Metabolic response to a ketogenic breakfast in the healthy elderly

  • E. Freemantle
  • M. Vandal
  • J. Tremblay-Mercier
  • M. Plourde
  • J. Poirier
  • S. C. Cunnane
JNHA: Nutrition



To determine whether the metabolism of glucose or ketones differs in the healthy elderly compared to young or middle-aged adults during mild, short-term ketosis induced by a ketogenic breakfast.

Design and participants

Healthy subjects in three age groups (23±1, 50±1 and 76±2 y old) were given a ketogenic meal and plasma -hydroxybutyrate, glucose, insulin, triacylglycerols, total cholesterol, non-esterified fatty acids and breath acetone were measured over the subsequent 6 h. Each subject completed the protocol twice in order to determine the oxidation of a tracer dose of both carbon-13 (13C) glucose and 13C- -hydroxybutyrate. The tracers were given separately in random order. Apolipoprotein E genotype was also determined in all subjects.


Plasma glucose decreased and -hydroxybutyrate, acetone and insulin increased similarly over 6 h in all three groups after the ketogenic meal. There was no significant change in cholesterol, triacylglycerols or non-esterified fatty acids over the 6 h. 13C-glucose and 13C- -hydroxybutyrate oxidation peaked at 2–3 h post-dose for all age groups. Cumulative 13C-glucose oxidation over 24 h was significantly higher in the elderly but only versus the middle-aged group. There was no difference in cumulative 13C- -hydroxybutyrate oxidation between the three groups. Apolipoprotein E ( 4) was associated with elevated fasting cholesterol but was unrelated to the other plasma metabolites.


Elderly people in relatively good health have a similar capacity to produce ketones and to oxidize 13C- -hydroxybutyrate as middle-aged or young adults, but oxidize 13C-glucose a little more rapidly than healthy middle-aged adults.

Key words

Ketones glucose healthy elderly 13C stable isotope tracers 


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Copyright information

© Serdi and Springer Verlag France 2009

Authors and Affiliations

  • E. Freemantle
    • 1
    • 2
  • M. Vandal
    • 1
    • 2
  • J. Tremblay-Mercier
    • 1
    • 2
  • M. Plourde
    • 1
    • 2
  • J. Poirier
    • 3
  • S. C. Cunnane
    • 1
    • 4
    • 2
  1. 1.Research Center on AgingHealth and Social Services Center — Sherbrooke University Geriatrics InstituteSherbrookeCanada
  2. 2.Departments of Medicine and Physiology and BiophysicsUniversité de SherbrookeSherbrookeCanada
  3. 3.Departments of Medicine and PsychiatryMcGill UniversitySherbrookeCanada
  4. 4.SherbrookeCanada

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