Background: postmenopausal obesity leads to many serious health risks such as cardiovascular disease, diabetes and psychological disorder. Purpose: This study aimed to determine the effect of ketogenic diet and exercise on lipid profile in obese postmenopausal women. Subjects: Forty obese postmenopausal women participated in this study, aged from 50-55 years, with body mass index (BMI) of 30-35 kg/m 2 ,were selected from outpatient clinic of El Mahalla General Hospital, El Mahalla El Kobra city, El Gharbia Governorate, Egypt. They received very low carbohydrate ketogenic diet for 4 weeks and aerobic exercises in form of walking on the treadmill for 30 min, three times per week for 4 weeks. Material and method: anthropometric measures (body weight, BMI and waist and hip circumference), and lipid profile were assessed pre and post treatment program. Result: comparing pre and post treatment result, there was a significant improvement in body weight, body mass index, waist hip ratio, total cholesterol, triglyceride, low density lipoprotein cholesterol and high density lipoprotein cholesterol after treatment program than pre-treatment values. Conclusion: combined therapy of ketogenic diet and aerobic exercise is an effective method in improving lipid profile and body weight in obese postmenopausal women
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