Top

Published in:

01-08-2021 | Original Article

Effects of a low-carbohydrate ketogenic diet on health parameters in resistance-trained women

Authors: Salvador Vargas-Molina , Leandro Carbone, Ramón Romance, Jorge L. Petro, Brad J. Schoenfeld, Richard B. Kreider, Diego A. Bonilla, Javier Benítez-Porres

Published in: European Journal of Applied Physiology | Issue 8/2021

Abstract

Purpose

The aim of this study was to evaluate the effect of a ketogenic diet on blood pressure, visceral adipose tissue (VAT), bone mineral content (BMC), and bone mineral density (BMD) in trained women.

Methods

Twenty-one resistance-trained women performed an 8-week resistance training program after a 3-week familiarization phase. Participants were randomly assigned to a non-ketogenic diet (n = 11, NKD) or ketogenic diet (n = 10, KD) group. Health parameters were measured before and after the nutritional intervention. Blood pressure was measured using a digital automatic monitor, while VAT, BMC, and BMD changes were measured by dual-energy X-ray absorptiometry.

Results

There was a significant reduction in systolic blood pressure in KD (mean ± SD [IC 95%], P value, Hedges’ g; − 6.3 ± 6.0 [− 10.5, − 2.0] mmHg, P = 0.009, g = − 0.81) but not in NKD (− 0.4 ± 8.9 [− 6.8, 6.0] mmHg, P = 0.890, g = − 0.04). The results on VAT showed no changes in both groups. The KD showed a small favorable effect on BMD (0.02 ± 0.02 [0.01, 0.03] g·cm⁻², P = 0.014, g = 0.19) while NKD did not show significant changes (0.00 ± 0.02 [− 0.02, 0.02] g·cm⁻², P = 0.886, g = 0.01). No differences in group or in the time × group interaction were found in any of the variables.

Conclusions

Consuming a low-carbohydrate high-fat KD in conjunction with a resistance training program might help to promote the improvement of health-related markers in resistance-trained women. Long-term studies are required to evaluate the superiority of a KD in comparison to a traditional diet.

Allen BG, Bhatia SK, Anderson CM, Eichenberger-Gilmore JM, Sibenaller ZA, Mapuskar KA, Schoenfeld JD, Buatti JM, Spitz DR, Fath MA (2014) Ketogenic diets as an adjuvant cancer therapy: history and potential mechanism. Redox Biol 2:963–970. https://doi.org/10.1016/j.redox.2014.08.002CrossRefPubMedPubMedCentral

Appel LJ, Sacks FM, Carey VJ, Obarzanek E, Swain JF, Miller ER 3rd, Conlin PR, Erlinger TP, Rosner BA, Laranjo NM, Charleston J, McCarron P, Bishop LM (2005) Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: results of the OmniHeart randomized trial. JAMA 294(19):2455–2464. https://doi.org/10.1001/jama.294.19.2455CrossRefPubMed

Bartlett JD, Hawley JA, Morton JP (2015) Carbohydrate availability and exercise training adaptation: too much of a good thing? Eur J Sport Sci 15(1):3–12. https://doi.org/10.1080/17461391.2014.920926CrossRefPubMed

Bergqvist AG (2012) Long-term monitoring of the ketogenic diet: Do’s and Dont’s. Epilepsy Res 100(3):261–266. https://doi.org/10.1016/j.eplepsyres.2011.05.020CrossRefPubMed

Bergqvist AG, Schall JI, Stallings VA, Zemel BS (2008) Progressive bone mineral content loss in children with intractable epilepsy treated with the ketogenic diet. Am J Clin Nutr 88(6):1678–1684. https://doi.org/10.3945/ajcn.2008.26099CrossRefPubMed

Bertoli S, Trentani C, Ferraris C, De Giorgis V, Veggiotti P, Tagliabue A (2014) Long-term effects of a ketogenic diet on body composition and bone mineralization in GLUT-1 deficiency syndrome: a case series. Nutrition 30(6):726–728. https://doi.org/10.1016/j.nut.2014.01.005CrossRefPubMed

Brito LC, Fecchio RY, Peçanha T, Andrade-Lima A, Halliwill JR, Forjaz CLM (2018) Postexercise hypotension as a clinical tool: a “single brick” in the wall. J Am Soc Hypertens 12(12):e59–e64. https://doi.org/10.1016/j.jash.2018.10.006CrossRefPubMed

Bueno NB, de Melo ISV, de Oliveira SL, da AtaideRocha T (2013) Very-low-carbohydrate ketogenic diet v low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. Br J Nutr 110(7):1178–1187. https://doi.org/10.1017/S0007114513000548CrossRefPubMed

Burke LM (2015) Re-examining high-fat diets for sports performance: did we call the ‘nail in the coffin’ too soon? Sports Med 45(1):33–49. https://doi.org/10.1007/s40279-015-0393-9CrossRefPubMedCentral

Cahill GF (1970) Starvation in man. N Engl J Med 282(12):668–675. https://doi.org/10.1056/NEJM197003192821209CrossRefPubMed

Cahill GF (2006) Fuel metabolism in starvation. Annu Rev Nutr 26:1–22. https://doi.org/10.1146/annurev.nutr.26.061505.111258CrossRefPubMed

Castellana M, Conte E, Cignarelli A, Perrini S, Giustina A, Giovanella L, Giorgino F, Trimboli P (2020) Efficacy and safety of very low calorie ketogenic diet (VLCKD) in patients with overweight and obesity: a systematic review and meta-analysis. Rev Endocr Metab Disord 21(1):5–16. https://doi.org/10.1007/s11154-019-09514-yCrossRefPubMed

Chang CK, Borer K, Lin PJ (2017) Low-carbohydrate-high-fat diet: can it help exercise performance? J Hum Kinet 56:81–92. https://doi.org/10.1515/hukin-2017-0025CrossRefPubMedPubMedCentral

Cicero AF, Benelli M, Brancaleoni M, Dainelli G, Merlini D, Negri R (2015) Middle and long-term impact of a very low-carbohydrate ketogenic diet on cardiometabolic factors: a multi-center, cross-sectional, clinical study. High Blood Press Cardiovasc Prev 22(4):389–394. https://doi.org/10.1007/s40292-015-0096-1CrossRefPubMedPubMedCentral

Colica C, Merra G, Gasbarrini A, De Lorenzo A, Cioccoloni G, Gualtieri P, Perrone MA, Bernardini S, Bernardo V, Di Renzo L, Marchetti M (2017) Efficacy and safety of very-low-calorie ketogenic diet: a double blind randomized crossover study. Eur Rev Med Pharmacol Sci 21(9):2274–2289PubMed

Cornelissen VA, Fagard RH, Coeckelberghs E, Vanhees L (2011) Impact of resistance training on blood pressure and other cardiovascular risk factors: a meta-analysis of randomized, controlled trials. Hypertension 58(5):950–958. https://doi.org/10.1161/HYPERTENSIONAHA.111.177071CrossRefPubMed

Cotter DG, Schugar RC, Crawford PA (2013) Ketone body metabolism and cardiovascular disease. Am J Physiol Heart Circ Physiol 304(8):H1060–H1076. https://doi.org/10.1152/ajpheart.00646.2012CrossRefPubMedPubMedCentral

Draaisma JMT, Hampsink BM, Janssen M, van Houdt NBM, Linders E, Willemsen MA (2019) The ketogenic diet and its effect on bone mineral density: a retrospective observational cohort study. Neuropediatrics 50(6):353–358. https://doi.org/10.1055/s-0039-1693059CrossRefPubMed

Durkalec-Michalski K, Nowaczyk PM, Siedzik K (2019) Effect of a four-week ketogenic diet on exercise metabolism in CrossFit-trained athletes. J Int Soc Sports Nutr 16(1):16. https://doi.org/10.1186/s12970-019-0284-9CrossRefPubMedPubMedCentral

Egan B, D’Agostino DP (2016) Fueling performance: ketones enter the mix. Cell Metab 24(3):373–375. https://doi.org/10.1016/j.cmet.2016.08.021CrossRefPubMed

Francois ME, Gillen JB, Little JP (2017) Carbohydrate-restriction with high-intensity interval training: an optimal combination for treating metabolic diseases? Front Nutr 4:49. https://doi.org/10.3389/fnut.2017.00049CrossRefPubMedPubMedCentral

Gregory RM (2017) A low-carbohydrate ketogenic diet combined with 6-weeks of crossfit training improves body composition and performance. Int J Sports Exerc Med. https://doi.org/10.23937/2469-5718/1510054CrossRef

Hartman AL, Vining EPG (2007) Clinical aspects of the ketogenic diet. Epilepsia 48(1):31–42. https://doi.org/10.1111/j.1528-1167.2007.00914.xCrossRefPubMed

Heikura IA, Burke LM, Hawley JA, Ross ML, Garvican-Lewis L, Sharma AP, McKay AKA, Leckey JJ, Welvaert M, McCall L, Ackerman KE (2019) A short-term ketogenic diet impairs markers of bone health in response to exercise. Front Endocrinol 10:880. https://doi.org/10.3389/fendo.2019.00880CrossRef

Hu T, Yao L, Reynolds K, Whelton PK, Niu T, Li S, He J, Bazzano LA (2015) The effects of a low-carbohydrate diet vs a low-fat diet on novel cardiovascular risk factors: a randomized controlled trial. Nutrients 7(9):7978–7994. https://doi.org/10.3390/nu7095377CrossRefPubMedPubMedCentral

Jabekk PT, Moe IA, Meen HD, Tomten SE, Hostmark AT (2010) Resistance training in overweight women on a ketogenic diet conserved lean body mass while reducing body fat. Nutr Metab (Lond) 7:17. https://doi.org/10.1186/1743-7075-7-17CrossRef

Kephart WC, Pledge CD, Roberson PA, Mumford PW, Romero MA, Mobley CB, Martin JS, Young KC, Lowery RP, Wilson JM, Huggins KW, Roberts MD (2018) The three-month effects of a ketogenic diet on body composition, blood parameters, and performance metrics in crossfit trainees: a pilot study. Sports (basel). https://doi.org/10.3390/sports6010001CrossRef

Koeslag JH, Noakes TD, Sloan AW (1980) Post-exercise ketosis. J Physiol 301(1):79–90. https://doi.org/10.1113/jphysiol.1980.sp013190CrossRefPubMedPubMedCentral

Kosinski C, Jornayvaz FR (2017) Effects of Ketogenic Diets on Cardiovascular Risk Factors: Evidence from Animal and Human Studies. Nutrients. https://doi.org/10.3390/nu9050517CrossRefPubMedPubMedCentral

Loucks AB (2003) Energy availability, not body fatness, regulates reproductive function in women. Exerc Sport Sci Rev 31(3):144–148CrossRefPubMed

McArtney R, Bailey A, Champion H (2017) What is a ketogenic diet and how does it affect the use of medicines? Arch Dis Child Educ Pract Ed 102(4):194–199. https://doi.org/10.1136/archdischild-2014-307000CrossRefPubMed

McKay AKA, Peeling P, Pyne DB, Welvaert M, Tee N, Leckey JJ, Sharma AP, Ross MLR, Garvican-Lewis LA, Swinkels DW, Laarakkers CM, Burke LM (2019) Chronic adherence to a ketogenic diet modifies iron metabolism in elite athletes. Med Sci Sports Exerc 51(3):548–555. https://doi.org/10.1249/MSS.0000000000001816CrossRefPubMed

Perissiou M, Borkoles E, Kobayashi K, Polman R (2020) The effect of an 8 week prescribed exercise and low carbohydrate diet on cardiorespiratory fitness, body composition and cardiometabolic risk factors in obese individuals: a randomised controlled trial. Nutrients. https://doi.org/10.3390/nu12020482CrossRefPubMedPubMedCentral

Phinney SD (2004) Ketogenic diets and physical performance. Nutr Metab (Lond) 1(1):2. https://doi.org/10.1186/1743-7075-1-2CrossRef

Puchalska P, Crawford PA (2017) Multi-dimensional roles of ketone bodies in fuel metabolism, signaling, and therapeutics. Cell Metab 25(2):262–284. https://doi.org/10.1016/j.cmet.2016.12.022CrossRefPubMedPubMedCentral

Reed JL, De Souza MJ, Mallinson RJ, Scheid JL, Williams NI (2015) Energy availability discriminates clinical menstrual status in exercising women. J Int Soc Sports Nutr 12:11. https://doi.org/10.1186/s12970-015-0072-0CrossRefPubMedPubMedCentral

Rondanelli M, Faliva MA, Gasparri C, Peroni G, Spadaccini D, Maugeri R, Nichetti M, Infantino V, Perna S (2020) Current opinion on dietary advice in order to preserve fat-free mass during a low-calorie diet. Nutrition. https://doi.org/10.1016/j.nut.2019.110667CrossRefPubMed

Rosenfeld R, Livne D, Nevo O, Dayan L, Milloul V, Lavi S, Jacob G (2008) Hormonal and volume dysregulation in women with premenstrual syndrome. Hypertension 51(4):1225–1230. https://doi.org/10.1161/HYPERTENSIONAHA.107.107136CrossRefPubMed

Simm PJ, Bicknell-Royle J, Lawrie J, Nation J, Draffin K, Stewart KG, Cameron FJ, Scheffer IE, Mackay MT (2017) The effect of the ketogenic diet on the developing skeleton. Epilepsy Res 136:62–66. https://doi.org/10.1016/j.eplepsyres.2017.07.014CrossRefPubMed

Sjödin A, Hellström F, Sehlstedt E, Svensson M, Burén J (2020) Effects of a ketogenic diet on muscle fatigue in healthy, young, normal-weight women: a randomized controlled feeding trial. Nutrients. https://doi.org/10.3390/nu12040955CrossRefPubMedPubMedCentral

Stachenfeld NS (2008) Sex hormone effects on body fluid regulation. Exerc Sport Sci Rev 36(3):152–159. https://doi.org/10.1097/JES.0b013e31817be928CrossRefPubMedPubMedCentral

Stubbs BJ, Cox PJ, Evans RD, Santer P, Miller JJ, Faull OK, Magor-Elliott S, Hiyama S, Stirling M, Clarke K (2017) On the metabolism of exogenous ketones in humans. Front Physiol 8:848. https://doi.org/10.3389/fphys.2017.00848CrossRefPubMedPubMedCentral

Teixeira V, Voci SM, Mendes-Netto RS, da Silva DG (2018) The relative validity of a food record using the smartphone application MyFitnessPal. Nutr Diet 75(2):219–225. https://doi.org/10.1111/1747-0080.12401CrossRefPubMed

Urbain P, Bertz H (2016) Monitoring for compliance with a ketogenic diet: what is the best time of day to test for urinary ketosis? Nutr Metab 13:77. https://doi.org/10.1186/s12986-016-0136-4CrossRef

Valenzano A, Polito R, Trimigno V, Di Palma A, Moscatelli F, Corso G, Sessa F, Salerno M, Montana A, Di Nunno N, Astuto M, Daniele A, Carotenuto M, Messina G, Cibelli G, Monda V (2019) Effects of very low calorie ketogenic diet on the orexinergic system, visceral adipose tissue, and ros production. Antioxidants (basel). https://doi.org/10.3390/antiox8120643CrossRef

Vargas S, Romance R, Petro JL, Bonilla DA, Galancho I, Espinar S, Kreider RB, Benitez-Porres J (2018) Efficacy of ketogenic diet on body composition during resistance training in trained men: a randomized controlled trial. J Int Soc Sports Nutr 15(1):31. https://doi.org/10.1186/s12970-018-0236-9CrossRefPubMedPubMedCentral

Vargas-Molina S, Petro JL, Romance R, Kreider RB, Schoenfeld BJ, Bonilla DA, Benitez-Porres J (2020) Effects of a ketogenic diet on body composition and strength in trained women. J Int Soc Sports Nutr 17(1):19. https://doi.org/10.1186/s12970-020-00348-7CrossRefPubMedPubMedCentral

Vasan RS, Larson MG, Leip EP, Evans JC, O’Donnell CJ, Kannel WB, Levy D (2001) Impact of high-normal blood pressure on the risk of cardiovascular disease. N Engl J Med 345(18):1291–1297. https://doi.org/10.1056/NEJMoa003417CrossRefPubMed

Veech RL (2004) The therapeutic implications of ketone bodies: the effects of ketone bodies in pathological conditions: ketosis, ketogenic diet, redox states, insulin resistance, and mitochondrial metabolism. Prostaglandins Leukot Essent Fatty Acids 70(3):309–319. https://doi.org/10.1016/j.plefa.2003.09.007CrossRefPubMed

Villalon KL, Gozansky WS, Van Pelt RE, Wolfe P, Jankowski CM, Schwartz RS, Kohrt WM (2011) A losing battle: weight regain does not restore weight loss-induced bone loss in postmenopausal women. Obesity 19(12):2345–2350. https://doi.org/10.1038/oby.2011.263CrossRefPubMed

Włodarek D (2019) Role of ketogenic diets in neurodegenerative diseases (Alzheimer’s disease and Parkinson’s disease). Nutrients 11(1):169CrossRefPubMedCentral

Wooding DJ, Packer JE, Kato H, West DWD, Courtney-Martin G, Pencharz PB, Moore DR (2017) Increased protein requirements in female athletes after variable-intensity exercise. Med Sci Sports Exerc 49(11):2297–2304. https://doi.org/10.1249/MSS.0000000000001366CrossRefPubMed

Wroble KA, Trott MN, Schweitzer GG, Rahman RS, Kelly PV, Weiss EP (2019) Low-carbohydrate, ketogenic diet impairs anaerobic exercise performance in exercise-trained women and men: a randomized-sequence crossover trial. J Sports Med Phys Fitness 59(4):600–607. https://doi.org/10.23736/S0022-4707.18.08318-4CrossRefPubMed

Yancy WS Jr, Westman EC, McDuffie JR, Grambow SC, Jeffreys AS, Bolton J, Chalecki A, Oddone EZ (2010) A randomized trial of a low-carbohydrate diet vs orlistat plus a low-fat diet for weight loss. Arch Intern Med 170(2):136–145. https://doi.org/10.1001/archinternmed.2009.492CrossRefPubMed

Zajac A, Poprzecki S, Maszczyk A, Czuba M, Michalczyk M, Zydek G (2014) The effects of a ketogenic diet on exercise metabolism and physical performance in off-road cyclists. Nutrients 6(7):2493–2508. https://doi.org/10.3390/nu6072493CrossRefPubMedPubMedCentral

Zhang M, Hu T, Zhang S, Zhou L (2015) Associations of Different Adipose Tissue Depots with Insulin Resistance: a systematic review and meta-analysis of observational studies. Sci Rep 5:18495. https://doi.org/10.1038/srep18495CrossRefPubMedPubMedCentral

Zinn C, Wood M, Williden M, Chatterton S, Maunder E (2017) 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 14:22. https://doi.org/10.1186/s12970-017-0180-0CrossRefPubMedPubMedCentral

Title: Effects of a low-carbohydrate ketogenic diet on health parameters in resistance-trained women
Authors: Salvador Vargas-Molina
Leandro Carbone
Ramón Romance
Jorge L. Petro
Brad J. Schoenfeld
Richard B. Kreider
Diego A. Bonilla
Javier Benítez-Porres
Publication date: 01-08-2021
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Applied Physiology / Issue 8/2021
Print ISSN: 1439-6319
Electronic ISSN: 1439-6327
DOI: https://doi.org/10.1007/s00421-021-04707-3

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Effects of a low-carbohydrate ketogenic diet on health parameters in resistance-trained women

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 8/2021

Physiological responses to maximal 4 s sprint interval cycling using inertial loading: the influence of inter-sprint recovery duration

Role of exercise on visceral adiposity after spinal cord injury: a cardiometabolic risk factor

Correction to: Molecular regulation of skeletal muscle mitochondrial biogenesis following blood flow-restricted aerobic exercise: a call to action

Cerebral autoregulation assessed by near-infrared spectroscopy: validation using transcranial Doppler in patients with controlled hypertension, cognitive impairment and controls

Physiological responses and cycle characteristics during double-poling versus diagonal-stride roller-skiing in junior cross-country skiers

The cold truth: the role of cryotherapy in the treatment of injury and recovery from exercise