Study: Resting metabolic rate of obese patients under very low calorie ketogenic diet

#1

RESULTS:
Despite the large body weight reduction, no metabolic adaptation was observed. The absent reduction in RMR was not due to increased sympathetic tone, as thyroid hormones, catecholamines, and leptin were reduced at any visit from baseline. Under regression analysis Free Fat Mass, adjusted by levels of ketonic bodies, was the only predictor of the RMR changes (R2 = 0.36; p < 0.001).

CONCLUSION:
The rapid and sustained weight and FM loss induced by VLCK-diet in obese subjects did not induce the expected reduction in RMR, probably due to the preservation of lean mass.

Limiting Fat Intake on Keto?#!
(Marie Dantoni) #2

This is interesting. It indicates that there’s no such thing as starvation mode on a ketogenic diet. Did they say what the macros and calories were ?

(Bunny) #3

METHODS: Nutritional intervention

”…All the patients followed a VLCK diet according to a commercial weight loss program (PNK method®), which includes lifestyle and behavioral modification support. The intervention included an evaluation by the specialist physician conducting the study, an assessment by an expert dietician, and exercise recommendations. This method is based on a high-biological-value protein preparations obtained from cow milk, soya, avian eggs, green peas and cereals. Each protein preparation contained 15 G protein, 4 g carbohydrates, 3 g fat, and 50 mg docohexaenoic acid, and provided 90–100 kcal.

The weight loss program has five steps (Additional file 1: Figure S1) and adheres to the most recent guidelines of 2015 European Food Safety Authority (EFSA) on total carbohydrates intake [3]. The first three steps consist of a VLCK diet (600–800 kcal/day), low in carbohydrates (< 50 g daily from vegetables) and lipids (only 10 g of olive oil per day). The amount of high-biological-value proteins ranged between 0.8 and 1.2 g per each kg of ideal body weight, to ensure patients were meeting their minimal body requirements and to prevent the loss of lean mass. In step 1, the patients ate high-biological-value protein preparations five times a day, and vegetables with low glycemic indexes. In step 2, one of the protein servings was substituted by a natural protein (e.g., meat or fish) either at lunch or at dinner. In step 3, a second serving of low fat natural protein was substituted for the second serving of biological protein preparation. Throughout these ketogenic phases, supplements of vitamins and minerals supplements, such as K, Na, Mg, Ca, and omega-3 fatty acids, were provided in accordance to international recommendations [22]. These three steps were maintained until the patient lost the target amount of weight, ideally 80%. Hence, the ketogenic steps were variable in time depending on the individual and the weight loss target…”

“…The maintenance diet, consisted of an eating plan balanced in carbohydrates, protein, and fat. Depending on the individual the calories consumed ranged between 1500 and 2000 kcal/day, and the target was to maintain the weight lost and promote healthy life styles. …More

(Rob) #4

So is this a product shill for PNK? Not that it invalidates anything per se. Did they measure ketones (not that I care about them)?

Also, this seems to be a rehash of the Newcastle study (8 weeks VLCK) but the RMR conclusion was definitely interesting and kind of supportive of keto (though this plan is horrible and restrictive for the first phase, and then lax and unclear in maintenance). I think this is too far from what we do to draw specific conclusions for normal keto.

I’d rather stick to proper keto and fasting rather that this but each to their own.

(Marie Dantoni) #5

Thanks. now I wonder how much influence “PNK” may have had in this study. Cynicism aside,this shines a ray of light into the abyss of set point theory.