{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:19:57Z","timestamp":1788826797095,"version":"build-2803163510"},"reference-count":45,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study assessed changes in body composition and 24\u2010h energy metabolism at 6 and 12\u2009months after initiation of a 1\u2010month very low\u2010calorie ketogenic diet (VLCKD) in women with obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seventeen women with obesity who completed a 1\u2010month VLCKD underwent a 4\u2010week transition phase with carbohydrate reintroduction, followed by a hypocaloric balanced diet. Assessments of body composition by dual\u2010energy X\u2010ray absorptiometry (DXA) and 24\u2010h energy expenditure (24hEE) by a whole\u2010room indirect calorimeter were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Following the initial 7% weight loss, body weight further decreased at 6\u2009months (\u22123.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), primarily driven by a significant decrease in fat mass (\u221210%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). From 6 to 12\u2009months, three participants continued to lose weight, whereas most remained stable or partially regained. Lean soft tissue, decreased during the VLCKD phase, remained stable throughout follow\u2010up. Both 24hEE and 24\u2010h sleeping metabolic rate\u00a0exhibited a progressive trend toward increase. Minute\u2010by\u2010minute 24hEE trajectories revealed a significant increase in metabolic rate from 1 to 6\u2009months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The metabolic adaptation observed after 1\u2009month of VLCKD was no longer detectable at either 6 or 12\u2009months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings provide novel insight into the physiological adaptations following VLCKD, supporting its role in supervised weight loss programs for selected patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov identifier: NCT07418281<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/oby.70236","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T01:26:06Z","timestamp":1781573166000},"page":"1558-1568","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Six\u2010 and Twelve\u2010Month Changes in Body Composition and\n                    <scp>24\u2010h<\/scp>\n                    Energy Expenditure After a Very Low\u2010Calorie Ketogenic Diet"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6888-7080","authenticated-orcid":false,"given":"Alessio","family":"Basolo","sequence":"first","affiliation":[{"name":"Obesity and Lipodystrophy Center, Endocrinology Unit 1 University Hospital of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Piaggi","sequence":"additional","affiliation":[{"name":"Department of Information Engineering University of Pisa  Pisa 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