Please use this identifier to cite or link to this item: http://localhost:8080/xmlui/handle/123456789/5208
Title: Effects of Exogenous Ketone Supplementation on Blood Glucose: A Systematic Review and Meta-analysis
Authors: Falkenhain, Kaja
Daraei, Ali
C Forbes, Scott
P Little, Jonathan
Keywords: β-hydroxybutyrate,
blood glucose,
exercise,
glycemia,
heart failure,
ketosis,
meta-analysis,
prediabetes,
systematic review,
type 2 diabetes
Issue Date: 2022
Publisher: Oxford University Press on behalf of the American Society for Nutrition 2022
Abstract: Recently developed ketone (monoester or salt) supplements acutely elevate blood β-hydroxybutyrate (BHB) exogenously without prolonged periods of fasting or carbohydrate restriction. Previous (small-scale) studies have found a blood glucose-lowering effect of exogenous ketones. This study aimed to systematically review available evidence and conduct meta-analyses of studies reporting on exogenous ketones and blood glucose. We searched 6 electronic databases on 13 December 2021 for randomized and nonrandomized trials of any length that reported on the use of exogenous ketones. We calculated raw mean differences (MDs) in blood BHB and glucose in 2 main analyses: 1) after compared with before acute ingestion of exogenous ketones and 2) following acute ingestion of exogenous ketones compared with a comparator supplement. We pooled effect sizes using random-effects models and performed prespecified subgroup analyses to examine the effect of potential explanatory factors, including study population, exercise, blood BHB, and supplement type, dosing, and timing. Risk of bias was examined using Cochrane’s risk-of-bias tools. Studies that could not be meta-analyzed were summarized narratively. Forty-three trials including 586 participants are summarized in this review. Following ingestion, exogenous ketones increased blood BHB (MD = 1.73 mM; 95% CI: 1.26, 2.21 mM; P < 0.001) and decreased mean blood glucose (MD = –0.54 mM; 95% CI: –0.68, –0.40 mM; P < 0.001). Similarly, when compared with placebo, blood BHB increased (MD = 1.98 mM; 95% CI: 1.52, 2.45 mM; P < 0.001) and blood glucose decreased (MD = –0.47 mM; 95% CI: –0.57, –0.36 mM; P < 0.001). Across both analyses, significantly greater effects were seen with ketone monoesters compared with salts (P < 0.001). The available evidence indicates that acute ingestion of exogenous ketones leads to increased blood BHB and decreased blood glucose. Limited evidence on prolonged ketone supplementation was found
URI: http://localhost:8080/xmlui/handle/123456789/5208
Appears in Collections:VOL 13 NO 5 2022

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