title: Ketosis and appetite-mediating nutrients and hormones after weight loss.
abstract: OBJECTIVE
  Diet-induced weight loss is accompanied by compensatory changes, which increase appetite and encourage weight regain. There is some evidence that ketogenic diets suppress appetite. The objective is to examine the effect of ketosis on a number of circulating factors involved in appetite regulation, following diet-induced weight loss.
  
  
  METHODS
  Of 50 non-diabetic overweight or obese subjects who began the study, 39 completed an 8-week ketogenic very-low-energy diet (VLED), followed by 2 weeks of reintroduction of foods. Following weight loss, circulating concentrations of glucose, insulin, non-esterified fatty acids (NEFA), β-hydroxybutyrate (BHB), leptin, gastrointestinal hormones and subjective ratings of appetite were compared when subjects were ketotic, and after refeeding.
  
  
  RESULTS
  During the ketogenic VLED, subjects lost 13% of initial weight and fasting BHB increased from (mean±s.e.m.) 0.07±0.00 to 0.48±0.07 mmol/l (P<0.001). BHB fell to 0.19±0.03 mmol/l after 2 weeks of refeeding (P<0.001 compared with week 8). When participants were ketotic, the weight loss induced increase in ghrelin was suppressed. Glucose and NEFA were higher, and amylin, leptin and subjective ratings of appetite were lower at week 8 than after refeeding.
  
  
  CONCLUSIONS
  The circulating concentrations of several hormones and nutrients which influence appetite were altered after weight loss induced by a ketogenic diet, compared with after refeeding. The increase in circulating ghrelin and subjective appetite which accompany dietary weight reduction were mitigated when weight-reduced participants were ketotic.
authors: Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
authors: P
authors: P
authors: Sumithran
authors: L A
authors: LA
authors: Prendergast
authors: E
authors: E
authors: Delbridge
authors: K
authors: K
authors: Purcell
authors: A
authors: A
authors: Shulkes
authors: A
authors: A
authors: Kriketos
authors: J
authors: J
authors: Proietto
mesh_terms: D020155:3-Hydroxybutyric Acid / Q000097:blood; D000328:Adult; D000368:Aged; D001069:Appetite Regulation / Q000502:physiology*; D015992:Body Mass Index; D031204:Caloric Restriction; D055423:Diet, Ketogenic; D005215:Fasting; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D005768:Gastrointestinal Hormones / Q000097:blood*; D054439:Ghrelin / Q000097:blood; D006801:Humans; D007328:Insulin / Q000097:blood; D058228:Islet Amyloid Polypeptide / Q000097:blood; D007662:Ketosis / Q000378:metabolism*; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy; D050177:Overweight / Q000178:diet therapy; D019894:Peptide YY / Q000097:blood; D017698:Postmenopause; D015431:Weight Loss / Q000502:physiology*
chemical_list: D005230:Fatty Acids, Nonesterified; D005768:Gastrointestinal Hormones; D054439:Ghrelin; D007328:Insulin; D058228:Islet Amyloid Polypeptide; D020738:Leptin; D019894:Peptide YY; D020155:3-Hydroxybutyric Acid