A very-low-calorie ketogenic diet (VLCKD) may be beneficial in the treatment of Cushing’s syndrome comorbidities, according to findings published in Nutrients.
“Cushing’s syndrome is characterized by an exogenous or endogenous excess of glucocorticoids (GCs) resulting in a combination of metabolic disorders, including visceral obesity, type 2 diabetes mellitus, dyslipidemia, and cardiovascular disease,” the researchers wrote. “Nutrition has an important role in the management of obesity, diabetes mellitus, and cardiovascular disease, and may be used as an additional treatment of the metabolic comorbidities in patients with CS waiting to undergo neurosurgery or to reach pharmacologically biochemical remission.”
Carla Giordano, MD, and colleagues conducted a review of the evidence on nutrition and cortisol levels and the positive impact of a VLCKD on metabolic complications, as well as the potential use of a VLCKD in patients with hypercortisolism for the management of comorbidities.
Metabolic Benefits of VLCKD Extend to Cushing’s Syndrome
Metabolic effects of a VLCKD include a decrease in glycemic and cholesterol values, improved ovarian function, weight loss, decreased visceral fat, cardiovascular risk, and insulin resistance. Potential implications of these effects are related to Cushing’s syndrome comorbidities like diabetes, dyslipidemia, polycystic ovary syndrome, adipose tissue dysfunction, cardiovascular disease, and insulin resistance.
“… A VLCKD induces weight loss and reduces visceral fat, by lowering appetite and lipogenesis and increasing lipolysis,” Dr. Giordano and colleagues wrote. “A VLCKD reduces glucose and insulin levels, improving insulin sensitivity and leading to an improvement in glycemic control for patients with type 2 diabetes mellitus and an improvement in gonadal function in women.”
VLCKD Has Positive Implications for Future Research
Another study in men with obesity demonstrated a significant reduction in salivary cortisol following 8 weeks of a VLCKD compared with baseline. That study also indicated that a VLCKD was associated with a substantial lowering of serum cortisol by reducing cortisol-binding proteins.
The results indicate that a VLCKD can be used successfully for treating comorbidities of Cushing’s syndrome, according to the researchers.
“To confirm our hypotheses, prospective larger studies on the use of a VLCKD in patients with [Cushing’s syndrome] should be performed,” Dr. Giordano and colleagues wrote.