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Purpose: Considerable interindividual heterogeneity has been observed in endurance performance responses following induction of a ketogenic diet (KD). It is plausible that a physiological stress response in the period following the dramatic dietary shift associated with transition to a KD may explain this heterogeneity. Methods: In a randomized, crossover study design, 8 trained male runners completed an incremental exercise test and ran to exhaustion at 70%VO2max before and after a 31-day rigorously controlled habitual diet or KD intervention, and recorded heart rate variability (root mean square of the sum of successive differences in R–R intervals [rMSSD]) upon waking each morning along with the recovery–stress questionnaire for athletes each week. Data were analyzed using linear mixed models. Results: A significant reduction in rMSSD was observed in the KD (−9.77 [4.03] ms, P = .02), along with an increase in day-to-day variability in rMSSD (2.1% [1.0%], P = .03). The reduction in rMSSD in the KD for the subgroup of individuals exhibiting impaired exercise capacity following induction of the KD approached significance (Δ −22  ms, P = .06, N = 4); whereas no effect was observed in those who exhibited unchanged exercise capacity (Δ 5  ms, P = .61, N = 4). No main effects were observed for recovery–stress questionnaire for athletes. Conclusions: Our data suggest those working with endurance athletes transitioning onto a KD may consider using noninvasive, inexpensive resting heart rate variability measures to gain individual-level insights into the likely short-term effects on exercise capacity.
Maunder, Dulson, and Shaw are with the Sports Performance Research Inst New Zealand, Auckland University of Technology, Auckland, New Zealand. Dulson is also with the School of Biomedical, Nutritional, and Sport Sciences, Newcastle University, Newcastle, United Kingdom. Shaw is also with the School of Sport, Exercise, and Nutrition, Massey University, Palmerston North, New Zealand.