307-OR: Mean Blood Beta-Hydroxybutyrate Predicts Clinically Significant Weight Loss following 90 Days Carbohydrate-Restricted Nutrition Therapy

Very low carbohydrate diets (VLCD) can reduce weight and often target nutritional ketosis (NK). This analysis assessed the relationship between NK (mean blood beta-hydroxybutyrate, BHB) and weight loss during the first 90 days in 6283 patients treated via a continuous remote care model. Daily medical record weight and fingerstick BHB data obtained from patients with BMI ≥ 25 kg/m2 and type 2 diabetes or prediabetes counseled to target NK for 90 days were included. Linear regression and receiver operating characteristic curve analyses were performed. Clinically significant weight loss (≥5%, CSWL) was achieved by 63.0% (3958/6283) of patients (6.6±4.7% body weight loss at 90 days). Mean BHB over 90 days was a significant predictor of weight change (F=982, R2=0.135, P 1 mM higher likelihood of achieving CSWL within 90 days of initiating a VLCD. A therapeutic target for BHB may be > 0.5-0.7 mM, and likelihood of CSWL increases with higher mean BHB. Future analyses should explore means by which the relationship can be further refined and the impact of longer therapy duration. Disclosure A. L. Mckenzie: Employee; Self; Virta Health Corp., Stock/Shareholder; Self; Virta Health Corp. S. J. Athinarayanan: Employee; Self; Virta Health Corp. R. N. Adams: Employee; Self; Virta Health Corp., Stock/Shareholder; Self; Virta Health Corp. B. M. Volk: Employee; Self; Virta Health Corp., Virta Health Corp. S. Phinney: Stock/Shareholder; Self; Beyond Obesity LLC, Virta Health Corp. R. E. Ratner: Employee; Self; Virta Health Corp.