Killing three birds with one stone: VLCKD in a female patient with obesity, celiac disease and migraine

Main Article Content

Luisella Vigna
Laura Tomaino
Veronica Lotito
Francesco Di Pierro
Maria Rosaria Ingenito
Daniela Sommaruga
Alessandra Piontini
Alessandro Marsili

Keywords

VLCKD, obesity, celiac disease, migraine

Abstract

Very Low-Calorie Ketogenic Diets (VLCKD) are indicated as a valid tool to treat morbid obesity. Growing evidence suggests an association between overweight/obesity and migraine symptoms and shows how a weight reduction improve pain and headache in these patients. This case report describes the clinical management of a patient affected by obesity, migraine, and celiac disease with a 6-month VLCKD supplemented with a probiotic. The nutritional intervention allowed a significant weight reduction and improvement of migraine symptoms, while being safe and suitable in the setting of a celiac disease.

Abstract 335 | PDF Downloads 233 Supplementary file Downloads 53

References

1. Dodick DW. Migraine. Lancet. 2018;391(10127):1315–30.
2. Silberstein SD. Migraine. Lancet [Internet]. 2004;363(9406):381–91. Available from: https://www.sciencedirect.com/science/article/pii/S0140673604154408
3. Razeghi Jahromi S, Ghorbani Z, Martelletti P, Lampl C, Togha M. Association of diet and headache. J Headache Pain. 2019 Nov;20(1):106.
4. Verrotti A, Di Fonzo A, Penta L, Agostinelli S, Parisi P. Obesity and headache/migraine: the importance of weight reduction through lifestyle modifications. Biomed Res Int. 2014;2014:420858.
5. Chai NC, Bond DS, Moghekar A, Scher AI, Peterlin BL. Obesity and headache: Part II--potential mechanism and treatment considerations. Headache. 2014 Mar;54(3):459–71.
6. Chai NC, Scher AI, Moghekar A, Bond DS, Peterlin BL. Obesity and headache: part I--a systematic review of the epidemiology of obesity and headache. Headache. 2014 Feb;54(2):219–34.
7. Lindfors K, Ciacci C, Kurppa K, Lundin KEA, Makharia GK, Mearin ML, et al. Coeliac disease. Nat Rev Dis Prim [Internet]. 2019;5(1):3. Available from: https://doi.org/10.1038/s41572-018-0054-z
8. Lebwohl B, Sanders DS, Green PHR. Coeliac disease. Lancet (London, England). 2018 Jan;391(10115):70–81.
9. White LE, Bannerman E, Gillett PM. Coeliac disease and the gluten-free diet: a review of the burdens; factors associated with adherence and impact on health-related quality of life, with specific focus on adolescence. J Hum Nutr Diet Off J Br Diet Assoc. 2016 Oct;29(5):593–606.
10. Koerner TB, Cleroux C, Poirier C, Cantin I, La Vieille S, Hayward S, et al. Gluten contamination of naturally gluten-free flours and starches used by Canadians with celiac disease. Food Addit Contam Part A, Chem Anal Control Expo risk Assess. 2013;30(12):2017–21.
11. Zanini B, Marullo M, Villanacci V, Salemme M, Lanzarotto F, Ricci C, et al. Persistent Intraepithelial Lymphocytosis in Celiac Patients Adhering to Gluten-Free Diet Is Not Abolished Despite a Gluten Contamination Elimination Diet. Nutrients [Internet]. 2016 Aug 26;8(9):525. Available from: https://pubmed.ncbi.nlm.nih.gov/27571100
12. de Sousa Moraes LF, Grzeskowiak LM, de Sales Teixeira TF, Gouveia Peluzio M do C. Intestinal microbiota and probiotics in celiac disease. Clin Microbiol Rev. 2014 Jul;27(3):482–9.
13. Laparra JM, Olivares M, Gallina O, Sanz Y. Bifidobacterium longum CECT 7347 modulates immune responses in a gliadin-induced enteropathy animal model. PLoS One. 2012;7(2):e30744.
14. Olivares M, Castillejo G, Varea V, Sanz Y. Double-blind, randomised, placebo-controlled intervention trial to evaluate the effects of Bifidobacterium longum CECT 7347 in children with newly diagnosed coeliac disease. Br J Nutr. 2014 Jul;112(1):30–40.
15. Di Pierro F, Bergomas F, Marraccini P, Ingenito MR, Ferrari L, Vigna L. Pilot study on non-celiac gluten sensitivity: effects of Bifidobacterium longum ES1 co-administered with a gluten-free diet. Minerva Gastroenterol Dietol. 2020 Sep;66(3):187–93.
16. Serra-majem L, Tomaino L, Dernini S, Berry EM, Lairon D, Ngo J, et al. Updating the Mediterranean Diet Pyramid towards Sustainability : Focus on Environmental Concerns. Int J Environ Res Public Health. 2020;17(8758).
17. Tragni E, Vigna L, Ruscica M, Macchi C, Casula M, Santelia A, et al. Reduction of Cardio-Metabolic Risk and Body Weight through a Multiphasic Very-Low Calorie Ketogenic Diet Program in Women with Overweight/Obesity: A Study in a Real-World Setting. Nutrients. 2021 May;13(6).
18. Castellana M, Conte E, Cignarelli A, Perrini S, Giustina A, Giovanella L, et al. Efficacy and safety of very low calorie ketogenic diet (VLCKD) in patients with overweight and obesity: A systematic review and meta-analysis. Rev Endocr Metab Disord. 2020 Mar;21(1):5–16.
19. Muscogiuri G, El Ghoch M, Colao A, Hassapidou M, Yumuk V, Busetto L. European Guidelines for Obesity Management in Adults with a Very Low-Calorie Ketogenic Diet: A Systematic Review and Meta-Analysis. Vol. 14, Obesity facts. 2021. p. 222–45.
20. Caprio M, Infante M, Moriconi E, Armani A, Fabbri A, Mantovani G, et al. Very-low-calorie ketogenic diet (VLCKD) in the management of metabolic diseases: systematic review and consensus statement from the Italian Society of Endocrinology (SIE). J Endocrinol Invest. 2019 Nov;42(11):1365–86.
21. Hu T, Mills KT, Yao L, Demanelis K, Eloustaz M, Yancy Jr WS, et al. Effects of low-carbohydrate diets versus low-fat diets on metabolic risk factors: a meta-analysis of randomized controlled clinical trials. Am J Epidemiol [Internet]. 2012 Oct 1;176 Suppl 7(Suppl 7):S44–54. Available from: https://pubmed.ncbi.nlm.nih.gov/23035144
22. Bueno NB, de Melo ISV, de Oliveira SL, da Rocha Ataide T. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. Br J Nutr. 2013 Oct;110(7):1178–87.
23. Bongiovanni D, Benedetto C, Corvisieri S, Del Favero C, Orlandi F, Allais G, et al. Effectiveness of ketogenic diet in treatment of patients with refractory chronic migraine. Neurol Sci Off J Ital Neurol Soc Ital Soc Clin Neurophysiol. 2021 Sep;42(9):3865–70.
24. Gazerani P. Migraine and Diet. Nutrients. 2020 Jun;12(6).
25. Gazerani P. A Bidirectional View of Migraine and Diet Relationship. Neuropsychiatr Dis Treat. 2021;17:435–51.
26. Barbanti P, Fofi L, Aurilia C, Egeo G, Caprio M. Ketogenic diet in migraine: rationale, findings and perspectives. Neurol Sci Off J Ital Neurol Soc Ital Soc Clin Neurophysiol. 2017 May;38(Suppl 1):111–5.
27. Di Lorenzo C, Currà A, Sirianni G, Coppola G, Bracaglia M, Cardillo A, et al. Diet transiently improves migraine in two twin sisters: possible role of ketogenesis? Funct Neurol [Internet]. 2013;28(4):305–8. Available from: https://pubmed.ncbi.nlm.nih.gov/24598400
28. Lorenzo C Di, Coppola G, Sirianni G, Lorenzo G Di, Bracaglia M, Lenola D Di. Migraine improvement during short lasting ketogenesis : a proof-of- concept study. Eur J Neurol. 2015;(22):170–7.
29. Di Lorenzo C, Pinto A, Ienca R, Coppola G, Sirianni G, Di Lorenzo G, et al. A Randomized Double-Blind, Cross-Over Trial of very Low-Calorie Diet in Overweight Migraine Patients: A Possible Role for Ketones? Nutrients. 2019 Jul;11(8).
30. Reddel S, Putignani L, Del Chierico F. The Impact of Low-FODMAPs, Gluten-Free, and Ketogenic Diets on Gut Microbiota Modulation in Pathological Conditions. Nutrients. 2019 Feb;11(2).

Most read articles by the same author(s)