Ketosis Suppression and Ageing (KetoSAge): The Effects of Suppressing Ketosis in Long Term Keto-Adapted Non-Athletic Females

Most studies on ketosis have focused on short-term effects, male athletes, or weight loss. Hereby, we studied the effects of short-term ketosis suppression in healthy women on long-standing ketosis. Ten lean (BMI 20.5 +/- 1.4), metabolically healthy, pre-menopausal women (age 32.3 +/- 8.9) maintaining nutritional ketosis (NK) for > 1 year (3.9 years +/- 2.3) underwent three 21-day phases: nutritional ketosis (NK; P1), suppressed ketosis (SuK; P2), and returned to NK (P3). Adherence to each phase was confirmed with daily capillary D-beta-hydroxybutyrate (BHB) tests (P1 = 1.9 +/- 0.7; P2 = 0.1 +/- 0.1; and P3 = 1.9 +/- 0.6 pmol/L). Ageing biomarkers and anthropometrics were evaluated at the end of each phase. Ketosis suppression significantly increased: insulin, 1.78-fold from 33.60 (+/- 8.63) to 59.80 (+/- 14.69) pmol/L (p = 0.0002); IGF1, 1.83-fold from 149.30 (+/- 32.96) to 273.40 (+/- 85.66) mu g/L (p = 0.0045); glucose, 1.17-fold from 78.6 (+/- 9.5) to 92.2 (+/- 10.6) mg/dL (p = 0.0088); respiratory quotient (RQ), 1.09-fold 0.66 (+/- 0.05) to 0.72 (+/- 0.06; p = 0.0427); and PAI-1, 13.34 (+/- 6.85) to 16.69 (+/- 6.26) ng/mL (p = 0.0428). VEGF, EGF, and monocyte chemotactic protein also significantly increased, indicating a pro-inflammatory shift. Sustained ketosis showed no adverse health effects, and may mitigate hyperinsulinemia without impairing metabolic flexibility in metabolically healthy women.