Asian Low-Carbohydrate Diet with Increased Whole Egg Consumption Improves Metabolic Outcomes in Metabolic Syndrome: A 52-Week Intervention Study

Background: The low-carbohydrate-ketogenic diet, an effective strategy to address metabolic syndrome (MetS) and obesity has been concerns about high fat consumption on atherogenic lipoproteins. This study aimed 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-week randomized clinical trial included three parallel groups: AKD with increased whole egg intake (Yolk-KD, aged 40.9 ± 1.7, n = 27), yolk-free ketogenic diet with egg white supplementation (White-KD, aged 41.5 ± 1.3, n = 26), and BLC diet (aged 38.5 ± 1.7, 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 to the BLC group, the AKD groups demonstrated significant improvements in fasting blood glucose, insulin resistance, and lipid profile at weeks 12 and 35 (P < 0.05). All groups experienced improvements in insulin sensitivity, inflammation, and appetite-related hormones like leptin and peptide YY (P < 0.05). From weeks 35 to 52, the AKD consistently maintained reductions in anthropometric measurements, improved glucose tolerance, enhanced lipid profiles, and better liver function compared to the BLC. Conclusion: The AKD proved safe and effective, yielding various metabolic improvements in individuals with Mets compared to the BLC. By emphasizing a low-saturated fat diet while disregarding dietary cholesterol, this approach holds promise for MetS and obesity management. Further studies are warranted. Trial registration: ClinicalTrials.gov identifier: NCT04608136, registered on September 21, 2020.