title: Acetone as biomarker for ketosis buildup capability--a study in healthy individuals under combined high fat and starvation diets.
abstract: BACKGROUND
  Ketogenic diets are high fat and low carbohydrate or very low carbohydrate diets, which render high production of ketones upon consumption known as nutritional ketosis (NK). Ketosis is also produced during fasting periods, which is known as fasting ketosis (FK). Recently, the combinations of NK and FK, as well as NK alone, have been used as resources for weight loss management and treatment of epilepsy.
  
  
  METHODS
  A crossover study design was applied to 11 healthy individuals, who maintained moderately sedentary lifestyle, and consumed three types of diet randomly assigned over a three-week period. All participants completed the diets in a randomized and counterbalanced fashion. Each weekly diet protocol included three phases: Phase 1 - A mixed diet with ratio of fat: (carbohydrate + protein) by mass of 0.18 or the equivalence of 29% energy from fat from Day 1 to Day 5. Phase 2- A mixed or a high-fat diet with ratio of fat: (carbohydrate + protein) by mass of approximately 0.18, 1.63, or 3.80 on Day 6 or the equivalence of 29%, 79%, or 90% energy from fat, respectively. Phase 3 - A fasting diet with no calorie intake on Day 7. Caloric intake from diets on Day 1 to Day 6 was equal to each individual's energy expenditure. On Day 7, ketone buildup from FK was measured.
  
  
  RESULTS
  A statistically significant effect of Phase 2 (Day 6) diet was found on FK of Day 7, as indicated by repeated analysis of variance (ANOVA), F(2,20) = 6.73, p < 0.0058. Using a Fisher LDS pair-wise comparison, higher significant levels of acetone buildup were found for diets with 79% fat content and 90% fat content vs. 29% fat content (with p = 0.00159**, and 0.04435**, respectively), with no significant difference between diets with 79% fat content and 90% fat content. In addition, independent of the diet, a significantly higher ketone buildup capability of subjects with higher resting energy expenditure (R(2) = 0.92), and lower body mass index (R(2) = 0.71) was observed during FK.
authors.affiliation: Current address: Center for Bioelectronics and Biosensors, the Biodesign Institute, Arizona State University, 1001 S McAllister Ave., Tempe, AZ, 85287, USA. aprabha1@asu.edu.
authors.forename: Amlendu
authors.initials: A
authors.lastname: Prabhakar
authors.affiliation: Current address: Center for Bioelectronics and Biosensors, the Biodesign Institute, Arizona State University, 1001 S McAllister Ave., Tempe, AZ, 85287, USA. ashley.quach@asu.edu.
authors.forename: Ashley
authors.initials: A
authors.lastname: Quach
authors.affiliation: Current address: Center for Bioelectronics and Biosensors, the Biodesign Institute, Arizona State University, 1001 S McAllister Ave., Tempe, AZ, 85287, USA. Haojiong.Zhang@asu.edu.
authors.forename: Haojiong
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Current address: Center for Bioelectronics and Biosensors, the Biodesign Institute, Arizona State University, 1001 S McAllister Ave., Tempe, AZ, 85287, USA. elianaterrera@hotmail.com.
authors.forename: Mirna
authors.initials: M
authors.lastname: Terrera
authors.affiliation: Current address: Center for Bioelectronics and Biosensors, the Biodesign Institute, Arizona State University, 1001 S McAllister Ave., Tempe, AZ, 85287, USA. D.Jackemeyer@asu.edu.
authors.forename: David
authors.initials: D
authors.lastname: Jackemeyer
authors.affiliation: Current address: Center for Bioelectronics and Biosensors, the Biodesign Institute, Arizona State University, 1001 S McAllister Ave., Tempe, AZ, 85287, USA. xiaojun.xian@asu.edu.
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Xian
authors.affiliation: Current address: Center for Bioelectronics and Biosensors, the Biodesign Institute, Arizona State University, 1001 S McAllister Ave., Tempe, AZ, 85287, USA. Tsing.Tsow@asu.edu.
authors.forename: Francis
authors.initials: F
authors.lastname: Tsow
authors.affiliation: Current address: Center for Bioelectronics and Biosensors, the Biodesign Institute, Arizona State University, 1001 S McAllister Ave., Tempe, AZ, 85287, USA. nongjian.tao@asu.edu.|School of Electrical, Computer, and Energy Engineering, Arizona State University, 650 E. Tyler Mall, Tempe, AZ, 85281, USA. nongjian.tao@asu.edu.
authors.forename: Nongjian
authors.initials: N
authors.lastname: Tao
authors.affiliation: Current address: Center for Bioelectronics and Biosensors, the Biodesign Institute, Arizona State University, 1001 S McAllister Ave., Tempe, AZ, 85287, USA. eforzani@asu.edu.|School for Engineering of Matter, Transport, and Energy, Arizona State University, 501 E. Tyler Mall, Tempe, AZ, 85287, USA. eforzani@asu.edu.
authors.forename: Erica S
authors.initials: ES
authors.lastname: Forzani
mesh_terms: D000096:Acetone / Q000097:blood* / Q000652:urine*; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism; D001944:Breath Tests; D018592:Cross-Over Studies; D050528:Diet, Carbohydrate-Restricted; D055423:Diet, Ketogenic; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage*; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D004734:Energy Metabolism; D005215:Fasting; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D007662:Ketosis / Q000097:blood* / Q000175:diagnosis; D008297:Male; D057185:Sedentary Behavior; D013217:Starvation / Q000097:blood*; D011795:Surveys and Questionnaires; D015431:Weight Loss; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins; D000096:Acetone