Acute nutritional ketosis: implications for exercise performance and metabolism

Cox, Pete J.; Clarke, Kieran

doi:10.1186/2046-7648-3-17

Cited by 75 publications

(80 citation statements)

References 113 publications

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“…However, some important differences between exogenous βHB administration (as βHB salts) and endogenous production (such as in fasting, ketogenic diets) are expected [16]. The strategy of oral supplementation of βHB salts provides the entry of this substrate without the need to synthesize it endogenously dispensing with the several steps of its production which include an increased glucagon/insulin ratio, lipolysis, transport of lipids to the liver and beta-oxidation.…”

Section: Discussionmentioning

confidence: 99%

Oral β-hydroxybutyrate increases ketonemia, decreases visceral adipocyte volume and improves serum lipid profile in Wistar rats

et al. 2017

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BackgroundKetosis can be induced in humans and in animals by fasting or dietary interventions, such as ketogenic diets. However, the increasing interest on the ketogenic state has motivated the development of alternative approaches to rapidly increase ketonemia using less drastic interventions. Here, it was tested whether oral intake of a β-hydroxybutyrate (βHB) mineral salt mixture could increase ketonemia in Wistar rats without any other dietary changes, thereby being a useful model to study ketones effects alone on metabolism.MethodsβHB salts were orally administered to provoke elevation in the ketonemia. Effects of this intervention were tested acutely (by gavage) and chronically (4 weeks in drinking water). Acutely, a concomitant glucose overload was used to suppress endogenous ketogenesis and verify whether βHB salts were really absorbed or not. Long-term administration allowed to weekly evaluate the impact on ketonemia, blood glucose and, after 4 weeks, on body weight, visceral fat mass, lipid blood profile, serum lipolysis products and adiponectinemia.ResultsβHB salts increased ketonemia in acute and long-term administrations, improved blood lipid profile by raising HDL-cholesterol concentration and decreasing LDL/HDL ratio, while reduced visceral adipocyte volume. Mean ketonemia correlated positively with HDLc and negatively with adipocyte volume and serum lipolysis products.ConclusionsOral βHB can rapidly increase ketonemia and, therefore, be used as an acute and long-term animal model of ketosis. Long-term treatment points to important beneficial effects of ketone bodies in serum lipid concentrations and visceral fat mass. These results may help to explain the metabolic adaptations following ketogenic diets, such as a better body fat control and a serum lipid profile improvement.

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Section: Discussionmentioning

confidence: 99%

Oral β-hydroxybutyrate increases ketonemia, decreases visceral adipocyte volume and improves serum lipid profile in Wistar rats

et al. 2017

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“…Potential therapeutic uses for nutritional ketosis that have been suggested include the management of cancer, acne, polycystic ovarian syndrome and neurological diseases, including Alzheimer's disease 97. More recent evidence suggest that ketones including those ingested orally during exercise may produce beneficial metabolic effects100 and enhance athletic performance 101…”

Section: Addressing Common Misconceptionsmentioning

confidence: 99%

Evidence that supports the prescription of low-carbohydrate high-fat diets: a narrative review

2017

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Low-carbohydrate high-fat (LCHF) diets are a highly contentious current topic in nutrition. This narrative review aims to provide clinicians with a broad overview of the effects of LCHF diets on body weight, glycaemic control and cardiovascular risk factors while addressing some common concerns and misconceptions. Blood total cholesterol and LDL-cholesterol concentrations show a variable, highly individual response to LCHF diets, and should be monitored in patients adhering to this diet. In contrast, available evidence from clinical and preclinical studies indicates that LCHF diets consistently improve all other markers of cardiovascular risk—lowering elevated blood glucose, insulin, triglyceride, ApoB and saturated fat (especially palmitoleic acid) concentrations, reducing small dense LDL particle numbers, glycated haemoglobin (HbA1c) levels, blood pressure and body weight while increasing low HDL-cholesterol concentrations and reversing non-alcoholic fatty liver disease (NAFLD). This particular combination of favourable modifications to all these risk factors is a benefit unique to LCHF diets. These effects are likely due in part to reduced hunger and decreased ad libitum calorie intake common to low-carbohydrate diets, allied to a reduction in hyperinsulinaemia, and reversal of NAFLD. Although LCHF diets may not be suitable for everyone, available evidence shows this eating plan to be a safe and efficacious dietary option to be considered. LCHF diets may also be particularly beneficial in patients with atherogenic dyslipidaemia, insulin resistance, and the frequently associated NAFLD.

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“…Combustion of the end‐glycolytic substrate, pyruvate, produces 10 ATP, whereas combustion of the ketone body, D‐β‐hydroxybutyrate, produces 13 ATP (4), which thereby increases the efficiency of hydraulic work in the working, perfused rat heart by ∼30% compared with oxidation of pyruvate (5). Ketones, as the most energy‐efficient fuel, may therefore be beneficial for muscle and brain in times of stress, such as during endurance exercise (6).…”

mentioning

confidence: 99%

“…The challenge, therefore, has been to elevate circulating ketone levels by using a palatable diet without altering lipid levels and thereby negating many of the desirable effects of ketone metabolism (6). Consequently, we made an orally absorbable form of ketone body by transesterifying ethyl ( R )‐3‐hydroxybutyrate with ( R )‐1, 3‐butanediol by using a solid‐supported lipase.…”

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confidence: 99%

Novel ketone diet enhances physical and cognitive performance

Murray¹,

et al. 2016

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Ketone bodies are the most energy-efficient fuel and yield more ATP per mole of substrate than pyruvate and increase the free energy released from ATP hydrolysis. Elevation of circulating ketones via high-fat, low-carbohydrate diets has been used for the treatment of drug-refractory epilepsy and for neurodegenerative diseases, such as Parkinson’s disease. Ketones may also be beneficial for muscle and brain in times of stress, such as endurance exercise. The challenge has been to raise circulating ketone levels by using a palatable diet without altering lipid levels. We found that blood ketone levels can be increased and cholesterol and triglycerides decreased by feeding rats a novel ketone ester diet: chow that is supplemented with (R)-3-hydroxybutyl (R)-3-hydroxybutyrate as 30% of calories. For 5 d, rats on the ketone diet ran 32% further on a treadmill than did control rats that ate an isocaloric diet that was supplemented with either corn starch or palm oil (P < 0.05). Ketone-fed rats completed an 8-arm radial maze test 38% faster than did those on the other diets, making more correct decisions before making a mistake (P < 0.05). Isolated, perfused hearts from rats that were fed the ketone diet had greater free energy available from ATP hydrolysis during increased work than did hearts from rats on the other diets as shown by using [31P]-NMR spectroscopy. The novel ketone diet, therefore, improved physical performance and cognitive function in rats, and its energy-sparing properties suggest that it may help to treat a range of human conditions with metabolic abnormalities.—Murray, A. J., Knight, N. S., Cole, M. A., Cochlin, L. E., Carter, E., Tchabanenko, K., Pichulik, T., Gulston, M. K., Atherton, H. J., Schroeder, M. A., Deacon, R. M. J., Kashiwaya, Y., King, M. T., Pawlosky, R., Rawlins, J. N. P., Tyler, D. J., Griffin, J. L., Robertson, J., Veech, R. L., Clarke, K. Novel ketone diet enhances physical and cognitive performance.

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Acute nutritional ketosis: implications for exercise performance and metabolism

Cited by 75 publications

References 113 publications

Oral β-hydroxybutyrate increases ketonemia, decreases visceral adipocyte volume and improves serum lipid profile in Wistar rats

Oral β-hydroxybutyrate increases ketonemia, decreases visceral adipocyte volume and improves serum lipid profile in Wistar rats

Evidence that supports the prescription of low-carbohydrate high-fat diets: a narrative review

Novel ketone diet enhances physical and cognitive performance

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