This review covers the physicochemical properties, physiological functions, and biosafety of 3-hydroxybutyrate (3HB) in the elderly. It compares exogenous 3HB sources, including the ketogenic diet, ketone esters, 1,3-butanediol, and ketone salts, and proposes that 3HB derived from polyhydroxyalkanoates is optimal for this population. It also outlines four challenges for mechanistic and clinical research on exogenous 3HB in elderly health.
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