GAINING MUSCLE ON KETO.

GAINING MUSCLE ON KETO SUMMARY

---

ARTICLE SUMMARY

• Building muscle on a keto diet may seem challenging, especially when compared to higher-carb diets. Nevertheless, it is possible to gain muscle on keto, provided the intake of protein and macros aligns with those of high-carbohydrate diets.
• Coffee, coupled with a Keto diet are good combinations to enhance fat mobilization.
• Furthermore, research studies on a keto diet and testosterone levels show that adding more fat above 30% will not increase testosterone levels. However, keto muscle twitching/ muscle cramps on keto is a common result of electrolyte imbalance.

---

9/28 RESEARCH UPDATE: KETOGENIC DIETS MAY BE BETTER FOR FAT LOSS BUT GAINING MUSCLE ON KETO MAY BE MORE DIFFICULT

If your goal is to lose weight and fat loss, a new review suggests that keto diets are more favorable than low-fat diets. Interestingly, the review also found that gaining muscle on keto was less effective and reduced performance. The literature review examined keto diet studies (i.e., 60-80% of the calories from fat), with less than 10% of calories coming from carbohydrates or <50 grams of carbs per day.

The non-keto diets included any study that used over 40% of their calories from carbohydrates. The researchers found 16 studies that fit their criteria and looked at muscle mass, fat loss, 1-RM strength, and cycling performance. Through their analysis, the researchers found keto diets were highly effective for fat loss but favored higher carbohydrates for increasing muscle mass, increasing 1-RM strength, and performing high-intensity exercise.

Therefore, gaining muscle on ketogenic diets may be less effective than a higher carb diet. Conversely, a ketogenic diet can work well if fat loss is your main goal.  (51)

In essence, muscle on keto is possible, but the diet may be less effective than a diet with carbohydrates. Keto may be better for dieting while trying to maintain muscle, whereas in the off-season, adding more carbs can be beneficial.

7/3/2022 NEW META-ANALYSIS ON GAINING MUSCLE ON KETO AND BODY COMPOSITION

The controversy of gaining muscle on keto is nothing new, but the research has been consistently clear that ketogenic diets will result in better short-term fat loss. In contrast, long term, there is no difference in fat loss compared to low-fat diets when protein and calories are similar.

The Study

Recently, a 2022 meta-analysis on ketogenic diets and body composition was released in the Journal of Critical Reviews in Food Sciences and Nutrition. The great part about this review is that it only used trained athletes in the analysis, eliminating people just starting to train and making large increases in strength and lean muscle mass.

Surprisingly, ketogenic diets still have a large following, and many people get quite angry if you tell them a ketogenic diet results in lean muscle loss. They will usually give you a testimonial that they are in the best shape of their life and have been on keto for x amount of years. In this context, the review examined 18 studies and examined performance, strength, and body composition outcomes for all the studies.

Results

The study revealed that ketogenic diets resulted in worse outcomes in cycling performance, 1-RM strength tests (i.e., women performed worse on ketogenic diet strength tests than men), and reduced lean muscle mass. However, ketogenic diets were more effective for reducing body weight and fat loss than low-fat/high-carbohydrate diets. (49) Additionally, these findings are similar to another 2021 meta-analysis of 13 studies that found that ketogenic diets resulted in greater fat loss but fewer gains in lean muscle mass. (50)

In sum, the author suggested ketogenic diets may benefit athletes during a non-competitive phase when performance is not a priority and loss of body fat is needed.

Furthermore, the author of the meta-analysis emphasized that the study interventions were only 12 weeks long and that more research is needed for longer-term studies. Nevertheless, from the studies, there does not seem to be an advantage to using ketogenic diets for weight loss, and fat loss is similar when calories and protein are controlled.

---

KETOSIS AND GAINING MUSCLE ON KETO

There has never been a more controversial subject than gaining muscle on keto diets and muscle loss. Notably, ketogenic diets are characterized by high-fat and moderate to high protein content but an insufficient level of carbohydrates (usually 20 g-50 g per day), thus forcing the body to primarily use fat as a fuel source. In essence, the ketogenic diet mimics metabolic starvation, increasing the body’s use of fat as an energy source.

THE EVOLUTION OF THE KETO DIET: FROM BACON TO KETO BOMBS

The original keto diet was high in saturated fat, low in carbohydrates, and low in protein. In a 4:1 ratio of fat to protein and carbs, 90% of calories come from fat, 6% from protein, and 4% from carbs.

Today, it is known that muscle protein synthesis is extremely important for muscle growth, so the newer versions of the keto diet have all increased the amount of protein to consume daily. There are at least 10 versions of the keto diet, such as the Lean Keto Diet, Keto Carnivore Diet, Keto Green Diet, Keto Liquid Diet, Keto 2.0 Diet, etc.

What can I eat before a workout on a keto diet is a very popular question? For a quick energy boost on a keto diet, Keto pre-workout snacks are also available, such as keto peanut butter fat bombs.

Famous keto bodybuilders to advocate this lifestyle are Vince Gironda, Clarence Bass, Serge Nubret, Samir Bannout, and Frank Zane. There are thousands of build muscle on keto Reddit threads. Joe Rogan Keto Diet is a long list of celebrities who endorse the low-carb lifestyle.

The reduction of dietary carbohydrates decreases plasma insulin and increases glucagon; this state promotes liver glycogen breakdown and gluconeogenesis (i.e., creation of glucose from non-carbohydrate sources) and lipolysis of adipose tissue through the increase of HSL (hormone-sensitive lipase).(1) Shifting from carbohydrates as a fuel source to fat is known as ketosis.

Based on the evidence, ketogenic diets increase the concentration of ketone bodies in the blood, usually above >0.5 mmol/L, indicating nutritional ketosis.(2) As the brain depends on glucose when following a ketogenic diet, the brain depends on ketone bodies as an energy source.(3) Ketone bodies are present under fed states; however, ketones increase with fasting, prolonged exercise, and reduced carbohydrate availability.

PROTEIN AND FAT

Ketogenic diets are effective for weight loss by increasing satiety and reducing appetite. In a systemic review of the literature, the keto diet resulted in a negative energy balance of -339 kcals per day compared to a control diet.(4)

Many studies in which subjects were not restricted by calories showed ketogenic diets resulted in lower calorie intake.(5, 6) However, when calories are matched (i.e., same calorie deficit), there are no significant differences in losing body weight or fat over a year.(7-9)

Based on the evidence, ketogenic diets result in more weight loss short term; however, there are no differences in fat loss or body weight long term compared to high carbohydrate, low-fat diets.(10) Furthermore, there is no evidence that a ketogenic diet is superior for fat loss to a high-carbohydrate, low-fat diet in the long term when calories are equal.

RULE #1 FOR GAINING MUSCLE ON LETO: EAT ENOUGH PROTEIN ON KETO

The decreases in appetite have been attributed to the high protein consumed on ketogenic diets and increased appetite-suppressing hormones (i.e., decreased leptin, ghrelin, etc.), resulting in a lower caloric intake. Others have suggested the increased fiber from consuming more vegetables also contributes to the reduced caloric intake.

Thus, keto reduces caloric intake compared to control diets. Some have touted that ketogenic diets result in a “metabolic advantage” resulting in increased energy expenditure, but this was disproven by Kevin Hall.

He showed that a ketogenic diet resulted in about a 100 kcal increase in energy expenditure after adjusting for body mass and composition.(11) The data from several studies suggest that the metabolic advantage of a ketogenic diet would be small, certainly not enough to make it superior to that of a carbohydrate-matched diet.

KETONE SUPPLEMENTS

Ketogenic diets also increase circulating ketones. Several supplement companies have also developed products to boost ketone levels, such as KETO BURN DIET PILL and exogenous ketones. A Keto diet fiber supplement is also recommended for those who do not consume vegetables.

KETOSIS AND GAINING MUSCLE ON KETO

Several studies have shown that exogenous administrations of ketone metabolites that increase ketones without carbohydrate restriction demonstrate anti-catabolic and anti-inflammatory properties. (12, 13)

Specifically, in endurance athletes, the administration of ketone esters has increased markers of recovery by preventing overtraining and overreaching.(14) Interestingly, despite symptoms of overreaching, the ketone supplemented group improved their overall work output and endurance performance test by 15% compared to the control group.

In the context of animal models, cancer-induced muscle wasting can be prevented with supplemental ketones.(15) Furthermore, others have found that ketone esters could increase anabolic signaling pathways in muscle (i.e., mTOR). (16)

However, despite these properties of ketones, most of the studies that have compared ketogenic diets to isocaloric diets with resistance exercise have found either decrease (17-20), similar changes(19, 21-26), or increases(25, 27) in lean muscle mass. In addition, the Wilson et al. study, the ketogenic diet was followed with a carbohydrate refeed in the post-evaluation period, likely enhancing glycogen and positively influencing the final lean mass results.(25)

GAINING MUSCLE ON KETOGENIC DIETS 

Most of the earlier studies on ketogenic diets used low protein diets; however, the studies in elite athletes found that a high protein (i.e., 30-40% protein) ketogenic diet maintained muscle mass.(28, 29) In sum, ketogenic diets can maintain lean mass but do not seem productive for increasing muscle mass.

Hence, most research suggests that combining a ketogenic diet with resistance training can favor a fat mass reduction in healthy and trained individuals. However, muscle mass may also be compromised.(30) Another consequence of a low-carbohydrate diet are feeling of fatigue or what has been referred to as the “Keto-flu.”(31) Furthermore, several meta-analyses have found that ketogenic diets are beneficial for losing body fat but are not favorable for increasing lean muscle mass.(4, 32, 33)

In sum, a ketogenic diet can maintain lean muscle mass as long as the protein intake is sufficiently high, ~1.7 g/kg/day or .8 grams per pound, but the studies do not show it’s beneficial for increasing lean muscle mass. Conversely, Others have found reductions in anabolic signaling pathways (i.e., mTOR, AMPK) and reduced anabolic hormones (i.e., testosterone and IGF-1), which could contribute to the reduced increases in lean mass.(20, 34-36)

KETOGENIC DIETS AND GLYCOGEN

The large increases in lean mass on a ketogenic diet can be attributed to increased water loss as ketones increase water loss and large reductions in glycogen (i.e., every gram of glycogen holds 3 grams of water).(37-39) Consequently, the larger increases in body weight losses with ketogenic diet over low-fat diets during short-term interventions are attributed to losses in body water.

Well-hydrated muscles account for almost 75% of the water content. For example, a study of bodybuilders who underwent a carbohydrate loading protocol before a show increased the size of their chest, thighs, arms, calves, etc., compared to a group that did not carb load before a competition.(40) Most studies measuring body composition using dual-energy X-ray absorptiometry or DEXA heavily rely on measuring body water content; thus, researchers don’t know whether there are actual losses in lean body mass or just water weight.

True Muscle Loss and Water Loss

Therefore, the losses of lean muscle mass in studies can incorrectly assume its lean mass when it could just be water weight loss. DEXA is widely used for its ease of use, but DEXA has been found to have a 4% error and has been found to poorly accurately detect changes in lean mass in response to resistance exercise. DEXA does not have the accuracy in detecting small to moderate increases in muscle size.(41)

“In a review of the literature on carbohydrate intake and its relationship to increasing muscle mass. Most studies found no significant difference in lean mass or body composition when protein intake and calories were similar.”

“The studies that showed higher carbohydrate diets resulted in greater gains in muscle mass can be confounded by the group consuming high carbohydrates also had a higher total energy intake. It could be the high carbohydrate group gained more muscle because they were eating more calories. Being in a caloric surplus always makes it easier to gain muscle.”

— HENSELMANS (2022)

DO KETOGENIC DIETS AFFECT MUSCULAR STRENGTH?

In terms of performance, most of the available studies have found that ketogenic diets do not affect short, high-intensity exercise. The studies are defined as high-intensity, low-duration exercises that last less than 2 minutes. Essentially, energy demands for short-term high-intensity exercise are met by the ATP-PC and lactic acid system, which are highly dependent upon skeletal muscle glycogen.

Ketogenic diets seemingly have not affected performance in gymnasts, powerlifters, and CrossFit athletes. (17, 25, 26, 42) Interestingly, a literature review found no clear performance benefit to athletes following a ketogenic diet. However, some athletes can perform better in short-duration, vigorous-intensity tests when weight loss occurs on a ketogenic diet, resulting in less body mass being moved. (43, 44)

Consequently, reducing body fat and weight will cause a higher strength/power-to-body mass ratio. Moreover, another review of the studies on keto diets found that keto diets with high protein (~1.8 g/kg/day or .8 grams of protein per pound of body weight) have a “muscle-sparing” effect as keto diets maintain muscle mass while having no harmful effects on strength or power. (45)

Furthermore, the review by Henselmans et al. found that low-carb diets did not impact strength gains. In the review, 15 out of 17 studies found no effects of carbohydrate intake on strength gains in which protein and calorie intake were matched between groups.(46)

DOES CARB CYCLING BUILD MORE MUSCLE THAN REGULAR DIETING?

The study by Wilson et al.(25) in which subjects who were following a ketogenic diet then switched to a high-carbohydrate diet gained more muscle mass than other ketogenic diet studies raised questions as to the efficacy of cycling in carbs on a carb-restricted diet to gain muscle mass.

The cyclical ketogenic diet includes weekly periods of ketosis in which you increase healthy fat intake/reduce carbs, followed by high-carb days/low-fat days designed to kick you out of ketosis. For example, Monday thru Friday would be low carbohydrate days, and Saturday and Sunday would be carbohydrate days.

The theory behind this is the concept of fuel shifting. There are periods of high-fat utilization on low-carb days, and high carbohydrates replenish glycogen stores for enhanced anabolism and restoration of high-intensity exercise with carbohydrates.

Gaining muscle on ketogenic diets: Study

For eight weeks, researchers assigned subjects to a cyclical ketogenic diet or a control diet with resistance exercise and cardio. The cyclical ketogenic diet consumed less than 30 grams of carbohydrates. The weekends consisted of carbohydrates super-compensation days in which 8-10 g/kg/bw were consumed (70% carbohydrate intake, 15% protein, and 15% fat).

Gaining muscle on ketogenic diets: Results

The control diet comprised 55% of carbohydrates, 30% of fat, and 15% protein. Both groups lost body weight and body fat at the end of eight weeks, but the cyclical ketogenic diet group lost more lean muscle mass. Thus, the cyclical ketogenic diet had neutral effects on strength gains, whereas the regular diet had greater strength improvements than the cyclical ketogenic diet group.(47)

Furthermore, body composition was measured for bioelectrical impedance, which is highly inaccurate, thus whether the actual losses in muscle were because of actual muscle loss or just fluid loss was not determined.

Gaining muscle on ketogenic diets KEY POINTS

In sum, keto diets are notably superior for short-term fat loss, but interestingly, there are identical fat losses when calories are matched in the long term.
Conversely, ketogenic diets don’t affect muscle strength but can induce reductions in performance for anaerobic exercise. Furthermore, gaining muscle on ketogenic diets is feasible, but a limited number of studies have concluded that gaining muscle on keto is more challenging compared to a carbohydrate control diet.

 

REFERENCES

1.         Paoli A, Cancellara P, Pompei P, Moro T. Ketogenic Diet and Skeletal Muscle Hypertrophy: a Frenemy Relationship? Journal of Human Kinetics. 2019;68(1):233-47.

2.         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. Journal of the International Society of Sports Nutrition. 2017;14(1).

3.         Guzmán M, Blázquez C. Ketone body synthesis in the brain: possible neuroprotective effects. Prostaglandins Leukot Essent Fatty Acids. 2004;70(3):287-92.

4.         Coleman JL, Carrigan CT, Margolis LM. Body composition changes in physically active individuals consuming ketogenic diets: a systematic review. Journal of the International Society of Sports Nutrition. 2021;18(1).

5.         Gibson AA, Seimon RV, Lee CMY, Ayre J, Franklin J, Markovic TP, et al. Do ketogenic diets really suppress appetite? A systematic review and meta-analysis. Obesity Reviews. 2015;16(1):64-76.

6.         Johnstone AM, Horgan GW, Murison SD, Bremner DM, Lobley GE. Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ad libitum. Am J Clin Nutr. 2008;87(1):44-55.

REFERENCES

7.         Cardillo S, Seshadri P, Iqbal N. The effects of a low-carbohydrate versus low-fat diet on adipocytokines in severely obese adults: three-year follow-up of a randomized trial. Eur Rev Med Pharmacol Sci. 2006;10(3):99-106.

8.         Tobias DK, Chen M, Manson JE, Ludwig DS, Willett W, Hu FB. Effect of low-fat diet interventions versus other diet interventions on long-term weight change in adults: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2015;3(12):968-79.

9.         Brinkworth GD, Noakes M, Buckley JD, Keogh JB, Clifton PM. Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo. Am J Clin Nutr. 2009;90(1):23-32.

10.       Ashtary-Larky D, Bagheri R, Bavi H, Baker JS, Moro T, Mancin L, et al. Ketogenic diets, physical activity, and body composition: A review. British Journal of Nutrition. 2021:1-68.

REFERENCES

11.       Hall KD, Chen KY, Guo J, Lam YY, Leibel RL, Mayer LE, et al. Energy expenditure and body composition changes after an isocaloric ketogenic diet in overweight and obese men. Am J Clin Nutr. 2016;104(2):324-33.

12.       Thomsen HH, Rittig N, Johannsen M, Møller AB, Jørgensen JO, Jessen N, et al. Effects of 3-hydroxybutyrate and free fatty acids on muscle protein kinetics and signaling during LPS-induced inflammation in humans: anti-catabolic impact of ketone bodies. The American Journal of Clinical Nutrition. 2018;108(4):857-67.

13.       White H, Heffernan AJ, Worrall S, Grunsfeld A, Thomas M. A Systematic Review of Intravenous β-Hydroxybutyrate Use in Humans – A Promising Future Therapy? Frontiers in Medicine. 2021;8.

14.       Poffé C, Ramaekers M, Van Thienen R, Hespel P. Ketone ester supplementation blunts overreaching symptoms during endurance training overload. J Physiol. 2019;597(12):3009-27.

15.       Koutnik AP, Poff AM, Ward NP, DeBlasi JM, Soliven MA, Romero MA, et al. Ketone Bodies Attenuate Wasting in Models of Atrophy. J Cachexia Sarcopenia Muscle. 2020;11(4):973-96.

16.       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. Frontiers in physiology. 2017;8:310-.

REFERENCES

17.       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. Sports. 2018;6(1):1.

18.       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. Journal of the International Society of Sports Nutrition. 2018;15(1):31.

19.       Vidić V, Ilić V, Toskić L, Janković N, Ugarković D. Effects of calorie restricted low carbohydrate high fat ketogenic vs. non-ketogenic diet on strength, body-composition, hormonal and lipid profile in trained middle-aged men. Clin Nutr. 2021;40(4):1495-502.

20.       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).

REFERENCES

21.       Rhyu HS, Cho SY. The effect of weight loss by ketogenic diet on the body composition, performance-related physical fitness factors and cytokines of Taekwondo athletes. J Exerc Rehabil. 2014;10(5):326-31.

22.       Skemp KM, * MS, Baumann aDD. The Effects of a Ketogenic Diet on Body Composition in Resistance Training Females. Annals of Sports Medicine and Research. 2021;8, 1176.

23.       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. Journal of the International Society of Sports Nutrition. 2020;17(1):19.

24.       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. The Journal of Strength & Conditioning Research. 2018;32(12):3373-82.

REFERENCES

25.       Wilson JM, Lowery RP, Roberts MD, Sharp MH, Joy JM, Shields KA, et al. Effects of Ketogenic Dieting on Body Composition, Strength, Power, and Hormonal Profiles in Resistance Training Men. The Journal of Strength & Conditioning Research. 2020;34(12):3463-74.

26.       Gregory R. A Low-Carbohydrate Ketogenic Diet Combined with 6-Weeks of Crossfit Training Improves Body Composition and Performance. International Journal of Sports and Exercise Medicine. 2017;3.

27.       Volek JS, Sharman MJ, Love DM, Avery NG, Gmez AL, Scheett TP, et al. Body composition and hormonal responses to a carbohydrate-restricted diet. Metabolism – Clinical and Experimental. 2002;51(7):864-70.

28.       Paoli A, Grimaldi K, D’Agostino D, Cenci L, Moro T, Bianco A, et al. Ketogenic diet does not affect strength performance in elite artistic gymnasts. Journal of the International Society of Sports Nutrition. 2012;9(1):34.

29.       Volek J, Sharman M, Gómez A, Judelson DA, Rubin M, Watson G, et al. Comparison of energy-restricted very low-carbohydrate and low-fat diets on weight loss and body composition in overweight men and women. Nutrition & metabolism. 2004;1(1):13-.

30.       Valenzuela PL, Castillo-García A, Lucia A, Naclerio F. Effects of Combining a Ketogenic Diet with Resistance Training on Body Composition, Strength, and Mechanical Power in Trained Individuals: A Narrative Review. Nutrients. 2021;13(9):3083.

REFERENCES

31.       Bostock ECS, Kirkby KC, Taylor BV, Hawrelak JA. Consumer Reports of “Keto Flu” Associated With the Ketogenic Diet. Frontiers in Nutrition. 2020;7.

32.       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.

33.       Amini MR, Aminianfar A, Naghshi S, Larijani B, Esmaillzadeh A. The effect of ketogenic diet on body composition and anthropometric measures: A systematic review and meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr. 2021:1-14.

34.       McDaniel SS, Rensing NR, Thio LL, Yamada KA, Wong M. The ketogenic diet inhibits the mammalian target of rapamycin (mTOR) pathway. Epilepsia. 2011;52(3):e7-e11.

35.       Freedland SJ, Mavropoulos J, Wang A, Darshan M, Demark-Wahnefried W, Aronson WJ, et al. Carbohydrate restriction, prostate cancer growth, and the insulin-like growth factor axis. Prostate. 2008;68(1):11-9.

REFERENCES

36.       Paoli A, Bianco A, Grimaldi KA. The Ketogenic Diet and Sport. Exercise and Sport Sciences Reviews. 2015;43(3):153-62.

37.       McPherson PA, McEneny J. The biochemistry of ketogenesis and its role in weight management, neurological disease and oxidative stress. J Physiol Biochem. 2012;68(1):141-51.

38.       Fernández-Elías VE, Ortega JF, Nelson RK, Mora-Rodriguez R. Relationship between muscle water and glycogen recovery after prolonged exercise in the heat in humans. Eur J Appl Physiol. 2015;115(9):1919-26.

39.       Shiose K, Yamada Y, Motonaga K, Sagayama H, Higaki Y, Tanaka H, et al. Segmental extracellular and intracellular water distribution and muscle glycogen after 72-h carbohydrate loading using spectroscopic techniques. J Appl Physiol (1985). 2016;121(1):205-11.

40.       de Moraes W, de Almeida FN, Dos Santos LEA, Cavalcante KDG, Santos HO, Navalta JW, et al. Carbohydrate Loading Practice in Bodybuilders: Effects on Muscle Thickness, Photo Silhouette Scores, Mood States and Gastrointestinal Symptoms. J Sports Sci Med. 2019;18(4):772-9.

REFERENCES

41.       Tavoian D, Ampomah K, Amano S, Law TD, Clark BC. Changes in DXA-derived lean mass and MRI-derived cross-sectional area of the thigh are modestly associated. Scientific reports. 2019;9(1):10028-.

42.       Durkalec-Michalski K, Nowaczyk PM, Główka N, Ziobrowska A, Podgórski T. Is a Four-Week Ketogenic Diet an Effective Nutritional Strategy in CrossFit-Trained Female and Male Athletes? Nutrients. 2021;13(3):864.

43.       McSwiney FT, Doyle L, Plews DJ, Zinn C. <p>Impact Of Ketogenic Diet On Athletes: Current Insights</p>. Open Access Journal of Sports Medicine. 2019;Volume 10:171-83.

44.       Harvey KL, Holcomb LE, Kolwicz SC. Ketogenic Diets and Exercise Performance. Nutrients. 2019;11(10):2296.

45.       Kang J, Ratamess NA, Faigenbaum AD, Bush JA. Ergogenic Properties of Ketogenic Diets in Normal-Weight Individuals: A Systematic Review. J Am Coll Nutr. 2020;39(7):665-75.

46.       Henselmans M, Bjørnsen T, Hedderman R, Vårvik FT. The Effect of Carbohydrate Intake on Strength and Resistance Training Performance: A Systematic Review. Nutrients. 2022;14(4).

REFERENCES

47.       Kysel P, Haluzíková D, Doležalová RP, Laňková I, Lacinová Z, Kasperová BJ, et al. The Influence of Cyclical Ketogenic Reduction Diet vs. Nutritionally Balanced Reduction Diet on Body Composition, Strength, and Endurance Performance in Healthy Young Males: A Randomized Controlled Trial. Nutrients. 2020;12(9):2832.

48. Henselmans, M.; Bjørnsen, T.; Hedderman, R.; Vårvik, F.T. The Effect of Carbohydrate Intake on Strength and Resistance Training Performance: A Systematic Review. Nutrients 2022, 14, 856. https://doi.org/10.3390/nu14040856 

49. Koerich ACC, Borszcz FK, Thives Mello A, de Lucas RD, Hansen F. 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. Crit Rev Food Sci Nutr. 2022:1-26.

50. 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.

REFERENCES

51. Koerich ACC, Borszcz FK, Thives Mello A, de Lucas RD, Hansen F. 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. Crit Rev Food Sci Nutr. 2022:1-26.

About The Author