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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

Koerich, Ana Clara C., Borszcz, Fernando Klitzke, Thives Mello, Arthur, de Lucas, Ricardo Dantas, Hansen, Fernanda·2023·Critical Reviews in Food Science and Nutrition

DOI 10.1080/10408398.2022.2090894

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Abstract

This systematic review with meta-analysis aimed to determine the effects of the ketogenic diet (KD) against carbohydrate (CHO)-rich diets on physical performance and body composition in trained individuals. The MEDLINE, EMBASE, CINAHL, SPORTDiscus, and The Cochrane Library were searched. Randomized and non-randomized controlled trials in athletes/trained adults were included. Meta-analytic models were carried out using Bayesian multilevel models. Eighteen studies were included providing estimates on cyclic exercise modes and strength one-maximum repetition (1-RM) performances and for total, fat, and free-fat masses. There were more favorable effects for CHO-rich than KD on time-trial performance (mode [95% credible interval]; -3.3% [-8.5%, 1.7%]), 1-RM (-5.7% [-14.9%, 2.6%]), and free-fat mass (-0.8 [-3.4, 1.9] kg); effects were more favorable to KD on total (-2.4 [-6.2, 1.8] kg) and fat mass losses (-2.4 [-5.4, 0.2] kg). Likely modifying effects on cyclic performance were the subject's sex and VO 2 max, intervention and performance durations, and mode of exercise. The intervention duration and subjects' sex were likely to modify effects on total body mass. KD can be a useful strategy for total and fat body losses, but a small negative effect on free-fat mass was observed. KD was not suitable for enhancing strength 1-RM or high-intensity cyclic performances.

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Authors: Koerich, A. C. C., Borszcz, F. K., Thives Mello, A., de Lucas, R. D., & Hansen, F.
Affiliations: Department of Nutrition, Health Sciences Center, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, Santa Catarina, Brazil
Physical Effort Laboratory, Sports Center, Federal University of Santa Catarina, University Campus, Pantanal, Florianópolis, Santa Catarina, Brazil
ORCID: Borszcz, Fernando Klitzke
Thives Mello, Arthur
de Lucas, Ricardo Dantas
Hansen, Fernanda
Venue: Critical Reviews in Food Science and Nutrition
Publisher: Informa UK Limited
Published: 2022-06-27
Volume: 63
Issue: 32
Pages: 11399-11424
ISSN: 1040-8398
1549-7852
DOI: 10.1080/10408398.2022.2090894
Cited by: 15
References: 37
Language: en
Funders: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (Finance Code001)

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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

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