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. 2021 Sep 18;10(18):4230.
doi: 10.3390/jcm10184230.

The Role of Very Low Calorie Ketogenic Diet in Sympathetic Activation through Cortisol Secretion in Male Obese Population

Rita Polito  1   2 , Giovanni Messina  2 , Anna Valenzano  2 , Alessia Scarinci  3 , Ines Villano  4 , Marcellino Monda  4 , Giuseppe Cibelli  2 , Chiara Porro  2 , Daniela Pisanelli  2 , Vincenzo Monda  4 , Antonietta Messina  4
Affiliations

The Role of Very Low Calorie Ketogenic Diet in Sympathetic Activation through Cortisol Secretion in Male Obese Population

Rita Polito et al. J Clin Med. .

Abstract

Adipose tissue is considered an endocrine organ, and its excess compromises the immune response and metabolism of hormones and nutrients. Furthermore, the accumulation of visceral fat helps to increase the synthesis of cortisol. The hypothalamus-pituitary-adrenal (HPA) axis is a neuroendocrine system involved in maintaining homeostasis in humans under physiological conditions and stress, and cortisol is the main hormone of the HPA axis. It is known that a stress-induced diet and cortisol reactivity to acute stress factors may be related to dietary behavior. In obesity, to reduce visceral adipose tissue, caloric restriction is a valid strategy. In light of this fact, the aim of this study was to assess the effects of a commercial dietary ketosis program for weight loss on the sympathetic nervous system and HPA axis, through evaluation of salivary cortisol and GSR levels. Thirty obese subjects were recruited and assessed before and after 8 weeks of Very Low Calorie Ketogenic Diet (VLCKD) intervention to evaluate body composition and biochemical parameters. Salivary cortisol levels and GSR significantly decreased after dietary treatment; in addition, body composition and biochemical features were ameliorated. The VLCKD had a short-term positive effect on the SNS and HPA axes regulating salivary cortisol levels. Finally, the effects of the VLCKD on the SNS and HPA axis may lead to more individualized treatment strategies that integrate obesity and stress and support the usefulness of such therapeutic interventions in promoting the reduction of the individual disease burden.

Keywords: adipose tissue; cortisol; galvanic skin response (GSR); hypothalamus-pituitary-adrenal (HPA) axis; obesity; sympathetic nervous system; very low-calorie ketogenic diet (VLCKD).

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Salivary cortisol levels before and after the VLCKD in obese subjects. μmol/L (micromole/litro); (*) inidcates a significant difference (p < 0.05) with respect to the basal value.
Figure 2
Figure 2
Changes in skin conductance level. μS (micro-Siemens); (*) indicates a significant difference (p < 0.05) with respect to the basal value.
Figure 3
Figure 3
Salivary cortisol concentrations correlated negatively with BMI and total cholesterol (A) and (B); and positively correlated with adiponectin (C). (Δ) indicates the variation between T1 and T0 in the VLCKD obese subjects for each parameter.
See this image and copyright information in PMC

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