AUTHOR=Ernesti Ilaria , Baratta Francesco , Watanabe Mikiko , Risi Renata , Camajani Elisabetta , Persichetti Agnese , Tuccinardi Dario , Mariani Stefania , Lubrano Carla , Genco Alfredo , Spera Giovanni , Gnessi Lucio , Basciani Sabrina 

TITLE=Predictors of weight loss in patients with obesity treated with a Very Low-Calorie Ketogenic Diet

JOURNAL=Frontiers in Nutrition

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2023.1058364

DOI=10.3389/fnut.2023.1058364

ISSN=2296-861X

ABSTRACT=The Very Low-Calorie Ketogenic Diet (VLCKD) has emerged as a safe and effective intervention for the management of metabolic disease. Studies examining weight loss predictors are scarce and none has investigated such factors upon VLCKD treatment. Among the molecules involved in energy homeostasis and, more specifically, in metabolic changes induced by ketogenic diets, Fibroblast Growth Factor 21 (FGF21) is a hepatokine with physiology that is still unclear. We evaluated the impact of a VLCKD on weight loss and metabolic parameters and assessed weight loss predictors, including FGF21. We treated 34 patients with obesity with a VLCKD for 45 days. Anthropometric parameters, body composition, and blood and urine chemistry were measured before and after treatment. We found a significant improvement in body weight and composi-tion and most metabolic parameters. Circulating FGF21 decreased significantly after the VLCKD (194.0[137.6–284.6] to 167.8[90.9 –281.5] p<0.001) and greater weight loss was predicted by lower baseline FGF21(Beta=-0.410; p=0.012), male sex (Beta=0.472; p=0.011), and central obesity (Be-ta=0.481; p=0.005). In conclusion, the VLCKD is a safe and effective treatment for obesity and obesity related metabolic derangements. Men with central obesity and lower circulating FGF21 may benefit more than others in terms of weight loss obtained following this diet. Further stud-ies investigating whether this is specific to this diet or to any caloric restriction are warranted.