Increased cardiorespiratory stress during submaximal cycling after ketone monoester ingestion in endurance-trained adults

There is growing interest in the effect of exogenous ketone body supplementation on exercise responses and performance. The limited studies to date have yielded equivocal data, likely due in part to differences in dosing strategy, increase in blood ketones, and participant training status. Using a randomized, double-blind, counterbalanced design, we examined the effect of ingesting a ketone monoester (KE) supplement (600 mg/kg body mass) or flavour-matched placebo in endurance-trained adults (n =10 males, n = 9 females; (V) over dotO(2peak) = 57 +/- 8 mL/kg/min). Participants performed a 30-min cycling bout at ventilatory threshold intensity (71 +/- 3% (V) over dotO(2peak)), followed 15 min later by a 3 kJ/kg body mass time-trial. KE versus placebo ingestion increased plasma beta-hydroxybutyrate concentration before exercise (3.9 +/- 1.0 vs 0.2 +/- 0.3 mM, p < 0.0001, d(z) = 3.4), ventilation (77 +/- 17 vs 71 +/- 15 L/min, p < 0.0001, d(z) = 1.3) and heart rate (155 +/- 11 vs 150 +/- 11 beats/min, p < 0.001, d(z) = 1.2) during exercise, and rating of perceived exertion at the end of exercise (15.4 +/- 1.6 vs 14.5 +/- 1.2, p < 0.01, d(z) = 0.85). Plasma beta-hydroxybutyrate concentration remained higher after KE vs placebo ingestion before the time-trial (3.5 +/- 1.0 vs 0.3 +/- 0.2 mM, p < 0.0001, d(z) = 3.1), but performance was not different (KE: 16:25 +/- 2:50 vs placebo: 16:06 +/- 2:40 min:s, p = 0.20; d(z) = 0.31). We conclude that acute ingestion of a relatively large KE bolus dose increased markers of cardiorespiratory stress during submaximal exercise in endurance-trained participants. Novelty: Limited studies have yielded equivocal data regarding exercise responses after acute ketone body supplementation. Using a randomized, double-blind, placebo-controlled, counterbalanced design, we found that ingestion of a large bolus dose of a commercial ketone monoester supplement increased markers of cardiorespiratory stress during cycling at ventilatory threshold intensity in endurance-trained adults.