Author:
Poff Angela M.,Kesl Shannon L.,Koutnik Andrew P.,Moss Sara E.,Rogers Christopher Q.,D’Agostino Dominic P.
Abstract
AbstractThe physiologic state of ketosis is characterized by decreased blood glucose, suppression of insulin, and an increase in the blood ketones β-hydroxybutyrate (βHB) and acetoacetate (AcAc), which serve as alternative sources of ATP in the brain. Ketones are elevated by fasting, caloric restriction, exercise, or the ketogenic diet (KD), and until recently these were the only known methods of inducing and sustaining ketosis in a nonpathologic setting. Many studies have revealed therapeutic effects of the KD, and data suggest that the benefits are mediated largely by ketone body metabolism and signaling. However, the KD often causes reduced patient compliance, which can make the KD a suboptimal long-term treatment. This has led researchers to develop exogenous ketone supplements—compounds that release or are metabolized into βHB and/or AcAc. The supplements rapidly elevate blood ketones in a dose-dependent manner, making them a practical method for inducing therapeutic ketosis. Ketone supplementation could potentially be used as stand-alone therapy in certain conditions, or possibly as a way to further augment the efficacy of the KD in the conditions in which it is being used or investigated, and it could increase compliance by allowing patients to maintain a less restrictive diet. Ketone supplements may also serve as an effective preventative medicine due to their potential to protect and enhance mitochondrial function. Preliminary evidence suggests there are several conditions for which ketone supplementation may be beneficial, including epilepsy, Alzheimer’s disease, glucose transporter type 1 deficiency syndrome, cancer, atrophy-related diseases, and metabolic syndrome.
Publisher
Oxford University PressNew York