Evidence mapPaperPMID 37299524Full record

ArticleNutrients2023

The Effects of a Very-Low-Calorie Ketogenic Diet on the Intestinal Barrier Integrity and Function in Patients with Obesity: A Pilot Study.

Michele Linsalata, Francesco Russo, Giuseppe Riezzo, Benedetta D'Attoma, Laura Prospero, Antonella Orlando, Antonia Ignazzi, Martina Di Chito, Annamaria Sila, Sara De Nucci and 3 more

Open access · goldAbstract read
In one paragraph

Article in Nutrients, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
4.4field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 25 citations in OpenAlex.

  1. Review
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  4. The Interplay between the Gut and Ketogenic Diets in Health and Disease.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 1 institution in 1 country.

Michele LinsalataFunctional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS "S. de Bellis", 70013 Castellana Grotte, Italy.ORCID 0000-0001-7350-2544
Francesco RussoFunctional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS "S. de Bellis", 70013 Castellana Grotte, Italy.ORCID 0000-0003-0538-6072
Giuseppe RiezzoFunctional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS "S. de Bellis", 70013 Castellana Grotte, Italy.
Benedetta D'AttomaFunctional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS "S. de Bellis", 70013 Castellana Grotte, Italy.
Laura ProsperoFunctional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS "S. de Bellis", 70013 Castellana Grotte, Italy.
Antonella OrlandoFunctional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS "S. de Bellis", 70013 Castellana Grotte, Italy.ORCID 0000-0001-8255-4776
Antonia IgnazziFunctional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS "S. de Bellis", 70013 Castellana Grotte, Italy.
Martina Di ChitoCenter of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy.
Annamaria SilaCenter of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy.
Sara De NucciCenter of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy.
Roberta RinaldiCenter of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy.ORCID 0000-0002-3817-8643
Gianluigi GiannelliScientific Direction, National Institute of Gastroenterology IRCCS "S. de Bellis", 70013 Castellana Grotte, Italy.ORCID 0000-0002-5140-8060
Giovanni De PergolaCenter of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy.
Gastroenterology Hospital "Saverio de Bellis" · IT

Funding

Italian Ministry of Health RC 2022-2024, Prog. N°19 (DDG n. 700/2020).
6 · The paper itself

Abstract

The very-low-calorie ketogenic diet (VLCKD) is effective and safe for obese individuals, but limited information exists on its impact on the intestinal barrier. This study analyzed the effects of 8 weeks of VLCKD on 24 obese patients (11M/13F). Carbohydrate intake was fixed at 20-50 g/day, while protein and lipid intake varied from 1-1.4 g/kg of ideal body weight and 15-30 g per day, respectively. Daily calorie intake was below 800 kcal. The lactulose-mannitol absorption test assessed small intestinal permeability. Multiple markers, such as serum and fecal zonulin, fatty acid-binding protein, diamine oxidase concentrations, urinary dysbiosis markers (indican and skatole), and circulating lipopolysaccharide levels, were analyzed. Inflammation markers (serum interleukin 6, 8, 10, and tumor necrosis factor-α concentrations) were also evaluated. The results showed significant reductions in weight, BMI, and waist circumference post-diet. However, the lactulose-mannitol ratio increased by 76.5%, and a significant increase in dysbiosis markers at the end of the diet occurred. This trend was particularly evident in a subgroup of patients. Despite initial benefits, the VLCKD might negatively affect the intestinal barrier function in obese patients, potentially worsening their compromised intestinal balance.

Indexed as

Diet, KetogenicDysbiosisHumansLactuloseMannitolObesityPilot ProjectsLactuloseMannitoldysbiosisinflammationintestinal barrierintestinal permeabilityketogenic dietobesity

Identifiers

PMID37299524
PMCPMC10255565
OpenAlexW4378882785

What Socratic holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.