The Effect of Exercise During Ketogenic Diet on Hepatokines and Blood Lipid Profile in Overweight or Obese Men

Abstract

Background and Aims Liver heptokines are important factors in obesity-related diseases. Both exercise and diet are essential interventions for obesity control. This study aims to compare the effectiveness of six weeks of aerobic and resistance exercises and ketogenic diet on fibroblast growth factor 21 (FGF21) selenoprotein P. levels and blood lipid profile in overweight or obese men. Methods This is a quasi-experimental study with a pretest-posttest design. Participants were 36 overweight or obese male college students with a body mass index above 25 kg/m2 , who were selected using a convenience sampling method, and were randomly divided into three groups including aerobic exercise + ketogenic diet (n=12), resistance exercise + ketogenic diet (n=12), and ketogenic diet (n=12). Aerobic exercise consisted of moderate-intensity running for six weeks at three sessions per week. Resistance training consisted of circuit training for six weeks at three sessions per week. The ketogenic diet included the restriction of carbohydrate intake to ≤10% of total daily energy intake. Fasting blood samples were collected in pre-test and post-test phases. Serum levels of FGF21 and selenoprotein P. were measured by the ELISA method, and blood lipid profile including total cholesterol, HDL, and LDL were measured by enzyme assay method. Two-way mixed analysis of variance (ANOVA) was used for statistical analysis. Bonferroni post hoc test was used for between-group comparison and paired t-test was used for within-group comparison. Results The interaction effect of time and group was no significant for FGF21 (P˃0.05), but the main effect of time was significant (P=0.001). All three groups showed a significant increase in FGF21 in the posttest phase compared to the pretest phase (P≤0.05). The selenoprotein P. serum level was not significantly different between groups or between two evaluation times (P˃0.05). The interaction effect of time and group was not significant for lipid profile (P˃0.05). The within-group comparison indicated a significant decrease in LDL and total cholesterol and an increase in HDL in all groups (P≤0.05). Conclusion It seems that both aerobic and resistance exercises during a ketogenic diet can increase FGF21 and improve lipid profile in overweight or obese men. There is no significant difference between the two methods. They have no superiority over the ketogenic diet alone in affecting heptokines and lipid profile.