Carbohydrate ingestion eliminates hypoglycemia and improves endurance exercise performance in triathletes adapted to very low- and high-carbohydrate isocaloric diets

This study examines the belief that very-low-carbohydrate diets (LCHF) impair prolonged exercise performance during strenuous exercise by comparing it with high-carbohydrate diets in competitive triathletes. After 6-wk diet adaptation, time-to-exhaustion (TTE) performance was similar across both diets. Minimal carbohydrate supplementation (10 g/h) during exercise eliminated exercise-induced hypoglycemia and improved TTE by 22% on both diets. These findings suggest that LCHF diets do not impair exercise performance and require a 4-wk adaptation period for metabolic homeostasis.