parameter Antropometri dan Biokimia Pasien Obesitas VLCKD

variasi pada subjek VLCKD

sebelum dan sesudah diet
menunjukkan :
• korelasi negatif antara
jaringan adiposa visceral
(VAT) dan kadar serum
orexin-A (A)
• Korelasi negatif antara kadar
serum orexin-A dan CRP (B)
• Korelasi positif antara kadar
serum VAT dan CRP pada
(C)
 Metabolit oksigen
reaktif dalam
plasma subjek
obesitas VLCKD
sebelum diet lebih
tinggi daripada
subjek obesitas
VLCKD setelah
terapi diet. Terdapat
perbedaan yang
signifikan secara
statistik.

Produksi spesies oksigen reaktif (ROS) dimodulasi dengan kuat sebelum dan
sesudah VLCKD. Sel Hep-G2 yang dikultur dan dirawat selama 24, 48, dan 72

Result jam hanya dengan FBS dan dengan serum subyek obesitas VLCKD sebelum dan
setelah 8 minggu diet menunjukkan peningkatan produksi ROS yang signifikan
secara statistik dibandingkan dengan sel Hep-G2 yang diobati dengan N-
asetilsistein (NAC) selama 24, 48, dan 72 jam
Produksi ROS
 DISCUSSION
Pengurangan VAT menyebabkan penurunan peradangan kronis, memblokir sitokin proinflamasi dan
meningkatkan produksi anti-inflamasi, yang didukung oleh penurunan CRP dalam serum subjek VLCKD
setelah intervensi diet. Mempraktikkan pembatasan kalori mungkin cukup untuk meningkatkan beberapa
biomarker terkait kesehatan, mengurangi massa lemak, dan mempertahankan massa otot pada subjek yang
terlatih dengan resistensi. Secara umum, diet VLCK memiliki banyak efek menguntungkan pada berbagai
organ dan jaringan. Diet ini memerlukan pembatasan kalori dan karbohidrat yang signifikan, yang
menginduksi pengurangan simpanan glikogen di hati dan otot, menginduksi ketosis metabolik, dan
mengurangi produksi glukosa dan sekresi hati, menurunkan kadar glukosa darah sebagai efek utamanya.
Memang, resistensi insulin di hati dan otot menghilang karena simpanan lemak di organ ini berkurang,
keadaan ketogenik meningkatkan rasa kenyang, yang mengarah pada kepatuhan diet yang lebih besar.

Pada kondisi obesitas, paparan ROS juga menginduksi penurunan kapasitas antioksidan di hati, yang
meningkatkan kemungkinan kerusakan sel akibat stres oksidatif. ROS dalam keadaan fisiologis memiliki
banyak fungsi yang bermanfaat, seperti ekspresi gen, pertumbuhan sel, pertahanan terhadap infeksi, dan
kontrol sel endotel vaskular.
VLCKD memberikan efek positif pada
pengurangan VAT, memperbaiki adipositas dan
parameter biokimia darah. Dalam jangka pendek,
intervensi diet ini mengurangi peradangan dan
CONCLUSION
produksi ROS.
JOURNAL 3
KETOGENIC DIET WITH DIABETES
JOURNAL REFERENCE
 JOURNAL IDENTITY
TITLE Therapeutic effect of ketogenic diet treatment on type 2 diabetes

Fang Li, Yang Shen, Qun Chen, Xingyu Li, Hongnan Yang, Canyang Zhang,
AUTHOR Jinjun Lin, Zhicheng Du, Chenyao Jiang, Chengming Yang, Dongmei Yu, &
Peiwu Qin

YEAR 2022
JOURNAL NAME Journal of Future Foods
VOLUME 2-2
PAGE 177-183
 INTRODUCTION
Diabetes merupakan salah satu jenis Perencanaan diet dan asupan nutrisi memainkan
penyakit metabolik dengan kadar glukosa peran yang sangat penting dalam pengobatan
darah yang tinggi. Glukosa darah yang diabetes tipe 2 secara keseluruhan. Oleh karena
terus-menerus tinggi meyebabkan itu, diet rendah karbohidrat yang lebih ketat yaitu
komplikasi penyakit lain. diet ketogenik berpotensi memiliki efek terapeutik
yang lebih baik pada diabetes mellitus tipe 2

Diet ketogenik membatasi total karbohidrat

Menurut laporan International Diabetes
hingga 20‒30 g/hari. Sumber karbohidrat
Federation (IDF) pada tahun 2017, 451
berasal dari kacang-kacangan, produk susu,
juta orang (usia ≥ 18) menderita diabetes
dan buah-buahan. Pada studi lain, intervensi
secara global. Jumlah pasien akan
diet ketogenik yang lebih lama mengurangi
mencapai 693 juta pada tahun 2045
kadar HbA1c di bawah ambang risiko di antara
dengan prediksi
55% dari total diabetes.
Research Question

Bagaimana efek diet

ketogenik setelah 3 bulan
pengobatan berturut-turut?
 METHODS

Population & Sample Exposure

Dewasa dengan dm tipe 2 Efek terapeutik diet ketogonik

(N=8, dari usia 18 hingga 65
tahun) yang bersedia
mengikuti panduan
pengobatan kamidan durasi
diabetes kurang dari 3 tahun

Statistical Analysis Outcome

Phython Test Diabetes Mellitus tipe 2
RESULTS

Berdasarkan gambar 1 di samping, peneliti

melakukan record parameter fisiologis dan gambar
MRI dari delapan peserta sebelum dan sesudah
dilakukannya diet ketogenik. Subyek yang terlibat
bersedia mengikuti panduan diet ketogenik.
 RESULTS
Berdasarkan gambar 2 di samping, konsentrasi
GLU dalam darah (mmol/L) masing-masing
dicatat pada 0, 30, 60, 120, dan 180 menit dalam
OGTT. Peneliti memilih titik dari fase naik
untuk pemasangan kurva linier karena titik jatuh
berarti tubuh menyerap. Offset kurva hijau
(setelah perawatan diet ketogenik) secara
signifikan lebih kecil daripada kurva merah
(sebelum perawatan), yang menunjukkan
kemampuan metabolisme glukosa meningkat
pada subyek setelah perawatan 3 bulan. Tingkat
FBG secara signifikan lebih rendah setelah
intervensi ketogenik, yang juga menunjukkan
bahwa diet ketogenik dapat meredakan gejala
diabetes.

*OGTT (Offset of Oral Glucose Test)

*FBG (fasting blood glucose)
 RESULTS

Berdasarkan gambar 3 di samping,

didapatkan hasil bahwa perbedaan
parameter fisiologis kritis untuk semua
peserta menunjukkan kecenderungan
penurunan menuju keadaan sehat
setelah perawatan diet ketogenik 3
bulan, terutama pada ALT, FBG,
HbA1c, dan TG.

*ALT (alanine aminotransferase), FBG (fasting blood glucose), HbA1c (hemoglobin A1c), TG (triglyceride)
 RESULTS

Berdasarkan tabel 1 di samping,

hasil segmentasi menunjukkan
bahwa kinerja PSPNet dan
Deeplabv3 lebih baik daripada
FCN dan UNet.
RESULTS
 RESULTS

Berdasarkan tabel 2 dan tabel 3 di atas, dirangkum hasil bahwa HbA1c,

TG, ALT, FBG, BMI, berat badan, dan parameter lainnya untuk semua
peserta dan menunjukkan penurunan yang signifikan setelah adanya diet
ketogenik
Discussion &
Conclusion
Diet ketogenik telah menunjukkan kefektifan yang baik
dalam pengobatan epilepsi, tumor, diabetes, dan
penyakit lainnya. Perawatan diet ketogenik
membutuhkan disiplin diri yang ketat, yang merupakan
tantangan yang sulit bagi sebagian besar pasien.

Efek diet ketogenik pada jaringan adiposa pada pasien

diabetes mellitus tipe 2 dianalisis dengan pembelajaran
lebih lanjut untuk mengelompokkan dan mengevaluasi
jaringan adiposa subkutan. Hasilnya menunjukkan
penurunan yang signifikan dalam parameter fisiologis
dan volume jaringan adiposa tersegmentasi setelah
adanya perawatan 3 bulan.
JOURNAL 4
KETOGENIC DIET WITH
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SLIDE

Obesitas adalah penyakit kronis

multifaktorial jangka panjang yang ditandai
dengan ketidakseimbangan energi akibat
kelebihan asupan kalori dibandingkan
dengan pengeluaran energi dan deregulasi
parameter metabolik lainnya, seperti profil
lipid yang berubah, peningkatan resistensi
insulin, dan keadaan proinflamasi kronis
LOREM IPSUM
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