Endocrine Abstracts

Introduction: The VLCKD is an established diet regimen with positive metabolic effects. Based on that, it was hypothesized that VLCKD could also have positive effects on glucose metabolism and insulin resistance, as well as obesity. Specifically, we aimed to investigate the efficacy of VLCKD on glucose metabolism in subjects with obesity compared to Mediterranean Diet.

Methods: In this cross-sectional study anthropometric parameters (weight, height and waist circumference), body composition (by bioimpedance analysis) and biochemistry data (fasting blood glucose, insulin and HbA1c) of subjects with obesity that underwent to VLCKD were collected before and at the end of active phase of the ketogenic protocol. Finally, Homeostasis Model Assessment of Insulin Resistance (HoMA-IR) was calculated.

Results: Fifty subjects with obesity were enrolled of whom 32 reached the end of the active phase of VLCKD (M5/F27, aged 37.33±15.91 years). At the end of the active phase, the average weight loss was nearly 11.8% of initial weight, with significant reduction in BMI (36.90±5.15 kg/m² vs 32.53±7.54 kg/m², P=0.001), waist circumference (106.83±15.8 cm vs 97.05±23.36 cm, P=0.009) and fat mass (40.32±6.01% vs 35.15±11.47%, P=0.008). No significant changes were found in fat free mass (59.68±6.01% vs 58.28±16.94%, P=0.641). We also detected a significant improvement in fasting blood glucose (89.94±11.5 mg/dl vs 82.66±9.4 mg/dl, P=0.002) compared to the baseline. Finally, comparison from baseline to the end of active phase of VLCKD of HOMA-IR showed an improving trend in insulin sensitivity although it was not statistically significant (P=0.127).

Conclusion: Our results suggest that VLCKD can be a suitable nutritional approach for subjects with obesity and glucose derangements. Indeed, VLCKD allows a faster weight loss compared to other nutritional approaches¹ thus rapidly shortening the history of obesity and thus the obesity-related damage on glucose metabolism. Finally, the same entity of weight loss is accompanied by a greater improvement of glucose metabolism when it is obtained by VLCKD compared to other nutritional approach such as MD^2-5 and this could be due to VLCKD property to preserve muscle mass, i.e. tissue important for metabolic activities.

References: 1. Moore L et al., 2000.

2. Thomazella MC et al., 2011.

3. Rallidis LS et al., 2009.

4. Kaliora AC et al., 2019.

5. Shai I et al., 2009.