Ketone Drinks: Do They Really Improve Sports Performance?

The stories of Asterix and his friend Obelix introduced us to a magical potion that comes in a small bottle and doesn’t taste very good, but greatly increases strength and physical fitness. Sports nutrition scientists have long sought to find or develop a compound with such characteristics.

Many supplements have been proposed, but few actually work.

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The latest supplement that gets a lot of attention is ketones. They come in small bottles and their taste is to put it bluntly awful. Due to their high price and claimed improvement gains, many have called for their ban. But do they really improve performance?

First, let’s look at what ketones are.

During exercise, and even at rest, we get the energy we need by breaking down carbohydrates and fats. While most tissues can use fat, the brain relies on glucose (a form of carbohydrate). Once the body’s carbohydrate stores are depleted, glucose begins to be produced in limited quantities from other sources, including skeletal muscle protein and the byproducts of fat breakdown. This, however, provides less than what the brain needs, which is more than 100 grams of glucose per day.

When the availability of carbohydrates decreases, the liver begins converting fat into ketone bodies, as ketones are properly called, which provide an alternative source of fuel for the brain. Ketone bodies can also be utilized in other tissues, such as muscle, and could possibly be used as fuel during exercise.

One of the popular diets these days is the so-called keto diet. The idea behind it is that if carbohydrate intake is reduced to less than 50 grams per day, the body produces ketone bodies for brain fuel while other tissues rely on fat for fuel.

While this diet may work for weight loss, many studies have shown that sports performance is impaired. This is not surprising as carbohydrates are essential to sustain high intensity exercise.

Nuts, fish, avocado, oil
The keto diet might help with weight loss, but sportsmen need carbohydrates.
Oleksandra Naumenko/Shutterstock

Ketone Supplements: The Best of Both Worlds?

Because ketone bodies can be a source of energy, just like carbohydrates and fats, scientists have become interested in supplements that would increase blood ketone body concentrations without reducing carbohydrate availability. In this way, at least in theory, athletes could benefit from the use not only of carbohydrates and fats but also of ketone bodies, the use of which could save precious carbohydrates which are stored in very limited quantities.

Many attempts have been made to develop a ketone supplement. Initially, most ketone supplements caused gastrointestinal problems and did not sufficiently increase the availability of ketone bodies.

For example, an Australian study published in 2017 of professional cyclists used a diester ketone supplement (a ketone body bound to a compound called a diester) and reported impaired time trial performance, accompanied by significant intestinal discomfort and an increase limited availability of ketone bodies.

A new ketone monoester drink (ketone body bound to a compound called a monoester) has been shown not to cause gastrointestinal discomfort and sufficiently increase blood ketone body concentrations. However, this did not lead to an improvement in performance, as a new study by researchers at McMaster University in Canada has shown. They found that the ketone supplement impaired performance of a 20-minute time trial by 2.4% compared to a placebo.

The mechanisms underlying these findings are not yet clear. The most likely explanation is that this reduction in exercise performance occurs because ketone supplements make the blood more acidic, something that has long been known to impair performance.

There is some limited evidence that combining ketones and baking soda supplements might counteract this. However, the jury is still out as not all studies show this.

Ketones on the rise

It appears that consuming ketones before or during exercise provides no benefit to exercise performance. Indeed, it can compromise it. However, there is some evidence from KU Leuven, a research university in Belgium, that taking ketone supplements during resistance exercise recovery can help reduce the symptoms (called overreaching) associated with overtraining. But there is no evidence to suggest that ketone supplementation will provide any benefit to athletes during regular training.

It appears that ketones are nowhere near as efficient as the magic potion used by Asterix, and we will continue to search for the lost village druid recipe from the Getafix series.

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