Ketone Bodies as an Ergogenic Aid

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You’ve probably already heard of BCAA’s, glutamine, creatine, B-alanine, carnitine and nitric oxide. The world of sports supplements is diverse, controversial and at times, confusing. Now, introducing the newest, latest and greatest supplement to hit the market- Ketones.

The Ketogenic Diet

If you’re interested in nutrition (you probably are since you’re reading this article), you’ve probably heard of the ketogenic diet. You may have even tried it yourself. The ketogenic diet and ketone bodies are intimately related (if you couldn’t already guess that from the name). The purpose of the ketogenic diet is to starve the body of carbohydrate, increasing its reliance on fat and ketone bodies as a primary fuel. There is some evidence to suggest that ketosis (the state of using ketones as a primary fuel) is beneficial to extreme endurance sporting performance. Some athletes have seen great success on the ketogenic diet, while others have suffered in the face of carbohydrate starvation. This is reflective of the highly variable nature of our metabolism and an excellent example of why we cannot recommend ‘one size fits all’ diets.

As aforementioned, the drawback of the ketogenic diet is the lack of carbohydrate. Our body requires carbohydrate for short sharp bursts of exercise. For many, an extremely low carbohydrate diet is not achievable, let alone sustainable.

Que Exogenous Ketones

What if you were told you could achieve ketosis, while consuming carbohydrates and get the best of both worlds? Seems too good to be true, and maybe it is…

The Pitch

Exogenous ketones (ketone bodies consumed through the diet) have recently boomed on the supplement market. It is claimed that by consuming ketone bodies and carbohydrates, you can achieve ketosis. This is thought to increase sporting performance through providing carbohydrate for short sharp bouts of exercise, while maintaining ketones for extreme endurance. This theory is the reason why people are buying them at $33 a pop.

Beyond the Pitch

For these prices, you would hope there is significant scientific backing for the supplement. However, the leading ketone supplier uses a grand total of six scientific articles to substantiate their claims.

Safety

One of the six pieces of evidence is an investigation into the safety of the supplement. While I was pleased to read that the supplement has in fact been deemed safe, this only leaves five articles to prove that $33 per bottle, isn’t a rip off.

What has a rat’s heart got to do with anything?

Of the remaining five studies, I was disappointed to find that only three of them were conducted in humans. Drawing conclusions about human performance from a study conducted in a rat’s heart is inappropriate at best, and deceiving at worst. The study didn’t even investigate the effect of ketone bodies on the exercise capacity of the heart. In fact, it studied the compensatory effects of ketone bodies on mitochondrial energy transduction deficiency. Unless you are a rat, with an unusual metabolism defect, I don’t see how this study is of any relevance.

The Human Trials

The type of evidence typically used demonstrate supplement efficacy collates data from hundreds of valid clinical trials involving thousands of participants in order to draw informed conclusions. The three trails presented are nowhere near sufficient in supporting the outlandish claims.

One of the studies, investigates the effects of exogenous ketones on blood ketone concentrations. It found that the blood ketone concentration of the 15 participants studied, increases after ingestion of a ketone ester drink. Hence, a valid conclusion can be drawn; a ketone drink will increase blood ketones. As will a glucose drink for blood glucose. Or a sodium drink, for blood sodium. Does this mean it improves sporting performance though? From this study, it is impossible to say. All this proves is that when we ingest ketones, they show up in our blood.

Another study, with an even smaller sample size of 8, used a gold standard method (randomised placebo-controlled double blind) to investigate the role of ketone drinks in exercise recovery. The most obvious flaw, was that the manufacturer recommends ketone bodies be ingested as part of a pre-work out. However, in this study, participants drink the supplement after an intense exercise bout, which is not reflective of manufacturer’s directions. Putting, this aside, I continued to read on. The results show ketone bodies have no effect on muscle glycogen resynthesis, contradicting claims made on the website. The researchers also found an increase in mTOR1 markers, associated with the ketone drink consumption. mTOR1 is a muscle metabolite produced with exercise. In vitro studies confirm it may have muscle synthesis signalling effects. However, this is not proven in human trails. Furthermore, it is not necessarily associated increased exercise performance, like the website claims.

I had high hopes pinned on the final human trial. I wish I could say it was the saving grace. The study involves 12 participants whom ingest the supplement after an exercise bout in order to assess its effect on muscle recovery. The results show an increase in muscle glycogen resynthesis, contradicting the previous study. Not only is it unprofessional to include two conflicting studies as part of your evidence, it is also discrediting. The research doesn’t prove that the supplement will have a beneficial effect, as suggested by the website. All it proves, is that we need more research. Much more research, before we should recommend the consumption of this expensive supplement. A possible explanation behind the apparent confliction is the small sample size. Since each person is individual, and responds to interventions in varying ways, we need large sample sizes in order to cancel out the individualists effect.

The Last one

5 out of 6 have missed the mark thus far, so let’s see what the final study is all about. It is not experimental. Rather, it is a detailed explanation of the mechanism behind ketosis but provides no evidence for its’ practical application. While it’s a clever idea and a sound physiological mechanism, the human body is complex and doesn’t always act the way we expect it to in theory.

Save Your Money

I’m not here to tell you to not buy ketones. If you are using them and you find them helpful, by all means, you do you. All I can say is that the evidence just does not stack up. In a couple of years we might have sufficient evidence to be recommending ketones (and to justify paying for them). For now, I’d save your money.

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Renae Earle

Renae Earle is a Masters of Dietetics student at the University of Queensland. Having achieved her Bachelor of Exercise and Nutrition Science with distinction, she is motivated to complete her studies and become an accredited practicing dietitian.

Renae is passionate about evidence-based practice and debunking nutrition myths. She believes that in today’s fad celebrity diet culture, it is increasingly important to deliver the facts. She aims to help people achieve a sustainable and healthful lifestyle by combating the flurry of misinformation offered by tabloids and social media.

In order to achieve this goal, Renae has dedicated herself to the field of nutrition. She is well educated on a wide range of nutrition topics such as supplementation, chronic disease, restrictive diets and metabolism.

Renae has a keen interest in offering personalised nutrition plans that suit the specific needs of her future clients.