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Low-Calorie Ketogenic Diet Improved Body Composition, Gut Microbiota Profile in T2D



Different dietary approaches were in a position to improve the state of health in patients with type 2 diabetes (T2D), with very-low-calorie ketogenic diets demonstrating higher results on gut microbiota profile.

Gut microbiota (GM) profile was affected by dietary approaches, namely a very-low-calorie ketogenic weight loss program (VLCKD), in patients with type 2 diabetes (T2D), in accordance with a latest study published in Metabolites. The profit to this weight loss program seemed to be higher than a classical Mediterranean weight loss program for weight reduction and impact on GM.

GM has been found to be a primary consider the pathogenesis of insulin resistance and T2D. Different diets have been identified as ways to modulate GM composition. Specifically, the Mediterranean weight loss program and the VLCKD have been effective in patients who’re chubby or obese and have T2D. The aim of the current study was to guage the short-term effects on GM using 2 dietary models, the Mediterranean weight loss program and VLCKD, in patients with newly diagnosed T2D.

Study participants were outpatients of the Obesity Unit of the AOU of Cagliari and the Diabetology Unit of the PO Binaghi in Cagliari, Italy, from March to May of 2020. Patients were included in the event that they had a latest diagnosis of T2D, a glycosylated hemoglobin (HbA1C) value of 6.5% to eight.9%, and were drug naïve for T2D.

Patients were excluded in the event that they had type 1 diabetes; serious heart disease; severe or uncontrolled hypertension; severe or uncompensated kidney, liver, or thyroid disease; painful pathologies; tumors being treated with chemotherapy or radiotherapy; sever psychopathology; gastrointestinal disease; therapy with corticosteroids; proton pump inhibitors; prebiotic or probiotic intake; or any dietary supplements or participation in other dietary regimens inside 3 months of the sample collection.

Baseline evaluations (T0) were performed 3 months after baseline assessment (T3) for a comparison. Dietary intervention took place over the primary (T1) and second (T2) months to guage adherence to the dietary program.

Clinical examinations included a full medical history, physical examination, standard blood pressure and heart rate measurement, and a high quality of life assessment.

There have been 2 study groups: KETO underwent a VLCKD and MEDI that followed a low-calorie Mediterranean weight loss program protocol. The MEDI group had a Mediterranean weight loss program with macronutrient intake whereas the KETO group had a multiphasic model with protein meal-replacement products.

There have been 11 patients included within the study, 6 men and 5 women, split evenly into the MEDI and KETO groups. The researchers found that each diets improved anthropometric and metabolic status but found significant success within the KETO group.

Participants within the VLCKD group achieved significant progress in total weight reduction (–14.3 vs –3.04 kg), body mass index (–5.3 vs –1.1 kg/m2), waist circumference (–12.9 vs –4.7 cm) and fat mass (–7% vs –3.1%) reduction compared with the MEDI group; differences in fat-free mass kg, fasting plasma glycemia levels, HbA1C values, lipid status, and bloodpressure values weren’t significant.

The KETO group significantly increased protein intake (19.7% [2.1%] vs 26.7% [2.6%]) and Mediterranean weight loss program scores relative to fish (1.7 [0.8] vs 2.8 [0.7]) and vegetables (3.3 [1.5] vs 5[0]) intake. A discount in body weight, body mass index, and waist circumference was present in the VLCKD protocol within the transient evaluation at T2 compared with the KETO group. The MEDI group saw a major reduction in waist circumference but not of body weight and body mass index in the identical time period.

There was no significant differences between the two weight loss program groups when evaluating the GM of every participant through different analyses. The researchers found that the KETO weight loss program was related to steroid biosynthesis, carotenoid biosynthesis, and nonhomologous end-joining pathways in T2 and T3 compared with baseline.

The small sample size as a result of the COVID-19 pandemic was the principal limitation of this study; the pandemic also interrupted the enrollment of patients whose data could possibly be used for added evaluation.

The researchers concluded that the advantages of VLCKD protocol in drug-naïve patients with T2D were significant within the short term. The advantages were more significant than patients following a classic Mediterranean weight loss program by way of weight reduction and the impact on GM.


Deledda A, Palmas V, Heidrich V, et al. Dynamics of gut microbiota and clinical variables after ketogenic and Mediterranean diets in drug-naïve patients with type 2 diabetes mellitus and obesity. Metabolites. Published online November 10, 2022. doi:10.3390/metabo12111092

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