AUTHOR=Cuenoud Bernard , Hartweg Mickaël , Godin Jean-Philippe , Croteau Etienne , Maltais Mathieu , Castellano Christian-Alexandre , Carpentier André C. , Cunnane Stephen C. TITLE=Metabolism of Exogenous D-Beta-Hydroxybutyrate, an Energy Substrate Avidly Consumed by the Heart and Kidney JOURNAL=Frontiers in Nutrition VOLUME=7 YEAR=2020 URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2020.00013 DOI=10.3389/fnut.2020.00013 ISSN=2296-861X ABSTRACT=

There is growing interest in the metabolism of ketones owing to their reported benefits in neurological and more recently in cardiovascular and renal diseases. As an alternative to a very high fat ketogenic diet, ketones precursors for oral intake are being developed to achieve ketosis without the need for dietary carbohydrate restriction. Here we report that an oral D-beta-hydroxybutyrate (D-BHB) supplement is rapidly absorbed and metabolized in humans and increases blood ketones to millimolar levels. At the same dose, D-BHB is significantly more ketogenic and provides fewer calories than a racemic mixture of BHB or medium chain triglyceride. In a whole body ketone positron emission tomography pilot study, we observed that after D-BHB consumption, the ketone tracer 11C-acetoacetate is rapidly metabolized, mostly by the heart and the kidneys. Beyond brain energy rescue, this opens additional opportunities for therapeutic exploration of D-BHB supplements as a “super fuel” in cardiac and chronic kidney diseases.