Study accidentally finds drinking ketones improves heart health

Drinking ketones improves heart health, a new small-scale study from the University of Portsmouth has found.

Patients with T2DM mellitus (T2DM) have been given a drink with ketone esters for the first time – a supplement used to put the body into ketosis – in order to monitor its effect on the heart.

Ketosis is the metabolic state where your body is forced to burn fats instead of carbohydrates.

The study was conducted after a new drug, set to lower sugar levels in people with T2DM, was found to treatment people with cardiovascular disease.

 “It’s still early days, but these results are promising. We saw an improvement in cardiac efficiency after the participants had the drink with ketones, compared to a placebo drink,” said Dr Maria Perissiou from the University of Portsmouth’s School of Psychology, Sport and Health Sciences and the study’s author.

The trial involved 13 participants who were given a drink with ketones, and then a placebo drink more than a week later.

On each occasion cardiovascular function was measured 30 minutes after administration of the drink, using non-invasive monitoring – similar to an ECG – an ultrasound to assess microvascular function, and infrared spectroscopy to assesses blood flow into small vessels. 

“In all 13 of the participants, their hearts were working more efficiently after the ketone drink, both at rest and during moderate intensity exercise, compared to the placebo drink. I’m feeling very positive about the results, but more research is needed because we only assessed participants on the day, which means we have no idea what the longer term impact of drinking ketones would be,” said Dr Perissiou.

Dr Perissiou added that the effect of ketones on heart health is a serendipitous finding: “It’s only really by chance that we’ve been able to establish this connection after seeing an improvement in cardiovascular health of patients being treated for diabetes with a drug called sodium-glucose cotransporter-2 inhibitors (SGLT2i).”

Our bodies have two different fuel tanks - glucose and free fatty acids. Healthy people use glucose because it’s more efficient, but people with diabetes tend to use free fatty acids because their bodies are unable to break down glucose into energy due to insulin resistance.

Dr Perissiou said: “For patients with diabetes, glucose can stay in the bloodstream and act like rust – gradually destroying the vessels. And for those with T2DM, their hearts are using fatty acids and gradually working harder and harder, which means they’re at risk of dying from different cardiovascular diseases.

“The drug SGLT2i was used to lower glucose in patients with diabetes and longitudinal studies were showing that it was inadvertently protecting the heart. The hypothesis was that the drug induces ketosis and the heart was using ketones, which improved heart health, but the evidence for this was limited so our research set out to prove the connection.”

For further reading please visit: 10.1152/japplphysiol.00800.2024