title: Effects of n-3 polyunsaturated fatty acids (ω-3) supplementation on some cardiovascular risk factors with a ketogenic Mediterranean diet.
abstract: BACKGROUND
  the ketogenic diet (KD) has become a widely used nutritional approach for weight loss. Some of the KD's positive effects on metabolism and cardiovascular risk factors are similar to those seen after n-3 polyunsaturated fatty acids (ω-3) supplementation. We hypothesized that a ketogenic Mediterranean diet with phytoextracts combined with ω-3 supplementation may have increased positive effects on cardiovascular risk factors and inflammation.
  
  
  METHODS
  We analyzed 34 male overweight subjects; aged between 25 and 65 years who were overall healthy apart from overweight. The subjects followed a ketogenic diet protocol for four weeks; with (KDO3) or without (KD) ω-3 supplementation.
  
  
  RESULTS
  All subjects experienced a significant loss of body weight and body fat and there was no significant differences between treatment (body weight: KD-4.7 kg, KDO3-4.03 kg, body fat KD-5.41 kg, KDO3-5.86 kg). There were also significant decreases in total cholesterol, LDL-c, and glucose levels. Triglycerides and insulin levels decreased more in KDO3 vs. KD subjects, with a significant difference. All the investigated inflammatory cytokines (IL-1β, IL-6, TNF-α) decreased significantly in KDO3 subjects whilst only TNF-α showed a significant decrease in KD subjects over the 12 month study period. No significant changes were observed in anti-inflammatory cytokines (IL-10 and IL-1Ra), creatinine, urea and uric acid. Adiponectin increased significantly only in the KDO3 group.
  
  
  CONCLUSIONS
  ω-3 supplementation improved the positive effects of a ketogenic Mediterranean diet with phytoextracts on some cardiovascular/metabolic risk factors and inflammatory state.
authors.affiliation: Department of Biomedical Sciences, University of Padova, 35131 Padova, Italy. antonio.paoli@unipd.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Paoli
authors.affiliation: Department of Biomedical Sciences, University of Padova, 35131 Padova, Italy. tatiana.moro.phd@gmail.com.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Moro
authors.affiliation: Department of Biomedical Sciences, University of Padova, 35131 Padova, Italy. gerardo.bosco@unipd.it.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Bosco
authors.affiliation: Sport and Exercise Sciences Research Unit, University of Palermo, 90144 Palermo, Italy. antonino.bianco@unipa.it.
authors.forename: Antonino
authors.initials: A
authors.lastname: Bianco
authors.affiliation: Biomedical Engineering Laboratory, Institute of Communication and Computer Systems, National Technical University of Athens, Athens 15773, Greece. keith.grimaldi@gmail.com.
authors.forename: Keith A
authors.initials: KA
authors.lastname: Grimaldi
authors.affiliation: Department of Surgery, University of South Florida, Tampa, FL 33620, USA. dmangar1@gmail.com.|TEAMHealth, Tampa, FL 33606, USA. dmangar1@gmail.com.|Tampa General Hospital, Tampa, FL 33606, USA. dmangar1@gmail.com.
authors.forename: Enrico
authors.initials: E
authors.lastname: Camporesi
authors.affiliation: TEAMHealth, Tampa, FL 33606, USA. dmangar1@gmail.com.|Tampa General Hospital, Tampa, FL 33606, USA. dmangar1@gmail.com.
authors.forename: Devanand
authors.initials: D
authors.lastname: Mangar
mesh_terms: D050154:Adiposity / Q000187:drug effects; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000097:blood; D016207:Cytokines / Q000097:blood; D055423:Diet, Ketogenic; D038441:Diet, Mediterranean; D019587:Dietary Supplements; D015525:Fatty Acids, Omega-3 / Q000494:pharmacology*; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000178:diet therapy; D010936:Plant Extracts / Q000627:therapeutic use; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D008078:Cholesterol, LDL; D016207:Cytokines; D015525:Fatty Acids, Omega-3; D007328:Insulin; D010936:Plant Extracts; D014280:Triglycerides