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A ketone monoester (KME) drink containing \u03b2-hydroxybutyrate (\u03b2-OHB) rapidly lowers plasma glucose, which may be a strategy protecting against postprandial hyperglycemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We hypothesized that KME would attenuate 2-hour postprandial glucose, lower systemic inflammation, and improve vascular function in adults with obesity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a randomized crossover design, 14 participants with obesity (age = 56\u2005\u00b1\u200512 years; body mass index = 32.8\u2005\u00b1\u20057.7 kg\/m2) consumed KME (12 g \u03b2-OHB) or placebo 15 minutes prior to each meal for 14 days with all meals provided and matched between conditions. Postprandial glycemia was assessed by continuous glucose monitoring. Vascular function and inflammation were assessed before and after treatment periods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Postprandial glucose was 8.0% lower in KME versus placebo (g\u2005=\u20050.735; P\u2005=\u20050.011) and 24-hour average glucose reduced by 7.8% (g\u2005=\u20050.686; P\u2005=\u20050.0001). Brachial artery flow-mediated dilation increased from 6.2 \u2005\u00b1\u2005 1.5% to 8.9\u2005\u00b1\u20053.3% in KME (g\u2005=\u20051.05; P\u2005=\u20050.0004) with no changes in placebo (condition \u00d7 time interaction, P\u2005=\u20050.004). There were no changes in plasma cytokines; however, lipopolysaccharide-stimulated monocyte caspase-1 activation was lower following KME supplementation versus placebo (stimulation \u00d7 condition \u00d7 time interaction; P\u2005=\u20050.004). The KME supplement was well tolerated by participants and adherence to the supplementation regimen was very high.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In adults with obesity, 14 days of premeal KME supplementation improves glucose control, enhances vascular function, and may reduce cellular inflammation. KME supplementation may be a viable, nonpharmacological approach to improving and protecting vascular health in people with heightened cardiometabolic risk.<\/jats:p><\/jats:sec>","DOI":"10.1210\/clinem\/dgaa925","type":"journal-article","created":{"date-parts":[[2020,12,26]],"date-time":"2020-12-26T17:29:43Z","timestamp":1609003783000},"page":"1738-1754","source":"Crossref","is-referenced-by-count":57,"title":["14-Day Ketone Supplementation Lowers Glucose and Improves Vascular Function in Obesity: A Randomized Crossover Trial"],"prefix":"10.1210","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1782-7074","authenticated-orcid":false,"given":"Jeremy J","family":"Walsh","sequence":"first","affiliation":[{"name":"Exercise Metabolism and Inflammation Laboratory, University of British Columbia Okanagan, Kelowna, BC, Canada"},{"name":"Department of Kinesiology, McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Neudorf","sequence":"additional","affiliation":[{"name":"Exercise Metabolism and Inflammation Laboratory, University of British Columbia Okanagan, Kelowna, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9796-2008","authenticated-orcid":false,"given":"Jonathan P","family":"Little","sequence":"additional","affiliation":[{"name":"Exercise Metabolism and Inflammation Laboratory, University of British Columbia Okanagan, Kelowna, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2020,12,26]]},"reference":[{"key":"2021122205214955600_CIT0001","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1146\/annurev-nutr-071816-064916","article-title":"Verdin E. \u03b2-Hydroxybutyrate: a signaling metabolite","volume":"37","author":"Newman","year":"2017","journal-title":"Annu. 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