scholarly journals Very Low-Calorie Ketogenic Diet: A Safe and Effective Tool for Weight Loss in Patients with Obesity and Mild Kidney Failure

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 333 ◽  
Author(s):  
Adriano Bruci ◽  
Dario Tuccinardi ◽  
Rossella Tozzi ◽  
Angela Balena ◽  
Silvia Santucci ◽  
...  
Keyword(s):  
Weight Loss ◽  
Kidney Function ◽  
Kidney Failure ◽  
Dietary Intervention ◽  
Real Life ◽  
Average Weight ◽  
Efficacy And Safety ◽  
Anthropometric Parameters ◽  
Low Calorie ◽  
Ketogenic Diets

Very low-calorie ketogenic diets (VLCKD) are an effective and increasingly used tool for weight loss. Traditionally considered high protein, ketogenic diets are often looked at with concern by clinicians due to the potential harm they pose to kidney function. We herein evaluated the efficacy and safety of a VLCKD in patients with obesity and mild kidney failure. A prospective observational real-life study was conducted on ninety-two patients following a VLCKD for approximately 3 months. Thirty-eight had mild kidney failure and fifty-four had no renal condition and were therefore designated as control. Anthropometric parameters, bioelectrical impedance and biochemistry data were collected before and at the end of the dietary intervention. The average weight loss was nearly 20% of initial weight, with a significant reduction in fat mass. We report an improvement of metabolic parameters and no clinically relevant variation regarding liver and kidney function. Upon stratification based on kidney function, no differences in the efficacy and safety outcomes were found. Interestingly, 27.7% of patients with mild renal failure reported normalization of glomerular filtrate after dietary intervention. We conclude that, when conducted under the supervision of healthcare professionals, a VLCKD is an effective and safe treatment for weight loss in patients with obesity, including those affected by mild kidney failure.

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 Reduction of Cardio-Metabolic Risk and Body Weight through a Multiphasic Very-Low Calorie Ketogenic Diet Program in Women with Overweight/Obesity: A Study in a Real-World Setting

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1804
Author(s):  
Elena Tragni ◽  
Luisella Vigna ◽  
Massimiliano Ruscica ◽  
Chiara Macchi ◽  
Manuela Casula ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Waist Circumference ◽  
Real World ◽  
Metabolic Complications ◽  
Multi Centre Study ◽  
Low Calorie ◽  
Ketogenic Diets ◽  
Real World Setting ◽  
Overweight Or Obesity

Background: The prevention and treatment of obesity and its cardio-metabolic complications are relevant issues worldwide. Among lifestyle approaches, very low-calorie ketogenic diets (VLCKD) have been shown to lead to rapid initial weight loss, resulting in better long-term weight loss maintenance. As no information on VLCKD studies carried on in a real-world setting are available, we conducted this multi-centre study in a real-world setting, aiming at assessing the efficacy and the safety of a specific multiphasic VLCKD program in women with overweight or obesity. Methods: A multi-center, prospective, uncontrolled trial was conducted in 33 outpatient women (age range 27–60 y) with overweight or obesity (BMI: 30.9 ± 2.7 kg/m2; waist circumference: 96.0 ± 9.4 cm) who started a VLCKD dietary program (duration: 24 weeks), divided into four phases. The efficacy of VLCKD was assessed by evaluating anthropometric measures and cardiometabolic markers; liver and kidney function biomarkers were assessed as safety parameters. Results: The VLCKD program resulted in a significant decrease of body weight and BMI (−14.6%) and waist circumference (−12.4%). At the end of the protocol, 33.3% of the participants reached a normal weight and the subjects in the obesity range were reduced from 70% to 16.7%. HOMA-IR was markedly reduced from 3.17 ± 2.67 to 1.73 ± 1.23 already after phase 2 and was unchanged thereafter. Systolic blood pressure decreased after phase 1 (−3.5 mmHg) and remained unchanged until the end of the program. Total and LDL cholesterol and triglycerides were significantly reduced by VLCKD along with a significant HDL cholesterol increase. Liver, kidney and thyroid function markers did not change and remained within the reference range. Conclusions: The findings of a multi-center VLCKD program conducted in a real-world setting in a cohort of overweight/obese women indicate that it is safe and effective, as it results in a major improvement of cardiometabolic parameters, thus leading to benefits that span well beyond the mere body weight/adiposity reduction.

scholarly journals 3461 A community-based, low calorie dietary intervention for the prevention and remission of type 2 diabetes mellitus

2019 ◽  
Vol 3 (s1) ◽  
pp. 137-137
Author(s):  
Kim Qumby ◽  
Colette George ◽  
Ian Hambleton ◽  
Patrick Olivier ◽  
Nigel Unwin
Keyword(s):  
Weight Loss ◽  
Blood Glucose ◽  
Dietary Intervention ◽  
Fasting Blood Glucose ◽  
Community Setting ◽  
Diabetes Remission ◽  
Dietary Advice ◽  
Low Calorie ◽  
Health Team ◽  
Physical Measurements

OBJECTIVES/SPECIFIC AIMS: The aim is to investigate if sustained weight loss due to caloric restriction can be achieved in a community setting, using faith-based organisations (FBOs) as hubs; and if this weight loss can lead to the re-establishment of normal metabolism (using the normalisation of blood sugar levels while off glucose lowering medication as a proxy) in a person with pre-diabetes or T2DM. METHODS/STUDY POPULATION: Members of the FBO with either a diagnosis of T2DM for <6 years or pre-diabetes as defined by the American Diabetes Association (ADA); and a Body Mass index (BMI) of ≥27 kg/m2 are eligible. After counselling, participants will be placed on a 12 week low calorie liquid diet, supplemented by low carbohydrate vegetables, totalling approximately 840 kcal/day. During this time, participants will be monitored weekly at their FBO by trained members of their congregation, with oversight from the study team, for change in weight, fasting blood glucose, waist and hip circumference and blood pressure. This will be followed by a 3 month period during which participants will receive ongoing dietary advice as they transfer to a balanced, reduced calorie, solid diet. Physical measurements will be monitored monthly during this 3 month period. The next 6 months is a period where the participants and the FBO health team move towards ‘independence’. This involves further training of the FBO health team and participants in healthy lifestyle habits; and a commitment by the leadership of the FBO to assume ‘ownership’ for NCD monitoring within their community. Physical measurements will be repeated at the end of one year. RESULTS/ANTICIPATED RESULTS: Based on previous studies, we expect that participants who are compliant to the diet will lose approximately 2.2 kg per week over the 12 week period. This will be associated with rapid (within 1 week) normalisation of fasting blood glucose levels (<7mmol / L). We expect that, due to the accessibility of NCD monitoring and support, that participants to be satisfied with their care and compliant to their regime and that the results of the first 12 weeks will be sustained at the 12 month follow up. We expect that the FBO leadership will assume the responsibility of continuing and NCD programme, not only for the local congregation but for the surrounding community. DISCUSSION/SIGNIFICANCE OF IMPACT: Diabetes remission with a low calorie diet is a viable intervention for T2DM remission however social support is key to an individual’s success. This novel study which proposes institution of a diabetes remission intervention which fits into the participant’s locale and involves peer support, should increase long-term success.

scholarly journals The management of very low-calorie ketogenic diet in obesity outpatient clinic: a practical guide

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Giovanna Muscogiuri ◽  
Luigi Barrea ◽  
Daniela Laudisio ◽  
Gabriella Pugliese ◽  
Ciro Salzano ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Maintenance ◽  
Rapid Weight Loss ◽  
Epidemic Disease ◽  
Low Calorie ◽  
Ketogenic Diets ◽  
Obstructive Sleep ◽  
The Times ◽  
Nutritional Strategies

Abstract The epidemic of obesity is growing steadily across the whole world. Obesity is not only a merely aesthetic disease but is the “mother” of most chronic diseases such as associated with a range of type 2 diabetes, cardiovascular disease, obstructive sleep apnea, and cancer. However, although there is a need to find a strategy to stop this epidemic disease, most of the times the current nutritional strategies are not effective in weight loss and in long term weight maintenance. Very low-calorie ketogenic diets (VLCKD) is increasingly establishing as a successful nutritional pattern to manage obesity; this is due to rapid weight loss that gives rise to a positive psychological cycle which in turn increases the compliance to diet. Another important key point of VLCKD is the ability to preserve fatty free mass which is known to play a role of paramount importance in glucose metabolism. Despite the clinical evidence of VLCKD there are paucity of data regarding to its management. Therefore, we will provide a useful guide to be used by nutrition experts taking care of subjects with obesity. In particular, we will report recommendations on the correct use of this therapeutic approach for weight loss and management of side effects.

scholarly journals Moderate Caloric Restriction Partially Improved Oxidative Stress Markers in Obese Humans

Antioxidants ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 1018
Author(s):  
Dominika Kanikowska ◽  
Alina Kanikowska ◽  
Ewelina Swora-Cwynar ◽  
Marian Grzymisławski ◽  
Maki Sato ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Antioxidant Status ◽  
Dietary Intervention ◽  
Real Life ◽  
Ros Generation ◽  
Oxidative Stress Markers ◽  
Short Term ◽  
Anthropometric Parameters ◽  
Stress Markers

Oxidative stress and inflammation are implicated in obesity. Therefore, we investigated whether moderate and short-term calorie restriction (CR) reflects a real-life situation, mediates weight loss, and improves oxidative stress markers. We analyzed oxidative stress markers in patients with obesity undergoing moderate CR. Serum oxidative stress markers (myeloperoxidase (MPO), superoxide dismutase (SOD), catalase, total antioxidant status (TAS), and reactive oxygen species (ROS) (generation by endothelial cells in vitro)) were measured in 53 subjects (mean BMI 37.8 ± 5.9 kg/m2) who underwent 8 weeks of CR, which included a reduction of 300–500 kcal/day. MPO was the most CR-sensitive parameter. The mean level of serum MPO in patients with obesity was 20% higher than that in post CR intervention (p < 0.001). SOD increased by 12% after CR (p < 0.05), which was largely due to the improvement in glucose tolerance and the reduction in insulin resistance after CR. Other tested parameters were not modified during the treatment. CR resulted in an expected decrease in body weight (by 5.9 ± 4.6 kg, p < 0.0001) and other anthropometric parameters. Additionally, it was accompanied by a significant change in hsCRP, hsTNF alpha, hsIL-6, leptin (all p < 0.0001), and HOMA-IR (p < 0.05). Cardiovascular and metabolic parameters were also partially improved. Short-term, moderate CR partially improves antioxidant capacity but is enough to substantially change anthropometric parameters in obese patients. Our observations indicate that mimicking real-life situations and low-cost dietary intervention can be successfully implemented in obesity treatment with a simultaneous moderate effect on antioxidant status.

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.

scholarly journals Evaluation of an Eight-Week Whole-Food Plant-Based Lifestyle Modification Program

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2068 ◽  
Author(s):  
Erin K. Campbell ◽  
Mohammad Fidahusain ◽  
Thomas M. Campbell II
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Dietary Intervention ◽  
Ldl Cholesterol ◽  
Plasma Lipids ◽  
Lifestyle Modification ◽  
The United States ◽  
Food Plant ◽  
Average Weight ◽  
Chronic Medication

Poor diet quality is the leading cause of death both in the United States and worldwide, and the prevalence of obesity is at an all-time high and is projected to significantly worsen. Results from an eight-week group program utilizing an ad-libitum whole-food plant-based dietary pattern, were reviewed. There were 79 participants, all self-referred from the community, including 24 (30.4%) who were already vegetarian or vegan at baseline. Seventy-eight participants (98.7%) completed the eight-week program. Among completers, those with higher BMI at baseline lost a larger percentage of their body weight (total body weight loss of 3.0 ± SD 2.1%, 5.8 ± 2.8%, and 6.4 ± 2.5% for participants who had baseline BMI in normal, overweight, and obese range, respectively). The average weight loss for all the completers was 5.5 ± 3.0 kg (p < 0.0001). Final blood pressure and plasma lipids were reduced compared to baseline (SBP decreased 7.1 ± 15.5 mmHg (p = 0.0002), DBP decreased 7.3 ± 10.9 mmHg (p < 0.0001), total cholesterol decreased 25.2 ± 24.7 mg/dL (p < 0.0001), LDL decreased 15.3 ± 21.1 mg/dL (p < 0.0001)). Twenty-one (26.9%) participants were able to decrease or stop at least one chronic medication compared to two (2.6%) participants who required an increased dose of a chronic medication. Participants who were already vegetarian or vegan at baseline experienced statistically significant weight loss and reductions in total and LDL cholesterol. There was a non-significant trend toward less weight loss in these participants compared to participants who were non-vegetarian at baseline. Reductions in total and LDL cholesterol were not significantly different when comparing vegetarian or vegan and non-vegetarian participants. A whole-food plant-based dietary intervention may provide significant short-term benefits for both non-vegetarian, vegetarian, and vegan individuals.

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