Dose response of a novel exogenous ketone supplement on physiological, perceptual and performance parameters

Philip J Prins,Dalton W Jones,Dana L Ault,Adam D Atwell,Kylie G Aiken,Andrew P Koutnik,Emilia L England,Samuel R Henson,Gary L Welton,Tyler J Rothfuss,Christopher Q Rogers,Dominic P D’Agostino,Jeffrey D Buxton,Jantzen L Hose

doi:10.1186/s12986-020-00497-1

Abstract

BackgroundInterest into the health, disease, and performance impact of exogenous ketone bodies has rapidly expanded due to their multifaceted physiological and signaling properties but limiting our understanding is the isolated analyses of individual types and dose/dosing protocols.MethodsThirteen recreational male distance runners (24.8 ± 9.6 years, 72.5 ± 8.3 kg, VO2max 60.1 ± 5.4 ml/kg/min) participated in this randomized, double-blind, crossover design study. The first two sessions consisted of a 5-km running time trial familiarization and a VO2max test. During subsequent trials, subjects were randomly assigned to one (KS1: 22.1 g) or two (KS2: 44.2 g) doses of beta-hydroxybutyrate (βHB) and medium chain triglycerides (MCTs) or flavor matched placebo (PLA). Blood R-βHB, glucose, and lactate concentrations were measured at baseline (0-min), post-supplement (30 and 60 min), post-exercise (+ 0 min, + 15 min). Time, heart rate (HR), rating of perceived exertion (RPE), affect, respiratory exchange ratio, oxygen consumption (VO2), carbon dioxide production, and ventilation were measured during exercise. Cognitive performance was evaluated prior to and post-exercise.ResultsKS significantly increased R-βHB, with more potent and prolonged elevations in KS2, illustrating an administrative and dosing effect. R-βHB was significantly decreased in KS1 compared to KS2 illustrating a dosing and exercise interaction effect. Blood glucose elevated post-exercise but was unchanged across groups. Blood lactate significantly increased post-exercise but was augmented by KS administration. Gaseous exchange, respiration, HR, affect, RPE, and exercise performance was unaltered with KS administration. However, clear responders and none-responders were indicated. KS2 significantly augmented cognitive function in pre-exercise conditions, while exercise increased cognitive performance for KS1 and PLA to pre-exercise KS2 levels.ConclusionNovel βHB + MCT formulation had a dosing effect on R-βHB and cognitive performance, an administrative response on blood lactate, while not influencing gaseous exchange, respiration, HR, affect, RPE, and exercise performance.

Highlights

Ketones bodies are metabolic end products of lipid metabolism traditionally produced during fasting/starvation, severe caloric restriction, or low carbohydrate diets [1]
medium chain triglycerides (MCT) enter hepatic portal circulation and are rapidly metabolize to acetyl CoA resulting in subsequent hepatic ketogenesis and elevations in circulating Beta hydroxybutyrate (βHB). βHB-salts or -amino acids are synthetically derived βHB molecules which are stabilized via chemical bonds electrolytes and/or amino acid. βHB-salts and/or -amino acid directly elevated circulating levels of βHB without hepatic metabolism
The three main experimental trials consisted of a 5-km running time trial (TT) with cognitive tests before (30 min) and after (+ 5 min), and were completed in a randomized counterbalanced sequence separated by 7 days

Summary

Introduction

Ketones bodies are metabolic end products of lipid metabolism traditionally produced during fasting/starvation, severe caloric restriction, or low carbohydrate diets [1]. Available exogenous ketone bodies include medium chain triglycerides (MCT), betahydroxybutyrate (βHB)-salts and/or amino acids, and esters, all commercially available and generally recognized as safe (GRAS approved) by FDA. MCTs enter hepatic portal circulation and are rapidly metabolize to acetyl CoA resulting in subsequent hepatic ketogenesis and elevations in circulating βHB. ΒHB-salts and/or -amino acid directly elevated circulating levels of βHB without hepatic metabolism. Gastric esterases cleave βHB and/or AcAc from 1,3 butanediol backbone, directly elevating βHB and/or AcAc. The 1,3 butanediol backbone enters hepatic circulation and is subsequently catabolized via alcohol and aldehyde dehydrogenases into βHB. All exogenous ketone bodies result in subsequent elevations in circulating ketone body elevations, but with diverse kinetics, tolerance, and application impact [1, 3, 6, 7]. Disease, and performance impact of exogenous ketone bodies has rapidly expanded due to their multifaceted physiological and signaling properties but limiting our understanding is the isolated analyses of individual types and dose/dosing protocols

Methods

Results

Discussion

Conclusion