The Effects of a High-protein, Low-fat, Ketogenic Diet on Adolescents With Morbid Obesity: Body Composition, Blood Chemistries, and Sleep Abnormalities

Willi, Steven M.; Oexmann, Mary Joan; Wright, Nancy A.; Collop, Nancy A.; Key, L. Lyndon

doi:10.1542/peds.101.1.61

Cited by 137 publications

(89 citation statements)

References 30 publications

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“…This shift to ketogenesis may play a direct role in the cytoprotective effects of IF, because it has been reported that rats fed a ketogenic diet exhibit increased resistance to seizures (25), and that ␤-hydroxybutyrate protects neurons in rodent models of Alzheimer's and Parkinson's diseases (27). Ketogenic diets are prescribed for some patients with epilepsy (26) and are also implemented in several popular weight-loss programs (40,41). The findings of this study suggest that IF can enhance health and cellular resistance to disease even if the fasting period is followed by a period of overeating such that overall caloric intake is not decreased.…”

Section: Resultsmentioning

confidence: 99%

Intermittent fasting dissociates beneficial effects of dietary restriction on glucose metabolism and neuronal resistance to injury from calorie intake

Anson

Guo

Cabo

et al. 2003

Proc. Natl. Acad. Sci. U.S.A.

629

537

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Dietary restriction has been shown to have several health benefits including increased insulin sensitivity, stress resistance, reduced morbidity, and increased life span. The mechanism remains unknown, but the need for a long-term reduction in caloric intake to achieve these benefits has been assumed. We report that when C57BL͞6 mice are maintained on an intermittent fasting (alternateday fasting) dietary-restriction regimen their overall food intake is not decreased and their body weight is maintained. Nevertheless, intermittent fasting resulted in beneficial effects that met or exceeded those of caloric restriction including reduced serum glucose and insulin levels and increased resistance of neurons in the brain to excitotoxic stress. Intermittent fasting therefore has beneficial effects on glucose regulation and neuronal resistance to injury in these mice that are independent of caloric intake.caloric restriction ͉ hippocampus ͉ insulin ͉ ␤-hydroxybutyrate ͉ ketosis

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Section: Resultsmentioning

confidence: 99%

Intermittent fasting dissociates beneficial effects of dietary restriction on glucose metabolism and neuronal resistance to injury from calorie intake

Anson

Guo

Cabo

et al. 2003

Proc. Natl. Acad. Sci. U.S.A.

629

537

View full text Add to dashboard Cite

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“…So far, very few reports are available dealing with adolescents who are affected with very severe forms of obesity and who underwent therapeutic regimen, which are beyond dietetic/ behavioural treatment programmes: drugs like sibutramin have been used, 1 as well as ketogenic diets 2 and very low calorie diets; 3 however, only short-term results in regard to weight loss have been achieved.…”

Section: Introductionmentioning

confidence: 99%

Adjustable gastric banding surgery in morbidly obese adolescents: experiences with eight patients

2004

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BACKGROUND: Excessive obesity in children and adolescents is increasing in western countries all over the world. Treatment of those young subjects is extremely difficult. In cases who do not respond in any regard to conservative treatment regimens, it is worthwhile to also offer bariatric surgical procedures. METHODS: In eight young subjects with a mean age of 16.071.3 y, mean BMI 49.175.2 who where totally resistant against different therapeutic regimens, we performed adjustable laparoscopic banding surgery. Psychological tests were carried out to find out if there were any psychological disturbances. In all patients, the depression inventory for adolescents (DIKJ) and clinical interviews were carried out. RESULTS: No complications were seen; mean follow-up of 10.576.0 months showed a weight loss of 2576.5 kg. All adolescents felt for the first time that it was possible to lose weight and were very happy about their body attitude. They were able to adhere to a strict dietary regimen, which allowed them to eat without any hunger problems. It was observed that most of these patients have depressive symptoms and a very low self-esteem. Some patients suffer from nervous anxiety, poor peer acceptance, less athletic competence or forms of victimisation too. CONCLUSIONS: From these results, we conclude that laparoscopic gastric banding surgery seems to be a method that could be offered to morbidly obese adolescents. However, long-term follow-up is essential and psychological problems should be carefully studied.

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“…Recently, we have shown (17) that this diet induces rapid weight loss and improves sleep apnea while preserving lean body mass in nondiabetic obese children. In obese adults with type 2 diabetes, the diet has been shown to safely induce rapid weight loss while decreasing hyperinsulinemia (18) and improving blood pressure (19,20).…”

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confidence: 99%

Treatment of Type 2 Diabetes in Childhood Using a Very-Low-Calorie Diet

et al. 2004

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OBJECTIVE -Pharmacologic agents currently approved for use in children with type 2 diabetes (metformin and insulin) are less than optimal for some patients. We evaluated the use of a ketogenic, very-low-calorie diet (VLCD) in the treatment of type 2 diabetes.RESEARCH DESIGN AND METHODS -We conducted a chart review of 20 children (mean age 14.5 Ϯ 0.4 years) who consumed a ketogenic VLCD in the treatment of type 2 diabetes. Several response variables (BMI, blood pressure, HbA 1c , blood glucose, and treatment regimens) were examined before, during, and up to 2 years after the diet and compared with a matched diabetic control group.RESULTS -Before starting the diet, 11 of 20 patients were treated with insulin and 6 with metformin. Mean daily blood glucose values fell from 8.9 Ϯ 1.1 to 5.5 Ϯ 0.38 mmol/l (P Ͻ 0.0001) in the first 3 days of the VLCD, allowing insulin and oral agents to be discontinued in all but one subject. BMI fell from 43.5 Ϯ 1.8 to 39.3 Ϯ 1.8 kg/m 2 (P Ͻ 0.0001) and HbA 1c dropped from 8.8 Ϯ 0.6 to 7.4 Ϯ 0.6% (P Ͻ 0.005) as the diet was continued for a mean of 60 Ϯ 8 days (range 4 -130 days), and none required resumption of antidiabetic medications. Sustained decreases in BMI and insulin requirements were observed in patients remaining on the VLCD for at least 6 weeks when compared with those of the control group.CONCLUSIONS -The ketogenic VLCD is an effective short-term, and possibly long-term, therapy for pediatric patients with type 2 diabetes. Blood glucose control and BMI improve, allowing the discontinuation of exogenous insulin and other antidiabetic agents. This diet, although strict, has potential as an alternative to pharmacologic therapies for this emerging subset of diabetic individuals. Diabetes Care 27:348 -353, 2004T he prevalence of obesity in adolescence has increased dramatically within the past two decades, with at least 12% of adolescents defined as overweight (BMI above the 95th percentile for age and sex) (1). The U.S. National Diabetes Commission and the Nurse's Health Study have both found a direct relationship between weight gain and the risk for diabetes (2,3). Excessive weight among adolescents threatens to become a major public health problem, as the emergence of type 2 diabetes in this age-group has risen exponentially (4). A number of groups have reported a profound increase in the incidence of type 2 diabetes among minority children in North America (5-9). Among African-American adolescents, this subset of diabetes is frequently associated with morbid obesity and hypertension (8,10). This condition is characterized by the absence of islet cell antibodies, normal to elevated fasting C-peptide levels, acanthosis nigricans, and a parental history of type 2 diabetes (11). At the time of presentation, many of the signs of type 1 diabetes (weight loss, polyuria, and polydipsia) may be lacking, while variable degrees of ketosis and even ketoacidosis are quite common (12). Obesity and puberty appear to combine with genetic predisposition to result in disease presentation (13...

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The Effects of a High-protein, Low-fat, Ketogenic Diet on Adolescents With Morbid Obesity: Body Composition, Blood Chemistries, and Sleep Abnormalities

Abstract: The K diet can be used effectively for rapid weight loss in adolescents with morbid obesity. Loss in lean body mass is blunted, blood chemistries remain normal, and sleep abnormalities significantly decrease with weight loss.

Cited by 137 publications

References 30 publications

Intermittent fasting dissociates beneficial effects of dietary restriction on glucose metabolism and neuronal resistance to injury from calorie intake

Intermittent fasting dissociates beneficial effects of dietary restriction on glucose metabolism and neuronal resistance to injury from calorie intake

Adjustable gastric banding surgery in morbidly obese adolescents: experiences with eight patients

Treatment of Type 2 Diabetes in Childhood Using a Very-Low-Calorie Diet

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