Dear Editor-In-Cheif

A short-term intervention combining aerobic exercise with medium-chain triglycerides (MCT) is more ketogenic than either MCT or aerobic exercise alone: a comparison of normoglycemic and prediabetic older women

“…The aim of this study was to determine whether a short, moderateintensity AE program combined with an MCT supplement would increase plasma ketones in older women more than either intervention alone. Our results confirm previous reports that, separately, MCT supplementation (Henderson 2008;Courchesne-Loyer et al 2013) or moderate AE (Balasse et al 1978;Koeslag et al 1980;Koeslag 1982;Féry and Balasse 1983, 1986 increases plasma ketones in older NG women (Fig. 2).…”

“…4) would diminish lipid oxidation (Kelley and Mandarino 2000). In fact, the entry of FFA into skeletal muscle requires carnitine before the FFA are ␤-oxidized and converted to ketones in mitochondria (Koeslag 1982). Muscle free carnitine availability is reduced during conditions of high glycolytic flux such as elevated carbohydrate availability, thus inhibiting long-chain fatty acid oxidation via the transporter carnitine palmitoyltransferase I (Stephens 2018).…”

“…However, conditions of insulin resistance and high blood insulin may impact negatively on the availability and/or uptake of both of the brain's main fuels. Aerobic exercise (AE) mildly increases plasma ketones endogenously via the mobilization of free fatty acids (FFA) from the adipose tissue in healthy adults (Koeslag et al 1980;Koeslag 1982;Féry and Balasse 1983, 1986. AE also increases brain ketone uptake in AD .…”