Defining ketone supplementation: the evolving evidence for postexercise ketone supplementation to improve recovery and adaptation to exercise

This review covers the evidence for postexercise ketone supplementation on exercise recovery and training adaptation. It states that studies of ketones taken before or during exercise generally observed no performance improvement, whereas more studies report beneficial effects when ketones are ingested after exercise. Reported effects of postexercise ketone supplementation include blunted overtraining symptoms and improved sleep, muscle anabolic signaling, circulating erythropoietin levels and skeletal muscle angiogenesis. The review also covers proposed mechanisms, including epigenetic effects, receptor signaling, neurotransmitter modulation, energy metabolism, and oxidative and anti-inflammatory pathways.