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Very Low-Calorie Ketogenic Diet: A Safe and Effective Tool for Weight Loss in Patients With Obesity and Mild Kidney Failure.
Bruci, A, Tuccinardi, D, Tozzi, R, Balena, A, Santucci, S, Frontani, R, Mariani, S, Basciani, S, Spera, G, Gnessi, L, et al
Nutrients. 2020;12(2)
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Plain language summary
Very low-calorie ketogenic diets (VLCKD) may be an effective way to lose weight. However, the high amount of protein they contain may harm the kidneys, especially in those who already have impaired kidney function. This observational study of 92 obese men and women aimed to evaluate the effect of VLCKD on weight loss in individuals with mild kidney failure, compared to healthy individuals. A VLCKD diet resulted in significantly decreased BMI and body weight, due to a decrease in fat mass and slight decrease in muscle mass. Improvements were seen in blood pressure, indicators for diabetes and cholesterol levels. No changes to kidney or liver function were apparent and only a few minor adverse events were reported. Interestingly a small percentage of individuals with mildly impaired kidney function reported improvements in their condition. It was concluded that VLCKD is a safe and effective way to lose weight in patients with obesity and mild kidney disease. This study could be used by healthcare professionals to consider recommending a VLCKD to patients who are obese and have mild kidney disease.
Abstract
Very low-calorie ketogenic diets (VLCKD) are an effective and increasingly used tool for weight loss. Traditionally considered high protein, ketogenic diets are often looked at with concern by clinicians due to the potential harm they pose to kidney function. We herein evaluated the efficacy and safety of a VLCKD in patients with obesity and mild kidney failure. A prospective observational real-life study was conducted on ninety-two patients following a VLCKD for approximately 3 months. Thirty-eight had mild kidney failure and fifty-four had no renal condition and were therefore designated as control. Anthropometric parameters, bioelectrical impedance and biochemistry data were collected before and at the end of the dietary intervention. The average weight loss was nearly 20% of initial weight, with a significant reduction in fat mass. We report an improvement of metabolic parameters and no clinically relevant variation regarding liver and kidney function. Upon stratification based on kidney function, no differences in the efficacy and safety outcomes were found. Interestingly, 27.7% of patients with mild renal failure reported normalization of glomerular filtrate after dietary intervention. We conclude that, when conducted under the supervision of healthcare professionals, a VLCKD is an effective and safe treatment for weight loss in patients with obesity, including those affected by mild kidney failure.
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Randomised controlled trial of effect of fruit and vegetable consumption on plasma concentrations of lipids and antioxidants.
Zino, S, Skeaff, M, Williams, S, Mann, J
BMJ (Clinical research ed.). 1997;314(7097):1787-91
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Previous studies have suggested that people with high intake of fruit and vegetables or plasma antioxidant levels have a reduced risk of cancer and cardiovascular disease. There is limited data concerning the extent to which increased intake of fruit and vegetables, opposed to antioxidant supplementation, correlate with antioxidant plasma concentration levels. he aim of this trial was to examine whether advice to increase fruit and vegetable consumption affect the plasma concentrations of antioxidants, total and low-density lipoprotein (LDL). Eighty-seven subjects with normal lipid profiles who ate three of fewer servings of fruit and vegetables a day were included and the intervention group was asked to consume eight servings of fruit and vegetables a day for eight weeks. he findings of this study showed that plasma concentrations of vitamin C, alpha-carotene and beta-carotene, factors associated with reduced cancer risk, increased in parallel with increased fruit and vegetable intake in the intervention group. More specific dietary advice may be required to modify the levels of lipoprotein and vitamin E.
Abstract
OBJECTIVES To determine the extent to which plasma antioxidant concentrations in people with habitual low intake of fruit and vegetables respond to increased intakes of these foods. To examine whether advice to increase fruit and vegetables will result in reduction of concentrations of total and low density lipoprotein cholesterol. DESIGN Randomised controlled trial in which intervention and control groups were followed up for eight weeks. The intervention group was asked to consume eight servings of fruit and vegetables a day. SETTING Dunedin, New Zealand. SUBJECTS Eighty seven subjects with normal lipid concentrations who ate three or fewer servings of fruit and vegetables daily. MAIN OUTCOME MEASURES Plasma concentrations of vitamin C, retinol, alpha and beta carotene, alpha tocopherol, lipids, and lipoproteins. Dietary intake assessed with diet records over four days. RESULTS The mean plasma vitamin C, alpha carotene, and beta carotene concentrations increased in parallel with increased dietary intake of fruit and vegetables in the intervention group. Concentrations of retinol, alpha tocopherol, lipids, and lipoproteins remained unchanged despite some increase in dietary vitamin E and a small reduction in saturated fat intake. CONCLUSIONS Following a recommendation to increase fruit and vegetable consumption produces change in plasma concentrations of vitamin C, alpha carotene, and beta carotene likely to reduce incidence of cancer. More specific dietary advice to modify fat intake may be necessary to reduce the risk of cardiovascular disease mediated by lipoprotein and vitamin E.