{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:51:23Z","timestamp":1793382683265,"version":"4.5.0"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T00:00:00Z","timestamp":1754956800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T00:00:00Z","timestamp":1754956800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Nutr"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>\u03b2-hydroxybutyrate can suppress endogenous glucose production, with potential implications for carbohydrate metabolism during post-exercise recovery. The aim of the current study was to assess the effects of ketone ester ingestion during post-exercise recovery, on carbohydrate metabolism and subsequent exercise capacity. Thirteen endurance-trained men (age: 18\u201361 years, maximal aerobic capacity: 50 to 73 mL kg<jats:sup>\u22121<\/jats:sup> min<jats:sup>\u22121<\/jats:sup>) completed two conditions in a randomized crossover design. During both conditions, participants performed two exhaustive bouts of running separated by 4\u00a0h of recovery, during which they ingested sucrose (1\u00a0g kg<jats:sup>\u22121<\/jats:sup> h<jats:sup>\u22121<\/jats:sup> and high natural abundance <jats:sup>13<\/jats:sup>C) and whey protein (0.4\u00a0g kg<jats:sup>\u22121<\/jats:sup> h<jats:sup>\u22121<\/jats:sup>) beverages. In one condition, the beverage was supplemented with 0.29\u00a0g kg<jats:sup>\u22121<\/jats:sup> h<jats:sup>\u22121<\/jats:sup> of ketone monoester (KETONE), in the other, the beverage was supplemented with an isoenergetic (fat), taste-matched placebo (PLACEBO). Breath samples were analysed for CO<jats:sub>2<\/jats:sub> production and <jats:sup>13<\/jats:sup>C enrichment to determine the fate of ingested carbohydrate. Blood was sampled to examine metabolite and insulin concentrations. KETONE increased blood \u03b2-hydroxybutyrate concentrations (&gt;\u20093.5 mmol L<jats:sup>\u22121<\/jats:sup> versus PLACEBO, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and retention of ingested sucrose (from 206\u2009\u00b1\u200926\u00a0g with PLACEBO to 220\u2009\u00b1\u200926\u00a0g with KETONE, <jats:italic>p<\/jats:italic>\u2009=\u20090.001) while lowering glycemia (&gt;\u20091 mmol L<jats:sup>\u22121<\/jats:sup> versus PLACEBO, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). This occurred with no evidence of increased gastrointestinal distress during recovery, but mild additional lower gastrointestinal distress during the second run (<jats:italic>p<\/jats:italic>\u2009=\u20090.03). There was no evidence for differences in time-to-exhaustion during the second run (PLACEBO:54\u2009\u00b1\u200933\u00a0min, KETONE:52\u2009\u00b1\u200928\u00a0min; <jats:italic>p<\/jats:italic>\u2009=\u20090.87). In conclusion, ketone ester ingestion during post-exercise recovery augments retention of ingested carbohydrates and lowers glycemia. No evidence for increased exercise capacity was detected during subsequent running.<\/jats:p>","DOI":"10.1007\/s00394-025-03784-w","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T15:24:52Z","timestamp":1755012292000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Ketone ester ingestion increases exogenous carbohydrate storage and lowers glycemia during post-exercise recovery: a randomised crossover trial"],"prefix":"10.1007","volume":"64","author":[{"given":"Lizzie","family":"Clarke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie L.","family":"Russell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Spellanzon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Maher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Betts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9939-0074","authenticated-orcid":false,"given":"Javier T.","family":"Gonzalez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,12]]},"reference":[{"issue":"4","key":"3784_CR1","doi-asserted-by":"publisher","first-page":"344","DOI":"10.3390\/nu9040344","volume":"9","author":"JT Gonzalez","year":"2017","unstructured":"Gonzalez JT, Fuchs CJ, Betts JA, Van Loon LJ (2017) Glucose plus Fructose ingestion for post-exercise recovery\u2014greater than the sum of its parts? Nutrients 9(4):344","journal-title":"Nutrients"},{"issue":"Pt 1","key":"3784_CR2","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1111\/j.1469-7793.2001.00295.x","volume":"536","author":"LJ van Loon","year":"2001","unstructured":"van Loon LJ, Greenhaff PL, Constantin-Teodosiu D, Saris WH, Wagenmakers AJ (2001) The effects of increasing exercise intensity on muscle fuel utilisation in humans. J Physiol 536(Pt 1):295\u2013304. https:\/\/doi.org\/10.1111\/j.1469-7793.2001.00295.x","journal-title":"J Physiol"},{"key":"3784_CR3","doi-asserted-by":"publisher","first-page":"E543","DOI":"10.1152\/ajpendo.00232.2016","volume":"311","author":"JT Gonzalez","year":"2016","unstructured":"Gonzalez JT, Fuchs CJ, Betts JA, van Loon LJ (2016) Liver glycogen metabolism during and after prolonged endurance-type exercise. Am J Physiol-Endocrinol Metab 311:E543\u2013E553","journal-title":"Am J Physiol - Endocrinol Metab"},{"issue":"5","key":"3784_CR4","doi-asserted-by":"publisher","first-page":"E1062","DOI":"10.1152\/ajpendo.00163.2018","volume":"315","author":"RM Edinburgh","year":"2018","unstructured":"Edinburgh RM, Hengist A, Smith HA, Travers RL, Koumanov F, Betts JA, Thompson D, Walhin JP, Wallis GA, Hamilton DL et al (2018) Preexercise breakfast ingestion versus extended overnight fasting increases postprandial glucose flux after exercise in healthy men. Am J Physiol-Endocrinol Metab 315(5):E1062\u2013E74. https:\/\/doi.org\/10.1152\/ajpendo.00163.2018","journal-title":"Am J Physiol-Endocrinol Metab"},{"issue":"2","key":"3784_CR5","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1113\/JP278600","volume":"598","author":"GK McConell","year":"2020","unstructured":"McConell GK, Sj\u00f8berg KA, Ceutz F, Gliemann L, Nyberg M, Hellsten Y, Fr\u00f8sig C, Kiens B, Wojtaszewski JF, Richter EA (2020) Insulin-induced membrane permeability to glucose in human muscles at rest and following exercise. J Physiol 598(2):303\u2013315","journal-title":"J Physiol"},{"key":"3784_CR6","doi-asserted-by":"publisher","first-page":"941","DOI":"10.2165\/11536900-000000000-00000","volume":"40","author":"JA Betts","year":"2010","unstructured":"Betts JA, Williams C (2010) Short-term recovery from prolonged exercise: exploring the potential for protein ingestion to accentuate the benefits of carbohydrate supplements. Sports Med 40:941\u2013959","journal-title":"Sports Med"},{"issue":"11","key":"3784_CR7","doi-asserted-by":"publisher","first-page":"1328","DOI":"10.1152\/japplphysiol.01023.2015","volume":"120","author":"CJ Fuchs","year":"2016","unstructured":"Fuchs CJ, Gonzalez JT, Beelen M, Cermak NM, Smith FE, Thelwall PE, Taylor R, Trenell MI, Stevenson EJ, van Loon LJ (2016) Sucrose ingestion after exhaustive exercise accelerates liver, but not muscle glycogen repletion compared with glucose ingestion in trained athletes. J Appl Physiol (1985) 120(11):1328\u20131334. https:\/\/doi.org\/10.1152\/japplphysiol.01023.2015","journal-title":"J Appl Physiol (1985)"},{"issue":"10","key":"3784_CR8","doi-asserted-by":"publisher","first-page":"1964","DOI":"10.1249\/MSS.0b013e318218ca5a","volume":"43","author":"J D\u00e9combaz","year":"2011","unstructured":"D\u00e9combaz J, Jentjens R, Ith M, Scheurer E, Buehler T, Jeukendrup A, Boesch C (2011) Fructose and galactose enhance postexercise human liver glycogen synthesis. Med Sci Sports Exerc 43(10):1964\u20131971","journal-title":"Med Sci Sports Exerc"},{"issue":"1","key":"3784_CR9","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1123\/ijsnem.2019-0211","volume":"30","author":"EA Gray","year":"2020","unstructured":"Gray EA, Green TA, Betts JA, Gonzalez JT (2020) Postexercise glucose\u2013fructose coingestion augments cycling capacity during short-term and overnight recovery from exhaustive exercise, compared with isocaloric glucose. Int J Sport Nutr Exerc Metab 30(1):54\u201361","journal-title":"Int J Sport Nutr Exerc Metab"},{"issue":"5","key":"3784_CR10","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1249\/MSS.0000000000001516","volume":"50","author":"E Maunder","year":"2018","unstructured":"Maunder E, Podlogar T, Wallis GA (2018) Postexercise fructose-maltodextrin ingestion enhances subsequent endurance capacity. Med Sci Sports Exerc 50(5):1039\u20131045","journal-title":"Med Sci Sports Exerc"},{"issue":"2","key":"3784_CR11","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1210\/jc.2014-2608","volume":"100","author":"KH Mikkelsen","year":"2015","unstructured":"Mikkelsen KH, Seifert T, Secher NH, Grondal T, van Hall G (2015) Systemic, cerebral and skeletal muscle ketone body and energy metabolism during acute hyper-D-beta-hydroxybutyratemia in post-absorptive healthy males. J Clin Endocrinol Metab 100(2):636\u2013643. https:\/\/doi.org\/10.1210\/jc.2014-2608","journal-title":"J Clin Endocrinol Metab"},{"key":"3784_CR12","doi-asserted-by":"publisher","first-page":"E56","DOI":"10.1152\/ajpendo.00264.2022","volume":"324","author":"E Evans","year":"2022","unstructured":"Evans E, Walhin J-P, Hengist A, Betts JA, Dearlove DJ, Gonzalez JT (2022) Ketone monoester ingestion increases post-exercise serum erythropoietin concentrations in healthy men. Am J Physiol-Endocrinol Metab 324:E56","journal-title":"Am J Physiol-Endocrinol Metab"},{"issue":"1","key":"3784_CR13","doi-asserted-by":"publisher","first-page":"E65","DOI":"10.1152\/ajpendo.2000.278.1.E65","volume":"278","author":"A Casey","year":"2000","unstructured":"Casey A, Mann R, Banister K, Fox J, Morris PG, Macdonald IA, Greenhaff PL (2000) Effect of carbohydrate ingestion on glycogen resynthesis in human liver and skeletal muscle, measured by 13\u00a0C MRS. Am J Physiol-Endocrinol Metab 278(1):E65\u2013E75","journal-title":"Am J Physiol-Endocrinol Metab"},{"issue":"9","key":"3784_CR14","doi-asserted-by":"publisher","first-page":"1789","DOI":"10.1249\/MSS.0000000000001292","volume":"49","author":"DA Holdsworth","year":"2017","unstructured":"Holdsworth DA, Cox PJ, Kirk T, Stradling H, Impey SG, Clarke K (2017) A ketone ester drink increases postexercise muscle glycogen synthesis in humans. Med Sci Sports Exerc 49(9):1789","journal-title":"Med Sci Sports Exerc"},{"key":"3784_CR15","doi-asserted-by":"publisher","first-page":"310","DOI":"10.3389\/fphys.2017.00310","volume":"8","author":"T Vandoorne","year":"2017","unstructured":"Vandoorne T, De Smet S, Ramaekers M, Van Thienen R, De Bock K, Clarke K, Hespel P (2017) Intake of a ketone ester drink during recovery from exercise promotes mTORC1 signaling but not glycogen resynthesis in human muscle. Front Physiol 8:310","journal-title":"Front Physiol"},{"key":"3784_CR16","unstructured":"World Medical Association (2013) WMA Declaration of Helsinki\u2013ethical principles for medical research involving human participants"},{"issue":"10","key":"3784_CR17","doi-asserted-by":"publisher","first-page":"2040","DOI":"10.1249\/MSS.0b013e318264526f","volume":"44","author":"JA Betts","year":"2012","unstructured":"Betts JA, Thompson D (2012) Thinking outside the bag (not necessarily outside the lab). Med Sci Sport Exerc 44(10):2040. https:\/\/doi.org\/10.1249\/MSS.0b013e318264526f","journal-title":"Med Sci Sport Exerc"},{"issue":"6","key":"3784_CR18","doi-asserted-by":"publisher","first-page":"E1031","DOI":"10.1152\/ajpendo.1995.269.6.E1031","volume":"269","author":"P Schneiter","year":"1995","unstructured":"Schneiter P, Di Vetta V, J\u00e9quier E, Tappy L (1995) Effect of physical exercise on glycogen turnover and net substrate utilization according to the nutritional state. Am J Physiol-Endocrinol Metab 269(6):E1031\u2013E6","journal-title":"Am J Physiol-Endocrinol Metab"},{"issue":"6","key":"3784_CR19","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1123\/ijsnem.2019-0014","volume":"29","author":"BJ Stubbs","year":"2019","unstructured":"Stubbs BJ, Cox PJ, Kirk T, Evans RD, Clarke K (2019) Gastrointestinal effects of exogenous ketone drinks are infrequent, mild, and vary according to ketone compound and dose. Int J Sport Nutr Exerc Metab 29(6):596\u2013603","journal-title":"Int J Sport Nutr Exerc Metab"},{"key":"3784_CR20","doi-asserted-by":"publisher","DOI":"10.1113\/JP277767","author":"A Hengist","year":"2019","unstructured":"Hengist A, Koumanov F, Gonzalez JT (2019) Fructose and metabolic health: governed by hepatic glycogen status? J Physiol. https:\/\/doi.org\/10.1113\/JP277767","journal-title":"J Physiol"},{"issue":"9","key":"3784_CR21","doi-asserted-by":"publisher","first-page":"2400","DOI":"10.2337\/db17-0433","volume":"66","author":"GM Kowalski","year":"2017","unstructured":"Kowalski GM, Moore SM, Hamley S, Selathurai A, Bruce CR (2017) The effect of ingested glucose dose on the suppression of endogenous glucose production in humans. Diabetes 66(9):2400\u20132406","journal-title":"Diabetes"},{"issue":"4","key":"3784_CR22","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1139\/apnm-2020-0644","volume":"46","author":"G Greaves","year":"2021","unstructured":"Greaves G, Xiang R, Rafiei H, Malas A, Little JP (2021) Prior ingestion of a ketone monoester supplement reduces postprandial glycemic responses in young healthy-weight individuals. Appl Physiol Nutr Metab 46(4):309\u2013317","journal-title":"Appl Physiol Nutr Metab"},{"key":"3784_CR23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00125-024-06122-7","volume":"67","author":"AJ Monteyne","year":"2024","unstructured":"Monteyne AJ, Falkenhain K, Whelehan G, Neudorf H, Abdelrahman DR, Murton AJ, Wall BT, Stephens FB, Little JP (2024) A ketone monoester drink reduces postprandial blood glucose concentrations in adults with type 2 diabetes: a randomised controlled trial. Diabetologia 67:1\u20137","journal-title":"Diabetologia"},{"issue":"1","key":"3784_CR24","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1123\/ijsnem.2022-0170","volume":"33","author":"JT Gonzalez","year":"2023","unstructured":"Gonzalez JT, King AJ (2023) For flux sake: isotopic tracer methods of monitoring human carbohydrate metabolism during exercise. Int J Sport Nutriiton Exerc Metabolism 33(1):60\u201370. https:\/\/doi.org\/10.1123\/ijsnem.2022-0170","journal-title":"Int J Sport Nutriiton Exerc Metabolism"},{"issue":"2","key":"3784_CR25","first-page":"628","volume":"55","author":"KN Frayn","year":"1983","unstructured":"Frayn KN (1983) Calculation of substrate oxidation rates in vivo from gaseous exchange. J Appl Physiol Respir Environ Exerc Physiol 55(2):628\u2013634","journal-title":"J Appl Physiol Respir Environ Exerc Physiol"},{"issue":"3","key":"3784_CR26","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1249\/MSS.0000000000002502","volume":"53","author":"DJ Dearlove","year":"2020","unstructured":"Dearlove DJ, Harrison OK, Hodson L, Jefferson A, Clarke K, Cox PJ (2020) The effect of blood ketone concentration and exercise intensity on exogenous ketone oxidation rates in athletes. Med Sci Sports Exerc 53(3):505","journal-title":"Med Sci Sports Exerc"},{"issue":"2","key":"3784_CR27","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1111\/j.1748-1716.1974.tb05592.x","volume":"90","author":"K Piehl","year":"1974","unstructured":"Piehl K (1974) Time course for refilling of glycogen stores in human muscle fibres following exercise-induced glycogen depletion. Acta Physiol Scand 90(2):297\u2013302","journal-title":"Acta Physiol Scand"}],"container-title":["European Journal of Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00394-025-03784-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00394-025-03784-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00394-025-03784-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T04:13:01Z","timestamp":1760501581000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00394-025-03784-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,12]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["3784"],"URL":"https:\/\/doi.org\/10.1007\/s00394-025-03784-w","relation":{},"ISSN":["1436-6207","1436-6215"],"issn-type":[{"value":"1436-6207","type":"print"},{"value":"1436-6215","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,12]]},"assertion":[{"value":"23 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"253"}}