4.5 Article

Prior ingestion of a ketone monoester supplement reduces postprandial glycemic responses in young healthy-weight individuals

Journal

APPLIED PHYSIOLOGY NUTRITION AND METABOLISM
Volume 46, Issue 4, Pages 309-317

Publisher

CANADIAN SCIENCE PUBLISHING
DOI: 10.1139/apnm-2020-0644

Keywords

beta-hydroxybutyrate; postprandial glycemia; glycemic control; ketone supplement; insulin resistance; carbohydrate metabolism; exogenous ketones

Funding

  1. Canadian Institutes of Health Research (CIHR) New Investigator Salary Award [MSH-141980]
  2. Michael Smith Foundation for Health Research (MSFHR) Scholar Award [16890]
  3. Natural Sciences and Engineering Research Council (NSERC) [RGPIN-2019-05204]

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The study showed that acute ketone monoester supplementation taken 15 minutes before a mixed meal can lower postprandial glucose and NEFA levels without significantly impacting postprandial insulin release or gastric emptying. The glucose- and NEFA-lowering effects of ketone monoester supplementation do not appear to be mediated by changes in insulin release or gastric emptying. Further research is needed to explore the potential benefits of KME supplementation for individuals with impaired glycemic control.
The main objective of this study was to determine whether acute ingestion of a ketone monoester (KME) supplement impacted mixed-meal tolerance test (MMTT) glucose area under the curve (AUC). Nineteen healthy young volunteers (10 males/9 females; age, 24.7 +/- 4.9 years; body mass index, 22.7 +/- 2.4 kg/m(2)) participated in a double-blind, placebo-controlled crossover study. Following overnight fasting (>= 10 h), participants consumed 0.45 mL/kg of a KME supplement or taste-matched placebo followed by an MMTT 15 min later. Blood samples were collected every 15-30 min over 2.5 h. KME supplementation acutely raised beta-hydroxybutyrate AUC (590%, P < 0.0001, d = 2.4) and resulted in decreases in blood glucose AUC (-9.4%, P = 0.03, d = 0.56) and nonesterified fatty acid (NEFA) AUC (-27.3%, P = 0.023, d = 0.68) compared with placebo. No differences were found for plasma insulin AUC (P = 0.70) or gastric emptying estimated by co-ingested acetaminophen AUC (P = 0.96) between ketone and placebo. Overall, results indicate that KME supplementation attenuates postprandial glycemic and NEFA responses when taken 15 min prior to a mixed meal in young healthy individuals. Future studies are warranted to investigate whether KME supplementation may benefit individuals with impaired glycemic control. Novelty: Acute ketone monoester supplementation 15 min prior to a mixed meal decreased postprandial glucose and NEFA levels without significantly impacting postprandial insulin or estimates of gastric emptying. Glucose- and NEFA-lowering effects of ketone monoester supplementation are apparently not mediated by changes in insulin release or gastric emptying.

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