The Effects of Concurrent Training Combined with Low-Carbohydrate High-Fat Ketogenic Diet on Body Composition and Aerobic Performance: A Systematic Review and Meta-Analysis

Int J Environ Res Public Health. 2022 Sep 14;19(18):11542. doi: 10.3390/ijerph191811542.


(1) Background: Recently, studies have emerged to explore the effects of concurrent training (CT) with a low-carb, high-fat ketogenic diet (LCHF) on body composition and aerobic performance and observed its benefits. However, a large variance in the study design and observations is presented, which needs to be comprehensively assessed. We here thus completed a systematic review and meta-analysis to characterize the effects of the intervention combining CT and LCHF on body composition and aerobic capacity in people with training experience as compared to that combining CT and other dietary strategies. (2) Methods: A search strategy based on the PICOS principle was used to find literature in the databases of PubMed, Web of Science, EBSCO, Sport-discuss, and Medline. The quality and risk of bias in the studies were independently assessed by two researchers. (3) Result: Eight studies consisting of 170 participants were included in this work. The pooled results showed no significant effects of CT with LCHF on lean mass (SMD = -0.08, 95% CI -0.44 to 0.3, p = 0.69), body fat percentage (SMD = -0.29, 95% CI -0.66 to 0.08, p = 0.13), body mass (SMD = -0.21, 95% CI -0.53 to 0.11, p = 0.2), VO2max (SMD = -0.01, 95% CI -0.4 to 0.37, p = 0.95), and time (or distance) to complete the aerobic tests (SMD = -0.02, 95% CI -0.41 to 0.37, p = 0.1). Subgroup analyses also showed that the training background of participants (i.e., recreationally trained participants or professionally trained participants) and intervention duration (e.g., > or ≤six weeks) did not significantly affect the results. (4) Conclusions: This systematic review and meta-analysis provide evidence that compared to other dietary strategies, using LCHF with CT cannot induce greater benefits for lean mass, body fat percentage, body mass, VO2max, and aerobic performance in trained participants.

Keywords: aerobic performance; athletes; body composition; concurrent training; high-fat ketogenic diet; low-carb.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Composition
  • Carbohydrates
  • Diet, High-Fat
  • Diet, Ketogenic*
  • Exercise Tolerance
  • Humans


  • Carbohydrates

Grants and funding

D.B. was supported by Key Research and Development Projects of the Ministry of Science and Technology (2018YFC2000602).