Ketones: Big Metabolic Effects, Mixed Performance Benefits π
Evidence on active and trained individuals.
Ketone Supplementation in Trained and Physically Active Individuals: Effects on Athletic Performance and Metabolic Variables-A Systematic Review
Study Details
This new systematic review of 26 studies (380 participants) evaluated how exogenous ketone supplements affect performance, metabolism and physiological responses in trained or physically active people π
Here are the key findings β¬οΈ
Key Findings
π§ͺ Ketone supplementation consistently increased circulating Ξ²-hydroxybutyrate concentrations
π Ketones commonly reduced blood glucose and altered lactate, substrate use and acidβbase balance
π Most acute studies found no improvement in time-trial performance, time to exhaustion or maximal workload
β οΈ Some studies reported impaired performance during sustained high-intensity endurance exercise
π§ Ketone esters can induce metabolic acidosis by reducing blood pH and bicarbonate concentrations
π₯ Adding sodium bicarbonate can reduce this acidosis, but performance benefits remained inconsistent
π§ Some studies reported improvements in vigilance, reaction time or cognitive function during fatiguing exercise
π Team-sport and intermittent-exercise settings showed more promising effects than continuous endurance exercise
π Ketone salts produced smaller increases in blood ketones and generally failed to improve performance
π Repeated supplementation showed more promising effects on recovery and training adaptation than single acute doses
π©Έ Three weeks of ketone ester use during endurance overload increased muscle capillarisation and pro-angiogenic signalling
π Repeated ketone use around strenuous exercise improved sleep efficiency and helped preserve REM sleep in one study
π₯Ύ Ketones maintained alertness and increased dopamine during a 100 km trail race without improving race performance
Conclusion
Ketones may be more useful for supporting adaptation, cognition or recovery than as a reliable race-day performance aid β
Current evidence remains low certainty because studies were small and protocols varied considerably β οΈ
Overall, ketones produce clear metabolic effects, but performance benefits depend heavily on dose, formulation, exercise intensity and co-ingestion strategy π§
Reference
https://pubmed.ncbi.nlm.nih.gov/42514217/
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