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How and when do I use it?

Acute use for exercise

  • A variety of protocols have been investigated in scientific trials with the most common involving the intake of the ketone ester before, and sometimes during, endurance exercise.
  • Total dose = ~570-750 mg/kg (40-60 g). Note that one 40 g bottle of the Ketone Ester contains 25 g of the active compound.
  • The protocols of use associated with testimonials in some sports (e.g. road cycling) are unknown.

Chronic or periodic use

  • Protocols recommended for chronic or periodic use have not yet been established.

Current evidence to support the use of ketone supplements is summarised in the table below. >

Summary of investigations of the use of ketone supplements by athletes

1. Acute performance enhancement

  • Provision of an additional substrate for the muscle which may offer additional advantages of enhanced economy (less oxygen required to produce ATP)
  • Provision of an additional substrate for the brain and central nervous system which may enhance cognitive function

Direct performance enhancement has been tested in ~20 studies (including published, in press and in review literature)

Meta-analyses

2,4,7,8

fail to show benefits to sports performance. Ketone Ester appears to be the supplement form most likely to have a benefit

Note that the two studies which have found acute performance benefits included the following protocols:

  • The use of a KE supplement9,10
  • Co-ingestion with carbohydrate in overnight fasted subjects9
  • Co-ingestion with bicarbonate to address the change in blood pH associated with ketone body ingestion.10 However, a further study from the same group failed to replicate these findings, and reported a performance impairment11
  • There are a large range of protocols of use (doses, timing of intake and accompaniment with carbohydrate or bicarbonate) and protocols of exercise. It is difficult to compare the findings due to the range of variables

2. Post-exercise recovery

  • Recovery/resilience to over-training when used chronically
  • Acute enhancement of protein synthesis
  • Acute enhancement of glycogen restoration
  • Satiety/Appetite suppression for weight control

The effect of post-exercise ketone supplements on glycogen synthesis and protein metabolism requires further investigation. There are testimonials that athletes use ketone supplements during post-exercise recovery to suppress appetite and assist with body composition manipulation. However, the study which reported benefits of chronic use of ketone supplements in post-exercise recovery, via an apparent blunting of over-reaching, also found that the cyclists reported an increase in energy intake with the use of the ketone supplement

3. Health and training adaptation

A large range of claims are made for general health benefits of high circulating levels of ketone bodies (e.g. reduced inflammation, enhanced metabolic adaptation), especially associated with the chronic adherence to ketogenic LCHF diet. Whether these benefits are real, and whether strategic periodic/chronic use of ketone supplements can achieve health benefits or superior metabolic is unknown.

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