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Comprehensive nutrient consumption estimation and metabolic profiling during ketogenic diet and relationship with myocardial glucose uptake on FDG-PET.

Publication ,  Journal Article
Selvaraj, S; Seidelmann, SB; Soni, M; Bhattaru, A; Margulies, KB; Shah, SH; Dugyala, S; Qian, C; Pryma, DA; Arany, Z; Kelly, DP; Chirinos, JA ...
Published in: Eur Heart J Cardiovasc Imaging
November 17, 2022

AIMS: The ketogenic diet (KD) is standard-of-care to achieve myocardial glucose suppression (MGS) for assessing inflammation using fluorine-18 fluorodeoxyglucose-positron emission tomography (FDG-PET). As KD protocols remain highly variable between centres (including estimation of nutrient intake by dietary logs for adequacy of dietary preparation), we aimed to assess the predictive utility of nutrient intake in achieving MGS. METHODS AND RESULTS: Nineteen healthy participants underwent short-term KD, with FDG-PET performed after 1 and 3 days of KD (goal carbohydrate intake <20 g/day). Nutrient consumption was estimated from dietary logs using nutrition research software. The area under receiver operating characteristics (AUROC) of macronutrients (carbohydrate, fat, and protein intake) for predicting MGS was analysed. The association between 133 nutrients and 4 biomarkers [beta-hydroxybutyrate (BHB), non-esterified fatty acids, insulin, and glucagon] with myocardial glucose uptake was assessed using mixed effects regression with false discovery rate (FDR) correction. Median (25th-75th percentile) age was 29 (25-34) years, 47% were women, and 42% were non-white. Median (25th-75th percentile) carbohydrate intake (g) was 18.7 (13.1-30.7), 16.9 (10.4-28.7), and 21.1 (16.6-29.0) on Days 1-3. No macronutrient intake (carbohydrate, fat, or protein) predicted MGS (c-statistic 0.45, 0.53, 0.47, respectively). Of 133 nutrients and 4 biomarkers, only BHB was associated with myocardial glucose uptake after FDR correction (corrected P-value 0.003). CONCLUSIONS: During highly supervised, short-term KD, approximately half of patients meet strict carbohydrate goals. Yet, in healthy volunteers, dietary review does not provide reassurance for adequacy of myocardial preparation since no clear thresholds for carbohydrate or fat intake reliably predict MGS.

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Published In

Eur Heart J Cardiovasc Imaging

DOI

EISSN

2047-2412

Publication Date

November 17, 2022

Volume

23

Issue

12

Start / End Page

1690 / 1697

Location

England

Related Subject Headings

  • Radiopharmaceuticals
  • Positron-Emission Tomography
  • Nutrients
  • Male
  • Humans
  • Glucose
  • Fluorodeoxyglucose F18
  • Female
  • Diet, Ketogenic
  • Adult
 

Citation

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Chicago
ICMJE
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Selvaraj, S., Seidelmann, S. B., Soni, M., Bhattaru, A., Margulies, K. B., Shah, S. H., … Bravo, P. E. (2022). Comprehensive nutrient consumption estimation and metabolic profiling during ketogenic diet and relationship with myocardial glucose uptake on FDG-PET. Eur Heart J Cardiovasc Imaging, 23(12), 1690–1697. https://doi.org/10.1093/ehjci/jeac031
Selvaraj, Senthil, Sara B. Seidelmann, Meshal Soni, Abhijit Bhattaru, Kenneth B. Margulies, Svati H. Shah, Supritha Dugyala, et al. “Comprehensive nutrient consumption estimation and metabolic profiling during ketogenic diet and relationship with myocardial glucose uptake on FDG-PET.Eur Heart J Cardiovasc Imaging 23, no. 12 (November 17, 2022): 1690–97. https://doi.org/10.1093/ehjci/jeac031.
Selvaraj S, Seidelmann SB, Soni M, Bhattaru A, Margulies KB, Shah SH, et al. Comprehensive nutrient consumption estimation and metabolic profiling during ketogenic diet and relationship with myocardial glucose uptake on FDG-PET. Eur Heart J Cardiovasc Imaging. 2022 Nov 17;23(12):1690–7.
Selvaraj, Senthil, et al. “Comprehensive nutrient consumption estimation and metabolic profiling during ketogenic diet and relationship with myocardial glucose uptake on FDG-PET.Eur Heart J Cardiovasc Imaging, vol. 23, no. 12, Nov. 2022, pp. 1690–97. Pubmed, doi:10.1093/ehjci/jeac031.
Selvaraj S, Seidelmann SB, Soni M, Bhattaru A, Margulies KB, Shah SH, Dugyala S, Qian C, Pryma DA, Arany Z, Kelly DP, Chirinos JA, Bravo PE. Comprehensive nutrient consumption estimation and metabolic profiling during ketogenic diet and relationship with myocardial glucose uptake on FDG-PET. Eur Heart J Cardiovasc Imaging. 2022 Nov 17;23(12):1690–1697.
Journal cover image

Published In

Eur Heart J Cardiovasc Imaging

DOI

EISSN

2047-2412

Publication Date

November 17, 2022

Volume

23

Issue

12

Start / End Page

1690 / 1697

Location

England

Related Subject Headings

  • Radiopharmaceuticals
  • Positron-Emission Tomography
  • Nutrients
  • Male
  • Humans
  • Glucose
  • Fluorodeoxyglucose F18
  • Female
  • Diet, Ketogenic
  • Adult