Louise M. Burke, Megan L. Ross, Laura A. Garvican‐Lewis, Marijke Welvaert, Ida A. Heikura, Sara G. Forbes, Joanne G. Mirtschin, Louise E. Cato, Nicki Strobel, Avish P. Sharma, John A. Hawley

We investigated the effects of adaptation to a ketogenic low-carbohydrate (CHO), high-fat diet (LCHF) during 3 wk of intensified training on metabolism and performance of world-class endurance athletes. We controlled three isoenergetic diets in elite race walkers: 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) consumed before/during/after training (HCHO, n = 9): identical macronutrient intake, periodised within/between days to alternate between low and high CHO availability (PCHO, n = 10); LCHF (<50 g.d(-1) CHO; 78% energy as fat; 2.1 g.kg(-) 1.d(-1) protein; LCHF, n = 10). Post-intervention, VO2 peak during race walking increased in all groups (P < 0.001, 90%CI: [2.55 - 5.20%]). LCHF was associated with markedly increased rates of whole-body fat oxidation, attaining peak rates of 1.57 ± 0.32 g.min(-1) during 2 h of walking at ∼80%VO2 peak. However, LCHF also increased the oxygen (O2 ) cost of race walking at velocities relevant to real-life race performance: O2 uptake (expressed as % of new VO2peak ) at a speed approximating 20 km race pace was reduced in HCHO and PCHO (90%CI:[-7.047;-2.55] and [-5.18;-0.86], respectively, but was maintained at pre-intervention levels in LCHF. HCHO and PCHO groups improved times for 10 km race walk: 6.6% (90% CI: [4.1; 9.1%]) and 5.3% [3.4; 7.2%], with no improvement (-1.6% [-8.5; 5.3%] for the LCHF group. In contrast to training with diets providing chronic or periodised high-CHO availability, and despite a significant improvement in VO2peak , adaptation to the topical LCHF diet negated performance benefits in elite endurance athletes, in part, due to reduced exercise economy. This article is protected by copyright. All rights reserved.