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Cell Metab. 2016 Aug 9;24(2):256-68. doi: 10.1016/j.cmet.2016.07.010. Epub 2016 Jul 27.

Nutritional Ketosis Alters Fuel Preference and Thereby Endurance Performance in Athletes.

Author information

1
Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford OX1 3PT, UK; Department of Cardiovascular Medicine, University of Oxford, Oxford OX3 9DU, UK. Electronic address: petejcox456@gmail.com.
2
Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford OX1 3PT, UK.
3
Department of Biochemistry & Cambridge Systems Biology Centre, University of Cambridge & MRC Human Nutrition Research, Cambridge CB1 9NL, UK.
4
UK Sport, 40 Bernard Street, London WC1N 1ST, UK.
5
Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge CB2 3EG, UK.
6
Laboratory of Metabolic Control, NIAAA/NIH, Rockville, MD 20852, USA.
7
Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford OX1 3PT, UK; Department of Cardiovascular Medicine, University of Oxford, Oxford OX3 9DU, UK.
8
Department of Cardiovascular Medicine, University of Oxford, Oxford OX3 9DU, UK.

Abstract

Ketosis, the metabolic response to energy crisis, is a mechanism to sustain life by altering oxidative fuel selection. Often overlooked for its metabolic potential, ketosis is poorly understood outside of starvation or diabetic crisis. Thus, we studied the biochemical advantages of ketosis in humans using a ketone ester-based form of nutrition without the unwanted milieu of endogenous ketone body production by caloric or carbohydrate restriction. In five separate studies of 39 high-performance athletes, we show how this unique metabolic state improves physical endurance by altering fuel competition for oxidative respiration. Ketosis decreased muscle glycolysis and plasma lactate concentrations, while providing an alternative substrate for oxidative phosphorylation. Ketosis increased intramuscular triacylglycerol oxidation during exercise, even in the presence of normal muscle glycogen, co-ingested carbohydrate and elevated insulin. These findings may hold clues to greater human potential and a better understanding of fuel metabolism in health and disease.

Comment in

PMID:
27475046
DOI:
10.1016/j.cmet.2016.07.010
[Indexed for MEDLINE]
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