To date, ketogenic high fat-low carbohydrate diets have been found to be most beneficial for endurance athletes such as long distance runners (see books and scientific articles by Jeff Volek and Stephen Phinney). There are fewer studies evaluating the benefits of MCTs. But there are reasons to be optimistic. With MCTs and exogenous KBs, the advantages of weight management, energy for sustained sports activity, and cognitive benefits would be achieved rapidly, but without the need to be on a strictly ketogenic diet and without the typical two weeks required to keto adapt to effectively using KBs as a primary energy source. It is possible one could yo-yo from high carbohydrate/low fat to low carbohydrate/high fat and still achieve the benefits of consuming MCTs and KBs. Also, with a classical ketogenic diet, one must not consume excessive amounts of protein to be in nutritional ketosis, but higher amounts of protein may be acceptable when exogenous MCT plus KBs are provided. Here are a few examples from some of my favorite sports:
In cyclists who consumed beverages with 10% glucose and 4.3% MCT, muscle glycogen was spared, lactate was reduced, and time trials were completed more rapidly, versus cyclists who consumed only glucose or only MCT (Van Zyl 1996). In another study, recreational cyclists who consumed foods containing 6 g MCT for two weeks had longer time to exhaustion at 80% peak VO2 compared to those consuming equivalent amount of longer chain fats (Nosaka et al. 2009). This indicates MCTs (and by extension, MCT plus KBs) will have a performance benefit. Ketones are not currently on WADAs prohibited substance list, but are apparently already being used by professional cyclists to improve performance (Cycling Weekly UK), and being used by Team Sky (but they will not confirm so as to keep their competitive advantage!).
Women artistic gymnasts who consumed a very low carbohydrate modified ketogenic diet for 30 days, there was no loss in athletic performance, but body weight and fat mass decreased, with a non-significant increase in muscle mass (Paoil et al. 2012). Since the majority of athletes struggle to keep their weight down living in our land of plenty, these results are encouraging, particularly for weekend warriors.
In Taekwondo karate athletes, athletes lost similar body weight and body fat on both ketogenic (high fat foods) and non-ketogenic diets, but the ketogenic diet improved measures of athletic performance (finished 2,000 m sprint in less time and felt less fatigue in the Wingate test) and reduced measures of inflammation relative to the non-ketogenic diet (Rhyu and Cho 2014). Ketone bodies are known to have anti-inflammatory properties, and this an advantage of consuming the combination of MCTs and KBs.
In murine swimmers (swimming mice), MCTs increased endurance swim capacity, relative to mice who consumed longer chain fatty acid triglycerides, whether they were trained or not; and the mechanism likely involved improved mitochondrial TCA enzymes (Fushiki et al. 1995). Let’s hope the same benefit applies to their human counterparts.
Golfing, Darts, Billiards…Since MCTs have benefits on cognition, I would expect this combination of ingredients to have benefits for activities requiring intense concentration (golfing, darts, billiards), where maintaining body weight can be a challenge (use of golf carts; beer drinking before-, during-, and after the activity).