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Effects of Resistance Training Combined with a Ketogenic Diet: A Systematic Review and Meta-Analysis

Sinott, L. R.; Flores da Silva, C. S.; Scheer, A. K.; Atrib, A. B.; Schneider, A.; Barros, C. C.

2024-06-20 nutrition
10.1101/2024.06.19.24308878 medRxiv
Show abstract

Weight loss treatments require adherence to physical exercise and diet. Restrictive diets have been proposed for obesity treatment, including a ketogenic diet that are high in lipids, moderate in proteins, and low in carbohydrates. In recent years, there has been criticism of this diet because of the reduction in fat-free mass and, consequently, a reduction in basal energy expenditure, which is considered negative in obesity treatment. However, resistance training is known to promote skeletal muscle hypertrophy. The hypothesis for this review was: "Resistance training is sufficient to maintain lean mass during diets that cause ketosis." Despite the slight reduction in lean mass identified in the meta-analysis, some authors reported no loss in physical performance. Others suggested that this difference in lean mass is associated with water loss in the participants, which aligns with a few studies that reported a final phase with carbohydrate reintroduction into the diet. Our results indicated physical exercise was an important tool for maintaining lean mass in individuals who consumed carbohydrate-restricted diets that cause ketosis.

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