TY - JOUR AU - Paoli, Antonio AU - Gorini, Stefania AU - Caprio, Massimiliano PY - 2020 DA - 2020/11/20 TI - The dark side of the spoon - glucose, ketones and COVID-19: a possible role for ketogenic diet? JO - Journal of Translational Medicine SP - 441 VL - 18 IS - 1 AB - The novel coronavirus disease (COVID-19) is posing a serious challenge to the health-care systems worldwide, with an enormous impact on health conditions and loss of lives. Notably, obesity and its related comorbidities are strictly related with worse clinical outcomes of COVID-19 disease. Recently, there is a growing interest in the clinical use of ketogenic diets (KDs), particularly in the context of severe obesity with related metabolic complications. KDs have been proven effective for a rapid reduction of fat mass, preserving lean mass and providing an adequate nutritional status. In particular, the physiological increase in plasma levels of ketone bodies exerts important anti-inflammatory and immunomodulating effects, which may reveal as precious tools to prevent infection and potential adverse outcomes of COVID-19 disease. We discuss here the importance of KDs for a rapid reduction of several critical risk factors for COVID-19, such as obesity, type 2 diabetes and hypertension, based on the known effects of ketone bodies on inflammation, immunity, metabolic profile and cardiovascular function. We do believe that a rapid reduction of all modifiable risk factors, especially obesity with its metabolic complications, should be a pillar of public health policies and interventions, in view of future waves of SARS-CoV-2 infection. SN - 1479-5876 UR - https://doi.org/10.1186/s12967-020-02600-9 DO - 10.1186/s12967-020-02600-9 ID - Paoli2020 ER -