Thomas DT, Erdman KA, Burke LM. American College of Sports Medicine joint position statement. Nutrition and athletic performance. Med Sci Sports Exerc. 2016;48(3):543–68. https://doi.org/10.1249/MSS.0000000000000852.
Stellingwerff T, Maughan RJ, Burke LM. Nutrition for power sports: middle-distance running, track cycling, rowing, canoeing/kayaking, and swimming. J Sports Sci. 2011;29(Suppl 1):S79–89. https://doi.org/10.1080/02640414.2011.589469.
Sundgot-Borgen J, Garthe I. Elite athletes in aesthetic and Olympic weight-class sports and the challenge of body weight and body compositions. J Sports Sci. 2011;29(Suppl 1):S101–14. https://doi.org/10.1080/02640414.2011.565783.
Khodaee M, Olewinski L, Shadgan B, Kiningham RR. Rapid weight loss in sports with weight classes. Curr Sports Med Rep. 2015;14(6):435–41. https://doi.org/10.1249/JSR.0000000000000206.
Manore MM. Weight Management for Athletes and Active Individuals: A Brief Review. Sports Med. 2015;45(Suppl 1):S83–92.
Berryman CE, Sepowitz JJ, McClung HL, Lieberman HR, Farina EK, McClung JP, et al. Supplementing an energy adequate, higher protein diet with protein does not enhance fat-free mass restoration after short-term severe negative energy balance. J Appl Physiol (1985). 2017;122(6):1485–93.
Berryman CE, Young AJ, Karl JP, Kenefick RW, Margolis LM, Cole RE, et al. Severe negative energy balance during 21 d at high altitude decreases fat-free mass regardless of dietary protein intake: a randomized controlled trial. FASEB J. 2018;32(2):894–905. https://doi.org/10.1096/fj.201700915R.
Margolis LM, Rood J, Champagne C, Young AJ, Castellani JW. Energy balance and body composition during US Army special forces training. Appl Physiol Nutr Metab. 2013;38(4):396–400. https://doi.org/10.1139/apnm-2012-0323.
Murphy NE, Carrigan CT, Philip Karl J, Pasiakos SM, Margolis LM. Threshold of energy deficit and lower-body performance declines in military personnel: a meta-regression. Sports Med. 2018;48(9):2169–78. https://doi.org/10.1007/s40279-018-0945-x.
Pasiakos SM, Cao JJ, Margolis LM, Sauter ER, Whigham LD, McClung JP, et al. Effects of high-protein diets on fat-free mass and muscle protein synthesis following weight loss: a randomized controlled trial. FASEB J. 2013;27(9):3837–47. https://doi.org/10.1096/fj.13-230227.
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. 2020;34(12):3463–74.
Aragon AA, Schoenfeld BJ, Wildman R, Kleiner S, VanDusseldorp T, Taylor L, et al. International society of sports nutrition position stand: diets and body composition. J Int Soc Sports Nutr. 2017;14:16.
Volek JS, Freidenreich DJ, Saenz C, Kunces LJ, Creighton BC, Bartley JM, et al. Metabolic characteristics of keto-adapted ultra-endurance runners. Metabolism. 2016;65(3):100–10. https://doi.org/10.1016/j.metabol.2015.10.028.
Webster CC, Noakes TD, Chacko SK, Swart J, Kohn TA, Smith JA. Gluconeogenesis during endurance exercise in cyclists habituated to a long-term low carbohydrate high-fat diet. J Physiol. 2016;594(15):4389–405. https://doi.org/10.1113/JP271934.
Vargas S, Romance R, Petro JL, Bonilla DA, Galancho I, Espinar S, et al. Efficacy of ketogenic diet on body composition during resistance training in trained men: a randomized controlled trial. J Int Soc Sports Nutr. 2018;15(1):31. https://doi.org/10.1186/s12970-018-0236-9.
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. https://doi.org/10.1016/j.metabol.2017.10.010.
Bueno NB, de Melo IS, de Oliveira SL, da Rocha Ataide T. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. Br J Nutr. 2013;110(7):1178–87. https://doi.org/10.1017/S0007114513000548.
Volek JS, Noakes T, Phinney SD. Rethinking fat as a fuel for endurance exercise. Eur J Sport Sci. 2015;15(1):13–20. https://doi.org/10.1080/17461391.2014.959564.
Wallace BC, Small K, Brodley CE, Lau J, Trikalinos TA. Deploying an interactive machine learning system in an evidence-based practice center: abstrackr. In: Proceedings of the 2nd ACM SIGHIT International Health Informatics Symposium. Miami: Association for Computing Machinery; 2012. p. 819–24.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. https://doi.org/10.1371/journal.pmed.1000097.
Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898.
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(12):3373–82. https://doi.org/10.1519/JSC.0000000000002904.
Prins PJ, Noakes TD, Welton GL, Haley SJ, Esbenshade NJ, Atwell AD, et al. High rates of fat oxidation induced by a low-carbohydrate, high-fat diet, do not impair 5-km running performance in competitive recreational athletes. J Sports Sci Med. 2019;18(4):738–50.
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(3):570–9. https://doi.org/10.1249/MSS.0000000000001477.
Nazarewicz RR, Ziolkowski W, Vaccaro PS, Ghafourifar P. Effect of short-term ketogenic diet on redox status of human blood. Rejuvenation Res. 2007;10(4):435–40. https://doi.org/10.1089/rej.2007.0540.
Dostal T, Plews DJ, Hofmann P, Laursen PB, Cipryan L. Effects of a 12-week very-low carbohydrate high-fat diet on maximal aerobic capacity, high-intensity intermittent exercise, and cardiac autonomic regulation: non-randomized parallel-group study. Front Physiol. 2019;10:912. https://doi.org/10.3389/fphys.2019.00912.
Vargas-Molina S, Petro JL, Romance R, Kreider RB, Schoenfeld BJ, Bonilla DA, et al. Effects of a ketogenic diet on body composition and strength in trained women. J Int Soc Sports Nutr. 2020;17(1):19. https://doi.org/10.1186/s12970-020-00348-7.
Kephart WC, Pledge CD, Roberson PA, Mumford PW, Romero MA, Mobley CB, et al. The Three-Month Effects of a Ketogenic Diet on Body Composition, Blood Parameters, and Performance Metrics in CrossFit Trainees: A Pilot Study. 2018;6(1):1. https://doi.org/10.3390/sports6010001.
LaFountain RA, Miller VJ, Barnhart EC, Hyde PN, Crabtree CD, McSwiney FT, et al. Extended Ketogenic diet and physical training intervention in military personnel. Mil Med. 2019;184(9–10):e538–e47. https://doi.org/10.1093/milmed/usz046.
Gregory RM, Hamdan H, Torisky D, Akers J. A low-carbohydrate ketogenic diet combined with 6-weeks of crossfit training improves body composition and performance. Int J Sports Exerc Med. 2017;3:1–10.
Paoli A, Cenci L, Pompei P, Sahin N, Bianco A, Neri M, et al. Effects of Two Months of Very Low Carbohydrate Ketogenic Diet on Body Composition, Muscle Strength, Muscle Area, and Blood Parameters in Competitive Natural Body Builders. Nutrients. 2021;13(2):374. https://doi.org/10.3390/nu13020374.
Tsafnat G, Glasziou P, Choong MK, Dunn A, Galgani F, Coiera E. Systematic review automation technologies. Syst Rev. 2014;3(1):74. https://doi.org/10.1186/2046-4053-3-74.
Hoyt RW, Opstad PK, Haugen AH, DeLany JP, Cymerman A, Friedl KE. Negative energy balance in male and female rangers: effects of 7 d of sustained exercise and food deprivation. Am J Clin Nutr. 2006;83(5):1068–75. https://doi.org/10.1093/ajcn/83.5.1068.
Siri WE. The gross composition of the body. Adv Biol Med Phys. 1956;4:239–80. https://doi.org/10.1016/B978-1-4832-3110-5.50011-X.
Wang Z, Deurenberg P, Wang W, Pietrobelli A, Baumgartner RN, Heymsfield SB. Hydration of fat-free body mass: review and critique of a classic body-composition constant. Am J Clin Nutr. 1999;69(5):833–41. https://doi.org/10.1093/ajcn/69.5.833.
Tinsley GM, Graybeal AJ, Moore ML, Nickerson BS. Fat-free mass characteristics of muscular physique athletes. Med Sci Sports Exerc. 2019;51(1):193–201. https://doi.org/10.1249/MSS.0000000000001749.
Gomez-Arbelaez D, Bellido D, Castro AI, Ordoñez-Mayan L, Carreira J, Galban C, et al. Body composition changes after very-low-calorie Ketogenic diet in obesity evaluated by 3 standardized methods. J Clin Endocrinol Metab. 2017;102(2):488–98. https://doi.org/10.1210/jc.2016-2385.
Bingham SA. Limitations of the various methods for collecting dietary intake data. Ann Nutr Metab. 1991;35(3):117–27. https://doi.org/10.1159/000177635.
McClernon FJ, Yancy WS Jr, Eberstein JA, Atkins RC, Westman EC. The effects of a low-carbohydrate ketogenic diet and a low-fat diet on mood, hunger, and other self-reported symptoms. Obesity (Silver Spring). 2007;15(1):182–7. https://doi.org/10.1038/oby.2007.516.
Boden G, Sargrad K, Homko C, Mozzoli M, Stein TP. Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes. Ann Intern Med. 2005;142(6):403–11. https://doi.org/10.7326/0003-4819-142-6-200503150-00006.
Rodin J, Wack J, Ferrannini E, DeFronzo RA. Effect of insulin and glucose on feeding behavior. Metabolism. 1985;34(9):826–31. https://doi.org/10.1016/0026-0495(85)90106-4.
Holt SH, Miller JB. Increased insulin responses to ingested foods are associated with lessened satiety. Appetite. 1995;24(1):43–54. https://doi.org/10.1016/S0195-6663(95)80005-0.
Hall KD. A review of the carbohydrate-insulin model of obesity. Eur J Clin Nutr. 2017;71(3):323–6. https://doi.org/10.1038/ejcn.2016.260.
Burke LM, Ross ML, Garvican-Lewis LA, Welvaert M, Heikura IA, Forbes SG, 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(9):2785–807. https://doi.org/10.1113/JP273230.
Shaw DM, Merien F, Braakhuis A, Maunder ED, Dulson DK. Effect of a Ketogenic diet on submaximal exercise capacity and efficiency in runners. Med Sci Sports Exerc. 2019;51(10):2135–46. https://doi.org/10.1249/MSS.0000000000002008.
Burke LM, Sharma AP, Heikura IA, Forbes SF, Holloway M, McKay AKA, et al. Crisis of confidence averted: impairment of exercise economy and performance in elite race walkers by ketogenic low carbohydrate, high fat (LCHF) diet is reproducible. PLoS One. 2020;15(6):e0234027. https://doi.org/10.1371/journal.pone.0234027.
Burke LM, Whitfield J, Heikura IA, MLR R, Tee N, Forbes SF, et al. Adaptation to a low carbohydrate high fat diet is rapid but impairs endurance exercise metabolism and performance despite enhanced glycogen availability. J Physiol. 2021;599(3):771–90.
Whitfield J, Burke LM, Mckay AKA, Heikura IA, Hall R, Fensham N, et al. Acute Ketogenic Diet and Ketone Ester Supplementation Impairs Race Walk Performance. Med Sci Sports Exerc. 2021;53(4):776–84.
Murtaza N, Burke LM, Vlahovich N, Charlesson B, O'Neill HM, Ross ML, et al. Analysis of the Effects of Dietary Pattern on the Oral Microbiome of Elite Endurance Athletes. Nutrients. 2019;11(3):614. https://doi.org/10.3390/nu11030614.
Murphy NE, Carrigan CT, Margolis LM. High-Fat Ketogenic Diets and Physical Performance: A Systematic Review. Adv Nutr. 2021;12(1):223–33.
Langfort J, Pilis W, Zarzeczny R, Nazar K, Kaciuba-Uscilko H. Effect of low-carbohydrate-ketogenic diet on metabolic and hormonal responses to graded exercise in men. J Physiol Pharmacol. 1996;47(2):361–71.
Langfort J, Zarzeczny R, Pilis W, Nazar K, Kaciuba-Uscitko H. The effect of a low-carbohydrate diet on performance, hormonal and metabolic responses to a 30-s bout of supramaximal exercise. Eur J Appl Physiol Occup Physiol. 1997;76(2):128–33. https://doi.org/10.1007/s004210050224.
Egan B, D'Agostino DP. Fueling performance: ketones enter the mix. Cell Metab. 2016;24(3):373–5. https://doi.org/10.1016/j.cmet.2016.08.021.
Evans M, Cogan KE, Egan B. Metabolism of ketone bodies during exercise and training: physiological basis for exogenous supplementation. J Physiol. 2017;595(9):2857–71. https://doi.org/10.1113/JP273185.
Sherrier M, Li H. The impact of keto-adaptation on exercise performance and the role of metabolic-regulating cytokines. Am J Clin Nutr. 2019;110(3):562–73. https://doi.org/10.1093/ajcn/nqz145.
Pinckaers PJ, Churchward-Venne TA, Bailey D, van Loon LJ. Ketone bodies and exercise performance: the next magic bullet or merely hype? Sports Med. 2017;47(3):383–91. https://doi.org/10.1007/s40279-016-0577-y.
Webster CC, van Boom KM, Armino N, Larmuth K, Noakes TD, Smith JA, et al. Reduced glucose tolerance and skeletal muscle GLUT4 and IRS1 content in cyclists habituated to a long-term low-carbohydrate, high-fat diet. Int J Sport Nutr Exerc Metab. 2020, p. 1–8. https://doi.org/10.1123/ijsnem.2019-0359.
Zderic TW, Davidson CJ, Schenk S, Byerley LO, Coyle EF. High-fat diet elevates resting intramuscular triglyceride concentration and whole body lipolysis during exercise. Am J Physiol Endocrinol Metab. 2004;286(2):E217–25. https://doi.org/10.1152/ajpendo.00159.2003.
Howard EE, Margolis LM. Intramuscular Mechanisms Mediating Adaptation to Low-Carbohydrate, High-Fat Diets during Exercise Training. Nutrients. 2020;12(9):2496. https://doi.org/10.3390/nu12092496.
Cameron-Smith D, Burke LM, Angus DJ, Tunstall RJ, Cox GR, Bonen A, et al. A short-term, high-fat diet up-regulates lipid metabolism and gene expression in human skeletal muscle. Am J Clin Nutr. 2003;77(2):313–8. https://doi.org/10.1093/ajcn/77.2.313.
Margolis LM, Wilson MA, Whitney CC, Carrigan CT, Murphy NE, Hatch AM, et al. Exercising with low muscle glycogen content increases fat oxidation and decreases endogenous, but not exogenous carbohydrate oxidation. Metabolism. 2019;97:1–8. https://doi.org/10.1016/j.metabol.2019.05.003.
Wang YX. PPARs: diverse regulators in energy metabolism and metabolic diseases. Cell Res. 2010;20(2):124–37. https://doi.org/10.1038/cr.2010.13.
Schuler M, Ali F, Chambon C, Duteil D, Bornert JM, Tardivel A, et al. PGC1alpha expression is controlled in skeletal muscles by PPARbeta, whose ablation results in fiber-type switching, obesity, and type 2 diabetes. Cell Metab. 2006;4(5):407–14. https://doi.org/10.1016/j.cmet.2006.10.003.
Tanaka T, Yamamoto J, Iwasaki S, Asaba H, Hamura H, Ikeda Y, et al. Activation of peroxisome proliferator-activated receptor delta induces fatty acid beta-oxidation in skeletal muscle and attenuates metabolic syndrome. Proc Natl Acad Sci U S A. 2003;100(26):15924–9. https://doi.org/10.1073/pnas.0306981100.
Robinson AM, Williamson DH. Physiological roles of ketone bodies as substrates and signals in mammalian tissues. Physiol Rev. 1980;60(1):143–87. https://doi.org/10.1152/physrev.19126.96.36.199.
Fery F, Balasse EO. Ketone body turnover during and after exercise in overnight-fasted and starved humans. Am J Phys. 1983;245(4):E318–25.
Cox PJ, Kirk T, Ashmore T, Willerton K, Evans R, Smith A, et al. Nutritional ketosis alters fuel preference and thereby endurance performance in athletes. Cell Metab. 2016;24(2):256–68. https://doi.org/10.1016/j.cmet.2016.07.010.
Balasse E, Ooms HA. Changes in the concentrations of glucose, free fatty acids, insulin and ketone bodies in the blood during sodium beta-hydroxybutyrate infusions in man. Diabetologia. 1968;4(3):133–5. https://doi.org/10.1007/BF01219433.
Taggart AK, Kero J, Gan X, Cai TQ, Cheng K, Ippolito M, et al. (D)-beta-Hydroxybutyrate inhibits adipocyte lipolysis via the nicotinic acid receptor PUMA-G. J Biol Chem. 2005;280(29):26649–52. https://doi.org/10.1074/jbc.C500213200.
Bjorntorp P, Schersten T. Effect of beta-hydroxybutyrate on lipid mobilization. Am J Phys. 1967;212(3):683–7. https://doi.org/10.1152/ajplegacy.19188.8.131.523.
Shaw DM, Merien F, Braakhuis A, Maunder E, Dulson DK. Exogenous ketone supplementation and Keto-adaptation for endurance performance: disentangling the effects of two distinct metabolic states. Sports Med. 2020;50(4):641–56. https://doi.org/10.1007/s40279-019-01246-y.
Carbone JW, McClung JP, Pasiakos SM. Skeletal muscle responses to negative energy balance: effects of dietary protein. Adv Nutr. 2012;3(2):119–26. https://doi.org/10.3945/an.111.001792.
Mettler S, Mitchell N, Tipton KD. Increased protein intake reduces lean body mass loss during weight loss in athletes. Med Sci Sports Exerc. 2010;42(2):326–37. https://doi.org/10.1249/MSS.0b013e3181b2ef8e.
Mero AA, Huovinen H, Matintupa O, Hulmi JJ, Puurtinen R, Hohtari H, et al. Moderate energy restriction with high protein diet results in healthier outcome in women. J Int Soc Sports Nutr. 2010;7(1):4. https://doi.org/10.1186/1550-2783-7-4.
Areta JL, Burke LM, Camera DM, West DW, Crawshay S, Moore DR, et al. Reduced resting skeletal muscle protein synthesis is rescued by resistance exercise and protein ingestion following short-term energy deficit. Am J Physiol Endocrinol Metab. 2014;306(8):E989–97. https://doi.org/10.1152/ajpendo.00590.2013.
Hector AJ, McGlory C, Damas F, Mazara N, Baker SK, Phillips SM. Pronounced energy restriction with elevated protein intake results in no change in proteolysis and reductions in skeletal muscle protein synthesis that are mitigated by resistance exercise. FASEB J. 2018;32(1):265–75.
Gwin JA, Church DD, Hatch-McChesney A, Howard EE, Carrigan CT, Murphy NE, et al. Effects of high versus standard essential amino acid intakes on whole-body protein turnover and mixed muscle protein synthesis during energy deficit: a randomized, crossover study. Clin Nutr. 2021;40(3):767–77.
Vandoorne T, De Smet S, Ramaekers M, Van Thienen R, De Bock K, Clarke K, et al. Intake of a ketone Ester drink during recovery from exercise promotes mTORC1 signaling but not glycogen Resynthesis in human muscle. Front Physiol. 2017;8:310. https://doi.org/10.3389/fphys.2017.00310.
Carbone JW, McClung JP, Pasiakos SM. Recent advances in the characterization of skeletal muscle and whole-body protein responses to dietary protein and exercise during negative energy balance. Adv Nutr. 2019;10(1):70–9. https://doi.org/10.1093/advances/nmy087.
Ashtary-Larky D, Bagheri R, Asbaghi O, Tinsley GM, Kooti W, Abbasnezhad A, et al. Effects of resistance training combined with a ketogenic diet on body composition: a systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2021:1–16.
Marra M, Sammarco R, De Lorenzo A, Iellamo F, Siervo M, Pietrobelli A, et al. Assessment of body composition in health and disease using bioelectrical impedance analysis (BIA) and dual energy X-ray absorptiometry (DXA): a critical overview. Contrast Media Mol Imaging. 2019;2019:3548284.