Very low-calorie ketogenic diet tied to greater BP reduction than intermittent fasting
Key takeaways:
- Women who adhered to a very low-calorie ketogenic diet had a decline in systolic and diastolic blood pressure at 6 months.
- Of the ketogenic diet group, 22.2% stopped using antihypertensive therapy at 6 months.
Women with hypertension who followed a very low-calorie ketogenic diet had greater reductions in systolic and diastolic blood pressure than those who engaged in intermittent fasting, researchers reported.
In an open-label trial, researchers randomly assigned women aged 50 to 65 years with a BMI of at least 25 kg/m2 and a diagnosis of essential uncomplicated arterial hypertension who were on antihypertensive therapy for at least 6 months to a very low-calorie ketogenic diet, participate in intermittent fasting or have no dietary restrictions for 6 months. In addition to having the largest reductions in BP of the three groups, women assigned a very low-calorie ketogenic diet had greater reductions in percentage of body weight and total body fat lost than the other two groups.
“Also, we firstly demonstrated that a very low-calorie ketogenic diet may promote a significant down-titration of antihypertensive drug therapies by reducing the number of BP-lowering medications compared to other dietary groups, thus highlighting the potential beneficial effects of a very low-calorie ketogenic diet in nonpharmacological management of hypertension in our study population,” Giuliano Tocci, MD, PhD, associate professor in the hypertension unit, division of cardiology, department of clinical and molecular medicine in the faculty of medicine and psychology at University of Rome Sapienza and Sant’Andrea Hospital in Italy, and colleagues wrote in Nutrition, Metabolism & Cardiovascular Diseases.
There were 43 women who completed the trial, with 18 women in the very low-calorie ketogenic diet group, 16 in the intermittent fasting group and nine in the group with no dietary restrictions (free diet group). Participants assigned a very low-calorie ketogenic diet were restricted to eating between 600 kcal and 800 kcal, less than 30 g carbohydrates, 1 g to 1.5 g protein per kilogram of body weight and 15 g to 30 g fat per day. The intermittent fasting group restricted participants to eating all meals in an 8-hour window between noon and 8 p.m. each day, with the food based on the Mediterranean diet. The free diet group was given nutritional advice but had no restrictions. BP and cardiometabolic measures were collected at baseline, 2 and 6 months.
Ketogenic diet significantly lowers BP
At 6 months, the ketogenic diet group had a lower brachial systolic BP (118 mm Hg) than the intermittent fasting group (128.25 mm Hg) and free diet group (137.33 mm Hg; P = .005). Brachial diastolic BP was also lower for the ketogenic diet group (73.16 mm Hg), than the intermittent fasting (83.5 mm Hg) and free diet groups (90.33 mm Hg) at 6 months (P = .002). A significantly lower central systolic and diastolic BP was also observed at 6 months with a very low-calorie ketogenic diet compared with intermittent fasting or a free diet.
The very low-calorie ketogenic diet group had significant reductions in both brachial and central systolic and diastolic BP from baseline to 6 months. Women participating in intermittent fasting had significant decreases in central systolic and diastolic BP from baseline to 6 months. No changes in BP were observed for the free diet group.
At 6 months, 22.2% of the very low-calorie ketogenic diet group stopped using antihypertensive drugs, 11.2% were using one medication and 33.3% were receiving dual or triple combination therapy. The mean number of antihypertensive drugs used for the ketogenic diet group declined from 1.72 at baseline to 1.22 at 6 months (P = .0007). Women assigned intermittent fasting or a free diet had no change in antihypertensive medication use.
Change in body fat, weight
Women assigned a very low-calorie ketogenic diet had an 8.62% decrease in body fat from baseline to 6 months vs. a 3.34% decline for women participating in intermittent fasting and an 0.26% decrease with a free diet (P < .0001). Total body weight loss was 12.66% with a very low-calorie ketogenic diet compared with a 5.58% total weight loss with intermittent fasting and 1.32% weight reduction with a free diet (P < .0001).
The study results show the importance of maintaining and adhering to a single diet, with the very low-calorie ketogenic diet conferring the most health benefits, the researchers wrote.
“Given the critical role of diet in managing and potentially preventing CVDs, further rigorous randomized controlled trials on broader populations are recommended to validate and expand on our findings,” the researchers wrote.
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