Coleman · Aerospace medicine and human performance 2021 · placebo-controlled crossover pilot trial · n=11

A Metabolic Intervention for Improving Human Cognitive Performance During Hypoxia.

Cited 20 times in the scientific literature.

Level 2 - randomized trial

Small placebo-controlled crossover trial

PubMed 34503629 · doi:10.3357/AMHP.5767.2021 · record verified 2026-08-29

What was done

Eleven participants completed a cognitive performance test battery under both normoxic and hypoxic conditions (minimum oxygen saturation ranged between 63% and 88%) after consuming either an exogenous ketone ester (KE) drink or a placebo control drink in a pilot study.

What was found

Hypoxia alone significantly lengthened blink duration (partial eta squared [Ph2] = 0.665), decreased blink rate (Ph2 = 0.626), and disrupted performance on a code substitution task (Ph2 = 0.487). Ketone ester consumption exerted significant counteracting effects during testing on blink duration (Ph2 = 0.270) and code substitution performance (Ph2 = 0.309).

Why it matters

Supplying an alternative metabolic brain substrate via oral ketone esters may help preserve select cognitive and neurophysiological functions during acute hypoxic exposures encountered in aviation or extreme environments.

Limits

The study was a very small pilot trial (n=11). The abstract does not specify randomization procedures, blinding details, sex distribution, or full cognitive battery metrics beyond blink parameters and code substitution.

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