{
    "abstract": "Very low-calorie ketogenic diet (VLCKD) is a low-carbohydrate, low-calorie regimen that leads to rapid weight loss and may reduce inflammation. This study assessed the impact of VLCKD on anthropometric measurements, inflammatory biomarkers, metabolic health, and cardiovascular risk in psoriatic arthritis (PsA) patients moderately overweight or in class I obesity.\nA proof-of-concept single-arm monocentric study involved PsA patients undergoing a 9-week VLCKD treatment. Patients with Body Mass Index (BMI) \u226527 and <35, in stable (\u22656 months) remission or low disease activity, as defined by Disease Activity in PSoriatic Arthritis (DAPSA) score, were included and underwent nutritional evaluations every 3 weeks. The study analyzed changes after the VLCKD intervention and the association between changes of anthropometric parameters and clinical and laboratory variables.\nTwenty patients were enrolled since April 2022 and completed the study in May 2023. Median baseline BMI was 30.9 (interquartile range 29.1-33) kg/m\u00b2. All participants exhibited low baseline disease activity, which correlated with BMI (Spearman's correlation coefficient (rs)=0.59,p=0.007). Following VLCKD, significant improvements were observed in all anthropometric measures (BMI -3.5[-4;-2.6]), PsA activity (DAPSA -6.1[-16.8;3.7]), cardiovascular parameters (SCORE2 index -0.2[-0.7;0.1]), insulin resistance (Homeostatic Model Assessment-Insuline Resistance -2.1[-1.1;-3.0]), and lipid profile. Most inflammatory biomarkers remained within normal limits. BMI reduction correlated with changes in DAPSA scores (rs=0.52,p=0.020). Patients with higher baseline weight or clinical activity experienced more pronounced improvements.\nVLCKD significantly improved PsA activity and metabolic health. Patients with a higher BMI and less controlled disease are particularly motivated and could benefit more from VLCKD compared to those with lower BMI or better disease control.",
    "authors": [
        {
            "affiliation": "Rheumatology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy.",
            "firstname": "Roberta",
            "initials": "R",
            "lastname": "Ramonda"
        },
        {
            "affiliation": "Rheumatology Outpatient Clinic, Local Health Unit 6 Euganea (Azienda ULSS 6 Euganea), Padova, Italy.",
            "firstname": "Francesca",
            "initials": "F",
            "lastname": "Ometto"
        },
        {
            "affiliation": "Rheumatology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy.",
            "firstname": "Giovanni",
            "initials": "G",
            "lastname": "Striani"
        },
        {
            "affiliation": "Rheumatology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy.",
            "firstname": "Giacomo",
            "initials": "G",
            "lastname": "Cozzi"
        },
        {
            "affiliation": "Laboratory Medicine, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy.",
            "firstname": "Daniela",
            "initials": "D",
            "lastname": "Basso"
        },
        {
            "affiliation": "Rheumatology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy.",
            "firstname": "Filippo",
            "initials": "F",
            "lastname": "Evangelista"
        },
        {
            "affiliation": "Rheumatology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy.",
            "firstname": "Mariagrazia",
            "initials": "M",
            "lastname": "Lorenzin"
        },
        {
            "affiliation": "Rheumatology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy.",
            "firstname": "Laura",
            "initials": "L",
            "lastname": "Scagnellato"
        },
        {
            "affiliation": "Laboratory Medicine, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy.",
            "firstname": "Ada",
            "initials": "A",
            "lastname": "Aita"
        },
        {
            "affiliation": "Rheumatology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy.\nInternal Medicine 1, Department of Medicine (DIMED), AULSS2 Marca Trevigiana, Ca' Foncello Hospital, Piazzale dell'Ospedale, Treviso, Italy.",
            "firstname": "Marta",
            "initials": "M",
            "lastname": "Favero"
        },
        {
            "affiliation": "Affidea Morgagni Polyclinic, Padova, Italy.",
            "firstname": "Filippo",
            "initials": "F",
            "lastname": "Brocadello"
        },
        {
            "affiliation": "Rheumatology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy.",
            "firstname": "Andrea",
            "initials": "A",
            "lastname": "Doria"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright: \u00a9 2025 Ramonda 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.",
    "doi": "10.1371/journal.pone.0321140\n10.4081/reumatismo.2008.95\n10.4414/smw.2015.14190\n10.1016/j.jbspin.2022.105476\n10.4081/reumatismo.2009.10\n10.1002/acr.24112\n10.1136/ard.2009.113696\n10.1016/j.joca.2023.06.011\n10.1136/rmdopen-2021-001681\n10.3390/nu13020374\n10.1016/j.seizure.2016.03.006\n10.1016/j.eplepsyres.2011.07.014\n10.3390/nu9050517\n10.1016/j.celrep.2017.02.004\n10.1016/j.jpain.2012.12.015\n10.1038/nm.3804\n10.3389/fmed.2021.792846\n10.3389/fendo.2019.00703\n10.3390/nu14194213\n10.1016/j.clnu.2022.05.007\n10.3390/ijms25052475\n10.1002/art.21972\n10.1093/eurheartj/ehab309\n10.1007/s40618-019-01061-2\n10.1186/s13075-019-1810-5\n10.3389/fendo.2020.00607\n10.3390/nu15112561\n10.3390/ijerph191610429\n10.3390/nu5041218\n10.1186/s13075-020-02350-5",
    "journal": "PloS one",
    "keywords": [],
    "methods": null,
    "publication_date": "2025-04-22",
    "pubmed_id": "40261944\n12588750\n23940215\n18651052\n26523418\n25030783\n34902577\n29926091\n36404571\n19370182\n32799405\n32452348\n23842084\n19773290\n37423596\n34876490\n33530512\n27061881\n21880467\n28534852\n36106928\n38892552\n32222582\n35653127\n10812493\n28249154\n23499319\n25686106\n34970568\n31736870\n36235866\n35667273\n38473723\n16871531\n38238506\n34120177\n31111407\n30635024\n38219223\n33042004\n37299524\n36012064\n23584084\n33092646",
    "results": "Twenty patients were enrolled since April 2022 and completed the study in May 2023. Median baseline BMI was 30.9 (interquartile range 29.1-33) kg/m\u00b2. All participants exhibited low baseline disease activity, which correlated with BMI (Spearman's correlation coefficient (rs)=0.59,p=0.007). Following VLCKD, significant improvements were observed in all anthropometric measures (BMI -3.5[-4;-2.6]), PsA activity (DAPSA -6.1[-16.8;3.7]), cardiovascular parameters (SCORE2 index -0.2[-0.7;0.1]), insulin resistance (Homeostatic Model Assessment-Insuline Resistance -2.1[-1.1;-3.0]), and lipid profile. Most inflammatory biomarkers remained within normal limits. BMI reduction correlated with changes in DAPSA scores (rs=0.52,p=0.020). Patients with higher baseline weight or clinical activity experienced more pronounced improvements.",
    "title": "Ketogenic diet improves disease activity and cardiovascular risk in psoriatic arthritis: A proof of concept study.",
    "xml": "<Element 'PubmedArticle' at 0x7885047f1030>"
}