Efficacy and Tolerability of the Ketogenic Diet Compared to the Mediterranean Diet in a Cohort of Overweight/Obese Patients: Effects on Anthropometric and Metabolic Parameters

— Background: According to the World Health Organization (WHO) and the Global Burden of Disease Study, a healthy and balanced diet could significantly reduce the incidence and prevalence of the main chronic-degenerative diseases. Scientific studies show that following a varied and balanced diet, characterized by the balanced intake of all nutrients, offers countless benefits. Therefore, a healthy diet combined with an active lifestyle helps prevent and treat many chronic diseases such as obesity and overweight, arterial hypertension, metabolic diseases and some forms of cancer. Obesity is now widely regarded as a global epidemic and, for this reason, there is a need to resort to less invasive interventions, such as nutritional therapy and physical activity, even before resorting to more invasive interventions, such as bariatric surgery. Objectives: Leaving aside pharmacological and surgical interventions, the aim of our study is to evaluate the efficacy and tolerability of two types of diets, Mediterranean Diet and Ketogenic Diet, in a cohort of overweight / obese patients and evaluate the effects that these have on anthropometric and metabolic parameters. Methods: The study includes a population of 60 subjects divided into two groups; a first group consisting of 30 subjects followed a Mediterranean diet (MetDiet) while the other group, also composed of 30 subjects, followed a ketogenic diet (KetoDiet). In this study, the mean age was 53 ± 14 years, and 75% of the population was female. All subjects were reviewed after 3 weeks and after 4 months of nutritional therapy. Data were reported as mean ± standard deviation (SD). The differences between the means in the two treatment groups were compared using a Student's t-test for independent samples. All analyzes were conducted using SPSS 25.0 statistical software for Windows. A two-sided p-value <0.05 was considered statistically significant. Results: There is a higher prevalence of subjects suffering from arterial hypertension, type 2 diabetes mellitus, treated with diuretics and oral hypoglycemic agents, in participants who followed the Mediterranean diet compared those who followed a ketogenic diet. After 3 weeks of nutritional therapy, individuals treated with the ketogenic diet have a greater reduction in body weight, body mass index (BMI), waist circumference (CV), waist-hip ratio (WHR), fat mass (FM), visceral fat mass (FMV) compared to subjects who followed the Mediterranean diet. Conclusions: The results of this study suggest, after 4 months of nutritional therapy, a greater compliance of the ketogenic diet compared to the Mediterranean diet in limiting some anthropometric parameters (such as: body weight, degree of obesity, CV, WHR, FM and FMV) and some parameters metabolic (such as: reduction of Tot-col, LDL-col and uric acid, glycaemia, HbA1c and triglycerides). Therefore, very low calorie diets have shown better results than the MetDiet, but maintenance nutritional therapy or the possible worsening of obesity complications still require careful analysis and more in-depth studies.