膳食治疗是超重与肥胖人群体重管理的关键措施之一。研究表明,相较于其他膳食治疗方案,极低热量生酮饮食(very low-calorie ketogenic diet, VLCKD)具有短期减重效果明显、改善胰岛素抵抗等优势,具备较高的潜在临床应用价值。然而VLCKD在调节血脂、共病改善、长期减重及副作用严重程度等方面仍存在一定争议,对其临床应用产生一定困扰。本文在概述VLCKD概念与临床应用的基础上,重点阐述VLCKD对肥胖人群体重、血糖、血脂、其他疾病等的影响以及副 作用的产生与预防,进而为肥胖临床膳食治疗提供参考与证据支持。

Dietary therapy is one of the key measures for weight management in overweight and obese populations. Research evidence indicates that, compared with other dietary treatment options, the very low-calorie ketogenic diet (VLCKD) exhibits significant advantages, including the evident short-term effect of weight loss and improvement of insulin resistance, showing considerable potential for clinical applications. However, there are still controversies regarding the role of VLCKD in regulating blood lipids, improving comorbidities, and achieving long-term weight loss, as well as the severity of its side effects, thereby complicating its clinical application. Therefore, based on an overview of the concept and clinical applications of VLCKD, this article focuses on the impact of VLCKD on weight, blood glucose, blood lipids, and other diseases in obese individuals, as well as the generation and prevention of side effects, aiming to provide references and evidence to support clinical dietary treatment for obesity.