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PreDiabetesKETO-IMNCT05681468

Metabolic and Inflammatory Outcomes of the Ketogenic Diet Comparing Saturated and Unsaturated Fat Sources

A study testing Keto-SAT, Keto-CAN and LFD in people with PreDiabetes and Diabetes Mellitus, Type 2, run by University of Alberta at 1 site in Canada.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

The goal of this clinical trial is to compare a healthy KETO diet supplemented with canola oil (KETO-Can) compared to a traditional KETO diet high in saturated fat (KETO-Sat) and low-fat diet (LFD) in adults at high risk of or diagnosed with type 2 diabetes. Read more about this study

Who is it for?
Ages 18 to 70 years
What is being tested?
Keto-SAT, Keto-CAN and LFD
Could I receive a placebo?
No, everyone receives an active treatment
How many people
164 participants
Where
1 siteCanada
Study dates
18 Sep 2023to 31 Jan 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Having overweight or obesity and HbA1C ≥ 5.7% at screening

Who cannot join

  • Individuals with specific nutritional habits preventing them from adhering to nutritional recommendations
  • Pregnant women
  • People on dialysis or recommended to follow a low-protein diet (base on glomerular filtration rate)
  • Familial hypercholesterolemia or hypertriglyceridemia
  • Transitioning trans-gender
  • For safety purposes, other individuals would be excluded if are under unstable health conditions.

Trial locations and contacts

1 site in 1 country.

Canada1 site
  • University of Alberta

    Edmonton, Alberta, T6G 2E1

Other trials in Canada

About this study

The goal of this clinical trial is to compare a healthy KETO diet supplemented with canola oil (KETO-Can) compared to a traditional KETO diet high in saturated fat (KETO-Sat) and low-fat diet (LFD) in adults at high risk of or diagnosed with type 2 diabetes. The main question[s] it aims to answer are:

  • Effects on CVD risk factors (plasma cholesterol, TG, ApoB100, glucose, insulin and HbA1C).
  • Effects on systemic inflammation and immune function.
  • Adherence to interventions.

Participants will be randomized into 1 of the dietary treatments during which they will follow a Keto or a low-fat diet.

Comparisons among groups at 3 and 6 months of intervention will be conducted.

Read the detailed description

The ketogenic diet (KETO) is popular for weight loss and is gaining interest as a treatment for type 2 diabetes (T2D) because it is believed to help manage blood glucose and weight. However, KETO is often high in saturated fats (SFA), which may increase cholesterol and other cardiovascular (CVD) risk factors, such as inflammatory profile. Substituting a heart-healthy oil for SFA may improve these outcomes.

The purpose of our study is to investigate the health beneficial effects of a healthy KETO diet supplemented with Canola oil, compared to a traditional Keto Diet and low-fat diet in adults at high risk of type 2 diabetes. Participants will be randomized to one of these three diets and will receive nutrition counselling during 6 months.

Each month, participants will receive a 1-month supply of canola oil in the KETO-Can group, butter and coconut oil in the KETO-Sat group and whole grain foods (pasta or brown rice) and oatmeal in the LFD group to ensure compliance to key nutrients.

Fasting blood samples will be taken at baseline, 3 and 6 months. Anthropometric measurements (weight (BW), waist circumference (WC), BMI), blood pressure (BP), systemic inflammation (CRP, IL-6, TNF-α, IL-18), immune function, cardiometabolic risk factors (TG, cholesterol, glucose, insulin and HbA1C) will be determined at each time point.

A total of three 24h-recall questionnaires (2 weekdays and 1 weekend day) will be completed at each time point (baseline, 3 months, 6 months). Once a month (in between study visits) a 24h-recall will be completed before meeting the nutrition expert in order to personalize recommendations according to participants' respective diet groups.

As in any nutritional study, adherence for nutrition study is a key factor and will be measured differently during the intervention. Menu examples will be provided for each group to facilitate adherence. Adherence to the study protocol will be assessed by (1) evaluation of 24-h recall data (14 in total). Participants with 11 out of 14 recalls being within meeting dietary objectives will be considered highly compliant, 6 or less would be low compliance; (2) Ketosis state will be measured at each study visit using ketone strips to assess adherence to both KETO diets; (3) Participants will be asked to report the food consumed each month to determine the level of consumption. Finally, fatty acid composition in plasma (short-term) and red blood cells (RBCs; reflect the past 3 months) will be assessed to confirm adherence between the two keto diets.

Being tested
Keto-SAT, Keto-CAN, LFD
Medical subject headings
Prediabetic State, Diabetes Mellitus, Type 2, Overweight, Obesity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Keto-SATOther

    Nutrition counselling focused on Keto diet (saturated fat).

    10% TE as carbohydrate (mainly from vegetables and whole grain products), protein between 20-30% TE and fat between 60-70%.

  • Keto-CANOther

    Nutrition counselling focused on Keto diet (unsaturated fat).

    10% TE as carbohydrate (mainly from vegetables and whole grain products), protein between 20-30% TE and fat between 60-70%.

  • LFDOther

    Nutrition counselling focused on low-fat diet.

    30% total energy (TE) as fat, 50% TE as carbohydrates (primarily whole grains) and 17-20% TE protein (mainly lean sources).

Study groups in NCT05681468
Study groupRoleWhat they receive
KETO-CanExperimentalKETO diet supplemented with Canola oil (high in MUFA and omega-3 FA).
Receives: Other: Keto-CAN
KETO-SatExperimentalKETO diet supplemented with butter and coconut oil (high in SFA).
Receives: Other: Keto-SAT
Low fat diet (LFD)Active comparatorLow fat diet supplemented with whole grain foods (pasta or brown rice) and oatmeal.
Receives: Other: LFD

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Effect of diets on plasma triglycerides levels by comparing groups at 3 months of intervention (i.e. control low fat diet and the 2 keto groups) and changes over time within each group (i.e. baseline vs. 3 months).

    Assess triglycerides levels collecting blood samples in a fasting state. Triglycerides will be determined using commercially available equipment at a local laboratory (Roche Cobas c503). Measurements will be performed for between group comparison and within groups comparison to understand the effect of diets.

    Measured: 3 months

  2. Effect of diets on plasma triglycerides levels by comparing groups at 6 months of intervention (i.e. control low fat diet and the 2 keto groups) and changes over time within each group (i.e. baseline vs. 6 months).

    Assess triglycerides levels collecting blood samples in a fasting state. Triglycerides will be determined using commercially available equipment at a local laboratory (Roche Cobas c503). Measurements will be performed for between group comparison and within groups comparison to understand the effect of diets.

    Measured: 6 months

  3. Effect of diets on LDL-cholesterol levels by comparing groups at 3 months of intervention (i.e. control low fat diet and the 2 keto groups) and changes over time within each group (i.e. baseline vs. 3 months).

    Assess LDL-cholesterol levels collecting blood samples in a fasting state. LDL-Cholesterol levels will be determined using commercially available equipment at a local laboratory (Roche Cobas c503). Measurements will be performed for between group comparison and within groups comparison to understand the effect of diets.

    Measured: 3 months

  4. Effect of diets on LDL-cholesterol levels by comparing groups at 6 months of intervention (i.e. control low fat diet and the 2 keto groups) and changes over time within each group (i.e. baseline vs. 6 months).

    Assess LDL-cholesterol levels collecting blood samples in a fasting state. LDL-Cholesterol levels will be determined using commercially available equipment at a local laboratory (Roche Cobas c503). Measurements will be performed for between group comparison and within groups comparison to understand the effect of diets.

    Measured: 6 months

Secondary outcomes (12)
  1. Effect of diets on blood glucose levels by comparing groups at 3 months of intervention (i.e. control low fat diet and the 2 keto groups) and changes over time within each group (i.e. baseline vs. 3 months).

    Assess blood glucose levels collecting blood samples in a fasting state. Blood glucose levels will be determined using commercially available equipment at a local laboratory (Roche Cobas c503). Measurements will be performed for between group comparison and within groups comparison to understand the effect of diets.

    Measured: 3 months

  2. Effect of diets on blood glucose levels by comparing groups at 6 months of intervention (i.e. control low fat diet and the 2 keto groups) and changes over time within each group (i.e. baseline vs. 6 months).

    Assess blood glucose levels collecting blood samples in a fasting state. Blood glucose levels will be determined using commercially available equipment at a local laboratory (Roche Cobas c503). Measurements will be performed for between group comparison and within groups comparison to understand the effect of diets.

    Measured: 6 months

  3. Effect of diets on insulin levels by comparing groups at 3 months of intervention (i.e. control low fat diet and the 2 keto groups) and changes over time within each group (i.e. baseline vs. 3 months).

    Assess insulin levels collecting blood samples in a fasting state. Insulin levels will be determined using commercially available equipment at a local laboratory (Roche Cobas e801). Measurements will be performed for between group comparison and within groups comparison to understand the effect of diets.

    Measured: 3 months

  4. Effect of diets on insulin levels by comparing groups at 6 months of intervention (i.e. control low fat diet and the 2 keto groups) and changes over time within each group (i.e. baseline vs. 6 months).

    Assess insulin levels collecting blood samples in a fasting state. Insulin levels will be determined using commercially available equipment at a local laboratory (Roche Cobas e801). Measurements will be performed for between group comparison and within groups comparison to understand the effect of diets.

    Measured: 6 months

  5. Effect of diets on hemoglobin A1C (HbA1c) levels by comparing groups at 3 months of intervention (i.e. control low fat diet and the 2 keto groups) and changes over time within each group (i.e. baseline vs. 3 months).

    Assess HbA1c collecting blood samples in a fasting state. HbA1c levels will be determined using commercially available equipment at a local laboratory (COBAS c513) and reported in percentage. Measurements will be performed for between group comparison and within groups comparison to understand the effect of diets.

    Measured: 3 months

  6. Effect of diets on hemoglobin A1C (HbA1c) levels by comparing groups at 6 months of intervention (i.e. control low fat diet and the 2 keto groups) and changes over time within each group (i.e. baseline vs. 6 months).

    Assess HbA1c collecting blood samples in a fasting state. HbA1c levels will be determined using commercially available equipment at a local laboratory (COBAS c513) and reported in percentage. Measurements will be performed for between group comparison and within groups comparison to understand the effect of diets.

    Measured: 6 months

  7. Effect of diets on ApoB100 levels by comparing groups at 3 months of intervention (i.e. control low fat diet and the 2 keto groups) and changes over time within each group (i.e. baseline vs. 3 months).

    Assess ApoB100 collecting blood samples in a fasting state. ApoB100 levels will be determined using commercially available equipment at a local laboratory (Siemens BNII Nephelometer). Measurements will be performed for between group comparison and within groups comparison to understand the effect of diets.

    Measured: 3 months

  8. Effect of diets on ApoB100 levels by comparing groups at 6 months of intervention (i.e. control low fat diet and the 2 keto groups) and changes over time within each group (i.e. baseline vs. 6 months).

    Assess ApoB100 collecting blood samples in a fasting state. ApoB100 levels will be determined using commercially available equipment at a local laboratory (Siemens BNII Nephelometer). Measurements will be performed for between group comparison and within groups comparison to understand the effect of diets.

    Measured: 6 months

  9. Effect of diets on immune function and Inflammation measured by blood Immune Markers by comparing groups at 3 months of intervention and changes over time within each group compared to baseline.

    In the fasting state, immune cell subset and activation states will be determined by flow cytometry using whole blood to quantify various immune cell phenotypes. Immune cells will be stained for T cell (CD3, CD4+, CD8+, CD45RA+, CD45RO+), Treg (FOXP3+), B cell (CD20), macrophage (CD14), NK cell (CD56+) and activation markers (CD11b+, CD25+, CD28+, CD86+). The quantification of cytokine secretion by immune cells stimulated with mitogens (phytohemagglutinin (PHA, a T cell mitogen) and lipopolysaccharide (LPS, an antigen-presenting cell stimulant)) is used to evaluate their effector function. Cytokines assessed in the supernatant include IL-1β (only for LPS), IL-2 (only for PHA), IL-6, IL-10, IFN-γ, and TNF-α for both mitogen.

    Measured: 3 months

  10. Effect of diets on immune function and Inflammation measured by blood Immune Markers by comparing groups at 6 months of intervention and changes over time within each group compared to baseline.

    In the fasting state, immune cell subset and activation states will be determined by flow cytometry using whole blood to quantify various immune cell phenotypes. Immune cells will be stained for T cell (CD3, CD4+, CD8+, CD45RA+, CD45RO+), Treg (FOXP3+), B cell (CD20), macrophage (CD14), NK cell (CD56+) and activation markers (CD11b+, CD25+, CD28+, CD86+). The quantification of cytokine secretion by immune cells stimulated with mitogens (phytohemagglutinin (PHA, a T cell mitogen) and lipopolysaccharide (LPS, an antigen-presenting cell stimulant)) is used to evaluate their effector function. Cytokines assessed in the supernatant include IL-1β (only for LPS), IL-2 (only for PHA), IL-6, IL-10, IFN-γ, and TNF-α for both mitogen.

    Measured: 6 months

  11. Effect of diets on inflammatory markers (C-reactive protein (CRP)) by comparing groups at 3 months of intervention (i.e. control low fat diet and the 2 keto groups) and changes over time within each group (i.e. baseline vs. 3 months).

    Assess levels of acute phase protein (CRP) collecting blood samples in a fasting state. CRP will be determined using commercially available equipment at a local laboratory (Roche Cobas c503). Measurements will be performed for between group comparison and within groups comparison to understand the effect of diets.

    Measured: 3 months

  12. Effect of diets on inflammatory markers (C-reactive protein (CRP)) by comparing groups at 6 months of intervention (i.e. control low fat diet and the 2 keto groups) and changes over time within each group (i.e. baseline vs. 6 months).

    Assess levels of acute phase protein (CRP) collecting blood samples in a fasting state. CRP will be determined using commercially available equipment at a local laboratory (Roche Cobas c503). Measurements will be performed for between group comparison and within groups comparison to understand the effect of diets.

    Measured: 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 Jan 2023
  2. Study start18 Sep 2023
  3. Primary completion31 Jan 2027 (estimated)
  4. Study completion31 Jan 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Parallel groups
Model description
Randomized Controlled Trial (3-parallel arm study).
Masking
None (open label)
Enrolment
164 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05681468
Sponsor's protocol ID
Pro00123687
Acronym
KETO-IM
Status last verified
Oct 2026
First submitted
8 Dec 2022
Last updated
26 Oct 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Fulton JL, Gartke T, Blanco Cervantes P, Mojibi Y, Makarowski A, Richard C, Chan CB. Protocol for a randomized controlled trial comparing saturated and unsaturated fat sources of a ketogenic diet (KETO-IM) investigating cardiovascular, inflammatory and immune function outcomes in adults living with overweight and prediabetes or type 2 diabetes in Edmonton, Canada. Trials. 2026 Feb 11;27(1):264. doi: 10.1186/s13063-026-09501-0.

    PubMed 41673680

Questions about this trial

What is this clinical trial studying?

A study testing Keto-SAT, Keto-CAN and LFD in people with PreDiabetes and Diabetes Mellitus, Type 2, run by University of Alberta at 1 site in Canada.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 26 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Effect of diets on plasma triglycerides levels by comparing groups at 3 months of intervention (i.e. control low fat diet and the 2 keto groups) and changes over time within each group (i.e. baseline vs. 3 months). (time frame: 3 months). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05681468, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Oct 2026.

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