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We repeated our study of intensified training on a ketogenic low-carbohydrate (CHO), high-fat diet (LCHF) in world-class endurance athletes, with further investigation of a “carryover” effect on performance after restoring CHO availability in comparison to high or periodised CHO diets.    Methods  After Baseline testing (10,000 m IAAF-sanctioned race, aerobic capacity and submaximal walking economy) elite male and female race walkers undertook 25 d supervised training and repeat testing (Adapt) on energy-matched diets: High CHO availability (8.6 g∙kg -1 ∙d -1  CHO, 2.1 g∙kg -1 ∙d -1  protein; 1.2 g∙kg -1 ∙d -1  fat) including CHO before/during/after workouts (HCHO, n = 8): similar macronutrient intake periodised within/between days to manipulate low and high CHO availability at various workouts (PCHO, n = 8); and LCHF (<50 g∙d -1  CHO; 78% energy as fat; 2.1 g∙kg -1 ∙d -1  protein; n = 10). After Adapt, all athletes resumed HCHO for 2.5 wk before a cohort (n = 19) completed a 20 km race.    Results  All groups increased VO 2 peak (ml∙kg -1 ∙min -1 ) at Adapt (p = 0.02, 95%CI: [0.35–2.74]). LCHF markedly increased whole-body fat oxidation (from 0.6 g∙min -1  to 1.3 g∙min -1 ), but also the oxygen cost of walking at race-relevant velocities. Differences in 10,000 m performance were clear and meaningful: HCHO improved by 4.8% or 134 s (95% CI: [207 to 62 s]; p < 0.001), with a trend for a faster time (2.2%, 61 s [-18 to +144 s]; p = 0.09) in PCHO. LCHF were slower by 2.3%, -86 s ([-18 to -144 s]; p < 0.001), with no evidence of superior “rebound” performance over 20 km after 2.5 wk of HCHO restoration and taper.    Conclusion  Our previous findings of impaired exercise economy and performance of sustained high-intensity race walking following keto-adaptation in elite competitors were repeated. Furthermore, there was no detectable benefit from undertaking an LCHF intervention as a periodised strategy before a 2.5-wk race preparation/taper with high CHO availability.    Trial registration  Australia New Zealand Clinical Trial Registry:  ACTRN12619000794101 .

plos one

Crisis of confidence averted: Impairment of exercise economy and performance in elite race walkers by ketogenic low carbohydrate, high fat (LCHF) diet is reproducible