Disclosures: The Heart and Stroke Foundation of Canada funded this study. Little reports he holds shares in Metabolic Insights Inc., a for-profit company developing noninvasive metabolic monitoring devices. He is also chief scientific officer for the not-for-profit Institute for Personalized Therapeutic Nutrition.
January 11, 2021
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Premeal ketone drink improves glucose, endothelial function in obesity

Disclosures: The Heart and Stroke Foundation of Canada funded this study. Little reports he holds shares in Metabolic Insights Inc., a for-profit company developing noninvasive metabolic monitoring devices. He is also chief scientific officer for the not-for-profit Institute for Personalized Therapeutic Nutrition.
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Adults with obesity saw improvements in glycemic response and endothelial function after a 14-day intervention with a ketone monoester drink consumed before each meal, data from a small study show.

Jonathan P. Little

“Our study provides proof-of-concept that raising blood beta-hydroxybutyrate through thrice daily premeal ketone monoester supplementation may have beneficial effects to improve free-living glucose control and vascular endothelial function in adults with obesity,” Jonathan P. Little, PhD, FACSM, associate professor at the University of British Columbia School of Health and Exercise Science, Canada, told Healio. “Given that elevated postprandial glucose spikes can predict future development of type 2 diabetes and cardiovascular disease, nutritional ketosis, in general, or ketone monoester supplementation, specifically, could be a potential therapeutic strategy.”

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In a randomized, double-blind crossover study, Little and colleagues analyzed data from 14 adults with obesity (10 women; mean age, 56 years; mean BMI, 32.8 kg/m²) who consumed a ketone monoester drink containing 12 g of beta-hydroxybutyrate or taste-matched placebo, 15 minutes before every meal for 14 days. All meals were provided and matched between conditions.

Researchers measured postprandial glycemia via masked continuous glucose monitoring. Vascular function and inflammation were also assessed before and after treatment periods.

The findings were published in The Journal of Clinical Endocrinology & Metabolism.

Researchers found that postprandial glucose was 8% lower after participants consumed the ketone monoester drink compared with placebo (P = .011) and 24-hour average glucose reduced by 7.8% (P = .0001). Brachial artery flow-mediated dilation increased from a mean of 6.2% to 8.9% after consuming the ketone drink (P = .0004) with no changes observed after consuming the placebo (P = .004 for condition by time interaction).

The ketone supplement was well tolerated by participants and adherence was high, Little said.

Little noted that the study was small, conducted under free-living yet highly controlled dietary conditions.

“We provided all meals and snacks for participants and controlled eating times, so it was likely not representative of what the participants would normally eat when left to their own devices,” Little said. “Future studies certainly need to test ketone monoester supplementation over a longer period. Also, given that we saw reduced postprandial glucose spikes with premeal ketone monoester supplementation, it will be important to determine whether this strategy has similar effects in individuals with impaired glucose control, such as participants with type 2 diabetes or prediabetes.”

For more information:

Jonathan P. Little, PhD, FACSM, can be reached at Jonathan.little@ubc.ca.