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Very low-calorie ketogenic diet (VLCKD)possesses further advantageous actions over’ Mediterranean diet in terms of better enhancement of gut microbiota (GM) in type2 diabetes mellitus patients- a short communication:
June 2023
DOI:10.15406/jdmdc.2023.10.00252


Abstract and Figures
There has been as escalating incidence of obesity &type2 diabetes mellitus (T2DM), &other co-morbidities for which diabesity had to be coined for this worldwide epidemic. All the newer combinations like Qsymia (topiramate, phentermine), Contrive (naltrexone: buprion), liraglutide etc have not been successful with cost prohibitions, or side effects/ contraindications. Thus attention had shifted to dietary therapies like Mediterranean diet (MD).Probiotic therapy. However none has been able for ensuring sustenance of weight reduction. We had reviewed in 2018 how the very low calorie ketogenic (VLCKD) diet might be successful not only in therapy of obesity but lot of correlated endocrine dysfunction. Subsequently we contrasted the effectiveness of VLCKD/ MD proving that VLCKD faired superiorly over MD. Furthermore, previously we had reviewed numerous publications on Gut Microbiota (GM) including role of Pro/ Prebiotics in obesity trials under way for NAFLD/ NASH/HCC/ type2 diabetes (T2D). Recently Deledda‘s group attempted a detailed assessment of alterations subsequent to VLCKD as well as MD. They contrasted various paradigms in 11 patients with recently diagnosed T2DM overweight/obesity patients following the VLCKD(KETO)or hypocaloric MD(MEDI) respectively; recording of paradigms at baseline(T0) &at two(T2) and three(T3) MThs. The outcomes obtained -VLCKD possessed greater significant advantageous actions in contrast to MD over anthropometric paradigms, whereas biochemical enhancements were not statistically significant in2. Regarding GM , no significant outcomes were seen in alpha diversity ,beta diversity, and Firmicutes: Bacteroides ratio amongst the 2 groups in the KETO group, a significantly escalated advantageous taxa like the Verrumicrobiota phylum in addition to its members Verrumicrobiae and Verrumicrobiales, Akkermansiacea, Akkermansia, Christensellacea family, Eubacterium spp and decrease in microbial taxa prior correlated with obesity(Firmicutes along with Actinobacteriota)or other diseases(Allistipis) was seen at T2 as well as T3. Regarding MEDI group differences were restricted to a significant escalation in Actinobacteriota phylum at T2 as well as T3 as well as Firmicutes phylum at T3. Furthermore, a metagenomics change is correlated with certain metabolic pathway were seen only in the KETO group. Hence they concluded that both dietary strategies aided in enhancement of their health status, however VLCKD has illustrated greater advantageous outcomes regarding body makeup along with their GM paradigms. Their results showed VLCKD correlated with superior GM& good anthropometric changes -not seen with MD at 3 mth time point .Only limitation was 11 pts due to COVID arrival, hence no more recruitment, thus future studies warranted. Keywords: mediterranean diet (MD), very low calorie ketogenic diet, gut microbiota