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The lack of central carbon and nitrogen catabolism not only leads to energy deficiency but also reduces the supply of the main metabolite anabolic precursors such as pyruvate, acetyl-CoA, glucose-6-phosphate, and erythrose 4-phosphate used for biomass biosynthesis 21

In this context, the adoption of VLCKD is advised by the Italian Society of Endocrinology (SIE) for several obesity-related diseases, including hypertension, dyslipidemia, and type 2 diabetes mellitus [2]

It supports heart rate and cardiovascular function by promoting optimal performance and contractility of the heart muscles

Once T3 binds to TRs, it activates or represses the transcription of many genes