This systematic review searched PubMed, Web of Science, ProQuest and Science Direct up to October 2023 for human studies of ketogenic diets or ketone supplements in adult endurance runners. It included 5 studies on ketogenic diets and 7 on ketone supplements, involving a total of 132 endurance runners. Outcomes were markers of aerobic performance such as VO2 max, race time, time to exhaustion and rate of perceived exertion. Some ketogenic diet studies reported reductions in bodyweight and fat with preserved lean mass and improved glycemic control, and the authors call for larger trials with longer interventions.
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