1Meta-Analysis2021
Zhang LM, DU TH, Niu LL, Wang LY, Li JN, Ma PF · Zhongguo Zhong Yao Za Zhi (2021)
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136 peer-reviewed studies
What the evidence says
Most Exogenous Ketones studies are mechanism or observational rather than RCTs that measure a clinical effect — keep findings provisional.
Most evidence is from high-quality meta-analyses and randomised trials published 1994–2026 with a typical study size of 16 participants.
Based on 136 studies · 10 meta-analyses · 113 RCTs · 2,269 total participants
Confidence
High confidenceBy outcome
117 studies in the last 5 years · Latest meta-analysis: 2026
Zhang LM, DU TH, Niu LL, Wang LY, Li JN, Ma PF · Zhongguo Zhong Yao Za Zhi (2021)
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Marcotte-Chénard A, Tremblay R, Falkenhain K, Little JP, Riesco E · J Diet Suppl (2024)
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Yi YH, Zhang GH, Lv SM, Rong YH, Liu H, Teng J · Medicine (Baltimore) (2024)
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Falkenhain K, Daraei A, Forbes SC, Little JP · Adv Nutr (2022)
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Brooks E, Lamothe G, Nagpal TS, Imbeault P, Adamo K, Kara J · Int J Sport Nutr Exerc Metab (2022)
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Yu Q, Falkenhain K, Little JP, Wong KK, Nie J, Shi Q · Complement Ther Clin Pract (2023)
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Wang KY, Wang HC, Jin XY, Zhang MY, Li N, Pang WT · Zhongguo Zhong Yao Za Zhi (2021)
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Margolis LM, O'Fallon KS · Adv Nutr (2020)
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Bonnechère B, Stephens EB, Boileau AC, Ducker M, Stubbs BJ · Front Nutr (2026)
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Grammatikopoulou MG, Tousinas G, Balodimou C, Anastasilakis DA, Gkiouras K, Dardiotis E · Maturitas (2022)
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Mohib O, Bomans S, Jimenez Garcia B, Leemans L, Ligneel C, De Waele E · Nutrients (2025)
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Bohnen JLB, Albin RL, Bohnen NI · Front Neurol (2023)
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Storoschuk KL, Wood TR, Stubbs BJ · Front Physiol (2023)
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In plain English: Ketone infusion raised cardiac output by 2.0 L/min in heart failure — the finding that launched serious therapeutic interest.
Nielsen R et al. · Circulation (2019)
Rittig N, Christiansen Arlien-Søborg M, Svart MV, Thomsen HH, Kirkegaard K, Greve VH · Eur J Endocrinol (2025)
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Valenzuela PL, Santalla A, Alejo LB, Bustos A, Ozcoidi LM, Castellote-Bellés L · Clin Nutr (2024)
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Perissiou M, Saynor ZL, Feka K, Edwards C, James TJ, Corbett J · J Appl Physiol (1985) (2025)
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Shaw DM, Merien F, Braakhuis A, Keaney L, Dulson DK · Eur J Appl Physiol (2020)
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Rourke AJ, Yong CMS, Coombs GB, Odisho AR, Nash JA, Bone J · J Physiol (2026)
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Hannaian SJ, Lov J, Hawley SE, Dargegen M, Malenda D, Gritsas A · Am J Clin Nutr (2024)
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