{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:56:39Z","timestamp":1792176999487,"version":"4.4.0"},"reference-count":31,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T00:00:00Z","timestamp":1763251200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ketone Labs","award":["KETAD-021919"],"award-info":[{"award-number":["KETAD-021919"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Overweight and obesity affect a majority of adults, contributing to metabolic disorders. Caloric restriction often leads to undesirable lean mass loss alongside fat reduction. This study investigated whether exogenous \u03b2-hydroxybutyrate (BHB) supplementation, as an adjunct to a hypocaloric diet, improves body composition and metabolic markers in overweight and obese adults by preferentially reducing fat mass while preserving lean mass. Methods: In this 8-week randomized, double-blind, placebo-controlled trial, 51 adults were assigned to receive either racemic BHB mineral salts or placebo (maltodextrin) twice daily, alongside modest caloric restriction. Assessments at baseline and week 8 included dual-energy X-ray absorptiometry for body composition, indirect calorimetry for resting metabolic rate (RMR), and venous blood analyses for cardiometabolic biomarkers (e.g., lipids, HOMA-IR, uric acid, liver enzymes). Results: Body mass decreased in both groups over the intervention (p &lt; 0.01 within placebo and p &lt; 0.001 within BHB). Within the BHB group, fat mass decreased significantly (\u22122 kg; p &lt; 0.05 vs. baseline), body fat percentage improved (p &lt; 0.01 vs. baseline), and lean-to-fat mass ratio increased (p &lt; 0.05 vs. baseline); no such significant changes were observed within the placebo group. Group \u00d7 time interactions were not significant for these body composition variables (p &gt; 0.05). Furthermore, lean mass was largely preserved, with no declines in RMR. Within the BHB group, LDL cholesterol was reduced (p &lt; 0.05 vs. baseline), while other lipids, HOMA-IR, and uric acid remained stable, with liver enzymes showing a positive change. Conclusions: Exogenous BHB supplementation may enhance the quality of diet-induced weight loss through within-group improvements in fat mass reduction and lean mass preservation, with no adverse metabolic impacts.<\/jats:p>","DOI":"10.3390\/nu17223582","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T11:05:31Z","timestamp":1763463931000},"page":"3582","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Effect of Exogenous Ketones as an Adjunct to Low-Calorie Diet on Metabolic Markers"],"prefix":"10.3390","volume":"17","author":[{"given":"Eliza J.","family":"Roeth","sequence":"first","affiliation":[{"name":"Department of Cell Biology and Physiology, Brigham Young University, Provo, UT 84602, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genevieve","family":"Parker","sequence":"additional","affiliation":[{"name":"Department of Cell Biology and Physiology, Brigham Young University, Provo, UT 84602, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ella F.","family":"Cooper-Leavitt","sequence":"additional","affiliation":[{"name":"Department of Cell Biology and Physiology, Brigham Young University, Provo, UT 84602, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colson G.","family":"Beus","sequence":"additional","affiliation":[{"name":"Department of Cell Biology and Physiology, Brigham Young University, Provo, UT 84602, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cameron R.","family":"Braithwaite","sequence":"additional","affiliation":[{"name":"Department of Cell Biology and Physiology, Brigham Young University, Provo, UT 84602, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeline D.","family":"Morris","sequence":"additional","affiliation":[{"name":"Department of Cell Biology and Physiology, Brigham Young University, Provo, UT 84602, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asher P.","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Department of Cell Biology and Physiology, Brigham Young University, Provo, UT 84602, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethan P.","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Cell Biology and Physiology, Brigham Young University, Provo, UT 84602, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack H.","family":"Radford","sequence":"additional","affiliation":[{"name":"Department of Cell Biology and Physiology, Brigham Young University, Provo, UT 84602, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fischer D.","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Mathematics, Utah Tech University, St. George, UT 84770, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0931-3025","authenticated-orcid":false,"given":"Paul R.","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Department of Cell Biology and Physiology, Brigham Young University, Provo, UT 84602, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6798-6140","authenticated-orcid":false,"given":"R. Ryley","family":"Parrish","sequence":"additional","affiliation":[{"name":"Department of Cell Biology and Physiology, Brigham Young University, Provo, UT 84602, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin T.","family":"Bikman","sequence":"additional","affiliation":[{"name":"Department of Cell Biology and Physiology, Brigham Young University, Provo, UT 84602, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,16]]},"reference":[{"key":"ref_1","unstructured":"Hales, C.M., Carroll, M.D., Fryar, C.D., and Ogden, C.L. (2020). Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017\u20132018. NCHS Data Brief, 1\u20138."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.mcna.2017.08.012","article-title":"Maintenance of Lost Weight and Long-Term Management of Obesity","volume":"102","author":"Hall","year":"2018","journal-title":"Med. Clin. N. 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