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OBJECTIVE: Very low-calorie di-ets (VLCDs,< 800 kcal day-1) and Ketogenic diet (KD) are generally used as part of integrated intervention, medical monitoring and a program of lifestyle modification, to improve a multitude of clinical states. The effect of three different very low calories KD (VLCKD), with (VLCKD1) or without (VLCKD2, 3) synthetic amino acid replacement of the 50% protein intake, were analyzed after weight loss.

PATIENTS AND METHODS: The clinical study used a cross-over randomized double-blind placebo-controlled trial. Obese subjects, who were eligible for the study, were randomly (R) divided into three groups: one intervention group (IG) and two control groups (CG1 and CG2). We comprehensively analyzed body composition, serum metabolites, superoxide dismutase (SOD1), nuclear factor kappa-light-chain-enhancer of activated B cells (NfKB), Chemokine (CC Motif) Ligand 2 (CCL2) gene expression. RESULTS: After VLDKDs a significant decreased in BMI was observed. TBF (kg) significantly decrease after VLCKD1 and VLCKD3. After VLCKD2, a reduction of waist circumference (p= 0.02), FM L2-L5 (p< 0.05) was observed. After VLCKD1 reduction of IMAT (p= 0.00), LDL-C (p= 0.00) and HDL-C (p= 0.00) were observed. No significant changes of GH, ESR, and fibrinogen were highlighted. CRP (p= 0.02) reduced significantly after VLCKD3. Significant modulation of SOD1 expression (p= 0.009), CRP and decrease of glucose levels (p= 0.03) were obtained after VLCKD3.