This systematic review followed PRISMA guidelines, searched MEDLINE and Scopus, and analyzed 51 studies of exogenous ketosis in adults with disease: 22 neurological, 1 psychiatric, 22 metabolic, 5 cardiovascular and 1 inflammatory. Potential benefits were reported across conditions including Alzheimer's disease, mild cognitive impairment, McArdle's disease, various forms of heart failure, cardiogenic shock, pulmonary hypertension and COVID-19-related acute respiratory distress syndrome. The authors state that evidence is mostly limited to surrogate endpoints, and that subtherapeutic ketone concentrations from medium-chain triglycerides and short follow-up often precluded firm conclusions.
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