Ketogenic Diet may Alleviate Gas Exchange And Sleep Apnoea In Obesity Hypoventilation Syndrome

Obesity hypoventilation syndrome (OHS) poses a significant challenge in managing hypercapnia, a condition characterized by excessive carbon dioxide levels in the blood, often unresponsive to existing treatments. A recent study published in the Official Journal Of The Asian Pacific Society Of Respirology has shed light on a potential breakthrough in the form of a ketogenic diet. This dietary intervention has shown promising results in improving gas exchange and sleep apnea among patients with OHS. The findings highlight a novel approach that may help alleviate the burden of OHS and improve the quality of life for affected individuals.

In a single-arm crossover clinical trial, researchers Adam Osman and team investigated the effects of a ketogenic diet on CO2 levels in patients with OHS. The study involved 20 subjects who adhered to a specific diet regimen, including one week of a regular diet, followed by two weeks of a ketogenic diet, and another week of a regular diet. Throughout the trial, the participants underwent various assessments, including blood gas measurements, calorimetry, body composition analysis, metabolic profiling, and sleep studies. Adherence to the diet was monitored using capillary ketone levels and continuous glucose monitors.

The findings of the study were:

● In this study, a group of 20 participants successfully completed the investigation.

● Blood ketone levels exhibited a substantial increase from 0.14 ± 0.08 during the regular diet phase to 1.99 ± 1.11 mmol/L (p < 0.001) after following a ketogenic diet for two weeks.

● The ketogenic diet intervention led to a decrease in venous CO2 levels by 3.0 mm Hg (p = 0.008) and bicarbonate levels by 1.8 mmol/L (p = 0.001).

● Participants experienced a significant reduction in weight, with an average loss of 3.4 kg (p < 0.001).

● The study also revealed notable improvements in sleep apnea severity and nocturnal oxygen levels following the ketogenic diet intervention.

● The ketogenic diet was found to lower the respiratory quotient, fat mass, body water, as well as levels of glucose, insulin, triglycerides, leptin, and insulin-like growth factor 1.

● These findings collectively suggest a positive impact of the ketogenic diet on metabolic profiles and body composition.

The ketogenic diet was well tolerated by the participants, indicating its feasibility and acceptability as a dietary intervention in the context of obesity hypoventilation syndrome. These results provide promising evidence for the potential of the ketogenic diet in effectively managing hypercapnia and improving various health markers in individuals with obesity hypoventilation syndrome.

The findings of this study demonstrate the potential of a ketogenic diet as a valuable intervention for managing hypercapnia and sleep apnea in patients with obesity hypoventilation syndrome. By significantly reducing CO2 levels, improving sleep apnea severity, and offering additional metabolic benefits, the ketogenic diet offers hope for individuals suffering from this challenging condition. Further research is warranted to explore the long-term effects and optimize the implementation of this dietary intervention in clinical practice.

Reference:

Osman, A., Gu, C., Kim, D. E., Duan, D., Barron, B., Pham, L. V., Polotsky, V. Y., & Jun, J. C. (2023). Ketogenic diet acutely improves gas exchange and sleep apnoea in obesity hypoventilation syndrome: A non‐randomized crossover study. Respirology (Carlton, Vic.). https://doi.org/10.1111/resp.14526.