Effects of ketone supplements on blood β-hydroxybutyrate, glucose and insulin: A systematic review and three-level meta-analysis

This systematic review and three-level meta-analysis pooled 327 data points from 30 randomized crossover or parallel studies with 408 participants, comparing acute exogenous ketone supplementation with placebo. Ketones increased blood beta-hydroxybutyrate (Hedges g of 1.4994, 95 percent CI 1.2648 to 1.7340), reduced glucose (Hedges g of -0.3796, 95 percent CI -0.4550 to -0.3041), and raised insulin in the non-athlete healthy population (Hedges g of 0.1214, 95 percent CI 0.0582 to 0.3011), with no significant insulin change in obesity and prediabetes. Dose-response and time-effect relationships were observed for beta-hydroxybutyrate, glucose and insulin.