Pinsawas B.Surawit A.Mongkolsucharitkul P.Pongkunakorn T.Suta S.Manosan T.Ophakas S.Pumeiam S.Sranacharoenpong K.Mayurasakorn K.Mahidol University2024-10-162024-10-162024-01-01Journal of Nutrition (2024)00223166https://repository.li.mahidol.ac.th/handle/20.500.14594/101613Background: The low-carbohydrate-ketogenic diet, an effective strategy to address metabolic syndrome (MetS) and obesity has raised concerns about high-fat consumption on atherogenic lipoproteins. Objective: The aim of this study was to compare the Asian ketogenic diet (AKD), which incorporates balanced protein and fat intake from Asian foods, with a balanced low-caloric diet (BLC) in individuals diagnosed with MetS. Methods: A 52-wk randomized clinical trial included 3 parallel groups: AKD with increased whole egg intake [egg yolk Asian ketogenic diet (Yolk-AKD, n = 28)], yolk-free ketogenic diet with egg white supplementation [egg white Asian ketogenic diet (White-AKD, n = 26)], and BLC (n = 22). Primary outcomes were anthropometric and metabolic changes. Results: The AKD groups achieved significant reductions in weight and waist circumference (P < 0.05). Compared with the BLC group, the AKD groups demonstrated significant improvements in insulin resistance at week 6 and in triglyceride concentrations at weeks 12 (Yolk-AKD) and 35 (White-AKD) (P < 0.05). The AKD groups experienced improvements in hormones associated with insulin sensitivity and appetite, whereas only the Yolk-AKD group had a significant decrease in inflammation-related hormones (P < 0.05). From weeks 35–52, the AKD maintained reductions in anthropometric measurements, blood pressure, improved glucose tolerance, enhanced lipid profiles, and better liver function compared with the BLC. Conclusions: The AKD proved safe and effective, yielding various metabolic improvements in individuals with MetS compared with the BLC. Emphasizing a low-saturated fat diet while disregarding dietary cholesterol, this approach holds promise for MetS and obesity management. The inclusion of both White-AKD and Yolk-AKD groups allowed for a comprehensive assessment of the AKD's impact, elucidating the differential effects of whole egg consumption on metabolic outcomes. Further studies are warranted. This trial was registered at clinicaltrials.gov as NCT04608136.NursingMedicineArticleSCOPUS10.1016/j.tjnut.2024.08.0272-s2.0-852059330831541610039245182