Still, the aforementioned effect needs to be interpreted carefully, while it was achieved after generating acute ketosis by synergistic ingestion of ketone esters and CHO. These conditions cannot be recreated in long-term consumption of KD. However, the utility of the KD in athletes has been studied extensively in the last decade . For this reason, it is difficult to make direct comparisons between our results and results obtained by other authors. Most of the studies included only male subjects , with only a few studies including both male and female participants .