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Obesity Surgery
Published in: Obesity Surgery 4/2021

Open Access 01-04-2021 | Obesity | Original Contributions

A Randomized, Controlled Trial Comparing the Impact of a Low-Calorie Ketogenic vs a Standard Low-Calorie Diet on Fat-Free Mass in Patients Receiving an Elipse™ Intragastric Balloon Treatment

Authors: Luigi Schiavo, Giovanni De Stefano, Francesco Persico, Stefano Gargiulo, Federica Di Spirito, Giulia Griguolo, Niccolò Petrucciani, Eric Fontas, Antonio Iannelli, Vincenzo Pilone

Published in: Obesity Surgery | Issue 4/2021

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Abstract

Background

The Elipse™ intragastric balloon (EIGB) is a new swallowable balloon for weight loss (WL). Preserving metabolically active fat-free mass (FFM) and resting metabolic rate (RMR) during WL are crucial to maximize fat mass (FM) loss. After EIGB placement, a standard low-calorie diet (LCD) is generally prescribed. A low-calorie ketogenic diet (LCKD) has proven to be safe and effective in reducing FM while preserving FFM and RMR.

Objective

To prospectively compare the effects on WL, FM, FFM, and RMR in two groups of patients who were randomized to two different diets: LCKD and a standard LCD after EIGB placement.

Methods

WL, FM, FFM, and RMR were measured before EIGB and at 4 months in 48 patients who received either a LCKD (n = 24) or a standard LCD (n = 24). Compliance in following the prescribed diet was determined with food frequency questionnaires in all patients. The impact of LCKD and LCD on renal function was also evaluated.

Results

The LCKD group showed a significantly lower decrease in FFM and RMR when compared with the LCD group (3.55 vs 14.3%, p < 0.001; 9.79 vs 11.4%, p < 0.001, respectively). FM decreased more significantly with LCKD compared to LCD (41.6 vs 33.1%, p = 0.0606). Compliance in following the prescribed diets, without negative impact on renal function, was found.

Conclusion

Based on our findings, despite the small sample size, we were able to support the hypothesis that LCKD is associated with an increased FM loss while reducing the FFM loss and the RMR, without interfering with renal function after EIGB.
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Metadata
Title
A Randomized, Controlled Trial Comparing the Impact of a Low-Calorie Ketogenic vs a Standard Low-Calorie Diet on Fat-Free Mass in Patients Receiving an Elipse™ Intragastric Balloon Treatment
Authors
Luigi Schiavo
Giovanni De Stefano
Francesco Persico
Stefano Gargiulo
Federica Di Spirito
Giulia Griguolo
Niccolò Petrucciani
Eric Fontas
Antonio Iannelli
Vincenzo Pilone
Publication date
01-04-2021
Publisher
Springer US
Keywords
Obesity
Obesity
Published in
Obesity Surgery / Issue 4/2021
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-05133-8

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