Ketogenic Diet Supplements
The ketogenic diet has been touted for its weight loss benefits, but without the right nutrition fatigue can set in compromising performance. Learn what ketogenic diet supplements may benefit your exercise routine.
What is the Ketogenic Diet
The ketogenic diet (keto diet) is a diet where the majority of calories are from healthy fats. It also includes some proteins and very low carbs. Starches, grains, and legumes are avoided. Vegetables consist mostly of leafy greens.
A high intake of fatty foods increases ketone levels putting the body in a state of ketosis. The body will use ketones instead of glucose for energy.
How the Keto Diet Affects Exercise
People on ketogenic diets can have decreased energy levels due the lack of carbohydrates and protein in their diets. This is because high-intensity and muscle building exercises rely on glucose and amino acids [R, R].
Fatigue from keto diet may also prevent someone from wanting to exercise [R].
A ketogenic diet may impair exercise performance at intensities higher than 60 percent. Long term keto diets may also cause reductions in body mass or skeletal muscle may also occur due to impaired anaerobic power and strength [R].
Ketogenic Diet Supplements That May Be Needed
A low carb diet may not provide enough vitamins, fiber, and protein needed for exercise [R, R, R]. Ketogenic diet supplements may improve nutrient intake and combat nausea, back pain, headache, weakness, muscle cramps, constipation, and diarrhea associated with the keto flu [R].
Omega-3 Fatty Acids
Ketone esters had a 2% increase in exercise performance and recovery when used in conjunction with carbohydrate intake. Some have been found to affect blood pressure and electrolyte function. True effects on exogenous ketones on exercise are still unknown [R, R, R].
Greens Powder Supplements
Greens powder supplements offer an easy way to get a larger serving of vegetables with just a scoop of powder. Add it to your workout drinks and smoothies to get a dose of antioxidants, phytochemicals, vitamins, and minerals in one serving
Losses in calcium, sodium, potassium, calcium, and magnesium can occur with the keto diet. These nutrients are needed to maintain muscle contractions, heartbeat, blood pressure, and kidney function [R].
Electrolyte supplements can put back these lost nutrients.
Creatine and Branched-Chain Amino Acid Supplements
Risks and Contraindications of Ketogenic Diet Supplements
There are some risks and contraindications involved with taking ketogenic diet supplements.
MCT Oil Risks and Contraindications
Side effects of MCT oil include diarrhea, vomiting, irritability, nausea, stomach discomfort, intestinal gas, essential fatty acid deficiency. Taking as low a dose as possible with food may reduce these effects. [R].
Omega-3 Fatty Acids Risks and Contraindications
Those with blood clotting should avoid omega-3 fat supplements [R]. A vegan omega-3 is recommended for those with fish allergies.
Exogenous Ketones Risks and Contraindications
Ketone supplements should not be used by anyone with high blood pressure or kidney issues. Side effects include stomach upset, diarrhea, constipation, and stomach pain [R].
Electrolyte Supplements Risks and Contraindications
Supplements can shift the balance of electrolytes [R]. There are no specific drug interactions but if you’re on medications it's best to talk to a healthcare provider before taking them.
Fiber Supplements Risks and Contraindications
Greens Powder Risks and Contraindications
Those on blood thinning medications may want to be careful about their intake of vitamin K found in super greens powder. It can interact with antibiotics, cholesterol medications, weight-loss drugs, and blood thinners [R]. Some side effects such as stomach upset and diarrhea have been seen from overuse.
Creatine and Branched-Chain Amino Acid Supplements Risks and Contraindications
Branched-chain amino acids may cause fatigue and loss of coordination. Those on levodopa or antidiabetic medications may have interactions with BCAAs [R].
Final Thoughts on Ketogenic Diet Supplements
The ketogenic diet restriction of food groups can leave out many important nutrients needed for exercise performance.The addition of keto supplements like fiber, greens powder, omega 3’s, creatine, branched-chain amino acids, electrolytes, and MCT oil may combat keto fatigue. However, there may be potential side effects. Those with health conditions and on medications should talk to their healthcare provider before starting any ketogenic diet supplements.
- Carbone, John W., and Stefan M. Pasiakos. 2019. “Dietary Protein and Muscle Mass: Translating Science to Application and Health Benefit.” Nutrients 11 (5). https://pubmed.ncbi.nlm.nih.gov/31121843/
- Masood, Wajeed, Pavan Annamaraju, and Kalyan R. Uppaluri. 2020. “Ketogenic Diet.” In StatPearls. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499830/
- White, Andrea M., Carol S. Johnston, Pamela D. Swan, Sherrie L. Tjonn, and Barry Sears. 2007. “Blood Ketones Are Directly Related to Fatigue and Perceived Effort during Exercise in Overweight Adults Adhering to Low-Carbohydrate Diets for Weight Loss: A Pilot Study.” Journal of the American Dietetic Association 107 (10): 1792–96. https://pubmed.ncbi.nlm.nih.gov/17904939/
- Harvey, Kristin L., Lola E. Holcomb, and Stephen C. Kolwicz Jr. 2019. “Ketogenic Diets and Exercise Performance.” Nutrients 11 (10). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6835497/
- Calton, Jayson B. 2010. “Prevalence of Micronutrient Deficiency in Popular Diet Plans.” Journal of the International Society of Sports Nutrition 7 (June): 24. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2905334/
- Perticone, Maria, Raffaele Maio, Angela Sciacqua, Edoardo Suraci, Angelina Pinto, Roberta Pujia, Roberta Zito, Simona Gigliotti, Giorgio Sesti, and Francesco Perticone. 2019. “Ketogenic Diet-Induced Weight Loss Is Associated with an Increase in Vitamin D Levels in Obese Adults.” Molecules 24 (13). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6651455/
- Carbone, John W., and Stefan M. Pasiakos. 2019. “Dietary Protein and Muscle Mass: Translating Science to Application and Health Benefit.” Nutrients 11 (5). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566799/
- Westman, Eric C., William S. Yancy Jr, John C. Mavropoulos, Megan Marquart, and Jennifer R. McDuffie. 2008. “The Effect of a Low-Carbohydrate, Ketogenic Diet versus a Low-Glycemic Index Diet on Glycemic Control in Type 2 Diabetes Mellitus.” Nutrition & Metabolism 5 (December): 36. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633336/
- Liu, Yeou-Mei Christiana, and Huei-Shyong Wang. 2013. “Medium-Chain Triglyceride Ketogenic Diet, an Effective Treatment for Drug-Resistant Epilepsy and a Comparison with Other Ketogenic Diets.” Biomedical Journal 36 (1): 9–15. https://pubmed.ncbi.nlm.nih.gov/23515148/
- Eyres, Laurence, Michael F. Eyres, Alexandra Chisholm, and Rachel C. Brown. 2016. “Coconut Oil Consumption and Cardiovascular Risk Factors in Humans.” Nutrition Reviews 74 (4): 267–80. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4892314/
- Zivkovic, Angela M., Natalie Telis, J. Bruce German, and Bruce D. Hammock. 2011. “Dietary Omega-3 Fatty Acids Aid in the Modulation of Inflammation and Metabolic Health.” California Agriculture 65 (3): 106–11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4030645/
- Paoli, Antonio, Tatiana Moro, Gerardo Bosco, Antonino Bianco, Keith A. Grimaldi, Enrico Camporesi, and Devanand Mangar. 2015. “Effects of N-3 Polyunsaturated Fatty Acids (ω-3) Supplementation on Some Cardiovascular Risk Factors with a Ketogenic Mediterranean Diet.” Marine Drugs 13 (2): 996–1009. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4344614/
- Cox, Pete J., Tom Kirk, Tom Ashmore, Kristof Willerton, Rhys Evans, Alan Smith, Andrew J. Murray, et al. 2016. “Nutritional Ketosis Alters Fuel Preference and Thereby Endurance Performance in Athletes.” Cell Metabolism 24 (2): 256–68. https://pubmed.ncbi.nlm.nih.gov/27475046/
- Shrimanker, Isha, and Sandeep Bhattarai. 2020. “Electrolytes.” In StatPearls. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK541123/
- “Calcium.” 2014. April 22, 2014. https://lpi.oregonstate.edu/mic/minerals/calcium.
- Lanhers, Charlotte, Bruno Pereira, Geraldine Naughton, Marion Trousselard, François-Xavier Lesage, and Frédéric Dutheil. 2015. “Creatine Supplementation and Lower Limb Strength Performance: A Systematic Review and Meta-Analyses.” Sports Medicine 45 (9): 1285–94. https://pubmed.ncbi.nlm.nih.gov/25946994/
- Kreider, Richard B., Douglas S. Kalman, Jose Antonio, Tim N. Ziegenfuss, Robert Wildman, Rick Collins, Darren G. Candow, Susan M. Kleiner, Anthony L. Almada, and Hector L. Lopez. 2017. “International Society of Sports Nutrition Position Stand: Safety and Efficacy of Creatine Supplementation in Exercise, Sport, and Medicine.” Journal of the International Society of Sports Nutrition 14 (June): 18. https://pubmed.ncbi.nlm.nih.gov/28615996/
- Blomstrand, E., P. Hassmén, S. Ek, B. Ekblom, and E. A. Newsholme. 1997. “Influence of Ingesting a Solution of Branched-Chain Amino Acids on Perceived Exertion during Exercise.” Acta Physiologica Scandinavica 159 (1): 41–49. https://www.ncbi.nlm.nih.gov/pubmed/9124069
- Hall, G. van, J. S. Raaymakers, W. H. Saris, and A. J. Wagenmakers. 1995. “Ingestion of Branched-Chain Amino Acids and Tryptophan during Sustained Exercise in Man: Failure to Affect Performance.” The Journal of Physiology 486 ( Pt 3) (August): 789–94. https://www.ncbi.nlm.nih.gov/pubmed/7473239
- Blomstrand, E., P. Hassmén, B. Ekblom, and E. A. Newsholme. 1991. “Administration of Branched-Chain Amino Acids during Sustained Exercise--Effects on Performance and on Plasma Concentration of Some Amino Acids.” European Journal of Applied Physiology and Occupational Physiology 63 (2): 83–88. https://www.ncbi.nlm.nih.gov/pubmed/1748109
- Gualano, A. B., T. Bozza, P. Lopes De Campos, H. Roschel, A. Dos Santos Costa, M. Luiz Marquezi, F. Benatti, and A. Herbert Lancha Junior. 2011. “Branched-Chain Amino Acids Supplementation Enhances Exercise Capacity and Lipid Oxidation during Endurance Exercise after Muscle Glycogen Depletion.” The Journal of Sports Medicine and Physical Fitness 51 (1): 82–88. https://www.ncbi.nlm.nih.gov/pubmed/21297567
- Jin, Guanghua, Yosky Kataoka, Masaaki Tanaka, Hiroshi Mizuma, Satoshi Nozaki, Tsuyoshi Tahara, Kei Mizuno, Masanori Yamato, and Yasuyoshi Watanabe. 2009. “Changes in Plasma and Tissue Amino Acid Levels in an Animal Model of Complex Fatigue.” Nutrition 25 (5): 597–607. https://www.ncbi.nlm.nih.gov/pubmed/19216057
- Ament, Wim, and Gijsbertus J. Verkerke. 2009. “Exercise and Fatigue.” Sports Medicine 39 (5): 389–422. https://www.ncbi.nlm.nih.gov/pubmed/19402743
- Falavigna, Gina, Jonas Alves de Araújo Jr, Marcelo Macedo Rogero, Ivanir Santana de Oliveira Pires, Rogério Graça Pedrosa, Eivor Martins Jr, Inar Alves de Castro, and Julio Tirapegui. 2012. “Effects of Diets Supplemented with Branched-Chain Amino Acids on the Performance and Fatigue Mechanisms of Rats Submitted to Prolonged Physical Exercise.” Nutrients 4 (11): 1767–80. https://pubmed.ncbi.nlm.nih.gov/23201847/
- Lambeau, Kellen V., and Johnson W. McRorie Jr. 2017. “Fiber Supplements and Clinically Proven Health Benefits: How to Recognize and Recommend an Effective Fiber Therapy.” Journal of the American Association of Nurse Practitioners 29 (4): 216–23. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413815/
- Yang, Jing, Hai-Peng Wang, Li Zhou, and Chun-Fang Xu. 2012. “Effect of Dietary Fiber on Constipation: A Meta Analysis.” World Journal of Gastroenterology: WJG 18 (48): 7378–83. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3544045/
- “Medium Chain Triglycerides (Mcts): Uses, Side Effects, Interactions, Dosage, and Warning.” n.d. https://www.webmd.com/vitamins/ai/ingredientmono-915/medium-chain-triglycerides-mcts
- Ma, Yonggang, Merry L. Lindsey, and Ganesh V. Halade. 2012. “DHA Derivatives of Fish Oil as Dietary Supplements: A Nutrition-Based Drug Discovery Approach for Therapies to Prevent Metabolic Cardiotoxicity.” Expert Opinion on Drug Discovery 7 (8): 711–21. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3969443/
- “Beta-Hydroxybutyrate (Bhb): Uses, Side Effects, Interactions, Dosage, and Warning.” n.d. https://www.webmd.com/vitamins/ai/ingredientmono-1569/beta-hydroxybutyrate-bhb
- “Fluid and Electrolyte Balance.” 2005. Food and Nutrition, September. https://medlineplus.gov/fluidandelectrolytebalance.html
- McRorie, Johnson W., Jr. 2015. “Evidence-Based Approach to Fiber Supplements and Clinically Meaningful Health Benefits, Part 1: What to Look for and How to Recommend an Effective Fiber Therapy.” Nutrition Today 50 (2): 82–89. https://journals.lww.com/nutritiontodayonline/Fulltext/2015/03000/Evidence_Based_Approach_to_Fiber_Supplements_and.8.aspx
- “Fiber Capsules Side Effects.” n.d. https://www.drugs.com/sfx/fiber-capsules-side-effects.html
- Norman, Anthony. 2012. Vitamin D. Elsevier. https://ods.od.nih.gov/factsheets/VitaminK-HealthProfessional/
- “Drugs & Medications.” n.d. https://www.webmd.com/drugs/2/drug-20897/creatine-monohydrate-oral/details
- Kreider, Richard B., Charles Melton, Christopher J. Rasmussen, Michael Greenwood, Stacy Lancaster, Edward C. Cantler, Pervis Milnor, and Anthony L. Almada. 2003. “Long-Term Creatine Supplementation Does Not Significantly Affect Clinical Markers of Health in Athletes.” Molecular and Cellular Biochemistry 244 (1-2): 95–104. https://pubmed.ncbi.nlm.nih.gov/12701816/
- “Branched-Chain Amino Acids (Bcaas): Uses, Side Effects, Interactions, Dosage, and Warning.” n.d. https://www.webmd.com/vitamins/ai/ingredientmono-1005/branched-chain-amino-acids-bcaas