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Very Low-Carbohydrate Ketogenic Diet Before Bariatric Surgery: Prospective Evaluation of a Sequential Diet

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Abstract

Background

We evaluated the effectiveness of a sequential diet regimen termed the obese preoperative diet (OPOD) in morbidly obese patients with and without type 2 diabetes mellitus (T2DM) scheduled for laparoscopic bariatric surgery.

Methods

Fifty patients (body mass index 53.5 ± 8.4 kg/m2) scheduled for bariatric surgery, including 14 with T2DM, were prospectively enrolled and followed the OPOD regimen: a very low-calorie ketogenic diet for 10 days, followed by a very low-calorie diet for 10 days, and then a low-calorie diet for 10 days. Patients were evaluated at baseline (T0) and after 10 days (T1), 20 days (T2), and 30 days (T3).

Results

Body weight, body mass index, waist circumference, and neck circumference were significantly lower at T1, T2, and T3 than at T0 in the 48 patients who completed the OPOD. Two patients discontinued the OPOD after 4–7 days. In patients with T2DM, fasting plasma glucose levels decreased significantly, enabling reduction of diabetic medications. Plasma and urine ketone levels increased at T1 but were all <1 mmol/L, and hunger decreased during the diet period.

Conclusions

OPOD, including 10 days of a VLCKD, was safe and effective in morbidly obese patients, and it seems to be promising in morbidly obese patients with and without T2DM scheduled for laparoscopic bariatric surgery.

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Conflict of Interest

The study received support by Nutri & Biotech which provided products and funded the editing of the manuscript. Frida Leonetti, Fabio Cesare Campanile, Federica Coccia, Danila Capoccia, Laura Alessandroni, Alessandro Puzziello, Ilenia Coluzzi, and Gianfranco Silecchia have no conflicts of interest or other financial ties to disclose.

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Authors and Affiliations

  1. Department of Experimental Medicine, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy

    Frida Leonetti, Federica Coccia, Danila Capoccia & Laura Alessandroni

  2. Division of General Surgery, Hospital Andosilla, ASL VT, Civita Castellana, VT, Italy

    Fabio Cesare Campanile

  3. Department of General Surgery, University Magna Graecia, Catanzaro, Italy

    Alessandro Puzziello

  4. Department of Medico-Surgical Sciences and Biotechnology, Division of General & Bariatric Surgery, ICOT, Sapienza University of Rome, Latina, Italy

    Ilenia Coluzzi & Gianfranco Silecchia

Authors
  1. Frida Leonetti
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  2. Fabio Cesare Campanile
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Correspondence to Fabio Cesare Campanile.

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Leonetti, F., Campanile, F.C., Coccia, F. et al. Very Low-Carbohydrate Ketogenic Diet Before Bariatric Surgery: Prospective Evaluation of a Sequential Diet. OBES SURG 25, 64–71 (2015). https://doi.org/10.1007/s11695-014-1348-1

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