A Short-Term Ketogenic Diet Impairs Markers of Bone Health in Response to Exercise
Objectives: To investigate diet-exercise interactions related to bone markers in elite endurance athletes after a 3.5-week ketogenic low-carbohydrate, high-fat (LCHF) diet and subsequent restoration of carbohydrate (CHO) feeding.Methods: World-class race walkers (25 male, 5 female) completed 3.5-wee...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-01-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fendo.2019.00880/full |
| _version_ | 1828494823966900224 |
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| author | Ida A. Heikura Ida A. Heikura Louise M. Burke Louise M. Burke John A. Hawley Megan L. Ross Megan L. Ross Laura Garvican-Lewis Laura Garvican-Lewis Avish P. Sharma Avish P. Sharma Alannah K. A. McKay Alannah K. A. McKay Jill J. Leckey Marijke Welvaert Marijke Welvaert Marijke Welvaert Lauren McCall Kathryn E. Ackerman Kathryn E. Ackerman |
| author_facet | Ida A. Heikura Ida A. Heikura Louise M. Burke Louise M. Burke John A. Hawley Megan L. Ross Megan L. Ross Laura Garvican-Lewis Laura Garvican-Lewis Avish P. Sharma Avish P. Sharma Alannah K. A. McKay Alannah K. A. McKay Jill J. Leckey Marijke Welvaert Marijke Welvaert Marijke Welvaert Lauren McCall Kathryn E. Ackerman Kathryn E. Ackerman |
| author_sort | Ida A. Heikura |
| collection | DOAJ |
| description | Objectives: To investigate diet-exercise interactions related to bone markers in elite endurance athletes after a 3.5-week ketogenic low-carbohydrate, high-fat (LCHF) diet and subsequent restoration of carbohydrate (CHO) feeding.Methods: World-class race walkers (25 male, 5 female) completed 3.5-weeks of energy-matched (220 kJ·kg·d−1) high CHO (HCHO; 8.6 g·kg·d−1 CHO, 2.1 g·kg·d−1 protein, 1.2 g·kg·d−1 fat) or LCHF (0.5 g·kg·d−1 CHO, 2.1 g·kg·d−1 protein, 75–80% of energy from fat) diet followed by acute CHO restoration. Serum markers of bone breakdown (cross-linked C-terminal telopeptide of type I collagen, CTX), formation (procollagen 1 N-terminal propeptide, P1NP) and metabolism (osteocalcin, OC) were assessed at rest (fasting and 2 h post meal) and after exercise (0 and 3 h) at Baseline, after the 3.5-week intervention (Adaptation) and after acute CHO feeding (Restoration).Results: After Adaptation, LCHF increased fasting CTX concentrations above Baseline (p = 0.007, Cohen's d = 0.69), while P1NP (p < 0.001, d = 0.99) and OC (p < 0.001, d = 1.39) levels decreased. Post-exercise, LCHF increased CTX concentrations above Baseline (p = 0.001, d = 1.67) and above HCHO (p < 0.001, d = 0.62), while P1NP (p < 0.001, d = 0.85) and OC concentrations decreased (p < 0.001, d = 0.99) during exercise. Exercise-related area under curve (AUC) for CTX was increased by LCHF after Adaptation (p = 0.001, d = 1.52), with decreases in P1NP (p < 0.001, d = 1.27) and OC (p < 0.001, d = 2.0). CHO restoration recovered post-exercise CTX and CTX exercise-related AUC, while concentrations and exercise-related AUC for P1NP and OC remained suppressed for LCHF (p = 1.000 compared to Adaptation).Conclusion: Markers of bone modeling/remodeling were impaired after short-term LCHF diet, and only a marker of resorption recovered after acute CHO restoration. Long-term studies of the effects of LCHF on bone health are warranted. |
| first_indexed | 2024-12-11T12:03:45Z |
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| id | doaj.art-00acf5042f364003b38e04ccf9b72ad3 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-12-11T12:03:45Z |
| publishDate | 2020-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-00acf5042f364003b38e04ccf9b72ad32022-12-22T01:08:00ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922020-01-011010.3389/fendo.2019.00880495813A Short-Term Ketogenic Diet Impairs Markers of Bone Health in Response to ExerciseIda A. Heikura0Ida A. Heikura1Louise M. Burke2Louise M. Burke3John A. Hawley4Megan L. Ross5Megan L. Ross6Laura Garvican-Lewis7Laura Garvican-Lewis8Avish P. Sharma9Avish P. Sharma10Alannah K. A. McKay11Alannah K. A. McKay12Jill J. Leckey13Marijke Welvaert14Marijke Welvaert15Marijke Welvaert16Lauren McCall17Kathryn E. Ackerman18Kathryn E. Ackerman19Australian Institute of Sport, Canberra, ACT, AustraliaExercise and Nutrition Research Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, AustraliaAustralian Institute of Sport, Canberra, ACT, AustraliaExercise and Nutrition Research Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, AustraliaExercise and Nutrition Research Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, AustraliaAustralian Institute of Sport, Canberra, ACT, AustraliaExercise and Nutrition Research Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, AustraliaAustralian Institute of Sport, Canberra, ACT, AustraliaExercise and Nutrition Research Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, AustraliaAustralian Institute of Sport, Canberra, ACT, AustraliaGriffith Sports Physiology and Performance, School of Allied Health Sciences, Griffith University, Gold Coast, QLD, AustraliaAustralian Institute of Sport, Canberra, ACT, AustraliaSchool of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, WA, AustraliaExercise and Nutrition Research Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, AustraliaAustralian Institute of Sport, Canberra, ACT, AustraliaUniversity of Canberra Research Institute for Sport and Exercise, Canberra, ACT, AustraliaStatistical Consulting Unit, Australian National University, Canberra, ACT, AustraliaDivision of Sports Medicine, Boston Children's Hospital, Boston, MA, United StatesDivision of Sports Medicine, Boston Children's Hospital, Boston, MA, United StatesNeuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United StatesObjectives: To investigate diet-exercise interactions related to bone markers in elite endurance athletes after a 3.5-week ketogenic low-carbohydrate, high-fat (LCHF) diet and subsequent restoration of carbohydrate (CHO) feeding.Methods: World-class race walkers (25 male, 5 female) completed 3.5-weeks of energy-matched (220 kJ·kg·d−1) high CHO (HCHO; 8.6 g·kg·d−1 CHO, 2.1 g·kg·d−1 protein, 1.2 g·kg·d−1 fat) or LCHF (0.5 g·kg·d−1 CHO, 2.1 g·kg·d−1 protein, 75–80% of energy from fat) diet followed by acute CHO restoration. Serum markers of bone breakdown (cross-linked C-terminal telopeptide of type I collagen, CTX), formation (procollagen 1 N-terminal propeptide, P1NP) and metabolism (osteocalcin, OC) were assessed at rest (fasting and 2 h post meal) and after exercise (0 and 3 h) at Baseline, after the 3.5-week intervention (Adaptation) and after acute CHO feeding (Restoration).Results: After Adaptation, LCHF increased fasting CTX concentrations above Baseline (p = 0.007, Cohen's d = 0.69), while P1NP (p < 0.001, d = 0.99) and OC (p < 0.001, d = 1.39) levels decreased. Post-exercise, LCHF increased CTX concentrations above Baseline (p = 0.001, d = 1.67) and above HCHO (p < 0.001, d = 0.62), while P1NP (p < 0.001, d = 0.85) and OC concentrations decreased (p < 0.001, d = 0.99) during exercise. Exercise-related area under curve (AUC) for CTX was increased by LCHF after Adaptation (p = 0.001, d = 1.52), with decreases in P1NP (p < 0.001, d = 1.27) and OC (p < 0.001, d = 2.0). CHO restoration recovered post-exercise CTX and CTX exercise-related AUC, while concentrations and exercise-related AUC for P1NP and OC remained suppressed for LCHF (p = 1.000 compared to Adaptation).Conclusion: Markers of bone modeling/remodeling were impaired after short-term LCHF diet, and only a marker of resorption recovered after acute CHO restoration. Long-term studies of the effects of LCHF on bone health are warranted.https://www.frontiersin.org/article/10.3389/fendo.2019.00880/fullketogenic dietbone healthexercisenutritionendurance athletes |
| spellingShingle | Ida A. Heikura Ida A. Heikura Louise M. Burke Louise M. Burke John A. Hawley Megan L. Ross Megan L. Ross Laura Garvican-Lewis Laura Garvican-Lewis Avish P. Sharma Avish P. Sharma Alannah K. A. McKay Alannah K. A. McKay Jill J. Leckey Marijke Welvaert Marijke Welvaert Marijke Welvaert Lauren McCall Kathryn E. Ackerman Kathryn E. Ackerman A Short-Term Ketogenic Diet Impairs Markers of Bone Health in Response to Exercise Frontiers in Endocrinology ketogenic diet bone health exercise nutrition endurance athletes |
| title | A Short-Term Ketogenic Diet Impairs Markers of Bone Health in Response to Exercise |
| title_full | A Short-Term Ketogenic Diet Impairs Markers of Bone Health in Response to Exercise |
| title_fullStr | A Short-Term Ketogenic Diet Impairs Markers of Bone Health in Response to Exercise |
| title_full_unstemmed | A Short-Term Ketogenic Diet Impairs Markers of Bone Health in Response to Exercise |
| title_short | A Short-Term Ketogenic Diet Impairs Markers of Bone Health in Response to Exercise |
| title_sort | short term ketogenic diet impairs markers of bone health in response to exercise |
| topic | ketogenic diet bone health exercise nutrition endurance athletes |
| url | https://www.frontiersin.org/article/10.3389/fendo.2019.00880/full |
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