Abstract

BACKGROUND

a very low-calorie ketogenic diet (VLCKD) is associated with improvement of metabolic and cardiovascular disorders. We aimed to evaluate the effects of a VLCKD in patients with Cushing's disease (CD) as adjunctive therapy to treatment for the primary disease.

METHODS

we evaluated clinical, hormonal and metabolic parameters in 15 patients with CD and 15 controls at baseline after 1 week and 3 weeks of VLCKD and, further, after 2 weeks of a low-carbohydrate ketogenic diet (LCKD).

RESULTS

after 5 weeks of diet, a significant decrease in BMI ( = 0.002), waist circumference (WC) ( = 0.024), systolic blood pressure ( = 0.015), diastolic blood pressure ( = 0.005), ACTH ( = 0.026), cortisone ( = 0.025), total cholesterol ( = 0.006), LDL cholesterol ( = 0.017), triglycerides ( = 0.016) and alkaline phosphatase ( = 0.008) and a significant increase in HDL cholesterol ( = 0.017), vitamin D ( = 0.015) and oral disposition index (oDI) ( = 0.004) was observed in the CD patients. A significant decrease in BMI ( = 0.003), WC ( = 0.002), systolic blood pressure ( = 0.025), diastolic ( = 0.007) blood pressure and total cholesterol ( = 0.026) and an increase in HDL cholesterol ( = 0.001) and oDI ( < 0.001) was observed in controls.

CONCLUSIONS

the current study confirms that a ketogenic diet is effective in improving metabolic disorders in CD and shows that a nutritional approach may be combined with conventional CD therapy in order to improve metabolic and cardiovascular comorbidities.

MeSH

Steroids, Comorbidity, Cholesterol, Ldl, Therapeutics, Waist Circumference, Cortisone, Diabetes Mellitus, Diet, Obesity, Blood Pressure, Cholesterol, Hdl, Pituitary Acth Hypersecretion

Cited by

• Ketogenic Diet in Steatotic Liver Disease: A Metabolic Approach to Hepatic Health. Nutrients, 2025
• Advancing Obesity Management: the Very Low-Energy Ketogenic therapy (VLEKT) as an Evolution of the "Traditional" Ketogenic Diet. Curr Obes Rep, 2025