Effects of the ketogenic diet on performance and body composition in athletes and trained adults: a systematic review and Bayesian multivariate multilevel meta-analysis and meta-regression

Koerich, Ana Clara C; Borszcz, Fernando Klitzke; Mello, Arthur Thives; Lucas, Ricardo Dantas de; Hansen, Fernanda

doi:10.1080/10408398.2022.2090894

Cited by 11 publications

(15 citation statements)

References 108 publications

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“…The only study that verified effects slightly more favorable to ketogenic was in a sample of overweight individuals following 12 weeks of intervention [16 ▪ ]. Regarding this issue, a recent systematic review with meta-analysis using Bayesian probabilistic inferences verified by using meta-regressions that the magnitude of effects of ketogenic diets against carbohydrate-based diets is modulated by the diet and performance (for aerobic activities) durations [7 ▪ ]. Also, the meta-regression showed that the ketogenic diet impairs endurance performance to a greater extent in participants with higher aerobic fitness (measured by relative VO 2 max) [7 ▪ ].…”

Section: Exercise Performancementioning

confidence: 99%

“…Regarding this issue, a recent systematic review with meta-analysis using Bayesian probabilistic inferences verified by using meta-regressions that the magnitude of effects of ketogenic diets against carbohydrate-based diets is modulated by the diet and performance (for aerobic activities) durations [7 ▪ ]. Also, the meta-regression showed that the ketogenic diet impairs endurance performance to a greater extent in participants with higher aerobic fitness (measured by relative VO 2 max) [7 ▪ ]. Therefore, a ketogenic diet could be more suitable for long performance tasks and when followed by a long period in untrained individuals.…”

Section: Exercise Performancementioning

confidence: 99%

“…As these studies were conducted on untrained individuals, it is not possible to extrapolate the findings to the athletic population's performance. Nevertheless, the ketogenic diet appears to be an efficient strategy for total body mass and fat mass loss [7 ▪ ,16 ▪ ,19,20], improves the levels of HDL-c, VLDL-c, and triglycerides [21], and the mitochondrial mass and function in skeletal muscle (in mice) [22,23].…”

Section: Training Adaptationsmentioning

confidence: 99%

“…Regarding exercise performance, the most recent systematic reviews, including or not meta-analysis, showed that the ketogenic diet does not produce better effects compared with carbohydrate-based diets in both aerobic (e.g. cycling and running) and strength performances [7 ▪ ,9] and seems to have no effect in improving endurance performance even when combined with concurrent training [8].…”

Section: Exercise Performancementioning

confidence: 99%

“…Over the decades, several studies have been conducted about the effects of the ketogenic diet on exercise performance in different modalities and exercise modes, and on the body composition in diverse populations. Concerning this issue, there were several studies with meta-analyses published recently [7 ▪ ,8–10]. They all showed no advantage of the ketogenic diet over normal/high carbohydrate-based diets on physical performance.…”

Section: Introductionmentioning

confidence: 99%

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Ketogenic diets, exercise performance, and training adaptations

Borszcz

Gabiatti

Lucas

et al. 2023

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of reviewThe ketogenic diet has been proposed as a nutritional strategy in sports. This review was undertaken to provide an overview of the recent literature concerning the effects of ketogenic diet on exercise performance and training adaptations. Recent findingsMost recent literature on the ketogenic diet and exercise performance showed no beneficial effects, especially for trained individuals. During a period of intensified training, performance was clearly impaired during the ketogenic intervention, while a diet with high carbohydrates maintained physical performance. The main effect of the ketogenic diet resides in metabolic flexibility, inducing the metabolism to oxidize more fat for ATP resynthesis regardless of submaximal exercise intensities.

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Section: Exercise Performancementioning

confidence: 99%

Section: Exercise Performancementioning

confidence: 99%

Section: Training Adaptationsmentioning

confidence: 99%

Section: Exercise Performancementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Ketogenic diets, exercise performance, and training adaptations

Borszcz

Gabiatti

Lucas

et al. 2023

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Nutritional Considerations During Major Weight Loss Therapy: Focus on Optimal Protein and a Low-Carbohydrate Dietary Pattern

Volek,

Kackley,

Buga

2024

Curr Nutr Rep

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Purpose of Review Considering the high prevalence of obesity and related metabolic impairments in the population, the unique role nutrition has in weight loss, reversing metabolic disorders, and maintaining health cannot be overstated. Normal weight and well-being are compatible with varying dietary patterns, but for the last half century there has been a strong emphasis on low-fat, low-saturated fat, high-carbohydrate based approaches. Whereas low-fat dietary patterns can be effective for a subset of individuals, we now have a population where the vast majority of adults have excess adiposity and some degree of metabolic impairment. We are also entering a new era with greater access to bariatric surgery and approval of anti-obesity medications (glucagon-like peptide-1 analogues) that produce substantial weight loss for many people, but there are concerns about disproportionate loss of lean mass and nutritional deficiencies. Recent Findings No matter the approach used to achieve major weight loss, careful attention to nutritional considerations is necessary. Here, we examine the recent findings regarding the importance of adequate protein to maintain lean mass, the rationale and evidence supporting low-carbohydrate and ketogenic dietary patterns, and the potential benefits of including exercise training in the context of major weight loss. Summary While losing and sustaining weight loss has proven challenging, we are optimistic that application of emerging nutrition science, particularly personalized well-formulated low-carbohydrate dietary patterns that contain adequate protein (1.2 to 2.0 g per kilogram reference weight) and achieve the beneficial metabolic state of euketonemia (circulating ketones 0.5 to 5 mM), is a promising path for many individuals with excess adiposity. Graphical Abstract Created with Biorender.com.

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The effect of the ketogenic diet on resistance training load management: a repeated-measures clinical trial in trained participants

Vargas-Molina,

García-Sillero,

Bonilla

et al. 2024

Journal of the International Society of Sports Nutrition

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Background The effect of low-carbohydrate high-fat dietary manipulation, such as the ketogenic diet (KD), on muscle strength assessment in resistance-training (RT) participants has focused on the one-repetition maximum test (1-RM). However, a pre-specified 1-RM value during an exercise training program disregards several confounding factors (i.e. sleep, diet, and training-induced fatigue) that affect the exerciser’s “true” load and daily preparedness. We aimed to evaluate the effect of a 6-week RT program on load control-related variables in trained subjects following a KD intervention. Methods Fourteen resistance-trained individuals (3F, 11 M; 30.1 [6.2] years; 174.2 [7.6] cm; 75.7 [10.8] kg; BMI 24.8 [2.1] kg·m −2 ) completed this single-arm repeated-measures clinical trial. Load management variables included volume load, number of repetitions, perceived exertion (RPE), movement velocity loss, and exertion index. These primary outcomes were assessed weekly before, during, and at the end of a 6-week RT program that included traditional RT exercises (bench press, femoral lying down, lat pulldown, leg extension, and back squat). Results There was a significant difference in RPE between weeks ( p = 0.015, W = 0.19) with a slight trend in decreasing RPE. We found differences in the volume load per week ( p < 0.001; W = 0.73 and p < 0.001, W = 0.81, respectively), with an increase in the last weeks. In the control of the load based on movement velocity, we did not find significant differences between weeks ( p = 0.591, W = 0.06), although significant differences were found in the effort index ( p = 0.026, W = 0.17). Conclusions A KD diet in recreational strength participants does not appear to lead to performance losses during a RT program aimed at improving body composition. However, the lack of adherence and familiarity with the ketogenic diet must be considered specially during first weeks.

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Effects of the ketogenic diet on performance and body composition in athletes and trained adults: a systematic review and Bayesian multivariate multilevel meta-analysis and meta-regression

Cited by 11 publications

References 108 publications

Ketogenic diets, exercise performance, and training adaptations

Ketogenic diets, exercise performance, and training adaptations

Nutritional Considerations During Major Weight Loss Therapy: Focus on Optimal Protein and a Low-Carbohydrate Dietary Pattern

The effect of the ketogenic diet on resistance training load management: a repeated-measures clinical trial in trained participants

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