Middle and Long-Term Impact of a Very Low-Carbohydrate Ketogenic Diet on Cardiometabolic Factors: A Multi-Center, Cross-
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ORIGINAL ARTICLE
Middle and Long-Term Impact of a Very Low-Carbohydrate Ketogenic Diet on Cardiometabolic Factors: A Multi-Center, Cross-Sectional, Clinical Study Arrigo F. G. Cicero1 • Maddalena Benelli2 • Marco Brancaleoni3 • Giuseppe Dainelli3 Desire´ Merlini3 • Raffaele Negri3
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Received: 26 February 2015 / Accepted: 22 April 2015 Ó The Author(s) 2015. This article is published with open access at Springerlink.com
Abstract Introduction Obesity is a constantly growing illness in developed countries and it is strictly related to cardiovascular (CV) diseases, i.e. the main cause of mortality throughout industralised areas. Aim to test the ability of trained general physician to safely and effectively prescribe a very-low carbohydrate ketogenic (VLCK) diet in clinical practice, with a specific attention to the effect of this approach on overweight related CV risk factors (anthropometric measures) blood pressure, lipid levels, glucose metabolism). Methods The study has been carried out on a group of 377 patients scattered across Italy and monitored during 1 year. The proposed VLCK diet is a nutritional regimen characterized by low-fat and low- carbohydrates formulations and a protein content of 1.2/1.5 g/kg of ideal body weight, followed by a period of slow re-insertion and alimentary re-education. Results All the predetermined goals—namely safety, reduction of body weight and CV risk factors levels—have been reached with a significant reduction of body weight (from baseline to 4 weeks (-7 ± 5 kg, p \ 0.001), from 4 to 12 weeks (-5 ± 3 kg, p \ 0.001), no changes from
Lignaform Study Group: M. Benelli, M. Brancaleoni, G. Dainelli, D. Merlini, R. Negri. & Arrigo F. G. Cicero [email protected]; [email protected] 1
Medical and Surgical Sciences Department, Sant’OrsolaMalpighi University Hospital, University of Bologna, U.O. Medicina Interna Borghi-Via Albertoni, 15, Bologna, Italy
2
Santa Chiara Foundation, Lodi, Italy
3
National Public Health System, Rome, Italy
12 weeks to 12 months; waistline (from baseline to 4 weeks (-7 ± 4 cm, p \ 0.001), from 4 to 12 weeks (-5 ± 7 cm, p \ 0.001), no changes from 12 weeks to 12 months; fatty mass (from baseline to 4 weeks (-3.8 ± 3.8 %, p \ 0.001), from 4 to 12 weeks (-3.4 ± 3.5 %, p \ 0.001), no changes from 12 weeks to 12 months; SBP from baseline to 3 months (-10.5 ± 6.4 mmHg, p \ 0.001), no further changes after 1 year of observation). Conclusion the tested VLCD diet suggested by trained general physicians in the setting of clinical practice seems to be able to significantly improve on the middle-term a number of anthropometric, haemodynamic and laboratory with an overall good tolerability. Keywords Ketogenic diet General practice Safety Cardiovascular risk factors
1 Introduction Overweight and obesity are pandemic conditions [1] associated to increased risk for type 2 diabetes, cardiovascular disease, cancer and all cause-mortality [2, 3], and a dramatic increase in public health expense to their management [4, 5]. Mediterranean diet seems to be a
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