Evidence supporting the use of: Beta-hydroxybutyrate
For the health condition: Exercise

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Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Beta-hydroxybutyrate (BHB) is a ketone body that has gained attention for its potential role in supporting exercise performance, particularly in endurance sports. Scientific interest in BHB supplementation stems from its role as an alternative energy substrate during periods of low carbohydrate availability, such as fasting, ketogenic diets, or prolonged exercise. When ingested as a supplement (either in salt or ester form), BHB can increase circulating ketone levels, providing muscles and the brain with an additional fuel source.

Several studies have investigated the effects of exogenous ketone supplementation on exercise performance. Some research indicates that BHB may enhance endurance performance by sparing muscle glycogen and reducing lactate accumulation, though these effects seem most pronounced during prolonged, moderate-intensity exercise and when individuals are already adapted to ketogenic metabolism. However, findings are mixed: other studies report no improvement or even impairment in high-intensity exercise performance, possibly due to gastrointestinal discomfort or metabolic shifts unfavorable for sprint activities.

Systematic reviews and meta-analyses suggest that while BHB supplementation can elevate ketone levels and alter substrate utilization, the ergogenic (performance-enhancing) benefits are modest and not universally observed. The strongest evidence for benefit appears in specific scenarios such as ultra-endurance events or in athletes adhering to low-carbohydrate diets. In summary, scientific validation exists but is moderate and context-dependent, and more research is needed to clarify optimal dosing, timing, and target populations.

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