Comparing the effects of a ketogenic diet app versus a calorie restricted, low-fat diet on weight loss in patients with overweight or obesity.

This study compared the effects of a ketogenic diet mobile health application (Keyto app) with breath acetone biofeedback (device) versus a calorie-restricted, low-fat diet (WW; weight watchers) app on weight loss and metabolic risk in patients with overweight or obesity. The data showed that a ketogenic diet app with a breath acetone biofeedback device was more effective in promoting weight loss than a calorie-restricted, low-fat diet app in these patients. 

Diabetes involves excessive glucose (sugar) in the blood and can reduce overall health. Type 2 diabetes (T2D) is closely related to obesity. For patients with T2D and obesity, sustained weight loss can improve blood glucose control. However, weight loss through dieting can be challenging.

A ketogenic diet is based on changing the way the body uses energy. Normally, the body primarily uses blood glucose as a source of energy. The body gets glucose from carbohydrates (carbs). A ketogenic diet strictly limits carbs in the diet, such as bread, root vegetables, or beans. When the body does not have access to glucose, it can break down fat into ketones (acids made by the liver) to use as fuel. A ketogenic diet may improve glucose control. Because this diet includes fat and protein, it can prevent hunger even when calories are reduced. An effective ketogenic diet causes the patient to have an acetone breath (a fruity scent like nail polish). 

Whether a Mediterranean-style, ketogenic diet mobile health application (Keyto app) with breath acetone biofeedback (device) is better than a calorie-restricted, low-fat diet app (WW app) in promoting weight loss in patients with overweight or obesity is still unknown.

The study involved 155 patients with overweight/obesity. Patients were randomly assigned into 2 groups. Group 1 included 77 patients who used a ketogenic diet app with a biofeedback device. Group 2 included 78 patients who used a calorie-restricted low-fat diet app. Patients received a wireless weight scale and were instructed to take daily weight measurements.

After 12 weeks, the weight loss was significantly greater in group 1 compared to group 2. The average weight loss in group 1 was 5.6 kg compared to 2.5 kg in group 2.

After 24 weeks, the weight loss was significantly greater in group 1 compared to group 2. The average weight loss in group 1 was 5.5 kg compared to 2.8 kg in group 2.

After 12 weeks, the glycosylated hemoglobin (average blood glucose over the last 3 months; HbA1c) levels and liver enzymes were significantly improved in group 1 compared to group 2.

This study concluded that a ketogenic diet app with a breath acetone biofeedback device was more effective in promoting weight loss than a calorie-restricted low-fat diet app in patients with overweight/obesity.

The sample size was very small. The weight measurements were self-reported. Larger studies with a longer follow-up are necessary to validate the conclusions.