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• W4328049591 abstract "Abstract Background A ketogenic diet (KD) reduces daily carbohydrates (CHOs) ingestion by replacing most calories with fat. KD is of increasing interest among athletes because it may increase their maximal oxygen uptake (VO 2 max), the principal performance limitation at high-altitudes (1500–3500 m). We examined the tolerance of a 4-week isocaloric KD (ICKD) under simulated hypoxia and the possibility of evaluating ICKD performance benefits with a maximal graded exercise bike test under hypoxia and collected data on the effect of the diet on performance markers and arterial blood gases. Methods In a randomised single-blind cross-over model, 6 recreational mountaineers (age 24–44 years) completed a 4-week ICKD followed or preceded by a 4-week usual mixed Western-style diet (UD). Performance parameters (VO 2 max, lactate threshold [LT], peak power [P peak ]) and arterial blood gases (PaO 2 , PaCO 2 , pH, HCO 3 − ) were measured at baseline under two conditions (normoxia and hypoxia) as well as after a 4-week UD and 4-week ICKD under the hypoxic condition. Results We analysed data for all 6 participants (BMI 19.9–24.6 kg m −2 ). Mean VO 2 max in the normoxic condition was 44.6 ml kg −1 min −1 . Hypoxia led to decreased performance in all participants. With the ICKD diet, median values for PaO 2 decreased by − 14.5% and VO 2 max by + 7.3% and P peak by + 4.7%. Conclusion All participants except one could complete the ICKD. VO 2 max improved with the ICKD under the hypoxia condition. Therefore, an ICKD is an interesting alternative to CHOs dependency for endurance performance at high-altitudes, including high-altitude training and high-altitude races. Nevertheless, decreased PaO 2 with ICKD remains a significant limitation in very-high to extreme altitudes (> 3500 m). Trial registration Clinical trial registration Nr. NCT05603689 (Clinicaltrials.gov). Ethics approval CER-VD, trial Nr. 2020-00427, registered 18.08 .2020—prospectively registered." @default.
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• W4328049591 date "2023-03-20" @default.
• W4328049591 modified "2023-10-08" @default.
• W4328049591 title "Effect of a four-week isocaloric ketogenic diet on physical performance at very high-altitude: a pilot study" @default.
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• W4328049591 doi "https://doi.org/10.1186/s13102-023-00649-9" @default.
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