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  • Introduction: Low-carbohydrate diets (LCDs) have been suggested as a potential treatment option for females with lipedema, due to their superiority in reducing pain, possibly through improvements in insulin dynamics. Objectives: The objective of this secondary analysis was to compare changes in markers of glucose and insulin dynamics after a low-carbohydrate versus low-fat low-energy diets in females with lipedema and obesity. A secondary objective was to investigate potential associations between changes in glucose and insulin dynamics and changes in pain.Methods: Females with obesity and lipedema were randomized to either an LCD or a low-fat low-energy diets (1200 kcal/day for both; 75 vs. 180 g carbohydrates/day) for 8 weeks. Basal and postprandial (total and incremental area under the curve (tAUC and iAUC)) concentrations of glucose, insulin, glucose-dependent insulinotropic polypeptide (GIP), and C-peptide were measured before and after the intervention, and HOMA-IR, Matsuda index and insulin clearance calculated.Results: A total of 70 females (35 in each group, age 47 ± 11 years, BMI 37 ± 5 kg/m2) were included in the analysis. Both groups lost body weight, but with a significantly greater weight loss in the LCD group. Both groups showed ed a reduction in basal glucose, C-peptide, and insulin concentrations, with a greater reduction in glucose on the LCD. A significant increase in glucose iAUC, C-peptide iAUC, insulin clearance, and Matsuda index was observed in the LCD group only. Both groups experienced an increase in GIP tAUC, as well as a reduction in HOMA-IR, with no significant differences between groups. No associations were seen between changes in glucose and insulin measures and changes in pain.Conclusion: Both diets improved insulin dynamics in females with lipedema and obesity, despite additional benefits in the LCD group. However, changes in the measured indices of insulin dynamics were not associated with pain reduction, suggesting that the effects of the LCD on pain and systemic metabolic regulation may involve other pathways.

  • BACKGROUND: Ketosis seems to attenuate, or prevent, the rise in both ghrelin concentrations and subjective hunger ratings that follow weight loss. However, most of the previous studies have employed very-low energy diets (VLED) and are therefore limited in terms of generalizability. OBJECTIVES: To compare changes in ghrelin plasma concentrations after a low-carbohydrate (LCD) versus an isocaloric low-fat low energy diet (LED) in females with lipedema. Secondary objectives were to determine potential differences between diets in changes in satiety hormones, and subjective ratings of appetite. METHODS: Females with obesity and lipedema were randomized to either an LCD (75 g carbohydrates) or low-fat diet (180 g carbohydrates) for 8 weeks. Plasma concentrations of ghrelin, peptide YY, cholecystokinin (CCK), and glucagon-like peptide 1 (GLP-1), and subjective ratings of appetite were measured in the fasting and postprandial states, pre and post intervention. RESULTS: 55 females (30 in LCD) were included (age 47.9 ± 11.3 years, BMI 36.8 ± 5.1 kg/m2). Both LCD and low-fat groups lost weight (10.3 %, P < 0.001 and 7.3 %, P < 0.001, respectively), but the LCD lost significantly more. No within or between groups differences were found for ghrelin in the fasting state. A reduction in postprandial (tAUC) ghrelin was seen only in the LCD group (P = 0.002), and this change was significantly different from the low-fat group (P = 0.046). The LCD group also reported an increase in postprandial (both iAUC and tAUC) fullness ratings (P = 0.035 and P = 0.005, respectively), but this was not significantly different from the low-fat group (P = 0.703 and P = 0.365, respectively), despite the latter experiencing no change (P = 0.127 and P = 0.152, respectively). Conversely, only the low-fat group reported increased hunger in fasting (P = 0.046), but changes were not significantly different from the LCD group (P = 0.711). A decrease in postprandial (both tAUC and iAUC) CCK was observed in both LCD and low-fat diet groups (P ≤ 0.005 for all). CONCLUSION: Despite no changes in fasting ghrelin concentrations in either of the diet groups, a reduction in postprandial ghrelin and increased fullness was seen in the LCD group. These favorable changes in appetite in the LCD group might have contributed to the greater weight loss observed in this group. CLINICAL TRIAL REGISTRATION: NCT04632810, Effect of Ketosis on Pain and Quality of Life in Patients With Lipedema (Lipodiet).

Last update from database: 9/13/26, 7:19 AM (UTC)