Nice short study on Keto and Ironman ultra-endurance events (Maunder E, Kilding AE, Plews DJ. Substrate Metabolism During Ironman Triathlon: Different Horses on the Same Courses. Sports Med. 2018 May 18. doi: 10.1007/s40279-018-0938-9.).
Given the finite human capacity for endogenous carbohydrate storage, minimising the endogenous carbohydrate cost associated with performing exercise at competitive intensities should be a goal of Ironman preparation. A range of strategies exist that may help to achieve this goal, including, but not limited to, adoption of a low-carbohydrate diet, exogenous carbohydrate supplementation and periodised training with low carbohydrate availability.
Given the diverse metabolic stimuli evoked by Ironman triathlons at different performance levels, it is proposed that the performance level of the Ironman triathlete is considered when adopting metabolic strategies to minimise the endogenous carbohydrate cost associated with exercise at competitive intensities. Specifically, periodised training with low carbohydrate availability combined with exogenous carbohydrate supplementation during competition might be most appropriate for elite and top-amateur Ironman triathletes who elicit very high rates of energy expenditure.
Conversely, the adoption of a low-carbohydrate or ketogenic diet might be appropriate for some lower performance amateurs (> 12 h), in whom associated high rates of fat oxidation may be almost completely sufficient to match the energy demands required.