Self-reported menses physiology is positively modulated by a well-formulated, energy-controlled ketogenic diet vs. low fat diet in women of reproductive age with overweight/obesity.

Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

Original Publication: San Francisco, CA : Public Library of Science

Diet, Ketogenic* ; Obesity*/diet therapy ; Self Report* ; Weight Loss* ; Diet, Fat-Restricted*; Humans ; Female ; Adult ; Overweight/diet therapy ; Menstruation/physiology ; Body Composition ; Middle Aged ; Body Mass Index ; Young Adult

Weight loss can positively alter female physiology; however, whether dietary carbohydrate- or fat- restriction confer unique effects is less studied. Precisely designed, hypocaloric well-formulated ketogenic diets (KD; ~75% energy for weight maintenance) were compared to isocaloric/isonitrogenous low-fat diet (LFD) on self-reported menses in pre-menopausal overweight and obese women (mean ± SD: 34 ± 10 years, BMI: 32.3 ± 2.7 kg/m2). Women received a precisely-weighed and formulated KD with either twice-daily with ketone salts (KS; n = 6) or a flavor-matched placebo (PL; n = 7) daily for six-weeks. An age and BMI-matched cohort (n = 6) was later assigned to the LFD and underwent the same testing procedures as the KD. Self-reported menses fluctuations were assessed bi-weekly along with measures of body weight, body composition, and fasting serum clinical chemistries using repeated measures ANOVA with Bonferroni post-hoc corrections. Both diets elicited clinically-significant weight-loss (Δ: -7.0 ± 0.5 kg; p < 0.001), primarily from fat-mass (Δ: -4.6 ± 0.3 kg; p < 0.001), and improved insulin-sensitivity and serum lipids (all p < 0.05). Fasting plasma glucose and inflammatory markers were not different between diets. Fasting capillary beta-hydroxybutyrate (R-βHB) increased significantly during the KD, independent of supplementation (Δ: 1.2 ± 0.3 mM R-βHB; p < 0.001). Women randomized to the KD+KS (30%) and KD+PL (43%) reported subjective increases in menses frequency and intensity after 14 days, whereas another third reported a regain of menses (>1 year since the last period) after 28 days. No LFD participants reported menses changes. Nutrient-dense, whole-food KDs and LFD improved weight, BMI, body composition, and blood parameters in pre-menopausal women after six-weeks. Changes in self-reported menses were described by most of the KD participants, but none of the LFD women suggesting there may be unique effects of nutritional ketosis, independent of weight loss.
Competing Interests: JV receives royalties for low-carbohydrate nutrition books; is founder, consultant, and stockholder of Virta Health, Inc. and is a member of the advisory boards for Simply Good Foods. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
(Copyright: © 2024 Kackley et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Front Public Health. 2018 Jul 31;6:211. (PMID: 30109221)
J Postgrad Med. 2017 Oct-Dec;63(4):242-251. (PMID: 29022562)
J Hum Reprod Sci. 2020 Oct-Dec;13(4):261-271. (PMID: 33627974)
J Clin Endocrinol Metab. 2023 Feb 15;108(3):653-664. (PMID: 36240323)
Nutrients. 2021 Sep 22;13(10):. (PMID: 34684300)
J Clin Endocrinol Metab. 2023 Jun 16;108(7):1727-1739. (PMID: 36629058)
Am J Clin Nutr. 2022 Sep 2;116(3):640-652. (PMID: 35641199)
JCI Insight. 2019 Jun 20;4(12):. (PMID: 31217353)
JAMA. 2007 Mar 7;297(9):969-77. (PMID: 17341711)
Cancer Epidemiol Biomarkers Prev. 2020 Jan;29(1):157-168. (PMID: 31641012)
Nutr Metab (Lond). 2005 Dec 16;2:35. (PMID: 16359551)
Nutrients. 2021 Mar 17;13(3):. (PMID: 33802651)
Brain Sci. 2022 Aug 27;12(9):. (PMID: 36138878)
Nutr Metab (Lond). 2006 Jan 11;3:7. (PMID: 16403234)
Eur J Clin Nutr. 2013 Aug;67(8):789-96. (PMID: 23801097)
Front Nutr. 2021 Mar 24;8:618520. (PMID: 33869263)
Front Neurosci. 2022 Sep 30;16:971144. (PMID: 36248655)
Nutr Metab (Lond). 2004 Nov 08;1(1):13. (PMID: 15533250)
Int J Environ Res Public Health. 2021 Nov 27;18(23):. (PMID: 34886216)
Front Nutr. 2022 Apr 04;9:876620. (PMID: 35445067)
Nutrients. 2021 Mar 02;13(3):. (PMID: 33801247)
PLoS One. 2014 Nov 21;9(11):e113605. (PMID: 25415333)
Clin Nutr ESPEN. 2023 Apr;54:277-287. (PMID: 36963874)
J Obstet Gynaecol Res. 2021 Mar;47(3):1145-1152. (PMID: 33462940)
Mymensingh Med J. 2015 Jan;24(1):161-7. (PMID: 25725683)
Diabetes Care. 2007 Jul;30(7):1747-52. (PMID: 17468352)
J Am Coll Nutr. 2004 Apr;23(2):177-84. (PMID: 15047685)
J Am Nutr Assoc. 2023 Feb;42(2):169-177. (PMID: 35512774)
Ann Intern Med. 2023 Jan;176(1):10-21. (PMID: 36508737)
Endocrinol Diabetes Metab. 2022 Jan;5(1):e00300. (PMID: 34787952)
Worldviews Evid Based Nurs. 2022 Feb;19(1):35-41. (PMID: 35044076)
J Nutr. 2003 Sep;133(9):2756-61. (PMID: 12949361)
Nurs Womens Health. 2021 Apr;25(2):139-151. (PMID: 33838849)
J Transl Med. 2020 Feb 27;18(1):104. (PMID: 32103756)
Obesity (Silver Spring). 2014 Jan;22(1):5-13. (PMID: 24307184)

Date Created: 20240816 Date Completed: 20240816 Latest Revision: 20240818

20240818

PMC11329152

10.1371/journal.pone.0293670

39150916