Body Composition Changes After Very-Low-Calorie Ketogenic Diet in Obesity Evaluated by 3 Standardized Methods

Abstract Context: Common concerns when using low-calorie diets as a treatment for obesity are the reduction in fat-free mass, mostly muscular mass, that occurs together with the fat mass (FM) loss, and determining the best methodologies to evaluate body composition changes. Objective: This study aim...

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Bibliographic Details
Published in:The journal of clinical endocrinology and metabolism 2017-02, Vol.102 (2), p.488-498
Main Authors: Gomez-Arbelaez, Diego, Bellido, Diego, Castro, Ana I., Ordoñez-Mayan, Lucia, Carreira, Jose, Galban, Cristobal, Martinez-Olmos, Miguel A., Crujeiras, Ana B., Sajoux, Ignacio, Casanueva, Felipe F.
Format: Article
Language:English
Subjects:
Absorptiometry, Photon - methods
Adenosine diphosphate
Adipose Tissue - pathology
Adolescent
Adult
Aged
Anthropometry - methods
Bioelectricity
Body composition
Body Composition - physiology
Body fat
Body water
Body Water - physiology
Body weight loss
Caloric Restriction
Diet
Diet, Ketogenic
Dual energy X-ray absorptiometry
Electric Impedance
Fat-free body mass
High fat diet
Humans
Hypocaloric diet
Ketogenesis
Ketosis
Ketosis - physiopathology
Low carbohydrate diet
Middle Aged
Muscle strength
Muscle Strength - physiology
Nutrient deficiency
Obesity
Obesity - diet therapy
Obesity - physiopathology
Patients
Plethysmography
Plethysmography - methods
Prospective Studies
Weight control
Weight loss
Weight Loss - physiology
Weight reduction
Young Adult
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Summary:Abstract Context: Common concerns when using low-calorie diets as a treatment for obesity are the reduction in fat-free mass, mostly muscular mass, that occurs together with the fat mass (FM) loss, and determining the best methodologies to evaluate body composition changes. Objective: This study aimed to evaluate the very-low-calorie ketogenic (VLCK) diet-induced changes in body composition of obese patients and to compare 3 different methodologies used to evaluate those changes. Design: Twenty obese patients followed a VLCK diet for 4 months. Body composition assessment was performed by dual-energy X-ray absorptiometry (DXA), multifrequency bioelectrical impedance (MF-BIA), and air displacement plethysmography (ADP) techniques. Muscular strength was also assessed. Measurements were performed at 4 points matched with the ketotic phases (basal, maximum ketosis, ketosis declining, and out of ketosis). Results: After 4 months the VLCK diet induced a −20.2 ± 4.5 kg weight loss, at expenses of reductions in fat mass (FM) of −16.5 ± 5.1 kg (DXA), −18.2 ± 5.8 kg (MF-BIA), and −17.7 ± 9.9 kg (ADP). A substantial decrease was also observed in the visceral FM. The mild but marked reduction in fat-free mass occurred at maximum ketosis, primarily as a result of changes in total body water, and was recovered thereafter. No changes in muscle strength were observed. A strong correlation was evidenced between the 3 methods of assessing body composition. Conclusion: The VLCK diet-induced weight loss was mainly at the expense of FM and visceral mass; muscle mass and strength were preserved. Of the 3 body composition techniques used, the MF-BIA method seems more convenient in the clinical setting. Very-low-calorie ketogenic diets in obesity induce a decrease in total and visceral fat mass and preserve fat-free mass and muscle strength, according to evaluation by DXA, MF-BIA, and ADP.
ISSN:0021-972X
1945-7197
DOI:10.1210/jc.2016-2385