Many successful ultra-endurance athletes have switched from a high-carbohydrate to a low-carbohydrate diet, but they have not previously been studied to determine the extent of metabolic adaptations. Twenty elite ultra-marathoners and ironman distance triathletes performed a maximal graded exercise test and a 180 min submaximal run at 64% VO2max on a treadmill to determine metabolic responses. One group habitually consumed a traditional high-carbohydrate (HC: n=10, %carbohydrate:protein:fat=59:14:25) diet, and the other a low-carbohydrate (LC; n=10, 10:19:70) diet for an average of 20 months (range 9 to 36 months). Peak fat oxidation was 2.3-fold higher in the LC group (1.54±0.18 vs 0.67±0.14 g/min; P=0.000) and it occurred at a higher percentage of VO2max (70.3±6.3 vs 54.9±7.8%; P=0.000). Mean fat oxidation during submaximal exercise was 59% higher in the LC group (1.21±0.02 vs 0.76±0.11 g/min; P=0.000) corresponding to a greater relative contribution of fat (88±2 vs 56±8%; P=0.000). Despite these marked differences in fuel use between LC and HC athletes, there were no significant differences in resting muscle glycogen and the level of depletion after 180 min of running (-64% from pre-exercise) and 120 min of recovery (-36% from pre-exercise). Compared to highly trained ultra-endurance athletes consuming an HC diet, long-term keto-adaptation results in extraordinarily high rates of fat oxidation, whereas muscle glycogen utilization and repletion patterns during and after a 3 hour run are similar.

Recent meta-analyses have found no association between heart disease and dietary saturated fat; however, higher proportions of plasma saturated fatty acids (SFA) predict greater risk for developing type-2 diabetes and heart disease. These observations suggest a disconnect between dietary saturated fat and plasma SFA, but few controlled feeding studies have specifically examined how varying saturated fat intake across a broad range affects circulating SFA levels. Sixteen adults with metabolic syndrome (age 44.9±9.9 yr, BMI 37.9±6.3 kg/m²) were fed six 3-wk diets that progressively increased carbohydrate (from 47 to 346 g/day) with concomitant decreases in total and saturated fat. Despite a distinct increase in saturated fat intake from baseline to the low-carbohydrate diet (46 to 84 g/day), and then a gradual decrease in saturated fat to 32 g/day at the highest carbohydrate phase, there were no significant changes in the proportion of total SFA in any plasma lipid fractions. Whereas plasma saturated fat remained relatively stable, the proportion of palmitoleic acid in plasma triglyceride and cholesteryl ester was significantly and uniformly reduced as carbohydrate intake decreased, and then gradually increased as dietary carbohydrate was re-introduced. The results show that dietary and plasma saturated fat are not related, and that increasing dietary carbohydrate across a range of intakes promotes incremental increases in plasma palmitoleic acid, a biomarker consistently associated with adverse health outcomes.

Commercial high-intensity, short rest (HI/SR) protocols have been anecdotally postured to be extremely demanding. However, limited prior studies have demonstrated HI/SR protocols to produce hyperreactions in metabolic and adrenal function; thus, the purpose of this study was to evaluate the physiological effects of an acute, high-intensity (75% 1-repetition maximum), short rest resistance exercise protocol. Nine trained men (age: 23.5 ± 3.5 years, height: 172.4 ± 4.0 cm, weight: 77.8 ± 8.8 kg) and 9 trained women (age: 22.9 ± 2.0 years, height: 168.4 ± 9.4 cm, weight: 68.5 ± 10.4 kg) participated in the HI/SR protocol, which consisted of a descending pyramid scheme of back squat, bench press, and deadlift, beginning with 10 repetitions of each, then 9, then 8, and so on until 1 repetition on the final set. Significant time effects were observed in lactate (immediate post [IP], +15, +60) and cortisol (IP, +15, +60) response. Significant sex effects were observed in lactate response (IP, +15) but not in cortisol response. Total work was higher in men and influenced magnitude of increase in lactate but not cortisol. No significant sex differences were noted in time to completion, average relative intensity, heart rate response or rating of perceived exertion scores. Highest lactate (IP men: 17.3 mmol·L(-1); IP women: 13.8 mmol·L(-1)) and cortisol (+15 men: 1,860.2 nmol·L(-1); +15 women: 1,831.7 nmol·L(-1)) values were considerably greater than those produced in typical resistance exercise programs, confirming that relative intensity and rest period length are important factors determining magnitude of metabolic and adrenal stress. Practical applications for the coach include cautious implementation of HI/SR protocols, as long-term sequential use may promote overtraining. A gradual reduction in rest interval length with concurrent gradual increase in intensity should be used to minimize potential negative effects such as nonfunctional overreaching.