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Published in: Reviews in Endocrine and Metabolic Disorders 1/2020

01-03-2020 | Confusion

Confusion in the nomenclature of ketogenic diets blurs evidence

Authors: Pierpaolo Trimboli, Marco Castellana, Diego Bellido, Felipe F. Casanueva

Published in: Reviews in Endocrine and Metabolic Disorders | Issue 1/2020

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Abstract

Ketogenic diets have been proposed as a non-pharmacological strategy for the management of several chronic conditions. Their efficacy and safety have been evaluated in the field of neurology, oncology and endocrinology for disorders including cancer, dementia, drug-resistant epilepsy, migraines, obesity, polycystic ovary syndrome and type 2 diabetes mellitus. The nutritional requirements of these subjects are expected to differ significantly. Indeed, although all ketogenic diets restrict carbohydrates, each intervention is characterized by a specific daily calorie intake, macronutrient composition and duration. However, the adopted nomenclature was often unclear to the general reader; also, the same abbreviations for different protocols were used. This possibly resulted in mistakes in the interpretation of the available evidence and limited the impact of studies on the topic in the clinical practice. Adopting a clear and consistent vocabulary is key in any context. Here, we present a practical and clinically-based proposal for the classification and abbreviation of ketogenic diets.
Literature
1.
go back to reference Thomas DD, Istfan NW, Bistrian BR, Apovian CM. Protein sparing therapies in acute illness and obesity: a review of George Blackburn's contributions to nutrition science. Metabolism. 2018;79:83–96.CrossRef Thomas DD, Istfan NW, Bistrian BR, Apovian CM. Protein sparing therapies in acute illness and obesity: a review of George Blackburn's contributions to nutrition science. Metabolism. 2018;79:83–96.CrossRef
2.
go back to reference Ludwing DS. The ketogenic diet: evidence for optimism but high-quality research needed. J Nutr. Ludwing DS. The ketogenic diet: evidence for optimism but high-quality research needed. J Nutr.
3.
go back to reference Caprio M, Infante M, Moriconi E, Armani A, Fabbri A, Mantovani G, et al. Cardiovascular Endocrinology Club of the Italian Society of Endocrinology. Very-low-calorie ketogenic diet (VLCKD) in the management of metabolic diseases: systematic review and consensus statement from the Italian Society of Endocrinology (SIE). J Endocrinol Invest. 2019;42(11):1365–86.CrossRef Caprio M, Infante M, Moriconi E, Armani A, Fabbri A, Mantovani G, et al. Cardiovascular Endocrinology Club of the Italian Society of Endocrinology. Very-low-calorie ketogenic diet (VLCKD) in the management of metabolic diseases: systematic review and consensus statement from the Italian Society of Endocrinology (SIE). J Endocrinol Invest. 2019;42(11):1365–86.CrossRef
5.
go back to reference Stubbs BJ, Newman JC. Ketogenic diet and adipose tissue inflammation – a simple story? Fat chance! Nature Metabolism. 2020;2:3–4.CrossRef Stubbs BJ, Newman JC. Ketogenic diet and adipose tissue inflammation – a simple story? Fat chance! Nature Metabolism. 2020;2:3–4.CrossRef
6.
go back to reference Hussain TA, Mathew TC, Dashti AA, Asfar S, Al-Zaid N, Dashti HM. Effect of low-calorie versus low-carbohydrate ketogenic diet in type 2 diabetes. Nutrition. 2012;10:1016–21.CrossRef Hussain TA, Mathew TC, Dashti AA, Asfar S, Al-Zaid N, Dashti HM. Effect of low-calorie versus low-carbohydrate ketogenic diet in type 2 diabetes. Nutrition. 2012;10:1016–21.CrossRef
7.
go back to reference Schiavo L, Pilone V, Rossetti G, Barbarisi A, Cesaretti M, Iannelli A. A 4-week preoperative ketogenic micronutrient-enriched diet is effective in reducing body weight, left hepatic lobe volume, and micronutrient deficiencies in patients undergoing bariatric surgery: a prospective pilot study. Obes Surg. 2018;28:2215–24.CrossRef Schiavo L, Pilone V, Rossetti G, Barbarisi A, Cesaretti M, Iannelli A. A 4-week preoperative ketogenic micronutrient-enriched diet is effective in reducing body weight, left hepatic lobe volume, and micronutrient deficiencies in patients undergoing bariatric surgery: a prospective pilot study. Obes Surg. 2018;28:2215–24.CrossRef
8.
go back to reference Castellana M, Conte E, Cignarelli A, Perrini S, Giustina A, Giovanella L, et al. Efficacy and safety of very low calorie ketogenic diet (VLCKD) in patients with overweight and obesity: a systematic review and meta-analysis [published ahead of print Nov 9, 2019]. Rev Endocr Metab Disord. 2019. https://doi.org/10.1007/s11154-019-09514-y. Castellana M, Conte E, Cignarelli A, Perrini S, Giustina A, Giovanella L, et al. Efficacy and safety of very low calorie ketogenic diet (VLCKD) in patients with overweight and obesity: a systematic review and meta-analysis [published ahead of print Nov 9, 2019]. Rev Endocr Metab Disord. 2019. https://​doi.​org/​10.​1007/​s11154-019-09514-y.
9.
go back to reference Bueno NB, de Melo IS, de Oliveira SL. A Rocha Ataide T. very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. Br J Nutr. 2013;110(7):1178–87.CrossRef Bueno NB, de Melo IS, de Oliveira SL. A Rocha Ataide T. very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. Br J Nutr. 2013;110(7):1178–87.CrossRef
10.
go back to reference Erickson N, Boscheri A, Linke B, Huebner J. Systematic review: isocaloric ketogenic dietary regimes for cancer patients. Med Oncol. 2017;34(5):72.CrossRef Erickson N, Boscheri A, Linke B, Huebner J. Systematic review: isocaloric ketogenic dietary regimes for cancer patients. Med Oncol. 2017;34(5):72.CrossRef
12.
go back to reference Ministrini S, Calzini L, Nulli Migliola E, Ricci MA, Roscini AR, Siepi D, et al. Lysosomal acid lipase as molecular target of the very low carbohydrate ketogenic diet in morbidly obese patients: the potential effects on liver steatosis and cardiovascular risk factors. J Clin Med 2019; 8(5) pii: E621. Ministrini S, Calzini L, Nulli Migliola E, Ricci MA, Roscini AR, Siepi D, et al. Lysosomal acid lipase as molecular target of the very low carbohydrate ketogenic diet in morbidly obese patients: the potential effects on liver steatosis and cardiovascular risk factors. J Clin Med 2019; 8(5) pii: E621.
13.
go back to reference Brinkworth GD, Noakes M, Buckley JD, Keogh JB, Clifton PM. Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo. Am J Clin Nutr. 2009;90(1):23–32.CrossRef Brinkworth GD, Noakes M, Buckley JD, Keogh JB, Clifton PM. Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo. Am J Clin Nutr. 2009;90(1):23–32.CrossRef
14.
go back to reference Hu FB. Calorie restriction in an obesogenic environment: reality or fiction? Lancet Diabetes Endocrinol. 2019;7(9):658–9.CrossRef Hu FB. Calorie restriction in an obesogenic environment: reality or fiction? Lancet Diabetes Endocrinol. 2019;7(9):658–9.CrossRef
15.
go back to reference Moreno B, Crujeiras AB, Bellido D, Sajoux I, Casanueva FF. Obesity treatment by very low-calorie-ketogenic diet at two years: reduction in visceral fat and on the burden of disease. Endocrine. 2016;54(3):681–90.CrossRef Moreno B, Crujeiras AB, Bellido D, Sajoux I, Casanueva FF. Obesity treatment by very low-calorie-ketogenic diet at two years: reduction in visceral fat and on the burden of disease. Endocrine. 2016;54(3):681–90.CrossRef
16.
go back to reference Bertoli S, Trentani C, Ferraris C, De Giorgis V, Veggiotti P, Tagliabue A. Long-term effects of a ketogenic diet on body composition and bone mineralization in GLUT-1 deficiency syndrome: a case series. Nutrition. 2014;30(6):726–8.CrossRef Bertoli S, Trentani C, Ferraris C, De Giorgis V, Veggiotti P, Tagliabue A. Long-term effects of a ketogenic diet on body composition and bone mineralization in GLUT-1 deficiency syndrome: a case series. Nutrition. 2014;30(6):726–8.CrossRef
18.
go back to reference Albanese A, Prevedello L, Markovich M, Busetto L, Vettor R, Foletto M. Pre-operative very low calorie ketogenic diet (VLCKD) vs. very low calorie diet (VLCD): surgical impact. Obes Surg. 2019;29(1):292–6.CrossRef Albanese A, Prevedello L, Markovich M, Busetto L, Vettor R, Foletto M. Pre-operative very low calorie ketogenic diet (VLCKD) vs. very low calorie diet (VLCD): surgical impact. Obes Surg. 2019;29(1):292–6.CrossRef
Metadata
Title
Confusion in the nomenclature of ketogenic diets blurs evidence
Authors
Pierpaolo Trimboli
Marco Castellana
Diego Bellido
Felipe F. Casanueva
Publication date
01-03-2020
Publisher
Springer US
Keyword
Confusion
Published in
Reviews in Endocrine and Metabolic Disorders / Issue 1/2020
Print ISSN: 1389-9155
Electronic ISSN: 1573-2606
DOI
https://doi.org/10.1007/s11154-020-09546-9

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