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Body composition changes in physically active individuals consuming ketogenic diets: a systematic review.

Julie L Coleman1,2, Christopher T Carrigan1, Lee M Margolis3

  • 1U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Building 42, Natick, MA, 01760, USA.

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|June 6, 2021
PubMed
Summary

Ketogenic diets (KD) effectively reduce body mass and fat mass (FM) while preserving fat-free mass (FFM) in physically active individuals. This systematic review highlights KD's potential for body composition improvement in athletes.

Keywords:
Carbohydrate oxidationFat oxidationHigh-fatKetosisLow carbohydrate

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Area of Science:

  • Sports Nutrition
  • Human Physiology
  • Dietary Interventions

Background:

  • Athletes aim to optimize strength-to-power ratio by reducing fat mass (FM) and maintaining fat-free mass (FFM).
  • Ketogenic diets (KD), characterized by high fat and low carbohydrate intake, are emerging as a strategy for body mass reduction.

Purpose of the Study:

  • To systematically review and compare the effects of ketogenic diets (KD) versus control diets (CON) on body mass and composition.
  • To evaluate KD's efficacy in reducing FM while preserving FFM in physically active populations.

Main Methods:

  • Systematic literature review of randomized and non-randomized studies.
  • Searched PubMed and Cochrane Library for studies on physically active adults (≥18 years) on KD (carbohydrate <50g/d or β-hydroxybutyrate >0.5 mmol/L for ≥14 days) versus CON.

Main Results:

  • Thirteen studies were included, showing KD reduced body mass by 2.7kg and FM by 2.3kg, while CON showed minimal change.
  • FFM decreased by 0.3kg in KD and increased by 0.7kg in CON, indicating potential FFM retention with KD.
  • KD group had an estimated energy deficit of -339 kcal/d, while CON had a near-zero energy balance (5 kcal/d).

Conclusions:

  • Ketogenic diets can promote fat mobilization and reduce FM while aiding in FFM retention.
  • Variability in FFM outcomes across studies and potential risks of bias warrant further investigation.
  • KD shows promise for athletes seeking body composition improvements, but careful consideration of individual responses is advised.