The Science of BHBs

The Science of BHBs

With the latest diet trend of keto in full swing, the popularity of keto-centric supplements has been on the rise as companies scramble to meet the demands of consumers looking for ways to supplement and support their lifestyle. One of the key areas of innovation ingredient wise is that of exogenous ketones in the form of BHB salts. While these are fantastic for supporting the ketogenic diet, in this article I also want to highlight the benefits and potential uses of BHBs for those that aren’t utilizing the ketogenic diet and their potential performance enhancement characteristics.

What are Ketones?

Before we move along further, let’s discuss exactly what ketosis is as most know about the diet, but aren’t sure of how it works. Essentially ketosis is a metabolic state that the body shifts to when the intake of dietary carbohydrates is so low that the body must rely on fatty acid oxidation and ketone metabolism. The brain requires about 400 calories per day, almost exclusively being glucose (in this case about 100g), so when there is not adequate intake of carbohydrates to supply this glucose, the body will pull stored glucose from the liver as a safeguard. When this store is depleted, the body will then begin to produce ketone bodies to be released into the blood for use by your brain and other tissues that don’t utilize fat for energy.

Ketones (also referred to as ketone bodies) are water-soluble compounds produced as a by-product substrate when the body burns fat for energy. They’re almost always present in small quantities, but when fat is being used as a primary fuel source ketone production amplifies and they are carried from the liver though the blood to vital organs including the brain, heart and additionally skeletal muscle for energy. Unbeknownst to most, there are 3 different types of ketones including beta-hydroxybutyrate (βOHB) acetoacetate (AcAc) and acetone. BHB and acetoacetate are the most abundant and responsible for providing energy throughout the body while acetone is simply exhaled via the lungs, and when it comes to supplementing exogenous ketones, they are in BHB form and that will be the focus of this article.

BHB Supplementation

             Now with this in mind, exogenous ketones (in this case BHBs) are designed to provide a source of ketones for fueling the body, which is especially helpful in fueling performance when on a ketogenic diet, but the science behind them goes beyond just for those in ketosis.

One of the key benefits of BHB ketone supplementation is that they not only fuel the brain, but also provide a source of fuel for skeletal and cardiac muscle. Most notably, BHB have been shown in research to provide lean mass preservation during periods of very low carb dieting and as well as other catabolic scenarios including surgical recovery, skeletal trauma, sepsis and severe burns1,2 Furthermore there is even data demonstrating that ketones can promote muscle protein synthesis in human subjects3. Last but not least, anticatabolic data was observed in regards to inflammation induced atrophy such as in a 2018 study where it was observed that the markers of muscle breakdown were reduced by an impressive 70%4. All these factors are part of an ongoing body of research supporting this highly valuable characteristic of BHB supplementation. There has been some research on the performance applications of exogenous ketones, however most of this date is in relation to keto esters and not keto salts, and the studies on keto salts is still ongoing.

             Another key area that ketones have shown promise and is one of the main reasons some opt for using a ketogenic diet in general is that ketones have been shown to suppress appetite (both supplemental and diet induced). This is due to the reduction of the hunger hormone ghrelin. In one particular study, ingestion of exogenous ketones was shown to reduce postprandial plasma insulin, ghrelin, GLP-1, and PYY levels significantly 2 to 4 hours after ingestion and reported desire to eat was significantly reduced for 1.5 hours after consumption5. It should be noted that in this study the ester version of exogenous ketones was used that the research for salt based exogenous ketones continues for further data.

             Finally, one of the most impressive areas that BHB supplementation may be able to help enhance cognition. This stems from multiple research studies conducted in humans, specifically on Alzheimer’s patients. In one study, it was shown that in 152 subjects diagnosed with mild to moderate Alzheimer’s when ingesting a ketogenic supplement had rapidly elevated serum ketone bodies and resulted in significant differences in ADAS-Cog scores compared to the Placebo6. In healthy subjects, the improvements are anecdotal as many report immediate boosts in mental clarity and focus, however research is still ongoing.

Exogenous Ketone Forms

             Lastly an area that we need to cover quick is the two main types of exogenous ketones that are used for supplementation: Ketone Salts and Ketone Esters. In a short summation, ketone salts are a BHB attached to a mineral (sodium, magnesium, calcium) and raise blood levels in an isoform of BHB called l-beta-hydroxybutyrate. They have a longer lasting effect regarding blood ketone levels compared to keto esters, however, are less potent in terms of blood ketone levels.

             Keto esters on the other hand are BHB attached to an alcohol molecule and raise blood levels of an isoform of BHB known as d-beta-hydroxybutyrate. It has a shorter lasting, but more potent effect on blood ketone levels compared to ketone salts but the main issue is that the taste is notoriously horrendous in this form7.

With the emergence of the keto diet popularity and the supplementation that coincides, one can imagine how many different types of products have flooded the market. However not all are created equal and some various issues that have arose is lack of purity, less than optimal potency due to mixed isomers (DL) and some production methods use formaldehyde as a component. One that I have used in formulations is KetoVantage? as it is consistent in quality with HPLC purity verified, is the active isomer D and doesn’t have the formaldehyde issue. There are other quality BHB suppliers, but speaking from an experience perspective, that is what I recommend for consistency and quality.

Conclusion

             The keto diet isn’t going anywhere any time soon, and although I’m not an advocate of keto dieting, I do like that it has brought to light the aspect of BHB supplementation. There are a lot of benefits both currently research supported as well as under ongoing research and this is an exciting front in the world of sports nutrition. Hopefully this article shed a little light on exactly what BHBs are and the potential benefits behind them.

REFERENCES

1.          Manninen A. Very-low-carbohydrate diets and preservation of muscle mass. Nutr Metab. 2006;3(9). doi:10.1186/1743-7075-3-9

2.          Thompson J. The effect of ketone bodies on nitrogen metabolism in skeletal muscle. Comp Biochem Physiol. 1991;100(2):209-216. doi:10.1016/0305-0491(91)90363-i

3.          Evans M. Metabolism of ketone bodies during exercise and training: physiological basis for exogenous supplementation. J Physiol. 2017;595(9):2857-2871. doi:10.1113/JP273185

4.          Thomsen H. Effects of 3-hydroxybutyrate and free fatty acids on muscle protein kinetics and signaling during LPS-induced inflammation in humans: anticatabolic impact of ketone bodies. Am J Clin Nutr. 2018;108(4):857-867. doi:10.1093/ajcn/nqy170

5.          Stubbs B. A Ketone Ester Drink Lowers Human Ghrelin and Appetite. Obesity. 2018;26(2):269-273. doi:10.1002/oby.22051

6.          Henderson S. Study of the Ketogenic Agent AC-1202 in Mild to Moderate Alzheimer’s Disease: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial. Nur Metab. 2009;6(31). doi:10.1186/1743-7075-6-31

7.          Harvey K. Ketogenic Diets and Exercise Performance. Nutrients. 2019;11(10):2296. doi:10.3390/nu11102296