Posts tagged diet
The ketogenic diet in sport performance - 6 years of experiments and scientific evidence

The ketogenic diet had a large impact on my life and my climbing. Here is a detailed discussion of 6 years of my own experiences with the keto diet for sport performance as a pro rock climber, with references to 150 scientific papers on the performance, health and other effects of the diet. You can find all the references below.

I’ve also published an audio version of the piece on my Patreon page as a thanks to my Patreon supporters. I thought that might be useful for folk to listen to it on the move since it’s a long and detailed piece.

Bibliography

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772061/

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9. Pontzer, H., B.M. Wood, and D.A. Raichlen, Hunter-gatherers as models in public health. Obes Rev, 2018. 19 Suppl 1: p. 24-35. https://pubmed.ncbi.nlm.nih.gov/30511505/

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4979043/

11. Alvheim, A.R., et al., Dietary linoleic acid elevates endogenous 2-AG and anandamide and induces obesity.Obesity (Silver Spring), 2012. 20(10): p. 1984-94. https://pubmed.ncbi.nlm.nih.gov/22334255/

12. Naughton, S.S., et al., Fatty Acid modulation of the endocannabinoid system and the effect on food intake and metabolism. Int J Endocrinol, 2013. 2013: p. 361895. https://doi.org/10.1155/2013/361895

13. Naughton, S.S., et al., The Acute Effect of Oleic- or Linoleic Acid-Containing Meals on Appetite and Metabolic Markers; A Pilot Study in Overweight or Obese Individuals. Nutrients, 2018. 10(10): p. 1376. https://www.ncbi.nlm.nih.gov/pubmed/30261617

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213143/

14. Clark, T.M., et al., Theoretical Explanation for Reduced Body Mass Index and Obesity Rates in Cannabis Users.Cannabis and cannabinoid research, 2018. 3(1): p. 259-271. https://www.ncbi.nlm.nih.gov/pubmed/30671538

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340377/

15. Deol, P., et al., Soybean Oil Is More Obesogenic and Diabetogenic than Coconut Oil and Fructose in Mouse: Potential Role for the Liver. PLOS ONE, 2015. 10(7): p. e0132672. https://doi.org/10.1371/journal.pone.0132672

16. Deol, P., et al., Dysregulation of Hypothalamic Gene Expression and the Oxytocinergic System by Soybean Oil Diets in Male Mice. Endocrinology, 2020. https://doi.org/10.1210/endocr/bqz044

17. Benani, A., et al., Role for Mitochondrial Reactive Oxygen Species in Brain Lipid Sensing. Diabetes, 2007. 56(1): p. 152. http://diabetes.diabetesjournals.org/content/56/1/152.abstract

18. López, S., et al., Distinctive postprandial modulation of β cell function and insulin sensitivity by dietary fats: monounsaturated compared with saturated fatty acids. The American Journal of Clinical Nutrition, 2008. 88(3): p. 638-644. https://doi.org/10.1093/ajcn/88.3.638

19. Harvey, C.J.d.C., et al., Effects of differing levels of carbohydrate restriction on the achievement of nutritional ketosis, mood, and symptoms of carbohydrate withdrawal in healthy adults: A randomized clinical trial. Nutrition: X, 2019: p. 100005. http://www.sciencedirect.com/science/article/pii/S2665902619300056

20. Stellingwerff, T., Case Study: Body Composition Periodization in an Olympic-Level Female Middle-Distance Runner Over a 9-Year Career. Int J Sport Nutr Exerc Metab, 2018. 28(4): p. 428-433. https://pubmed.ncbi.nlm.nih.gov/29140157/

21. Holt, S.H.A., et al., A Satiety Index of common foods. European journal of clinical nutrition, 1995. 49: p. 675-90. https://pubmed.ncbi.nlm.nih.gov/7498104/

22. Edwards, K.H., B.T. Elliott, and C.M. Kitic, Carbohydrate intake and ketosis in self-sufficient multi-stage ultramarathon runners. J Sports Sci, 2020. 38(4): p. 366-374. https://pubmed.ncbi.nlm.nih.gov/31835963/

23. Baar, K. and T. Stellingwerff, Maximising power to weight ratio. Peak Performance, 2015(337): p. 1-5. https://fliphtml5.com/mrom/hiie/basic

24. Koutnik, A., D. D'Agostino, and B. Egan, Anticatabolic Effects of Ketone Bodies in Skeletal Muscle. Trends in Endocrinology and Metabolism, 2019. 30: p. 227-229. https://pubmed.ncbi.nlm.nih.gov/30712977/

25. Paoli, A., et al., Ketogenic Diet and Skeletal Muscle Hypertrophy: A Frenemy Relationship? Journal of human kinetics, 2019. 68: p. 233-247. https://pubmed.ncbi.nlm.nih.gov/31531148

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6724590/

26. Impey, S.G., et al., Fuel for the Work Required: A Theoretical Framework for Carbohydrate Periodization and the Glycogen Threshold Hypothesis. Sports Med, 2018. 48(5): p. 1031-1048. https://pubmed.ncbi.nlm.nih.gov/29453741/

27. Wallace, I.J., et al., Knee osteoarthritis has doubled in prevalence since the mid-20th century. Proceedings of the National Academy of Sciences, 2017. 114(35): p. 9332. http://www.pnas.org/content/114/35/9332.abstract

28. Goldberg, E.L., et al., Ketogenic diet activates protective γδ T cell responses against influenza virus infection.Science Immunology, 2019. 4(41): p. eaav2026. http://immunology.sciencemag.org/content/4/41/eaav2026.abstract

29. Pardo, A.C., Ketogenic Diet: A Role in Immunity? Pediatr Neurol Briefs, 2020. 34: p. 5. https://pubmed.ncbi.nlm.nih.gov/32174748/

30. Entrenas Castillo, M., et al., “Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot randomized clinical study”. The Journal of Steroid Biochemistry and Molecular Biology, 2020. 203: p. 105751. https://www.sciencedirect.com/science/article/pii/S0960076020302764

31. Antonio, J., et al., The effects of consuming a high protein diet (4.4 g/kg/d) on body composition in resistance-trained individuals. J Int Soc Sports Nutr, 2014. 11: p. 19. http://www.ncbi.nlm.nih.gov/pubmed/24834017

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4022420/pdf/1550-2783-11-19.pdf

32. Berrazaga, I., et al., The Role of the Anabolic Properties of Plant- versus Animal-Based Protein Sources in Supporting Muscle Mass Maintenance: A Critical Review. Nutrients, 2019. 11(8). 

33. Carmen, M., et al., Treating binge eating and food addiction symptoms with low-carbohydrate Ketogenic diets: a case series. Journal of Eating Disorders, 2020. 8(1): p. 2. https://doi.org/10.1186/s40337-020-0278-7

34. SACN, Saturated Fats and Health. 2019: SACN. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/814995/SACN_report_on_saturated_fat_and_health.pdf

35. Ness, A.R., et al., Diet in childhood and adult cardiovascular and all cause mortality: the Boyd Orr cohort. Heart, 2005. 91(7): p. 894-8. https://pubmed.ncbi.nlm.nih.gov/15958357/

36. Mente, A., et al., A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. Arch Intern Med, 2009. 169(7): p. 659-69. https://pubmed.ncbi.nlm.nih.gov/19364995/

37. Skeaff, C.M. and J. Miller, Dietary fat and coronary heart disease: summary of evidence from prospective cohort and randomised controlled trials. Ann Nutr Metab, 2009. 55(1-3): p. 173-201. 

38. Siri-Tarino, P.W., et al., Saturated fat, carbohydrate, and cardiovascular disease. Am J Clin Nutr, 2010. 91(3): p. 502-9. https://www.ncbi.nlm.nih.gov/pubmed/20089734

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824150/pdf/ajcn9130502.pdf

39. Siri-Tarino, P.W., et al., Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. The American Journal of Clinical Nutrition, 2010. 91(3): p. 535-546. https://doi.org/10.3945/ajcn.2009.27725

40. Kuipers, R.S., et al., Saturated fat, carbohydrates and cardiovascular disease. Neth J Med, 2011. 69(9): p. 372-8. https://pubmed.ncbi.nlm.nih.gov/21978979/

41. Hooper, L., et al., Reduced or modified dietary fat for preventing cardiovascular disease. Cochrane Database Syst Rev, 2012(5): p. Cd002137. https://pubmed.ncbi.nlm.nih.gov/22592684/

42. Chowdhury, R., et al., Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis. Ann Intern Med, 2014. 160(6): p. 398-406. 

43. Schwingshackl, L. and G. Hoffmann, Dietary fatty acids in the secondary prevention of coronary heart disease: a systematic review, meta-analysis and meta-regression. BMJ Open, 2014. 4(4): p. e004487. http://bmjopen.bmj.com/content/4/4/e004487.abstract

44. Hooper, L., et al., Reduction in saturated fat intake for cardiovascular disease. Cochrane Database Syst Rev, 2015(6): p. Cd011737. https://pubmed.ncbi.nlm.nih.gov/26068959/

45. de Souza, R.J., et al., Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. Bmj, 2015. 351: p. h3978. https://pubmed.ncbi.nlm.nih.gov/26268692/

46. Harcombe, Z., J.S. Baker, and B. Davies, Evidence from prospective cohort studies does not support current dietary fat guidelines: a systematic review and meta-analysis. Br J Sports Med, 2016. https://www.ncbi.nlm.nih.gov/pubmed/27697938

http://bjsm.bmj.com/content/early/2016/10/03/bjsports-2016-096550.long

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48. Dehghan, M., et al., Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Lancet, 2017. 390(10107): p. 2050-2062. https://doi.org/10.1016/S0140-6736(17)32252-3

49. Hamley, S., The effect of replacing saturated fat with mostly n-6 polyunsaturated fat on coronary heart disease: a meta-analysis of randomised controlled trials. Nutrition Journal, 2017. 16(1): p. 30. https://doi.org/10.1186/s12937-017-0254-5

50. Dehghan, M., et al., Association of dairy intake with cardiovascular disease and mortality in 21 countries from five continents (PURE): a prospective cohort study. The Lancet, 2018. 392(10161): p. 2288-2297. http://www.sciencedirect.com/science/article/pii/S0140673618318129

51. DuBroff, R. and M. de Lorgeril, Fat or fiction: the diet-heart hypothesis. BMJ Evidence-Based Medicine, 2019: p. bmjebm-2019-111180. http://ebm.bmj.com/content/early/2019/07/10/bmjebm-2019-111180.abstract

52. Heileson, J.L., Dietary saturated fat and heart disease: a narrative review. Nutrition Reviews, 2019. https://doi.org/10.1093/nutrit/nuz091

53. Khan, S.U., et al., Effects of Nutritional Supplements and Dietary Interventions on Cardiovascular Outcomes: An Umbrella Review and Evidence Map. Annals of Internal Medicine, 2019. 171(3): p. 190-198. https://doi.org/10.7326/M19-0341

54. Zhu, Y., Y. Bo, and Y. Liu, Dietary total fat, fatty acids intake, and risk of cardiovascular disease: a dose-response meta-analysis of cohort studies. Lipids in Health and Disease, 2019. 18(1): p. 91. https://doi.org/10.1186/s12944-019-1035-2

55. Astrup, A., et al., Saturated Fats and Health: A Reassessment and Proposal for Food-based Recommendations: JACC State-of -the-Art Review. Journal of the American College of Cardiology, 2020. http://www.sciencedirect.com/science/article/pii/S0735109720356874

56. Sendra, E., Dairy Fat and Cardiovascular Health. Foods, 2020. 9(6). https://pubmed.ncbi.nlm.nih.gov/32604766/

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60. Young, S.S. and A. Karr, Deming, data and observational studies. Significance, 2011. 8(3): p. 116-120. https://doi.org/10.1111/j.1740-9713.2011.00506.x

61. Appleby, P.N., et al., Mortality in vegetarians and comparable nonvegetarians in the United Kingdom. The American journal of clinical nutrition, 2016. 103(1): p. 218-230. https://www.ncbi.nlm.nih.gov/pubmed/26657045

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62. Mihrshahi, S., et al., Vegetarian diet and all-cause mortality: Evidence from a large population-based Australian cohort - the 45 and Up Study. Prev Med, 2017. 97: p. 1-7. https://pubmed.ncbi.nlm.nih.gov/28040519/

63. Archer, E., G. Pavela, and C.J. Lavie, The Inadmissibility of What We Eat in America and NHANES Dietary Data in Nutrition and Obesity Research and the Scientific Formulation of National Dietary Guidelines. Mayo Clin Proc, 2015. 90(7): p. 911-26. 

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68. Howard, B.V., et al., Low-fat dietary pattern and risk of cardiovascular disease: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. JAMA, 2006. 295(6): p. 655-66. https://www.ncbi.nlm.nih.gov/pubmed/16467234

69. Beresford, S.A., et al., Low-fat dietary pattern and risk of colorectal cancer: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. JAMA, 2006. 295(6): p. 643-54. https://www.ncbi.nlm.nih.gov/pubmed/16467233

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73. Khaw, K.-T., et al., Randomised trial of coconut oil, olive oil or butter on blood lipids and other cardiovascular risk factors in healthy men and women. BMJ Open, 2018. 8(3): p. e020167. http://bmjopen.bmj.com/content/8/3/e020167.abstract

74. Creighton, B.C., et al., Paradox of hypercholesterolaemia in highly trained, keto-adapted athletes. BMJ Open Sport & Exercise Medicine, 2018. 4(1). http://bmjopensem.bmj.com/content/4/1/e000429.abstract

75. Phinney, S.D., et al., The transient hypercholesterolemia of major weight loss. Am J Clin Nutr, 1991. 53(6): p. 1404-10. 

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77. Bartlett, J., et al., Is Isolated Low High-Density Lipoprotein Cholesterol a Cardiovascular Disease Risk Factor? New Insights From the Framingham Offspring Study. Circ Cardiovasc Qual Outcomes, 2016. 9(3): p. 206-212. https://pubmed.ncbi.nlm.nih.gov/27166203/

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79. Kawamoto, R., et al., Low density lipoprotein cholesterol and all-cause mortality rate: findings from a study on Japanese community-dwelling persons. Lipids in Health and Disease, 2021. 20(1): p. 105. https://doi.org/10.1186/s12944-021-01533-6

80. Feinman, R.D. and J.S. Volek, Low carbohydrate diets improve atherogenic dyslipidemia even in the absence of weight loss. Nutrition & metabolism, 2006. 3: p. 24-24. https://www.ncbi.nlm.nih.gov/pubmed/16790045

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81. Volek, J.S., et al., Dietary carbohydrate restriction induces a unique metabolic state positively affecting atherogenic dyslipidemia, fatty acid partitioning, and metabolic syndrome. Progress in Lipid Research, 2008. 47(5): p. 307-318. http://www.sciencedirect.com/science/article/pii/S0163782708000167

82. Hallberg, S.J., et al., Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study. Diabetes Ther, 2018. 9(2): p. 583-612. https://pubmed.ncbi.nlm.nih.gov/29417495/

83. Borén, J., et al., Low-density lipoproteins cause atherosclerotic cardiovascular disease: pathophysiological, genetic, and therapeutic insights: a consensus statement from the European Atherosclerosis Society Consensus Panel. European Heart Journal, 2020. 41(24): p. 2313-2330. https://doi.org/10.1093/eurheartj/ehz962

84. Penson, P.E., et al., Associations between very low concentrations of low density lipoprotein cholesterol, high sensitivity C-reactive protein, and health outcomes in the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study. Eur Heart J, 2018. 39(40): p. 3641-3653. https://pubmed.ncbi.nlm.nih.gov/30165636/

85. Willeit, P., et al., Low-Density Lipoprotein Cholesterol Corrected for Lipoprotein(a) Cholesterol, Risk Thresholds, and Cardiovascular Events. J Am Heart Assoc, 2020. 9(23): p. e016318. https://pubmed.ncbi.nlm.nih.gov/33222611/

86. Noto, H., et al., Low-Carbohydrate Diets and All-Cause Mortality: A Systematic Review and Meta-Analysis of Observational Studies. PLOS ONE, 2013. 8(1): p. e55030. https://doi.org/10.1371/journal.pone.0055030

87. Mazidi, M., et al., P5409Low-carbohydrate diets and all-cause and cause-specific mortality: a population-based cohort study and pooling prospective studies. European Heart Journal, 2018. 39(suppl_1). https://doi.org/10.1093/eurheartj/ehy566.P5409

88. Seidelmann, S.B., et al., Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis. The Lancet Public Health, 2018. 3(9): p. e419-e428. http://www.sciencedirect.com/science/article/pii/S246826671830135X

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89. Lagiou, P., et al., Low carbohydrate-high protein diet and mortality in a cohort of Swedish women. J Intern Med, 2007. 261(4): p. 366-74. https://pubmed.ncbi.nlm.nih.gov/17391111/

90. Trichopoulou, A., et al., Low-carbohydrate-high-protein diet and long-term survival in a general population cohort. Eur J Clin Nutr, 2007. 61(5): p. 575-81. https://pubmed.ncbi.nlm.nih.gov/17136037/

91. Fung, T.T., et al., Low-carbohydrate diets and all-cause and cause-specific mortality: two cohort studies. Ann Intern Med, 2010. 153(5): p. 289-98. https://pubmed.ncbi.nlm.nih.gov/20820038/

92. Nilsson, L.M., et al., Low-carbohydrate, high-protein score and mortality in a northern Swedish population-based cohort. Eur J Clin Nutr, 2012. 66(6): p. 694-700. https://www.nature.com/articles/ejcn20129.pdf

93. Johnston, B.C., et al., Comparison of Weight Loss Among Named Diet Programs in Overweight and Obese Adults: A Meta-analysis. JAMA, 2014. 312(9): p. 923-933. https://doi.org/10.1001/jama.2014.10397

94. Buga, A., et al., Extended Ketogenic Diet and Physical Training Intervention in Military Personnel. Military Medicine, 2019. 184(9-10): p. e538-e547. https://dx.doi.org/10.1093/milmed/usz046

95. Chawla, S., et al., The Effect of Low-Fat and Low-Carbohydrate Diets on Weight Loss and Lipid Levels: A Systematic Review and Meta-Analysis. Nutrients, 2020. 12(12). https://pubmed.ncbi.nlm.nih.gov/33317019/

96. Falkenhain, K., et al., Keyto App and Device versus WW App on Weight Loss and Metabolic Risk in Adults with Overweight or Obesity: A Randomized Trial. Obesity, 2021. https://pubmed.ncbi.nlm.nih.gov/34124856/

97. Aamodt, S., Why Diets Make Us Fat: The Unintended Consequences of Our Obsession with Weight Loss. 2016. 204. https://amzn.to/3CptAFM

98. Fothergill, E., et al., Persistent metabolic adaptation 6 years after "The Biggest Loser" competition. Obesity (Silver Spring), 2016. 24(8): p. 1612-9. https://pubmed.ncbi.nlm.nih.gov/27136388/

99. McKenzie, A.L., et al., Type 2 Diabetes Prevention Focused on Normalization of Glycemia: A Two-Year Pilot Study. Nutrients, 2021. 13(3): p. 749. https://www.mdpi.com/2072-6643/13/3/749

100. Murphy, N.E., C.T. Carrigan, and L.M. Margolis, High-Fat Ketogenic Diets and Physical Performance: A Systematic Review. Advances in Nutrition, 2020. https://doi.org/10.1093/advances/nmaa101

101. Gardner, C.D., et al., Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion: The DIETFITS Randomized Clinical Trial.JAMA, 2018. 319(7): p. 667-679. https://doi.org/10.1001/jama.2018.0245

102. Ludwig, D.S., et al., The carbohydrate-insulin model: a physiological perspective on the obesity pandemic.The American Journal of Clinical Nutrition, 2021. https://doi.org/10.1093/ajcn/nqab270

103. Aronica, L., et al., Examining differences between overweight women and men in 12-month weight loss study comparing healthy low-carbohydrate vs. low-fat diets. International Journal of Obesity, 2020. https://doi.org/10.1038/s41366-020-00708-y

104. Lindeberg, S., et al., Age relations of cardiovascular risk factors in a traditional Melanesian society: the Kitava Study. The American Journal of Clinical Nutrition, 1997. 66(4): p. 845-852. https://pubmed.ncbi.nlm.nih.gov/9322559/

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