Reply from Chiel Poffé, Monique Ramaekers and Peter Hespel

Poffé, Chiel; Ramaekers, Monique; Hespel, Peter

doi:10.1113/jp278884

Cited by 1 publication

(1 citation statement)

References 9 publications

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“…Together, these results suggested that daily consumption of R-BD R-βHB KME blunted the symptoms of overreaching in this cohort. While this study was well performed and clearly an enormous undertaking for participants and researchers, these finding have been the subject of much discourse [259][260][261][262][263][264][265][266]. In particular, a focus has been on the dietary control around the performance tests, and important between-group differences that arose in the dietary intake data.…”

Section: Effects Of Ingestion Of the R-bd R-βhb Ketone Monoester On R...mentioning

confidence: 94%

Exogenous Ketone Supplements in Athletic Contexts: Past, Present, and Future

Evans

McClure²,

Koutnik³

et al. 2022

Sports Med

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The ketone bodies acetoacetate (AcAc) and β-hydroxybutyrate (βHB) have pleiotropic effects in multiple organs including brain, heart, and skeletal muscle by serving as an alternative substrate for energy provision, and by modulating inflammation, oxidative stress, catabolic processes, and gene expression. Of particular relevance to athletes are the metabolic actions of ketone bodies to alter substrate utilisation through attenuating glucose utilisation in peripheral tissues, anti-lipolytic effects on adipose tissue, and attenuation of proteolysis in skeletal muscle. There has been long-standing interest in the development of ingestible forms of ketone bodies that has recently resulted in the commercial availability of exogenous ketone supplements (EKS). These supplements in the form of ketone salts and ketone esters, in addition to ketogenic compounds such as 1,3-butanediol and medium chain triglycerides, facilitate an acute transient increase in circulating AcAc and βHB concentrations, which has been termed ‘acute nutritional ketosis’ or ‘intermittent exogenous ketosis’. Some studies have suggested beneficial effects of EKS to endurance performance, recovery, and overreaching, although many studies have failed to observe benefits of acute nutritional ketosis on performance or recovery. The present review explores the rationale and historical development of EKS, the mechanistic basis for their proposed effects, both positive and negative, and evidence to date for their effects on exercise performance and recovery outcomes before concluding with a discussion of methodological considerations and future directions in this field.

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