ReviewSports medicine (Auckland, N.Z.)2022
Exogenous Ketone Supplements in Athletic Contexts: Past, Present, and Future.
Review in Sports medicine (Auckland, N.Z.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06368297 (The Effect of Ketone Ester Supplementation and Ketogenic Diet on Brain Plasticity in Overweight/Obese Adults), which is not on this map. Cited by 41 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effect of Ketone Ester Supplementation and Ketogenic Diet on Brain Plasticity in Overweight/Obese Adults: A Neurophysiological and Resting Functional Magnetic Resonance Study (rfMRI)
Who cites it
41 citing papers in PubMed, 70 citations in OpenAlex.
- Effects of acute ketone monoester ingestion on heart rate, blood pressure and muscle sympathetic nerve activity at rest and stress in healthy adults.Physiological reports · 2025Trial
- A ketogenic-promoting beverage acutely elevates cardiac function and myocardial blood flow compared to placebo in adults: A cardiac MRI investigation.Physiological reports · 2025Trial
- Ketone monoester attenuates oxygen desaturation during weighted ruck exercise under acute hypoxic exposure but does not impact cognitive performance.Experimental physiology · 2024Trial
- Ketone monoester attenuates declines in cognitive performance and oxygen saturation during acute severe hypoxic exposure under resting conditions.Experimental physiology · 2024Trial
- Metabolic and ruck performance effects of a novel, light-weight, energy-dense ketogenic bar.Experimental physiology · 2023Trial
- Review
- Performance, cardioventilatory and perceptual responses to perceived opponent ability during head-to-head cycling competition.Experimental physiology · 2026Article
- The Ketogenic Diet in Obesity Management: Friend or Foe?Cell biochemistry and biophysics · 2026Review
- β-Hydroxybutyrate, a primary metabolite of ketogenic diets and its dual role in modulating colorectal cancer: from molecular mechanisms to therapeutic insights.Clinical and experimental medicine · 2026Review
- Review
- The science of ketogenic supplements for athletes: boosting endurance, efficiency, and energy metabolism.Nutrition & metabolism · 2025Review
- Pharmacokinetics and metabolic effects of ketone monoester supplementation: The first simultaneous CKM and CGM study under normal diet and activities.Metabolism open · 2025Article
- Ketone ester supplementation protects from experimental colitis via improved goblet cell differentiation and function.European journal of nutrition · 2025Article
- The muscle specific MEF2Dα2 isoform promotes muscle ketolysis and running capacity in mice.EMBO reports · 2025Article
- Acute and Intermittent Exogenous Ketosis to Support Recovery From Exercise and Adaptations to Exercise Training: A Narrative Review.Scandinavian journal of medicine & science in sports · 2025Review
- Providing alternative fuel for the brain in anorexia nervosa: a review of the literature on ketones and their effects on metabolism and the brain.Translational psychiatry · 2025Review
- Potential therapeutic benefit of exogenous ketone ester administration in delirium: a narrative review.Critical care (London, England) · 2025Review
- Divergent Hepatic Outcomes of Chronic Ketone Supplementation: Ketone Salts Preserve Liver Health While Ketone Esters and Precursors Drive Inflammation and Steatosis.Pharmaceuticals (Basel, Switzerland) · 2025Article
- Ketone body β-hydroxybutyrate-mediated histone β-hydroxybutyrylation upregulates lipolysis and attenuates metabolic syndrome.American journal of physiology. Cell physiology · 2025Article
- Ketone body supplementation in keto-adapted mice reveals metabolic adaptations and glycogen-independent exercise capacity.Physiological reports · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
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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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.