Background: The very low-calorie ketogenic diet (VLCKD) has been recently proposed as an appealing nutritional strategy for obesity management. The VLCKD is characterized by a low carbohydrate content (#x3c;50 g/day), 1–1.5 g of protein/kg of ideal body weight, 15–30 g of fat/day, and a daily intake of about 500–800 calories. Objectives: The aim of the current document is to suggest a common protocol for VLCKD and to summarize the existing literature on its efficacy in weight management and weight-related comorbidities, as well as the possible side effects. Methods: This document has been prepared in adherence with Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Literature searches, study selection, methodology development, and quality appraisal were performed independently by 2 authors and the data were collated by means of a meta-analysis and narrative synthesis. Results: Of the 645 articles retrieved, 15 studies met the inclusion criteria and were reviewed, revealing 4 main findings. First, the VLCKD was shown to result in a significant weight loss in the short, intermediate, and long terms and improvement in body composition parameters as well as glycemic and lipid profiles. Second, when compared with other weight loss interventions of the same duration, the VLCKD showed a major effect on reduction of body weight, fat mass, waist circumference, total cholesterol and triglyceridemia as well as improved insulin resistance. Third, although the VLCKD also resulted in a significant reduction of glycemia, HbA1c, and LDL cholesterol, these changes were similar to those obtained with other weight loss interventions. Finally, the VLCKD can be considered a safe nutritional approach under a health professional’s supervision since the most common side effects are usually clinically mild and easily to manage and recovery is often spontaneous. Conclusions: The VLCKD can be recommended as an effective dietary treatment for individuals with obesity after considering potential contra-indications and keeping in mind that any dietary treatment has to be personalized. Prospero Registry: The assessment of the efficacy of VLCKD on body weight, body composition, glycemic and lipid parameters in overweight and obese subjects: a meta-analysis (CRD42020205189).
Obes Facts

中文翻译：

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欧洲极低热量生酮饮食成人肥胖管理指南：系统回顾和荟萃分析

背景：极低热量生酮饮食（VLCKD）最近被提出作为肥胖管理的一种有吸引力的营养策略。VLCKD 的特点是碳水化合物含量低（#x3c；50 克/天），每公斤理想体重 1–1.5 克蛋白质，每天 15–30 克脂肪，每日摄入量约为 500–800卡路里。目标：本文件的目的是提出 VLCKD 的通用方案，并总结其在体重管理和体重相关合并症方面的功效以及可能的副作用的现有文献。方法：本文件是根据系统审查和荟萃分析首选报告项目 (PRISMA) 指南编写的。文献检索、研究选择、方法开发和质量评估由两位作者独立进行，并通过荟萃分析和叙述综合的方式整理数据。结果：在检索到的 645 篇文章中，有 15 篇研究符合纳入标准并经过审查，揭示了 4 个主要发现。首先，VLCKD 被证明可以在短期、中期和长期内显着减轻体重，并改善身体成分参数以及血糖和血脂状况。其次，与相同持续时间的其他减肥干预措施相比，VLCKD 对减轻体重、脂肪量、腰围、总胆固醇和甘油三酯血症以及改善胰岛素抵抗有显着效果。第三，虽然 VLCKD 还导致血糖、HbA1c 和 LDL 胆固醇显着降低，但这些变化与其他减肥干预措施所获得的变化相似。最后，VLCKD 可以被认为是在健康专业人员监督下的一种安全营养方法，因为最常见的副作用通常在临床上轻微且易于管理，并且通常可以自发恢复。结论：考虑到潜在的禁忌症并记住任何饮食治疗都必须个性化，VLCKD 可以被推荐作为肥胖个体的有效饮食治疗。Prospero 注册：评估 VLCKD 对超重和肥胖受试者体重、身体成分、血糖和血脂参数的疗效：荟萃分析 (CRD42020205189)。
肥胖事实