On the nutritional and therapeutic effects of ketone body D-β-hydroxybutyrate

This review covers D-beta-hydroxybutyrate (D-3HB), a natural ketone body, and the use of ketogenic diets, ketone salts and ketone esters to raise its serum level. It describes strict adherence to the ketogenic diet as often associated with poor compliance and ketone salts as causing gastrointestinal distress through excessive mineral intake. It presents biologically synthesized D-3HB as able to induce a faster increase in plasma D-3HB than the diet, salts or esters, and covers applications in exercise performance and in metabolic or age-related diseases. The authors state that specific dose-response relationships and safety margins remain to be elucidated.