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 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 ma…
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Our results are consistent with other adult ketogenic dietary studies that reported no bone mass loss in short-term or long-term follow-up of 2 and 5 years.
“Our results are consistent with other adult ketogenic dietary studies that reported no bone mass loss in short-term (66) or long-term follow-up of 2 (67, 82) and 5 (83) years.”
In obese individuals following a very low-calorie ketogenic diet for four months, weight loss was mainly at the expense of fat mass and visceral fat mass, while preserving lean mass.
“After four months, the ketogenic diet induced weight loss mainly at the expense of FM and visceral FM, while preserving LM [20].”
From Body Composition Changes in Weight Loss: Strategies and Supplementation for Maintaining Lean Body Mass, a Brief Review (2018) · cites this paper as [20]
Other low-carbohydrate interventions report visceral fat reduction as a component of weight loss.
“This is consistent with other low-carbohydrate interventions reporting visceral fat reduction as a component of weight loss (30, 56, 66–68).”
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Self-citation
- Authors
- Gomez-Arbelaez, D., Bellido, D., Castro, A. I., Ordoñez-Mayan, L., Carreira, J., Galban, C., Martinez-Olmos, M. A., Crujeiras, A. B., Sajoux, I., & Casanueva, F. F.
- Affiliations
- Division of Endocrinology, Department of Medicine, and
- Complejo Hospitalario Universitario de Ferrol (ES)
- Instituto de Salud Carlos III (ES)
- Family Medicine, Sanitary Area of Ferrol, 15405 Ferrol, Spain;
- Complejo Hospitalario Universitario de Santiago (ES)
- PronoKal Group (Spain) (ES)
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2016-10-18
- Volume
- 102
- Issue
- 2
- Pages
- 488-498
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2534798107
- Cited by
- 214
- References
- 45
- Citations by year
- 2026: 7 · 2025: 14 · 2024: 16 · 2023: 16 · 2022: 18 · 2021: 29 · 2020: 73 · 2019: 19 · 2018: 9 · 2017: 10 · 2016: 1
- FWCI
- 10.45
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Hispana (submittedVersion)
- Funders
- Xunta de Galicia
- Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición
- Instituto de Salud Carlos III
- European Regional Development Fund
- Topics
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Keywords
- very low-calorie ketogenic diet, obesity, body composition, fat loss, fat-free mass, visceral fat, muscle strength, dual-energy X-ray absorptiometry, air displacement plethysmography, total body water, weight loss
- MeSH terms
- Adipose Tissue, Adolescent, Adult, Aged, Anthropometry, Body Composition, Body Water, Humans, Ketosis, Middle Aged, Obesity, Plethysmography, Prospective Studies, Weight Loss, Absorptiometry, Photon, Electric Impedance, Caloric Restriction, Muscle Strength, Diet, Ketogenic, Young Adult
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