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Controlled Clinical Trial
. 2018 Sep 21;10(10):1348.
doi: 10.3390/nu10101348.

Effect of A Very Low-Calorie Ketogenic Diet on Food and Alcohol Cravings, Physical and Sexual Activity, Sleep Disturbances, and Quality of Life in Obese Patients

Ana I Castro  1   2 , Diego Gomez-Arbelaez  3   4 , Ana B Crujeiras  5   6 , Roser Granero  7   8 , Zaida Aguera  9   10 , Susana Jimenez-Murcia  11   12 , Ignacio Sajoux  13 , Patricio Lopez-Jaramillo  14 , Fernando Fernandez-Aranda  15   16 , Felipe F Casanueva  17   18
Affiliations
Controlled Clinical Trial

Effect of A Very Low-Calorie Ketogenic Diet on Food and Alcohol Cravings, Physical and Sexual Activity, Sleep Disturbances, and Quality of Life in Obese Patients

Ana I Castro et al. Nutrients. .

Abstract

Psychological well-being and hunger and food control are two relevant factors involved in the success of weight-loss therapy in treating obesity. Thus, this study aims to evaluate food and alcohol cravings, physical and sexual activity, sleep, and life quality (QoL) in obese patients following a very low-calorie ketogenic (VLCK) diet, as well as the role of weight lost and ketosis on these parameters. A battery of psychological test was performed in twenty obese patients (12 females, 47.2 ± 10.2 year and BMI of 35.5 ± 4.4) through the course of a 4-month VLCK diet on four subsequent visits: baseline, maximum ketosis, reduced ketosis, and endpoint. Each subject acted as their own control. Relevantly, the dietary-induced changes in body composition (7.7 units of BMI lost, 18 kg of fat mass (1.2 kg of visceral fat mass)) were associated with a statistically significant improvement in food craving scores, physical activity, sleepiness, and female sexual function. Overall, these results also translated in a notable enhancement in QoL of the treated obese patients. Therefore, the rapid and sustained weight and fat mass (FM) loss induced by the VLCK diet is associated with good food control and improvements in the psychological well-being parameters in obese subjects, which could contribute to the long-term success of this therapy.

Keywords: PNK method; QoL; food addition; ketogenic diet; obesity; protein diet; sexual function; sleep quality; very low-energy diet.

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Conflict of interest statement

A.B.C. and F.F.C. received advisory board fees and or research grants from Pronokal Protein Supplies Spain. I.S. is Medical Director of Pronokal Spain SL. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

Figures

Figure 1
Figure 1
Ketone bodies and body composition changes during the very low-calorie-ketogenic diet treatment. Data represent mean ± standard error of changes from baseline. (*) Denotes statistically significant differences as compared with baseline. (△) Denotes differences from baseline. β-OHB, β-Hydroxy-Butyrate.
Figure 2
Figure 2
Changes in food craving during the very low-calorie-ketogenic diet treatment. (A) Food craving trait and state. (B) Food craving inventory. Data represent mean ± standard error of changes from baseline. (ƚ) Denotes statistically significant differences through the intervention (p for trend < 0.05) evaluated by means of repeated-measures ANOVA. (*) Denotes statistically significant differences (p < 0.05) from baseline after post-hoc pairwise comparisons employing the Tukey’s adjustment for multiple comparisons.
Figure 3
Figure 3
Effect of the nutritional intervention with a very low-calorie-ketogenic diet on physical activity pattern (A) and sleep disturbances (B). Data represent mean ± standard error of changes from baseline. (ƚ) Denotes statistically significant differences through the intervention (p for trend < 0.05) evaluated by means of repeated-measures ANOVA. (*) Denotes statistically significant differences (p < 0.05) from baseline after post-hoc pairwise comparisons employing the Tukey’s adjustment for multiple comparisons. IPQA, International Physical Activity Questionnaire.
Figure 4
Figure 4
Effect of the nutritional intervention on sexual activity in men (A) and women (B). Data represent mean ± standard error of changes from baseline. (ƚ) Denotes statistically significant differences through the intervention (p for trend < 0.05) evaluated by means of repeated-measures ANOVA. (*) Denotes statistically significant differences (p < 0.05) from baseline after post-hoc pairwise comparisons employing the Tukey’s adjustment for multiple comparisons.
Figure 5
Figure 5
Changes in the impact of weight on quality of life-lite (IWQOL-Lite). Raw scores (higher scores indicate poorer quality of life on the IWQOL-Lite) were converted into a T-score (0–100), with 100 representing best possible health. Mean ± standard error of changes from baseline are reported for total score. (ƚ) Denotes statistically significant differences through the intervention (p for trend < 0.05) evaluated by means of repeated-measures ANOVA. (*) Denotes statistically significant differences (p < 0.05) from baseline after post-hoc pairwise comparisons employing the Tukey’s adjustment for multiple comparisons.
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