Obesity treatment by very low-calorie-ketogenic diet at two years: reduction in visceral fat and on the burden of disease

Abstract

The long-term effect of therapeutic diets in obesity treatment is a challenge at present. The current study aimed to evaluate the long-term effect of a very low-calorie-ketogenic (VLCK) diet on excess adiposity. Especial focus was set on visceral fat mass, and the impact on the individual burden of disease. A group of obese patients (n = 45) were randomly allocated in two groups: either the very low-calorie-ketogenic diet group (n = 22), or a standard low-calorie diet group; (n = 23). Both groups received external support. Adiposity parameters and the cumulative number of months of successful weight loss (5 or 10 %) over a 24-month period were quantified. The very low-calorie-ketogenic diet induced less than 2 months of mild ketosis and significant effects on body weight at 6, 12, and 24 months. At 24 months, a trend to regress to baseline levels was observed; however, the very low-calorie-ketogenic diet induced a greater reduction in body weight (-12.5 kg), waist circumference (-11.6 cm), and body fat mass (-8.8 kg) than the low-calorie diet (-4.4 kg, -4.1 cm, and -3.8 kg, respectively; p < 0.001). Interestingly, a selective reduction in visceral fat measured by a specific software of dual-energy x-ray absorptiometry (DEXA)-scan (-600 g vs. -202 g; p < 0.001) was observed. Moreover, the very low-calorie-ketogenic diet group experienced a reduction in the individual burden of obesity because reduction in disease duration. Very low-calorie-ketogenic diet patients were 500 months with 5 % weight lost vs. the low-calorie diet group (350 months; p < 0.001). In conclusion, a very low-calorie-ketogenic diet was effective 24 months later, with a decrease in visceral adipose tissue and a reduction in the individual burden of disease.

Effects of Nutritional Education Interventions on Metabolic Risk in Children and Adolescents: A Systematic Review of Controlled Trials

“…First, central adiposity appears to be the predominant diagnostic criteria for MetS [38,39] and related comorbidities [40,41] as reported in the literature. Moreover, abdominal adiposity is an outcome sensitive to changes in nutrition and lifestyle [42,43], which are the main components of the evaluated education interventions. Regarding primary outcome measures, WC is used as an indicator of abdominal adiposity in several published definitions of pediatric MetS (Cook [44], de Ferranti [45], Cruz [46], Ford [47], and International Diabetes Federation Consensus [48]).…”

Effect of Synbiotic Supplementation in a Very‐Low‐Calorie Ketogenic Diet on Weight Loss Achievement and Gut Microbiota: A Randomized Controlled Pilot Study

“…Understanding the effects of a VLCKD on these diseases is an important issue, and controlled clinical trials are a necessary tool to elucidate the factors involved in the effects produced by VLCKDs. Previous studies have suggested that a VLCKD may be an effective tool to manage obesity and its metabolic complications because this dietary regimen seems to be more effective than the traditional calorie restriction . However, the mechanisms underlying the effects of a VLCKD on weight loss are still a subject of debate, possibly due to the lower energy intake, protein‐induced satiety, and low‐carbohydrate consumption …”

Visceral fat reference values derived from healthy European men and women aged 20-30 years using GE Healthcare dual-energy x-ray absorptiometry

“…However, these indices do not allow distinguishing between VAT and subcutaneous abdominal fat and, in general, are fundamentally inaccurate in quantifying VAT [5]. VAT is a relatively small component of total body fat; however, due to known metabolic effects of VAT, there is constantly increasing interest in this fat depot as an attractive target for non-pharmacological [6, 7] and pharmacological interventions [8]. …”