About KENKEN is a revolutionary weight reduction technique developed by Italian Professor Gianfranco Capello who set up the first clinic in Rome. This technique can help obese people lose up to 6 – 10% of their initial body weight in just 10 days. KEN allows the body to switch into “Ketogenic” mode, whereby it breaks down its own fat stored for use as energy. The patients do not feel hungry throughout the entire duration of the 10 day session, and can perform normal daily activities without impairment and without the need for any additional food.The doctor threads a narrow tube through the patient’s nose, down their throat and into their stomach. A pump drip feeds a protein liquid formula through the tube continuously throughout the day and night for a period of 10 days. There is no limit on how often this 10 day cycle can be repeated but there needs to be a 10 day rest period in between cycles. The estimated energy intake while on this diet is 240 calories per day.

Ketogenic Enteral Nutrition

Blackburn explained that reduced insulin release and production accounted for the observed protein sparing effect.

Carbohydrates, especially glucose, stimulate the release and production of insulin thereby promoting protein catabolism and fat deposition, the precise opposites of dieters’ desired outcomes.

Infusion of proteins, however, stimulates the production and release of insulin much less, so infusion of proteins spares lean body mass and burns fat, accounting for the observed production of ketone bodies (see 4) and triglycerides.

Through KEN, obese patients rapidly lose body fat while sparing muscle and vital organs. Too, the ketone bodies from KEN reduce or even eliminate hunger.

Protein sparing effectBlackburn (Harvard Medical School, 1973)

Can the production of ketone bodies during Protein Sparing KEN diet harm the client?

No, not at the low ketone body levels observed in KEN.

• An increase in blood ketone bodies, ketonemia, is observed whenever body fat is catabolized. When the catabolism of fat is slow, the increase in ketone bodies is slight. When the catabolism of fat is rapid, the increase in ketone bodies is significant and metabolic acidosis occurs.

• In the normal non-diabetic patient, ketonemia stimulates insulin production, slowing the mobilization of fat and preventing ketonemia from rising dangerously.

• The ketonemia becomes dangerous only when it occurs in patients with reduced insulin response, as in uncompensated diabetes. ( Type- 1).

• The slight ketonemia of KEN is helpful during the weight loss program because it reduces the appetite for food and so increases patient tolerance of the KEN fast.

• Prolonged ketogenic diets are used safely in refractory epileptic patients. In such cases there is no risk to health and brain activity, such as cognitive abilities or task performance, such as driving a car.

Why is each KEN cycle limited to 10 days?

After 10 days of KEN’s marked sustained reduction in caloric intake, body metabolism shifts towards a series of homeostatic defence mechanisms that cause markedly lower energy expenditure—reduction of general motility, decreased heart rate, and a tendency to stupor. To abort the counter-productive lower energy expenditure, a 2 week rest period of resumed controlled oral feedings is interposed between cycles of KEN. The 2 week rest period is sufficient to reacquire the original rapid weight loss response when KEN is resumed.Rest periods were instituted to optimize rapid weight loss and to increase patient satisfaction and acceptance. The rest periods provide a psychological relief to the patient who can return to a normal life. Rest periods are utilized to train the patient in developing dietary and lifestyle modifications necessary to manage weight once the treatment is discontinued.

During KEN cycles, why may patients may take only water, tea, chamomile tea and coffee without sugar or other sweeteners?

• The fewer carbohydrates consumed, the greater the reduction of insulin which would otherwise tend to conserve fat.

• Elevated insulin would also increase the sense of hunger, leading towards treatment failure: the client would suffer and resign to the temptation to cease the diet.

• Of course we cannot completely eliminate carbohydrates. There are small amounts of carbohydrates in the KEN solution and in some prescriptions that the patient may take.

• Prescription tablets containing small amounts of carbohydrates that are absorbed slowly are preferred to the same drugs taken in the form of a soluble powder or soluble tablets contain a quantity of sweeteners that are absorbed more rapidly and therefore are more at risk of stimulating insulin.

Should patients take plenty of fluids during KEN?

• Normal (unforced) hydration and urine output is encouraged.• We advise patients to drink when thirsty and not to force the

fluid intake. Recall that we already administer 2 litres of fluid per day through the KEN infusion pump.

• Since the urinary levels of ketones during KEN is very low, even doubling the loss of urinary ketone is not a huge factor and can entail a greater sacrifice for patients who are already subjected to frequent urination, especially at night.

• Some client tend to drink fluids heavily even though we do not recommend it. This can lead to a reduction in the ketonuria that is recorded daily.

Transition – KEN

KEN ClinicAIWO CHENNAIKamaraj Memorial Hall,

Basement,498/500 – Anna Salai, Teynampet,Chennai – 600 006, India.Tel: +91 044 2433 5916 / 044 6694 9080Phone: +91 95000 65656Email: contact@aiwo.comWeb: www.aiwo.com

AIWO KEN MUMBAIMilan Clinic

B, Saraswati Road,Near Gokul ICE Cream, Santacruz (W),Mumbai 400 054Ph: +91 022-26492762 / 022-26482749

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