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Nutrients
Volume 17
Issue 22
10.3390/nu17223582
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Article

Effect of Exogenous Ketones as an Adjunct to Low-Calorie Diet on Metabolic Markers

by
Eliza J. Roeth
1,
Genevieve Parker
1,
Ella F. Cooper-Leavitt
1,
Colson G. Beus
1,
Cameron R. Braithwaite
1,
Madeline D. Morris
1,
Asher P. Reynolds
1,
Ethan P. Evans
1,
Jack H. Radford
1,
Fischer D. Davis
2,
Paul R. Reynolds
1,
R. Ryley Parrish
1 and
Benjamin T. Bikman
1,*
1
Department of Cell Biology and Physiology, Brigham Young University, Provo, UT 84602, USA
2
Department of Mathematics, Utah Tech University, St. George, UT 84770, USA
*
Author to whom correspondence should be addressed.
Nutrients 2025, 17(22), 3582; https://doi.org/10.3390/nu17223582
Submission received: 9 October 2025 / Revised: 13 November 2025 / Accepted: 14 November 2025 / Published: 16 November 2025
(This article belongs to the Special Issue The Ketogenic Diet: Biochemical Mechanisms and Clinical Applications)
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Abstract

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 β-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 < 0.01 within placebo and p < 0.001 within BHB). Within the BHB group, fat mass decreased significantly (−2 kg; p < 0.05 vs. baseline), body fat percentage improved (p < 0.01 vs. baseline), and lean-to-fat mass ratio increased (p < 0.05 vs. baseline); no such significant changes were observed within the placebo group. Group × time interactions were not significant for these body composition variables (p > 0.05). Furthermore, lean mass was largely preserved, with no declines in RMR. Within the BHB group, LDL cholesterol was reduced (p < 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.
Keywords: ketones; weight loss; body composition; beta-hydroxybutyrate ketones; weight loss; body composition; beta-hydroxybutyrate

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MDPI and ACS Style

Roeth, E.J.; Parker, G.; Cooper-Leavitt, E.F.; Beus, C.G.; Braithwaite, C.R.; Morris, M.D.; Reynolds, A.P.; Evans, E.P.; Radford, J.H.; Davis, F.D.; et al. Effect of Exogenous Ketones as an Adjunct to Low-Calorie Diet on Metabolic Markers. Nutrients 2025, 17, 3582. https://doi.org/10.3390/nu17223582

AMA Style

Roeth EJ, Parker G, Cooper-Leavitt EF, Beus CG, Braithwaite CR, Morris MD, Reynolds AP, Evans EP, Radford JH, Davis FD, et al. Effect of Exogenous Ketones as an Adjunct to Low-Calorie Diet on Metabolic Markers. Nutrients. 2025; 17(22):3582. https://doi.org/10.3390/nu17223582

Chicago/Turabian Style

Roeth, Eliza J., Genevieve Parker, Ella F. Cooper-Leavitt, Colson G. Beus, Cameron R. Braithwaite, Madeline D. Morris, Asher P. Reynolds, Ethan P. Evans, Jack H. Radford, Fischer D. Davis, and et al. 2025. "Effect of Exogenous Ketones as an Adjunct to Low-Calorie Diet on Metabolic Markers" Nutrients 17, no. 22: 3582. https://doi.org/10.3390/nu17223582

APA Style

Roeth, E. J., Parker, G., Cooper-Leavitt, E. F., Beus, C. G., Braithwaite, C. R., Morris, M. D., Reynolds, A. P., Evans, E. P., Radford, J. H., Davis, F. D., Reynolds, P. R., Parrish, R. R., & Bikman, B. T. (2025). Effect of Exogenous Ketones as an Adjunct to Low-Calorie Diet on Metabolic Markers. Nutrients, 17(22), 3582. https://doi.org/10.3390/nu17223582

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