Elevated ketone production and utilization results in a host of health benefits. The aim of this study was to assess the rate of ketone production during a prolonged fast and to evaluate how an initial bout of exercise influences this production. Mood and hunger, along with plasma insulin and glucagon, were also assessed. In this crossover study, 20 adult subjects (11 Male, 9 Female) completed two 36-hour fasts, with one protocol requiring the subject to complete an intense treadmill exercise session at the beginning of the fast. Ketone levels were assessed via blood ketone meter and recorded every two hours. Subjective mood and hunger ratings were also recorded every two hours. Venipuncture was performed every 12 hours to assess plasma insulin and glucagon. The mean area under the ketone production curve for the nonexercise intervention was 19.19 ± 2.59 mmol/L and 27.49 ± 2.59 mmol/L for the exercise intervention, resulting in a significant 8.30 mmol/L difference between conditions (95% probability interval was 1.94 to 14.82 mmol/L). The mean time to nutritional ketosis was 21.07 ± 2.95 hours with fasting alone, and 17.5 ± 1.69 hours when combined with exercise (posterior probability = 0.89). There was a significant decrease in insulin over time (F(3,133) = 61.75, p < 0.0001). There was also a significant increase in glucagon over time (F(3,133) = 21.10, p < 0.0001). Hunger and stomach discomfort did not differ between conditions. Anger (F(10,394) = 2.74, p = 0.0028), depression (F(10,394) = 2.91, p = 0.0016), tension (F(10,394) = 2.29, p = 0.0128), vigor (F(10,394) = 11.65, p < 0.0001), and fatigue (F(10,394) = 10.60, p = 0.0001) increased over the course of the fast, but did not differ between conditions. Completing aerobic exercise at the beginning of a 36-hour fast results in significantly more ketone production. The impact of exercise on ketone production comes at little or no impact on hunger, stomach discomfort and negative moods. A difference in time to achieving nutritional ketosis between conditions may exist, but this was not observed in this study.



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Life Sciences



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ketosis, ketogenesis, blood ketone, fasting, exercise, beta-hydroxybutyrate



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Life Sciences Commons