Acute Insulin Secretory Effects of a Classic Ketogenic Meal in Healthy Subjects: A Randomized Cross-Over Study
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Published:2023-02-23
Issue:5
Volume:15
Page:1119
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ISSN:2072-6643
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Container-title:Nutrients
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language:en
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Short-container-title:Nutrients
Author:
Battezzati Alberto12, Foppiani Andrea1ORCID, Leone Alessandro1ORCID, De Amicis Ramona13ORCID, Spadafranca Angela1, Mari Andrea4, Bertoli Simona13ORCID
Affiliation:
1. ICANS-DIS, Department of Food Environmental and Nutritional Sciences, University of Milan, 20133 Milan, Italy 2. Clinical Nutrition Unit, Department of Endocrine and Metabolic Medicine, IRCCS Istituto Auxologico Italiano, 20100 Milan, Italy 3. Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, 20145 Milan, Italy 4. National Research Council (CNR), Institute of Neuroscience, 35127 Padua, Italy
Abstract
The classic ketogenic diet (KD) is a high-fat, low-carbohydrate diet that mimics a starvation state with sufficient caloric intake to sustain growth and development. KD is an established treatment for several diseases, and it is currently evaluated in the management of insulin-resistant states, although insulin secretion after a classic ketogenic meal has never been investigated. We measured the insulin secretion to a ketogenic meal in 12 healthy subjects (50% females, age range 19–31 years, BMI range 19.7–24.7 kg/m2) after cross-over administrations of a Mediterranean meal and a ketogenic meal both satisfying ~40% of an individual’s total energy requirement, in random order and separated by a 7-day washout period. Venous blood was sampled at baseline and at 10, 20, 30, 45, 60, 90, 120, and 180 min to measure glucose, insulin, and C-peptide concentrations. Insulin secretion was calculated from C-peptide deconvolution and normalized to the estimated body surface area. Glucose, insulin concentrations, and insulin secretory rate were markedly reduced after the ketogenic meal with respect to the Mediterranean meal: glucose AUC in the first OGTT hour −643 mg × dL−1 × min−1, 95% CI −1134, −152, p = 0.015; total insulin concentration −44,943 pmol/L, 95% CI −59,181, −3706, p < 0.001; peak rate of insulin secretion −535 pmol × min−1 × m−2, 95% CI −763, −308, p < 0.001. We have shown that a ketogenic meal is disposed of with only a minimal insulin secretory response compared to a Mediterranean meal. This finding may be of interest to patients with insulin resistance and or insulin secretory defects.
Subject
Food Science,Nutrition and Dietetics
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