Ketone Monoester Plus Carbohydrate Supplementation Does Not Alter Exogenous and Plasma Glucose Oxidation or Metabolic Clearance Rate During Exercise in Men Compared with Carbohydrate Alone

Howard, Emily E.; Allen, Jillian T.; Coleman, Julie L.; Small, Stephanie D.; Karl, J Philip; O’Fallon, Kevin S.; Margolis, Lee M.

doi:10.1016/j.tjnut.2023.03.002

Cited by 7 publications

(3 citation statements)

References 43 publications

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“…In addition to the inappropriateness of indirect calorimetry to assess changes in substrate utilization under conditions of nutritional ketosis (35), it was not possible to measure the uptake and oxidation of KB into skeletal muscle or other tissues such as the heart to determine the full extent of acute nutritional ketosis on exercise metabolism. The current understanding is that the contribution of KB to overall energy expenditure during exercise is less than 5% after the acute ingestion of R-BD R-βHB KME (5), and acute nutritional ketosis has somewhat minor effects on substrate utilization during exercise (4–7). Therefore, the incorporation of skeletal muscle biopsies, inclusion of additional blood markers such as insulin and FFA, and isotope tracers to isolate the contribution of the various substrates, are required if future studies are to provide additional mechanistic insights.…”

Section: Discussionmentioning

confidence: 99%

“…This provision of KB through exogenous means has been touted as a potential ergogenic aid, particularly for endurance performance, given the myriad of metabolic effects associated with acute nutritional ketosis (1). These effects, however, have failed to consistently translate into improvements in exercise performance (1), and recent studies (4–7) have challenged the initial findings of altered substrate utilization and a major contribution of KB to energy provision during exercise after acute ingestion of an exogenous ketone supplement (8).…”

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confidence: 99%

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Acute Ingestion of a Ketone Monoester without Co-ingestion of Carbohydrate Improves Running Economy in Male Endurance Runners

Brady

Egan

2023

Medicine &Amp; Science in Sports &Amp; Exercise

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Purpose Acute ingestion of a ketone monoester, with and without co-ingestion of carbohydrate, was investigated for effects on running economy (RE), time to exhaustion (TTE), and other related indices of endurance running performance. Methods Using a three condition, placebo-controlled, randomized crossover design, eleven male middle- and long- distance runners ran at five submaximal speeds (10 to 14 km.h-1) on a motorized treadmill for 8 min each, immediately followed by a ramp test to volitional exhaustion. Participants consumed either a 10% carbohydrate solution (CHO), a 10% carbohydrate solution with 750 mg.kg-1 body mass of a (R)-3-hydroxybutyl (R)-3-hydroxybutyrate ketone monoester (CHO + KE), or 750 mg.kg-1 body mass of the ketone monoester in flavored water (KE) before (2/3 of the dose) and during (1/3 of the dose) exercise. Results βHB concentration averaged 1.8 ± 0.3 mM and 2.1 ± 0.3 mM during exercise in CHO + KE and KE, respectively. RE was lower at each submaximal running speed (ES = 0.48 to 0.98) by an average of 4.1% in KE compared to CHO, but not between CHO + KE and CHO. TTE did not differ between CHO (369 ± 116 s), CHO + KE (342 ± 99 s), or KE (333 ± 106 s) (P = 0.093). Conclusions Acute ingestion of a ketone monoester without carbohydrate, but not when co-ingested with carbohydrate, improved RE in middle- and long- distance runners at a range of submaximal running speeds, and did not alter TTE in a short duration ramp test to volitional exhaustion. Further investigation is required to examine if these differences translate into positive performance outcomes over longer durations of exercise.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Acute Ingestion of a Ketone Monoester without Co-ingestion of Carbohydrate Improves Running Economy in Male Endurance Runners

Brady

Egan

2023

Medicine &Amp; Science in Sports &Amp; Exercise

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“…Irrespective of physical performance, a secondary purpose of the study was to explore the cognitive performance benefits, if any, after the ingestion of a KME + CHO compared with CHO alone. Indeed, the ingestion of exogenous ketones induces a unique metabolic state, whereas the elevation in ketone bodies appears to simply lower circulating glucose concentrations likely via reduced hepatic glycogenolysis, while leaving glucose metabolic clearance rates unaffected (36). Within a cohort of trained athletes, the adequate provision of an exogenous CHO mimics real-life nutritional strategies for enhancing performance and should theoretically meet the energetic demands of exercising muscle, even when hepatic glycogenolysis is lowered during the coingestion of a KME.…”

Section: Discussionmentioning

confidence: 99%

A Ketone Monoester with Carbohydrate Improves Cognitive Measures Postexercise, but Not Performance in Trained Females

WALDMAN,

O’NEAL,

BARKER

et al. 2023

Medicine &Amp; Science in Sports &Amp; Exercise

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Purpose Acute ingestion of a ketone monoester with co-ingestion of a carbohydrate (KME + CHO) compared to carbohydrate (CHO) was investigated on cycling performance and cognitive performance in trained females. Methods Using a two condition, placebo-controlled, double-blinded and crossover design, twelve trained females (mean ± SD: age, 23 ± 3 y; height, 1.64 ± 0.08 m; mass, 65.2 ± 12.7 kg) completed a baseline assessment of cognitive performance (psychomotor vigilance testing (PVT), task switching, and incongruent flanker), followed by 6x5-min intervals at 40%, 45%, 50%, 55%, 60%, and 65% of their maximal power output (Wmax) and then a 10-km time trial (TT), concluding with the same assessments of cognitive performance. Participants consumed either 375 mg·kg-1 body mass of KME with a 6% CHO solution (1 g·min-1 of exercise) or CHO alone, across 3 boluses (50:25:25). Results Blood β-hydroxybutyrate concentrations averaged 1.80 ± 0.07 mM and 0.13 ± 0.01 mM during exercise in KME + CHO and CHO, respectively. Blood glucose decreased following drink 1 of KME + CHO (~15%; P = 0.01) but not CHO, and lactate concentrations were lower in KME + CHO at 50%, 55%, 60%, and 65%Wmax (all P < 0.05), compared to CHO. Despite these changes, no differences were found between conditions for TT finishing times (KME + CHO, 29.7 ± 5.7 min; CHO, 29.6 ± 5.7 min; P = 0.92). However, only KME + CHO resulted in increases in PVT speed (~4%; P = 0.01), and faster reaction times (~14%; P < 0.01), speed (~15%; P < 0.01), and correct responses (~13%; P = 0.03) in the incongruent flanker during post-testing compared to CHO. Conclusions Acute ingestion of a KME + CHO elevated blood β-hydroxybutyrate and lowered glucose and lactate across multiple timepoints during exercise compared to CHO. Although these changes did not affect physical performance, several markers of cognitive performance were improved by the addition of a KME in trained females.

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No Benefit of Ingesting a Low-Dose Ketone Monoester Supplement on Markers of Cognitive Performance in Females

Waldman,

O’Neal,

Barker

et al. 2023

J Cogn Enhanc

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Ketone Monoester Plus Carbohydrate Supplementation Does Not Alter Exogenous and Plasma Glucose Oxidation or Metabolic Clearance Rate During Exercise in Men Compared with Carbohydrate Alone

Cited by 7 publications

References 43 publications

Acute Ingestion of a Ketone Monoester without Co-ingestion of Carbohydrate Improves Running Economy in Male Endurance Runners

Acute Ingestion of a Ketone Monoester without Co-ingestion of Carbohydrate Improves Running Economy in Male Endurance Runners

A Ketone Monoester with Carbohydrate Improves Cognitive Measures Postexercise, but Not Performance in Trained Females

No Benefit of Ingesting a Low-Dose Ketone Monoester Supplement on Markers of Cognitive Performance in Females

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