Ketogenic nutritional therapy (KeNuT)—a multi-step dietary model with meal replacements for the management of obesity and its related metabolic disorders: a consensus statement from the working group of the Club of the Italian Society of Endocrinology (SIE)—diet therapies in endocrinology and metabolism

Journal of Endocrinological Investigation, Journal Year: 2024, Volume and Issue: 47(3), P. 487 - 500

Published: Jan. 18, 2024

Abstract Purpose The ketogenic nutritional therapy (KeNuT) is an effective dietary treatment for patients with obesity and obesity-related comorbidities, including type 2 diabetes, dyslipidaemia, hypertension, coronary artery disease, some of cancers. However, to date official document on the correct prescription diet, validated by authoritative societies in nutrition or endocrine sciences, missing. It important emphasize that requires proper medical supervision patient selection, due complex biochemical implications ketosis need a strict therapeutic compliance, experienced nutritionist personalization whole protocol. Methods This practical guide provides update main clinical indications contraindications meal replacements its mechanisms action. In addition, various phases protocol involving replacements, monitoring, management potential side effects, are also discussed. Conclusion will help healthcare provider acquire necessary skills provide comprehensive care overweight, diseases, using multistep treatment, recognized Club Italian Society Endocrinology (SIE)—Diet Therapies Metabolism.

Language: Английский

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Akkermansia muciniphila inhibits nonalcoholic steatohepatitis by orchestrating TLR2-activated γδT17 cell and macrophage polarization

Gut Microbes, Journal Year: 2023, Volume and Issue: 15(1)

Published: June 22, 2023

Current evidence indicates that the next-generation probiotic Akkermansia muciniphila (A. muciniphila) has therapeutic potential for nonalcoholic fatty liver disease (NAFLD), especially its inflammatory stage known as steatohepatitis (NASH). However, mechanisms of A. in NASH prevention remain unknown. Here, supplementation prevented hepatic inflammation high-fat diet-induced mice, characterized by reduced proinflammatory macrophages (M1) and γδT γδT17 cells. Consistently, M1 cells were enriched biopsy-proven patients high-fat/high-carbohydrate mice. Antibiotics M1, Furthermore, inhibited intestinal barrier disruption accordingly downregulated Toll-like receptor 2 (TLR2) expression The activation TLR2 lipoteichoic acid (not M1) normal diet-fed mice neutralized cell-lowering inflammation-protecting effects Additionally, activated could promote macrophage polarization via IL−17. Our study first supported modulating TLR2-activated further polarization, facilitating clinical applications.

Language: Английский

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Ketogenic diet administration to mice after a high-fat-diet regimen promotes weight loss, glycemic normalization and induces adaptations of ketogenic pathways in liver and kidney

Molecular Metabolism, Journal Year: 2022, Volume and Issue: 65, P. 101578 - 101578

Published: Aug. 20, 2022

The ketogenic diet (KD), characterized by very limited dietary carbohydrate intake and used as nutritional treatment for GLUT1-deficiency syndromes pharmacologically refractory epilepsy, may promote weight loss improve metabolic fitness, potentially alleviating the symptoms of osteoarthritis. Here, we have studied effects administration a in mice previously rendered obese feeding high fat (HFD) submitted to surgical destabilization medial meniscus mimic osteoarthritis.6-weeks old were fed an HFD 10 weeks then switched chow (CD), KD or maintained on 8 weeks. Glycemia, β-hydroxybutyrate (BHB), body mass compared among groups. In liver kidney, protein expression histone post-translational modifications assessed Western blot, gene quantitative Real-Time PCR.After HDF feeding, CD induced comparable decrease mass, with better glycemic normalization group. Histone β-hydroxybutyrylation, but not acetylation, was increased kidney rate-limiting enzyme HMGCS2 upregulated - at level and, even greater extent, kidney. KD-induced overexpression be dependent FGF21, whose liver.Over period weeks, is more effective than induce normalization. Besides acting fuel molecule, BHB exert its through modulation epigenome via β-hydroxybutyrylation extensive transcriptional

Language: Английский

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Chronotype as a predictor of weight loss and body composition improvements in women with overweight or obesity undergoing a very low-calorie ketogenic diet (VLCKD)

Clinical Nutrition, Journal Year: 2023, Volume and Issue: 42(7), P. 1106 - 1114

Published: May 19, 2023

Recent studies reported that chronotype play a role in the development of metabolic comorbidities and determining dietary habits obesity. However, little is known if could predict efficacy nutritional approaches for The aim this study was to investigate whether categories can have very low-calorie ketogenic diet (VLCKD) terms weight loss changes body composition women with overweight or

Language: Английский

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Effect of a Very Low-Calorie Diet on Oxidative Stress, Inflammatory and Metabolomic Profile in Metabolically Healthy and Unhealthy Obese Subjects

Antioxidants, Journal Year: 2024, Volume and Issue: 13(3), P. 302 - 302

Published: Feb. 29, 2024

The purpose of the study was to determine impact weight loss through calorie restriction on metabolic profile, and inflammatory oxidative stress parameters in metabolically healthy (MHO) unhealthy (MUHO) obese individuals. A total 74 subjects (34 MHO 40 MUHO) received two cycles a very low-calorie diet, alternating with hypocaloric diet for 24 weeks. Biochemical, stress, markers, as well serum metabolomic analysis by nuclear magnetic resonance, were performed at baseline end intervention. After there an improvement insulin resistance, significant decrease parameters, enhancing damage, mitochondrial membrane potential, glutathione, antioxidant capacity. This more MUHO group. showed healthier profile lipoprotein profile. Lipid carbonyls also same time unsaturated fatty acids increase. We display small succinate, glycA, alanine, BCAAs (valine isoleucine), slight increase taurine. These findings show that moderate reduction leads lipid subfractions markers; these changes are pronounced population.

Language: Английский

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Fabry Disease: Cardiac Implications and Molecular Mechanisms

Current Heart Failure Reports, Journal Year: 2024, Volume and Issue: 21(2), P. 81 - 100

Published: Jan. 30, 2024

Abstract Purpose of Review This review explores the interplay among metabolic dysfunction, oxidative stress, inflammation, and fibrosis in Fabry disease, focusing on their potential implications for cardiac involvement. We aim to discuss biochemical processes that operate parallel sphingolipid accumulation contribute disease pathogenesis, emphasizing importance a comprehensive understanding these processes. Recent Findings Beyond accumulation, emerging studies have revealed mitochondrial chronic inflammation could be significant contributors These factors promote remodeling may predispose patients conduction disturbances, ventricular arrhythmias, heart failure. While current treatments, such as enzyme replacement therapy pharmacological chaperones, address progression symptoms, effectiveness is limited. Summary Our uncovers relationships disease–related complications. Current findings suggest beyond other mechanisms significantly pathogenesis. prompts exploration innovative therapeutic strategies underscores holistic approach managing disease.

Language: Английский

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Effects of Weight Loss on Key Obesity-Related Biomarkers Linked to the Risk of Endometrial Cancer: A Systematic Review and Meta-Analysis

Cancers, Journal Year: 2024, Volume and Issue: 16(12), P. 2197 - 2197

Published: June 11, 2024

Endometrial cancer (EC) includes various histologic types, with estrogen-dependent endometrioid carcinoma being the most common. Obesity significantly increases risk of developing this type, especially in postmenopausal women, due to elevated estrogen production by adipocytes. This review examines impact weight loss from different interventions on reducing obesity-related factors for EC. A systematic and meta-analysis were conducted three interventions: bariatric surgery, pharmacotherapy, lifestyle changes. The effects these inflammatory biomarkers (CRP, TNF-α, IL-6) hormones (leptin, estrogen) analyzed. Data controlled studies pooled assess significance biomarkers. Despite heterogeneity, surgery resulted an overall 25.8% reduction, outperforming pharmacotherapy interventions. Weight reduced CRP levels 33.5% IL-6 41.9%. TNF-α decreased 13% percent over 7%. Leptin also significantly, although exact percentage was not statistically significant. effectively reduces proinflammatory markers associated increased strengths include a comprehensive examination weight-loss large pool participants. However, limitations high heterogeneity among only 43% participants postmenopausal. Limited data sex racial disparities underscore need further research.

Language: Английский

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Clinical Impact of Enteral Protein Nutritional Therapy on Patients with Obesity Scheduled for Bariatric Surgery: A Focus on Safety, Efficacy, and Pathophysiological Changes

Nutrients, Journal Year: 2023, Volume and Issue: 15(6), P. 1492 - 1492

Published: March 20, 2023

Background: Ketogenic diet-induced weight loss before bariatric surgery (BS) has beneficial effects on the reduction in liver volume, metabolic profile, and intra- post-operative complications. However, these can be limited by poor dietary adherence. A potential solution patients showing a adherence following prescribed diet could represented enteral nutrition strategies. To date, no studies describe protocol to use for efficacy safety of pre-operative ketogenic nutrition-based protocols terms reduction, efficacy, with obesity scheduled BS. Aims scope: assess clinical impact, protein (NEP) vs. nutritional hypocaloric (NEI) candidate Patients methods: 31 NEP were compared 29 NEI through 1:1 randomization. The body (BW), mass index (BMI), waist circumference (WC), hip (HC), neck (NC) assessed at baseline 4-week follow-up. Furthermore, parameters blood tests, asked daily report any side effects, using self-administered questionnaire. Results: Compared baseline, BW, BMI, WC, HC, NC significantly reduced both groups studied (p < 0.001). we did not find significative difference between = 0.559), BMI (p= 0.383), WC 0.779), HC while statistically significant was found (NEP, −7.1% NEI, −4%, p 0.011). amelioration general status groups. glycemia −16% −8.5%, 0.001), insulin −49.6% −17.8%, 0.0028), HOMA −57.7% −24.9%, total cholesterol −24.3% −2.8%, low-density lipoprotein −30.9% 1.96%, apolipoprotein A1 −24.2% −7%, B −23.1% −2.3%, whereas aortomesenteric fat thickness 0.332), triglyceride levels 0.534), degree steatosis 0.616), left hepatic lobe volume 0.264). treatments well tolerated, major registered. Conclusions: Enteral feeding is an effective safe treatment BS, leading better results than glycemic lipid profiles. Further larger randomized trials are needed confirm preliminary data.

Language: Английский

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The Impact of Weight Loss on Inflammation, Oxidative Stress, and Mitochondrial Function in Subjects with Obesity

Antioxidants, Journal Year: 2024, Volume and Issue: 13(7), P. 870 - 870

Published: July 19, 2024

Inflammation, oxidative stress, and mitochondrial function are implicated in the development of obesity its comorbidities. The purpose this study was to assess impact weight loss through calorie restriction on metabolic profile, inflammatory stress parameters, respiration an obese population. A total 109 subjects underwent two cycles a very low-calorie diet alternated with (24 weeks). We analyzed biochemical parameters serum, as well markers, mRNA antioxidant gene expression, peripheral blood mononuclear cells (PBMCs). After intervention, there improvement both insulin resistance lipid profiles, including cholesterol subfractions. Weight produced significant reduction ROSs content increase glutathione levels, coupled enhancement expression systems (SOD1, GSR, CAT). In addition, basal oxygen consumption, maximal respiration, ATP production observed. These findings demonstrate that moderate can improve resistance, profiles subfractions, respiration. Therefore, we affirm dietary intervention simultaneously achieve profile obesity.

Language: Английский

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The effect of the ketogenic diet on Acne: Could it be a therapeutic tool?

Critical Reviews in Food Science and Nutrition, Journal Year: 2023, Volume and Issue: 64(19), P. 6850 - 6869

Published: Feb. 13, 2023

Acne is a chronic inflammatory disease of the pilosebaceous unit resulting from androgen-induced increased sebum production, altered keratinization, inflammation, and bacterial colonization hair follicles face, neck, chest back by Propionibacterium acnes. Overall, inflammation immune responses are strongly implicated in pathogenesis acne. Although early with acnes family history may play an important role disease, it remains unclear exactly what triggers acne how treatment affects progression. The influence diet on growing research topic, yet few studies have examined effects development clinical severity results often been contradictory. Interestingly, very low-calorie ketogenic (VLCKD) has associated both significant reductions body weight status through production ketone bodies thus expected to reduce exacerbation manifestations or even block trigger disease. Given paucity regarding implementation VLCKD management acne, this review aims provide evidence available scientific literature support speculative use

Language: Английский

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