Very low-calorie ketogenic diet (VLCKD): an antihypertensive nutritional approach

BackgroundObesity is accompanied by hormonal, inflammatory and endothelial alterations. These alterations induce a stimulation of several other mechanisms that contribute to the hypertensive state and to increase the cardiovascular morbidity. This pilot, open - label, single- center, prospective clinical trial aimed to evaluate the effect of very low- calorie ketogenic diet (VLCKD) on blood pressure (BP) in women with of obesity and hypertension.MethodsA total of 137 women, who met the inclusion criteria and accepted to adhere to VLCKD, were consecutively enrolled. Assessment of anthropometric parameters (weight, height, and waist circumference), body composition (through bioelectrical impedance analysis), systolic (SBP) and diastolic blood pressure (DBP) and blood sample collection were carried out at baseline and after 45 days of the active phase of VLCKD.ResultsAfter VLCKD all the women experienced a significant reduction in body weight and an overall improvement of body composition parameters. In addition, high sensitivity C reactive protein (hs- CRP) levels were significantly diminished (p < 0.001), while phase angle (PhA) increased by almost 9% (p < 0.001). Interestingly, both SBP and DBP were significantly improved (-12.89% and - 10.77%, respectively; p < 0.001). At baseline, SBP and DBP showed statistically significant correlations with body mass index (BMI), waist circumference, hs-CRP levels, PhA, total body water (TBW), extracellular water (ECW), Na / K ratio, and fat mass. Even after VLCKD, all correlations among SBP and DBP with the study variables were statistically significant, except for the association between DBP and Na / K ratio. Changes (%) in both SBP and DBP were associated with increment BMI%, increment PhA% and increment hs- CRP levels (p < 0.001). In addition, only increment SBP% was associated with increment waist circumference (p = 0.017), increment TBW (p = 0.017), and increment fat mass (p < 0.001); while only increment DBP% was associated with increment ECW (p = 0.018), and increment Na / K ratio (p = 0.048). After adjusting for increment BMI, increment WC, increment PhA, increment TBW, and increment fat mass, the correlation between changes in increment SBP and increment hs -CRP levels remained statistically significant (p < 0.001). Similarly, the correlation between increment DBP and increment hs- CRP levels also remained statistically significant after adjustment for increment BMI, increment PhA, increment Na / K ratio, and increment ECW (p < 0.001). From multiple regression analysis increment hs- CRP levels seemed to be the main predictor of changes of BP (p < 0.001).ConclusionVLCKD reduces BP in women with of obesity and hypertension in a safely manner.

Automated summary

Very low-calorie ketogenic diet (VLCKD) significantly reduces blood pressure and improves body weight and composition in women with obesity and hypertension.