Isingeniso

Ngisalele emuva kakhulu ekubhaleni lesi sihloko. Uma ngikhuluma iqiniso, ngigweme ukubhala mayelana nokusetshenziswa kwezidlo ze-ketogenic ezinezinkinga zokudla ngokuphelele. Ngangingafuni ukubhekana nalokho engangicabanga ukuthi kungaba ukuhlehla komphakathi wezengqondo yezokwelapha, onenkolelo eqinile yokuthi noma yiluphi uhlobo lokuvinjelwa ekukhetheni ukudla luzoholela ekwenyukeni kwezimpawu noma lube namandla okudala ukudla. ukuphazamiseka kukodwa nje. 

Kodwa-ke kwafika kimi ukuthi mhlawumbe abantu bangacabanga ukuthi ngenxa yokuthi ababonanga ukuphazamiseka kokudla okufakwe kule sayithi, ukudla okune-ketogenic akufanele kubhekwe njengendlela yokwelashwa. Noma ukuthi, ngandlela thize, abukho ubufakazi obanele bokusekela ukusetshenziswa kwayo.

Futhi lokho akulona neze icala.

Ngakho-ke, kulesi sihloko, ngizokwenqabela noma yibaphi abafundi okungenzeka ukuthi bafike ngokungaqondile kulowo mcabango. Kodwa engingeke ngikwenze ukungena encazelweni ye-Binge Eating Disorder (BED) noma ngikunikeze inqwaba yezibalo mayelana nokusabalala kwayo. Kuningi okuthunyelwe kwebhulogi okuhlinzeka ngaleyo sevisi. Ngizothatha ngokuthi uma uke wafuna noma wahlangana nalesi sihloko, wena noma othile omthandayo usetholakele noma uhlonzwe njengonalolu hlobo lokuphazamiseka kwemikhuba yokudla. Futhi ukuthi ulapha ukuze uthole inkulumo eqondile mayelana nokuthi ukudla kwe-ketogenic kungase kube nendima kanjani ekululameni futhi, uma kunjalo, ukuthi kungashintsha kanjani ezinye zezinqubo ze-pathological ezicashile esizibona kulesi sifo.

Ekupheleni kwalesi sihloko, uzoqonda ukuthi kungani ukudla kwe-ketogenic akufanele nje kubhekwe njengokwelashwa okusebenzayo kwe-Binge Eating Disorder (BED) kodwa kufanele kunikezwe njengengxenye yezinga lokunakekelwa. Ngiyaxolisa uma leso sitatimende siphikisana futhi sibeka umbono wakho wamanje mayelana nokuthi lezi zinto zisebenza kanjani engcupheni.

Kodwa empeleni, isayensi nje.

I-Science Behind BED kanye ne-Ketogenic Diets

I-Brain Hypometabolism ku-BED

Ama-Neurons angamaseli asebenza kakhulu futhi asebenzayo adinga ukuhlinzekwa kwamandla okuqhubekayo. Ezimweni ze-hypometabolism yobuchopho ukusebenza kahle kokumukeka nokusetshenziswa kwe-glucose ngama-neuron konakala, okuholela ekushodeleni kwamandla. I-Brain hypometabolism yisimo sokuncipha kokusebenza kwe-metabolic ebuchosheni, futhi iziyaluyalu eziningi zitholakala ukuthi zinalokhu njengendlela eyisisekelo ye-pathological.

Sikwazi kanjani lokhu? Ngoba ukuncipha kwemetabolism kungatholwa kusetshenziswa amasu e-imaging yezokwelapha njengezikena ze-positron emission tomography (PET), ezigqamisa izindawo zobuchopho ezingasebenzi kahle ekusetshenzisweni kweglucose. Umsebenzi onciphile obonwa ngokuvamile uhilela izinga eliphansi lokuthatha nokusetshenziswa kweglucose, okubalulekile emisebenzini yobuchopho. Futhi kungabonakala kungakhathaliseki ukuthi uthatha i-glucose engakanani ekudleni kwakho. Imishini iphukile. Kufana nokuba nemoto engapheli. Akukhathalekile ukuthi ufutha uphethroli ongakanani kuwo, injini ngeke ijike ikhiqize amandla. Noma uma unenhlanhla futhi yenza, ngeke iqhubeke isebenza njalo. Futhi, akunandaba ukuthi ingakanani igesi (glucose) ethangini. Imishini (injini) ayisebenzi kahle.

Ukuqonda nokuhlonza i-hypometabolism yobuchopho bekugxilwe kuzo izifo ezihlukahlukene ze-neurodeergenerative. Futhi akukutholi ukunakwa okwanele njengomshayeli oyisisekelo we-pathology ekuguleni kwengqondo. Kodwa ukunganaki kwethu kukho kubantu abahlushwa izimpawu zempilo yengqondo akusho ukuthi akubalulekile noma akukho.

Ngakho-ke, cishe ngeke umangale lapho ngikutshela ukuthi abacwaningi babona izindawo ze-hypometabolism kubantu abane-Binge Eating Disorder (BED).

I-Hypoactivity kumasekethe e-frontostriatal kubikwe ezifundweni ezine ze-fMRI zeziguli ze-BN ezisesimweni sokugula kakhulu.

Donnelly, B., Touyz, S., Hay, P., Burton, A., Russell, J., & Caterson, I. (2018). I-Neuroimaging ku-bulimia nervosa kanye ne-binge eating disorder: ukubuyekezwa okuhlelekile. Ijenali Yezinkinga Zokudla, 6(1), 1-24. https://doi.org/10.1186/s40337-018-0187-1

Manje, ngifuna ukwabelana nawe, ngenjongo yokubeka izinto obala, ukuthi iningi lezifundo ze-neuroimaging ezibheka izindawo zokunciphisa umsebenzi noma i-hypometabolism zibheka i-Bulimia Nervosa (BN) hhayi ku-Binge Eating Disorders (BED) ngokuqondile. Ekubuyekezweni kwakamuva kwezifundo ze-neuroimaging, bathole ukuthi izifundo ezintathu kuphela kwezingamashumi amathathu nambili abazibuyekeza ziqhathaniswa namaqembu e-BN nama-BED.

Futhi nakuba ngazi ukuthi ngithe ngeke ngingene ezimisweni zokuxilonga ze-Binge Eating Disorder (BED), angifuni ukuthi uthole umbono wokuthi ngenxa yokuthi umsebenzi wenziwa kakhulu neziguli ze-Bulimia, ukuthi ngandlela thize akubalulekile. Thatha isikhashana ubheke ukufana okukhulu phakathi kwalokhu okubili, njengoba kuvezwe ku- Incwadi Yokuxilonga Nezibalo (DSM-V).

Imigomo	I-Bulimia Nervosa (BN)	I-Binge Eating Disorder (BED)
Iziqephu Zokudla Ngokuzitika	Present	Present
Izindlela Zokuziphatha Ezinxephezela	Okukhona (isb, ukuzihlanza okuzidalela wena, ukusetshenziswa kabi kwama-laxatives)	Akukho
Imvamisa Yokuziphatha	Okungenani kanye ngesonto izinyanga ezintathu	Okungenani kanye ngesonto izinyanga ezintathu
Ukuzihlola	Ukuthonywa ngokungafanele ukuma komzimba nesisindo	Akuyona inkomba ethile yokuxilonga
Usizi	Ukucindezeleka okuphawulekayo mayelana nokudla ngokweqile	Ngokuvamile kuhlobene nokudla ngokweqile
Ukugxila Kokuhlonza	Ukudla ngokweqile okulandelwa ukuziphatha okuyisinxephezelo	Ukudla ngokweqile ngaphandle kokuziphatha okuyisinxephezelo
Umthelela Wengqondo	Ngokuvamile kuhlobene kokubili ukudla ngokweqile kanye nokuziphatha okunxephezela	Ngokuvamile kuhlobene nokudla ngokweqile

Kukhona okushayela ukucwila kuzo zombili lezi zifo.

Ezinye zezifundo zokuthwebula zenziwa ngesikhathi somsebenzi, ukubona ukuthi yiziphi izindawo zobuchopho ezicushiwe noma ezingakenziwa zisebenze ngesikhathi sangempela. Ngesikhathi somsebenzi wokuqonda noma wokusebenza, indawo ye-hypometabolic ingase ingabonisi ukwanda okulindelekile emsebenzini ngenxa yokuncipha komthamo wayo we-metabolic (ikhono lokwenza amandla). Lokhu kuntuleka kokuphendula noma ukuncipha kokwenza kusebenze ngokuvamile kungaba umphumela oqondile we-hypometabolism engaphansi.

Muva nje, sibone umehluko wokuqalisa ukusebenza kobuchopho phakathi kwabantu abakhuluphele abane-BED nabangenayo ngesikhathi somsebenzi wokulawula ingqondo, neqembu le-BED elibonisa ukusebenza okunciphile ku-IFG, vmPFC, kanye ne-insula (38).

Donnelly, B., Touyz, S., Hay, P., Burton, A., Russell, J., & Caterson, I. (2018). I-Neuroimaging ku-bulimia nervosa kanye ne-binge eating disorder: ukubuyekezwa okuhlelekile. Ijenali Yezinkinga Zokudla, 6(1), 1-24. https://doi.org/10.1186/s40337-018-0187-1

Ucwaningo lwe-Neuroimaging olugxile ku-Binge Eating Disorder (BED) lubonisa umehluko omkhulu emsebenzini wobuchopho, okuveza ukuthi abantu abakhuluphele ngokweqile abane-BED babonisa umsebenzi oncishisiwe ku-Ventromedial Prefrontal Cortex (vmPFC) lapho bechayeka ezinkomba zokudla uma kuqhathaniswa nalabo abangenayo i-BED. I-vmPFC ibalulekile ekuthathweni kwezinqumo nezimpendulo ezithinta inhliziyo, iphakamisa ukuthi i-BED ithinta indlela abantu abacubungula ngayo izinto ezithinta ukudla.

Ucwaningo luphinde lwabona ukuthi ngesikhathi semisebenzi yokulawula ingqondo, abantu abakhuluphele abane-BED babonise ukusebenza okuncishisiwe ku-Inferior Frontal Gyrus (IFG) kanye ne-Insula. Lo msebenzi onciphile ku-IFG ne-Insula phakathi kwabantu be-BED kucatshangwa ukuthi ukhomba umehluko ongase ube khona emandleni abo okulawula ingqondo kanye nendlela ababona ngayo izimo zangaphakathi ezihlobene nokuziphatha kokudla.

Lezi zindlela eziyingqayizivele ze-neural ku-BED zibonisa umsebenzi oncishisiwe, ikakhulukazi ezindaweni zobuchopho ezihlobene nokwenza izinqumo, ukucubungula imizwa, nokulawula kwengqondo esimweni sokudla.

Ingabe ukungenelela okubhekana ngokuphumelelayo nokuncishiswa kokwenziwa kusebenze okubangelwa i-hypometabolism kulesi sibalo sabantu bekungeke kube ukwelashwa okubalulekile?

Ngilapha ukuzokutshela ukuthi ikhona.

Izidlo ze-Ketogenic ziyindlela yokwelapha eyaziwayo yezimo ezinezindawo ze-hypometabolism yobuchopho. Banikeza omunye uphethiloli osesimweni sama-ketone athathwa kalula ubuchopho obulambele amandla futhi badlule imishini ye-glucose ephukile ebandakanyeka ezimeni ze-hypometabolic. Futhi sesikwazile lokhu isikhathi eside ngempela.

…ubuchopho bungakwazi futhi buyathembela, okungenani ngokwengxenye, kwamanye ama-substrates, ikakhulukazi imizimba ye-ketone.

Sokoloff, LOUIS (1973). I-Metabolism yemizimba ye-ketone ngobuchopho. Ukubuyekezwa konyaka kwemithi, 24(1), 271-280. https://doi.org/10.1146/annurev.me.24.020173.001415

Uma isingaphakathi ku-neuron, imizimba ye-ketone iba nochungechunge lwezinguquko ze-biochemical okuholela ekusetshenzisweni kwayo yiketango lokuthutha lama-electron ukukhiqiza i-ATP (amandla). Abagcini nje ngokusebenza njengomthombo kaphethiloli, kodwa futhi bawumthombo kaphethiloli okhethwayo, okwazi ukukhiqiza i-ATP (amandla) eningi kunalokho okubonwa ngokusetshenziswa kwe-glucose, okuyenza isebenze kahle. Lokhu kukhiqizwa kwe-ATP (amandla) okuthuthukisiwe okuvela ku-ketone metabolism kungasiza ukulwa ne-hypometabolism ebangelwa ukungasebenzi kahle kwe-glucose.

Angifuni ukuthi ucabange ukuthi ngenxa yokuthi azikho Izivivinyo Ezilawulwa Ngokungahleliwe (RCTs) okwamanje (ngesikhathi salesi sihloko) zisebenzisa izidlo ze-ketogenic eziqondiswe ngqo kwi-Binge Eating Disorder (BED), asazi futhi siyaqonda izindlela zokuthi kungani udla i-ketogenic. ukudla kwe-ketogenic kunamandla okwelapha izindlela eziyisisekelo ze-pathological esizibona ukushayela noma ukugcina izimpawu.

Imizimba yeKetone (KBs) iwumthombo obalulekile wamandla obuchopho.

Morris, AAM (2005). I-cerebral ketone metabolism emzimbeni. Ijenali yesifo se-metabolic esizuzwe njengefa, 28(2), 109-121.  https://doi.org/10.1007/s10545-005-5518-0

Ngifuna ukuveza ukuthi ukuze ukwazi ukuzithiba, udinga ukuba ne-frontal lobe esebenzayo ukuze uqhube ukuvimbela ukuziphatha. Ngisanda kwabelana nawe ukuthi zikhona izincwadi zocwaningo eziphakamisa ukuthi abantu abaphethwe yi-binge disorder banezindawo embotsheni yabo yangaphambili ezingasebenze ngokwanele, okungenzeka ukuthi kungenxa yezinqubo ze-hypometabolic.

Njengoba singena emiphumeleni yokudla kwe-ketogenic kuma-neurotransmitters nakuso sonke lesi sihloko, ngifuna ukuthi ukugcine lokho engqondweni.

Kodwa leyo ngenye yezindlela izidlo ze-ketogenic ezingasiza ngazo ukuguqula esikubona kwenzeka ebuchosheni babantu abane-Binge Eating Disorder (BED). Masiqhubeke futhi sibone ukuthi iziphi ezinye izindlela ezingasebenza njengokwelashwa.

Ukungalingani kwe-Neurotransmitter ku-BED

Kunokuphazamiseka okuningana ekusebenzeni kwe-neurotransmitter okubonwa kubantu abahlangabezana nemibandela ye-Binge Eating Disorder kanye nenqwaba yemithi yengqondo esetshenziswa emzamweni wokuyishintsha ukuze inciphise izimpawu.

Kodwa yimuphi umehluko ekusebenzeni kwe-neurotransmitter esiyibona ku-Binge Eating Disorder (BED) ehambisana nemiphumela ebonwa ngokudla kwe-ketogenic? Uma sikhuluma ngomsebenzi we-neurotransmitter, sivame ukukhuluma ngokunganele noma kakhulu, kodwa empeleni, umlingo umayelana nendlela lawo ma-neurotransmitters asebenza ngayo.

Umsebenzi we-Glutamate/GABA

Umsebenzi we-Glutamate ubalulekile ku-Binge Eating Disorder (BED). Kangangoba abacwaningi baphenya ama-receptors e-glutamate ahlukene njengezinhloso zezidakamizwa ezingase zelashwe. Ama-Glutamate receptors adlala indima endleleni abantu abazwa ngayo umuzwa womvuzo kanye nokulawulwa kokuziphatha kokudla. Kucatshangwa ukuthi izidakamizwa ezisungulwe ukuze zilinganise lawa ma-receptors zingasiza ekulawuleni ukudla ngokweqile nokudla ngokweqile ngokushintsha impendulo yobuchopho emiklomelweni ehlobene nokudla.

… ukuguqulwa okungekuhle kwe-mGluR5 nakho kunciphisa ukudla okufana nokuzitika, uhlobo oluvame kakhulu lokuphazamiseka kwemikhuba yokudla. Sekukonke imiphumela yethu iveze i-mGluR5 njengento engase ibe khona ekwelapheni ukukhuluphala kanye nokuphazamiseka okuhlobene.

U-Oliveira, TP, Gonçalves, BD, Oliveira, BS, De Oliveira, ACP, Reis, HJ, Ferreira, CN, … & Vieira, LB (2021). Ukuguquguquka okungekuhle kohlobo 5 lwe-metabotropic glutamate Receptor njengendlela yokwelapha engaba khona ekukhuluphaleni nasekuziphatheni okufana nokudla. Imingcele e-Neuroscience, 15, 631311. https://doi.org/10.3389/fnins.2021.631311

Okunye okuphawulekayo okutholakele ukuthi ezikhathini eziningi, ngemva kokuvela kwe-post-traumatic stress disorder (PTSD), kungase kuthuthuke izinkinga ezihlukahlukene zokudla, kuhlanganise nesifo sokuzitika. Olunye ucwaningo lugxile ezinguqukweni ezabiwe ku-glutamatergic neurotransmission ezitholakala kulezi zimo. Kucatshangwa ukuthi ukuvuthwa ngokweqile kwe-glutamate kuholela ku-excitotoxicity, okuholela ku-axis ye-hypothalamic-pituitary-adrenal esebenza ngokweqile, futhi ukuhlukumezeka noma izinguquko ezibangelwa ukucindezeleka okwedlulele ekusebenzeni kwe-glutamate kungase kubangele ukuqala kwe-PTSD kanye nokuphazamiseka kokudla okulandelayo.

Ngakho-ke, ukulinganisa umsebenzi we-glutamatergic kungaba yindlela ebalulekile ekwelapheni abantu abanalezi zinkinga. 

Ukubuyekezwa kwamanje kuphakamisa ukuthi ukuguqulwa komsebenzi we-glutamate ngokuhlukumezeka noma ukucindezeleka okukhulu kungase kusize i-PTSD kanye nokuqala kwesifo sokudla okulandelayo, nokuthi ukuguqulwa kwe-glutamatergic kungase kube ukwelashwa okubalulekile ...

Murray, SL, & Holton, KF (2021). I-post-traumatic stress disorder ingase ibeke isigaba se-neurobiological sezinkinga zokudla: Ukugxila ekungasebenzini kahle kwe-glutamatergic. Isifiso, 167, 105599. https://doi.org/10.1016/j.appet.2021.105599

Nakuba i-glutamate ibhekwa njenge-neurotransmitter ejabulisayo, i-y-amino-butyric acid (GABA) iyavinjelwa. Imithi elungisa i-GABA isetshenziselwa isithuthwane kanye nokwelashwa kotshwala nokusetshenziswa kwezidakamizwa. Kodwa yona le mithi iye yasetshenziswa ekwelapheni i-Binge Eating Disorder (BED).

Ukwenza kube lula nokuyichaza ngokujwayelekile, akubonakali “inenele” i-GABA, noma umsebenzi we-GABA ukuvimbela imiphumela ejabulisayo ebonwa ngokukhiqizwa okuphezulu kwe-glutamate osekucashuniwe. I-GABA ibonakala inethonya emvuzweni nasekuziphatheni kokudla okuhlobene nokudla kakhulu. Ngokuyisisekelo, ukuyithulisa.

Ngempela, ukusebenza kwe-VTA [ventral tegmental area] I-GABAergic neurons inhibit dopaminergic neurons futhi ivimbela ngokushesha ukukhothwa kwesisombululo se-sucrose ezilwaneni ezikhawulelwe ukudla.

U-Yang, B. (2021). Kufanele uyeke nini ukudla: ibhuleki elisizayo ekusetshenzisweni kokudla okuvela ku-nucleus accumbens. I-Journal ye-Neuroscience, 41(9), i-1847-1849.  https://doi.org/10.1523/JNEUROSCI.1666-20.2020

Ukungasebenzi kahle kwe-GABA ye-neurotransmitter kuthinteka kakhulu kangangokuthi izidakamizwa ezisetshenziselwa Uma kuziwa ku-Binge Eating Disorder (BED), abacwaningi babona umsebenzi we-GABA uhilelekile, nakuba kungenjalo kakhulu njengoba kubonakala nge-dopamine.

Ungase umangale ukuthola ukuthi imithi ye-ADHD isetshenziswa nalesi sibalo, ngokwengxenye ngenxa yemiphumela yaleyo mithi ku-dopamine.

Izidakamizwa ezithuthukisa i-noradrenergic kanye ne-dopaminergic neurotransmission kanye/noma ezisebenza kahle ku-ADHD yizindawo ezithembisa kakhulu zokwelapha ezintsha ze-BED.

Feng, B., Harms, J., Chen, E., Gao, P., Xu, P., & He, Y. (2023). Okutholakele Kwamanje kanye Nemiphumela Yesikhathi Esizayo Yezinkinga Zokudla. Ijenali Yamazwe Ngamazwe Yocwaningo Lwezemvelo kanye Nezempilo Yomphakathi, 20(14), 6325. https://doi.org/10.3390/ijerph20146325

I-Dopamine ne-Serotonin

Ezimweni ezibonakala ngokudla ngokweqile, njengoba kubonakala ku-Binge Eating Disorder (BED), kukhona ukuphazamiseka kumanethiwekhi obuchopho okubalulekile ekukhuthazeni, ekutholeni injabulo, ukwenza izinqumo, nokuzithiba. Endleleni ye-mesolimbic, lokhu kuphazamiseka ikakhulukazi kuhilela i-glutamate ne-dopamine.

Lapho i-BED ihlolwa ngokukhanya kwethiyori yokusetshenziswa kokudla okungalindelekile/okuphoqelekile, kanye nokulawulwa kwayo ngokuqagela kwesistimu yemivuzo yobuchopho, i-neurotransmission ye-dopaminergic ibonakala iyindlela ekhanga kakhulu yokuhlola.

Levitan, MN, Papelbaum, M., Carta, MG, Appolinario, JC, & Nardi, AE (2021). Isifo sokudla ngokuzitika: Ucwaningo lweminyaka emi-5 lokubheka emuva emithini yokuhlola. Ijenali ye-Experimental Pharmacology, I-33-47. https://doi.org/10.2147/JEP.S255376

Izinkinga zokudla ngokuzitika zibonakala ngesimo se-hyperdopaminergic, esinomsebenzi owengeziwe we-dopamine, noma isimo se-hypodopaminergic, esimakwa ngokuncipha komsebenzi we-dopamine.

I-D1 kanye ne-D2 dopamine receptors, etholakala ngokuyinhloko ku-striatum kanye ne-prefrontal cortex, ilawula imisebenzi ebalulekile njengokulangazelela ukudla, ukwenza izinqumo, nemisebenzi yokuphatha. Izinguquko ekutholakaleni kwazo nasekuhlobaneni kwazo kunomthelela omkhulu ekuziphatheni kokudla ngokuzitika.

Ama-polymorphisms ezakhi zofuzo, ikakhulukazi kuzakhi zofuzo ze-D2, D3, ne-D4 receptor, anomthelela ekuhlukeni ngakunye emsebenzini wama-receptor. Lo mehluko wofuzo ungathinta indlela i-dopaminergic system yomuntu esabela ngayo ezicini zemvelo nezokuziphatha, okunomthelela ekuthambekeni kwabo ekuziphatheni kokudla kakhulu.

Ngaphandle kofuzo, ukusebenza kwe-dopamine receptor kuthonywa kakhulu indlela yokuphila kanye nezici zemvelo. Isibonelo, ukujwayela ukudla okunoshukela omningi noma okunamafutha amaningi kungashintsha ukutholakala kwe-dopamine receptor, okufana nezinguquko ze-neuroadaptive ezibonwa ekuphazamisekeni kokusetshenziswa kwezidakamizwa. Ukwengeza, i-neuroplasticity yobuchopho ivumela lawa ma-receptors ukuthi azivumelanise nezimo ekuphenduleni imikhuba yokudla engapheli, okungenzeka inciphise impendulo ye-dopamine ngokuhamba kwesikhathi.

I-neurotransmitter dopamine ihileleke ekunxaneleni ukudla, ekuthathweni kwezinqumo, ekusebenzeni kokuphatha, kanye nesici sobuntu sokuthatheka; konke okunomthelela ekuthuthukisweni nasekulondolozeni ukudla okudlayo.

UBlanco-Gandia, MC, Montagud-Romero, S., & Rodríguez-Arias, M. (2021). Ukudla ngokuzitika kanye nokuluthwa yi-psychostimulant. I-World Journal of Psychiatry, 11(9), i-517. http://dx.doi.org/10.5498/wjp.v11.i9.517

Izimo zokucindezeleka nezimo ezingokomzwelo nazo zidlala indima ebalulekile ekulungiseni ukusebenza kwe-dopamine receptor. Ukucindezeleka okungapheli kungashintsha izindlela zokubonisa i-dopamine, kuthinte ukuminyana kwe-receptor nokuzwela futhi ngaleyo ndlela kube nomthelela emaphethini wokuzitika ngokuzitika.

Imithi yokwelapha ye-BED ngezinye izikhathi ihlanganisa i-serotonin reuptake inhibitors (SSRIs) ekhethiwe, okwandisa isikhathi esihlala i-serotonin ekhona ku-synapse ye-neuron. Lokhu kuhloswe ukwandisa ukutholakala kwe-serotonin ukuze isetshenziswe ebuchosheni. Ekuthuthukisweni kwe-BED, kunokuqashelwa okuphawulekayo kokubonakaliswa kwe-serotonin ebuchosheni ekhubazekile, isici esibalulekile ekulawuleni imizwa nokuziphatha kokudla.

Ekuthuthukisweni kwe-BED kubantu, ukusayina kwe-serotonin yobuchopho (5-HT) ekhubazekile kuye kwabonwa. 

Feng, B., Harms, J., Chen, E., Gao, P., Xu, P., & He, Y. (2023). Okutholakele Kwamanje kanye Nemiphumela Yesikhathi Esizayo Yezinkinga Zokudla. Ijenali Yamazwe Ngamazwe Yocwaningo Lwezemvelo kanye Nezempilo Yomphakathi, 20(14), 6325. https://doi.org/10.3390/ijerph20146325

Uhlelo lwe-serotonergic, olubandakanyeka ekudambiseni amasignali e-satiety kanye nokulawulwa kwemizwelo, lubonisa ukushoda ku-BED, ikakhulukazi kwabesifazane abanokukhuluphala ngokweqile. Lokhu kuholela embuzweni othakazelisayo: ingabe ukudla kwe-ketogenic kungaba nomthelela ku-serotonin namanye ama-neurotransmitters ku-BED? Ucwaningo oluvelayo lukhomba ukuxhumana okuhle. Imithi esetshenziselwa lokhu kuxilongwa ihlanganisa i-Tricyclic Antidepressants (TCAs), i-Serotonin 5-HT2C Receptor Agonists, kanye ne-Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs).

Ngakho-ke, ingabe ukudla okune-ketogenic kungaba nemiphumela kulawa namanye ama-neurotransmitters ahlobene ahlobene nokwelapha i-Binge Eating Disorder (BED)?

Kubonakala kuyiqiniso impela.

Ngesisekelo salobu bufakazi, imizimba ye-ketone ingalawula ukugcinwa kwama-neurotransmitters afana ne-GABA, i-glutamate, i-serotonin, i-dopamine, kanye ne-neurotrophic factor etholakala ebuchosheni ehilelekile ku-neurologic pathology.

U-Chung, JY, Kim, OY, & Song, J. (2022). Indima yemizimba ye-ketone ekuwohlokeni komqondo okubangelwa isifo sikashukela: ama-sirtuin, ukumelana ne-insulin, i-synaptic plasticity, ukungasebenzi kahle kwe-mitochondrial, kanye ne-neurotransmitter. Izibuyekezo zokudla okunomsoco, 80(4), i-774-785. https://doi.org/10.1093/nutrit/nuab118

Ukudla kwe-ketogenic kunemiphumela eyaziwayo ekuguquguqukeni kwe-neurotransmitter engaphakamisa ukuthi ihlinzeka ngemiphumela yokwelapha kuma-neurotransmitters abonwa njengabalulekile ekudaleni nasekugcinweni kokuziphatha kokudla ngokuzitika.

Kodwa kuthiwani ngezinye izindlela eziyisisekelo esizibona zihilelekile kulokhu kugula? Ingabe i-neuroinflammation kanye nengcindezi ye-oxidative nayo iyabonakala kulokhu kuphazamiseka, njengoba kuningi okucwaningwe futhi okubhalwe ngakho kule bhulogi?

Impendulo inguyebo.

I-Neuroinflammation kanye ne-Oxidative Stress ku-BED

I-Neuroinflammation ingenzeka ngenxa yezizathu ezihlukahlukene. Kungaba ngenxa yokuthi ama-neurons alwela amandla, ukuntuleka kwe-micronutrient okuphazamisa ukusebenza okuvamile kwe-neuronal nokugcinwa kwendlu, noma ukuchayeka ezintweni ezeqe umgoqo wegazi nobuchopho okungafanele kube khona. Noma, ukugcwala kobuchopho kumazinga eglucose (ushukela) engakwazi ukuwasebenzisa ngenxa yokumelana ne-insulin yobuchopho.

I-Leaky Brain kanye ne-Ketogenic Diets

Kuyenzeka futhi lapho amasosha omzimba esebenza ngenxa yegciwane noma ukutheleleka kwebhaktheriya. Kungakhathaliseki ukuthi yisiphi isizathu, isimiso somzimba sokuzivikela ezifweni siyasebenza lapho lokhu kucindezeleka kwenzeka. Futhi ngokuvamile, lokho kuhle. Ikhipha ama-proinflammatory cytokines ukusiza ukubuyisela izinto kwesijwayelekile. I-Neuroinflammation iyimpendulo evamile ye-neuroimmunological ekuvikelayo. Kodwa ezimweni eziningi zempilo yengqondo okuxoxwe ngazo kule bhulogi, i-neuroinflammation iba umshayeli wezimpawu ezingapheli. 

Ngakho-ke futhi, akufanele kusimangaze ukuthi ukuvuvukala kwe-neuroinflammation kukhonjwe njengendlela eyisisekelo ye-pathological ezinkingeni zokudla, okuhlanganisa i-Binge Eating Disorder (BED). Amazinga aphakeme ama-cytokines ane-proinflammatory njenge-Tumor Necrosis Factor Alpha (TNFα), i-Interleukin 1 Beta (IL1ß), ne-Interleukin 6 (IL6) ayizinkomba zezinqubo ze-neuroinflammatory. Lawa ma-cytokines ayingxenye yenqubo yokuvuvukala, futhi ukuba khona kwawo okuphezulu ezinkingeni zokudla kuphakamisa ukuthi adlala indima ye-neuroinflammation ku-pathology yalezi zimo.

Ngokuphathelene ne-ED, ukugxila kwe-plasma ephakeme ye-cytokines ye-proinflammatory (TNFα, IL1ß ne-IL6) kanye nabanye abaxhumanisi abavuthayo kanye ne-oxido-nitrosative (COX2, TBARS) kuye kwabikwa.

U-Ruiz-Guerrero, F., Del Barrio, AG, de la Torre-Luque, A., Ayad-Ahmed, W., Beato-Fernandez, L., Montes, FP, … & Díaz-Marsá, M. (2023) . Ukucindezeleka kwe-oxidative kanye nezindlela zokuvuvukala ezinkingeni zokudla zabesifazane kanye nokuphazamiseka kobuntu obusemngceleni nokuhlukunyezwa ngokomzwelo njengezici ezixhumanisa nokuthatheka nokuhlukumezeka. I-Psychoneuroendocrinology, 158, 106383. https://doi.org/10.1016/j.psyneuen.2023.106383

Kubantu abane-BED nokukhuluphala ngokweqile, ukuba khona kokuvuvukala okungapheli, okusezingeni eliphansi kubhalwe kahle, nokuvuvukala kwezinhlobo zezilwane kuxhunyaniswa nemisebenzi yobuchopho enomthelela ekuziphatheni kwemizwelo kanye nenkumbulo.

Ama-cytokines ane-pro-inflammatory ahileleke ekulawuleni ukudla ngokusebenza ku-hypothalamus futhi kucatshangwa ukuthi athonya ibhalansi ye-orexigenic (i-appetite-stimulating) kanye ne-anorexigenic (ukucindezela ukudla) ama-neurons ngaphakathi kwe-hypothalamus, okungase kube nomthelela ekulawuleni ukudla nokusutha.

Ubufakazi bamanje bukhombisa ubudlelwano obungaba khona be-bi-directional phakathi kwezimpawu zokuvuvukala/amasosha omzimba kanye nokuziphatha okuhlobene nokudla okuhlobene nokukhuluphala.

Meng, Y., & Kautz, A. (2022). Ukubuyekezwa kobufakazi bokuhlotshaniswa kwezimpawu zokuzivikela komzimba nezokuvuvukala nokuziphatha okuhlobene nokudla okuhlobene nokukhuluphala. Imingcele e-Immunology, 13, 902114. https://doi.org/10.3389/fimmu.2022.902114

Lapho i-neuroinflammation ingapheli, amasistimu omzimba we-antioxidant asetshenziselwa ukuhlanza umonakalo obangelwa yi-neuroinflammation angase anganele. Kulapho ukucindezeleka kwe-oxidative kwenzeka khona. Leli gama libhekisela ekungakwazini kobuchopho ukuhambisana nezinga lomonakalo owenziwayo. 

Uma namanje ungakacaci kahle mayelana nomehluko phakathi kwe-neuroinflammation ne-oxidative stress, ungase ujabulele lesi sihloko esingezansi.

Ukube Ubuchopho Bakho BekuyiDolobha: Ukuqonda Ukucindezeleka Kwe-Oxidative kanye Neuroinflammation

Ngamandla ocwaningo oluqinisekisa ukuthi kokubili i-neuroinflammation kanye nokucindezeleka okwenziwe nge-oxidative kukhona emiphakathini yokudla, futhi ku-Binge Eating Disorder (BED) ngokuqondile, kuholela embuzweni wemvelo wokuthi ukudla kwe-ketogenic kungase kube nemiphumela yokwelapha enenzuzo kulezi zici.

Ake ngiphendule umbuzo wakho ngoyebo ozwakalayo.

I-βOHB iyi-inhibitor ye-histone deacetylases eholela ekukhulisweni kwezakhi zofuzo ezihilelekile ekuvikelweni ekucindezelekeni kwe-oxidative ...

Achanta, LB, & Rae, CD (2017). I-β-Hydroxybutyrate ebuchosheni: i-molecule eyodwa, izindlela eziningi. Ucwaningo lwe-Neurochemical, 42, I-35-49. https://doi.org/10.1007/s11064-016-2099-2

Imikhiqizo ye-fatty acid ye-KD iphinde yenze kusebenze izici zokulotshwa kwamaprotheni akhuthaza ukuvikelwa kwe-neuroprotection ngokulawula ukuvezwa kwezimpawu ze-pro-mitochondrial antioxidant kanye ne-anti-inflammatory.

Ukudla kwe-ketogenic kuthonya izindlela zokucindezeleka okwenziwe nge-oxidative ebuchosheni, ngokwengxenye ngokusebenzisa indlela ye-NRF2. I-NRF2 (I-Nuclear Factor Erythroid 2-Related Factor 2) iyisici esibalulekile sokuloba esilawula impendulo yeselula ekucindezelekeni kwe-oxidative ngokuqala ukubhalwa kwezakhi zofuzo eziningi ezibhekene nokuvikela okulwa ne-antioxidant kanye ne-detoxification.

Kungani kubalulekile, futhi kungani kufanele sikukhathalele lokhu ngempilo yobuchopho futhi njengendlela yokwelapha ezifweni ezinjenge-Binge Eating Disorder (BED) nezinye eziningi?

Ngoba kuholela ekwandeni kokukhiqizwa kwama-molecule abalulekile e-antioxidant afana ne-glutathione, kanye namanye ama-enzyme abalulekile abandakanyeka ekwenziweni kwe-oksijini esebenzayo nezinhlobo ze-nitrogen. Lezi zinguquko zamangqamuzana zifaka isandla kakhulu ekunciphiseni ukucindezeleka okwenziwe nge-oxidative ngaphakathi kobuchopho. Kuthuthukiswe ukudla kwe-ketogenic, le mpendulo ye-antioxidant ye-NRF2-mediated iwukushintsha umdlalo ngoba isiza ukuvikela amangqamuzana e-neural emonakalweni we-oxidative.

Ukudla kwe-ketogenic nakho kulungisa i-PPARgamma (i-Peroxisome Proliferator-Activated Receptor Gamma). I-PPARgamma iyisamukeli senuzi esibalulekile esidlala indima ebalulekile ekulawuleni i-lipid metabolism, i-glucose homeostasis, kanye nebhalansi yamandla. Ngaphezu nje kokulawula imisebenzi ye-metabolic, i-PPARgamma inesandla ekulawuleni uhla lwezakhi zofuzo ezihambisana nezimpendulo ezilwa nokuvuvukala kanye ne-antioxidant. Uma icushiwe iholela ekulotshweni kwezakhi zofuzo ezithuthukisa i-metabolism yamaselula, zinciphise ukuvuvukala, futhi zithuthukise umsebenzi we-mitochondrial. Lena indlela ebalulekile yokusebenza enikeza izinzuzo zokwelapha.

Isiphetho: Ukwabelana ngenye enye indlela esekelwe ebufakazini

I-Binge Eating Disorder (BED) iyinselele edlangile, ethinta cishe u-0.9% wabantu esikhathini sokuphila kwabo. Kuyisifo esivame kakhulu sokudla, esivame ukuhambisana nokwanda kwe-psychopathology kanye nezinkinga ezihlobene nokukhuluphala.

Amasu amanje awasebenzi ngokwanele kuwo wonke umuntu. Futhi nokho, ukudla kwe-ketogenic kubhekana ngqo nokungalingani kwe-neurobiological kanye ne-metabolic engase kusize ukushayela i-Binge Eating Disorder (BED). I-Hypometabolism, ukungalingani kwe-neurotransmitter, i-neuroinflammation, ukucindezeleka okwenziwe nge-oxidative - ukudla kwe-ketogenic kubonise amandla okulawula lezi, nokunye okuningi.

Ngokusekelwe ebufakazini besayensi obethulwe ngakho ... Le ndlela yokuhlukanisa imikhakha kufanele ihlanganise uhlelo lwendlela yokuphila ehlelekile nokuhlela ukudla okunempilo, i-PA, nokungenelela kokuziphatha, ngokusho kwethimba lochwepheshe bemikhakha eminingi.

Feng, B., Harms, J., Chen, E., Gao, P., Xu, P., & He, Y. (2023). Okutholakele Kwamanje kanye Nemiphumela Yesikhathi Esizayo Yezinkinga Zokudla. Ijenali Yomhlaba Wonke Wocwaningo Lwezemvelo kanye Nezempilo Yomphakathi, 20(14), i-6325. https://doi.org/10.3390/ijerph20146325

Uma ucwaningo olubuyekezwe ngontanga lumela uhlelo lokwelapha oluhlelekile oluhlanganisa ukudla, ukuvivinya umzimba, nokungenelela kokuziphatha, kuyacaca ukuthi ukudla kwe-ketogenic kungena kuphi. Akuyona enye indlela kodwa inketho edingekayo, esekelwa ubufakazi besayensi, ukuhlanganiswa nezinga lokunakekelwa kwe-BED.

Uma kubhekwa ukusabalala kwe-BED kanye neqiniso lokuthi ukwelapha kwamanje akusebenzi kuwo wonke umuntu, ukudla okune-ketogenic kunikeza ithemba. Kuyindlela eqondile, esekelwe ebufakazini engenza umehluko wangempela kwabaningi. Ochwepheshe bezokunakekelwa kwempilo kanye nezengqondo kufanele bakucabangele ngokungathi sína njengengxenye yendlela yokwelapha ehlukahlukene ye-BED.

Umbuzo wami ungaba, uma lezo ziyizincomo zokwelashwa ezibekwe ezincwadini, kungani ukudla kwe-ketogenic kungenakufakwa? Uma wena noma othile omthandayo ehlushwa I-Binge Eating Disorder (BED), ngicabanga ukuthi ungakuthethelela lokho ngolwazi lwakho olusha oluvela kulesi sihloko. Udokotela wakho angase akwazi ukudlulisela kusazi sokudla okunempilo noma isazi sezokudla, futhi ungase ucele ukuthi baqeqeshwe ngokudla okune-ketogenic futhi basebenzise ukuqeqeshwa kwezinye izici ezifanele zendlela yokuphila ezitholakala ziwusizo ekululameni.

Futhi manje njengoba usuqonda ukuthi ukudla kwe-ketogenic kuthinta kanjani ezinye zezinqubo zebhayoloji eziyisisekelo eziqhuba lesi sifo, ungase ube endaweni engcono yokwenza lolo hlobo lwesinqumo esibalulekile ngokwakho. Ngiyethemba ukuthi usesimweni esingcono sokuzimela wena nodokotela wakho kanye nenkampani yomshuwalense ukuze uthole ukufinyelela ekudleni kwe-ketogenic njengokwelashwa kunalokho owawuyikho ngenkathi uqala.

Uma ubheke ukungeza udokotela onolwazi nge-ketogenic eqenjini lakho lezokwelapha noma ethimbeni lothile omthandayo, ngizoqala e-Mental Health Keto Training and Resource Page.

Izinsiza Zezempilo Yengqondo Zokudla Kwe-Ketogenic

Ucwaningo lwezindlela eziyisisekelo luqinile. Kodwa angifuni ucabange ukuthi lesi sihloko simane nje siwumcabango. Izincwadi zocwaningo zikhona empeleni zisebenzisa ukudla kwe-ketogenic njengokwelashwa kwe-Binge Eating Disorder (BED). Futhi kuyinjabulo yami ukukunikeza isingeniso kulokho abakuthola kulesi sihloko esingezansi.

Ukubuyekezwa Kafushane Kocwaningo Ngokudla Kwe-Ketogenic Njengokwelashwa Kwe-Binge Eating Disorder (BED)

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