Effects of a Personalized VLCKD on Body Composition and Resting Energy Expenditure in the Reversal of Diabetes to Prevent Complications

Lorenzo Romano, Marco Marchetti, Paola Gualtieri, Laura Di Renzo, Meriann Belcastro, Gemma Lou De Santis, Marco Alfonso Perrone, Antonino De Lorenzo, Lorenzo Romano, Marco Marchetti, Paola Gualtieri, Laura Di Renzo, Meriann Belcastro, Gemma Lou De Santis, Marco Alfonso Perrone, Antonino De Lorenzo

Abstract

The reversion of diabetes and the treatment of long-term obesity are difficult challenges. The failure mechanisms of rapid weight loss are mainly related to the wasting of lean mass. This single-arm study aims to evaluate the effects of a very low-calorie ketogenic diet (VLCKD) on body composition and resting energy expenditure in the short term reversal of diabetes mellitus Type 2. For eight weeks, subjects were administered a personalized VLCKD with protein intake based on lean mass and synthetic amino acidic protein supplementation. Each subject was assessed by anthropometry, Dual-energy X-ray Absorptiometry(DXA), bioimpedentiometric analysis (BIA), indirect calorimetry, and biochemical analysis. The main findings were the saving of lean mass, the reduction of abdominal fat mass, restored metabolic flexibility, the maintenance of resting energy expenditure, and the reversion of diabetes. These results highlight how the application of preventive, predictive, personalized, and participative medicine to nutrition may be promising for the prevention of diabetes and enhancement of obesity treatment.

Keywords: VLCKD; body composition; diabetes; indirect calorimetry; lean mass; nutrition; obesity; prevention; resting energy expenditure; reversibility.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Comparison among baseline, four weeks, and eight weeks for waist circumference (cm) and android fat mass (kg). Points sharing the same superscript letter are not significantly different from each other. Statistical significance attributed to results with p < 0.05. Circ: Circumference. FM: Fat Mass; 4W: four weeks; 8W: eight weeks.
Figure 2
Figure 2
Comparison among baseline, four weeks, and eight weeks for whole FM and whole LM. Points sharing the same superscript letter are not significantly different from each other. Statistical significance attributed to results with p < 0.05. FM: Fat Mass; LM: Lean Mass; ECW: Extra Cellular Water; BCM: Body Cell Mass; 4W: 4 weeks; 8W: 8 weeks.
Figure 3
Figure 3
Comparison among baseline, four weeks, and eight weeks for ECW (L) and BCM (kg). Points sharing the same superscript letter are not significantly different from each other. Statistical significance attributed to results with p < 0.05. ECW: Extra Cellular Water; BCM: Body Cell Mass; 4W: 4 weeks; 8W: 8 weeks.
Figure 4
Figure 4
Comparison among baseline, four weeks, and eight weeks for VO2 and VCO2. Points sharing the same superscript letter are not significantly different from each other. Statistical significance attributed to results with p < 0.05. VO2: Volume of Oxygen; CO2: Volume of Carbon Dioxide; mL/MIN: milliliter/minutes; 4W: weeks; 8W: weeks.

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