Very-Low-Calorie Ketogenic Diets With Whey, Vegetable, or Animal Protein in Patients With Obesity: A Randomized Pilot Study
- 1 September 2020
- journal article
- research article
- Published by The Endocrine Society in Journal of Clinical Endocrinology & Metabolism
- Vol. 105 (9), 2939-2949
- https://doi.org/10.1210/clinem/dgaa336
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, homeostatic model assessment (HOMA) index >= 2.5, aged 56.2 +/- 6.1 years, body mass index [BMI] 35.9 +/- 4.1 kg/m(2)) 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 low-density lipoprotein 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.This publication has 64 references indexed in Scilit:
- Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) dietsEuropean Journal of Clinical Nutrition, 2013
- Executive Summary: Heart Disease and Stroke Statistics—2013 UpdateCirculation, 2013
- Effect of proteins from different sources on body compositionNutrition, Metabolism and Cardiovascular Diseases, 2011
- A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approachAge and Ageing, 2011
- Circulating levels of IGF1 are associated with muscle strength in middle-aged- and oldest-old womenActa Endocrinologica, 2011
- Diets with High or Low Protein Content and Glycemic Index for Weight-Loss MaintenanceThe New England Journal of Medicine, 2010
- Hepatic steatosis index: A simple screening tool reflecting nonalcoholic fatty liver diseaseDigestive and Liver Disease, 2010
- The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitusNutrition & Metabolism, 2008
- Has carbohydrate-restriction been forgotten as a treatment for diabetes mellitus? A perspective on the ACCORD study designNutrition & Metabolism, 2008
- Long-term effectiveness of weight-loss interventions in adults with pre-diabetes: A reviewAmerican Journal of Preventive Medicine, 2005