A comparison of a ketogenic diet with a LowGI/nutrigenetic diet over 6 months for weight loss and 18-month follow-up

Maria Vranceanu, Craig Pickering, Lorena Filip, Ioana Ecaterina Pralea, Senthil Sundaram, Aseel Al-Saleh, Daniela-Saveta Popa, Keith A Grimaldi, Maria Vranceanu, Craig Pickering, Lorena Filip, Ioana Ecaterina Pralea, Senthil Sundaram, Aseel Al-Saleh, Daniela-Saveta Popa, Keith A Grimaldi

Abstract

Background: Obesity and its related metabolic disturbances represent a huge health burden on society. Many different weight loss interventions have been trialled with mixed efficacy, as demonstrated by the large number of individuals who regain weight upon completion of such interventions. There is evidence that the provision of genetic information may enhance long-term weight loss, either by increasing dietary adherence or through underlying biological mechanisms.

Methods: The investigators followed 114 overweight and obese subjects from a weight loss clinic in a 2-stage process. 1) A 24-week dietary intervention. The subjects self-selected whether to follow a standardized ketogenic diet (n = 53), or a personalised low-glycemic index (GI) nutrigenetic diet utilising information from 28 single nucleotide polymorphisms (n = 61). 2) After the 24-week diet period, the subjects were monitored for an additional 18 months using standard guidelines for the Keto group vs standard guidelines modified by nutrigenetic advice for the low-Glycaemic Index nutrigenetic diet (lowGI/NG) group.

Results: After 24 weeks, the keto group lost more weight: - 26.2 ± 3.1 kg vs - 23.5 ± 6.4 kg (p = 0.0061). However, at 18-month follow up, the subjects in the low-GI nutrigenetic diet had lost significantly more weight (- 27.5 ± 8.9 kg) than those in the ketogenic diet who had regained some weight (- 19.4 ± 5.0 kg) (p < 0.0001). Additionally, after the 24-week diet and 18-month follow up the low-GI nutrigenetic diet group had significantly greater (p < 0.0001) improvements in total cholesterol (ketogenic - 35.4 ± 32.2 mg/dl; low-GI nutrigenetic - 52.5 ± 24.3 mg/dl), HDL cholesterol (ketogenic + 4.7 ± 4.5 mg/dl; low-GI nutrigenetic + 11.9 ± 4.1 mg/dl), and fasting glucose (ketogenic - 13.7 ± 8.4 mg/dl; low-GI nutrigenetic - 24.7 ± 7.4 mg/dl).

Conclusions: These findings demonstrate that the ketogenic group experienced enhanced weight loss during the 24-week dietary intervention. However, at 18-month follow up, the personalised nutrition group (lowGI/NG) lost significantly more weight and experienced significantly greater improvements in measures of cholesterol and blood glucose. This suggests that personalising nutrition has the potential to enhance long-term weight loss and changes in cardiometabolic parameters.

Trial registration: NCT04330209, Registered 01/04/2020, retrospectively registered.

Keywords: BMI; Cholesterol; Genetic testing; Glycaemic index; Ketogenic; Nutrigenetics; Weight loss.

Conflict of interest statement

Competing interestsCP is a former employee of DNAfit Life Sciences; he receives no financial benefits at present from either DNAfit or Prenetics. At the time of the study, and during the writing of the manuscript, he was a full-time employee of DNAfit Life Sciences. SS is an employee of Prenetics, a genetic testing company. KG is Chief Scientific Officer of DNAFit Life Sciences, and is the founder and director of Eurogenetica Ltd. MV uses Eurogenetica tests, among others, in the clinic. LF, AS, DSP, and IP have no competing interests to declare, and receive no financial benefits from either DNAfit or Prenetics.

© The Author(s) 2020.

Figures

Fig. 1
Fig. 1
Percentage weight lost compared to baseline for each group (mean, 95% CI). At 104 weeks (2 years), the low-GI nutrigenetic group lost significantly more weight
Fig. 2
Fig. 2
Individual fasting glucose (mg/dl) between diet groups
Fig. 3
Fig. 3
Percentage change from baseline for Total Cholesterol (TC), High Density Lipoprotein (HDL), and Fasting Blood Glucose (FBG) for both groups at two-year follow up

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