scholarly journals Severe Metabolic Acidosis: A Case of Triple Hit with Ketogenic Diet, Vinegar, and Metformin in an Obese Patient

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Abdul Mughees Rana ◽  
Kannan Mansoor ◽  
Salman Assad ◽  
Mahmoud Abouzid ◽  
Iheanyichukwu Ogu ◽  
...  
Keyword(s):  
Weight Loss ◽  
Acetic Acid ◽  
Adverse Effects ◽  
Ketogenic Diet ◽  
Herbal Supplements ◽  
Dietary Practices ◽  
Over The Counter ◽  
Mainstream Media ◽  
Ketogenic Diets ◽  
Increased Risk

Obesity is an epidemic with high burden of disease. It is directly proportional to increased risk of morbidity and mortality. Ketogenic diet and herbal supplements have recently gained popularity amongst patients struggling with weight loss. There are limited data available for most of these supplements contrary to the claims laid by the mainstream media. Due to lack of awareness, this patient population is at high risk of adverse effects. We present a case of severe acidosis secondary to ketogenic diet and acetic acid (vinegar) ingestion. The use of dietary acetic acid is usually well tolerated; however, in this case, the large quantities and presence of acute renal injury and metformin use may have worsened the acidosis. Severe ketosis in setting of ketogenic diets is a serious complication, which is infrequently reported in literature. Many of these diets and supplements may seem harmless, but as our case illustrates, when combined with other risk factors, patients can face serious adverse effects and even require hospitalization. It is imperative that such dietary practices are physician supervised to avoid complications. With the recent surge of over-the-counter weight loss supplements and ketogenic diets, physicians also need to engage in dietary discussion with patients when attempting to lose weight.

scholarly journals Comparing the Keyto App and Device with Weight Watchers’ WW App for Weight Loss: Protocol for a Randomized Trial

10.2196/19053 ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. e19053
Author(s):  
Sean R Locke ◽  
Kaja Falkenhain ◽  
Dylan A Lowe ◽  
Terry Lee ◽  
Joel Singer ◽  
...  
Keyword(s):  
Weight Loss ◽  
Cardiovascular Risk ◽  
Randomized Trial ◽  
Ketogenic Diet ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Ketogenic Diets ◽  
Phone Calls ◽  
Weight Watchers ◽  
The Impact

Background Obesity and being overweight are major contributing factors for many diseases. Calorie restricted diets often fail to result in sustained long-term weight loss. Very low–carbohydrate, high-fat ketogenic diets have been suggested to have superior metabolic and weight loss effects. Keyto is a low-cost, highly scalable mobile health (mHealth) app paired with a noninvasive biofeedback tool aimed at facilitating weight loss through a personalized healthy and predominantly plant- and fish-based ketogenic diet. Objective This protocol describes a randomized trial comparing the efficacy of the Keyto mHealth app and device intervention to that of Weight Watchers’ WW app in individuals who are overweight or obese. The primary outcome is weight loss after 12 weeks. Secondary and exploratory outcomes, including metabolic and cardiovascular risk factors, will be assessed at 12, 24, and 48 weeks. Methods A total of 144 participants will be recruited and randomized to either the Keyto program or Weight Watchers program. Study participants will be guided through the study via video conference or phone calls and will undergo a fasting blood analysis performed by a third-party diagnostic lab at weeks 0 and 12 to assess metabolic and cardiovascular risk markers. All participants will be asked to weigh themselves daily on a study-provided Bluetooth-enabled scale. Participants randomized to the Keyto arm will also be asked to measure their breath acetone levels, a measure of ketosis, with the Keyto device 3 times per day. Results Recruitment started in December 2019. Rolling recruitment is expected to be completed by July 2020. Data collection and analysis of the primary intervention phase is expected to be completed in October 2020. The 24- and 48-week follow-ups are expected to be completed in January 2021 and July 2021, respectively. Conclusions This trial will provide high-quality evidence regarding the efficacy of the Keyto weight loss program in individuals who are overweight and obese in a free-living condition. This study also fills a gap by examining the impact of a ketogenic diet emphasizing plant- and fish-based fats on blood lipid profile and cardiovascular disease risk. Trial Registration ClinicalTrials.gov NCT04165707; https://clinicaltrials.gov/ct2/show/NCT04165707. International Registered Report Identifier (IRRID) DERR1-10.2196/19053

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 Short-term Ketogenic Diet Induces a Molecular Response that is Distinct from Dietary Protein Restriction

2021 ◽  
Author(s):  
Krystle Kalafut ◽  
Sarah J Mitchell ◽  
Michael R MacArthur ◽  
James R Mitchell
Keyword(s):  
Weight Loss ◽  
Insulin Sensitivity ◽  
Protein Content ◽  
Ketogenic Diet ◽  
Dietary Protein ◽  
Control Diet ◽  
Protein Restriction ◽  
Short Term ◽  
Dietary Protein Restriction ◽  
Ketogenic Diets

There is increasing interest in utilizing short-term dietary interventions in the contexts of cancer, surgical stress and metabolic disease. These short-term diets may be more feasible than extended interventions and may be designed to complement existing therapies. In particular, the high-fat, low-carbohydrate ketogenic diet (KD), traditionally used to treat epilepsy, has gained popularity as a potential strategy for weight loss and improved metabolic health. In mice, long-term KD improves insulin sensitivity and extends lifespan and healthspan. Dietary protein restriction (PR) causes increased energy expenditure, weight loss and improved glucose homeostasis. Since KD is inherently a low-protein diet (10% of calories from protein vs. 20% in control diet), here we evaluated the potential for mechanistic overlap between PR and KD via activation of a PR response. Mice were fed control, protein-free (PF), or one of four ketogenic diets with varying protein content for 8 days. PF and KD diets both decreased body weight, fat mass, and liver weights, and reduced fasting glucose and insulin levels, compared to mice fed the control diet. However, PF and KD differed with respect to insulin tolerance and hepatic insulin sensitivity, which were increased in PF-fed mice and impaired in KD-fed mice relative to controls. Furthermore, contrary to the PF-fed mice, mice fed ketogenic diets containing at least 5% protein did not increase hepatic Fgf21 or brown adipose Ucp1 expression. Interestingly, mice fed KD lacking protein demonstrated greater elevations in hepatic Fgf21 than mice fed a low-fat PF diet. To further elucidate potential mechanistic differences between PF and KD diets and the interplay between dietary protein and carbohydrate restriction, we conducted RNA-seq analysis on livers from mice fed each of the six diets and identified distinct gene sets which respond to dietary protein content, dietary fat content, and ketogenesis. We conclude that KD with 10% of energy from protein does not induce a protein restriction response, and that the overlapping metabolic benefits of KD and PF diets occur via distinct underlying mechanisms.

scholarly journals Ketogenic Ratio of Macronutrients and Risk of Diabetes Among Postmenopausal Women

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 459-459
Author(s):  
Tyler Titcomb ◽  
Buyun Liu ◽  
Linda Snetselaar ◽  
Terry Wahls ◽  
Wei Bao
Keyword(s):  
Postmenopausal Women ◽  
Ketogenic Diet ◽  
Kidney Diseases ◽  
Cox Proportional Hazards ◽  
Diabetes Research ◽  
Total Carbohydrate ◽  
Ketogenic Diets ◽  
Increased Risk ◽  
Incident Cases

Abstract Objectives To evaluate the association of the ketogenic ratio of macronutrients (KR) with incidence of diabetes (DM). Methods Dietary information was obtained at baseline from postmenopausal women enrolled in the Women's Health Initiative (WHI) clinical trials (not including the intervention arm of dietary modification trial) and observational study. Participants were excluded if they had prevalent diabetes or unknown status of diabetes at baseline or reported energy intakes <600 or >5000 kilocalories. The KR was calculated as follows: (0.9*grams fat + 0.46*grams protein) divided by (0.1*grams fat + 0.58*grams protein + grams total carbohydrate – grams total fiber). A KR value 1.5 is considered the minimum threshold to predict a ketogenic diet. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between KR and risk of DM. Follow-up time was the number of days from enrollment to the first instance of incident DM. Results Among 128 752 participants, there were 19 439 incident cases of DM with median follow-up time of 20.7 years. The median KR was 0.36 and 12 participants (<0.0001%) exceeded the KR threshold for a ketogenic diet. After adjustment for age, race/ethnicity, comorbidities, education, income, marital status, health insurance, smoking, DM family history, hormone use, energy intake, HEI scores, physical activity, region, and WHI arm, each KR quintile was associated with increased risk of DM. Comparing extreme quintiles of KR, the adjusted HR (95% CI) for diabetes was 1.32 (1.26–1.39; Ptrend < 0.0001). The association remained significant after further adjustment for BMI, with an adjusted HR (95% CI) of 1.22 (1.16–1.29; Ptrend < 0.0001) comparing the highest with lowest quintile of KR. We were unable to show an association of exceeding the KR threshold with DM due to the small number of participants who exceeded the KR threshold. Conclusions The KR was positively associated with incidence of DM. However, we are unable to draw conclusions about ketogenic diets because the majority of participants were below the KR threshold for a ketogenic diet. Funding Sources This work was supported by the Fraternal Order of Eagles Diabetes Research Center with funding from the National Institutes of Diabetes and Digestive and Kidney Diseases.

scholarly journals Ketogenic Diet: Its Benefits & Overall Effects on Adults objective

2021 ◽  
Vol 6 (2) ◽  
Keyword(s):  
Weight Loss ◽  
Ketogenic Diet ◽  
Fat Intake ◽  
Trans Fat ◽  
Moderate Amount ◽  
Secondary Sources ◽  
Ketogenic Diets ◽  
The World ◽  
Dietary Education ◽  
Health Complications

The ketogenic diet has been the most popular diet in the world in recent years. Therefore, the keto diet, short for ketogenic, involves eating a lot of fat, a moderate amount of protein, and very little carbohydrate. People are more likely to take a ketogenic diet for weight loss, but it can also help control certain medical conditions, such as epilepsy, heart problems, certain brain conditions, and even acne. This research paper aims to find out the benefits of KD and shares its outcomes on adults. In this research, the descriptive methodology has been adopted which refers to secondary sources of data. In this project, the examiner used a variety of research that has also been undertaken by numerous researchers including dietitians who tend to support the positive benefits of using ketogenic diets to manage losing weight as well as other health complications that could result from overweight. Finally, it is essential to note that the ketogenic diet has created debate, partially although traditional dietary education has, for years, illustrated the adverse effects of high overall including trans-fat intake.

scholarly journals Comparing the Efficacy of Ketogenic Diet with Low-Fat Diet for Weight Loss in Obesity Patients: Evidenc-Based Case Report

2018 ◽  
Vol 2 (1) ◽  
pp. 7
Author(s):  
Nurul Ratna Manikam ◽  
Nico I Pantoro ◽  
Karina Komala ◽  
Ayu Diandra Sari
Keyword(s):  
Weight Loss ◽  
Ketogenic Diet ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Nutritional Intervention ◽  
Diet Group ◽  
Low Fat ◽  
Low Fat Diet ◽  
Long Term Effect ◽  
Increased Risk

Introduction Obesity is a nutritional disease which is still a health burden particularly in Jakarta. The main treatment for obesity is nutritional intervention. Nowadays, several dietary approaches have been developed, including ketogenic diet, which is still controversial. Methods Literature search had been done within 4 databases including PubMed®, Cochrane®, Google® Scholar, and Science Direct®, using keywords: obesity, ketogenic diet, low-fat diet, and weight loss. Then, Medical Sub Heading (MeSH) was used. The search resulted in two articles which were appraised according to aspects of validity, importance, and applicability Results A randomized-controlled trial study showed similar effect of weight loss with ketogenic diet compared to low-fat diet. On the other hand, a meta-analysis study showed ketogenic diet caused more weight loss than low-fat diet. Both studies showed an increased risk of cardiovascular disease from the ketogenic diet group, which were shown by a decrease of flow-mediated dilatation and an increase of LDL-C. Conclusion Ketogenic diet shows a better long-term effect for weight loss in obese patients than low-fat diet. However, ketogenic diet may increase the cardiovascular event risk significantly.

scholarly journals The Expanding Role of Ketogenic Diets in Adult Neurological Disorders

2018 ◽  
Vol 8 (8) ◽  
pp. 148 ◽  
Author(s):  
Tanya McDonald ◽  
Mackenzie Cervenka
Keyword(s):  
Alzheimer’S Disease ◽  
Adverse Effects ◽  
Malignant Glioma ◽  
Ketogenic Diet ◽  
Neurological Disorders ◽  
Scientific Literature ◽  
Management Strategies ◽  
Ketogenic Diets ◽  
Current Review

The current review highlights the evidence supporting the use of ketogenic diet therapies in the management of adult epilepsy, adult malignant glioma and Alzheimer’s disease. An overview of the scientific literature, both preclinical and clinical, in each area is presented and management strategies for addressing adverse effects and compliance are discussed.

scholarly journals Sibutramine as a Cause of Sudden Cardiac Death

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Miguel Rodriguez-Guerra ◽  
Mayank Yadav ◽  
Manoj Bhandari ◽  
Archna Sinha ◽  
Jonathan N. Bella ◽  
...  
Keyword(s):  
Weight Loss ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Public Health Issue ◽  
Herbal Supplements ◽  
Over The Counter ◽  
Coronary Catheterization ◽  
Coronary Syndrome ◽  
First Case ◽  
The Us

Importance. Sibutramine was withdrawn from the US market due to association with adverse cardiovascular outcomes especially with patients having preexisting cardiac disease. However, continued presence of sibutramine in herbal medications is a concern to public safety. Results. We report a case of a patient with no evidence of previous coronary heart disease, who presented with non-ST elevation acute coronary syndrome (NSTE-ACS). Urgent coronary catheterization showed nonobstructive coronaries. However, patient died unexpectedly within 24 hours of admission. The patient denied toxic habits but was taking over-the-counter weight loss herbal supplements. Complete autopsy was performed which showed sibutramine in the toxicology. Patient died due to complications of acute inadvertent intoxication of sibutramine. Conclusion and Relevance. This is the first case report in literature showing association of sibutramine to sudden cardiac death in patients with no prior cardiac history. The continued presence of sibutramine in some over-the-counter weight loss formulations is a very concerning public health issue.

scholarly journals Comparing the Keyto App and Device with Weight Watchers’ WW App for Weight Loss: Protocol for a Randomized Trial (Preprint)

2020 ◽  
Author(s):  
Sean R Locke ◽  
Kaja Falkenhain ◽  
Dylan A Lowe ◽  
Terry Lee ◽  
Joel Singer ◽  
...  
Keyword(s):  
Weight Loss ◽  
Cardiovascular Risk ◽  
Randomized Trial ◽  
Ketogenic Diet ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Ketogenic Diets ◽  
Phone Calls ◽  
Weight Watchers ◽  
The Impact

BACKGROUND Obesity and being overweight are major contributing factors for many diseases. Calorie restricted diets often fail to result in sustained long-term weight loss. Very low–carbohydrate, high-fat ketogenic diets have been suggested to have superior metabolic and weight loss effects. Keyto is a low-cost, highly scalable mobile health (mHealth) app paired with a noninvasive biofeedback tool aimed at facilitating weight loss through a personalized healthy and predominantly plant- and fish-based ketogenic diet. OBJECTIVE This protocol describes a randomized trial comparing the efficacy of the Keyto mHealth app and device intervention to that of Weight Watchers’ WW app in individuals who are overweight or obese. The primary outcome is weight loss after 12 weeks. Secondary and exploratory outcomes, including metabolic and cardiovascular risk factors, will be assessed at 12, 24, and 48 weeks. METHODS A total of 144 participants will be recruited and randomized to either the Keyto program or Weight Watchers program. Study participants will be guided through the study via video conference or phone calls and will undergo a fasting blood analysis performed by a third-party diagnostic lab at weeks 0 and 12 to assess metabolic and cardiovascular risk markers. All participants will be asked to weigh themselves daily on a study-provided Bluetooth-enabled scale. Participants randomized to the Keyto arm will also be asked to measure their breath acetone levels, a measure of ketosis, with the Keyto device 3 times per day. RESULTS Recruitment started in December 2019. Rolling recruitment is expected to be completed by July 2020. Data collection and analysis of the primary intervention phase is expected to be completed in October 2020. The 24- and 48-week follow-ups are expected to be completed in January 2021 and July 2021, respectively. CONCLUSIONS This trial will provide high-quality evidence regarding the efficacy of the Keyto weight loss program in individuals who are overweight and obese in a free-living condition. This study also fills a gap by examining the impact of a ketogenic diet emphasizing plant- and fish-based fats on blood lipid profile and cardiovascular disease risk. CLINICALTRIAL ClinicalTrials.gov NCT04165707; https://clinicaltrials.gov/ct2/show/NCT04165707. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/19053

Comparing the Efficacy of Ketogenic Diet with Low-Fat Diet for Weight Loss in Obesity Patients: Evidenc-Based Case Report

2018 ◽  
Vol 2 (1) ◽  
pp. 7
Author(s):  
Nurul Ratna Manikam ◽  
Nico I Pantoro ◽  
Karina Komala ◽  
Ayu Diandra Sari
Keyword(s):  
Weight Loss ◽  
Ketogenic Diet ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Nutritional Intervention ◽  
Diet Group ◽  
Low Fat ◽  
Low Fat Diet ◽  
Long Term Effect ◽  
Increased Risk

Introduction Obesity is a nutritional disease which is still a health burden particularly in Jakarta. The main treatment for obesity is nutritional intervention. Nowadays, several dietary approaches have been developed, including ketogenic diet, which is still controversial. Methods Literature search had been done within 4 databases including PubMed®, Cochrane®, Google® Scholar, and Science Direct®, using keywords: obesity, ketogenic diet, low-fat diet, and weight loss. Then, Medical Sub Heading (MeSH) was used. The search resulted in two articles which were appraised according to aspects of validity, importance, and applicability Results A randomized-controlled trial study showed similar effect of weight loss with ketogenic diet compared to low-fat diet. On the other hand, a meta-analysis study showed ketogenic diet caused more weight loss than low-fat diet. Both studies showed an increased risk of cardiovascular disease from the ketogenic diet group, which were shown by a decrease of flow-mediated dilatation and an increase of LDL-C. Conclusion Ketogenic diet shows a better long-term effect for weight loss in obese patients than low-fat diet. However, ketogenic diet may increase the cardiovascular event risk significantly.

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