Order of administration:
100% vegetable fat blend
100% Anhydrous Milk Fat (AMF)
100% Cream (AMF + milk fat globular membranes)

Order of administration:
100% vegetable fat blend
100% Cream (AMF + milk fat globular membranes)
100% Anhydrous Milk Fat (AMF)

Order of administration:
100% Anhydrous Milk Fat (AMF)
100% vegetable fat blend
100% Cream (AMF + milk fat globular membranes)

Order of administration:
100% Anhydrous Milk Fat (AMF)
100% Cream (AMF + milk fat globular membranes)
100% vegetable fat blend

Order of administration:
100% Cream (AMF + milk fat globular membranes)
100% Anhydrous Milk Fat (AMF)
100% vegetable fat blend

Order of administration:
100% Cream (AMF + milk fat globular membranes)
100% vegetable fat blend
100% Anhydrous Milk Fat (AMF)

Genomics

Postprandial Metabolism

Nutrition

Metabolism

Dietary lipid challenge test: 600 ml skimmed milk plus 95 gram of vegetable fat blend.

100% vegetable blend

Dietary lipid challenge test: 600 ml skimmed milk plus 95 gram of anhydrous milk fat.

100% AMF

Dietary lipid challenge test: 600 ml skimmed milk plus 95 gram of anhydrous milk fat plus milk fat globular membranes.

100% cream

Wageningen University, Division of Human Nutrition

Postprandial Effects of Milk Fats

The Effects of Different Fat Structures on Postprandial Responses in Healthy Subjects

By using untargeted whole genome Affymetrix microarray the investigators will measure gene expression in isolated monocytes.

Cytokine concentrations in the circulation will be measured via ELISA.

Cell study with isolated monocytes from the circulation. The cells will be treated with LPS to evaluate functional responses. We will measure fold changes.

Cell study with isolated monocytes from the circulation. The cells will be treated with different fat loads and inflammatory stimuli to evaluate the sensitivity of the collected monocytes. We will measure fold changes.

TAG concentration in plasma will be measured in a clinical chemical lab.

Cardio-metabolic markers such as glucose (mg/dl) will be measured in the circulation.

Cardio-metabolic markers such as adiponectin (pg/ml) will be measured in the circulation.

Cardio-metabolic markers such as insulin (mIU/L) will be measured in the circulation.

Using untargeted proteomic platforms, the changes in protein profiles in the circulation will be measured.

Using targeted proteomic platforms, the changes in protein profiles in the circulation will be measured.

Using untargeted metabolomic platforms, the changes in protein profiles in the circulation will be measured.

Using targeted metabolomic platforms, the changes in protein profiles in the circulation will be measured.

Feelings of hunger and satiety will be measured via a questionnaire using a Visual Analog Scale (VAS), a 100 mm line anchored at each end by descriptors. Research subjects will place a mark on the scale that corresponds to their feelings of hunger and satiety. The distance from the lower end of the scale is then measured and recorded.

Cytokine concentrations in the circulation obtained via catheter cannula will be measured via ELISA. The investigators will also measure cytokine concentrations in dried blood spots obtained via a finger prick (via a Meso Scale Discovery Electrochemiluminescence platform).

Relative immune cell populations will be determined in whole blood via FACS analysis.

The CRP value of each research subject will be determined by using a QuikRead CRP test.

Both waist and Hip circumference will be measured using a measuring tape.

weight (in kg) and height (in meters) will be measured and combined to report BMI in kg/m^2

ALAT (IU/L), ASAT (IU/L) will be measured in a clinical chemical lab.

creatinine (mg/dL) will be measured in a clinical chemical lab.

Hemoglobin will be determined via a finger prick.

Lydia A. Afman

Principal Investigator

Wageningen University

Friesland Campina

Each research subject will visit the university on three separate occasions with a wash-out period of at least one week. At each visit the research subject will undergo one of the three dietary lipid challenge tests (a shake) in a randomized order. All research subjects have consumed all three dietary lipid challenge tests at the end of the study.

the intervention will consist of 3 phases: a one week run-in period, 24 weeks strict KD and 24 weeks Modified Atkins Diet.
Every day, 40 g of KetoCal, a nutritionally complete ready-to-drink liquid, is foreseen to ensure adequate amounts of vitamins and minerals and to ensure ketosis during the night (some patients drink some sips of the shake during the night). During this run-in period, patients will become familiar with their diet and, in particular, they will learn which foods are allowed and which are not.

During the run-in period, the dietician will discuss the diet and maintenance of an isocaloric diet with the patients. As such, the diet of the control group will not change from their normal dietary pattern, unless a patient is following an Atkins-like diet. In the latter case, the patient will be asked to change the diet to a normal Belgian diet.

Lymphedema

Ketogenic Dieting

Ketocal, a nutritionally complete ready-to-drink liquid, is foreseen to ensure adequate amounts of vitamins and minerals will be used. After 24 weeks a Modified Atkins diet will be started.

Ketogenic diet

Isocaloric diet

UZ Leuven

Ketogenic Diet: a Novel Metabolic Strategy to Treat Lymphedema Patients?

measured with QOL questionnaire, a scale from 0-10 on 16 items, how higher the score, how higher the QOL

measured with Lymph ICF (international classification of functioning, disability and Health), a scale from 0-10 on 29 items, total score ranged from 0-100, 0-4: indicate no problem; 5-24 a small problem; 26-49: moderate problem; 50-95: severe problem; 96-100: very severe problem

Universitaire Ziekenhuizen Leuven

After baseline assessment, patients will be randomized in one of the treatment groups.
Randomization is performed according to 'www.randomization.com'. This free generator randomizes each subject to a single treatment by using the method of randomly permuted blocks.
Assessments are performed by a person blinded to the treatment allocation groups.
Randomization will be stratified for baseline lymphedema volume (3-9.9%, 10.0-19.9% and ≥20%), affected limb (arm or leg) and gender (females or males). The staff members who perform the measurements are blinded for the allocation.

The staff members who perform the measurements are blinded for the allocation.

Dyslipidaemia

Insulin Resistance

500mg bid for one week followed by 1 gram bid for one week prior to lipoprotein study.

Resveratrol

Toronto General Hospital

Regulation of Intestinal and Hepatic Lipoprotein Secretion by Resveratrol

Regulation of Intestinal (and Hepatic) Lipoprotein Secretion by Resveratrol

10 hour lipoprotein turnover study as described above following 2 weeks treatment with resveratrol or placebo.

HOMA-IR calculated from fasting insulin and fasting glucose will be used to assess change in insulin sensitivity before and after 2 weeks of resveratrol treatment.

University Health Network, Toronto

Canadian Institutes of Health Research (CIHR)

Cystic Fibrosis

Pancreatic Insufficiency

Two fats (Pentadecanoic acid and Triheptadecanoin) are administered in a breakfast shake for the purposes of determining malabsorption.
in breakfast shake x1

alcohol withdrawal delirium/triglyceride

Postprandial Effects of Milk Fats

Ketogenic Diet: a Novel Metabolic Strategy to Treat Lymphedema Patients?

Regulation of Intestinal and Hepatic Lipoprotein Secretion by Resveratrol

Malabsorption Blood Test:Toward a Novel Approach to Quantify Steatorrhea

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