Nutr Metab (Lond). 2025 Dec 14. doi: 10.1186/s12986-025-01067-z. Online ahead of print.

ABSTRACT

Ketogenic supplements have gained much attention in exercise nutrition because they have the potential to enhance endurance, maximize metabolic efficiency, and provide an additional source of fuel during exercise. This review is an examination into the molecular process, physiological alteration, and overall impact of ketogenic supplementation on sport performance. Various forms of ketogenic supplements, including exogenous ketones, medium-chain triglyceride (MCT) oil, and ketone esters, are examined in terms of their ability to induce ketosis and influence cellular energy pathways. The influence of ketone bodies on ATP synthesis, mitochondrial function, and metabolic shifts from carbohydrates to fats is summarized with special attention to endurance and high-intensity exercise implications. Furthermore, the long-term physiological adaptations, including enhanced fat oxidation, improved recovery, and resistance to fatigue, are analyzed. While ketogenic supplementation offers potential performance benefits, it also presents challenges such as muscle glycogen depletion, gastrointestinal distress, and electrolyte imbalances. A risk-benefit analysis is provided, outlining strategies to optimize supplementation while minimizing adverse effects. Finally, gaps in current research and future directions for ketogenic supplementation in sports are explored, emphasizing the need for individualized approaches and further investigation into long-term effects.

PMID:41392283 | DOI:10.1186/s12986-025-01067-z

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