EFFECT OF A 2-MONTH VERY LOW-CALORIE KETOGENIC DIET (VLCKD) COMPARED TO A STANDARD LOW-CALORIE DIET (LCCD) ON DEEP SUPERFICIAL ADIPOSE TISSUE IN OBESE ADULTS: A RANDOMIZED, CONTROLLED TRIAL

Amro Ashmawy

Resumen:

AbstractBackground: Obesity represents a global health challenge requiring effective interventions targeting metabolically active adipose tissue compartments. Deep subcutaneous adipose tissue (dSAT) is closely associated with visceral adiposity and metabolic risk. Very low-calorie ketogenic diets (VLCKD) have shown promise for rapid weight loss and metabolic improvement, but their specific effects on adipose tissue compartments remain understudied.Objective: To compare the effects of a 2-month VLCKD versus a standard low-calorie diet (LCCD) on dSAT thickness measured by ultrasound in obese adults.Methods: This randomized, controlled trial enrolled 70 obese adults (BMI 30-40 kg/m²) who were randomly assigned to either VLCKD (n=35) or LCCD (n=35) for 8 weeks. The primary outcome was the change in dSAT thickness measured by ultrasound. Secondary outcomes included changes in superficial subcutaneous adipose tissue (sSAT), anthropometric measurements, and body composition. Safety and tolerability were assessed throughout the study.Results: After 2 months, the VLCKD group showed significantly greater reduction in dSAT thickness (-3.86 ± 1.24 mm) compared to the LCCD group (-2.88 ± 1.18 mm) (p < 0.05), representing a -20.8% versus -15.1% relative reduction. The VLCKD group also experienced superior fat loss efficiency (90.5% vs 75.9% of weight loss from fat mass, p < 0.001) and better preservation of lean body mass. Both interventions were well-tolerated with no serious adverse events.Conclusions: VLCKD is superior to a standard low-calorie diet in reducing deep subcutaneous adipose tissue and improving body composition in obese adults. These findings support the use of VLCKD as an effective intervention for targeting metabolically active adipose tissue compartments.