A University of Connecticut Health clinical trial is testing whether a ketone supplement can improve strength and cognition in older adults, without requiring them to change their diet, according to lead researcher Jenna Bartley.
The study is enrolling adults 65 and older who are considered “pre-frail,” meaning they have begun to slow down but are not yet frail. Participants are randomly assigned to take either a ketone ester or a placebo for 20 weeks, Bartley said. The supplement comes in a packet that dissolves in a liquid or even in applesauce, and participants build up to two packets in the morning and two at night over four weeks.
The trial is a collaboration with John Newman of the Buck Institute and Jeff Volek of Ohio State University, Bartley said. It is double-blinded, so neither participant nor researchers know who is receiving the supplement until the study ends.
Ketones are molecules the body makes when it burns fat for energy, such as during a ketogenic diet or caloric restriction. Bartley mentioned how researchers once viewed them mainly as backup fuel; however, newer research shows how they also act as signaling molecules that may affect inflammation and muscle breakdown which are both tied to aging.
The study’s primary outcome is a composite score that combines physical function and cognitive testing, Bartley said. She said researchers chose it because ketones do not appear to target just one aspect of aging.
Bartley said ketogenic diets have powerful effects on health but are hard for people to follow. Because the diet is so restrictive, she said, “most people find it pretty difficult.”
She pointed to a large calorie restriction study in which middle-aged adults were asked to cut their calories by about 25%. On average, most could only maintain about 10 to 12%, Bartley said.
That is why the trial adds a supplement to participants’ normal diet rather than changing what they eat, Bartley said. “It’s much easier to have someone add in a supplement… compared to changing your entire diet that you normally eat,” she said.
Medical professionals raise the question of ketoacidosis, which is a medical emergency that can occur in people with uncontrolled diabetes, which Bartley said is not applicable here. The dose in the study at UConn “does not raise blood ketones high enough to get any concerning level whatsoever,” she said.
Ketone is not meant to compete with GLP-1 weight loss drugs, which can be concerning for older adults on the drugs. The concern is because 25% to 50% of weight loss can be lean mass like muscle, which older adults have difficulty rebuilding, according to Bartley. Ketone research aims to target biological drivers of aging rather than cause weight loss.
Researchers will not see results until the last participant finishes. Bartley said recruitment will continue for about another year with results expected roughly a year and a half after that.
If the supplement works, Bartley said, it could eventually be recommended to older adults who are beginning to slow down, before frailty or conditions such as Alzheimer’s development.
UConn Storrs students interested in aging research can get involved through Education in Aging and Geroscience Research (EAGER), a program led by Dr. Ken Campellone of the molecular and cell biology department. The program includes a summer internship placing students in labs at UConn Health and Storrs, Bartley said.