The Benefits of The Ketogenic Diet
生酮飲食的效益
There is a ton of hype surrounding the ketogenic diet. Some researchers swear that it is the best diet for most people to be on, while others think it is just another fad diet.
生酮飲食有著許多的爭議。有些研究者認為生酮飲食是目前最健康的飲食法，因此認為人如果要保持健康都應該要採用生酮飲食，但是也有部分的研究人員認為，它只是像以前廣為流傳的飲食方式，像是阿金飲食法一樣，不過就只是個噱頭而已〈編按：每個人的身體結構與反應都不盡相同，沒有一個絕對好或是絕對不好的飲食法〉。
To some degree, both sides of the spectrum are right. There isn’t one perfect diet for everyone or every condition, regardless of how many people “believe” in it. The ketogenic diet is no exception to this rule.
在部分的層面來看，兩邊的說法都是對的。並沒有任何一種飲食法是適合每個人或是各種的身體狀況，而生酮飲食也不例外。
However, the ketogenic diet also has plenty of solid research backing up its benefits. In fact, it has been found to be better than most diets at helping people with:
然而，也有許多有力的科學證據支持生酮飲食。目前已經發現，生酮飲食對於下列這些人來說，所帶來的健康效益比起其他飲食法來得更好：
Epilepsy 癲癇
Type 2 Diabetes 第二型糖尿病
Type 1 Diabetes 第一型糖尿病
High Blood Pressure 高血壓
Alzheimer’s disease 阿茲海默症
Parkinson’s disease 帕金森氏症
Chronic Inflammation 慢性發炎
High Blood Sugar Levels 高血糖
Obesity 肥胖
Heart Disease 心臟疾病
Polycystic Ovary Syndrome 多囊性卵巢症候群
Fatty Liver Disease 脂肪肝
Cancer 癌症
Migraines 偏頭痛
Even if you are not at risk from any of these conditions, the ketogenic diet can be helpful for you too. Some of the benefits that most people experience are:
即使您並沒有任何有關上述症狀的疾病風險，生酮飲食也能夠提供您一些健康效益，像是：
Better brain function 更好的腦部功能
A decrease in inflammation 降低發炎的機率
An increase in energy 體能提升
Improved body composition 身體組分的改善
As you can see, the ketogenic diet has a wide array of benefits, but is it any better than other diets?
到目前為止，您已經發現生酮飲食有非常多的效益，但它真的比其它的飲食法來得更好嗎？
The Calorie Conundrum 難解的熱量攝取問題
Many researchers argue that ketosis (burning ketones for fuel) and carbohydrate restrictions only play a minor role in the benefits of the ketogenic diet. Their argument is that people tend to eat fewer calories on the ketogenic diet, and this is the main reason for its benefits.
許多研究者認為酮症和限制碳水攝取並非生酮飲食效益的主要因素。他們認為在採用生酮飲食的人通常會攝取較少的熱量，而這是這些效益的主因。
It is true that people on the ketogenic diet tend to eat less because of how satiating eating a high-fat moderate-protein diet is for us. And it is also true that less calorie consumption leads to improved health and weight loss, but there is something that many researchers don’t consider.
的確，採用生酮飲食的人較容易吃比較少的食物，是因為攝取這種高脂肪中等蛋白質的營養比例是很容易飽的，此外，卡路里攝取量的減少也正好改善了健康狀況並能夠減重，但是也有許多是這些研究人員所沒列入考量的部分。
The ketogenic diet elicits many other important mechanisms in the body and cells that are nonexistent in other diets. These unique mechanisms explain the benefits of the ketogenic diet that eating fewer calories cannot.
生酮飲食能帶給身體許多其他飲食法所沒有的重要機轉。這些特殊的機轉可以解釋生酮飲食的效益不僅僅是因為卡路里攝取量的減少而已。
How The Body Adapts To The Ketogenic Diet— The Main Reason for Many of the Benefits
身體適應生酮飲食的方式-生酮飲食效益的主要原因
From The Cell’s Point of View 從細胞觀點來看
Carbohydrates are the body’s preferred fuel source. When its consumption is restricted, the body reacts as if it is fasting. This stimulates new energy pathways to provide energy for the cells. One of these energy pathways is called ketogenesis, and the result of ketogenesis is an alternative fuel source called a ketone body.
碳水化合物是身體優先會使用的能量來源，當它攝取量被限制時，我們的身體反應就會像絕食一樣。這樣的狀態會刺激新的能量管道來提供能量給細胞。生酮作用〈ketogenesis〉就是屬於上述的其中一種，而生酮作用的產物稱為酮體，是一種能量來源的替代物。
These ketones bodies can be used by almost every cell in your body for fuel (except for the liver and red blood cells). However, sugar and ketone bodies affect the body in many different ways.
這些酮體可用於大部分的細胞作為能量使用〈除了肝臟和紅血球細胞外〉。雖然同樣都能給予能量，糖和酮體對身體的影響卻是不同的。
For example, burning sugar for fuel creates more reactive oxygen species. These reactive oxygen species cause damage, inflammation, and cell death when they accumulate. This is why consuming too much sugar is known to impair brain function and cause plaque build up in the brain.
例如，燃燒糖來製造能量使可以產生許多活性的氧化物質。這些物質在積聚後可以對人體造成損害、發炎和細胞凋亡。而這也就是為何，攝取過多的糖分是會影響腦部功能並會產生腦部的斑塊。
On the other hand, ketones provide a more efficient energy source and help protect neuron cells in the brain. This is partly because burning ketones for fuel decreases the production of reactive oxygen species and enhances mitochondrial function and production.
另一方面，酮體提供更有效的能量來源，並幫助腦部神經元的維護。這也是幫助防止腦部老化的原因的一部分，主要是因為，燃燒酮體後能減少活性氧化物質的生產，進而增進粒線體功能與產量。
The healthy cells that are struggling to survive are helped by the carbohydrate restriction as well. Without access to carbohydrates, a cellular process called autophagy is activated. This process up-regulates many factors that improve cell health and resilience, clean up the cell from damage and illicit anti-inflammatory processes.
在常見的飲食情況下，健康的細胞是比較難存活下來的，但是透過限制碳水化合物的攝取量，可以幫助這些細胞生命的存續。既然體內能運用的碳水量變少，那麼體內一種稱為自噬作用〈autophagy〉的細胞作用會被活化。這種作用讓基因的表現量增加，可以改善細胞的健康程度與細胞彈性，並且可以清除細胞裡的危險因子和促進抗發炎的程序。
The combination of autophagy and ketone burning are essential in helping people with cancer and brain disorders like epilepsy, migraines, and Alzheimer’s.
自噬作用和酮體的燃燒對於幫助癌症和像是癲癇〈epilepsy〉、偏頭痛〈migraines〉和阿茲海默症〈Alzheimer’s〉等腦部疾病患者症狀的改善。
From The Body’s Perspective 從身體的角度來看
Now, let’s zoom out and look at how the ketogenic diet changes the body. It all begins with a change in insulin levels.
除了從細胞的角度來看生酮飲食的幫助外，以體內的機制來說，生酮飲食帶來的好處源自於胰島素水準的改變。
By restricting carbohydrates, we take the biggest stimulator of insulin out of the diet. This decreases insulin levels, increases fat burning, and reduces inflammation. The combination of these three changes addresses the primary drivers of many chronic diseases — insulin resistance, inflammation, and fat accumulation.
透過限制碳水化合物的攝取量，我們已將胰島素的刺激物質移出了平日的飲食中。而這樣的方法，可以降低胰島素水準、增進燃脂還能抑制發炎。這三件事情帶來的改變影響了許多慢性疾病的主因，像是胰島素抗性、發炎和脂肪的積聚等。
The Takeaway — The Mechanisms Behind The Ketogenic Diet
重點精華-生酮飲食在體內的機制
From a mechanistic level, here is why the ketogenic diets can lead to benefits that reach beyond caloric restriction:
下列為生酮飲食比熱量控制飲食法來得更有效益的部分：
On a cellular level: 以細胞的層次
Ketones burn more efficiently than sugar. 酮體燃燒的效率比糖來得更好
Carbohydrate restriction triggers autophagy and anti-inflammatory processes. 控制碳水的攝取促進自噬作用和抗炎的流程
Burning ketones for fuel creates less reactive oxygen species. 燃燒酮體較不會產出活性氧物質〈Reactive Oxygen Species〉
Ketone usage enhances mitochondrial function and production. 生酮的使用增強了粒線體〈mitochondrial〉的效能與產能
In the body: 以體內的層次
Insulin levels decrease because dietary carbohydrate isn’t stimulating its release. 胰島素水準會下降是因為，膳食中攝取的碳水減少，較不會刺激胰島素的釋出
Fat burning increases because the body needs to use alternative fuel sources. 燃脂效率會增強是因為，身體開始需要使用脂肪這種能替代醣類的能量來源
Inflammation is reduced because inflammatory fat levels decrease and less reactive oxygen species are formed.
發炎受到了抑制是因為，活性氧化物的減少及炎症性的脂肪水準的下降
The combination of the cellular and bodily effects of the ketogenic diet provides us with a basis for why they may be useful in the treatment of the conditions we mentioned earlier. However, this is only biochemistry. Is the ketogenic diet scientifically proven to help people with those conditions?
生酮飲食所帶來的細胞與身體的效益正是為何，它能夠對於上述症狀的改善有效的緣故。但這只是以生物化學的角度來看，那麼以科學的角度來說，生酮飲食改善這些症狀是否真有證據？
Treating Epilepsy — The Origins of The Ketogenic Diet
生酮飲食的起源-治療癲癇
Our journey through the research on the ketogenic diet starts in 1924 with Dr. Russell Wilder. At the prestigious Mayo Clinic, Dr. Wilder designed a carbohydrate-restricted diet to treat epilepsy in children, and the research at the time indicated that it was highly effective.
針對生酮飲食的研究就得從1924年開始，在美國知名的馬約診所〈Mayo Clinic〉裡，羅素王爾德醫師設計了一套控制碳水化合物的飲食法來治療罹患癲癇的小朋友，在當時，這樣的療法相當有效。
The first high-quality study on epilepsy and the ketogenic diet wasn’t published until much later, in 1998. In this study, researchers recruited 150 children, and nearly all of them had more than two seizures per week despite taking at least two seizure-reducing medications. The children were provided with a ketogenic diet for a one-year trial.
時間遲至1998年，第一項有科學根據的相關研究才被發表出來。在這項研究中，研究人員徵集了150個每周癲癇發作至少兩次並經歷兩次抑制癲癇療法的小朋友。研究人員提供這些小朋友為期一年生酮飲食的計畫。
After three months, about 34% of the children, or slightly over one-third, had over a 90% decrease in seizures.
在歷經了三個月之後，其中大約有34%的小朋友，癲癇發作的機率降低了大約90%。
After six months, 71% of the children remained on the ketogenic diet, and about 32% had over a 90% reduction in seizures. After a full year, 55% stayed on the diet and 27% at least a 90% decrease in seizures.
在實驗六個月後，大約有71%仍維持生酮飲食，而且大約有32%的小朋友的癲癇發作次數下降了90%。在經過一年的實驗期，剩下55%的實驗者仍維持生酮飲食，且仍有27%的小朋友癲癇發作的次數下降約90%。
Thus, the researchers stated that the ketogenic diet is “more effective than many of the new anticonvulsant medications and is well tolerated by children and families when it is effective.” Not only was the ketogenic diet helpful, but it was more helpful than some commonly used drugs.
由此來看，研究人員認為生酮飲食比其它新型抗驚厥的療法來得更有效，而且對於小朋友和家庭來說，生酮飲食的接受度較高。生酮飲食不只是對於痙孿的控制有幫助而已，它比其他常見的藥物來得更有效。
More recently, a meta-analysis was published in the Journal of Neurology that assessed the impact of the ketogenic diet in treating epilepsy. It included a total of 19 studies with a total of 1084 patients. After analyzing the data, the researchers noted that the patients who stayed on the diet had a 2.25 times greater probability of treatment success (at least a 50% reduction in seizures).
近年來，在神經學、神經外科學與精神病醫學期刊（The Journal of Neurology, Neurosurgery and Psychiatry）上，刊載了一篇有關生酮飲食治療癲癇的整合分析研究〈meta-analysis〉。這項整合性的研究結合了19項研究及1084個病患。在經資料分析後，研究人員發現，維持生酮飲食的病患，他們的癲癇的控制效果大約是未採用生酮飲食的2.25倍〈癲癇控制效果在實驗的定義為至少抑制了50%癲癇發作的頻率〉。
The Takeaway: With or without the help of medication, the ketogenic diet is effective in reducing seizures.
摘要：無論有沒有透過醫療的協助，生酮飲食確實在抑制癲癇發作是有效的。
Recommendations: If conventional therapies are not helping you or your child lower the frequency of seizures, strongly consider using a ketogenic diet. Remember to discuss a suitable plan with your doctor and a registered dietitian, and monitor its effectiveness. Use Ruled.me to gain access to critical information on the keto lifestyle and community that will help you stick to the diet.
推薦的治療方式：如果說一般的療法對於您或是您的小孩無效，那麼強烈建議您採用生酮飲食吧。在採用生酮飲食前，請記得要諮詢您的醫生和有執照的營養師，並定期追蹤。如果說想解更多相關資訊請查詢Ruled.me，裡面除了有詳細的說明外也有相關社群來協助您達到生酮飲食的目標。
For more in-depth information, check out:
如若想更深入了解相關資訊，可參考以下資料：
Treating Childhood Epilepsy: The Origins of the Ketogenic Diet
The Ketogenic Diet in Reversing Type 2 Diabetes
生酮飲食迴轉第二型糖尿病的效益
Insulin resistance is a widespread problem that, if not properly managed, can lead to prediabetes and eventually type 2 diabetes. Thankfully, abundant research suggests that modifying your diet to a low-carbohydrate or ketogenic diet can help people lower their insulin to healthy levels and reverse insulin resistance.
胰島素抗性〈Insulin resistance〉是一項常見的健康問題，如果沒能有效管理，可能會造成糖尿病前症，甚至最終會有第二型糖尿病的產生。幸好，有相當多的研究顯示，將您的飲食習慣改為低碳或是生酮飲食，是可以幫助降低胰島素水準至健康的範圍內，並能迴轉胰島素抗性。
In fact, after analyzing the data from 10 randomized trials on using diet to treat diabetes, researchers found that a low-carbohydrate diet has a greater effect on blood sugar control in type 2 diabetics than high-carbohydrate diets.
事實上，在經過十項治療糖尿病的隨機試驗後發現，低碳飲食在控制第二型糖尿病患的血糖比高碳水飲食來得更有效。
They even found a distinct relationship between carbohydrate restriction and blood sugar lowering. Less carbohydrate consumption meant better blood sugar levels.
研究人員還發現，控制碳水的攝取量與降低血糖有直接性的關係。碳水的攝取較少代表血糖水準較佳。
It’s that simple — put people with prediabetes or type 2 diabetes on a low-carbohydrate ketogenic diet, and their health improves, blood sugar levels drop, and insulin sensitivity increases. Even studies that put healthy individuals on a ketogenic diet found similar improvements.
這背後的機轉其實相當容易理解：當罹患糖尿病前症〈prediabetes〉或是第二型糖尿病的患者，在採用生酮飲食後，除了改善健康狀況外，也能降低血糖水準，並增加胰島素的敏感度。甚至也有研究發現，就算將研究對象變成一般健康的人，也有類似的效果。
The Takeaway: The ketogenic diet is highly effective at reversing type 2 diabetes.
摘要：生酮飲食對於胰島素抗性的迴轉是十分有效的。
Recommendations: If you have type 2 diabetes or any blood sugar issues, consider implementing the ketogenic diet for the best results.
推薦的治療方式：如果您正罹患第二型糖尿病或是其它血糖相關的症狀，可以考慮改採生酮飲食，或許對於症狀的改善是有幫助的。
For more in-depth information, check out:
如果想更深入了解相關資訊，請點閱下列頁面：
The Ketogenic Diet and Diabetes 生酮飲食與糖尿病之間的關係
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