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Very-low-calorie ketogenic diet (VLCKD) in the management of metabolic diseases: systematic review and consensus statement from the Italian Society of Endocrinology (SIE)

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Abstract

Background

Weight loss is a milestone in the prevention of chronic diseases associated with high morbility and mortality in industrialized countries. Very-low calorie ketogenic diets (VLCKDs) are increasingly used in clinical practice for weight loss and management of obesity-related comorbidities. Despite evidence on the clinical benefits of VLCKDs is rapidly emerging, some concern still exists about their potential risks and their use in the long-term, due to paucity of clinical studies. Notably, there is an important lack of guidelines on this topic, and the use and implementation of VLCKDs occurs vastly in the absence of clear evidence-based indications.

Purpose

We describe here the biochemistry, benefits and risks of VLCKDs, and provide recommendations on the correct use of this therapeutic approach for weight loss and management of metabolic diseases at different stages of life.

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Acknowledgements

We would like to thank all the members of the Cardiovascular Endocrinology Club of the Italian Society of Endocrinology, for the scientific support during the writing of the manuscript. The Cardiovascular Endocrinology Club of the Italian Society of Endocrinology: Massimiliano Caprio (coordinator), Fausto Bogazzi (coordinator), Guglielmo Beccuti, Bernadette Biondi, Salvatore Cannavò, Iacopo Chiodini, Giuseppe De Feudis, Simona Di Francesco, Aldo Di Gregorio, Francesco Fallo, Carlo Foresta, Gilberta Giacchetti, Riccarda Granata, Andrea M. Isidori, Paolo Magni, Pasquale Maiellaro, Mirko Parasiliti Caprino, Rosario Pivonello, Riccardo Pofi, Alfredo Pontecorvi, Chiara Simeoli and all authors of the manuscript.

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MC. gave talks in symposia sponsored by Therascience, Eli Lilly, Novo Nordisk and New Penta, participated to advisory board for Therascience and Sanofi, and received research grants from Bayer AG; G.M. participated to advisory boards for Novartis and Shire and received honoraria for courses sponsored by Pfizer; S.B. gave talks in symposia sponsored by New Penta; L.C. and R.V. gave talks in symposia sponsored by Therascience; F.P. received grants by Difass International, Nutricia Research Foundation, and Probiotical; G.A. received honoraria from Astra Zeneca and Sanofi. All the other authors have nothing to disclose, related to this publication.

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Caprio, M., Infante, M., Moriconi, E. et al. 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 42, 1365–1386 (2019). https://doi.org/10.1007/s40618-019-01061-2

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