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However, whether and how PEKS improves endurance performance during a periodised endurance training period remains unclear. Twenty\u2010eight trained males completed 8\u00a0weeks of supervised cycling, receiving either 25\u00a0g of the ketone monoester (\n R<\/jats:italic>\n )\u2010hydroxybutyl (\n R<\/jats:italic>\n )\u2010hydroxybutyrate (KE,\n n<\/jats:italic>\n \u00a0=\u00a014) or isocaloric placebo (CON,\n n<\/jats:italic>\n \u00a0=\u00a014) post\u2010exercise and before sleep. Outcomes included exercise performance and muscular\/cardiac adaptations assessed at baseline (PRE), week 3 (MID) and 7 (POST), and following a taper week (POST\n +1week<\/jats:sub>\n ). The training intervention improved 30\u00a0min time trial performance (TT\n 30min<\/jats:sub>\n ), absolute and relative , peak power output during the test (PPO ), citrate synthase (CS) activity, and peak cardiac output (all\n P<\/jats:italic>\n \u00a0<\u00a00.05 PRE\n vs<\/jats:italic>\n . POST). Notably, TT\n 30min<\/jats:sub>\n (CON: 291\u00a0\u00b1\u00a027\u00a0W\n vs<\/jats:italic>\n . KE: 302\u00a0\u00b1\u00a028\u00a0W,\n P<\/jats:italic>\n \u00a0<\u00a00.001, Hedges\u2019 g\u00a0=\u00a00.40) was 4% higher in KE compared to CON at POST. Although peak cardiac output was similar, relative increased more in KE (+12%) than CON (+6%, \u0394\n P<\/jats:italic>\n \u00a0<\u00a00.001), suggesting enhanced peripheral oxygen utilisation. Accordingly, CS activity was at POST 14% higher in KE (9.37\u00a0\u00b1\u00a01.36\u00a0mol\u00a0h\n \u22121<\/jats:sup>\n \u00a0kg protein\n \u22121<\/jats:sup>\n ) compared to CON (8.21\u00a0\u00b1\u00a00.97\u00a0mol\u00a0h\n \u22121<\/jats:sup>\n \u00a0kg protein\n \u22121<\/jats:sup>\n ,\n P<\/jats:italic>\n \u00a0=\u00a00.035, Hedges\u2019\n g<\/jats:italic>\n \u00a0=\u00a00.98) and OXPHOS complex II muscle protein content remained unaltered in CON while increasing by 25% in KE (\n P<\/jats:italic>\n \u00a0=\u00a00.030\n vs<\/jats:italic>\n . PRE). In conclusion, these findings establish PEKS as a nutritional strategy to enhance endurance performance and mitochondrial adaptations during periodised endurance training.\n \n \n image<\/jats:alt-text>\n <\/jats:graphic>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>\n \n Key points<\/jats:title>\n \n \n \n Previous research showed that post\u2010exercise ketone ester (KE) supplementation improves endurance performance and muscle adaptations during 3\u00a0weeks of excessive endurance exercise. Whether KE ingestion enhances performance, muscular and cardiac adaptations during a periodised endurance training intervention remained unknown.<\/jats:p>\n <\/jats:list-item>\n \n We demonstrate that KE supplementation post\u2010exercise and before sleep during an 8\u00a0week periodised endurance training period enhances endurance performance and peak oxygen uptake rate in trained male participants.<\/jats:p>\n <\/jats:list-item>\n \n These performance improvements were mediated by muscular adaptations (e.g. increased mitochondrial content), while cardiac adaptations were not affected by KE.<\/jats:p>\n <\/jats:list-item>\n \n Our findings show that KE enhances endurance performance primarily by muscular adaptations, indicating that post\u2010exercise KE supplementation is effective to amplify endurance exercise training adaptations.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1113\/jp290315","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:20:27Z","timestamp":1773030027000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Post\u2010exercise ketone supplementation improves endurance performance and mitochondrial adaptations during an 8\u2010week endurance training intervention"],"prefix":"10.1113","author":[{"given":"Ruben","family":"Robberechts","sequence":"first","affiliation":[{"name":"Exercise Physiology Research Group Department of Movement Sciences, KU Leuven Leuven Belgium"},{"name":"Faculty of Rehabilitation Sciences, Rehabilitation Research Center (REVAL) Hasselt University Diepenbeek Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youri","family":"Bekhuis","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences Cardiology, KU Leuven Leuven 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