Predictors of weight loss in patients with obesity treated with a Very Low-Calorie Ketogenic Diet
IntroductionThe Very Low-Calorie Ketogenic Diet (VLCKD) has emerged as a safe and effective intervention for the management of metabolic disease. Studies examining weight loss predictors are scarce and none has investigated such factors upon VLCKD treatment. Among the molecules involved in energy ho...
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2023.1058364/full |
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| author | Ilaria Ernesti Francesco Baratta Mikiko Watanabe Renata Risi Elisabetta Camajani Agnese Persichetti Dario Tuccinardi Stefania Mariani Carla Lubrano Alfredo Genco Giovanni Spera Lucio Gnessi Sabrina Basciani |
| author_facet | Ilaria Ernesti Francesco Baratta Mikiko Watanabe Renata Risi Elisabetta Camajani Agnese Persichetti Dario Tuccinardi Stefania Mariani Carla Lubrano Alfredo Genco Giovanni Spera Lucio Gnessi Sabrina Basciani |
| author_sort | Ilaria Ernesti |
| collection | DOAJ |
| description | IntroductionThe Very Low-Calorie Ketogenic Diet (VLCKD) has emerged as a safe and effective intervention for the management of metabolic disease. Studies examining weight loss predictors are scarce and none has investigated such factors upon VLCKD treatment. Among the molecules involved in energy homeostasis and, more specifically, in metabolic changes induced by ketogenic diets, Fibroblast Growth Factor 21 (FGF21) is a hepatokine with physiology that is still unclear.MethodsWe evaluated the impact of a VLCKD on weight loss and metabolic parameters and assessed weight loss predictors, including FGF21. VLCKD is a severely restricted diet (<800 Kcal/die), characterized by a very low carbohydrate intake (<50 g/day), 1.2–1.5 g protein/kg of ideal body weight and 15–30 g of fat/day. We treated 34 patients with obesity with a VLCKD for 45 days. Anthropometric parameters, body composition, and blood and urine chemistry were measured before and after treatment.ResultsWe found a significant improvement in body weight and composition and most metabolic parameters. Circulating FGF21 decreased significantly after the VLCKD [194.0 (137.6–284.6) to 167.8 (90.9–281.5) p < 0.001] and greater weight loss was predicted by lower baseline FGF21 (Beta = −0.410; p = 0.012), male sex (Beta = 0.472; p = 0.011), and central obesity (Beta = 0.481; p = 0.005).DiscussionVLCKD is a safe and effective treatment for obesity and obesity related metabolic derangements. Men with central obesity and lower circulating FGF21 may benefit more than others in terms of weight loss obtained following this diet. Further studies investigating whether this is specific to this diet or to any caloric restriction are warranted. |
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| issn | 2296-861X |
| language | English |
| last_indexed | 2024-04-10T20:31:56Z |
| publishDate | 2023-01-01 |
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| spelling | doaj.art-9eb1952f3a6a4253ba13b97014092c242023-01-25T06:01:32ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2023-01-011010.3389/fnut.2023.10583641058364Predictors of weight loss in patients with obesity treated with a Very Low-Calorie Ketogenic DietIlaria Ernesti0Francesco Baratta1Mikiko Watanabe2Renata Risi3Elisabetta Camajani4Agnese Persichetti5Dario Tuccinardi6Stefania Mariani7Carla Lubrano8Alfredo Genco9Giovanni Spera10Lucio Gnessi11Sabrina Basciani12Surgical Endoscopy Unit, Department of Surgical Sciences, Sapienza University of Rome, Rome, ItalyDepartment of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, ItalySection of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, ItalySection of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, ItalyDepartment of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, Rome, ItalySection of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, ItalyDepartment of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Rome, ItalySection of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, ItalySection of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, ItalySurgical Endoscopy Unit, Department of Surgical Sciences, Sapienza University of Rome, Rome, ItalySection of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, ItalySection of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, ItalySection of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, ItalyIntroductionThe Very Low-Calorie Ketogenic Diet (VLCKD) has emerged as a safe and effective intervention for the management of metabolic disease. Studies examining weight loss predictors are scarce and none has investigated such factors upon VLCKD treatment. Among the molecules involved in energy homeostasis and, more specifically, in metabolic changes induced by ketogenic diets, Fibroblast Growth Factor 21 (FGF21) is a hepatokine with physiology that is still unclear.MethodsWe evaluated the impact of a VLCKD on weight loss and metabolic parameters and assessed weight loss predictors, including FGF21. VLCKD is a severely restricted diet (<800 Kcal/die), characterized by a very low carbohydrate intake (<50 g/day), 1.2–1.5 g protein/kg of ideal body weight and 15–30 g of fat/day. We treated 34 patients with obesity with a VLCKD for 45 days. Anthropometric parameters, body composition, and blood and urine chemistry were measured before and after treatment.ResultsWe found a significant improvement in body weight and composition and most metabolic parameters. Circulating FGF21 decreased significantly after the VLCKD [194.0 (137.6–284.6) to 167.8 (90.9–281.5) p < 0.001] and greater weight loss was predicted by lower baseline FGF21 (Beta = −0.410; p = 0.012), male sex (Beta = 0.472; p = 0.011), and central obesity (Beta = 0.481; p = 0.005).DiscussionVLCKD is a safe and effective treatment for obesity and obesity related metabolic derangements. Men with central obesity and lower circulating FGF21 may benefit more than others in terms of weight loss obtained following this diet. Further studies investigating whether this is specific to this diet or to any caloric restriction are warranted.https://www.frontiersin.org/articles/10.3389/fnut.2023.1058364/fullfibroblast growth factor 21insulin resistancebody compositionlow carbohydrate diet (LCD)very low energy dietprotein sparing modified fasting |
| spellingShingle | Ilaria Ernesti Francesco Baratta Mikiko Watanabe Renata Risi Elisabetta Camajani Agnese Persichetti Dario Tuccinardi Stefania Mariani Carla Lubrano Alfredo Genco Giovanni Spera Lucio Gnessi Sabrina Basciani Predictors of weight loss in patients with obesity treated with a Very Low-Calorie Ketogenic Diet Frontiers in Nutrition fibroblast growth factor 21 insulin resistance body composition low carbohydrate diet (LCD) very low energy diet protein sparing modified fasting |
| title | Predictors of weight loss in patients with obesity treated with a Very Low-Calorie Ketogenic Diet |
| title_full | Predictors of weight loss in patients with obesity treated with a Very Low-Calorie Ketogenic Diet |
| title_fullStr | Predictors of weight loss in patients with obesity treated with a Very Low-Calorie Ketogenic Diet |
| title_full_unstemmed | Predictors of weight loss in patients with obesity treated with a Very Low-Calorie Ketogenic Diet |
| title_short | Predictors of weight loss in patients with obesity treated with a Very Low-Calorie Ketogenic Diet |
| title_sort | predictors of weight loss in patients with obesity treated with a very low calorie ketogenic diet |
| topic | fibroblast growth factor 21 insulin resistance body composition low carbohydrate diet (LCD) very low energy diet protein sparing modified fasting |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2023.1058364/full |
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