The Effect of Exogenous Beta-Hydroxybutyrate Salt Supplementation on Metrics of Safety and Health in Adolescents

The ketogenic diet is a high-fat, very low-carbohydrate, moderate-protein diet that will induce a state of ketosis, but because of its restrictive nature, it may be difficult to adhere to, especially in adolescents. Supplementing with exogenous beta-hydroxybutyrate salts may induce a state of temporary ketosis without any undesirable side effects, thereby promoting the benefits of ketosis and minimizing adherence requirements to a ketogenic diet. To date, beta-hydroxybutyrate supplementation in healthy adolescents has not been explored. Therefore, the purpose of this study was to examine the safety of exogenous beta-hydroxybutyrate salt supplementation in a healthy adolescent population. In the present study, 22 healthy male and female adolescents consumed 3.75 g of beta-hydroxybutyrate salts or maltodextrin placebo twice daily for 90 days. Comprehensive blood safety analysis, bone densitometry, happiness and emotional intelligence surveys, and blood pressure were assessed at Pre, Day 45, and Day 90. There were no significant differences detected in subjects supplementing with beta-hydroxybutyrate salts, indicating that exogenous beta-hydroxybutyrate salts had no detrimental impact on fasting blood safety metrics, bone density, happiness, emotional intelligence, or blood pressure. We conclude that supplementing with exogenous beta-hydroxybutyrate salts is safe and well-tolerated by healthy adolescents.

Download Full-text

A Case of Diabetic Ketoacidosis in a Patient on an SGLT2 Inhibitor and a Ketogenic Diet: A Critical Trio Not to Be Missed

Case Reports in Endocrinology ◽

10.1155/2020/8832833 ◽

2020 ◽

Vol 2020 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Samantha Steinmetz-Wood ◽

Matthew Gilbert ◽

Katherine Menson

Keyword(s):

Diabetic Ketoacidosis ◽

Ketogenic Diet ◽

Sglt2 Inhibitor ◽

Sglt2 Inhibitors ◽

Anion Gap ◽

Low Carbohydrate ◽

History Of ◽

Ph Level ◽

Beta Hydroxybutyrate ◽

Euglycemic Diabetic Ketoacidosis

Results from major clinical trials have shown significant cardiorenal-protective benefits of SGLT2 inhibitors in patients with type 2 diabetes (T2DM), leading to increased popularity. A rare but serious side effect of SGLT2 inhibitors is euglycemic diabetic ketoacidosis (EDKA), which presents more covertly but has been described. Identification and report of modifiable risk factors would be an important step in helping clinicians appropriately counsel patients. In this case report, we present DKA in a patient on an SGLT2 inhibitor and ketogenic diet (KD). A 47-year-old male with a history of poorly controlled T2DM on metformin and empagliflozin presented to the emergency department (ED) with several days of pharyngitis, dyspnea, emesis, abdominal pain, and anorexia. Of note, one month prior to this event, he presented to the ED with malaise and was found to have an anion gap of 21, a bicarbonate level of 13 mmol/L, a pH level of 7.22, 3+ ketonuria, and a glucose level of 7 mmol/L (127 mg/dl). Additional workup was negative, and findings were attributed to his KD. His use of empagliflozin was not identified on his medication list. At second presentation, the patient was tachypneic and tachycardic and had mild abdominal tenderness. Labs revealed anion gap 28, bicarbonate 5 mmol/l, pH 6.94, 3+ ketonuria, glucose 14.9 mmol/L (269 mg/dl), and beta-hydroxybutyrate 8.9 mmol/L. The patient was diagnosed with DKA and was treated accordingly. With closure of anion gap, the patient was transitioned to insulin and metformin, and his empagliflozin was discontinued indefinitely. Before prescribing this medication class, physicians should inquire about low-carbohydrate diets given the higher risk for DKA, though knowledge of this risk is still not widespread.

Download Full-text

Low-carbohydrate ketogenic diet and the combination of orlistat with a low-fat diet lead to comparable improvements in weight and blood lipids, but LCKD more beneficial for blood pressure

Evidence-Based Medicine ◽

10.1136/ebm1065 ◽

2010 ◽

Vol 15 (3) ◽

pp. 91-92 ◽

Cited By ~ 1

Author(s):

C. D. Gardner

Keyword(s):

Blood Pressure ◽

Ketogenic Diet ◽

Blood Lipids ◽

Low Fat ◽

Low Fat Diet ◽

Low Carbohydrate

Download Full-text

Effects of ketogenic diet intervention on selected obese IIUM students during Ramadhan

Food Research ◽

10.26656/fr.2017.4(s1).s20 ◽

2020 ◽

Vol 4 (S1) ◽

pp. 164-169

Author(s):

W.A.H. Wan Ali Munawar ◽

A. Amid ◽

A. Abdullah

Keyword(s):

Blood Pressure ◽

Blood Glucose ◽

Ketogenic Diet ◽

Ketone Bodies ◽

Control Group ◽

P Value ◽

Suitable Alternative ◽

Low Carbohydrate Diet ◽

Low Carbohydrate ◽

Obese Male

Obesity and overweight are one of the main problems faced by Malaysian society due to sedentary lifestyle and high-carbohydrate consumption. A “low glycemic diet” is suggested as a suitable alternative in preventing obesity, because of its low carbohydrate intake which can be referred to as Atkins or Ketogenic diet (KD). A case study was carried out to assess the effect of KD during Ramadan on obese individuals. KD meal intervention was developed upon consultation with a dietician and tailored for Sahur (a pre-dawn meal) and Iftar (evening meal for breaking fast). A total of six participants were involved in this study which consists of 2 groups. A control group of 3 selected obese male IIUM students received no specific diet, and a study group of 3 selected obese male IIUM students underwent KD meal intervention. The KD meal intervention was carried out one week before Ramadan to allow the participants’ body to familiarize with high fat and low carbohydrate diet. Results showed that most of the selected obese participants who applied KD meal intervention exhibited satisfactory results in weight and Body Mass Index (BMI) reduction, steady levels of blood glucose, normal blood pressure levels and the presence of ketone bodies at a p-value < 0.01. However, the participants in the control group showed no significant changes at p<0.01 in weight, BMI, blood glucose levels, blood pressure and not a trace of ketone bodies. The findings of this study indicated that KD showed a positive effect on obesity control when conducted during Ramadan fasting.

Download Full-text

A Low-Carbohydrate Ketogenic Diet and Treadmill Training Enhanced Fatty Acid Oxidation Capacity but Did Not Enhance Maximal Exercise Capacity in Mice

Nutrients ◽

10.3390/nu13020611 ◽

2021 ◽

Vol 13 (2) ◽

pp. 611

Author(s):

Sihui Ma ◽

Jiao Yang ◽

Takaki Tominaga ◽

Chunhong Liu ◽

Katsuhiko Suzuki

Keyword(s):

Fatty Acid ◽

Fatty Acid Oxidation ◽

Exercise Capacity ◽

Ketogenic Diet ◽

Maximal Exercise ◽

Treadmill Running ◽

Acid Oxidation ◽

Oxidation Capacity ◽

Low Carbohydrate ◽

Maximal Exercise Capacity

The low-carbohydrate ketogenic diet (LCKD) is a dietary approach characterized by the intake of high amounts of fat, a balanced amount of protein, and low carbohydrates, which is insufficient for metabolic demands. Previous studies have shown that an LCKD alone may contribute to fatty acid oxidation capacity, along with endurance. In the present study, we combined a 10-week LCKD with an 8-week forced treadmill running program to determine whether training in conjunction with LCKD enhanced fatty acid oxidation capacity, as well as whether the maximal exercise capacity would be affected by an LCKD or training in a mice model. We found that the lipid pool and fatty acid oxidation capacity were both enhanced following the 10-week LCKD. Further, key fatty acid oxidation related genes were upregulated. In contrast, the 8-week training regimen had no effect on fatty acid and ketone body oxidation. Key genes involved in carbohydrate utilization were downregulated in the LCKD groups. However, the improved fatty acid oxidation capacity did not translate into an enhanced maximal exercise capacity. In summary, while favoring the fatty acid oxidation system, an LCKD, alone or combined with training, had no beneficial effects in our intensive exercise-evaluation model. Therefore, an LCKD may be promising to improve endurance in low- to moderate-intensity exercise, and may not be an optimal choice for those partaking in high-intensity exercise.

Download Full-text

Effects of a low-carbohydrate ketogenic diet on reported pain, blood biomarkers and quality of life in patients with chronic pain: A pilot randomised clinical trial rationale, study design and protocol.

European Journal of Integrative Medicine ◽

10.1016/j.eujim.2021.101346 ◽

2021 ◽

pp. 101346

Author(s):

Rowena Fielda ◽

Fereshteh Pourkazemi ◽

Kieron Rooney

Keyword(s):

Quality Of Life ◽

Clinical Trial ◽

Chronic Pain ◽

Ketogenic Diet ◽

Study Design ◽

Randomised Clinical Trial ◽

Blood Biomarkers ◽

Low Carbohydrate

Download Full-text

Effects of Two Months of Very Low Carbohydrate Ketogenic Diet on Body Composition, Muscle Strength, Muscle Area, and Blood Parameters in Competitive Natural Body Builders

Nutrients ◽

10.3390/nu13020374 ◽

2021 ◽

Vol 13 (2) ◽

pp. 374

Author(s):

Antonio Paoli ◽

Lorenzo Cenci ◽

PierLuigi Pompei ◽

Nese Sahin ◽

Antonino Bianco ◽

...

Keyword(s):

Body Composition ◽

Muscle Strength ◽

Ketogenic Diet ◽

Inflammatory Cytokines ◽

Blood Parameters ◽

Maximal Strength ◽

Muscle Area ◽

Low Carbohydrate ◽

Before And After ◽

Adequate Quantity

Background: Ketogenic diet (KD) is a nutritional approach that restricts daily carbohydrates, replacing most of the reduced energy with fat, while maintaining an adequate quantity of protein. Despite the widespread use of KD in weight loss in athletes, there are still many concerns about its use in sports requiring muscle mass accrual. Thus, the present study sought to investigate the influence of a KD in competitive natural body builders. Methods: Nineteen volunteers (27.4 ± 10.5 years) were randomly assigned to ketogenic diet (KD) or to a western diet (WD). Body composition, muscle strength and basal metabolic rate were measured before and after two months of intervention. Standard blood biochemistry, testosterone, IGF-1, brain-derived neurotrophic factor (BDNF) and inflammatory cytokines (IL6, IL1β, TNFα) were also measured. Results: Body fat significantly decreased in KD (p = 0.030); whilst lean mass increased significantly only in WD (p < 0.001). Maximal strength increased similarly in both groups. KD showed a significant decrease of blood triglycerides (p < 0.001), glucose (p = 0.001), insulin (p < 0.001) and inflammatory cytokines compared to WD whilst BDNF increased in both groups with significant greater changes in KD (p < 0.001). Conclusions: KD may be used during body building preparation for health and leaning purposes but with the caution that hypertrophic muscle response could be blunted.

Download Full-text