Ketosis, ketoacidosis and very-low-calorie diets: putting the record straight

Mullins, Garrett R.; Hallam, Claire; Broom, Iain

doi:10.1111/j.1467-3010.2011.01916.x

Cited by 24 publications

(24 citation statements)

References 17 publications

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“…Weight loss occurs during a VLCD via the mechanism of ketosis. This is a benign metabolic state and differs from ketoacidosis. Ketoacidosis will only occur when insulin is insufficient .…”

Section: Overview Of the Physiological Mechanism Inducing Weight Lossmentioning

confidence: 99%

“…This is a benign metabolic state and differs from ketoacidosis. Ketoacidosis will only occur when insulin is insufficient . Ingestion of <800 kcal/3000 kJ per day will induce ketosis .…”

Section: Overview Of the Physiological Mechanism Inducing Weight Lossmentioning

confidence: 99%

“…Ingestion of <800 kcal/3000 kJ per day will induce ketosis . When accompanied by ongoing caloric restriction and less than 100 g of carbohydrate per day, metabolism of fat stores will occur . During ketosis, adipose tissue is broken down into free fatty acids and glycerol.…”

Section: Overview Of the Physiological Mechanism Inducing Weight Lossmentioning

confidence: 99%

“…The utilization of these ketone bodies has a protein sparing effect. More detailed information on this process is provided elsewhere …”

Section: Overview Of the Physiological Mechanism Inducing Weight Lossmentioning

confidence: 99%

“…By comparison, ketone levels in diabetic ketoacidosis may be as high as 25 mmol/L . A diagnosis of ketoacidosis is suggested when ketone bodies are detected and glucose is >11.1 mmol/L and significant acidosis (arterial pH < 7.3 or venous bicarbonate <15 mmol/L) …”

Section: Overview Of the Physiological Mechanism Inducing Weight Lossmentioning

confidence: 99%

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A practical guide for the use of very low calorie diets in adults with chronic kidney disease

et al. 2019

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Obesity is increasingly common in individuals with chronic kidney disease (CKD). Being overweight or obese is associated with both the development and progression of kidney disease. Lifestyle interventions such as the use of very low‐calorie diets (VLCD) are being used increasingly for patients with CKD despite warnings from manufacturers that they should be avoided or used with caution. Whilst these diets are effective and can induce rapid weight loss and suppress appetite, their use in patients with chronic and end stage kidney disease is more complex than in the general population. VLCD use in adults with kidney disease requires a more nuanced approach to prescription and closer monitoring for unintended side effects. This review describes the indications and clinical management of patients with CKD undertaking a very low‐calorie diet and provides practical guidance regarding how to manage a VLCD, particularly for the latter stages of CKD.

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“…Weight loss occurs during a VLCD via the mechanism of ketosis. This is a benign metabolic state and differs from ketoacidosis. Ketoacidosis will only occur when insulin is insufficient .…”

Section: Overview Of the Physiological Mechanism Inducing Weight Lossmentioning

confidence: 99%

“…This is a benign metabolic state and differs from ketoacidosis. Ketoacidosis will only occur when insulin is insufficient . Ingestion of <800 kcal/3000 kJ per day will induce ketosis .…”

Section: Overview Of the Physiological Mechanism Inducing Weight Lossmentioning

confidence: 99%

Section: Overview Of the Physiological Mechanism Inducing Weight Lossmentioning

confidence: 99%

“…The utilization of these ketone bodies has a protein sparing effect. More detailed information on this process is provided elsewhere …”

Section: Overview Of the Physiological Mechanism Inducing Weight Lossmentioning

confidence: 99%

Section: Overview Of the Physiological Mechanism Inducing Weight Lossmentioning

confidence: 99%

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A practical guide for the use of very low calorie diets in adults with chronic kidney disease

et al. 2019

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Is severe carbohydrate restriction necessary for appetite suppression? The ASKED randomized controlled trial

Roekenes,

Aukan,

Bomo

et al. 2024

Obesity

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ObjectiveThis trial aimed to compare three low‐energy diets (LEDs) with different amounts of carbohydrates (CHO) on ketosis and changes in hunger feelings in adults with obesity.MethodsA total of 101 adults (51 female) with obesity (BMI, mean [SEM], 34.7 [0.4] kg/m2) were randomized to follow three isocaloric LEDs (1000 kcal/day) for 8 weeks, containing either low, medium, or high CHO (70, 100, and 130 g/day, respectively), and 4 weeks of refeeding and weight stabilization. Body weight (BW) and composition, hunger and other appetite ratings, concentrations of β‐hydroxybutyrate (βHB), and appetite‐related hormones were measured at baseline and at the end of weeks 8 and 12.ResultsAt week 8, weight loss and βHB concentrations were significantly different among groups: Low CHO group versus Medium CHO group (BW: 2.32 [0.95] kg, 95% CI: 0.44 to 4.21, p = 0.016; βHB: −0.40 [0.09] mM, 95% CI: −0.67 to −0.09, p < 0.001); Low CHO group versus High CHO group (BW: 2.29 [0.96] kg, 95% CI: 0.39 to 4.19, p = 0.016; βHB: −0.644 [0.10] mM, 95% CI: −0.84 to −0.44, p < 0.001); and Medium CHO group versus High CHO group (BW: −0.03 [0.94] kg, 95% CI: −1.89 to 1.84, p = 0.977; βHB: −0.15 [0.08] mM, 95% CI: −0.30 to 0.002, p = 0.054). No significant differences in hunger were found among groups: Low CHO group versus Medium CHO group (−10.87 [5.92] mm, 95% CI: −0.82 to 22.57, p = 0.068); Low CHO group versus Medium CHO group (7.74 [7.36] mm, 95% CI: −6.77 to 22.26, p = 0.294); and Medium CHO group versus High CHO group (−3.13 [7.48] mm, 95% CI: −17.89 to 11.63, p = 0.676).ConclusionsAlthough the findings of this trial are not definitive, changes in hunger ratings with weight loss did not differ among groups. Additional studies with CHO intake of up to 130 g in 1000‐kcal/day LEDs are warranted to replicate these findings.

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Fast versus slow weight loss: development process and rationale behind the dietary interventions for the TEMPO Diet Trial

Gibson

Seimon

Franklin

et al. 2016

Obesity Science & Practice

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Summary Objective and methodsFinding effective solutions to curb the obesity epidemic is a great global public health challenge. The need for long-term follow-up necessitates weight loss trials conducted in real-world settings, outside the confines of tightly controlled laboratory or clinic conditions. Given the complexity of eating behaviour and the food supply, this makes the process of designing a practical dietary intervention that stands up to scientific rigor difficult. Detailed information about the dietary intervention itself, as well as the process of developing the final intervention and its underlying rationale, is rarely reported in scientific weight management publications but is valuable and essential for translating research into practice. Thus, this paper describes the design process and underlying rationale behind the dietary interventions in an exemplar weight loss trial -the TEMPO Diet Trial (Type of Energy Manipulation for Promoting optimal metabolic health and body composition in Obesity). This trial assesses the long-term effects of fast versus slow weight loss on adiposity, fat free mass, muscle strength and bone density in women with obesity (body mass index 30-40 kg m À2 ) that are 45-65 years of age, postmenopausal and sedentary. Results and conclusionsThis paper is intended as a resource for researchers and/or clinicians to illustrate how theoretical values based on a hypothesis can be translated into a dietary weight loss intervention to be used in free-living women of varying sizes.

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Ketosis, ketoacidosis and very-low-calorie diets: putting the record straight

Cited by 24 publications

References 17 publications

A practical guide for the use of very low calorie diets in adults with chronic kidney disease

A practical guide for the use of very low calorie diets in adults with chronic kidney disease

Is severe carbohydrate restriction necessary for appetite suppression? The ASKED randomized controlled trial

Fast versus slow weight loss: development process and rationale behind the dietary interventions for the TEMPO Diet Trial

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