The hypocaloric ketogenic diet Pnk® has been continuously evolving for 17 years through research and improvement in its application, which allows us to say that it is an increasingly attractive way to address the problem of overweight and obesity for many people with this disease. Today, the approach has been further deepened through the Genomics® study, which allows us to know the individual expression of a group of specific genes linked to obesity in each patient and to be able to act accordingly (with specific measures proven to be effective) on adverse genetics that often prevents the control of this health problem.
In spite of this, we must bear in mind that the Pnk protocol has indications and contraindications and it is important for the patient to be aware of them beforehand. This does not mean that, when in doubt, it is not possible to consult the expert doctor of the method and to know in detail the individual characteristics of each case.
The main indications of this diet are:
- Obesity: BMI > 30.
- Also in overweight with 25 less than BMI less than 30 + Metabolic syndrome.
- Preoperative.
- Patients refractory to other diets.
- A clear improvement of migraine headaches associated with obesity has also been observed with this type of diet.
The main contraindications of the Pnk® Method are well described and endorsed by renowned scientific societies in Spain such as FESNAD and SEEDO:
- Physiological: infancy, pregnancy, lactation, impaired elderly.
- BMI less than 30 kg/m2 without diseases secondary to overweight.
- Psychiatric disorders: eating disorders, severe depression, psychosis, drug addiction.
- Water and electrolyte disorders and orthostatic hypotension.
- Protein-losing diseases: Cushing’s disease, systemic lupus erythematosus, proteinuria, cancer (without oncological discharge), malabsorption syndrome, inflammatory bowel disease, etc.
- Treatment with corticosteroids, mainly oral or injectable.
- Situations in which caloric restriction may aggravate or precipitate a disease: porphyrias, neoplasms, liver or kidney disease, Gilbert’s disease.
- Acute or recent (less than 6 months of evolution) cardiovascular diseases, cardiac arrhythmias, stroke, heart failure.
- Major surgery or severe trauma in the last 3 months.
- Children and adolescents less than 16 years.
- Eating disorders (bulimia).
- Active alcoholism with or without treatment.
- Drug addiction.
- Severe psychological disturbance:
- Schizophrenia.
- Bipolar disorder.
- Major depression.
- Severe hepatic alteration (cirrhosis, hepatic insufficiency).
- Renal function alteration.
- DM type 1.
- Obligatory and permanent use of diuretics (thiazide, furosemide). Adrenal alterations (Cushing’s disease).