Exogenous Ketone Supplements in Athletic Contexts: Past, Present, and Future

This review covers the rationale, historical development and mechanisms of exogenous ketone supplements, including ketone salts, ketone esters, 1,3-butanediol and medium chain triglycerides, in athletic contexts. It describes how these supplements cause an acute transient increase in circulating acetoacetate and beta-hydroxybutyrate. The review states that some studies suggest benefits to endurance performance, recovery and overreaching, although many studies failed to observe benefits on performance or recovery. It also discusses methodological considerations and future directions.