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Weight loss after ketogenic, low-calorie meal plan greater vs. conventional diet
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A ketogenic, very low-calorie meal plan was effective for short-term weight loss of more than 5% in adults with obesity compared with a conventional, hypocaloric meal plan, published findings show.
Sangeeta Kashyap, MD, associate professor of medicine at Cleveland Clinic Lerner College of Medicine and staff physician in the department of endocrinology at Cleveland Clinic, and colleagues evaluated adults with obesity who underwent either a ketogenic, very low-calorie meal plan counseling (n = 127; protein-sparing modified fast; mean plan duration, 27.2 weeks) or conventional, hypocaloric meal plan counseling (n = 48; mean plan duration, 23.6 weeks) to determine weight-loss efficacy and predictor of weight-loss maintenance between the two plans.
Outcomes were assessed at baseline and 6, 12 and 24 months after the interventions. During the first month of the program, participants met with a dietitian every 2 weeks and then monthly thereafter.
Median change in weight was greater in the protein-sparing modified fast group (–12.4%) compared with the conventional diet group (–2.6%) from baseline to the end of the intervention (P < .001). Similarly, the protein-sparing modified fast group had greater decreases in absolute weight (P < .001), greater maintenance of weight loss 6 months after intervention (P = .003). At 6 and 12 months after intervention, more participants in the protein-sparing modified fast group maintained weight loss of at least 10% compared with the conventional diet group.
Overall, 40% of participants in the protein-sparing modified fast group continued to see a dietitian for carbohydrate refeeding instruction after the initial ketosis phase. Participants in the refeeding group spent a longer time in the ketosis phase of the diet (151.5 days) compared with the non-refeeding group (133.2 days; P = .17). At the end of the protein-sparing modified fast ketosis, participants who received refeeding instruction had greater weight loss (–17.5%) compared with the non-refeeding group (–8%; P < .001). Participants in the refeeding group also experienced better maintenance of weight loss compared with the non-refeeding group 6 months after intervention (–14.9% vs. –4.9%; P < .001) and 12 months (–9.8% vs. –1.5%; P < .001).
Weight loss from initial weight 12 months after protein-sparing modified fast was lower in participants with higher baseline BMI, whereas participants with lower baseline BMI had greater weight loss (P = .035).
“A ketogenic, very low-calorie meal plan as provided by [protein-sparing modified fast] resulted in significantly greater short-term weight loss compared to a conventional, low-calorie mean plan,” the researchers wrote. “Weight regain was common following the [protein-sparing modified fast] intervention, and long-term weight outcomes on average were similar by 1 year following end of intervention. This result is in line with several other studies that have studied weight loss with very low-calorie meal plans compared to conventional, low-calorie meal plans.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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