Nehlig · Prostaglandins, leukotrienes, and essential fatty acids 2004 · narrative review · n=?

Brain uptake and metabolism of ketone bodies in animal models.

Cited 180 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review of animal model mechanistic studies

PubMed 14769485 · doi:10.1016/j.plefa.2003.07.006 · record verified 2026-08-29

What was done

This narrative review synthesized evidence regarding the uptake, transport, and metabolic fate of the ketone bodies beta-hydroxybutyrate and acetoacetate in developing animal brains, focusing on suckling rats as a model of physiological ketosis during lactation.

What was found

Suckling rodents exhibit higher expression and activity of monocarboxylate transporters and ketogenic enzymes than mature rats. Ketone bodies supply approximately 30% to 70% of the total energy metabolism balance in the immature rat brain and act as substrates for amino acid and lipid biosynthesis. This ketone utilization spares glucose for metabolic pathways that ketones cannot fulfill, such as the pentose phosphate pathway (yielding ribose and NADPH), and for regional glucose needs supporting the emergence of vision, audition, and integrated behaviors.

Why it matters

It outlines the metabolic division of labor between ketone bodies and glucose during early brain development, illustrating how ketones support both bioenergetics and biosynthesis while sparing glucose for specialized functional maturation.

Limits

The abstract reports on a narrative review of animal studies without systematic search criteria or primary sample sizes. Findings from suckling rodent models cannot be directly extrapolated to human infant neurodevelopment without clinical validation.

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