What is it about
The KEN consists of a 24 hours a day infusion of a simple solution of proteins in a cycle of 10 days:
a) Infusion of proteins allows the patient to lose in 10 days up to 7% to 10% of initial body weight.
b) Continuous infusion creates a state of ketosis (children’s ketoacidosis) which takes away all feeling of hunger.
Ketogenic Enteral Nutrition (KEN)
Since 1986 we have used a protein-based AN to get a good weight loss in obese patients who were placed in treatment for a variety of illnesses (inflammatory bowel disease, abdominal fistulae, dysphagia from neurological conditions).
Four years ago, a young lady with colic fistula, and after the anterior resection of the rectum, obtained within one month the spontaneous healing of the fistula and a weight loss of 20 kg. The daughter, who was also heavily overweight, asked to be subjected to the same treatment with the only purpose to lose weight. Since it was accepted that the infusion of protein was of no risk of any kind, she was put on the tube and after 20 days she had lost 12 kg. It was the first case that dealt with obesity as an illness in its own right. From then on, and by word of mouth, patients begun increasing day by day. Since the slow infusion of protein generates ketosis (which eliminates the feeling of hunger) the technique was called Ketogenic Enteral Nutrition (KEN).
Up till the end of 2009, 8,834 patients have been treated with KEN who have lost around 106 tons collectively.
Before putting the tube, patients must fill out a questionnaire that gathers their past history in relation to obesity and in relation to major diseases.
In principle, only 3 categories of patients cannot be subjected to KEN:
a) Patients who cannot take a normal amount of protein. The KEN provides the administration of 60-80 grams of protein a day, when the amount that would normally be assumed corresponds to a gram of protein per kilogram of body weight (that is a much greater quantities). But there are patients with kidney failure that are forced on diets which are low in protein, including low-protein pasta and bread. These patients cannot categorically be included in the treatment with KEN.
b) Patients allergic to milk proteins. The solutions that we commonly use are proteins derived from milk. Those who are allergic to milk proteins and are prone to skin irritation due to dairy intake cannot be possibly subjected to the KEN with the usual protein solutions. They must use alternative types of protein solutions, although these have a higher cost.
c) Patients less than 14 years old. Diets below this age are likely to induce severe alterations that might lead to anorexia. We chose not to treat patients that might run this risk.