The Study

Paoli et al. (2015) studied the effects of a Mediterranean ketogenic diet (KD) used in combination with phytoextracts supplemented with marine omega-3 on cardiovascular and metabolic risk factors, as well as on inflammation.


Thirty-eight adult overweight males were selected to participate in this study. Apart from being overweight, subjects were otherwise healthy with no major diseases and taking no drugs on a regular basis, with the notable exception of ten subjects taking antihypertensive drugs. Selected subjects were also sedentary with no history of bariatric surgery or previous omega-3 consumption on a regular basis and had a stable weight for at least three months at the beginning of the study. Subjects were then randomly assigned either to a 4-week Mediterranean KD (10.8 ± 2.1% carbohydrates, 45.8 ± 4% fats and 43.4 ± 3.2% protein) or to a 4-week Mediterranean KD plus marine omega-3 supplementation from krill extract (10.5 ± 1.8% carbohydrates, 53.7 ± 5.2% fats and 43.2 ± 4% protein). Both diets were supplemented with phytoextracts, vitamins and minerals. Anthropometric measurements and blood tests were done at the beginning and at the end of the study period.


Thirty-four patients finished all the protocol, including all the follow-up visits, and were then included in the final study. Among then, 18 were in the KD group and 16 were in the KD plus omega-3 group. Participants in both groups lost significant weight with a decrease in many associated body parameters, such as body mass index (BMI) and fat mass. A significant decrease in total cholesterol, especially in the so-called “bad” cholesterol levels (LDL-cholesterol), was also observed in both groups. Triglyceride, the main constituent of body fat, as well as insulin levels were also decreased in both group, but this result was more pronounced in the KD plus omega-3 group. Levels of adiponectin, a hormone involved notably in glucose regulation and fatty acids oxidation, were significantly increased, but only in the KD plus omega-3 group. Finally, some molecules involved in the inflammation process were also significantly decreased in the KD plus omega-3 group.


This study confirms the positive effects of a Mediterranean KD on body weight and body composition, as well as on some cardiovascular risk factors. Furthermore, it also underlines the synergetic effects of the combination of a Mediterranean KD with marine omega-3 supplementation. As a matter of fact, the addition of marine omega-3 to the Mediterranean KD improved the positive effects already observed on many cardiovascular risk factors, as well as decreased the level of many inflammation mediators. As such, this study highlights the potential of a Mediterranean KD combined with marine omega-3 supplementation in the management of overweight patients.

Study Editor

Marie-Christine Brotherton holds a Ph.D. in Cellular and Molecular Biology with specific expertise in Parasitology, Proteomics, Drug Resistance and Genomics. She also holds a MBA with a major in Corporate Social and Environmental Responsibility. She has strong experience with the scientific publication process, including author guidelines requirements, as well as with the medical and social/environmental fields. She can be reached by email at

Full Text/PDF link


Paoli, A., Moro, T., Bosco, G., Bianco, A., Grimaldi, K. A., Camporesi, E., & Mangar, D. (2015). Effects of n-3 Polyunsaturated Fatty Acids (ω-3) Supplementation on Some Cardiovascular Risk Factors with a Ketogenic Mediterranean Diet. Marine drugs13(2), 996-1009.