Utility of Ketone Supplementation to Enhance Physical Performance: A Systematic Review.
Level 1 - systematic review of randomized trials
Systematic review of randomized controlled trials
PubMed 31586177 · doi:10.1093/advances/nmz104
What was done
This systematic review examined randomized controlled trials evaluating the effects of exogenous ketone supplements (ketone esters or ketone salts/precursors) versus nutritive or non-nutritive controls on human physical performance. A search screened 161 articles and extracted data from 10 eligible trials assessing 16 performance outcomes.
What was found
Across the 10 included trials (112 participants: 109 men, 3 women) evaluating 16 outcomes (8 lower-body power, 8 endurance performance), 3 outcomes showed positive effects, 10 showed null effects, and 3 showed negative effects of ketone supplements compared to controls. High heterogeneity was observed for lower-body power (Q = 40, I2 = 83%, P < 0.01), endurance performance (Q = 95, I2 = 93%, P < 0.01), ketone esters (Q = 111, I2 = 93%, P < 0.01), and ketone salts/precursors (Q = 25, I2 = 72%, P < 0.01).
Why it matters
Exogenous ketone supplementation lacks consistent evidence of an ergogenic benefit, with the vast majority of evaluated outcomes showing null or unfavorable results.
Limits
The total sample size was small across all 10 studies (112 participants) and heavily skewed toward men (109 men, 3 women). High statistical and methodological heterogeneity across supplement formulations and performance testing protocols limited firm conclusions.
Cited by
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