Ketogenic Diet: from the Historical Records to Use in Elite Athletes

Papers of particular interest, published recently, have been highlighted as: • Of importance

1. 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. 2.
   Atkins RC, Gare F, Mandell FG, Monica H. Dr Atkins' Diet Revolution. Bantam. 1972.Google Scholar
3. 3.
   Burke LM, Kiens B. “Fat adaptation” for athletic performance: the nail in the coffin? J Appl Physiol. 2006;100:7–8.CrossRefGoogle Scholar
4. 4.
   Wilder RM, Boothby WM, Beeler C. STUDIES OF THE METABOLISM OF DIABETES. J Biol Chem. 1922;51:311–57.Google Scholar
5. 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
6. 6.
   August Krogh JL. The Relative Value of Fat and Carbohydrate as Sources of Muscular Energy: With Appendices on the Correlation between Standard Metabolism and the Respiratory Quotient during Rest and Work. Biochem J. 1920;14:290–363.PubMedCentralGoogle Scholar
7. 7.
   LEVINE SA, GORDON B, DERICK CL. SOME CHANGES IN THE CHEMICAL CONSTITUENTS OF THE BLOOD FOLLOWING A MARATHON RACE: WITH SPECIAL REFERENCE TO THE DEVELOPMENT OF HYPOGLYCEMIA. JAMA. 1924;82:1778–9.CrossRefGoogle Scholar
8. 8.
   Krebs HA, Johnson WA. Metabolism of ketonic acids in animal tissues. Biochem J. 1937;31:645–60.PubMedPubMedCentralGoogle Scholar
9. 9.
   Advances in Enzymology and Related Areas of Molecular Biology.Google Scholar
10. 10.
    Bergström J, Hermansen L, Hultman E, Saltin B. Diet, muscle glycogen and physical performance. Acta Physiol Scand. 1967;71:140–50.CrossRefGoogle Scholar
11. 11.
    Maughan RJ, Poole DC. The effects of a glycogen-loading regimen on the capacity to perform anaerobic exercise. Eur J Appl Physiol Occup Physiol. 1981;46:211–9.CrossRefGoogle Scholar
12. 12.
    Bogardus C, LaGrange BM, Horton ES, Sims EA. Comparison of carbohydrate-containing and carbohydrate-restricted hypocaloric diets in the treatment of obesity. Endurance and metabolic fuel homeostasis during strenuous exercise. J Clin Invest. 1981;68:399–404.CrossRefGoogle Scholar
13. 13.
    Maunder E, Kilding AE, Plews DJ. Substrate Metabolism During Ironman Triathlon: Different Horses on the Same Courses. Sports Med. 2018;48:2219–26.CrossRefGoogle Scholar
14. 14.
    Holloszy JO, Coyle EF. Adaptations of skeletal muscle to endurance exercise and their metabolic consequences. J Appl Physiol Respir Environ Exerc Physiol. 1984;56:831–8.PubMedGoogle Scholar
15. 15.
    Henriksson J, Reitman JS. Time course of changes in human skeletal muscle succinate dehydrogenase and cytochrome oxidase activities and maximal oxygen uptake with physical activity and inactivity. Acta Physiol Scand. 1977;99:91–7.CrossRefGoogle Scholar
16. 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
17. 17.
    Symons JD, Jacobs I. High-intensity exercise performance is not impaired by low intramuscular glycogen. Med Sci Sports Exerc. 1989;21:550–7.CrossRefGoogle Scholar
18. 18.
    Grisdale RK, Jacobs I, Cafarelli E. Relative effects of glycogen depletion and previous exercise on muscle force and endurance capacity. J Appl Physiol. 1990;69:1276–82.CrossRefGoogle Scholar
19. 19.
    Brooks GA, Mercier J. Balance of carbohydrate and lipid utilization during exercise: the “crossover” concept. J Appl Physiol. 1994;76:2253–61.CrossRefGoogle Scholar
20. 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
21. 21.
    Greene DA, Varley BJ, Hartwig TB, Chapman P, Rigney M. A Low-Carbohydrate Ketogenic Diet Reduces Body Mass Without Compromising Performance in Powerlifting and Olympic Weightlifting Athletes. J Strength Cond Res. 2018;32:3373–82.PubMedGoogle Scholar
22. 22.
    Waldman HS, Krings BM, Basham SA, Smith JEW, Fountain BJ, McAllister MJ. Effects of a 15-Day Low Carbohydrate, High-Fat Diet in Resistance-Trained Men. J Strength Cond Res. 2018;32:3103–11.CrossRefGoogle Scholar
23. 23.
    McSwiney FT, Wardrop B, Hyde PN, Lafountain RA, Volek JS, Doyle L. Keto-adaptation enhances exercise performance and body composition responses to training in endurance athletes. Metabolism. 2018;81:25–34.CrossRefGoogle Scholar
24. 24.
    Heatherly AJ, Killen LG, Smith AF, Waldman HS, Seltmann CL, Hollingsworth A, et al. Effects of Ad libitum Low-Carbohydrate High-Fat Dieting in Middle-Age Male Runners. Med Sci Sports Exerc. 2018;50:570–9.CrossRefGoogle Scholar
25. 25.
    Kephart WC, Pledge CD, Roberson PA, et al. The Three-Month Effects of a Ketogenic Diet on Body Composition, Blood Parameters, and Performance Metrics in CrossFit Trainees: A Pilot Study. Sports (Basel). 2018.  https://doi.org/10.3390/sports6010001.CrossRefGoogle Scholar
26. 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. 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
28. 28.
    Zinn C, Wood M, Williden M, Chatterton S, Maunder E. Ketogenic diet benefits body composition and well-being but not performance in a pilot case study of New Zealand endurance athletes. J Int Soc Sports Nutr. 2017;14:22.CrossRefGoogle Scholar
29. 29.
    Zajac A, Poprzecki S, Maszczyk A, Czuba M, Michalczyk M, Zydek G. The effects of a ketogenic diet on exercise metabolism and physical performance in off-road cyclists. Nutrients. 2014;6:2493–508.CrossRefGoogle Scholar
30. 30.
    Paoli A, Bianco A, Grimaldi KA. The Ketogenic Diet and Sport: A Possible Marriage? Exerc Sport Sci Rev. 2015;43:153–62.CrossRefGoogle Scholar
31. 31.
    Vogt M, Puntschart A, Howald H, Mueller B, Mannhart C, Gfeller-Tuescher L, et al. Effects of dietary fat on muscle substrates, metabolism, and performance in athletes. Med Sci Sports Exerc. 2003;35:952–60.CrossRefGoogle Scholar
32. 32.
    Rowlands DS, and WHM-C, 2002 Effects of high-fat and high-carbohydrate diets on metabolism and performance in cycling. metabolismjournal.com
33. 33.
    Goedecke JH, Christie C, Wilson G, Dennis SC, Noakes TD, Hopkins WG, et al. Metabolic adaptations to a high-fat diet in endurance cyclists. Metabolism. 1999;48:1509–17.CrossRefGoogle Scholar
34. 34.
    Lambert EV, Speechly DP, Dennis SC, Noakes TD. Enhanced endurance in trained cyclists during moderate intensity exercise following 2 weeks adaptation to a high fat diet. Eur J Appl Physiol Occup Physiol. 1994;69:287–93.CrossRefGoogle Scholar
35. 35.
    O'Keeffe KA, Keith RE, Wilson GD, Blessing DL. Dietary carbohydrate intake and endurance exercise performance of trained female cyclists. Nutrition Research. 1989;9:819–30.CrossRefGoogle Scholar
36. 36.
    Phinney SD, Bistrian BR, Evans WJ, Gervino E, Blackburn GL. The human metabolic response to chronic ketosis without caloric restriction: preservation of submaximal exercise capability with reduced carbohydrate oxidation. Metabolism. 1983;32:769–76.CrossRefGoogle Scholar
37. 37.
    Paoli A, Grimaldi K, D'Agostino D, Cenci L, Moro T, Bianco A, et al. Ketogenic diet does not affect strength performance in elite artistic gymnasts. J Int Soc Sports Nutr. 2012;9:34.CrossRefGoogle Scholar