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Effects of a Low Carbohydrate Isoenergetic Diet on Sleep Behavior and Pulmonary Functions in Healthy Female Adult Humans

Diabetes and Metabolism Unit, Department of Medicine, University of Wales College of Medicine, University Hospital of Wales, Cardiff CF4 4XW, Great Britain

To study the effects of a low carbohydrate, isoenergetic diet on pulmonary physiology and sleep behavior, we measured pulmonary functions and respiratory gas exchange and carried out ambulatory electroencephalographic studies after a week's intake of isoenergetic diet containing only 50 g carbohydrate per day in 6 healthy female adult humans in a free-living condition. Compared with their normal intake, during the week of low carbohydrate intake there was a rise in the level of fasting plasma 3-hydroxybutyrate from 0.12 ± 0.07 (mean ± SD) to 1.01 ± 0.40 mmol/L(P < 0.01, paired t-test); a fall in serum bicarbonate from 26.2 ± 0.75 to 25.0 ± 1.41 mmol/L (P < 0.05) and in serum chloride from 107 ± 1.3 to 105 ± 1.8 mmol/L (P < 0.05). Serum urea rose from 4.3 ± 0.71 to 5.7 ± 0.70 mmol/L (P < 0.01), and serum uric acid from 0.34 ± 0.08 to 0.39 ± 0.10 mmol/L (P < 0.05). Functional residual capacity was increased from 2.07 ± 0.35 to 2.26 ± 0.34 L (P < 0.01). Respiratory gas exchange ratio fell from 0.81 ± 0.05 to 0.75 ± 0.04 (P < 0.05) and partial pressure of expired carbon dioxide reduced from 22 ± 3.3 to 21 ± 3.1 mmHg (P < 0.05). There was a reduction in endogenous carbon dioxide production and arterial carbon dioxide tension. An analysis of ambulatory electroencephalogram showed that REM latency increased from 66 ± 8 to 111 ± 38 min (P < 0.05), with no significant changes in sleep time and stages. These studies show that a low carbohydrate isoenergetic diet is tolerable, influences sleep behavior, reduces carbon dioxide production and respiratory gas exchange ratio, and may be therapeutically useful in patients with hypercapneic respiratory failure.

KEY WORDS: • low carbohydrate • sleep • pulmonary physiology

Manuscript received 26 December 1985. Revision accepted 17 July 1986.

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