The Effect of a Meatless,Keto Restrictive Diet on Body Composition,Strength Capacity,Oxidative Stress,Immune Response
Condition: Body Weight; Oxidative Stress; Trimethylamine N-oxide; Immunologic Factors; Glucose Metabolism Disorders; Insulin Resistance; Insulin Sensitivity; Insulin Tolerance; Carbohydrate Metabolism Disorder; Lipid Metabolism Disorders; Body Fat Disorder; Ketosis; Ketoses, Metabolic; Somatic Disorders
MeSH terms: Insulin Resistance; Metabolic Diseases; Glucose Metabolism Disorders; Ketosis; Lipid Metabolism Disorders; Body Weight
Study type: Interventional

Summary: 
      The subject of doctoral dissertation: Assessment of the effects of a meatless, ketogenic
      restrictive diet on body composition, strength capacity, oxidative stress and immune response

      During planning of research and topic of the doctoral dissertation, it was considered how to
      modify a standard ketogenic diet rich in saturated fatty acids so that the use of this model
      of nutrition has the most anti-inflammatory effect. Therefore, it was decided to conduct a
      research to check whether a diet rich in omega-3 polyunsaturated fatty acids will show such
      an effect when following a high-fat diet.

      Hypotheses:

      1. The ketogenic diet reduces systemic inflammation. 2.The ketogenic diet reduces oxidative
      stress. 3. The ketogenic diet reduces body fat. 4. A ketogenic diet does not worsen strength
      performance.
    

Detailed description: 
      a) main research assumption

      Reports in the international literature regarding the importance of the ketogenic diet are
      ambiguous. Some researchers believe that its use reduces body fat and improves insulin
      sensitivity or lipid profile, while others question this view and question it. Many authors
      emphasized the need for further research in this area, and this outline of the research
      project responds to this postulate.

      In the presented experiment, the duration of a single experiment was 14 days, because the
      individual adaptation period of each participant should be taken into account - the so-called
      "keto-adaptation".

      In order to assess the effectiveness of the nutritional intervention in this experiment, the
      following were performed: blood sampling for the determination of basic parameters (lipid
      profile, fasting glucose, fasting insulin, diabetic panel, hormones), determination of
      glucose and ketone bodies (β ketones) in the blood using a strip test - Optium Xido Neo
      glucometer, determination of the concentration of ketone bodies (acetoacetic acid) and
      glucose in the urine using Keto-Diastix - a strip test, examination by means of tests - force
      (maximum isokinetic force test with the use of Biodex apparatus), determination of
      inflammatory markers (TNF alpha, pro-inflammatory, anti-inflammatory and pro-or
      anti-inflammatory interleukins depending on the conditions), determination of oxidative
      stress markers - related to free radical damage to proteins (carbonyl groups, sulfhydryl
      groups (SH groups)), body composition measurement using the DEXA method (Dual Energy X-ray
      Absorptiometry). Choosing this method instead of the very common bioimpedance, due to the
      fact that using densitometry, it obtained very precise results of adipose tissue.

      The above-described procedures were used to check the molecular basis of the phenomenon under
      study, to determine the parameters in which significant changes are visible and to determine
      the extent to which they translate into the function of the muscle and the subjective
      feelings of the subject.

      Research methodology:

        -  body composition (DEXA)- Isometric muscle strength (Biodex)

        -  blood tests (lipid profile, glucose, insulin, ketone bodies)

        -  inflammatory markers - Luminex method with the use of BioRad BioPlex 200 reader Pro and
           anti-inflammatory cytokines (Bio-Plex Pro ™ Human Cytokine 8-plex Assay M50000007A,
           BIO-RAD, USA) (including IFN-y, IL-6, IL-8, IL-10, TNF-a, IL-2, IL-4)

        -  metabolic panel - Luminex method with the use of BioRad BioPlex 200 readerm (Bio-Plex
           Pro ™ Human Diabetes 10-Plex Assay # M171A7001M, BIO-RAD, USA) (including ghrelin,
           glucagon, insulin, leptin, resistin)

        -  markers of oxidative stress - Colorimetric method; Plate-based colorimetric measurement
           (360-385 nm) (concentration of protein carbonyl groups: Protein Carbonyl Colorimetric
           Assay Kit No. 100005020 (Cayman Chemical, Ann Arbor, MI, USA)

        -  markers of oxidative stress (concentration of protein thiol groups)

        -  TMAO (trimethylamine N-oxide)
    

Intervention name(s): Meatless, restrictive ketogenic diet
Intervention type(s): Other
Intervention description(s): Each participant received a nutritional plan that was the same qualitatively but differed quantitatively - a 500 kcal reduction based on Estimated Energy Requirement (EER) was assumed. Before the start of the study, each participant obtained information about the basic principles of the ketogenic diet. Diet was designed to be isoproteic (1.8gxKg-1xbody weight-1xday-1) with three meals a day. The distribution of macronutrients during the very low carbohydrate ketogenic diet (KD) was: protein 1.8 gxKg-1xbody weight-1xday-1(~25-30%), fats (~65-70%,with a strong emphasis on the content of omega 3 fatty acids) and carbohydrate (<30gxday-1;<10%).
The food lists encouraged the consumption of fish,raw and cooked vegetables, eggs,fruits with the lowest glycemic index (blueberry, raspberry), plant oils and fats from avocado,olives.Drinks permitted were tea, coffee without sugar and the foods and drinks to be avoided were alcohol,meat (any kind of meat),bread,pasta,rice,milk,dairy and potatoes.
Intervention model: Single Group Assignment
Intervention model description: Each participant received a nutritional plan that was the same qualitatively but differed quantitatively. It was calculated for each individual based on the Mifflin-St Jeor Equation (Basal Metabolic Rate).
After that, the levels of physical activity (PAL) were used to assess physical activity patterns and energy expenditure of individuals for placement into one of four PAL categories: sedentary, low active, active, or very active. That helped to calculate EER and made an individual reduction (minus 500 kcal / day). Before the start of the study, each participant obtained information about the basic principles of the ketogenic diet. Diet was designed to be isoproteic (1.8 g x Kg- 1 x body weight- 1 x day-1) with three meals a day. The distribution of macronutrients during the ketogenic diet (KD) was: protein 1.8 g x Kg-1 x body weight- 1 x day-1 (~ 25-30%), fats (~ 65-70%, with a strong emphasis on the content of omega 3 fatty acids) and carbohydrate (< 30 g x day- 1; < 10%).
Masking: None (Open Label)
Primary purpose: Basic Science
Keywords: ketogenic diet; ketosis; oxidative stress; immune response; insulin resistance; body composition; strength capacity; omega 3 acids; meatless diet