Effect of DHA supplementation in a very low-calorie ketogenic diet in the treatment of obesity: a randomized clinical trial

Weight loss after bariatric surgery decreases the earlier expansion of the adventitial vasa vasorum (VV), a biomarker of early atheromatous disease. However, no data are available regarding weight loss achieved by very low calorie ketogenic diets (VLCKD) on VV and lipid-based atherogenic indices. A randomized clinical trial was performed to examine changes in adventitial VV density in 20 patients with moderate obesity who underwent a 6-month very low calorie ketogenic diet (VLCKD, 600–800 kcal/day), and 10 participants with hypocaloric diet based on the Mediterranean Diet (MedDiet, estimated reduction of 500 kcal on the usual intake). Contrast-enhanced carotid ultrasound was used to assess the VV. Body composition analysis was also used. The atherogenic index of plasma (log (triglycerides to high-density lipoprotein cholesterol ratio)) and the triglyceride-glucose index were calculated. Serum concentrations of soluble intercellular adhesion molecule 1 (sICAM-1), and soluble vascular cell adhesion molecule 1 (sVCAM-1) were measured. The impact of weight on quality of life-lite (IWQOL-Lite) questionnaire was administered. Participants of intervention groups displayed a similar VV values. Significant improvements of BMI (−5.3 [−6.9 to −3.6] kg/m2, p < 0.001), total body fat (−7.0 [−10.7 to −3.3] %, p = 0.003), and IWQOL-Lite score (−41.4 [−75.2 to −7.6], p = 0.027) were observed in VLCKD group in comparison with MedDiet group. Although after a 6-months follow-up period VV density (mean, right and left sides) did not change significantly in any group, participants in the VLCKD exhibited a significantly decrease both in their atherogenic index of plasma and serum concentration of sICAM-1. A 6-month intervention with VLCKD do not impact in the density of the adventitial VV in subjects with moderate obesity, but induces significant changes in markers of endothelial dysfunction and CV risk.

Download Full-text

Comparison of a very low-calorie-ketogenic diet with a standard low-calorie diet in the treatment of obesity

Endocrine ◽

10.1007/s12020-014-0192-3 ◽

2014 ◽

Vol 47 (3) ◽

pp. 793-805 ◽

Cited By ~ 51

Author(s):

Basilio Moreno ◽

Diego Bellido ◽

Ignacio Sajoux ◽

Albert Goday ◽

Dolores Saavedra ◽

...

Keyword(s):

Ketogenic Diet ◽

Low Calorie ◽

Low Calorie Diet ◽

Calorie Diet ◽

Treatment Of Obesity

Download Full-text

An observational study of sequential protein-sparing, very low-calorie ketogenic diet (Oloproteic diet) and hypocaloric Mediterranean-like diet for the treatment of obesity

International Journal of Food Sciences and Nutrition ◽

10.1080/09637486.2016.1186157 ◽

2016 ◽

Vol 67 (6) ◽

pp. 696-706 ◽

Cited By ~ 7

Author(s):

Giuseppe Castaldo ◽

Luigi Monaco ◽

Laura Castaldo ◽

Giovanna Galdo ◽

Emanuele Cereda

Keyword(s):

Observational Study ◽

Ketogenic Diet ◽

Low Calorie ◽

Protein Sparing ◽

Treatment Of Obesity

Download Full-text

Treatment of Childhood Obesity Based on Brazilian Dietary Guidelines Plus Energy Restriction (PAPPAS HUPE Study): Protocol for a Randomized Clinical Trial

JMIR Research Protocols ◽

10.2196/16170 ◽

2020 ◽

Vol 9 (6) ◽

pp. e16170

Author(s):

Joana Maia Brandao ◽

Rosely Sichieri ◽

Simone Augusta Ribas ◽

Eliseu Verly-Jr ◽

Rosangela Alves Pereira ◽

...

Keyword(s):

Clinical Trial ◽

Childhood Obesity ◽

Randomized Clinical Trial ◽

Sugar Content ◽

Intervention Group ◽

Dietary Guidelines ◽

University Hospital ◽

National Council ◽

Educational Activities ◽

Treatment Of Obesity

Background The Food Guide for the Brazilian Population relies on natural or minimally processed foods mainly of plant origin such as beans and rice with low oil, salt, and sugar content and limited consumption of ultraprocessed foods. Reduction of ultraprocessed foods improves diet quality and energy consumption. Objective The goal of this study is to evaluate the effectiveness of an intervention for the treatment of obesity in children, with counseling based on the Brazilian Food Guide plus control of total energy intake. Methods A parallel, randomized clinical trial will include children aged 7 to 12 years. Randomization will be performed in blocks of 10 individuals using computer-generated random sequence numbers. Both the control and intervention groups will participate in 6 standardized educational activities based on the 10 steps of the Brazilian Food Guide. These activities will be conducted at the University Hospital Toy Library, located in the pediatric outpatient clinic. For the intervention group, in addition to the educational activities, an individualized food plan based on the nutritional recommendations of the Brazilian Society of Pediatrics will be prescribed and discussed with the mothers and fathers. The primary outcome of the study will be variations in body mass index, and secondary outcomes will include analysis of insulin resistance, blood pressure, body fat percentage, and waist and neck circumference. Results This project was funded by the National Council for Scientific and Technological Development in December 2017 (grant no 408333/2017-0). Recruitment began in August 2018 and by September 2019, we had enrolled the 101 participants. In addition to the patients referred by the national system of regulation, recruitment was made by medical outpatient referral and external indication. This is an ongoing study. We expect the results to be published in November 2020. Conclusions At the end of the project, in case of a positive result, a protocol for the treatment of obesity based on the Brazilian Food Guide will be proposed to the Unified Health System. A successful method to reduce childhood obesity is expected. Trial Registration Brazilian Registry of Clinical Trials RBR-3st5sn; http://www.ensaiosclinicos.gov.br/rg/RBR-3st5sn International Registered Report Identifier (IRRID) DERR1-10.2196/16170

Download Full-text

Treatment of Childhood Obesity Based on Brazilian Dietary Guidelines Plus Energy Restriction (PAPPAS HUPE Study): Protocol for a Randomized Clinical Trial (Preprint)

10.2196/preprints.16170 ◽

2019 ◽

Author(s):

Joana Maia Brandao ◽

Rosely Sichieri ◽

Simone Augusta Ribas ◽

Eliseu Verly-Jr ◽

Rosangela Alves Pereira ◽

...

Keyword(s):

Clinical Trial ◽

Childhood Obesity ◽

Randomized Clinical Trial ◽

Sugar Content ◽

Intervention Group ◽

Dietary Guidelines ◽

University Hospital ◽

National Council ◽

Educational Activities ◽

Treatment Of Obesity

BACKGROUND The Food Guide for the Brazilian Population relies on natural or minimally processed foods mainly of plant origin such as beans and rice with low oil, salt, and sugar content and limited consumption of ultraprocessed foods. Reduction of ultraprocessed foods improves diet quality and energy consumption. OBJECTIVE The goal of this study is to evaluate the effectiveness of an intervention for the treatment of obesity in children, with counseling based on the Brazilian Food Guide plus control of total energy intake. METHODS A parallel, randomized clinical trial will include children aged 7 to 12 years. Randomization will be performed in blocks of 10 individuals using computer-generated random sequence numbers. Both the control and intervention groups will participate in 6 standardized educational activities based on the 10 steps of the Brazilian Food Guide. These activities will be conducted at the University Hospital Toy Library, located in the pediatric outpatient clinic. For the intervention group, in addition to the educational activities, an individualized food plan based on the nutritional recommendations of the Brazilian Society of Pediatrics will be prescribed and discussed with the mothers and fathers. The primary outcome of the study will be variations in body mass index, and secondary outcomes will include analysis of insulin resistance, blood pressure, body fat percentage, and waist and neck circumference. RESULTS This project was funded by the National Council for Scientific and Technological Development in December 2017 (grant no 408333/2017-0). Recruitment began in August 2018 and by September 2019, we had enrolled the 101 participants. In addition to the patients referred by the national system of regulation, recruitment was made by medical outpatient referral and external indication. This is an ongoing study. We expect the results to be published in November 2020. CONCLUSIONS At the end of the project, in case of a positive result, a protocol for the treatment of obesity based on the Brazilian Food Guide will be proposed to the Unified Health System. A successful method to reduce childhood obesity is expected. CLINICALTRIAL Brazilian Registry of Clinical Trials RBR-3st5sn; http://www.ensaiosclinicos.gov.br/rg/RBR-3st5sn INTERNATIONAL REGISTERED REPORT DERR1-10.2196/16170

Download Full-text

Evaluation of the Scopinaro Modified Technique in the Surgical Treatment of Obesity Compared to the Classic Scopinaro Surgery – Results after an 18-Month Randomized Clinical Trial

International Journal of Nutrology ◽

10.1055/s-0039-3402030 ◽

2019 ◽

Vol 12 (02) ◽

pp. 071-080

Author(s):

Paulo Reis Esselin de Melo ◽

Thonya Cruz Braga ◽

Neusa Dias de Moura ◽

João Carlos Gonçalves Junior ◽

Marcos Vinicius Macedo de Oliveira ◽

...

Keyword(s):

Clinical Trial ◽

Body Mass Index ◽

Surgical Treatment ◽

Randomized Clinical Trial ◽

Body Mass ◽

Modified Technique ◽

Treatment Of Obesity ◽

Surgical Treatment Of Obesity

Resumo Objetivo Avaliar se a cirurgia de Scopinaro modificada é tão eficaz e segura quanto a cirurgia de Scopinaro clássica para reduzir o excesso de peso, controlar as comorbidades, e avaliar o surgimento de intercorrências clínicas e nutricionais, caso elas ocorram. Métodos O estudo teve 28 participantes obesos, que foram randomizados para a realização de um dos procedimentos cirúrgicos, e acompanhados por uma equipe multiprofissional em saúde para avaliar o impacto das cirurgias no tratamento da obesidade. Foram observadas as seguintes variáveis: comorbidades, e intercorrências clínicas e nutricionais. O protocolo de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa das Faculdades Integradas Pitágoras de Montes Claros (CAAE 26919414.9.0000.5109). Todos os participantes da pesquisa assinaram o termo de consentimento livre e esclarecido. Resultados A média do índice de massa corporal (IMC) pré-cirurgia do grupo Scopinaro clássica e do grupo Scopinaro modificada foi de, respectivamente, 46,89 kg/m2 e 43,22 kg/m2. Após 540 dias da realização das cirurgias, esses valores foram reduzidos para 32,16 kg/m2 e 28,79 kg/m2. A avaliação da porcentagem de IMC perdido (percentage of excess body mass index lost, %EBL, em inglês) no período comprovou o sucesso cirúrgico, com valores de 67,33% para a cirurgia de Scopinaro clássica, e de 80,37% para a cirurgia de Scopinaro modificada. Ocorreu controle das comorbidades, bem como melhora geral do quadro laboratorial para a maioria dos participantes submetidos a quaisquer das duas técnicas. Flatulência e diarreia constituíram as intercorrências clínicas predominantemente encontradas em ambos procedimentos. Conclusão A cirurgia de Scopinaro modificada mostrou-se tão eficaz e segura quanto a cirurgia de Scopinaro clássica na redução de peso e controle das comorbidades, apresentando ainda a possibilidade de acesso endoscópio a todo o estômago e duodeno, reversibilidade cirúrgica, e conversão em outro procedimento cirúrgico.

Download Full-text