Evidence map›Paper›PMID 41097203›Full record

SynthesisNutrients2025

Clinical Benefits of Exogenous Ketosis in Adults with Disease: A Systematic Review.

Othmane Mohib, Sarah Bomans, Berenice Jimenez Garcia, Lynn Leemans, Claudine Ligneel, Elisabeth De Waele, David Beckwée, Peter Janssens

Abstract readSystematic Review
In one paragraph

Synthesis in Nutrients, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Othmane MohibDepartment of Nephrology and Arterial Hypertension, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium.ORCID 0000-0002-4636-3988
Sarah BomansDepartment of Clinical Nutrition and Dietetics, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium.ORCID 0009-0008-8455-2262
Berenice Jimenez GarciaDepartment of Clinical Nutrition and Dietetics, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium.ORCID 0000-0002-3277-5682
Lynn LeemansVitality Research Group, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium.
Claudine LigneelDepartment of Clinical Pharmacology and Pharmacotherapy, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium.
Elisabeth De WaeleVitality Research Group, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium.ORCID 0000-0002-5126-3500
David BeckwéeRehabilitation Research Department, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium.ORCID 0000-0001-9951-9993
Peter JanssensDepartment of Nephrology and Arterial Hypertension, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium.ORCID 0000-0002-0981-8621

Funding

Research Foundation - Flanders G075423N
6 · The paper itself

Abstract

BACKGROUND/

objectivesKetone bodies are increasingly studied for their potential therapeutic effects, particularly through exogenous ketosis, in a variety of diseases. This systematic review aimed to rigorously assess the clinical efficacy of exogenous ketosis in adults with medical conditions.

methodsFollowing PRISMA guidelines, we systematically searched MEDLINE and Scopus databases. Our inclusion criteria were defined according to the PICOS framework, focusing on studies involving exogenous ketosis in adult patients with specific diseases. The study is registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42023492846).

resultsAfter a stringent selection process, fifty-one studies were analyzed. Twenty-two studies focused on neurological disorders, one on psychiatric disorders, twenty-two on metabolic disorders, five on cardiovascular disorders, and one on an inflammatory disorder. Exogenous ketosis demonstrated potential benefits across multiple conditions, including Alzheimer's disease, mild cognitive impairment, McArdle's disease, various forms of heart failure, cardiogenic shock, pulmonary hypertension, and COVID-19-related acute respiratory distress syndrome, although evidence is mostly limited to surrogate endpoints with insufficient hard outcome data. Subtherapeutic ketone concentrations induced by medium-chain triglycerides and limited follow-up periods often precluded firm conclusions regarding clinically meaningful outcomes.

conclusionsExogenous ketosis shows potential in neurological, metabolic, and cardiovascular disorders, while evidence in psychiatric and inflammatory conditions remains scarce and preliminary. Ketone esters appear preferable for effective and tolerable ketosis. Future research should focus on identifying responsive patient populations, optimizing treatment regimens, and conducting long-term clinical trials with hard endpoints to validate these findings.

Indexed as

Ketone BodiesKetosisMetabolic DiseasesAdultCardiovascular DiseasesCOVID-19HumansMental DisordersNervous System DiseasesKetone Bodiesexogenous ketosisketone esterketone saltketosismedium-chain triglycerides

Identifiers

PMID41097203
PMCPMC12525594

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.