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Emma Brooks, Gilles Lamothe, Taniya S. Nagpal, Pascal Imbeault, Kristi Adamo, Jameel Kara, and Éric Doucet

) diet ( Cox & Clarke, 2014 ; Robinson & Williamson, 1980 ). Under all of these circumstances, KBs become a pertinent energy source while glucose is restricted or depleted. Ketosis, or hyperketonaemia, is defined as plasma ketone concentrations that exceed 0.2 mM, according to Robinson and Williamson

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David M. Shaw, Fabrice Merien, Andrea Braakhuis, Daniel Plews, Paul Laursen, and Deborah K. Dulson

. , Ashmore , T. , Willerton , K. , Evans , R. , Smith , A. , . . . Clarke , K. ( 2016 ). Nutritional ketosis alters fuel preference and thereby endurance performance in athletes . Cell Metabolism, 24 ( 2 ), 256 – 268 . PubMed ID: 27475046 doi:10.1016/j.cmet.2016.07.010 10.1016/j.cmet.2016

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Manuel D. Quinones and Peter W.R. Lemon

endurance exercise performance because the resulting upregulated fat mobilization triggers a substantial increased accumulation of circulating ketone bodies. This is called nutritional ketosis ( Evans et al., 2017 ) and is characterized typically by a plasma ketone concentration of approximately 0.5–3.0 mM

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Pedro L. Valenzuela, Javier S. Morales, Adrián Castillo-García, and Alejandro Lucia

gastrointestinal symptoms might not necessarily contribute to the lack of significant ergogenic effects of ketone supplements. The type and dose of ketone supplements might also influence their effects on performance and on the physiological responses to exercise, with a minimal ketosis state being potentially

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Ed Maunder, Deborah K. Dulson, and David M. Shaw

. Ryan KK , Packard AEB , Larson KR , et al . Dietary manipulations that induce ketosis activate the HPA axis in male rats and mice: a potential role for fibroblast growth factor-21 . Endocrinology . 2018 ; 159 ( 1 ): 400 – 413 . PubMed ID: 29077838 doi:10.1210/en.2017-00486 29077838 10

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Ulrika Andersson-Hall, Stefan Pettersson, Fredrik Edin, Anders Pedersen, Daniel Malmodin, and Klavs Madsen

protein after the first session did not significantly affect this increase in fat oxidation, whereas maltodextrin intake somewhat attenuated the increase in fat oxidation during the second bout. Both PRO and CHO intake increased blood insulin levels and attenuated the postexercise ketosis seen after

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Grant M. Tinsley and Darryn S. Willoughby

Low-carbohydrate and very-low-carbohydrate diets are often used as weight-loss strategies by exercising individuals and athletes. Very-low-carbohydrate diets can lead to a state of ketosis, in which the concentration of blood ketones (acetoacetate, 3-β-hydroxybutyrate, and acetone) increases as a result of increased fatty acid breakdown and activity of ketogenic enzymes. A potential concern of these ketogenic diets, as with other weight-loss diets, is the potential loss of fat-free mass (e.g., skeletal muscle). On examination of the literature, the majority of studies report decreases in fat-free mass in individuals following a ketogenic diet. However, some confounding factors exist, such as the use of aggressive weight-loss diets and potential concerns with fat-free mass measurement. A limited number of studies have examined combining resistance training with ketogenic diets, and further research is needed to determine whether resistance training can effectively slow or stop the loss of fat-free mass typically seen in individuals following a ketogenic diet. Mechanisms underlying the effects of a ketogenic diet on fat-free mass and the results of implementing exercise interventions in combination with this diet should also be examined.

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Hunter S. Waldman, Brandon D. Shepherd, Brendan Egan, and Matthew J. McAllister

ester forms, it is specifically the (R)-3-hydroxybutyl (R)-3-hydroxybutyrate ketone monoester (KME) that produces dramatically higher plasma D -β-OHB concentrations (1.0–6.0 mM; Cox et al., 2016 ; Evans & Egan, 2018 ; Holdsworth et al., 2017 ). Inducing a state of nutritional ketosis (plasma D -β

Open access

Brianna J. Stubbs, Pete J. Cox, Tom Kirk, Rhys D. Evans, and Kieran Clarke

ketone drinks has grown ( Egan & D’Agostino, 2016 ). These drinks rapidly increase blood ketone concentrations to achieve ketosis (blood d -βHB >0.5 mM) without dietary modification ( Stubbs et al., 2017 ). Two classes of exogenous ketone compounds exist: ketone esters and ketone salts (KS). Ketone

Open access

Oliver J. Peacock, Javier T. Gonzalez, Simon P. Roberts, Alan Smith, Scott Drawer, and Keith A. Stokes

and both made an estimated 16  kJ/kg body mass (BM) available for metabolism (total energy intake 1,528 ± 145 kJ). The ketone monoester was provided at a total dose of 590 mg/kg BM based on pilot data showing that this dosing level induces a sustained moderate ketosis (blood BHB of ∼2–3 mmol/L) that