Abstract
This systematic review investigates the impact of a ketogenic diet combined with endurance training on adaptive changes in athletes. The study involved a comprehensive literature search across PubMed, Google Scholar, and Ovid databases, as well as the grey literature to find related studies that have been published since December 2013. The inclusion criteria were as follows: performance data before and after a low-fat high-carb (LFHC) ketogenic diet, a clinical trial, and human subjects. Six relevant studies were included after the selection and exclusion processes. The key fitness parameters analyzed included maximum rate of oxygen consumption (VO2max), Respiratory Exchange Ratio (RER), bench press performance, and body mass changes. The changes in performance parameters and body mass showed some consistency across the different studies, including increased VO2max and reduced body mass. Nevertheless, when compared using the t-test, the resulting data could not be found statistically significant, most likely due to the paucity of data. As a result, we concluded that there are some overall effects of the ketogenic diet on the performance and body composition of athletes. Whether or not these effects are beneficial or whether the diet can be utilized in a manner that confers benefit is yet to be determined. There remains a considerable gap in research on the effects of the ketogenic diet on athletic performance.