{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T01:45:03Z","timestamp":1780105503231,"version":"3.54.0"},"reference-count":23,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Obesity is constantly growing worldwide, representing a serious concern also for healthcare costs. Current anti-obesity pharmacological strategies, although effective, represent a significant cost for the patient. Similarly, very low energy ketogenic therapy (VLEKT) protocols with replacement meals also have high costs. Objectives: The objective of this study was to estimate the average costs of a VLEKT protocol with replacement meals compared with those of isocaloric diets with fresh foods. Methods: VLEKTs with replacement meals and fresh foods were developed considering an ideal young woman and man with grade II obesity (BMI \u2265 35.0 kg\/m2). The costs of the individual fresh foods were extrapolated from official Italian databases. The costs of replacement meals were obtained by consulting the catalogs of three companies specialized in VLEKTs operating in Italy. Results: On a monthly basis, VLEKT with fresh food had an average cost of EUR 253.44 and EUR 295.67, while VLEKT with replacement meals had an average cost of EUR 434.91 and EUR 535.99, for the woman and man, respectively. Conclusions: Although more expensive than a common diet, VLEKT should be seen not only as a dietary method for losing weight, but as a non-pharmacological, medicalized nutritional therapy, useful for managing various conditions, even those not directly related to obesity. Like a drug therapy, VLEKT requires the use of specific products that entail a higher cost, to be borne by the patient, but whose benefits should be emphasized, which go beyond weight loss and concern general health, thus considering them as a targeted nutritional strategy.<\/jats:p>","DOI":"10.3390\/nu17030422","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T04:32:22Z","timestamp":1737693142000},"page":"422","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Very Low Energy Ketogenic Therapy (VLEKT), Not Only a Price Matter: A Comparison Study on Average Costs of VLEKT with Fresh Foods and Replacement Meals"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1922-662X","authenticated-orcid":false,"given":"Giuseppe","family":"Annunziata","sequence":"first","affiliation":[{"name":"Facolt\u00e0 di Scienze Umane, della Formazione e dello Sport, Universit\u00e0 Telematica Pegaso, Via Porzio, Centro Direzionale, Isola F2, 80143 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludovica","family":"Verde","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Falco","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, European University of Madrid, 28670 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6986-266X","authenticated-orcid":false,"given":"Silvia","family":"Savastano","sequence":"additional","affiliation":[{"name":"Unit of Endocrinology, Diabetology, Andrology and Nutrition, DAI of Endocrinology, Diabetology, Andrology, Centro Italiano per la Cura e il Benessere del Paziente con Obesit\u00e0 (C.I.B.O), Azienda Ospedaliera Universitaria Federico II, Via Sergio Pansini 5, 80131 Naples, Italy"},{"name":"Unit of Endocrinology, Dipartimento di Medicina Clinica e Chirurgia, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annamaria","family":"Colao","sequence":"additional","affiliation":[{"name":"Unit of Endocrinology, Diabetology, Andrology and Nutrition, DAI of Endocrinology, Diabetology, Andrology, Centro Italiano per la Cura e il Benessere del Paziente con Obesit\u00e0 (C.I.B.O), Azienda Ospedaliera Universitaria Federico II, Via Sergio Pansini 5, 80131 Naples, Italy"},{"name":"Unit of Endocrinology, Dipartimento di Medicina Clinica e Chirurgia, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy"},{"name":"Cattedra Unesco \u201cEducazione Alla Salute e Allo Sviluppo Sostenibile\u201d, University Federico II, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Muscogiuri","sequence":"additional","affiliation":[{"name":"Unit of Endocrinology, Diabetology, Andrology and Nutrition, DAI of Endocrinology, Diabetology, Andrology, Centro Italiano per la Cura e il Benessere del Paziente con Obesit\u00e0 (C.I.B.O), Azienda Ospedaliera Universitaria Federico II, Via Sergio Pansini 5, 80131 Naples, Italy"},{"name":"Unit of Endocrinology, Dipartimento di Medicina Clinica e Chirurgia, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy"},{"name":"Cattedra Unesco \u201cEducazione Alla Salute e Allo Sviluppo Sostenibile\u201d, University Federico II, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9054-456X","authenticated-orcid":false,"given":"Luigi","family":"Barrea","sequence":"additional","affiliation":[{"name":"Dipartimento Psicologia e Scienze della Salute, Universit\u00e0 Telematica Pegaso, Centro Direzionale Isola F2, Via Porzio, 80143 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1038\/s41366-023-01398-y","article-title":"Economic Costs of Obesity: A Systematic Review","volume":"48","author":"Nagi","year":"2024","journal-title":"Int. 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