Cognitive, Sleep, and Autonomic Responses to Induction of a Ketogenic Diet in Military Personnel: A Pilot Study

BACKGROUND: This pilot study examined the effect of a 2-wk ketogenic diet (KD) compared with a carbohydrate (CHO) diet in military personnel on cognitive performance, mood, sleep, and heart rate variability (HRV).METHODS: A randomized-controlled, cross-over trial was conducted with eight male military personnel (age, 36 ± 7 yr; body mass, 83.7 ± 9.2 kg; BMI, 26.0 ± 2.3 kg · m^-2). Subjects ingested their habitual diet for 7 d (baseline), then an iso-energetic KD (∼25 g CHO/d) or CHO diet (∼285 g CHO/d) for 14 d (adaptation), separated by a 12-d washout. HRV, fasting capillary blood D-βHB, and glucose concentration, mood, and sleep were measured daily. Cognitive performance was measured on the 7^th day of baseline and the 7^th and 14^th days of adaptation. Data were analyzed using a series of linear mixed models.RESULTS: Mean weekly D-βHB was higher (95% CI, +0.34 to +2.38 mmol · L^-1) and glucose was lower (-0.45 to -0.21 mmol · L^-1) in the KD compared with the CHO diet. Cognitive performance (Psychomotor Vigilance Task, 2-choice reaction time, and running memory continuous performance test) and mean weekly fatigue, vigor, and sleep (sleep duration, sleep efficiency, and sleep onset latency) were similar between diets. A diet × week interaction for HRV approached significance, with exploratory analyses suggesting HRV was lower compared with baseline during week-2 adapt (-27 to +4 ms) in the KD.DISCUSSION: A 2-wk KD induction in military personnel does not appear to affect cognitive performance, mood, or sleep, but may lower HRV, indicating increased physiological stress.Shaw DM, Henderson L, van den Berg M.