Context We compared the efficacy, safety and effect of 45-day isocaloric very-low-calorie ketogenic diets (VLCKDs) incorporating whey, vegetable or animal protein on the microbiota in patients with obesity and insulin resistance to test the hypothesis that protein source may modulate the response to VLCKD interventions. Subjects and Methods Forty-eight patients with obesity [19 males and 29 females, HOMA index ≥ 2.5, age 56.2±6.1 years, body mass index (BMI) 35.9±4.1 kg/m2] were randomly assigned to three 45-day isocaloric VLCKD regimens (≤800 kcal/day) containing whey, plant or animal protein. Anthropometric indexes; blood and urine chemistry, including parameters of kidney, liver, glucose and lipid metabolism; body composition; muscle strength; and taxonomic composition of the gut microbiome were assessed. Adverse events were also recorded. Results Body weight, BMI, blood pressure, waist circumference, HOMA index, insulin, and total and LDL cholesterol decreased in all patients. Patients who consumed whey protein had a more pronounced improvement in muscle strength. The markers of renal function worsened slightly in the animal protein group. A decrease in the relative abundance of Firmicutes and an increase in Bacteroidetes were observed after the consumption of VLCKDs. This pattern was less pronounced in patients consuming animal protein. Conclusions VLCKDs led to significant weight loss and a striking improvement in metabolic parameters over a 45-day period. VLCKDs based on whey or vegetable protein have a safer profile and result in a healthier microbiota composition than those containing animal proteins. VLCKDs incorporating whey protein are more effective in maintaining muscle performance.

Very-low-calorie ketogenic diets with whey, vegetable or animal protein in patients with obesity: a randomized pilot study / Basciani, Sabrina; Camajani, Elisabetta; Contini, Savina; Persichetti, Agnese; Risi, Renata; Bertoldi, Loris; Strigari, Lidia; Prossomariti, Giancarlo; Watanabe, Mikiko; Mariani, Stefania; Lubrano, Carla; Genco, Alfredo; Spera, Giovanni; Gnessi, Lucio. - In: THE JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM. - ISSN 0021-972X. - (2020). [10.1210/clinem/dgaa336]

Very-low-calorie ketogenic diets with whey, vegetable or animal protein in patients with obesity: a randomized pilot study

Basciani, Sabrina;Camajani, Elisabetta;Contini, Savina;Risi, Renata;Prossomariti, Giancarlo;Watanabe, Mikiko;Mariani, Stefania;Lubrano, Carla;Genco, Alfredo;Spera, Giovanni;Gnessi, Lucio
2020

Abstract

Context We compared the efficacy, safety and effect of 45-day isocaloric very-low-calorie ketogenic diets (VLCKDs) incorporating whey, vegetable or animal protein on the microbiota in patients with obesity and insulin resistance to test the hypothesis that protein source may modulate the response to VLCKD interventions. Subjects and Methods Forty-eight patients with obesity [19 males and 29 females, HOMA index ≥ 2.5, age 56.2±6.1 years, body mass index (BMI) 35.9±4.1 kg/m2] were randomly assigned to three 45-day isocaloric VLCKD regimens (≤800 kcal/day) containing whey, plant or animal protein. Anthropometric indexes; blood and urine chemistry, including parameters of kidney, liver, glucose and lipid metabolism; body composition; muscle strength; and taxonomic composition of the gut microbiome were assessed. Adverse events were also recorded. Results Body weight, BMI, blood pressure, waist circumference, HOMA index, insulin, and total and LDL cholesterol decreased in all patients. Patients who consumed whey protein had a more pronounced improvement in muscle strength. The markers of renal function worsened slightly in the animal protein group. A decrease in the relative abundance of Firmicutes and an increase in Bacteroidetes were observed after the consumption of VLCKDs. This pattern was less pronounced in patients consuming animal protein. Conclusions VLCKDs led to significant weight loss and a striking improvement in metabolic parameters over a 45-day period. VLCKDs based on whey or vegetable protein have a safer profile and result in a healthier microbiota composition than those containing animal proteins. VLCKDs incorporating whey protein are more effective in maintaining muscle performance.
2020
Very low calorie ketogenic diet; VLCKD; obesity; whey proteins; vegetable proteins; animal proteins; intestinal microbiota; therapy
01 Pubblicazione su rivista::01a Articolo in rivista
Very-low-calorie ketogenic diets with whey, vegetable or animal protein in patients with obesity: a randomized pilot study / Basciani, Sabrina; Camajani, Elisabetta; Contini, Savina; Persichetti, Agnese; Risi, Renata; Bertoldi, Loris; Strigari, Lidia; Prossomariti, Giancarlo; Watanabe, Mikiko; Mariani, Stefania; Lubrano, Carla; Genco, Alfredo; Spera, Giovanni; Gnessi, Lucio. - In: THE JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM. - ISSN 0021-972X. - (2020). [10.1210/clinem/dgaa336]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1406035
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