Supplementary file 1_Targeting differential energy substrate metabolism on a therapeutic ketogenic diet: a case report.pdf

Ketogenic diets show promise in treating a range of serious illnesses, yet their clinical utility is often hindered by poor adherence and difficulty achieving targeted ketone levels. Recommendations for patients pursuing ketogenic diets provide detailed dietary guidance but largely neglect the potential role of exercise on ketone levels. In a case study of a glioblastoma patient following a ketogenic diet, we present data suggesting that intensity of exercise may predict ketone levels above and beyond energy expended through exercise, and we propose a possible mechanism for this observed association. It is our hope that this case study will highlight the need for further research investigating how intense exercise in particular may influence ketone levels for patients on therapeutic ketogenic diets, potentially enabling patients to achieve higher ketone levels or allowing ketosis on more liberal diets.

生酮饮食（ketogenic diets）展现出治疗多种重症疾病的潜力，但其临床应用价值常因患者依从性不佳、难以达到目标酮体水平而大打折扣。针对接受生酮饮食治疗的患者所制定的膳食指导方案虽详尽细致，但大多未考虑运动对酮体水平的潜在影响。本研究针对一名遵循生酮饮食的胶质母细胞瘤（glioblastoma）患者展开病例研究，所披露的数据显示，运动强度对酮体水平的预测能力可超出运动本身所消耗的能量范畴，据此我们针对这一观测到的关联提出了潜在的作用机制。我们期望本病例研究能够凸显开展相关后续研究的必要性，即探究高强度运动如何具体影响接受治疗性生酮饮食患者的酮体水平，从而有望帮助患者达到更高的酮体浓度，或是在更为宽松的膳食方案下维持酮症（ketosis）。