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This randomised, controlled, double-blind crossover study investigated how increasing glucose doses affects C8-MCT-induced ketone body synthesis after overnight fasting. Eleven healthy young woman (22.5\u2009\u00b1\u20091.9 years) received a constant dose of tricaprylin (99% C8; 0.2\u00a0g\/kg bodyweight) combined with increasing glucose doses (0.2\u20130.6\u00a0g\/kg bodyweight). In additional interventions, both C8-MCT and glucose were increased in parallel. Plasma \u03b2-hydroxybutyrate (\u03b2HB), glucose, and insulin were measured for up to 300\u00a0min post-dose. Indirect calorimetry in a subset and side effects were monitored. C8-MCT significantly increased \u03b2HB concentrations at low and medium glucose doses compared with control, but not at highest glucose dose. When both substrates were increased equally (1:1 ratio), ketone body synthesis increased. \u03b2HB was negative correlated with increasing glucose dosing at constant C8-MCT dosing, while parallel increases in both substrates showed a positive moderate correlation between \u03b2HB and C8-MCT doses. No dose-dependent side effects occurred. Overall, ketone body synthesis declines with rising glucose intake. It remains unclear whether a C8-MCT: glucose ratio of 1:3 represents a metabolic cut-off or whether glucose intake becomes excessive due to linear effects.<\/jats:p>\n                  <jats:p>\n                    <jats:italic>Trial registration<\/jats:italic>\n                    This study was prospectively registered in the German Clinical Trials Register (DRKS ID DRKS00035373\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.bfarm.de\/EN\/BfArM\/Tasks\/German-Clinical-Trials-Register\/_node.html\" ext-link-type=\"uri\">https\/\/www.bfarm.de\/EN\/BfArM\/Tasks\/GermanClinicalTrialsRegister\/_node.html<\/jats:ext-link>\n                    ).\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-47702-4","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T11:40:15Z","timestamp":1775734815000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of glucose on medium chain triglyceride induced ketosis in healthy adults in a randomized, double-blind, controlled study"],"prefix":"10.1038","volume":"16","author":[{"given":"Marius","family":"Frenser","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manfred","family":"Fobker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renata Antonina","family":"Feuerborn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thorsten","family":"Marquardt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Fischer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"47702_CR1","doi-asserted-by":"publisher","first-page":"1978","DOI":"10.1212\/WNL.0000000000001004","volume":"83","author":"P Klein","year":"2012","unstructured":"Klein, P., Tyrlikova, I. & Mathews, G. 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