Very low‐calorie ketogenic diet rapidly augments testosterone levels in non‐diabetic obese subjects

Abstract

Background:The very low-calorie ketogenic diet (VLCKD) represents an opportunity to attain clinically relevant weight loss in obese patients. Functional hypogonadism represents a frequent hormonal disorder associated with obesity and visceral fat accumulation characterised by low testosterone levels and subnormal luteinising hormone (LH) levels.Aim: To evaluate the early effects of VLCKD on serum total testosterone (TT) levels in non-diabetic obese patients.Methods: Twenty-two obese male patients (mean age 39.3 ± 11.7 years, mean body mass index (BMI) 38.2 ± 6.4 kg/m 2 ) were enrolled and treated for 28 days with VLCKD.Anthropometric and hormonal variables were assessed before, during and after diet intervention.Results: After 7 and 28 days on a VLCKD, a significant and persistent reduction in body weight, BMI, fat mass, blood glucose, insulin and homeostasis model assessment index was observed compared with baseline. TT significantly increased after 7 days (+35 ± 64 ng/dl) and 28 days (+74 ± 97 ng/dl) on a VLCKD. In addition to TT, a significant increase in serum sex hormone-binding globulin levels was observed after 7 (+2.1 ± 4.1) and 28 days (+7.7 ± 10.0). However, both calculated free testosterone and LH did not change after 7 or 28 days of VLCKD. Following cessation of VLCKD, hypogonadal subjects achieved a higher percentage of total weight loss (8.5% ± 1.5%), a greater reduction in weight (−9.94 ± 1.66 kg), fat mass (−7 ± 2.1 kg) and waist circumference (−6.31 ± 2.65 cm) and a greater improvement in glycaemia (−8.75 ± 10.92 mg/dl) as compared with eugonadal subjects. Furthermore, hypogonadal subjects exhibited a trend of higher TT increase (+98.12 ± 71.51 ng/dl) as compared with eugonadal subjects.Conclusions: VLCKD results in rapid improvements in TT levels associated with weight loss in male obese non-diabetic subjects, particularly in the presence of obesity-related hypogonadism.

Meta‐analysis and construction of simple‐to‐use nomograms for approximating testosterone levels gained from weight loss in obese men

“…The remaining 44 studies comprising 1,774 participants met the search criteria (Figure 1). 18–60 In total, there were 2,159 datasets as some studies included several datasets from the same group of participants, but at different time points. The ranges (lowest to highest) of baseline mean age, 21–68 years; BMI.…”

“…There was little evidence of bias due to confounding factors or in the selection of participants. Four studies were considered to suffer bias due to deviations from intended interventions as weight‐loss treatment was relatively short (≤ 4 weeks), 18,34,52,56 and one LCD study with the addition of the glucagon‐like peptide‐1 agonist Exenatide), 33 and two LCD studies used very low‐calorie ketogenic diet (35,36) 35,36 . Data for free testosterone were not reported in 12 studies 22,28,35,36,38,42,47–49,51,53,60 .…”

Not only a matter of glucose: The andrological consequences of diabetes mellitus

“…Both metabolic surgery 6 and ketogenic diet 7 could improve testosterone serum levels alongside body weight reduction and metabolic homeostasis improvement. The rapid body weight reduction after very low caloric ketogenic diet is associated with a prompt amelioration of serum testosterone levels, especially in hypogonadal subjects 8 …”

“…The rapid body weight reduction after very low caloric ketogenic diet is associated with a prompt amelioration of serum testosterone levels, especially in hypogonadal subjects. 8…”

Ketone Body β-Hydroxy-Butyrate Sustains Progressive Motility in Capacitated Human Spermatozoa: A Possible Role in Natural Fertility

“…However, a clear role of weight loss dietary strategies, and specifically of the ketogenic diet, on the improvement of testosterone levels is currently a matter of debate [ 11 , 14 ]. In addition to the possible retrieving of the proper endocrine pattern through weight lowering, other additional or parallel mechanisms on the testis function associated with nutritional-based ketosis, including fertility outcomes, are largely underinvestigated [ 6 , 15 ]. The biofluid profile of low/mid molecular weight metabolites has recently become a promising research field for the pathophysiological biomarkers of organ function [ 16 ].…”