Endocrine Abstracts

Introduction: The prevalence of obesity and metabolic disturbances is worryingly increasing worldwide, therefore the study of their pathophysiology is extremely important to find new strategies for their treatment. Obesity has an impact not only on the metabolism of the patients, but also profoundly influence their daily life, and potentially affect the quality of life and the quality of sleep. These latter are strictly related to the circadian rhythm of the individuals that, accordingly to animal models, can be influenced by the diet composition.

Aim: The aim of our research project is to study the effects of a ketogenic diet in comparison with an isocaloric balanced diet on quality of life and sleep quality in obese individuals.

Methods: 24 obese patients referred to the CASCO centre (High Specialization Centre for the Care of Obesity) in Sapienza University, Umberto I Polyclinic, Rome, Italy, were enrolled and completed the study. The enrolled patients were randomly divided in 2 branches and prescribed a ketogenic diet or an isocaloric balanced diet (1200 Kcal per day, protein content 1.2-1.4 g/Kg of ideal body weight for each patient), for 30 days. Patients were encouraged to walk 30 minutes every day. Questionnaires for assessing quality of life and quality of sleep were administered at baseline and at the end of the study. In a subgroup of 20 patient, an actigraphy study for assessing sleep parameters was performed.

Results: Quality of life was significantly ameliorated after both diets, and ketogenic diet had a greater positive effect. We observed a reduction of daily sleepiness in both diets. The ketogenic diet was more effective in achieving better-quality sleep, but this may be related to the greater weight loss seen. Total sleep time was insufficient in both groups.

Conclusion: A hypocaloric balanced diet and an isocaloric ketogenic diet are both able to induce a significant amelioration of the quality of life of obese patients even in the short-term, and the ketogenic diet has a greater beneficial effect. Improved quality of life, and in particular of the physical function and self-esteem domains, may act as a motivating factor for adherence to the diet. Diurnal sleepiness was ameliorated after both diets, and sleep quality significantly improved after the ketogenic diet, which induced a greater weight loss. As good quality sleep is important for healthy metabolism, measures aimed to a better sleep hygiene should be encouraged as part of weight-loss programs.