A Short-Term Ketogenic Diet Impairs Markers of Bone Health in Response to Exercise.

Autor:	Heikura IA; Australian Institute of Sport, Canberra, ACT, Australia.; Exercise and Nutrition Research Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia., Burke LM; Australian Institute of Sport, Canberra, ACT, Australia.; Exercise and Nutrition Research Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia., Hawley JA; Exercise and Nutrition Research Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia., Ross ML; Australian Institute of Sport, Canberra, ACT, Australia.; Exercise and Nutrition Research Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia., Garvican-Lewis L; Australian Institute of Sport, Canberra, ACT, Australia.; Exercise and Nutrition Research Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia., Sharma AP; Australian Institute of Sport, Canberra, ACT, Australia.; Griffith Sports Physiology and Performance, School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia., McKay AKA; Australian Institute of Sport, Canberra, ACT, Australia.; School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, WA, Australia., Leckey JJ; Exercise and Nutrition Research Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia., Welvaert M; Australian Institute of Sport, Canberra, ACT, Australia.; University of Canberra Research Institute for Sport and Exercise, Canberra, ACT, Australia.; Statistical Consulting Unit, Australian National University, Canberra, ACT, Australia., McCall L; Division of Sports Medicine, Boston Children's Hospital, Boston, MA, United States., Ackerman KE; Division of Sports Medicine, Boston Children's Hospital, Boston, MA, United States.; Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in endocrinology [Front Endocrinol (Lausanne)] 2020 Jan 21; Vol. 10, pp. 880. Date of Electronic Publication: 2020 Jan 21 (Print Publication: 2019).
DOI:	10.3389/fendo.2019.00880
Abstrakt:	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. (Copyright © 2020 Heikura, Burke, Hawley, Ross, Garvican-Lewis, Sharma, McKay, Leckey, Welvaert, McCall and Ackerman.)
Databáze:	MEDLINE
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