Cétones exogènes: pour ou contre?

Pour ou contre

Table des matières

Pour ou contre les cétones exogènes

Les cétones exogènes, c’est un sujet très controversé. Il y a des gens qui ne jurent que par ça et d’autres qui disent qu’il ne faut pas y toucher. Habituellement quand c’est aussi controversé, la vérité est quelque part entre les deux.

Pour clarifier le sujet, j’ai fait un vidéo disponible sur YouTube :

Bref résumé du vidéo


Une cétone, c’est d’abord une molécule produite par le corps à partir des gras lorsque les glucides ne sont pas disponibles (ou épuisés). En effet, le corps produit naturellement des cétones durant le jeûne, la diète céto, les sports d’endurance (si on ne lui donne pas constamment de glucides) et à la naissance. C’est un carburant super efficace et propre dont la production est inhibée par les glucides et la résistance à l’insuline.

Cétones exogènes et alimentation

Il faut d’abord savoir que les cétones exogènes ne remplacent ni une bonne alimentation, ni le jeûne. Personne ne peut manger de la chnoutte et être en santé juste en prenant des cétones. Elles peuvent être utiles pour aider à se sortir de là, mais pour améliorer la santé, il faut changer l’alimentation. Point.

Utilité des cétones

En revanche, les cétones exogènes augmentent l’efficacité de la diète céto sur la glycémie et le taux de cétones.

Elles sont aussi utiles pour plusieurs indications :

  • Amélioration du contrôle de la glycémie
  • Diminution de la faim (aide à moins manger)
  • Effet neuroprotecteur
  • Effet cardioprotecteur
  • Effet énergisant
  • Diminution de l’inflammation (partout, même dans l’intestin)
  • Épilepsie : amélioration de l’effet de la diète céto
  • Amélioration de la récupération post exercice
  • Etc.

Risques

Les cétones exogènes sont très sécuritaires. Mais faites attention aux additifs (édulcorants et colorants de synthèse) présents dans les différents produits. Tous les produits vendus sur le marché ne sont pas égaux. Personnellement, je consomme régulièrement des cétones et j’ai choisi les cétones Prüvit parce que la formulation est intéressante. Les dosages sont intéressants et les saveurs et édulcorants qu’ils contiennent sont tous d’origine naturelle.

On entend parfois parler d’un effet sur la production endogène. J’en discute vers la fin du vidéo. J’y donne aussi beaucoup plus de détails sur les différents points mentionnés ci-haut et je m’attarde également aux mécanismes d’action.

Conclusion

Pour moi, les cétones exogènes sont des outils parmi d’autres. Ils ont leur utilité, surtout lorsque l’énergie n’est pas au rendez-vous, mais ils ne sont pas « bons pour tout ».

Pour en savoir plus, regardez le vidéo sur YouTube : https://www.youtube.com/watch?v=Grc2xEoK-_4

Références

  1. Stubbs BJ, Cox PJ, Evans RD, et al. On the Metabolism of Exogenous Ketones in Humans. Front Physiol. 2017 Oct 30;8:848. doi: 10.3389/fphys.2017.00848. PMID: 29163194; PMCID: PMC5670148. https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2017.00848/full
  2. Owen OE, Morgan AP, Kemp HG, et al. Brain metabolism during fasting. J Clin Invest. 1967 Oct;46(10):1589-95. doi: 10.1172/JCI105650. PMID: 6061736; PMCID: PMC292907. https://www.jci.org/articles/view/105650
  3. Cahill GF Jr. Starvation in man. N Engl J Med. 1970 Mar 19;282(12):668-75. doi: 10.1056/NEJM197003192821209. PMID: 4915800. https://www.nejm.org/doi/abs/10.1056/NEJM197003192821209
  4. Gilbert DL, Pyzik PL, Freeman JM. (2000). The ketogenic diet: Seizure control correlates better with serum beta-hydroxybutyrate than with urine ketones. J. Child Neurol. 15, 787–790. doi: 10.1177/088307380001501203
  5. Koeslag, J. H., Noakes, T. D., and Sloan, A. W. (1980). Post-Exercise Ketosis. J. Physiol. 301, 79–90. doi: 10.1113/jphysiol.1980.sp013190
  6. Finn PF, Dice JF. Ketone bodies stimulate chaperone-mediated autophagy. J Biol Chem. 2005 Jul 8;280(27):25864-70. doi: 10.1074/jbc.M502456200. Epub 2005 May 9. PMID: 15883160.  https://www.jbc.org/article/S0021-9258(20)61402-8/fulltext 
  7. Cahill GF Jr, Veech RL. Ketoacids? Good medicine? Trans Am Clin Climatol Assoc. 2003;114:149-61; discussion 162-3. Review. PubMed PMID: 12813917; PubMed Central PMCID: PMC2194504. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2194504/
  8. Kovács Z, D’Agostino DP, Diamond D, et al. Therapeutic Potential of Exogenous Ketone Supplement Induced Ketosis in the Treatment of Psychiatric Disorders: Review of Current Literature. Front Psychiatry. 2019 May 23;10:363. doi: 10.3389/fpsyt.2019.00363. PMID: 31178772; PMCID: PMC6543248. https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2019.00363/full
  9. Laffel L. Ketone bodies: a review of physiology, pathophysiology and application of monitoring to diabetes. Diabetes Metab Res Rev. 1999 Nov-Dec;15(6):412-26. doi: 10.1002/(sici)1520-7560(199911/12)15:6<412::aid-dmrr72>3.0.co;2-8. PMID: 10634967.
  10. Clarke K, Tchabanenko K, Pawlosky R, et al. Kinetics, safety and tolerability of (R)-3-hydroxybutyl (R)-3-hydroxybutyrate in healthy adult subjects. Regul Toxicol Pharmacol. 2012 Aug;63(3):401-8. doi: 10.1016/j.yrtph.2012.04.008. PMID: 22561291; PMCID: PMC3810007. https://pmc.ncbi.nlm.nih.gov/articles/PMC3810007/
  11. Stubbs BJ, Cox PJ, Evans RD, et al. A Ketone Ester Drink Lowers Human Ghrelin and Appetite. Obesity (Silver Spring). 2018 Feb;26(2):269-273. doi: 10.1002/oby.22051. Epub 2017 Nov 6. PMID: 29105987; PMCID: PMC5813183. https://pmc.ncbi.nlm.nih.gov/articles/PMC5813183/
  12. Yang Xiang, Qi-Quan Wang, Xin-Qiang Lan, et al. Function and treatment strategies of β-hydroxybutyrate in aging. Smart Materials in Medicine, 2023 vol 4,p 160-172 https://www.sciencedirect.com/science/article/pii/S259018342200045X
  13. Youm YH, Nguyen KY, Grant RW, et al. The ketone metabolite β-hydroxybutyrate blocks NLRP3 inflammasome-mediated inflammatory disease. Nat Med. 2015;21(3):263‐269. doi:10.1038/nm.3804 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4352123/
  14. Dupuis N, Curatolo N, Benoist JF, Auvin S. Ketogenic diet exhibits anti-inflammatory properties. Epilepsia. 2015;56(7):e95‐e98. doi:10.1111/epi.13038 https://onlinelibrary.wiley.com/doi/full/10.1111/epi.13038
  15. Lu Y, Yang YY, Zhou MW, et al. Ketogenic diet attenuates oxidative stress and inflammation after spinal cord injury by activating Nrf2 and suppressing the NF-κB signaling pathways. Neurosci Lett. 2018;683:13‐18. doi:10.1016/j.neulet.2018.06.016  https://pubmed.ncbi.nlm.nih.gov/29894768/
  16. Nakagata T, Tamura Y, Kaga H, et al. Ingestion of an exogenous ketone monoester improves the glycemic response during oral glucose tolerance test in individuals with impaired glucose tolerance: A cross-over randomized trial. J Diabetes Investig. 2021 May;12(5):756-762. doi: 10.1111/jdi.13423. Epub 2020 Nov 1. PMID: 33010116; PMCID: PMC8088997.
  17. Myette-Côté É, Neudorf H, Rafiei H, et al. Prior ingestion of exogenous ketone monoester attenuates the glycaemic response to an oral glucose tolerance test in healthy young individuals. J Physiol. 2018 Apr 15;596(8):1385-1395. doi: 10.1113/JP275709. Epub 2018 Mar 2. Erratum in: J Physiol. 2019 Nov;597(22):5515. doi: 10.1113/JP279035.. Abstract corrected. PMID: 29446830; PMCID: PMC5899975. https://pmc.ncbi.nlm.nih.gov/articles/PMC5899975/
  18. Yu Q, Falkenhain K, Little JP, Wong KK, Nie J, Shi Q, Kong Z. Effects of ketone supplements on blood β-hydroxybutyrate, glucose and insulin: A systematic review and three-level meta-analysis. Complement Ther Clin Pract. 2023 Aug;52:101774. doi: 10.1016/j.ctcp.2023.101774. PMID: 37327753. https://www.sciencedirect.com/science/article/abs/pii/S1744388123000555
  19. Falkenhain K, Oliveira BF, Islam H, et al. The effect of acute and 14-day exogenous ketone supplementation on glycemic control in adults with type 2 diabetes: two randomized controlled trials. Am J Physiol Endocrinol Metab. 2024 Jan 1;326(1):E61-E72. doi: 10.1152/ajpendo.00332.2023. PMID: 37991451. https://journals.physiology.org/doi/full/10.1152/ajpendo.00332.2023
  20. Deemer SE, Plaisance EP, Martins C. Impact of ketosis on appetite regulation-a review. Nutr Res. 2020 May;77:1-11. doi: 10.1016/j.nutres.2020.02.010. Epub 2020 Feb 20. PMID: 32193016.
  21. Mu C, Kesler M, Chen X, et al. Exogenous ketones exert antiseizure effects and modulate the gut microbiome and mycobiome in a clinically relevant murine model of epilepsy. Epilepsia. 2024 Dec;65(12):3676-3688. doi: 10.1111/epi.18150. Epub 2024 Oct 16. PMID: 39412260. https://pubmed.ncbi.nlm.nih.gov/39412260/
  22. Sasaki K, Sasaki D, Hannya A, et al. In vitro human colonic microbiota utilises D-β-hydroxybutyrate to increase butyrogenesis. Sci Rep. 2020 May 22;10(1):8516. doi: 10.1038/s41598-020-65561-5. PMID: 32444846; PMCID: PMC7244492. https://pmc.ncbi.nlm.nih.gov/articles/PMC7244492/
  23. Hashim SA, VanItallie TB. Ketone body therapy: from the ketogenic diet to the oral administration of ketone ester. J Lipid Res. 2014 Sep;55(9):1818-26. doi: 10.1194/jlr.R046599. PMID: 24598140; PMCID: PMC4617348. https://www.jlr.org/article/S0022-2275(20)35657-1/fulltext
  24. Graybeal AJ, Aultman RS, Brandner CF, et al. Effects of Ketone Ester Supplementation on Cognition and Appetite in Individuals with and Without Metabolic syndrome: A Randomized Trial. J Diet Suppl. 2025;22(3):382-400. doi: 10.1080/19390211.2025.2473371. Epub 2025 Mar 4. PMID: 40040390; PMCID: PMC12018118. https://www.tandfonline.com/doi/full/10.1080/19390211.2025.2473371
  25. Baranowski BJ, Oliveira BF, Falkenhain K, et al. Effect of exogenous β-hydroxybutyrate on BDNF signaling, cognition, and amyloid precursor protein processing in humans with T2D and insulin-resistant rodents. Am J Physiol Cell Physiol. 2025 Feb 1;328(2):C541-C556. doi: 10.1152/ajpcell.00867.2024. Epub 2025 Jan 13. PMID: 39804761. https://journals.physiology.org/doi/full/10.1152/ajpcell.00867.2024
  26. Monteyne AJ, Falkenhain K, Whelehan G, et al. A ketone monoester drink reduces postprandial blood glucose concentrations in adults with type 2 diabetes: a randomised controlled trial. Diabetologia. 2024 Jun;67(6):1107-1113. doi: 10.1007/s00125-024-06122-7. Epub 2024 Mar 14. PMID: 38483543; PMCID: PMC11058041. https://pmc.ncbi.nlm.nih.gov/articles/PMC11058041/
  27. Soto-Mota A, Norwitz NG, Evans R, et al. Exogenous ketosis in patients with type 2 diabetes: Safety, tolerability and effect on glycaemic control. Endocrinol Diabetes Metab. 2021 May 20;4(3):e00264. doi: 10.1002/edm2.264. PMID: 34277987; PMCID: PMC8279633. https://onlinelibrary.wiley.com/doi/10.1002/edm2.264
  28. Bharmal SH, Alarcon Ramos GC, Ko J, Petrov MS. Abdominal fat distribution modulates the metabolic effects of exogenous ketones in individuals with new-onset prediabetes after acute pancreatitis: Results from a randomized placebo-controlled trial. Clin Nutr ESPEN. 2021 Jun;43:117-129. doi: 10.1016/j.clnesp.2021.03.013. Epub 2021 Mar 21. PMID: 34024503.
  29. Nakagata T, Tamura Y, Kaga H, et al. Ingestion of an exogenous ketone monoester improves the glycemic response during oral glucose tolerance test in individuals with impaired glucose tolerance: A cross-over randomized trial. J Diabetes Investig. 2021 May;12(5):756-762. doi: 10.1111/jdi.13423. Epub 2020 Nov 1. PMID: 33010116; PMCID: PMC8088997. https://onlinelibrary.wiley.com/doi/10.1111/jdi.13423
  30. Oneglia AP, Young BE, Cipher DJ, et al. Acute effects of β-hydroxybutyrate on left ventricular function in young, healthy adults. J Appl Physiol (1985). 2023 Dec 1;135(6):1440-1445. doi: 10.1152/japplphysiol.00630.2023. Epub 2023 Oct 26. PMID: 37881851; PMCID: PMC10979827. https://pmc.ncbi.nlm.nih.gov/articles/PMC10979827/
  31. Berg-Hansen K, Christensen KH, Gopalasingam N, et al. Beneficial Effects of Ketone Ester in Patients With Cardiogenic Shock: A Randomized, Controlled, Double-Blind Trial. JACC Heart Fail. 2023 Oct;11(10):1337-1347. doi: 10.1016/j.jchf.2023.05.029. Epub 2023 Jul 12. PMID: 37452805.
  32. Kansakar U, Nieves Garcia C, Santulli G, et al. Exogenous Ketones in Cardiovascular Disease and Diabetes: From Bench to Bedside. J Clin Med. 2024 Dec 4;13(23):7391. doi: 10.3390/jcm13237391. PMID: 39685849; PMCID: PMC11642481. https://www.mdpi.com/2077-0383/13/23/7391
  33. Lowery RP, Wilson JM, Sharp MH, et al. The effects of exogenous ketones on biomarkers of Crohn’s disease: A case report. J Gastroenterol Dig Dis. 2017;2(3):8-11. https://www.alliedacademies.org/articles/the-effects-of-exogenous-ketones-on-biomarkers-of-crohns-disease-a-casereport-9038.html
  34. Gross EC, Putananickal N, Orsini AL, et al. Defining metabolic migraine with a distinct subgroup of patients with suboptimal inflammatory and metabolic markers. Sci Rep. 2023 Mar 7;13(1):3787. doi: 10.1038/s41598-023-28499-y. PMID: 36882474; PMCID: PMC9992685. https://pmc.ncbi.nlm.nih.gov/articles/PMC9992685/
  35. Putananickal N, Gross EC, Orsini AL, et al. Efficacy and safety of exogenous beta-hydroxybutyrate for preventive treatment in episodic migraine: A single-centred, randomised, placebo-controlled, double-blind crossover trial. Cephalalgia. 2022 Apr;42(4-5):302-311. doi: 10.1177/03331024211043792. Epub 2021 Sep 20. PMID: 34541914.
  36. Harvey CJDC, Schofield GM, Williden M. The use of nutritional supplements to induce ketosis and reduce symptoms associated with keto-induction: a narrative review. PeerJ. 2018;6:e4488. Published 2018 Mar 16. doi:10.7717/peerj.4488. https://peerj.com/articles/4488/
  37. Kansakar U, Nieves Garcia C, et al. Exogenous Ketones in Cardiovascular Disease and Diabetes: From Bench to Bedside. J Clin Med. 2024 Dec 4;13(23):7391. doi: 10.3390/jcm13237391. PMID: 39685849; PMCID: PMC11642481. https://www.mdpi.com/2077-0383/13/23/7391
  38. Oliveira B, Falkenhain K, Davy B, et al. Acute effect of an exogenous ketone monoester supplement on appetite and food intake in adults with type 2 diabetes. Appl Physiol Nutr Metab. 2024 Oct 1;49(10):1431-1435. doi: 10.1139/apnm-2023-0568. Epub 2024 Jun 3. PMID: 38830266. https://cdnsciencepub.com/doi/10.1139/apnm-2023-0568
  39. Robberechts R, Poffé C. Defining ketone supplementation: the evolving evidence for postexercise ketone supplementation to improve recovery and adaptation to exercise. Am J Physiol Cell Physiol. 2024 Jan 1;326(1):C143-C160. doi: 10.1152/ajpcell.00485.2023. Epub 2023 Nov 20. PMID: 37982172. https://journals.physiology.org/doi/full/10.1152/ajpcell.00485.2023
  40. Cheng CW, Biton M, Haber AL, et al. Ketone Body Signaling Mediates Intestinal Stem Cell Homeostasis and Adaptation to Diet. Cell. 2019 Aug 22;178(5):1115-1131.e15. doi: 10.1016/j.cell.2019.07.048. PMID: 31442404; PMCID: PMC6732196. https://www.cell.com/cell/fulltext/S0092-8674(19)30848-7
  41. Hannaian SJ, Lov J, Hawley SE, et al. Acute ingestion of a ketone monoester, whey protein, or their co-ingestion in the overnight postabsorptive state elicit a similar stimulation of myofibrillar protein synthesis rates in young males: a double-blind randomized trial. Am J Clin Nutr. 2024 Mar;119(3):716-729. doi: 10.1016/j.ajcnut.2024.01.004. Epub 2024 Jan 11. PMID: 38215886; PMCID: PMC10972741. https://www.sciencedirect.com/science/article/pii/S0002916524000042
  42. Poffé C, Robberechts R, Van Thienen R, Hespel P. Exogenous ketosis elevates circulating erythropoietin and stimulates muscular angiogenesis during endurance training overload. J Physiol. 2023 Jun;601(12):2345-2358. doi: 10.1113/JP284346. Epub 2023 Apr 27. PMID: 37062892. https://physoc.onlinelibrary.wiley.com/doi/10.1113/JP284346
  43. Edwards C, Canfield J, Copes N, et al. D-beta-hydroxybutyrate extends lifespan in C. elegans. Aging (Albany NY). 2014 Aug;6(8):621-44. doi: 10.18632/aging.100683. PMID: 25127866; PMCID: PMC4169858. https://www.aging-us.com/article/100683/text
  44. Evans M, McClure TS, Koutnik AP, Egan B. Exogenous Ketone Supplements in Athletic Contexts: Past, Present, and Future. Sports Med. 2022 Dec;52(Suppl 1):25-67. doi: 10.1007/s40279-022-01756-2. PMID: 36214993; PMCID: PMC9734240. https://pmc.ncbi.nlm.nih.gov/articles/PMC9734240/
  45. Valenzuela PL, Castillo-García A, Morales JS, Lucia A. Perspective: Ketone Supplementation in Sports-Does It Work? Adv Nutr. 2021 Mar 31;12(2):305-315. doi: 10.1093/advances/nmaa130. PMID: 33094332; PMCID: PMC8243601. https://pmc.ncbi.nlm.nih.gov/articles/PMC8243601/
  46. James S, Kjerulf Greer B. Influence of Exogenous β-Hydroxybutyrate on Walking Economy and Rating of Perceived Exertion. J Diet Suppl. 2019;16(4):463-469. doi: 10.1080/19390211.2018.1471562. PMID: 29953297. https://pubmed.ncbi.nlm.nih.gov/29953297/
  47. Pinckaers PJ, Churchward-Venne TA, Bailey D, van Loon LJ. Ketone Bodies and Exercise Performance: The Next Magic Bullet or Merely Hype? Sports Med. 2017 Mar;47(3):383-391. doi: 10.1007/s40279-016-0577-y. PMID: 27430501; PMCID: PMC5309297. https://pmc.ncbi.nlm.nih.gov/articles/PMC5309297/
  48. Leckey JJ, Ross ML, Quod M, et al. Ketone Diester Ingestion Impairs Time-Trial Performance in Professional Cyclists. Front Physiol. 2017 Oct 23;8:806. doi: 10.3389/fphys.2017.00806. PMID: 29109686; PMCID: PMC5660098. https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2017.00806/full
  49. Poffé C, Robberechts R, Stalmans M, et al. Exogenous ketosis increases circulating dopamine concentration and maintains mental alertness in ultra-endurance exercise. J Appl Physiol (1985). 2023 Jun 1;134(6):1456-1469. doi: 10.1152/japplphysiol.00791.2022. Epub 2023 May 4. PMID: 37141424.
  50. Stalmans M, Tominec D, Lauriks W, et al. Exogenous ketosis attenuates acute mountain sickness and mitigates normobaric high-altitude hypoxemia. J Appl Physiol (1985). 2024 Nov 1;137(5):1301-1312. doi: 10.1152/japplphysiol.00190.2024. Epub 2024 Sep 26. PMID: 39323395. https://pubmed.ncbi.nlm.nih.gov/39323395/
  51. Hägele FA, Dörner R, Koop J, et al. Impact of one-day fasting, ketogenic diet or exogenous ketones on control of energy balance in healthy participants. Clin Nutr ESPEN. 2023 Jun;55:292-299. doi: 10.1016/j.clnesp.2023.03.025. Epub 2023 Apr 10. PMID: 37202059.
  52. Buga A, Kackley ML, Crabtree CD, et al. Fasting and diurnal blood ketonemia and glycemia responses to a six-week, energy-controlled ketogenic diet, supplemented with racemic R/S-BHB salts. Clin Nutr ESPEN. 2023 Apr;54:277-287. doi: 10.1016/j.clnesp.2023.01.030. Epub 2023 Feb 4. PMID: 36963874.
  53. Bolyard ML, Graziano CM, Fontaine KR, et al. Tolerability and Acceptability of an Exogenous Ketone Monoester and Ketone Monoester/Salt Formulation in Humans. Nutrients. 2023 Nov 22;15(23):4876. doi: 10.3390/nu15234876. PMID: 38068734; PMCID: PMC10708260. https://www.mdpi.com/2072-6643/15/23/4876
  54. Rojas-Morales P, Pedraza-Chaverri J, Tapia E. Ketone bodies for kidney injury and disease. Advances in Redox Research, 2021, Volume 2, 100009, ISSN 2667-1379, https://doi.org/10.1016/j.arres.2021.100009 https://www.sciencedirect.com/science/article/pii/S2667137921000096
  55. Stubbs BJ, Koutnik AP, Goldberg EL, et al. Investigating Ketone Bodies as Immunometabolic Countermeasures against Respiratory Viral Infections. Med. 2020 Dec 18;1(1):43-65. doi: 10.1016/j.medj.2020.06.008. Epub 2020 Jul 15. PMID: 32838361; PMCID: PMC7362813. https://pmc.ncbi.nlm.nih.gov/articles/PMC7362813/
  56. Shivva V, Cox PJ, Clarke K, et al. The Population Pharmacokinetics of D-β-hydroxybutyrate Following Administration of (R)-3-Hydroxybutyl (R)-3-Hydroxybutyrate. AAPS J. 2016 May;18(3):678-88. doi: 10.1208/s12248-016-9879-0. Epub 2016 Feb 18. PMID: 26893218; PMCID: PMC5256599. https://pmc.ncbi.nlm.nih.gov/articles/PMC5256599/
  57. Mikkelsen KH, Seifert T, Secher NH, et al. Systemic, cerebral and skeletal muscle ketone body and energy metabolism during acute hyper-D-β-hydroxybutyratemia in post-absorptive healthy males. J Clin Endocrinol Metab. 2015 Feb;100(2):636-43. doi: 10.1210/jc.2014-2608. Epub 2014 Nov 21. PMID: 25415176.

Image par Darby Browning de Pixabay

Laisser un commentaire

Votre adresse e-mail ne sera pas publiée. Les champs obligatoires sont indiqués avec *

Catégories