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Table 3 Themes from interviews and focus group with supporting transcripts

From: Ketogenic diet benefits body composition and well-being but not performance in a pilot case study of New Zealand endurance athletes

Positive themes Negative themes
Physical recovery Loss of power during exercise/training
 “The recovery each time was amazing. I would go for a 4–5 h run then be able to mountain bike the next day, just to be able to do it without sore muscles”.
 “The next day after a 4-h run I could have got up and done it again - my legs weren’t tired or sore”.
 “Certainly I’ve had the recovery benefits I felt fine to go out the next day and do stuff I didn’t feel the muscle soreness I would have expected”.
 “I don’t feel sore”.
 “I was surprised that I could run comfortably for that long so I think the recovery was huge I never felt this, it’s unheard of”
 “It was embarrassing to the point where I just got to the point where you just don’t have any energy”. (weeks 1–5)
 “I got too tired and I got to the point where I might have had some big runs, 4 or 5 h runs and wake in the night before hand, worried about it. I’d think, how am I going to do that tomorrow… it’s going to be hard”. (weeks 1–5)
 “The lack of power, I just couldn’t get up the hill.” (weeks 6–10)
Negative symptoms (weeks 1–3)
 “I hadn’t been for 4 days and I was starting to get bound up”. (constipation).
 “One of the downsides is that I had cramps, massive cramps”.
 “I may have seemed a bit irritable for a while. People close to me realised I was down and I’m pretty good at hiding that but people picked it up”.
Enjoyment of this way of eating
 “It’s given me the freedom to eat the things that I stopped eating for a long time because I thought it was a no-no”.
 “Not feeling hungry has been amazing”. (X2)
 “Not being bothered about food, you know food doesn’t bother me anymore, as before I had a meal and 3 h later I’d feel irritable if I didn’t eat”.
 “It’s been fantastic for me having food I couldn’t for a long time and I really enjoy it, the flavour, for me the reason why I want to carry on with this way of eating is because I actually enjoy it, I enjoy it far more than my previous diet”.
Food regime boredom
 “Bored with the food regime, actually I’m back on fruit …”
 “…but I am starting to get sick of the diet plan”.
 “You can’t even free load in your veggies.”
Weight management
 “Being able to shed that 5 kg was definitely a benefit”.
 “The benefit now of me being able to understanding how to manage my weight, that’s been a real effect, actually that’s been for all of us”.
Feel better overall (well-being)
 “My skin hasn’t been this good since I can remember”.
 “My prostate, a million times better because I can sleep”.
 “The other thing I noticed is my tinnitus is a lot better, I can’t hear the ringing in my ears I used to have”.
 “Just general health - I just feel better, I need less sleep”.
 “I noticed that I didn’t fart for 2 months, no gas”.
 “Yes, no gas, that’s the same as me.”
 “I feel sharper mentally”.
 “Food used to dictate my moods, and now it doesn’t”.
 “Positive skin, I have a facial every 6 weeks, I didn’t tell the facial lady what I was doing and she said to me what’s happened to your skin? No extractions in the last 8 weeks, no blockages”.