Evidence mapPaperPMID 42514217Full record

ReviewLife (Basel, Switzerland)2026

Ketone Supplementation in Trained and Physically Active Individuals: Effects on Athletic Performance and Metabolic Variables-A Systematic Review.

Jose Martí-Martí, Dídac Navarro-Martínez, Tamara Álvarez-Segura, Juan Bautista Miñana, Consuelo Moratal, Javier Zahonero

Abstract readReview
In one paragraph

Review in Life (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jose Martí-MartíDepartment of Physical Preparation and Conditioning, Faculty of Physical Activity and Sport Sciences, Catholic University of Valencia, 46900 Torrent, Spain.ORCID 0009-0006-9747-9645
Dídac Navarro-MartínezDepartment of Physical Preparation and Conditioning, Faculty of Physical Activity and Sport Sciences, Catholic University of Valencia, 46900 Torrent, Spain.
Tamara Álvarez-SeguraDepartment of Physical Preparation and Conditioning, Faculty of Physical Activity and Sport Sciences, Catholic University of Valencia, 46900 Torrent, Spain.
Juan Bautista MiñanaDepartment of Physical Preparation and Conditioning, Faculty of Physical Activity and Sport Sciences, Catholic University of Valencia, 46900 Torrent, Spain.
Consuelo MoratalDepartment of Physical Preparation and Conditioning, Faculty of Physical Activity and Sport Sciences, Catholic University of Valencia, 46900 Torrent, Spain.ORCID 0000-0002-4969-5427
Javier ZahoneroDepartment of Physical Preparation and Conditioning, Faculty of Physical Activity and Sport Sciences, Catholic University of Valencia, 46900 Torrent, Spain.ORCID 0009-0006-4578-9107

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Exogenous ketone supplementation has emerged as a potential ergogenic strategy for trained and physically active individuals, prompting increasing research into its effects on exercise performance and metabolism. This systematic review evaluated the effects of ketone supplementation on athletic performance, metabolic variables, and physiological responses in trained and physically active populations. Searches were conducted in EBSCOhost, PubMed, and Web of Science following PRISMA 2020 guidelines. Peer-reviewed controlled studies published between 2018 and December 2025 were included. Twenty-six studies met the eligibility criteria. Ketone supplementation consistently increased circulating β-hydroxybutyrate concentrations and modified glucose, lactate, and acid-base balance. Effects on exercise performance were heterogeneous, with some studies reporting improvements in time-trial performance and cognitive function, whereas others found no benefit or even impaired performance. Co-ingestion with sodium bicarbonate attenuated metabolic acidosis and occasionally enhanced performance outcomes. Ketone supplementation also influenced cardiorespiratory responses and fluid regulation, and may promote muscular angiogenesis during periods of training overload. Overall, current evidence remains heterogeneous and does not support definitive conclusions regarding ergogenic efficacy, which appears to depend on exercise intensity, participant characteristics, supplementation protocols, and co-ingestion strategies.

Indexed as

endurance performanceexogenous ketonesketonesmetabolismnutritional ergogenic aidssystematic reviewβ-hydroxybutyrate

Identifiers

PMID42514217
PMCPMC13412771

What Socratic holds

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Registered trials

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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.