Evidence map›Paper›PMID 41829932›Full record

ReviewNutrients2026

The Role of Ketogenic Diet and β-Hydroxybutyrate in the Prevention of Muscle Catabolism and Sarcopenia in Aging Populations: Mechanisms, Evidence, and Clinical Perspectives.

Claudia Venturini, Giulia Matacchione, Lucia Mancinelli, Sara Caccese, Michele Alfieri, Fabrizia Lattanzio, Fabiola Olivieri, Roberto Antonicelli

Abstract readReview
In one paragraph

Review in Nutrients, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Review
  2. Review
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.

Claudia VenturiniClinical Nutrition Unit, National Institute of Health and Science on Aging, IRCCS INRCA Ancona, 60127 Ancona, Italy.ORCID 0000-0001-8054-4128
Giulia MatacchioneClinic of Laboratory and Precision Medicine, IRCCS INRCA, 60127 Ancona, Italy.ORCID 0000-0002-1840-3903
Lucia MancinelliCardiology Unit, IRCCS INRCA, 60127 Ancona, Italy.
Sara CacceseAdvanced Technology Center for Aging Research and Geriatric Mouse Clinic, IRCCS INRCA, 60121 Ancona, Italy.ORCID 0009-0004-6427-1886
Michele AlfieriCardiology Unit, IRCCS INRCA, 60127 Ancona, Italy.
Fabrizia LattanzioScientific Direction, IRCCS INRCA Ancona, 60124 Ancona, Italy.
Fabiola OlivieriAdvanced Technology Center for Aging Research and Geriatric Mouse Clinic, IRCCS INRCA, 60121 Ancona, Italy.ORCID 0000-0002-9606-1144
Roberto AntonicelliCardiology Unit, IRCCS INRCA, 60127 Ancona, Italy.

Funding

Ministero della Salute Ricerca Corrente
6 · The paper itself

Abstract

Sarcopenia, characterized by the progressive loss of skeletal muscle mass, strength, and function, represents a growing public health challenge in aging populations. Emerging mechanistic evidence suggests that ketogenic diets (KDs) and elevated circulating β-hydroxybutyrate (βOHB) levels may offer selective and context-dependent nutritional strategies to support muscle health during aging. This review summarizes current evidence on the effects of ketogenic diets and ketone body metabolism on muscle mass and function, with a focus on underlying molecular mechanisms and clinical relevance in older adults. βOHB acts not only as an alternative energy substrate but also as a signaling molecule, notably through histone deacetylase inhibition and modulation of inflammatory pathways. Nutritional ketosis in humans typically results in circulating βOHB concentrations of approximately 0.5-3.0 mM, which may be sufficient to engage some of these signaling pathways, although the extent of these effects in human tissues remains incompletely defined. Preclinical studies indicate that long-term ketogenic diets preserve muscle mass, strength, and mitochondrial function in aging models. Limited clinical evidence, largely derived from populations with sarcopenic obesity or metabolic comorbidities, suggests that protein-adequate ketogenic diets, when implemented as an adjunct to physical exercise, may help preserve fat-free mass and improve functional outcomes, while exogenous ketones show potential to augment post-exercise anabolic signaling. Overall, the integration of mechanistic and preliminary clinical data provides a supplementary and exploratory framework suggesting that ketogenic diets may represent a promising adjunctive strategy for sarcopenia prevention, although well-designed long-term randomized controlled trials are required to define their efficacy, safety, and optimal clinical application.

Indexed as

3-Hydroxybutyric AcidAgingDiet, KetogenicMuscle, SkeletalSarcopeniaAgedAnimalsHumansKetone Bodies3-Hydroxybutyric AcidKetone Bodiesagingketogenic dietmuscle masssarcopeniaβ-hydroxybutyrate

Identifiers

PMID41829932
PMCPMC12986984

What OpenQuestion holds

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LicenceCC BY
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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.