, Volume 54, Issue 3, pp 681–690 | Cite as

Obesity treatment by very low-calorie-ketogenic diet at two years: reduction in visceral fat and on the burden of disease

  • Basilio Moreno
  • Ana B Crujeiras
  • Diego Bellido
  • Ignacio Sajoux
  • Felipe F CasanuevaEmail author
Original Article


The long-term effect of therapeutic diets in obesity treatment is a challenge at present. The current study aimed to evaluate the long-term effect of a very low-calorie-ketogenic (VLCK) diet on excess adiposity. Especial focus was set on visceral fat mass, and the impact on the individual burden of disease. A group of obese patients (n = 45) were randomly allocated in two groups: either the very low-calorie-ketogenic diet group (n = 22), or a standard low-calorie diet group; (n = 23). Both groups received external support. Adiposity parameters and the cumulative number of months of successful weight loss (5 or 10 %) over a 24-month period were quantified. The very low-calorie-ketogenic diet induced less than 2 months of mild ketosis and significant effects on body weight at 6, 12, and 24 months. At 24 months, a trend to regress to baseline levels was observed; however, the very low-calorie-ketogenic diet induced a greater reduction in body weight (−12.5 kg), waist circumference (−11.6 cm), and body fat mass (−8.8 kg) than the low-calorie diet (−4.4 kg, −4.1 cm, and −3.8 kg, respectively; p < 0.001). Interestingly, a selective reduction in visceral fat measured by a specific software of dual-energy x-ray absorptiometry (DEXA)-scan (−600 g vs. −202 g; p < 0.001) was observed. Moreover, the very low-calorie-ketogenic diet group experienced a reduction in the individual burden of obesity because reduction in disease duration. Very low-calorie-ketogenic diet patients were 500 months with 5 % weight lost vs. the low-calorie diet group (350 months; p < 0.001). In conclusion, a very low-calorie-ketogenic diet was effective 24 months later, with a decrease in visceral adipose tissue and a reduction in the individual burden of disease.


Waist Circumference Lean Mass Visceral Adipose Tissue Soft Tissue Mass Ketogenic Diet 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We acknowledge the Pronokal Division of Protein Supplies SL Spain for providing free of charge the diet of the ketosis group.

Compliance with ethical standards

Conflict of interest

BM, ABC, DB, AG, and FFC received advisory board fees and or research grants from Pronokal Protein Supplies Spain.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Basilio Moreno
    • 1
  • Ana B Crujeiras
    • 2
    • 3
  • Diego Bellido
    • 4
  • Ignacio Sajoux
    • 5
  • Felipe F Casanueva
    • 3
    • 6
    Email author
  1. 1.Division of Endocrinology and NutritionHospital G Universitario Gregorio MarañonMadridSpain
  2. 2.Laboratory of Molecular and Cellular Endocrinology, Instituto de Investigación Sanitaria (IDIS)Complejo Hospitalario Universitario de Santiago (CHUS), Santiago de Compostela University (USC)Santiago de CompostelaSpain
  3. 3.CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERobn)Santiago de CompostelaSpain
  4. 4.Division of EndocrinologyComplejo Hospitalario Universitario de Ferrol and Coruña UniversityFerrolSpain
  5. 5.Medical Department Pronokal, Protein Supplies SLBarcelonaSpain
  6. 6.Division of Endocrinology, Department of MedicineComplejo Hospitalario Universitario de Santiago (CHUS), Santiago de Compostela UniversitySantiago de CompostelaSpain

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