Obesity treatment by very low-calorie-ketogenic diet at two years: reduction in visceral fat and on the burden of disease.
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.
Division of Endocrinology and Nutrition, Hospital G Universitario Gregorio Marañon, Madrid, Spain.
Basilio
B
Moreno
Laboratory of Molecular and Cellular Endocrinology, Instituto de Investigación Sanitaria (IDIS), Complejo Hospitalario Universitario de Santiago (CHUS), Santiago de Compostela University (USC), Santiago de Compostela, Spain.|CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Santiago de Compostela, Spain.
Ana B
AB
Crujeiras
Division of Endocrinology, Complejo Hospitalario Universitario de Ferrol and Coruña University, Ferrol, Spain.
Diego
D
Bellido
Medical Department Pronokal, Protein Supplies SL, Barcelona, Spain.
Ignacio
I
Sajoux
CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Santiago de Compostela, Spain. endocrine@usc.es.|Division of Endocrinology, Department of Medicine, Complejo Hospitalario Universitario de Santiago (CHUS), Santiago de Compostela University, Santiago de Compostela, Spain. endocrine@usc.es.
Felipe F
FF
Casanueva
D015502:Absorptiometry, Photon; D050154:Adiposity; D000328:Adult; D055423:Diet, Ketogenic; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult