Research Article
Volume 16 Issue 7 - 2021
Medical Nutritional Therapy Laid in Expert Hands to Strongly Suppress Insulin Resistance and to Restore Metabolic Health; a Review of the Evidence
Elisabeth Govers1,2*, Wilma Bouwman1,3, Alie Lourens1,3, Harriet Verkoelen1,4, Berenice Jaime1,5 and Dave Schweitzer1,6
1Knowledge Centre for Dietitians on Overweight and Obesity, Amsterdam, The Netherlands
2European Federation of Associations of Dietitians (EFAD), European Specialist Dietetic Network of Dietitians on Obesity, Emmerich, Germany
3Primary Care Dietitian Practice Dieetzorg Friesland, Leeuwarden, The Netherlands
4Primary Care Dietitian and Diabetic Nurse practice, Buren, The Netherlands
5Primary Care Dietitian Practice Leidschendam, The Netherlands
6Department of Endocrinology, Reinier de Graaf Hospital, Delft, The Netherlands
*Corresponding Author: Elisabeth Govers, Knowledge Centre for Dietitians on Overweight and Obesity, Amsterdam, The Netherlands.
Received: June 02, 2021; Published: June 28, 2021




Abstract

Background: Very low calorie ketogenic diets, referred to as very low-carb/high-protein diets, well known for treating insulin resistance, are getting more accepted for obesity treatment. A recent review, published in Obesity Facts, presented positive results on weight loss and metabolic syndrome parameters. It has been shown that this diet reduces body weight substantially and decreases the impact of comorbidities, thus improving health. Based on available evidence, a well-formulated ketogenic diet reduces chronic low-grade inflammation through a very low-carb/high-protein diet as Medical Nutrition Therapeutic intervention. Our research question was whether Medical Nutrition Therapy (MNT) in the form of a very low-carb/high-protein diet in the hands of registered dietitians is effective and safe to suppress severe insulin resistance and its comorbidities.

Methods: We searched Pubmed, Medline and Google Scholar with the search terms: insulin resistance; obesity; overweight; weight loss; comorbidities; dietary treatment; low carb/high protein diet. And furthermore: fatty acids; omega 6-3 ratio; glycaemic index; glycaemic load and gut microbiome.

Results: Weight loss suppresses IR and chronic inflammation in obese and overweight patients through the reduction of inflammation markers like CRP, IL-6 and TNF-α; and an increase in adiponectin, IL-10 and IL-1ra. Weight loss leads to reversed postprandial inflammatory expression. The very low-carb/high-protein diet (VLCKD) that suppresses low grade inflammation is characterized by: a carbohydrate intake below 50 g/day during six months or more; a protein intake of 1 g/present weight; an omega 6/3 ratio of 4/1; ample intake of fiber; and suppletion of micronutrients including vitamin D and iodine. Treatment is long lasting, after an intensive phase of one year and carried out by registered dietitians.

Conclusion: Very low-carbohydrate/high-protein diets are effective for weight loss, to restore insulin sensitivity and reduce inflammation in patients with severe IR and comorbidities. Because of their complexity they should be administered by registered dietitians as part of Medical Nutrition Therapy.

Keywords: Medical Nutrition Therapy (MNT); Very Low Carb/High Protein Diet; Weight Loss; Insulin Resistance; Comorbidities; Gut Microbiome; Registered Dietitian; Saturated Fatty Acids; 6x6 diet = 6x daily 6 Grams of Carbohydrates; Omega 6/3 Ratio

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Citation: Elisabeth Govers., et al. “Medical Nutritional Therapy Laid in Expert Hands to Strongly Suppress Insulin Resistance and to Restore Metabolic Health; a Review of the Evidence”. EC Nutrition 16.7 (2021): 06-19.

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