Ketosis and appetite suppression

BACKGROUND

• Ketogenic diets can prevent the increase in appetite otherwise seen with diet-induced weight loss (WL).
• Due to the need for severe carbohydrate (CHO) restriction (<50 g/day), ketogenic diets require essential food groups, such as whole grains, dairy, fruit, and vegetables, to be eliminated or severely limited. This is of great concern as it might lead to nutritional inadequacy and increase the risk of developing certain types of cancer, bone, and cardiovascular diseases in the long term.

OBJECTIVES

• This trial aimed to identify the maximum carbohydrate (CHO) intake associated with no increase in appetite within a low energy diet (LED) in adults seeking weight loss. 
• A secondary aim was to evaluate the impact of WL, in and out of ketosis, on appetite markers.

IMPACT:

• Maximizing CHO intake (up to 13 0g/day) in LEDs can induce ketosis while preventing an increase in appetite feelings, allowing individuals seeking WL to eat more nutrient-rich foods.
• A more liberal incorporation of CHO-rich foods in LEDs should be considered in clinical practice for better alignment with nutritional guidelines for healthy eating, and reduction of common side effects of ketogenic diets, namely constipation, and bone loss.

PERIOD

2016-2020

CONTACT

Jessica Roekenes

DISSEMINATIONS

• Is severe carbohydrate restriction necessary for appetite suppression? The ASKED randomized controlled trial (Currently under review)
  
  
• Metabolic adaptation is an illusion, only present when participants are in negative energy balance 
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7657334/
  • Reply to Ravussin and Redman: https://pubmed.ncbi.nlm.nih.gov/33301007/

• Metabolic adaptation is associated with less weight and fat mass loss in response to low-energy diets https://pubmed.ncbi.nlm.nih.gov/34116675/

• Association between ketosis and metabolic adaptation at the level of resting metabolic rate https://pubmed.ncbi.nlm.nih.gov/34358822/
  
  
• Metabolic adaptation is associated with a greater increase in appetite following weight loss: a longitudinal study https://pubmed.ncbi.nlm.nih.gov/37863431/

• Association between b-hydroxybutyrate plasma concentrations after hypocaloric ketogenic diets and changes in body composition https://pubmed.ncbi.nlm.nih.gov/37182692/

• FUNDING
• Norwegian University of Science and Technology (NTNU) and the Liaison Committee for Education, Research, and Innovation in Central Norway in partnership with NTNU.

COLLABORATION

• Obesity Research Group, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
• Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
• School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Australia; ⁴ School of Human Sciences, The University of Western Australia, Crawley, Australia
• Section for Preventive Cardiology, Oslo University Hospital and Department of Nutrition, University of Oslo
• Department of Nutrition Sciences, The University of Alabama at Birmingham (UAB), Birmingham, USA.