{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T04:13:31Z","timestamp":1782533611447,"version":"3.54.5"},"reference-count":48,"publisher":"Elsevier BV","issue":"6","license":[{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"vor","delay-in-days":366,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"funder":[{"DOI":"10.13039\/100016156","name":"U.S. Army Medical Research and Development Command","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016156","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000015","name":"U.S. Department of Energy","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000015","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006229","name":"Oak Ridge Institute for Science and Education","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006229","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Nutrition"],"published-print":{"date-parts":[[2023,6]]},"DOI":"10.1016\/j.tjnut.2023.03.002","type":"journal-article","created":{"date-parts":[[2023,3,8]],"date-time":"2023-03-08T01:52:08Z","timestamp":1678240328000},"page":"1696-1709","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":18,"title":["Ketone Monoester Plus Carbohydrate Supplementation Does Not Alter Exogenous and Plasma Glucose Oxidation or Metabolic Clearance Rate During Exercise in Men Compared with Carbohydrate Alone"],"prefix":"10.1016","volume":"153","author":[{"given":"Emily E.","family":"Howard","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jillian T.","family":"Allen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie L.","family":"Coleman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie D.","family":"Small","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Philip","family":"Karl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin S.","family":"O\u2019Fallon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee M.","family":"Margolis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"3","key":"10.1016\/j.tjnut.2023.03.002_bib1","first-page":"543","article-title":"American College of Sports Medicine Joint Position Statement, nutrition and athletic performance","volume":"48","author":"Thomas","year":"2016","journal-title":"Med. Sci. Sports Exerc."},{"issue":"2","key":"10.1016\/j.tjnut.2023.03.002_bib2","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1111\/j.1748-1716.1967.tb03720.x","article-title":"Diet, muscle glycogen and physical performance","volume":"71","author":"Bergstr\u00f6m","year":"1967","journal-title":"Acta Physiol. Scand."},{"issue":"2","key":"10.1016\/j.tjnut.2023.03.002_bib3","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1111\/j.1748-1716.1967.tb03719.x","article-title":"Muscle glycogen during prolonged severe exercise","volume":"71","author":"Hermansen","year":"1967","journal-title":"Acta Physiol. Scand."},{"key":"10.1016\/j.tjnut.2023.03.002_bib4","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/2046-7648-3-17","article-title":"Acute nutritional ketosis: implications for exercise performance and metabolism","volume":"3","author":"Cox","year":"2014","journal-title":"Extrem. Physiol. Med."},{"issue":"9","key":"10.1016\/j.tjnut.2023.03.002_bib5","doi-asserted-by":"crossref","first-page":"2857","DOI":"10.1113\/JP273185","article-title":"Metabolism of ketone bodies during exercise and training: physiological basis for exogenous supplementation","volume":"595","author":"Evans","year":"2017","journal-title":"J.\u00a0Physiol."},{"issue":"1","key":"10.1016\/j.tjnut.2023.03.002_bib6","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1152\/physrev.1980.60.1.143","article-title":"Physiological roles of ketone bodies as substrates and signals in mammalian tissues","volume":"60","author":"Robinson","year":"1980","journal-title":"Physiol. Rev."},{"issue":"3","key":"10.1016\/j.tjnut.2023.03.002_bib7","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1249\/MSS.0000000000002502","article-title":"The effect of blood ketone concentration and exercise intensity on exogenous ketone oxidation rates in athletes","volume":"53","author":"Dearlove","year":"2021","journal-title":"Med. Sci. Sports Exerc."},{"issue":"Suppl 1","key":"10.1016\/j.tjnut.2023.03.002_bib8","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s40279-022-01756-2","article-title":"Exogenous ketone supplements in athletic contexts: past, present, and future","volume":"52","author":"Evans","year":"2022","journal-title":"Sports Med"},{"issue":"2","key":"10.1016\/j.tjnut.2023.03.002_bib9","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.cmet.2016.07.010","article-title":"Nutritional ketosis alters fuel preference and thereby endurance performance in athletes","volume":"24","author":"Cox","year":"2016","journal-title":"Cell Metab"},{"issue":"6","key":"10.1016\/j.tjnut.2023.03.002_bib10","doi-asserted-by":"crossref","first-page":"1643","DOI":"10.1152\/japplphysiol.00092.2020","article-title":"Exogenous ketosis impacts neither performance nor muscle glycogen breakdown in prolonged endurance exercise","volume":"128","author":"Poff\u00e9","year":"1985","journal-title":"J.\u00a0Appl. Physiol"},{"key":"10.1016\/j.tjnut.2023.03.002_bib11","doi-asserted-by":"crossref","first-page":"290","DOI":"10.3389\/fphys.2019.00290","article-title":"Nutritional ketoacidosis during incremental exercise in healthy athletes","volume":"10","author":"Dearlove","year":"2019","journal-title":"Front. Physiol."},{"issue":"11","key":"10.1016\/j.tjnut.2023.03.002_bib12","doi-asserted-by":"crossref","first-page":"2330","DOI":"10.1249\/MSS.0000000000001700","article-title":"Intermittent running and cognitive performance after ketone ester ingestion","volume":"50","author":"Evans","year":"2018","journal-title":"Med. Sci. Sports Exerc."},{"issue":"12","key":"10.1016\/j.tjnut.2023.03.002_bib13","doi-asserted-by":"crossref","first-page":"2506","DOI":"10.1249\/MSS.0000000000002065","article-title":"No benefit of ingestion of a ketone monoester supplement on 10-km running performance","volume":"51","author":"Evans","year":"2019","journal-title":"Med. Sci. Sports Exerc."},{"key":"10.1016\/j.tjnut.2023.03.002_bib14","doi-asserted-by":"crossref","first-page":"229","DOI":"10.3389\/fphys.2019.00229","article-title":"Beyond RPE: the perception of exercise under normal and ketotic conditions","volume":"10","author":"Faull","year":"2019","journal-title":"Front. Physiol."},{"issue":"5","key":"10.1016\/j.tjnut.2023.03.002_bib15","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1249\/MSS.0000000000002552","article-title":"Exogenous ketosis impairs 30-min time-trial performance independent of bicarbonate supplementation","volume":"53","author":"Poff\u00e9","year":"2021","journal-title":"Med. Sci. Sports Exerc."},{"issue":"8","key":"10.1016\/j.tjnut.2023.03.002_bib16","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1139\/apnm-2020-0999","article-title":"Increased cardiorespiratory stress during submaximal cycling after ketone monoester ingestion in endurance-trained adults","volume":"46","author":"McCarthy","year":"2021","journal-title":"Appl. Physiol. Nutr. Metab."},{"issue":"5","key":"10.1016\/j.tjnut.2023.03.002_bib17","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1123\/ijsnem.2021-0346","article-title":"Ketone monoester ingestion alters metabolism and simulated rugby performance in professional players","volume":"32","author":"Peacock","year":"2022","journal-title":"Int. J. Sport Nutr. Exerc. Metab."},{"issue":"10","key":"10.1016\/j.tjnut.2023.03.002_bib18","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1139\/apnm-2016-0641","article-title":"Nutritional ketone salts increase fat oxidation but impair high-intensity exercise performance in healthy adult males","volume":"42","author":"O\u2019Malley","year":"2017","journal-title":"Appl. Physiol. Nutr. Metab."},{"issue":"2","key":"10.1016\/j.tjnut.2023.03.002_bib19","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.ccc.2010.12.013","article-title":"Lactate: biomarker and potential therapeutic target","volume":"27","author":"Okorie","year":"2011","journal-title":"Crit. Care Clin."},{"issue":"2","key":"10.1016\/j.tjnut.2023.03.002_bib20","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1152\/jappl.1983.55.2.628","article-title":"Calculation of substrate oxidation rates in vivo from gaseous exchange","volume":"55","author":"Frayn","year":"1983","journal-title":"J.\u00a0Appl. Physiol. Respir. Environ. Exerc. Physiol."},{"key":"10.1016\/j.tjnut.2023.03.002_bib21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.metabol.2019.05.003","article-title":"Exercising with low muscle glycogen content increases fat oxidation and decreases endogenous, but not exogenous carbohydrate oxidation","volume":"97","author":"Margolis","year":"2019","journal-title":"Metabolism"},{"issue":"1","key":"10.1016\/j.tjnut.2023.03.002_bib22","doi-asserted-by":"crossref","first-page":"45","DOI":"10.7205\/MILMED.169.1.45","article-title":"Soldier load carriage: historical, physiological, biomechanical, and medical aspects","volume":"169","author":"Knapik","year":"2004","journal-title":"Mil. Med."},{"issue":"8","key":"10.1016\/j.tjnut.2023.03.002_bib23","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.1249\/mss.0b013e31806010f5","article-title":"Reliability of time-to-exhaustion versus time-trial running tests in runners","volume":"39","author":"Laursen","year":"2007","journal-title":"Med. Sci. Sports Exerc."},{"issue":"1","key":"10.1016\/j.tjnut.2023.03.002_bib24","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1111\/j.1469-7793.2001.00295.x","article-title":"The effects of increasing exercise intensity on muscle fuel utilisation in humans","volume":"536","author":"van Loon","year":"2001","journal-title":"J.\u00a0Physiol."},{"key":"10.1016\/j.tjnut.2023.03.002_bib25","doi-asserted-by":"crossref","first-page":"848","DOI":"10.3389\/fphys.2017.00848","article-title":"On the metabolism of exogenous ketones in humans","volume":"8","author":"Stubbs","year":"2017","journal-title":"Front. Physiol."},{"issue":"6","key":"10.1016\/j.tjnut.2023.03.002_bib26","doi-asserted-by":"crossref","first-page":"1620","DOI":"10.1152\/jappl.1982.53.6.1620","article-title":"Fate of exogenous glucose during exercise of different intensities in humans","volume":"53","author":"Pirnay","year":"1982","journal-title":"J.\u00a0Appl. Physiol. Respir. Environ. Exerc. Physiol."},{"key":"10.1016\/j.tjnut.2023.03.002_bib27","series-title":"ACSM\u2019s Guidelines for Exercise Testing and Prescription","year":"2021"},{"issue":"4","key":"10.1016\/j.tjnut.2023.03.002_bib28","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1080\/02640419608727717","article-title":"A\u00a01% treadmill grade most accurately reflects the energetic cost of outdoor running","volume":"14","author":"Jones","year":"1996","journal-title":"J.\u00a0Sports Sci."},{"issue":"3","key":"10.1016\/j.tjnut.2023.03.002_bib29","doi-asserted-by":"crossref","first-page":"G171","DOI":"10.1152\/ajpgi.00048.2015","article-title":"Homeostasis of the gut barrier and potential biomarkers","volume":"312","author":"Wells","year":"2017","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"key":"10.1016\/j.tjnut.2023.03.002_bib30","doi-asserted-by":"crossref","DOI":"10.1016\/j.metabol.2019.154030","article-title":"Acute hypoxia reduces exogenous glucose oxidation, glucose turnover, and metabolic clearance rate during steady-state aerobic exercise","volume":"103","author":"Margolis","year":"2020","journal-title":"Metabolism"},{"issue":"3\u20134","key":"10.1016\/j.tjnut.2023.03.002_bib31","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/BF00233844","article-title":"Influence of the bicarbonate pool and on the occurrence of 13CO2 in exhaled air","volume":"63","author":"Pallikarakis","year":"1991","journal-title":"Eur. J. Appl. Physiol. Occup. Physiol."},{"key":"10.1016\/j.tjnut.2023.03.002_bib32","series-title":"Isotope Tracers in Metabolic Research: Principles and Practice of Kinetic Analysis","author":"Wolfe","year":"2005"},{"issue":"1","key":"10.1016\/j.tjnut.2023.03.002_bib33","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1152\/jappl.1999.87.1.111","article-title":"Glucose production during exercise in humans: a-hv balance and isotopic-tracer measurements compared","volume":"87","author":"Bergeron","year":"1985","journal-title":"J.\u00a0Appl. Physiol."},{"issue":"2","key":"10.1016\/j.tjnut.2023.03.002_bib34","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1111\/j.1469-7793.1999.579ac.x","article-title":"Glucose kinetics during prolonged exercise in highly trained human subjects: effect of glucose ingestion","volume":"515","author":"Jeukendrup","year":"1999","journal-title":"J.\u00a0Physiol."},{"issue":"8","key":"10.1016\/j.tjnut.2023.03.002_bib35","doi-asserted-by":"crossref","first-page":"683","DOI":"10.2337\/diab.31.8.683","article-title":"Influence of plasma glucose and insulin concentration on plasma glucose clearance in man","volume":"31","author":"DeFronzo","year":"1982","journal-title":"Diabetes"},{"issue":"1","key":"10.1016\/j.tjnut.2023.03.002_bib36","first-page":"23","article-title":"Table\u00a0of nonprotein respiratory quotient: an update","volume":"16","author":"P\u00e9ronnet","year":"1991","journal-title":"Can. J. Sport Sci."},{"issue":"12","key":"10.1016\/j.tjnut.2023.03.002_bib37","doi-asserted-by":"crossref","DOI":"10.3390\/metabo11120828","article-title":"Serum branched-chain amino acid metabolites increase in males when aerobic exercise is initiated with low muscle glycogen","volume":"11","author":"Margolis","year":"2021","journal-title":"Metabolites"},{"issue":"1","key":"10.1016\/j.tjnut.2023.03.002_bib38","doi-asserted-by":"crossref","first-page":"R1","DOI":"10.1152\/ajpregu.00076.2021","article-title":"Metabolomic profiles are reflective of hypoxia-induced insulin resistance during exercise in healthy young adult males","volume":"321","author":"Margolis","year":"2021","journal-title":"Am. J. Physiol. Regul. Integr. Comp. Physiol."},{"key":"10.1016\/j.tjnut.2023.03.002_bib39","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1002\/cpbi.11","article-title":"Using MetaboAnalyst 3.0 for comprehensive metabolomics data analysis","volume":"55","author":"Xia","year":"2016","journal-title":"Curr. Protoc. Bioinformatics."},{"key":"10.1016\/j.tjnut.2023.03.002_bib40","doi-asserted-by":"crossref","first-page":"806","DOI":"10.3389\/fphys.2017.00806","article-title":"Ketone diester ingestion impairs time-trial performance in professional cyclists","volume":"8","author":"Leckey","year":"2017","journal-title":"Front. Physiol."},{"issue":"2","key":"10.1016\/j.tjnut.2023.03.002_bib41","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1210\/jc.2014-2608","article-title":"Systemic, cerebral and skeletal muscle ketone body and energy metabolism during acute hyper-D-beta-hydroxybutyratemia in post-absorptive healthy males","volume":"100","author":"Mikkelsen","year":"2015","journal-title":"J.\u00a0Clin. Endocrinol. Metab."},{"issue":"5","key":"10.1016\/j.tjnut.2023.03.002_bib42","first-page":"416","article-title":"Novel method for detection of glycogen in cells","volume":"27","author":"Skurat","year":"2017","journal-title":"Glycobiology"},{"issue":"2","key":"10.1016\/j.tjnut.2023.03.002_bib43","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1210\/jcem-67-2-245","article-title":"Effect of exercise on the disposal of infused ketone bodies in humans","volume":"67","author":"F\u00e9ry","year":"1988","journal-title":"J.\u00a0Clin. Endocrinol. Metab."},{"issue":"29","key":"10.1016\/j.tjnut.2023.03.002_bib44","doi-asserted-by":"crossref","first-page":"26649","DOI":"10.1074\/jbc.C500213200","article-title":"(D)-beta-Hydroxybutyrate inhibits adipocyte lipolysis via the nicotinic acid receptor PUMA-G","volume":"280","author":"Taggart","year":"2005","journal-title":"J.\u00a0Biol. Chem."},{"issue":"5","key":"10.1016\/j.tjnut.2023.03.002_bib45","doi-asserted-by":"crossref","first-page":"G623","DOI":"10.1152\/ajpgi.00415.2017","article-title":"Role of ketone signaling in the hepatic response to fasting","volume":"316","author":"Geisler","year":"2019","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"issue":"5","key":"10.1016\/j.tjnut.2023.03.002_bib46","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1123\/ijsnem.2018-0284","article-title":"The effect of 1,3-butanediol on cycling time-trial performance","volume":"29","author":"Shaw","year":"2019","journal-title":"Int. J. Sport Nutr. Exerc. Metab."},{"issue":"5","key":"10.1016\/j.tjnut.2023.03.002_bib47","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1007\/s00421-017-3582-4","article-title":"Intestinal fatty acid-binding protein and gut permeability responses to exercise","volume":"117","author":"March","year":"2017","journal-title":"Eur. J. Appl. Physiol."},{"issue":"10","key":"10.1016\/j.tjnut.2023.03.002_bib48","doi-asserted-by":"crossref","first-page":"801","DOI":"10.2165\/11591440-000000000-00000","article-title":"Effects of acute alkalosis and acidosis on performance: a meta-analysis","volume":"41","author":"Carr","year":"2011","journal-title":"Sports Med"}],"container-title":["The Journal of Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0022316623352817?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0022316623352817?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T05:41:23Z","timestamp":1758346883000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0022316623352817"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6]]},"references-count":48,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["S0022316623352817"],"URL":"https:\/\/doi.org\/10.1016\/j.tjnut.2023.03.002","relation":{},"ISSN":["0022-3166"],"issn-type":[{"value":"0022-3166","type":"print"}],"subject":[],"published":{"date-parts":[[2023,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Ketone Monoester Plus Carbohydrate Supplementation Does Not Alter Exogenous and Plasma Glucose Oxidation or Metabolic Clearance Rate During Exercise in Men Compared with Carbohydrate Alone","name":"articletitle","label":"Article Title"},{"value":"The Journal of Nutrition","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.tjnut.2023.03.002","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Published by Elsevier Inc. on behalf of American Society for Nutrition.","name":"copyright","label":"Copyright"}]}}