Abstract

Cardiometabolic diseases (CMD) describes a combination of metabolic abnormalities that increases the risk of type 2 diabetes, cardiovascular diseases, including pathological changes such as insulin resistance, hyperglycemia, non-alcoholic fatty liver disease (NAFLD), dyslipidemia, abdominal obesity, and hypertension. It is a multidimensional disease involving genetic, behavioral, and environmental factors, with increasing evidence that lifestyle changes and patient education can significantly reduce the risk of this disease. Cardiometabolic disease cannot be easily studied for morbidity due to its multifactorial nature. The study of comorbidity is an emerging field. NAFLD affects 32·4% of the world’s population and 13.5% of Africans. Diabetes affects 463 million cases globally in 2019 were expected to increase by 51% in 2045; with a much higher increase of 143% expected in Africa. This affects 2.7 million adults in Nigeria, which is estimated to increase to 47 million by 2045. The total number of ischemic heart disease (IHD)-related deaths reached 9.14 million in 2019, accounting for 49.2% of all CVD-related mortalities. There are many strategies used to tackle each of the components of cardiometabolic syndrome. Conventional drugs have huge economic implications and side effects that most people in third world countries have not been able to circumvent. Fasting therapies have been proposed as a treatment for seizure disorders since the time of Hippocrates and were more formally adopted for the treatment of epilepsy in 1911 by the French physicians Guelpa and Marie. KD is a very low carbohydrate, high protein, very high fat content diet which induces ketogenesis. KD mimics prolonged fasting affect state resulting in upregulated ketogenesis. Ketone bodies are bioactive compounds that elicit molecular signals resulting in inhibition of histone deacetylase from expressing genes that upregulate lipogenesis and upregulation of acetylation involved in expression of genes that upregulate ketogenesis. It increases the particulate size of LDL, (HMG-CoA) reductase, increase lipolysis, HMG-CoA synthase2, cataplerotic activity, upregulated sirtuins production, increase high-density lipoprotein, increased sirtuins production, hence eliciting therapeutic effect in the management of NAFLD, diabetes and cardiovascular disease. There is usually a mild side effects that are experienced with this therapy but can be overcome after four weeks or be treated with certain intervention. There is therefore a need to explore ways of incorporating KD in the clinical management and treatment of cardiometabolic diseases.

UN SDGs

Good Health and Wellbeing