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CompletedNCT04490226Updated Oct 1, 2021

Endogenous vs. Exogenous Ketone Bodies

An interventional study of Beta-Hydroxybutyrate as Ca-Mg-salt, active and ketogenic diet (KetoCal® 4:1 Neutral, Nutricia GmbH, Erlangen, Germany), active in Healthy, sponsored by University of Kiel. Completed at 1 site in Germany. Open to participants aged 20 Years to 35 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2021-10-01.

Sponsored by University of Kiel · Not applicable, Interventional, and Basic science

Phase
Not applicable
Study type
Interventional
Enrollment
8
Allocation
Non-randomized
Ages
20 Years to 35 Years
Sex
All
01

Study summary

Aim of the study is to compare the origin of ketone bodies: endogenous ketone bodies due to 36 hours fasting or 24 hours of ketogenic diet vs. exogenous ketone bodies as supplements additional to normal diet.

Secondary aim of the study is to validate the new metabolic chambers.

Read the detailed description

Each study week starts with a 3-day run-in period with controlled diet at home and ends with a test-meal (breakfast) in the lab and following food record over the rest of the day at home.

  1. week: physical activity level (PAL) 1.3, 3 intervention days in the metabolic chamber: ad libitum energy intake, washout day, isocaloric diet, 36 hours fasting
  2. week: physical activity level (PAL) 1.3, 2 intervention days in the metabolic chamber: isocaloric diet, 36 hours fasting
  3. week: physical activity level (PAL) 1.6, 2 intervention days in the metabolic chamber: ad libitum energy intake, 36 hours fasting
  4. week: physical activity level (PAL) 1.6, 2 intervention days in the metabolic chamber: isocaloric diet, ketogenic diet (isocaloric)
  5. week: physical activity level (PAL) 1.6, 2 intervention days in the metabolic chamber: isocaloric diet, isocaloric diet + ketone body supplements (isocaloric)
02

Conditions studied

  • Healthy

Keywords

  • ketone bodies
  • appetite control
  • macronutrient oxidation
  • metabolic chamber
  • exogenous ketones
03

In context

Lead sponsor

University of Kiel is the lead sponsor of 25 studies on the registry; 6 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
20 Years to 35 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • healthy
  • BMI 19-29 kg/m2
  • low-medium habitual physical activity
  • women using hormonal contraceptive

Exclusion criteria

Exclusion Criteria:

  • smoking
  • chronic illnesses
  • food allergies / intolerances
  • vegans and vegetarians
  • regular high physical activity (exercise >1 hour/d)
  • current weight loss diet / weight loss of >5 kg in the last 3 months
  • pregnant / lactating women
  • persons incapable of giving informed legal consent
05

Study design

Phase
Not applicable
Primary purpose
Basic science
Allocation
Non-randomized
Intervention model
Crossover assignment
Masking
None (open label)
Enrollment
8 participants (actual)

Study arms

  • Experimental
    fasting, active

    36 hours fasting, PAL 1.6

    Dietary Supplement: Beta-Hydroxybutyrate as Ca-Mg-salt, active · Dietary Supplement: ketogenic diet (KetoCal® 4:1 Neutral, Nutricia GmbH, Erlangen, Germany), active · Dietary Supplement: fasting, active · Dietary Supplement: fasting, inactive

  • Experimental
    ketogenic diet, active

    24 hours of ketogenic diet (liquid meals), PAL 1.6

    Dietary Supplement: Beta-Hydroxybutyrate as Ca-Mg-salt, active · Dietary Supplement: ketogenic diet (KetoCal® 4:1 Neutral, Nutricia GmbH, Erlangen, Germany), active · Dietary Supplement: fasting, active · Dietary Supplement: fasting, inactive

  • Experimental
    exogeneous ketone bodies, active

    24 hours of ketone body supplements (Beta-Hydroxybutyrate as Ca-Mg-salt) additional to a normal diet (liquid meals), PAL 1.6

    Dietary Supplement: Beta-Hydroxybutyrate as Ca-Mg-salt, active · Dietary Supplement: ketogenic diet (KetoCal® 4:1 Neutral, Nutricia GmbH, Erlangen, Germany), active · Dietary Supplement: fasting, active · Dietary Supplement: fasting, inactive

  • Experimental
    fasting, inactive

    36 hours fasting, PAL 1.3

    Dietary Supplement: Beta-Hydroxybutyrate as Ca-Mg-salt, active · Dietary Supplement: ketogenic diet (KetoCal® 4:1 Neutral, Nutricia GmbH, Erlangen, Germany), active · Dietary Supplement: fasting, active · Dietary Supplement: fasting, inactive

Interventions

  • Dietary supplementBeta-Hydroxybutyrate as Ca-Mg-salt, active

    24 hour intervention with ketone body supplements additional to a normal diet (isocaloric diet in total) to induce ketosis (exogenous ketone bodies), in a metabolic chamber at physical activity level of 1.6, after one day of isocaloric diet in a metabolic chamber at physical activity level of 1.6.

  • Dietary supplementketogenic diet (KetoCal® 4:1 Neutral, Nutricia GmbH, Erlangen, Germany), active

    24 hour interventions with ketogenic isocaloric diet to induce ketosis (endogenous ketone bodies), in a metabolic chamber at physical activity level of 1.6, after one day of isocaloric diet in a metabolic chamber at physical activity level of 1.6.

  • Dietary supplementfasting, active

    36 hours of fasting, in a metabolic chamber at physical activity level of 1.6, after one day of isocaloric diet in a metabolic chamber at physical activity level of 1.6.

  • Dietary supplementfasting, inactive

    36 hours of fasting, in a metabolic chamber at physical activity level of 1.3, after one day of isocaloric diet in a metabolic chamber at physical activity level of 1.3. The same intervention is reproduced one week later.

06

What researchers measure

Primary outcomes

  1. appetite control - ghrelin

    ghrelin concentration in plasma (24 hour AUC)

    Time frame: 24 hours

  2. appetite control - GLP-1 concentration in plasma

    Glucose Like Peptide-1 concentration in plasma (24 hour AUC)

    Time frame: 24 hours

  3. appetite control - PYY concentration in plasma

    Peptide YY concentration in plasma (24 hour AUC)

    Time frame: 24 hours

  4. appetite control - subjective feelings of hunger

    measured with visual analogue scales (24 hour AUC). The scale consists of a 10 cm vertical line anchored with "not hungry at all" at the left side and with "extremely hungry" at the right side.

    Time frame: 24 hours

  5. appetite control - satiety quotient

    satiety quotient of standard test-breakfast after 24 hours of intervention

    Time frame: 30 min

Secondary outcomes

  1. macronutrient oxidation

    measured with indirect calorimetry in a metabolic chamber

    Time frame: 24 hours

  2. energy expenditure

    measured with indirect calorimetry in a metabolic chamber

    Time frame: 24 hours

  3. glycemia - glucose AUC

    glucose AUC from continuous glucose monitoring data

    Time frame: 24 hours

  4. repeatability of energy expenditure measurements

    repeated measurement of 24h-energy expenditure in a metabolic chamber on inactive isocaloric and fasting days

    Time frame: 24 hours

  5. ß-Hydroxybutyrate concentration in serum

    24 hour ß-Hydroxybutyrate concentration in serum (AUC)

    Time frame: 24 hours

07

Study locations

1 site
  • Institute of Human Nutrition
    Kiel, 24105, Germany
08

References and documents

Publications

  • Dorner R, Hagele FA, Koop J, Rising R, Foerster T, Olsen T, Hasler M, Muller MJ, Bosy-Westphal A. Validation of energy expenditure and macronutrient oxidation measured by two new whole-room indirect calorimeters. Obesity (Silver Spring). 2022 Sep;30(9):1796-1805. doi: 10.1002/oby.23527. Epub 2022 Aug 4. PubMed 35927795 ↗
09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Oct 1, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04490226
Lead sponsor
University of Kiel
Responsible party
Prof. Dr. Dr. Anja Bosy-Westphal (Prof. Anja Bosy-Westphal, PhD, MD, University of Kiel) — Principal investigator
First posted
Jul 29, 2020
Start date
Aug 21, 2020
Primary completion
Jul 23, 2021
Completion
Jul 23, 2021
Last update
Oct 1, 2021

Study contacts

Anja Bosy-Westphal, PhD, MD
principal investigator · Institute of Human Nutrition, Kiel University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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