Anabolic and anticatabolic actions of ketone bodies on skeletal muscle: potential relevance in the management of skeletal muscle wasting.

Abstract

Skeletal muscle loss is a hallmark of aging, disease, and physical inactivity, with few effective treatments. Ketone bodies are lipid-derived molecules whose endogenous production is substantially amplified under conditions characterized by carbohydrate deprivation (e.g. fasting, a ketogenic diet). Orally ingested ketone supplements are now available that can rapidly induce a pronounced state of ketosis lasting hours without dietary carbohydrate restriction. Historically, ketone bodies have been hypothesized to spare muscle protein during starvation. Recently, their potential anabolic and anticatabolic effects on skeletal muscle have garnered renewed research and clinical interest. This review examines emerging evidence on ketone body administration and its influence on skeletal muscle protein turnover and related signaling, with consideration for therapeutic application in muscle wasting and rehabilitation.