Ketogenic Diet: from the Historical Records to Use in Elite Athletes
Purpose of Review
To review the available literature/evidence on low carbohydrate/high fat (LCHF) and low carbohydrate ketogenic (LCKD) diets’ effects on human athletic performance and to provide a brief review of the physiology and history of energy systems of exercise.
Multiple studies have been conducted in an attempt to answer this question, many within the last 3–5 years. Studies are heterogenous in design, intervention, and outcome measures.
Current available data show that LCHF and LCKD do not significantly enhance or impair performance in endurance or strength activities. However, there is a trend towards improved body composition (greater percent lean body mass) across multiple studies. While this may not translate to enhanced performance in the primarily laboratory conditions in the reviewed studies, there could be a benefit in sports in which an athlete’s strength-to-weight ratio is a significant determinant of outcome.
Keywords: Ketogenic diet Low carbohydrate diet Athletic performance Endurance sports Strength sports
Compliance with Ethical Standards
Conflict of Interest
Matthew B. Kaspar, Kerstin Austin, Martin Huecker, and Menaka Sarav declare they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
- 1.Gordon ES, Goldberg M, Chosy GJ. A New Concept in the Treatment of Obesity: A 48-hour total fast followed by six meals a day and later by stepwise increases in food and calorie intake has permitted patients to lose weight that they show no tendency to regain for periods of up to 6 months. It also promoted spontaneous evolution of good dietary habits. JAMA. 1963;186:50–60.CrossRefGoogle Scholar
- 2.Atkins RC, Gare F, Mandell FG, Monica H. Dr Atkins' Diet Revolution. Bantam. 1972.Google Scholar
- 4.Wilder RM, Boothby WM, Beeler C. STUDIES OF THE METABOLISM OF DIABETES. J Biol Chem. 1922;51:311–57.Google Scholar
- 5.Guelpa G. La lutte contre l'epiepsie par la desintoxication et par la reeducation alimentaire. Rev Ther Med Chir. 1911;78:8.Google Scholar
- 9.Advances in Enzymology and Related Areas of Molecular Biology.Google Scholar
- 16.• Phinney SD, Horton ES, Sims EA, Hanson JS, Danforth EJ, LaGrange BM. Capacity for moderate exercise in obese subjects after adaptation to a hypocaloric, ketogenic diet. J Clin Invest. 1980;66:1152–61 Rigorous and well-designed original/proof of concept experiment in human subjects. CrossRefGoogle Scholar
- 20.• Burke LM. Re-Examining High-Fat Diets for Sports Performance: Did We Call the “Nail in the Coffin” Too Soon? Sports Med. 2015;45(Suppl 1):S33–49 Thorough review of available literature on this topic to date (through 2015) with careful discussion of mechanisms and shortcomings of previous studies. CrossRefGoogle Scholar
- 26.• Burke LM, Ross ML, Garvican-Lewis LA, et al. Low carbohydrate, high fat diet impairs exercise economy and negates the performance benefit from intensified training in elite race walkers. J Physiol. 2017;595:2785–807 Most recent & one of the largest studies to date performed in human subjects. Rigorous control of diet and careful monitoring of both laboratory and “real world” outcomes. CrossRefGoogle Scholar
- 27.Wilson JM, Lowery RP, Roberts MD, Sharp MH, Joy JM, Shields KA, et al. The Effects of Ketogenic Dieting on Body Composition, Strength, Power, and Hormonal Profiles in Resistance Training Males. J Strength Cond Res Publish Ahead of Print. 2017;1.Google Scholar
- 32.Rowlands DS, and WHM-C, 2002 Effects of high-fat and high-carbohydrate diets on metabolism and performance in cycling. metabolismjournal.com