scholarly journals Erratum: Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets

2014 ◽  
Vol 68 (5) ◽  
pp. 641-641
Author(s):  
A Paoli ◽  
A Rubini ◽  
J S Volek ◽  
K A Grimaldi
Keyword(s):  
Weight Loss ◽  
Ketogenic Diets ◽  
Therapeutic Uses ◽  
Low Carbohydrate

Fat-Free Mass Changes During Ketogenic Diets and the Potential Role of Resistance Training

2016 ◽  
Vol 26 (1) ◽  
pp. 78-92 ◽  
Author(s):  
Grant M. Tinsley ◽  
Darryn S. Willoughby
Keyword(s):  
Weight Loss ◽  
Resistance Training ◽  
Ketogenic Diet ◽  
Potential Role ◽  
Mass Measurement ◽  
Fat Free Mass ◽  
Exercise Interventions ◽  
Ketogenic Diets ◽  
Low Carbohydrate

Low-carbohydrate and very-low-carbohydrate diets are often used as weight-loss strategies by exercising individuals and athletes. Very-low-carbohydrate diets can lead to a state of ketosis, in which the concentration of blood ketones (acetoacetate, 3-β-hydroxybutyrate, and acetone) increases as a result of increased fatty acid breakdown and activity of ketogenic enzymes. A potential concern of these ketogenic diets, as with other weight-loss diets, is the potential loss of fat-free mass (e.g., skeletal muscle). On examination of the literature, the majority of studies report decreases in fat-free mass in individuals following a ketogenic diet. However, some confounding factors exist, such as the use of aggressive weight-loss diets and potential concerns with fat-free mass measurement. A limited number of studies have examined combining resistance training with ketogenic diets, and further research is needed to determine whether resistance training can effectively slow or stop the loss of fat-free mass typically seen in individuals following a ketogenic diet. Mechanisms underlying the effects of a ketogenic diet on fat-free mass and the results of implementing exercise interventions in combination with this diet should also be examined.

scholarly journals A Pragmatic Approach to Translating Low- and Very Low-Carbohydrate Diets Into Clinical Practice for Patients With Obesity and Type 2 Diabetes

2021 ◽  
Vol 8 ◽  
Author(s):  
Dina Hafez Griauzde ◽  
Kathleen Standafer Lopez ◽  
Laura R. Saslow ◽  
Caroline R. Richardson
Keyword(s):  
Weight Loss ◽  
Clinical Practice ◽  
Evidence Based ◽  
Eating Patterns ◽  
Dietary Recommendations ◽  
Patient Centered ◽  
Ketogenic Diets ◽  
Low Carbohydrate ◽  
Potential Benefits ◽  
Based Medicine

Across all eating patterns, individuals demonstrate marked differences in treatment response; some individuals gain weight and others lose weight with the same approach. Policy makers and research institutions now call for the development and use of personalized nutrition counseling strategies rather than one-size-fits-all dietary recommendations. However, challenges persist in translating some evidence-based eating patterns into the clinical practice due to the persistent notion that certain dietary approaches—regardless of individuals' preferences and health outcomes—are less healthy than others. For example, low- and very low-carbohydrate ketogenic diets (VLCKDs)—commonly defined as 10–26% and <10% total daily energy from carbohydrate, respectively—are recognized as viable lifestyle change options to support weight loss, glycemic control, and reduced medication use. Yet, critics contend that such eating patterns are less healthy and encourage general avoidance rather than patient-centered use. As with all medical treatments, the potential benefits and risks must be considered in the context of patient-centered, outcome-driven care; this is the cornerstone of evidence-based medicine. Thus, the critical challenge is to identify and safely support patients who may prefer and benefit from dietary carbohydrate restriction. In this Perspective, we propose a pragmatic, 4-stepped, outcome-driven approach to help health professionals use carbohydrate-restricted diets as one potential tool for supporting individual patients' weight loss and metabolic health.

scholarly journals The Potential Roles of Very Low Calorie, Very Low Calorie Ketogenic Diets and Very Low Carbohydrate Diets on the Gut Microbiota Composition

2021 ◽  
Vol 12 ◽  
Author(s):  
Mariangela Rondanelli ◽  
Clara Gasparri ◽  
Gabriella Peroni ◽  
Milena Anna Faliva ◽  
Maurizio Naso ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gut Microbiota ◽  
Fecal Microbiota ◽  
Microbiota Composition ◽  
Fecal Microbiome ◽  
Low Calorie ◽  
Low Carbohydrate Diet ◽  
Ketogenic Diets ◽  
Low Carbohydrate ◽  
Gut Microbiota Composition

Several studies have described a strong correlation between diet, weight loss, and gut microbiota composition. The aim of this review was to evaluate the potential effects of energy-restricted diets, namely very low calorie diets (VLCDs), very low calorie ketogenic diets (VLCKDs), and very low carbohydrate diets (VLCarbDs), on the composition of the gut microbiota in humans. We performed a literature search using the following terms (with their abbreviations or acronyms): “very low calorie diet”, “very low calorie ketogenic diet”, “very low carbohydrate diet”, and “gut microbiota”. Our search strategy retrieved nine eligible studies. Overall, VLCDs and VLCarbDs affected the Bacteroidetes to Firmicutes ratio in obese patients, leading to a reduction in short-chain fatty acid production by fecal microbiota associated with Clostridial cluster XIVa. This reduction particularly affected Roseburia and Eubacterium rectale, the two most abundant butyrate-producing bacteria in human feces. VLCKDs preserved the core fecal microbiome, but altered the composition of fecal microbial populations in relation to the plasma metabolome and fecal bile acid composition. In particular, VLCKD-induced weight loss resulted in a reduction in E. rectale and Roseburia, an increase in Christensenellaceae and Akkermansia while not all studies show a decrease in Faecalibacterium prausnitzii. Although very few studies have analyzed the effects of VLCarbDs and VLCDs on gut microbiota, significant diet-induced changes in fecal microbiota composition have been observed. Further studies are needed.

A high-fat, ketogenic diet induces a unique metabolic state in mice

2007 ◽  
Vol 292 (6) ◽  
pp. E1724-E1739 ◽  
Author(s):  
Adam R. Kennedy ◽  
Pavlos Pissios ◽  
Hasan Otu ◽  
Bingzhong Xue ◽  
Kenji Asakura ◽  
...  
Keyword(s):  
Gene Expression ◽  
Weight Loss ◽  
Energy Expenditure ◽  
Ketogenic Diet ◽  
Metabolic Effects ◽  
Acid Oxidation ◽  
High Fat ◽  
Metabolic State ◽  
Ketogenic Diets ◽  
Low Carbohydrate

Ketogenic diets have been used as an approach to weight loss on the basis of the theoretical advantage of a low-carbohydrate, high-fat diet. To evaluate the physiological and metabolic effects of such diets on weight we studied mice consuming a very-low-carbohydrate, ketogenic diet (KD). This diet had profound effects on energy balance and gene expression. C57BL/6 mice animals were fed one of four diets: KD; a commonly used obesogenic high-fat, high-sucrose diet (HF); 66% caloric restriction (CR); and control chow (C). Mice on KD ate the same calories as mice on C and HF, but weight dropped and stabilized at 85% initial weight, similar to CR. This was consistent with increased energy expenditure seen in animals fed KD vs. those on C and CR. Microarray analysis of liver showed a unique pattern of gene expression in KD, with increased expression of genes in fatty acid oxidation pathways and reduction in lipid synthesis pathways. Animals made obese on HF and transitioned to KD lost all excess body weight, improved glucose tolerance, and increased energy expenditure. Analysis of key genes showed similar changes as those seen in lean animals placed directly on KD. Additionally, AMP kinase activity was increased, with a corresponding decrease in ACC activity. These data indicate that KD induces a unique metabolic state congruous with weight loss.

scholarly journals Baseline HOMA IR and Circulating FGF21 Levels Predict NAFLD Improvement in Patients Undergoing a Low Carbohydrate Dietary Intervention for Weight Loss: A Prospective Observational Pilot Study

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 2141 ◽  
Author(s):  
Mikiko Watanabe ◽  
Renata Risi ◽  
Elisabetta Camajani ◽  
Savina Contini ◽  
Agnese Persichetti ◽  
...  
Keyword(s):  
Weight Loss ◽  
Liver Disease ◽  
Dietary Intervention ◽  
Fibroblast Growth Factor 21 ◽  
Obese Patients ◽  
Anthropometric Parameters ◽  
Alcoholic Fatty Liver ◽  
Low Carbohydrate Diet ◽  
Ketogenic Diets ◽  
Low Carbohydrate

Background: Non-alcoholic fatty liver disease (NAFLD) is a major cause of liver disease. Very low-calorie ketogenic diets (VLCKD) represent a feasible treatment as they induce profound weight loss and insulin resistance (IR) improvement. Despite the recognized benefits on NAFLD deriving from pharmacological administration of fibroblast growth factor 21 (FGF21), whose endogenous counterpart is a marker of liver injury, little is known about its physiology in humans. Aim: To identify predictors of NAFLD improvement as reflected by the reduction of the non-invasive screening tool hepatic steatosis index (HSI) in obese patients undergoing a weight loss program. Methods: Sixty-five obese patients underwent a 90-day dietary program consisting of a VLCKD followed by a hypocaloric low carbohydrate diet (LCD). Anthropometric parameters, body composition, and blood and urine chemistry were assessed. Results: Unlike most parameters improving mainly during the VLCKD, the deepest HSI change was observed after the LCD (p = 0.02 and p < 0.0001, respectively). Baseline HOMA-IR and serum FGF21 were found to be positive (R = 0.414, p = 0009) and negative (R = 0.364, p = 0.04) independent predictors of HSI reduction, respectively. Conclusions: We suggest that patients with IR and NAFLD derive greater benefit from a VLCKD, and we propose a possible role of human FGF21 in mediating NAFLD amelioration following nutritional manipulation.

scholarly journals Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets

2013 ◽  
Vol 67 (8) ◽  
pp. 789-796 ◽  
Author(s):  
A Paoli ◽  
A Rubini ◽  
J S Volek ◽  
K A Grimaldi
Keyword(s):  
Disease Risk ◽  
Therapeutic Potential ◽  
Polycystic Ovary ◽  
Neurological Diseases ◽  
Cardiovascular Disease Risk ◽  
Ketogenic Diets ◽  
Therapeutic Uses ◽  
Low Carbohydrate ◽  
Therapeutic Tools ◽  
The 1960S

Abstract Very-low-carbohydrate diets or ketogenic diets have been in use since the 1920s as a therapy for epilepsy and can, in some cases, completely remove the need for medication. From the 1960s onwards they have become widely known as one of the most common methods for obesity treatment. Recent work over the last decade or so has provided evidence of the therapeutic potential of ketogenic diets in many pathological conditions, such as diabetes, polycystic ovary syndrome, acne, neurological diseases, cancer and the amelioration of respiratory and cardiovascular disease risk factors. The possibility that modifying food intake can be useful for reducing or eliminating pharmaceutical methods of treatment, which are often lifelong with significant side effects, calls for serious investigation. This review revisits the meaning of physiological ketosis in the light of this evidence and considers possible mechanisms for the therapeutic actions of the ketogenic diet on different diseases. The present review also questions whether there are still some preconceived ideas about ketogenic diets, which may be presenting unnecessary barriers to their use as therapeutic tools in the physician’s hand.

Effects of a Low Carbohydrate Weight Loss Diet on Exercise Capacity and Tolerance in Obese Subjects

Obesity ◽  
2009 ◽  
Author(s):  
Grant D. Brinkworth ◽  
Manny Noakes ◽  
Peter M. Clifton ◽  
Jonathan D. Buckley
Keyword(s):  
Weight Loss ◽  
Exercise Capacity ◽  
Weight Loss Diet ◽  
Low Carbohydrate ◽  
Obese Subjects

scholarly journals Alternate Day Fasting Combined with a Low Carbohydrate Diet: Effect on Sleep Quality, Duration, Insomnia Severity and Risk of Obstructive Sleep Apnea in Adults with Obesity

Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 211
Author(s):  
Faiza Kalam ◽  
Kelsey Gabel ◽  
Sofia Cienfuegos ◽  
Mark Ezpeleta ◽  
Eric Wiseman ◽  
...  
Keyword(s):  
Weight Loss ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Quality ◽  
Weight Maintenance ◽  
Carbohydrate Diet ◽  
Low Carbohydrate Diet ◽  
Obstructive Sleep ◽  
Low Carbohydrate ◽  
Insomnia Severity

Background: Alternate day fasting combined with a low carbohydrate diet (ADF-LC) is an effective weight loss regimen. Whether the weight loss induced by ADF-LC can improve sleep, remains unknown. Objective: This study examined the effect an ADF-LC diet on sleep quality, duration, insomnia severity and the risk of obstructive sleep apnea. Methods: Adults with obesity (n = 31) participated in ADF (600 kcal “fast day”; ad libitum intake “feast day”) with a low-carbohydrate diet (30% carbohydrates, 35% protein, and 35% fat). The 6-month trial consisted of a 3-month weight loss period followed by a 3-month weight maintenance period. Results: Reductions in body weight (−5 ± 1 kg, p < 0.001) and fat mass (−4 ± 1 kg, p < 0.01) were noted during the weight loss period, and these reductions were sustained during the weight maintenance period. Lean mass and visceral fat remained unchanged. The Pittsburgh Sleep Quality Index (PSQI) score indicated poor sleep quality at baseline (6.4 ± 0.7) with no change by month 3 or 6, versus baseline. ISI score indicated subthreshold insomnia at baseline (8.5 ± 1.0), with no change by month 3 or 6, versus baseline. The percent of subjects with high risk of obstructive sleep apnea at baseline was 45%, with no change by month 3 or 6. Wake time, bedtime, and sleep duration remained unchanged. Conclusion: The ADF-LC diet does not impact sleep quality, duration, insomnia severity or the risk of obstructive sleep apnea in adults with obesity.

scholarly journals Efficacy and safety of low and very low carbohydrate diets for type 2 diabetes remission: systematic review and meta-analysis of published and unpublished randomized trial data

BMJ ◽  
2021 ◽  
pp. m4743
Author(s):  
Joshua Z Goldenberg ◽  
Andrew Day ◽  
Grant D Brinkworth ◽  
Junko Sato ◽  
Satoru Yamada ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Low Carbohydrate ◽  
Remission Of Diabetes

Abstract Objective To determine the efficacy and safety of low carbohydrate diets (LCDs) and very low carbohydrate diets (VLCDs) for people with type 2 diabetes. Design Systematic review and meta-analysis. Data sources Searches of CENTRAL, Medline, Embase, CINAHL, CAB, and grey literature sources from inception to 25 August 2020. Study selection Randomized clinical trials evaluating LCDs (<130 g/day or <26% of a 2000 kcal/day diet) and VLCDs (<10% calories from carbohydrates) for at least 12 weeks in adults with type 2 diabetes were eligible. Data extraction Primary outcomes were remission of diabetes (HbA 1c <6.5% or fasting glucose <7.0 mmol/L, with or without the use of diabetes medication), weight loss, HbA 1c , fasting glucose, and adverse events. Secondary outcomes included health related quality of life and biochemical laboratory data. All articles and outcomes were independently screened, extracted, and assessed for risk of bias and GRADE certainty of evidence at six and 12 month follow-up. Risk estimates and 95% confidence intervals were calculated using random effects meta-analysis. Outcomes were assessed according to a priori determined minimal important differences to determine clinical importance, and heterogeneity was investigated on the basis of risk of bias and seven a priori subgroups. Any subgroup effects with a statistically significant test of interaction were subjected to a five point credibility checklist. Results Searches identified 14 759 citations yielding 23 trials (1357 participants), and 40.6% of outcomes were judged to be at low risk of bias. At six months, compared with control diets, LCDs achieved higher rates of diabetes remission (defined as HbA 1c <6.5%) (76/133 (57%) v 41/131 (31%); risk difference 0.32, 95% confidence interval 0.17 to 0.47; 8 studies, n=264, I 2 =58%). Conversely, smaller, non-significant effect sizes occurred when a remission definition of HbA 1c <6.5% without medication was used. Subgroup assessments determined as meeting credibility criteria indicated that remission with LCDs markedly decreased in studies that included patients using insulin. At 12 months, data on remission were sparse, ranging from a small effect to a trivial increased risk of diabetes. Large clinically important improvements were seen in weight loss, triglycerides, and insulin sensitivity at six months, which diminished at 12 months. On the basis of subgroup assessments deemed credible, VLCDs were less effective than less restrictive LCDs for weight loss at six months. However, this effect was explained by diet adherence. That is, among highly adherent patients on VLCDs, a clinically important reduction in weight was seen compared with studies with less adherent patients on VLCDs. Participants experienced no significant difference in quality of life at six months but did experience clinically important, but not statistically significant, worsening of quality of life and low density lipoprotein cholesterol at 12 months. Otherwise, no significant or clinically important between group differences were found in terms of adverse events or blood lipids at six and 12 months. Conclusions On the basis of moderate to low certainty evidence, patients adhering to an LCD for six months may experience remission of diabetes without adverse consequences. Limitations include continued debate around what constitutes remission of diabetes, as well as the efficacy, safety, and dietary satisfaction of longer term LCDs. Systematic review registration PROSPERO CRD42020161795.

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