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CompletedNCT04322110Updated Mar 26, 2020

MR Fat Quantification and Elastography During a Very Low-calorie-ketogenic Diet (Pronokal Method®) vs a Low Calorie Diet

An interventional study of PronoKal Method and Low calorie diet in Liver Fat, sponsored by Protein Supplies SL. Completed. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-03-26.

Sponsored by Protein Supplies SL · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Registered 3 years 6 months after the study started (first participant enrolled Sep 2016, registered Mar 2020).
Phase
Not applicable
Study type
Interventional
Enrollment
40
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Prospective, multicenter, open-label, randomized and controlled study of the effects of weight loss and reduced visceral fat on non-alcoholic fat infiltration into liver after a very low calorie ketogenic diet (VLCK diet) (Pronokal® Method) versus a hypocaloric diet, with a 6-month follow-up.

Read the detailed description

The investigators will include obese patients with BMI higher than 30 kg / m2 to follow a standardized multidisciplinary weight-loss program (PronoKal® Method), which consists of a very-low-calorie diet, into which natural foods are gradually reintroduced, accompanied by physical exercise and emotional support, versus hypocaloric diet.

The aim of this study are see the reduction of fatty liver, visceral fat and improvement of hepatic stiffness during the weight loss treatment.

Patients will be visited monthly and data will recorded on 4 occasions: pre-inclusion, initial visit, 2-months visit (end of ketosis) and 6-months visit.

Hepatic fatty infiltration and visceral fat will be scanned by MRI and hepatic stiffness will be assessed by MR Elastography at: baseline, 2 months and 6 months. Also will be recorded anthropometric data (weight, BMI, waist circumference) and complete blood tests.

02

Conditions studied

  • Liver Fat

Keywords

  • Low-Calorie-Ketogenic diet
  • Low Calorie Diet
  • Pronokal Method®
  • Fat reduction
03

In context

Lead sponsor

Protein Supplies SL is the lead sponsor of 5 studies on the registry; none are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Patients of either sex, older than 18 years
  • Obese patients with BMI equal or over 30kg/m2
  • Patients who agree to participate and sign the Informed Consent

Exclusion criteria

Exclusion Criteria:

  • Pregnant or lactating women.
  • Patients weighing over 140 kg (by limitation of the MRI device)
  • Patients on anti-obesity drugs (eg, sibutramine, orlistat and liraglutide) or weight-interfering medications (eg, topiramate). In such cases a wash out period of 3 months is required.
  • Patients with alcohol intake > 20 g/day in women and > 30 g/day in men.
  • Patients with liver failure or with pathologies that may affect the liver
  • Patients with other causes of liver steatosis: chronic viral hepatitis and/or drug intake (corticosteroids, estrogens, NSAIDs, calcium antagonists, amiodarone, tamoxifen, tetracyclines, chloroquine, antiretrovirals, perhexiline).
  • Patients with eating disorders.
  • Patients with any psychiatric disorder (eg schizophrenia, bipolar disorder, substance abuse, severe depression).
  • Patients receiving dicumarinic anticoagulants (Sintrom®).
  • Patients taking corticosteroids.
  • Patients with severe kidney failure (gfr \<30).
  • Patients with type 1 and type 2 diabetes mellitus.
  • Patients with hemopathies, including coagulation disorders
  • Patients with cardiovascular or cerebrovascular disease (of heart rate disorders, recent infarction [\<6m], unstable angina, decompensated heart failure, recent stroke [\<6m]).
  • Patients in acute attack of gout.
  • Patients with renal lithiasis verified by ultrasound.
  • Patients with cholelithiasis verified by ultrasound.
  • Patients with electrolyte imbalance, according to medical criteria.
  • Patients with orthostatic hypotension.
  • Patients with cancer or history of cancer who have not been discharged from oncology
  • Patients who are not expected to attend follow-up visits
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
40 participants (actual)

Study arms

  • Experimental
    VLCK diet group

    Subjects undergoing treatment with weight loss program PronoKal Method

    Other: PronoKal Method

  • Active comparator
    Control group

    Subjects undergoing treatment with low calorie diet

    Other: Low calorie diet

Interventions

  • OtherPronoKal Method

    Multidisciplinary program of weight loss based on diet (initially ketogenic diet), physical activity and emotional support

  • OtherLow calorie diet

    Balanced hypocaloric diet (caloric intake 10% below basal metabolic rate) accompanied by physical exercise.

06

What researchers measure

Primary outcomes

  1. Liver fatty infiltration at 6 months

    Liver fatty infiltration percentage, measured by a MRI technique of fat liver quantification, fat at the end of treatment

    Time frame: 6 months

Secondary outcomes

  1. Liver fatty infiltration at 2 months

    Liver fatty infiltration percentage, measured by a MRI technique of fat liver quantification, at the end of ketosis

    Time frame: 2 months

  2. Visceral fat at 2 months

    Viceral fat measured by the area in squared centimeters at the level of the 3rd vertebrae, using MRI technique, at the end of ketosis.

    Time frame: 2 months

  3. Visceral fat at 6 months

    Viceral fat measured by the area in squared centimeters at the level of the 3rd vertebrae, using MRI technique, at the end of treatment.

    Time frame: 6 months

  4. Liver stiffness at 2 months

    Liver stiffness detected by MR Elastography at the end of ketosis

    Time frame: 2 months

  5. Liver stiffness at 6 months

    Liver stiffness detected by MR Elastography at the end of treatment

    Time frame: 6 months

  6. Size of adrenal gland at 2 months

    Linear size in centimetres of adrenal gland at the end of ketosis, measured by MRI.

    Time frame: 2 months

  7. Size of adrenal gland at 6 months

    Linear size in centimetres of adrenal gland at the end of treatment, measured by MRI.

    Time frame: 6 months

  8. Body Weight loss at 2 months

    Change in body weight from baseline to end of ketosis.

    Time frame: 2 months

  9. Body Weight loss at 6 months

    Change in body weight from baseline to end of treatment.

    Time frame: 6 months

  10. Salivary cortisol levels at 2 months

    Salivary cortisol levels at the end of ketosis

    Time frame: 2 months

  11. Salivary cortisol levels at 6 months

    Salivary cortisol levels at the end of treatment

    Time frame: 6 months

07

Study locations

No study locations are listed for this record.

08

References and documents

Publications

  • Cunha GM, Guzman G, Correa De Mello LL, Trein B, Spina L, Bussade I, Marques Prata J, Sajoux I, Countinho W. Efficacy of a 2-Month Very Low-Calorie Ketogenic Diet (VLCKD) Compared to a Standard Low-Calorie Diet in Reducing Visceral and Liver Fat Accumulation in Patients With Obesity. Front Endocrinol (Lausanne). 2020 Sep 14;11:607. doi: 10.3389/fendo.2020.00607. eCollection 2020. PubMed 33042004 ↗

Study documents

  • Protocol and statistical analysis plan · Apr 21, 2016

Documents are hosted by the registry — open the source record to download them.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Mar 26, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04322110
Lead sponsor
Protein Supplies SL
Responsible party
Sponsor
First posted
Mar 26, 2020
Start date
Sep 12, 2016
Primary completion
Jul 4, 2017
Completion
Oct 25, 2017
Last update
Mar 26, 2020

Study contacts

Walmir Coutinho, Ph
principal investigator · IEDE - Instituto Estadual de Diabetes e Endocrinologia
Guilherme Moura da Cunha, Ph
principal investigator · CDPI - Clínica de Diagnóstico por Imagen

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in May 2016. You cannot join it, but the record below documents what was studied.

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