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In this acute intervention study, we investigated the potential benefit of ketone supplementation in humans by studying cardiac phosphocreatine to adenosine-triphosphate ratios (PCr/ATP) and skeletal muscle PCr recovery using phosphorus magnetic resonance spectroscopy ( 31 P-MRS) before and after ingestion of a ketone ester drink. We recruited 28 healthy individuals: 12 aged 23–70 years for cardiac  31 P-MRS, and 16 aged 60–75 years for skeletal muscle  31 P-MRS. Baseline and post-intervention resting cardiac and dynamic skeletal muscle  31 P-MRS scans were performed in one visit, where 25 g of the ketone monoester, deltaG ® , was administered after the baseline scan. Administration was timed so that post-intervention  31 P-MRS would take place 30 min after deltaG ®  ingestion. The deltaG ®  ketone drink was well-tolerated by all participants. In participants who provided blood samples, post-intervention blood glucose, lactate and non-esterified fatty acid concentrations decreased significantly (−28.8%,  p  ≪ 0.001; −28.2%,  p  = 0.02; and −49.1%,  p  ≪ 0.001, respectively), while levels of the ketone body  D -beta-hydroxybutyrate significantly increased from mean (standard deviation) 0.7 (0.3) to 4.0 (1.1) mmol/L after 30 min ( p  ≪ 0.001). There were no significant changes in cardiac PCr/ATP or skeletal muscle metabolic parameters between baseline and post-intervention. Acute ketone supplementation caused mild ketosis in blood, with drops in glucose, lactate, and free fatty acids; however, such changes were not associated with changes in  31 P-MRS measures in the heart or in skeletal muscle. Future work may focus on the effect of longer-term ketone supplementation on tissue energetics in groups with compromised mitochondrial function.

frontiers in physiology

Evaluation of Acute Supplementation With the Ketone Ester (R)-3-Hydroxybutyl-(R)-3-Hydroxybutyrate (deltaG) in Healthy Volunteers by Cardiac and Skeletal Muscle 31P Magnetic Resonance Spectroscopy