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Abstract
Although it is generally agreed that both ketogenic and nonketogenic very low calorie
diets promote weight reduction, there is no consensus on a preference of one diet
over the other in regard to protein sparing. In the present study, we compared the
effects of isocaloric (600 kcal/d) and isonitrogenous (8 g nitrogen/d) ketogenic (low
carbohydrate) and nonketogenic diets on parameters of protein and amino acid metabolism,
in 16 morbidly obese women maintained on these diets for 4 weeks while confined to
a metabolic ward. Cumulative urinary nitrogen excretion (g/4 wk) was significantly
(P < .01) greater (248 ± 6 v 207 ± 12, mean ± SEM, n = 8), and cumulative nitrogen balance significantly (P < .02) more negative (−50.4 ± 4.4 v −18.8 ± 5.7), during treatment with the ketogenic than with the nonketogenic diet.
Plasma leucine concentration (μmol/L) was significantly higher (P < .05) during treatment with the ketogenic than with the nonketogenic diet at day
14 (210 ± 17 v 150 ± 8), but not at day 28 (174 ± 9 v 148 ±8). Whole-body rates of leucine oxidation (mmol/h) were significantly higher
(P < .05) during treatment with the ketogenic than with the nonketogenic diet at day
14 (1.29 ± 0.20 v 0.92 ±0.10) and at day 28 (1.00 ± 0.16 v 0.75 ± 0.10). Conversely, proteolysis, as measured by leucine turnover rate and urinary
excretion of 3-methylhistidine, was not significantly different between the diets.
We conclude that there is greater protein sparing by the nonketogenic than by the
ketogenic very low calorie diet, and the mechanism appears to be greater protein synthesis.
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Article info
Footnotes
☆Supported by Grants No. DK 39157, DK 15855, and 5M01RR00056 from the National Institutes of Health.
☆☆Presented at the 1990 Annual Meeting of the American Federation for Clinical Research (Clin Res 138:257A, 1990).
Identification
Copyright
© 1992 Published by Elsevier Inc.
