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

1. Hyppönen, E. and C. Power, Hypovitaminosis D in British adults at age 45 y: nationwide cohort study of dietary and lifestyle predictors. The American Journal of Clinical Nutrition, 2007. 85(3): p. 860-868. https://doi.org/10.1093/ajcn/85.3.860

2. Nixon, R., Comparisons of aspects of Glasgow’s 56 neighbourhoods. 2016: G.C.f.P. Health. https://www.gcph.co.uk/assets/0000/5492/Comparisons_of_aspects_of_Glasgows_56_neighbourhoods.pdf

3. Price, W.A., Nutrition and physical degeneration. 1998, New Canaan, Conn.: Keats. https://amzn.to/39gxhkG

4. Weiser, M.J., C.M. Butt, and M.H. Mohajeri, Docosahexaenoic Acid and Cognition throughout the Lifespan.Nutrients, 2016. 8(2): p. 99-99. https://pubmed.ncbi.nlm.nih.gov/26901223

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

5. Careau, V., et al., Energy compensation and adiposity in humans. Current Biology. https://doi.org/10.1016/j.cub.2021.08.016

6. Pontzer, H., et al., Hunter-gatherer energetics and human obesity. PloS one, 2012. 7(7): p. e40503-e40503. https://pubmed.ncbi.nlm.nih.gov/22848382

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3405064/

7. Pontzer, H., et al., Energy expenditure and activity among Hadza hunter-gatherers. Am J Hum Biol, 2015. 27(5): p. 628-37. https://pubmed.ncbi.nlm.nih.gov/25824106/

8. Pontzer, H., et al., Constrained Total Energy Expenditure and Metabolic Adaptation to Physical Activity in Adult Humans. Curr Biol, 2016. 26(3): p. 410-7. https://pubmed.ncbi.nlm.nih.gov/26832439/

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/

10. Cowley, J., J. Kiely, and D. Collins, Unravelling the Glasgow effect: The relationship between accumulative bio- psychosocial stress, stress reactivity and Scotland's health problems. Preventive medicine reports, 2016. 4: p. 370-375. https://pubmed.ncbi.nlm.nih.gov/27512652

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

47. Ramsden, C.E., et al., Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73). Bmj, 2016. 353: p. i1246. https://pubmed.ncbi.nlm.nih.gov/27071971/

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/

57. Keys, A., Atherosclerosis: a problem in newer public health. J Mt Sinai Hosp N Y, 1953. 20(2): p. 118-39. https://pubmed.ncbi.nlm.nih.gov/13085148/

58. Yerushalmy, J. and H.E. Hilleboe, Fat in the diet and mortality from heart disease; a methodologic note. N Y State J Med, 1957. 57(14): p. 2343-54. https://pubmed.ncbi.nlm.nih.gov/13441073/

59. Grasgruber, P., et al., Food consumption and the actual statistics of cardiovascular diseases: an epidemiological comparison of 42 European countries. Food Nutr Res, 2016. 60: p. 31694. https://www.ncbi.nlm.nih.gov/pubmed/27680091

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

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4691673/

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. 

64. Archer, E., M.L. Marlow, and C.J. Lavie, Controversy and debate: Memory-Based Methods Paper 1: the fatal flaws of food frequency questionnaires and other memory-based dietary assessment methods. J Clin Epidemiol, 2018. 104: p. 113-124. http://www.sciencedirect.com/science/article/pii/S0895435617313756

65. Ioannidis, J.A., The challenge of reforming nutritional epidemiologic research. JAMA, 2018. http://dx.doi.org/10.1001/jama.2018.11025

66. Ioannidis, J., Why Most Published Research Findings Are False. PLoS medicine, 2005. 2: p. e124. https://doi.org/10.1371/journal.pmed.0020124

67. Ornish, D., et al., Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. Lancet, 1990. 336(8708): p. 129-33. https://pubmed.ncbi.nlm.nih.gov/1973470/

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

70. Prentice, R.L., et al., Low-fat dietary pattern and risk of invasive breast cancer: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. JAMA, 2006. 295(6): p. 629-42. https://www.ncbi.nlm.nih.gov/pubmed/16467232

71. Taubes, G., Good calories, bad calories : challenging the conventional wisdom on diet, weight control, and disease. 1st ed. 2007, New York: Knopf. xxv, 601 p. Table of contents only http://www.loc.gov/catdir/toc/ecip0711/2007006794.html

72. Ramsden, C.E., et al., Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis. BMJ : British Medical Journal, 2013. 346: p. e8707. http://www.bmj.com/content/346/bmj.e8707.abstract

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. 

76. Hockley, T.G., M, European Cholesterol Guidelines Report. 2017: P.A. Centre. https://policy-centre.com/wp-content/uploads/2017/04/European-Cholesterol-Guidelines07.pdf

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/

78. Assmann, G. and H. Schulte, Relation of high-density lipoprotein cholesterol and triglycerides to incidence of atherosclerotic coronary artery disease (the PROCAM experience). Prospective Cardiovascular Münster study. Am J Cardiol, 1992. 70(7): p. 733-7. 

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

https://www.ncbi.nlm.nih.gov/pmc/PMC1488852/

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

https://www.thelancet.com/pdfs/journals/lanpub/PIIS2468-2667(18)30135-X.pdf

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/

105. Lindeberg, S., et al., Low serum insulin in traditional Pacific Islanders--the Kitava Study. Metabolism, 1999. 48(10): p. 1216-9. https://www.metabolismjournal.com/article/S0026-0495(99)90258-5/pdf

106. Sacks, F.M., et al., Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association. Circulation, 2017. 136(3): p. e1-e23. https://pubmed.ncbi.nlm.nih.gov/28620111/

107. Blasbalg, T.L., et al., Changes in consumption of omega-3 and omega-6 fatty acids in the United States during the 20th century. Am J Clin Nutr, 2011. 93(5): p. 950-62. https://pubmed.ncbi.nlm.nih.gov/21367944/

108. Alvheim, A.R., et al., Dietary linoleic acid elevates endogenous 2-arachidonoylglycerol and anandamide in Atlantic salmon (Salmo salar L.) and mice, and induces weight gain and inflammation in mice. Br J Nutr, 2013. 109(8): p. 1508-17. https://pubmed.ncbi.nlm.nih.gov/22883314/

109. Alvheim, A.R., et al., Dietary linoleic acid elevates the endocannabinoids 2-AG and anandamide and promotes weight gain in mice fed a low fat diet. Lipids, 2014. 49(1): p. 59-69. https://pubmed.ncbi.nlm.nih.gov/24081493/

110. Desmarchelier, C., et al., Diet-induced obesity in ad libitum-fed mice: food texture overrides the effect of macronutrient composition. British Journal of Nutrition, 2013. 109(8): p. 1518-1527. https://www.cambridge.org/core/article/dietinduced-obesity-in-ad-libitumfed-mice-food-texture-overrides-the-effect-of-macronutrient-composition/725D71275CF7399332CEC8C9C76BE23F

111. Hall, K.D., et al., Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell Metab, 2019. 30(1): p. 67-77.e3. https://pubmed.ncbi.nlm.nih.gov/31105044/

112. Heaton, K.W., et al., Particle size of wheat, maize, and oat test meals: effects on plasma glucose and insulin responses and on the rate of starch digestion in vitro. The American Journal of Clinical Nutrition, 1988. 47(4): p. 675-682. https://doi.org/10.1093/ajcn/47.4.675

113. Juntunen, K.S., et al., Postprandial glucose, insulin, and incretin responses to grain products in healthy subjects. The American Journal of Clinical Nutrition, 2002. 75(2): p. 254-262. https://doi.org/10.1093/ajcn/75.2.254

114. Juntunen, K.S., et al., Structural differences between rye and wheat breads but not total fiber content may explain the lower postprandial insulin response to rye bread. The American Journal of Clinical Nutrition, 2003. 78(5): p. 957-964. https://doi.org/10.1093/ajcn/78.5.957

115. Sumithran, P., et al., Ketosis and appetite-mediating nutrients and hormones after weight loss. Eur J Clin Nutr, 2013. 67(7): p. 759-64. https://www.ncbi.nlm.nih.gov/pubmed/23632752

116. Phinney, S.D., et al., The human metabolic response to chronic ketosis without caloric restriction: preservation of submaximal exercise capability with reduced carbohydrate oxidation. Metabolism, 1983. 32(8): p. 769-76. https://pubmed.ncbi.nlm.nih.gov/6865776/

117. Hill, J.C. and I.S. Millan, Validation of musculoskeletal ultrasound to assess and quantify muscle glycogen content. A novel approach. Phys Sportsmed, 2014. 42(3): p. 45-52. https://pubmed.ncbi.nlm.nih.gov/25295766/

118. Greene, J., et al., State-of-the-Art Methods for Skeletal Muscle Glycogen Analysis in Athletes - The Need for Novel Non-Invasive Techniques. Biosensors, 2017. 7. https://www.ncbi.nlm.nih.gov/pubmed/28241495

119. Hettinga, F.J., A.M. Edwards, and B. Hanley, The Science Behind Competition and Winning in Athletics: Using World-Level Competition Data to Explore Pacing and Tactics. Frontiers in Sports and Active Living, 2019. 1(11). https://www.frontiersin.org/article/10.3389/fspor.2019.00011

120. Burke, L.M., Re-Examining High-Fat Diets for Sports Performance: Did We Call the 'Nail in the Coffin' Too Soon? Sports Med, 2015. 45 Suppl 1(Suppl 1): p. S33-49. https://pubmed.ncbi.nlm.nih.gov/26553488/

121. Stellingwerff, T., et al., Decreased PDH activation and glycogenolysis during exercise following fat adaptation with carbohydrate restoration. American Journal of Physiology - Endocrinology And Metabolism, 2006. 290(2): p. 380-388. https://pubmed.ncbi.nlm.nih.gov/16188909/

122. Peters, S.J., Regulation of PDH activity and isoform expression: diet and exercise. Biochemical Society Transactions, 2003. 31(6): p. 1274-1280. http://www.biochemsoctrans.org/content/ppbiost/31/6/1274.full.pdf

123. Wood, T., Lost Metabolic Machinery During Ketosis? Depends Where You Are Looking. Strength & Conditioning Journal, 2017. 39(5). https://journals.lww.com/nsca-scj/Fulltext/2017/10000/Lost_Metabolic_Machinery_During_Ketosis__Depends.13.aspx

124. Burke, L.M., et al., Low carbohydrate, high fat diet impairs exercise economy and negates the performance benefit from intensified training in elite race walkers. J Physiol, 2017. 595(9): p. 2785-2807. https://pubmed.ncbi.nlm.nih.gov/28012184/

125. Shaw, D.M., et al., Effect of a Ketogenic Diet on Submaximal Exercise Capacity and Efficiency in Runners.Med Sci Sports Exerc, 2019. 51(10): p. 2135-2146. https://pubmed.ncbi.nlm.nih.gov/31033901/

126. Burke, L.M., et al., Crisis of confidence averted: Impairment of exercise economy and performance in elite race walkers by ketogenic low carbohydrate, high fat (LCHF) diet is reproducible. PLoS One, 2020. 15(6): p. e0234027. https://pubmed.ncbi.nlm.nih.gov/32497061/

127. Burke, L.M. and J.A. Hawley, Swifter, higher, stronger: What’s on the menu? Science, 2018. 362(6416): p. 781. http://science.sciencemag.org/content/362/6416/781.abstract

128. Miller, V.J., et al., A ketogenic diet combined with exercise alters mitochondrial function in human skeletal muscle while improving metabolic health. American Journal of Physiology-Endocrinology and Metabolism, 2020. https://doi.org/10.1152/ajpendo.00305.2020

129. Lane, N., A unifying view of ageing and disease: The double-agent theory. Journal of theoretical biology, 2004. 225: p. 531-40. https://pubmed.ncbi.nlm.nih.gov/14615212/

130. Miller, V.J., F.A. Villamena, and J.S. Volek, Nutritional Ketosis and Mitohormesis: Potential Implications for Mitochondrial Function and Human Health. Journal of nutrition and metabolism, 2018. 2018: p. 5157645-5157645. https://pubmed.ncbi.nlm.nih.gov/29607218

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5828461/

131. San-Millán, I. and G.A. Brooks, Assessment of Metabolic Flexibility by Means of Measuring Blood Lactate, Fat, and Carbohydrate Oxidation Responses to Exercise in Professional Endurance Athletes and Less-Fit Individuals.Sports Medicine, 2018. 48(2): p. 467-479. https://doi.org/10.1007/s40279-017-0751-x

132. Cipryan, L., et al., Effects of a 4-Week Very Low-Carbohydrate Diet on High-Intensity Interval Training Responses. Journal of Sports Science & Medicine, 2018. 17(2): p. 259-268. https://www.ncbi.nlm.nih.gov/pubmed/29769827

https://www.ncbi.nlm.nih.gov/pmc/PMC5950743/

133. Prins, P.J., et al., 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, 2019. 18(4): p. 738-750. 

134. McSwiney, F.T., et al., Keto-adaptation enhances exercise performance and body composition responses to training in endurance athletes. Metabolism, 2018. 81: p. 25-34. https://pubmed.ncbi.nlm.nih.gov/29208366/

135. Mirtschin, J.G., et al., Organization of Dietary Control for Nutrition-Training Intervention Involving Periodized Carbohydrate Availability and Ketogenic Low-Carbohydrate High-Fat Diet. International Journal of Sport Nutrition and Exercise Metabolism, 2018. 28(5): p. 480-489. https://journals.humankinetics.com/view/journals/ijsnem/28/5/article-p480.xml

136. Dostal, T., et al., 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.Frontiers in Physiology, 2019. 10(912). https://www.frontiersin.org/article/10.3389/fphys.2019.00912

137. Volek, J.S., et al., Metabolic characteristics of keto-adapted ultra-endurance runners. Metabolism, 2016. 65(3): p. 100-110. http://www.sciencedirect.com/science/article/pii/S0026049515003340

138. Areta, J.L. and W.G. Hopkins, Skeletal Muscle Glycogen Content at Rest and During Endurance Exercise in Humans: A Meta-Analysis. Sports Med, 2018. 48(9): p. 2091-2102. https://pubmed.ncbi.nlm.nih.gov/29923148/

139. Brooks, G.A., The Science and Translation of Lactate Shuttle Theory. Cell Metab, 2018. 27(4): p. 757-785. https://pubmed.ncbi.nlm.nih.gov/29617642/

140. Greene, D.A., et al., A Low-Carbohydrate Ketogenic Diet Reduces Body Mass Without Compromising Performance in Powerlifting and Olympic Weightlifting Athletes. J Strength Cond Res, 2018. 32(12): p. 3373-3382. https://pubmed.ncbi.nlm.nih.gov/30335720/

141. Hetlelid, K.J., et al., Rethinking the role of fat oxidation: substrate utilisation during high-intensity interval training in well-trained and recreationally trained runners. BMJ Open Sport & Exercise Medicine, 2015. 1(1). http://bmjopensem.bmj.com/content/1/1/e000047.abstract

142. Cahill, G.F., Jr., Fuel metabolism in starvation. Annu Rev Nutr, 2006. 26: p. 1-22. https://pubmed.ncbi.nlm.nih.gov/16848698/

143. Cox, P., et al., Nutritional Ketosis Alters Fuel Preference and Thereby Endurance Performance in Athletes. Cell Metabolism, 2016. 24. https://pubmed.ncbi.nlm.nih.gov/27475046/

144. Sherman, W.M., et al., Effect of exercise-diet manipulation on muscle glycogen and its subsequent utilization during performance. Int J Sports Med, 1981. 2(2): p. 114-8. https://pubmed.ncbi.nlm.nih.gov/7333741/

145. MacLeod, D., et al., Physiological determinants of climbing-specific finger endurance and sport rock climbing performance. J Sports Sci, 2007. 25(12): p. 1433-43. 

146. Ortega, J.O., et al., Muscle force, work and cost: a novel technique to revisit the Fenn effect. J Exp Biol, 2015. 218(Pt 13): p. 2075-82. https://pubmed.ncbi.nlm.nih.gov/25964423/

147. Hargreaves, M. and L.L. Spriet, Skeletal muscle energy metabolism during exercise. Nature Metabolism, 2020. https://doi.org/10.1038/s42255-020-0251-4

148. Baker, J.S., M.C. McCormick, and R.A. Robergs, Interaction among Skeletal Muscle Metabolic Energy Systems during Intense Exercise. Journal of nutrition and metabolism, 2010. 2010: p. 905612-905612. https://pubmed.ncbi.nlm.nih.gov/21188163

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3005844/

149. Newcomer, B.R., M.D. Boska, and H.P. Hetherington, Non-Pi buffer capacity and Initial phosphocreatine breakdown and resynthesis kinetics of human gastrocnemius/soleus muscle groups using 0.5 s time-resolved 31P MRS at 4.1 T. NMR in Biomedicine, 1999. 12(8): p. 545-551. https://pubmed.ncbi.nlm.nih.gov/10668047/

150. Artioli, G.G., et al., Determining the contribution of the energy systems during exercise. J Vis Exp, 2012(61). https://pubmed.ncbi.nlm.nih.gov/22453254/

Nugget Climbing podcast
Usual suspects E9 6c.jpg

I did an interview with Steven for The Nugget climbing podcast here. We had a long discussion of many climbing related topics including fingerboarding and training in general, nutrition and use of keto, carnivore and other diets, navigating research in general, my own climbing progression and key things I did to advance it as well as various other things. Steven is releasing it in two parts so do check back for the second part in a week.

Big Walks episode 1

Something that has really helped us get through the lockdown has been doing big walks from the house with Freida. Over the weeks Freida has realised how far she can walk in a few hours and we’ve seen a great deal of sunshine, forest, wildlife and many other interesting discoveries in various corners of Lochaber.

One objective Freida had was to walk to school which is about 14 miles. We’ve done this a few times now by various routes. We made a wee video on Freida’s YouTube about our first walk to school. I’m highly biased but I think Freida’s commentary is great.

Mikayla Parton film

Check out the film I made about Fort William Pro downhill MTB rider Mikayla Parton. Mikayla is receiving the Scottish Youth Award for Excellence in Mountain Culture this year and for good reason. I thought Mikayla has all the ingredients needed to be a successful athlete and was really impressed by her clear vision of where she wants to go and organised approach of how to get there. The comments of both Mikayla and Miles in the film allude to what those ingredients are.

I’ve been making these films for the Fort William Mountain Festival for both adult and youth awards and shooting them has been a fascinating study in the common ingredients that underlie great achievements in life. These obviously take many forms - great literature, art, activism, filmmaking, and sporting success to name some. In most of the recipients, a driven and uncompromising nature seems either immediately apparent or not far below the surface.

Where does this come from? I feel that it can originate from many different sources. Influence from a parent or mentor can be important, or really strong experiences in nature at a young age. I have no doubt that some experience of hardship might be important in a few as well. 

Another important ingredient is agency. The ability to take hurdles by the throat and solve them even if they seem impossibly big or complex at the outset. A question I still have; is this agency a separate ingredient for success that evolves separately from a driven nature, or is it a downstream consequence of it? Or is it a mix of both? Perhaps If I keep making the films one day I might have a more useful insight into this!

In the meantime, enjoy getting to know Mikayla in this film and remember the Fort William Mountain Festival is live online now and you can stream the festival films any time over the next month.

Dave Morris film

For several years I’ve made films about the recipients of the Scottish Award for Excellence in Mountain Culture. They are always fascinating to shoot and hard to edit because the people are so interesting and are often my heroes!

This year Dave Morris is receiving. Among many other environmental campaigns, Dave played a central role in securing the superb access laws we have here in Scotland that give us all reliable access to our mountains and wild places. Something I feel grateful for nearly every day, as I spend my life on highland estates that were not always welcoming places to climbers and walkers.



Check out the film I made about Dave. I’ve uploaded all the other films onto the Fort William Mountain Festival channel as well. If you enjoyed my Nevis Faces series you might like these films too.



The Fort William Mountain Festival runs over this coming weekend. This year It’s online of course. A lot of good mountain films will be showing so check it out.

Laspo Kneepads in stock
Trying out the new Laspo Kneepad for the first time the other day, on the E10 project at Duntelchaig.

Trying out the new Laspo Kneepad for the first time the other day, on the E10 project at Duntelchaig.

One of the things I’ve been meaning to do for a while is make a video about how to kneebar and what makes a good kneepad. I made my first kneepad in 2008 and have a pretty big selection of them. As with rock shoes, I still do tend to use all of them once in a while for different specific use cases. All kneebars are different and getting the right pad makes a huge difference in how long you can stay in the rest and how relaxed you can be in it.

Like many folk, for a few years I’ve mostly used the Send pads which are quite good and very convenient to use and last really well. But I’m always on the hunt for something better and so was excited when I saw that La Sportiva were bringing out a pad. I had actually been toying with the idea of designing and making a pad myself, since there is still no perfect pad out there. Unfortunately the new Sportiva Laspo pad wasn’t available for ages but have just come back into stock. So as well as ordering a set for myself, I bought some in for my shop for you guys to try. They are available now, right here.

I’ve only had a chance to try them once but that went well! There is a crucial kneebar on the E10 project I’ve been trying with Robbie Phillips. With the Send pad I worked up to getting 6 seconds hands off, which was definitely worth it. But trying the Laspo, I could immediately get 14 seconds off which obviously makes a big difference. Just one data point. But it’s a good one! I’ll do a full review of the pad in my knee barring video soon. But so far I think this is the best one I’ve tried.

la-sportiva-laspo-knee-pad.jpg
I'm doing some nutrition research

My research questionnaire: https://glasgow-research.onlinesurveys.ac.uk/dietary-patterns-of-rock-climbers THANK YOU so much for your time to participate. Note that the questionnaire will only be live for a short time in July 2020.

In the video I above I discuss some thoughts on my own study of nutrition over the past few years and the research I’m currently doing. To complete the research I need your help and I’m asking climbers over 16 who climb regularly to complete a questionnaire about their diet.

The speech by Austin Bradford Hill I mentioned in the post is here:

HILL, A. B. 1965. THE ENVIRONMENT AND DISEASE: ASSOCIATION OR CAUSATION? Proceedings of the Royal Society of Medicine, 58, 295-300. https://pubmed.ncbi.nlm.nih.gov/14283879/



More information about how to participate in the brief video below:

How I went from 8b to 9a in 18 months

I plateaued at around 7C+ boulder/8b sport for quite a few years in my twenties. Then I made a jump to 8c and then 9a in a surprisingly short period of time. In this episode I go through what I did. Yes it involved a hangboard! I'm not sure my intervention would have the same effect on most climbers these days, but I will suggest some other equally important training for climbing that should reach the same place.

Fingerboarding for beginners

Many of you are getting to grips with the hangboard for the first time right now. Here is a deep dive on most of the priorities to think about to get the most out of the tool and stay uninjured. My Hangboard: The Edge.

In this video I reference a review of studies comparing high and low loads for strength training. If you would like to read the study, it is here.