Reply to Najjar, R.S. Comment on "Dynka et al. The Ketogenic Diet and Cardiovascular Diseases. Nutrients 2023, 15, 3368".

We thank Dr. Najjar for his interest [...].

Keto Menu-Effect of Ketogenic Menu and Intermittent Fasting on the Biochemical Markers and Body Composition in a Physically Active Man-A Controlled Case Study.

The combination of ketogenic diet (KD) with intermittent fasting (IF) has, for years, aroused a great interest in the scientific world and among healthy lifestyle enthusiasts. Its importance is even greater when the study subjects are physically active individuals. The aim of the study was a determination of the effect of strict calculated ketogenic menu combined with IF and with caloric deficit on the selected biochemical markers and body composition in a 23-year-old man performing strength training. At the same time, we decided to conduct the first so-deeply investigated and controlled case study in this respect. The study protocol included a 13-week-long ketogenic diet with intermittent fasting (of delayed time-restricted eating 16:8 type) and caloric deficit. A detailed menu was designed and was used by the man throughout the whole study duration. A number of blood tests were performed before and after the implemented dietary intervention. Additionally, body composition was determined weekly and the concentrations of glucose and ketone bodies, as well as pulse rate and arterial pressure, were measured daily. The most important changes noted included a significant increase in testosterone and vitamin D concentrations and significant reduction in the HOMA-IR index and concentrations of hepatic enzymes, insulin, glucose, iron, urea, and free triiodothyronine (FT3). Moreover, a significant improvement of body composition occurred (the ratio of total body mass to the adipose and muscular tissue and water mass improved). Favourable changes were also noted in heart rate and arterial pressure values. In view of that, the KD with IF and caloric deficit exerted favourable effects on most biochemical parameters and on body composition and caused an almost twofold increase in serum testosterone concentration.

The Ketogenic Diet and Cardiovascular Diseases.

The most common and increasing causes of death worldwide are cardiovascular diseases (CVD). Taking into account the fact that diet is a key factor, it is worth exploring this aspect of CVD prevention and therapy. The aim of this article is to assess the potential of the ketogenic diet in the prevention and treatment of CVD. The article is a comprehensive, meticulous analysis of the literature in this area, taking into account the most recent studies currently available. The ketogenic diet has been shown to have a multifaceted effect on the prevention and treatment of CVD. Among other aspects, it has a beneficial effect on the blood lipid profile, even compared to other diets. It shows strong anti-inflammatory and cardioprotective potential, which is due, among other factors, to the anti-inflammatory properties of the state of ketosis, the elimination of simple sugars, the restriction of total carbohydrates and the supply of omega-3 fatty acids. In addition, ketone bodies provide "rescue fuel" for the diseased heart by affecting its metabolism. They also have a beneficial effect on the function of the vascular endothelium, including improving its function and inhibiting premature ageing. The ketogenic diet has a beneficial effect on blood pressure and other CVD risk factors through, among other aspects, weight loss. The evidence cited is often superior to that for standard diets, making it likely that the ketogenic diet shows advantages over other dietary models in the prevention and treatment of cardiovascular diseases. There is a legitimate need for further research in this area.

Effect of the Ketogenic Diet on the Prophylaxis and Treatment of Diabetes Mellitus: A Review of the Meta-Analyses and Clinical Trials.

The exponentially growing frequency of diagnosing diabetes mellitus means that a verification of the previous dietetic approach to treating the disease seems justified. The simultaneous growth of interest in the ketogenic diet and the development of knowledge in this field have contributed to the increasingly frequent application of the ketogenic diet in diabetes treatment. This paper also deals with that issue; its aim includes an extensive analysis of the influence of the ketogenic diet on the prophylaxis and treatment of diabetes. The paper has been prepared based on a wide, meticulous analysis of the available literature on the subject. Among other findings, a favorable effect of that nutrition model has been demonstrated on the values of glycated hemoglobin, glucose, insulin, or other metabolic parameters in diabetes patients. The effect of the ketogenic diet on the pharmacotherapy of type 1 and type 2 diabetes has been presented and compared with the standard nutritional management plan recommended for that disease. Further research is needed in this field, especially studies with a long follow-up period. The discussed articles report interesting therapeutic advantages to the ketogenic diet in comparison with standard diets.

The Role of Ketogenic Diet in the Treatment of Neurological Diseases.

Over a hundred years of study on the favourable effect of ketogenic diets in the treatment of epilepsy have contributed to a long-lasting discussion on its potential influence on other neurological diseases. A significant increase in the number of scientific studies in that field has been currently observed. The aim of this paper is a widespread, thorough analysis of the available scientific evidence in respect of the role of the ketogenic diet in the therapy of neurological diseases such as: epilepsy, Alzheimer's disease (AD), Parkinson's disease (PD), multiple sclerosis (MS) and migraine. A wide range of the mechanisms of action of the ketogenic diet has been demonstrated in neurological diseases, including, among other effects, its influence on the reduction in inflammatory conditions and the amount of reactive oxygen species (ROS), the restoration of the myelin sheath of the neurons, the formation and regeneration of mitochondria, neuronal metabolism, the provision of an alternative source of energy for neurons (ketone bodies), the reduction in glucose and insulin concentrations, the reduction in amyloid plaques, the induction of autophagy, the alleviation of microglia activation, the reduction in excessive neuronal activation, the modulation of intestinal microbiota, the expression of genes, dopamine production and the increase in glutamine conversion into GABA. The studies discussed (including randomised controlled studies), conducted in neurological patients, have stressed the effectiveness of the ketogenic diet in the treatment of epilepsy and have demonstrated its promising therapeutic potential in Alzheimer's disease (AD), Parkinson's disease (PD), multiple sclerosis (MS) and migraine. A frequent advantage of the diet was demonstrated over non-ketogenic diets (in the control groups) in the therapy of neurological diseases, with simultaneous safety and feasibility when conducting the nutritional model.

Food Sources of Potassium in the Average Polish Diet.

The aim of this study was to identify the food sources of potassium in the average Polish diet based on the data from the 2016 Household Budget Survey conducted on the representative sample of the Polish population (36,886 households, n = 99,230). This survey is organized by the Central Statistical Office and is related to the expenditures, quantitative consumption and revenues in households. We analyzed 91 sub-groups (i.e., milk, red meat) from 13 food categories (i.e., milk and dairy products, meat and products). Our findings indicated that the daily supply of potassium in the average Polish diet was 2617.9 mg, which meant covering the average allowance in 83%. Vegetables provided 32.5% of potassium, of which potatoes accounted for 16.2% of supply, and other vegetables for 16.2%. Tomatoes as well as other vegetables and mushrooms provided a total of 8.2% of potassium among vegetables. The next position was taken by the meat and meat products category (17.7%), with the largest share of meat products (6.7%) and red meat (5.2%). Cereal products supplied 16.64% of potassium, of which bread, rolls and bread products (12.2%) were of the greatest importance. Milk and dairy products turned out to be the fourth product category as a source of potassium (11.9%), with the highest share of milk (6.8%) and yoghurts and milk drinks (3.9%).

Nutrition of students from dietetics profile education in the Siedlce University of Natural Sciences and Humanities compared with students from other academic centres.

BACKGROUND: Appropriate nutrition in humans is one of the most important factors affecting normal development, nutritional status and keeping healthy. University students can be overburdened with responsibilities arising from their studies which may result in abnormal diet/nutrition and decrease their levels of physical activity. OBJECTIVE: To determine and assess nutrition and eating habits for selected female students studying nutrition at the Siedlce University of Natural Sciences & Humanities (UPH), compared with young people from other academic centres also studying nutrition and having a similar education profile. MATERIAL AND METHODS: A diagnostic survey was undertaken anonymously on 100 female student subjects using a proprietary questionnaire. Students were undergraduates at the UPH during their 2nd and 3rd year. RESULTS: Dietetics students considered that the practical application of proper nutrition principles is very important. Nevertheless, 44% assessed themselves to follow abnormal diets; 58% declared they ate whole grains frequently whereas 58% and 65% respectively consumed fruit and vegetables daily. Dietary irregularities were identified, particularly in how often fish was eaten, where 46% either never ate fish or did so only occasionally. Subjects preferred lean cuts of poultry meat (65%), and the most common cooking practice was frying (52%). CONCLUSIONS: Subjects did not follow dietary recommendations, although responses varied in the different academic centres. Despite learning from their studies about normal nutritional requirements it seems that, to large degree, students follow eating habits acquired during their childhoods in the home.