Student or educator? Sign up with your school email and get 6 months of Pro free.
CoChat
Sign Up
Cited by 44

The DOI matches its Crossref record; 17 of the 17 references it cites were found in a registry or an index.

The Effect of a Ketogenic Low-Carbohydrate, High-Fat Diet on Aerobic Capacity and Exercise Performance in Endurance Athletes: A Systematic Review and Meta-Analysis

Cao, Jingguo, Lei, Siman, Wang, Xiuqiang, Cheng, Sulin·2021·Nutrients
DOI 10.3390/nu13082896
Open this paper in CoChat — free account

Abstract

A low-carbohydrate, high-fat (LCHF) diet has been proposed to enhance the fat utilization of muscle and the aerobic capacity of endurance athletes, thereby improving their exercise performance. However, it remains uncertain how the macronutrient intake shift from carbohydrate to fat affects endurance exercise training and performance. This study performed a systematic review and meta-analysis to explore the effects of a ketogenic low-carbohydrate, high-fat (K-LCHF) diet on aerobic capacity and exercise performance among endurance athletes. Searches were carried out in five electronic databases, and we followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The search included studies using an LCHF diet as an intervention protocol and compared data on factors such as maximum oxygen uptake (VO2max) and rating of perceived exertion (RPE) from the graded exercise test. In this case, 10 studies met the criteria and were included in the meta-analysis. We did not find a significant effect of K-LCHF diet interventions on VO2max, time to exhaustion, HRmax or RPE. However, a significant overall effect in the substrate oxidation response to respiratory exchange rate was observed. The meta-analysis showed that K-LCHF diets did not affect aerobic capacity and exercise performance. Therefore, high-quality interventions of a K-LCHF diet are needed to illustrate its effect on various endurance training programs.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.3390/nu13082896

Cites

17 of 17 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Research works printed but not linked: 51

  1. Paoli, 2013, Beyond weight loss: A review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets, Eur. J. Clin. Nutr., 67, 789, 10.1038/ejcn.2013.116 · DOI · Paper page
  2. Devrim-Lanpir, A., Hill, L., and Knechtle, B. (2021). Efficacy of Popular Diets Applied by Endurance Athletes on Sports Performance: Beneficial or Detrimental? A Narrative Review. Nutrients, 13. · DOI
  3. Valsdottir, T.D., Øvrebø, B., Falck, T.M., Litleskare, S., Johansen, E.I., Henriksen, C., and Jensen, J. (2020). Low-Carbohydrate High-Fat Diet and Exercise: Effect of a 10-Week Intervention on Body Composition and CVD Risk Factors in Overweight and Obese Women—A Randomized Controlled Trial. Nutrients, 13. · DOI
  4. Phinney, 1983, The human metabolic response to chronic ketosis without caloric restriction: Preservation of submaximal exercise capability with reduced carbohydrate oxidation, Metabolism, 32, 769, 10.1016/0026-0495(83)90106-3 · DOI · Paper page
  5. Kaspar, 2019, Ketogenic Diet: From the Historical Records to Use in Elite Athletes, Curr. Nutr. Rep., 8, 340, 10.1007/s13668-019-00294-0 · DOI
  6. Starling, 1997, Effects of diet on muscle triglyceride and endurance performance, J. Appl. Physiol., 82, 1185, 10.1152/jappl.1997.82.4.1185 · DOI
  7. Pitsiladis, 1999, The effects of exercise and diet manipulation on the capacity to perform prolonged exercise in the heat and in the cold in trained humans, J. Physiol., 517, 919, 10.1111/j.1469-7793.1999.0919s.x · DOI
  8. Sumithran, 2013, Ketosis and appetite-mediating nutrients and hormones after weight loss, Eur. J. Clin. Nutr., 67, 759, 10.1038/ejcn.2013.90 · DOI · Paper page
  9. Vidali, 2015, Mitochondria: The ketogenic diet—A metabolism-based therapy, Int. J. Biochem. Cell Biol., 63, 55, 10.1016/j.biocel.2015.01.022 · DOI
  10. Puchalska, 2017, Multi-dimensional Roles of Ketone Bodies in Fuel Metabolism, Signaling, and Therapeutics, Cell Metab., 25, 262, 10.1016/j.cmet.2016.12.022 · DOI · Paper page
  11. Grabacka, 2013, Peroxisome proliferator activated receptor α ligands as anticancer drugs targeting mitochondrial metabolism, Curr. Pharm. Biotechnol., 14, 342, 10.2174/1389201011314030009 · DOI
  12. Draznin, 2012, Effect of Dietary Macronutrient Composition on AMPK and SIRT1 Expression and Activity in Human Skeletal Muscle, Horm. Metab. Res., 44, 650, 10.1055/s-0032-1312656 · DOI
  13. McCarty, 2015, Ketosis may promote brain macroautophagy by activating Sirt1 and hypoxia-inducible factor-1, Med. Hypotheses, 85, 631, 10.1016/j.mehy.2015.08.002 · DOI
  14. Xu, 2021, Ketogenic diets inhibit mitochondrial biogenesis and induce cardiac fibrosis, Signal Transduct. Target. Ther., 6, 1
  15. Hawley, 1998, Strategies to Enhance Fat Utilisation During Exercise, Sports Med., 25, 241, 10.2165/00007256-199825040-00003 · DOI
  16. Chang, 2017, Low-Carbohydrate-High-Fat Diet: Can it Help Exercise Performance?, J. Hum. Kinet., 56, 81, 10.1515/hukin-2017-0025 · DOI
  17. Wycherley, 2014, Long-Term Effects of a Very Low-Carbohydrate Weight Loss Diet on Exercise Capacity and Tolerance in Overweight and Obese Adults, J. Am. Coll. Nutr., 33, 267, 10.1080/07315724.2014.911668 · DOI
  18. Jeukendrup, 2000, The bioenergetics of world class cycling, J. Sci. Med. Sport, 3, 414, 10.1016/S1440-2440(00)80008-0 · DOI · Paper page
  19. Spriet, 2007, Regulation of Substrate Use During the Marathon, Sports Med., 37, 332, 10.2165/00007256-200737040-00015 · DOI
  20. Paoli, 2012, Ketogenic diet does not affect strength performance in elite artistic gymnasts, J. Int. Soc. Sports Nutr., 9, 34, 10.1186/1550-2783-9-34 · DOI
  21. Murphy, 2021, High-Fat Ketogenic Diets and Physical Performance: A Systematic Review, Adv. Nutr., 12, 223, 10.1093/advances/nmaa101 · DOI · Paper page
  22. Durkalec-Michalski, K., Nowaczyk, P.M., Główka, N., Ziobrowska, A., and Podgórski, T. (2021). Is a Four-Week Ketogenic Diet an Effective Nutritional Strategy in CrossFit-Trained Female and Male Athletes?. Nutrients, 13. · DOI
  23. Greene, 2018, A Low-Carbohydrate Ketogenic Diet Reduces Body Mass Without Compromising Performance in Powerlifting and Olympic Weightlifting Athletes, J. Strength Cond. Res., 32, 3373, 10.1519/JSC.0000000000002904 · DOI
  24. Bazyler, 2015, Strength Training for Endurance Athletes: Theory to Practice, Strength Cond. J., 37, 1, 10.1519/SSC.0000000000000131 · DOI
  25. Green, S., Higgins, J., and Alderson, P. (2008). Cochrane Handbook for Systematic Reviews of Interventions, The Cochrane Collaboration. Version 5.10 ed. · DOI · Paper page
  26. Wan, 2014, Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range, BMC Med Res. Methodol., 14, 1, 10.1186/1471-2288-14-135 · DOI · Paper page
  27. Tran, 2018, Cardiopulmonary Exercise Testing, Methods Mol. Biol., 1735, 285, 10.1007/978-1-4939-7614-0_18 · DOI
  28. Gross, 2017, Physical activity and maximal oxygen uptake in adults with Prader–Willi syndrome, Eat. Weight. Disord. Stud. Anorex. Bulim. Obes., 23, 615, 10.1007/s40519-016-0356-7 · DOI
  29. Shea, B.J., Grimshaw, J.M., Wells, G.A., Boers, M., Andersson, N., Hamel, C., Porter, A.C., Tugwell, P., Moher, D., and Bouter, L.M. (2007). Development of AMSTAR: A measurement tool to assess the methodological quality of systematic reviews. BMC Med Res. Methodol., 7. · DOI · Paper page
  30. Cipryan, 2018, Effects of a 4-Week Very Low-Carbohydrate Diet on High-Intensity Interval Training Responses, J. Sports Sci. Med., 17, 259
  31. Dostal, 2019, 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., 10, 912, 10.3389/fphys.2019.00912 · DOI
  32. Fleming, 2003, Endurance capacity and high-intensity exercise performance responses to a high fat diet, Int. J. Sport Nutr. Exerc. Metab., 13, 466, 10.1123/ijsnem.13.4.466 · DOI
  33. Heatherly, 2018, Effects of Ad libitum Low-Carbohydrate High-Fat Dieting in Middle-Age Male Runners, Med. Sci. Sports Exerc., 50, 570, 10.1249/MSS.0000000000001477 · DOI
  34. Lambert, 1994, Enhanced endurance in trained cyclists during moderate intensity exercise following 2 weeks adaptation to a high fat diet, Graefes Arch. Clin. Exp. Ophthalmol., 69, 287
  35. Prins, 2019, 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., 18, 738
  36. Shaw, 2019, Effect of a Ketogenic Diet on Submaximal Exercise Capacity and Efficiency in Runners, Med. Sci. Sports Exerc., 51, 2135, 10.1249/MSS.0000000000002008 · DOI · Paper page
  37. Lambert, 2001, High-Fat Diet versus Habitual Diet Prior to Carbohydrate Loading: Effects on Exercise Metabolism and Cycling Performance, Int. J. Sport Nutr. Exerc. Metab., 11, 209, 10.1123/ijsnem.11.2.209 · DOI
  38. Greenhaff, 2001, The effects of increasing exercise intensity on muscle fuel utilisation in humans, J. Physiol., 536, 295, 10.1111/j.1469-7793.2001.00295.x · DOI · Paper page
  39. Helge, 1996, Interaction of training and diet on metabolism and endurance during exercise in man, J. Physiol., 492, 293, 10.1113/jphysiol.1996.sp021309 · DOI
  40. Soeters, 2012, Adaptive reciprocity of lipid and glucose metabolism in human short-term starvation, Am. J. Physiol. Metab., 303, E1397
  41. Havemann, 2006, Fat adaptation followed by carbohydrate loading compromises high-intensity sprint performance, J. Appl. Physiol., 100, 194, 10.1152/japplphysiol.00813.2005 · DOI · Paper page
  42. Helge, 2002, Long-term fat diet adaptation effects on performance, training capacity, and fat utilization, Med. Sci. Sports Exerc., 34, 1499, 10.1097/00005768-200209000-00016 · DOI
  43. Pellizzer, 1999, Reduced dietary fat intake increases parasympathetic activity in healthy premenopausal women, Clin. Exp. Pharmacol. Physiol., 26, 656, 10.1046/j.1440-1681.1999.03103.x · DOI
  44. Pendergast, 2000, A perspective on fat intake in athletes, J. Am. Coll. Nutr., 19, 345, 10.1080/07315724.2000.10718930 · DOI
  45. Havemann, L. (2008). The effect of Fat-Adaptation Followed by Carbohydrate-Loading on Simulated Ultra-Endurance Race Performance. [Ph.D. Thesis, University of Cape Town]. · DOI
  46. Nowaczyk, 2019, Effect of a four-week ketogenic diet on exercise metabolism in CrossFit-trained athletes, J. Int. Soc. Sports Nutr., 16, 16, 10.1186/s12970-019-0284-9 · DOI
  47. Owen, 1967, Brain Metabolism during Fasting*, J. Clin. Investig., 46, 1589, 10.1172/JCI105650 · DOI · Paper page
  48. Wentz, 2010, Adaptation of Myocardial Substrate Metabolism to a Ketogenic Nutrient Environment, J. Biol. Chem., 285, 24447, 10.1074/jbc.M110.100651 · DOI
  49. Owen, 2005, Ketone bodies as a fuel for the brain during starvation, Biochem. Mol. Biol. Educ., 33, 246, 10.1002/bmb.2005.49403304246 · DOI
  50. Han, 2020, β-hydroxybutyrate and its metabolic effects on age-associated pathology, Exp. Mol. Med., 52, 548, 10.1038/s12276-020-0415-z · DOI
  51. Achanta, 2017, β-Hydroxybutyrate in the Brain: One Molecule, Multiple Mechanisms, Neurochem. Res., 42, 35, 10.1007/s11064-016-2099-2 · DOI

Cited by

See all 44

Metadata

Authors
Cao, J., Lei, S., Wang, X., & Cheng, S.
Affiliations
Exercise, Health and Technology Centre, Department of Physical Education, Shanghai Jiao Tong University, Shanghai 200240, China
ORCID
Venue
Nutrients
Publisher
MDPI AG
Published
2021-08-23
Volume
13
Issue
8
Pages
2896
ISSN
2072-6643
DOI
10.3390/nu13082896
Cited by
44
References
17
Language
en
Licence
creativecommons.org/licenses/by/4.0/ (vor)
Funders
Xiuqiang Wang (AF4150043)

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Data sources

Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.