Journal club Ketones

General
1. Information about the author(s): Approx. 5 lines (Where is the group located? What is the
expertise of the group? How does this paper fit in their overall research interests? Tip: use Google!)

2. What is the research question and what is the hypothesis that is tested in the paper?

RQ: we examined whether β-OHB ketone salts influenced substrate utilization during steady-state
exercise and assessed their impact on high-intensity exercise performance.

No hypothesis.

3. Is this research question and hypothesis clearly defined?

Research question is formulated as study aim.

No hypothesis.

4. Is the chosen experimental setup (design) appropriate to answer the question? What other
choices would you have made? Explain.

A double-blind placebo-controlled crossover design. Good design to test supplement. Highest form of
evidence.

5. Is the work presented in the paper original (new, confirmatory, fails to advance knowledge)?
Explain.

According to the introduction it is. It’s a new study.

6. Is the work clearly presented (well organized, clearly written, or obscure and vague)? Explain.

Title / abstract
7. Does the title of the paper cover the content of the paper? Is the title clear, concise and
informative? Explain.

Add recreationally active men instead of healthy.

8. Is the abstract complete and does it attract your attention? Explain.

Introduction
9. Is the introduction understandable and do you recognize a clear funnel shape in the
introduction? Comment on this.
Info about ketone supplement and the most common ketone  Recent insights of ketone
supplementation  explanations of molecular working mechanisms  Knowledge gap  study aim

10. Are the appropriate references being used (enough references, too many references)?
Comment on this.

25 references is not a lot.

Methods
11. Is the description of the experiment protocol clear? Is all information available for other
researchers to re-perform the study? Comment on this.

I find the information quite clear. The instructions are quite detailed.

12. Are the participants (and selection criteria) well described? What selection criteria have been
used and why do you think this is appropriate or not?
participants are described in enough detail. Selection criteria are not mentioned.

13. What methods have been used? Are these methods valid and reliable? Comment on this.
Participant engaged in a ramp protocol on an electronically braked cycle ergometer (Lode Ergometer
Manager, Groningen, the Netherlands).

Expired gas was analyzed by a metabolic cart (TrueOne 2400 Metabolic Measurement System; Parvo
Medic, Murray, Ky., USA)

Ketone salts were acquired from a commercially available ketone supplement (KetoForce; Prototype
Nutrition, Urbana, Ill., USA).

The ergometer was set in linear mode and the time-trial was equated to a distance of 10 km by the
associated software program (Lode Ergometer Manager).

Substrate oxidation rates were calculated from indirect calorimetry measurements (Jeukendrup and
Wallis 2005).

repeated-measures ANOVA Sidak’s post hoc test.

14. What statistic tests are being used and what is your opinion on the statistics in this paper? Are
the tests used appropriate for this research? Comment on this
GraphPad Prism, version 6: I am unfamiliar with this program. Repeated measures ANOVA is good
because time is also an independent factor and it’s a cross-over design.

Results
15. Are the results clearly presented? Are the main results easily deducible? Comment on this.
Results section is very short. Easy to read.

16. How do you judge the completeness of the data given? Are also non-significant results and
negative outcomes displayed and clearly visible? Comment on this.
It seems like all data is given.

17. How many figures and tables have been used and do the figures explain themselves? Comment
on this.
3 figures. No tables. Easy to read and explain themselves.

Discussion
18. Is there are short summary given about the research and is this appropriate? Explain.

Not really. They do summarise the main findings. But not the research they did.

19. Is the interpretation consistent with results and earlier findings (references)? Explain.

20. What are the limitations of this study (potential bias, unforeseen issues)? Are these well
described? Explain.
21. What is the main outcome of this paper? Use your own words!

Elevating blood ketones through consumption of oral ketone supplements alters lipid and CHO
metabolism during exercise in humans. Our findings provide the first evidence that raising β-OHB
through provision of ketone salts may impair high-intensity exercise performance. The underlying
mechanisms for the performance impairment following ketone salt ingestion is not clear but based
on lower CHO oxidation during exercise may be related to inhibition of glycolysis, as postulated by
others.

22. What is your overall opinion of this paper? (Approximately 5-10 lines)