Evidence map›Paper›PMID 42449121›Full record

ArticleNutrition & diabetes2026

Defining a ketone threshold for weight loss: evidence from 14 day daily β-hydroxybutyrate monitoring in 217 subjects on a ketogenic diet.

Antonio Paoli, Giuseppe Cerullo, Samuele Paoli, Davide Charrier, Jacopo Givralli, Antonino Bianco, Giovanna Boccuzzo, Pietro Belloni, Lorenzo Cenci, Tatiana Moro

Abstract read
In one paragraph

Article in Nutrition & diabetes, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

10 authors.

Antonio PaoliDepartment of Biomedical Sciences, University of Padua, Padova, Italy.
Giuseppe CerulloDepartment of Biomedical Sciences, University of Padua, Padova, Italy. giuseppe.cerullo@unipd.it.ORCID http://orcid.org/0000-0001-8098-2283
Samuele PaoliDepartment of Statistical Sciences, University of Padua, Padova, Italy.
Davide CharrierDepartment of Biomedical Sciences, University of Padua, Padova, Italy.
Jacopo GivralliDepartment of Biomedical Sciences, University of Padua, Padova, Italy.
Antonino BiancoSport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy.
Giovanna BoccuzzoDepartment of Statistical Sciences, University of Padua, Padova, Italy.
Pietro BelloniDepartment of Statistical Sciences, University of Padua, Padova, Italy.
Lorenzo CenciDepartment of Biomedical Sciences, University of Padua, Padova, Italy.
Tatiana MoroDepartment of Biomedical Sciences, University of Padua, Padova, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe ketogenic diet (KD) is a widely used nutritional intervention for weight loss. The beneficial effects of the KD are intrinsically linked to the state of physiological ketosis, where ketone bodies (KBs) raise, even though minimal effective threshold of blood ketone concentration that correlates with significant weight loss remains unclear. Therefore, the main purpose of this study was to identify the optimal β-hydroxybutyrate (βHB) threshold associated with weight loss in individuals with overweight or obesity undergoing a KD.

methodsThis secondary analysis included 217 participants (111 males and 106 females) with overweight or obesity, who followed a KD for 14 days. Time to Ketosis (TtK)-defined as the number of days needed to reach and maintain a given ketone concentration-was calculated for each threshold.

resultsRegression analysis showed that a βHB concentration of ≥0.5 mmol/L was the most associated with significant weight loss. Moreover, body weight and gender significantly influenced TtK, suggesting interindividual variability in achieving effective ketosis.

conclusionsAchieving and maintaining a ketonemia of at least 0.5 mmol/L may represent a clinically meaningful threshold to optimize weight loss in individuals undergoing a KD. Monitoring βHB levels and reducing TtK may improve individual responsiveness to KD-based interventions.

Indexed as

3-Hydroxybutyric AcidDiet, KetogenicKetone BodiesObesityOverweightWeight LossAdultFemaleHumansKetosisMaleMiddle Aged3-Hydroxybutyric AcidKetone Bodies

Identifiers

PMID42449121
PMCPMC13645730

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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.