![]() Given the high ratio of calories as dietary fat (up to 90% daily energy), one common concern with the use of ketogenic diets is its propensity to causing dyslipidaemia – a major cardiovascular risk factor. In particular, ketone monoester drink containing D-β-hydroxybutyrate-R-1.3-butanediol (KEβHB) was shown to elevate the circulating levels of βHB to as high as 5 mmol/L within 30 min of ingestion in healthy individuals as well as those with metabolic disorders. Exogenous ketones, in the form of either ketone monoester or ketone salts, have recently been designed as a possible alternative to ketogenic diets. Further, the long-term adherence to ketogenic diets is typically limited due to their poor palatability and restrictive nature. However, these are often associated with metabolic acidosis and gastrointestinal symptoms. Until recently, nutritional ketosis has only been achieved by strict compliance with high-fat low-carbohydrate diets (i.e., ketogenic diets). Mild nutritional ketosis is beneficial in terms of aiding weight loss, reducing seizure events in recalcitrant epilepsy, and improving blood glucose control. Ketone bodies, in the form of β-hydroxybutyrate (βHB), acetoacetate, and acetone, are produced in the liver from fatty acids (released from adipose tissue) as an alternative energy source to glucose in response to fasting or carbohydrate restriction – a process called ‘endogenous ketosis’. This paves the way for investigating whether exogenous ketone supplementation reduces cardiovascular disease risk (via its actions on triglyceride-rich lipoproteins) in at-risk populations. Moreover, it led to significantly reduced circulating levels of remnant cholesterol and triglycerides. ConclusionĪcute ketosis had no untoward effect on plasma lipid profile. ![]() The changes in remnant cholesterol and triglycerides were statistically significant in individuals with high, but not low, habitual saturated fat intake. No statistically significant differences in the AUCs for total cholesterol, HDL cholesterol, LDL cholesterol, and the triglycerides to HDL cholesterol ratio were found. ![]() Acute ketosis resulted in significantly lower AUCs for remnant cholesterol (p = 0.022) and triglycerides (p = 0.022). Significant elevation of blood β-hydroxybutyrate from 0.2 mmol/L to 3.5 mmol/L (p < 0.001) was achieved within 30 min. Habitual saturated fat intake was ascertained using the EPIC-Norfolk food frequency questionnaire. The area under the curve (AUC) over 150 min was calculated for each outcome following ingestion of the drinks. Outcome variables included changes in total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, remnant cholesterol, triglycerides, and the triglycerides to HDL cholesterol ratio. Blood samples were collected every 30 min, from baseline to 150 min. Following an overnight fast, 18 adults (six women and 12 men) with prediabetes (diagnosed based on the American Diabetes Association criteria) ingested a single dose of KEβHB drink or placebo drink. This study was a randomized controlled trial with cross-over design. The secondary aim was to investigate the role of saturated fat intake in that effect. The primary aim was to study the effect of KEβHB on plasma lipid profile in individuals with prediabetes. Although evidence suggests that KEβHB can offer several therapeutic benefits, whether KEβHB affects lipid profile is still unknown. ![]() Ketone monoester β-hydroxybutyrate (KEβHB) ingestion has emerged as an effective method of inducing acute ketosis. ![]()
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