Ketone ester supplementation blunts overreaching symptoms during endurance training overload

It is well known that elevated blood ketones attenuate net muscle protein breakdown, as well as negate catabolic events, during energy deficit. Therefore, we hypothesized that oral ketones can blunt endurance training-induced overreaching. Fit male subjects participated in two daily training sessions (3 weeks, 6 days/week) while receiving either a ketone ester (KE, n=9) or a control drink (CON, n=9) following each session. Sustainable training load in week 3, as well as power output in the final 30 min of a 2 h standardized endurance session were 15% higher in KE than in CON (both p<0.05). KE inhibited the training-induced increase in nocturnal adrenaline (p<0.01) and noradrenaline (p<0.01) excretion, as well as blunted the decrease in resting (CON: -6 ± 2bpm; KE: +2 ± 3bpm, p<0.05), submaximal (CON: -15 ± 3bpm; KE: -7 ± 2bpm, p<0.05) and maximal (CON: -17 ± 2bpm; KE: -10 ± 2bpm, p<0.01) heart rate. Energy balance during the training period spontaneously turned negative in CON (-2135kJ/d), but not in KE (+198kJ/d). The training consistently increased growth differentiation factor 15 (GDF15), but ~2-fold more in CON than in KE (p<0.05). In addition, delta GDF15 correlated with the training-induced drop in maximal heart rate (r=0.60, p<0.001) and decrease in osteocalcin (r=0.61, p