What if all the supposed benefits of the ketogenic diet could be distilled into a single pill?
Researchers are working hard to find out just that.
A lot has been said about the ketogenic diet in recent months — and for much more than just weight loss.
But, for the sheer volume of headlines, there seems to be one glaring omission from many of them: beta-hydroxybutyrate (BHB), the potential miracle molecule at the center of it all.
In two high-profile studies this month, the ketogenic diet was linked to several properties beyond just losing a few pounds.
Mice fed a ketogenic diet experienced increased lifespan as well as better cognitive and motor functioning. That has led to speculation that the ketogenic diet might even be an avenue for Alzheimer’s research and brain health in general.
The results “clearly demonstrate that lifespan is increased in mice consuming a ketogenic diet” compared with a control group, researchers wrote.
They believe this increase is due to a high concentration of BHB in the bloodstream brought on by the ketogenic diet.
“BHB has direct activities relevant to aging,” the researchers wrote.
Dr. Eric Verdin, who serves as the president and CEO of the Buck Institute for Research on Aging, helped author that research.
“BHB has the potential to induce a protective state in the cells and make them more resistant to oxidative stress, and that’s on the heel of this, that we said: Let’s try to increase BHB levels so that we can see if it has a lifespan effect,” he told Healthline.
What is BHB?
BHB is one of three ketones the body produces during states of fasting or through low-carbohydrate, high-fat diets.
In both contexts, the body naturally changes its primary source of energy from glucose (provided by carbohydrates) to stored fat.
Fat is broken down and BHB is formed. It provides an alternate energy source for every part of the body, including the brain.
Of the three ketone bodies produced during ketosis (BHB, acetone, and acetoacetate), BHB is present in significantly higher quantities in the blood.
In his research, Verdin discovered that BHB is more than just an energy source for the body.
“The classic view of BHB was that it was an alternate nutrient that happens during fasting... It is also a signaling molecule. It triggers all kinds of things in cells that are protective,” he said.
“That brought a whole new dimension to the whole problem and forced people to start thinking that maybe there is something more to BHB being just a nutrient.”
But Verdin only came to that conclusion in 2013. That’s why there’s an abundant amount of literature on the supposed benefits of the ketogenic diet, but significantly less on the role BHB plays in them.
In fact, Verdin was merely hypothesizing that BHB would have a role in increasing lifespan in 2013.
This year, his research using the ketogenic diet in mice finally supported that idea.
Difficult diet to maintain
However, the claimed benefits of the ketogenic diet in humans — not mice — are still problematic. While anecdotal evidence supports many claims about it, there’s still much research to be done.
The impracticality of the diet also makes it difficult for longer studies.
Nutritionists tend to dislike the diet. They frequently speak out against it, mainly because it’s just too difficult to pull off for many people.
Difficult diets can lead to yo-yo dieting, the repeated stopping and starting of a diet. This cycle of rapid weight loss and weight gain can harm the body.
There are also psychological elements built in to dieting, and subsequent feelings of failure if it can’t be accomplished.
That’s what makes the prospect of a BHB pill or supplement so intriguing.
“Imagining that everyone is going to go on a ketogenic diet is very unlikely. I’ve done it myself, and it is hard as a diet to sustain for a long period of time,” said Verdin. “The interest for us in BHB is [if] can we recapitulate all the beneficial effects that we are seeing from the ketogenic diet simply by administering BHB as a food or as a drug, whatever you want to call it.”
Another expert contacted by Healthline says the benefits of the ketogenic diet could be more complex than just increasing BHB levels.
“Decreased glucose is also a hallmark of the ketogenic diet... The key may be increased BHB, it may be decreased glucose, it may be both effects — or it may be a critical ratio between the two changes,” said Susan A. Masino, PhD, a professor of applied science at Trinity College in Connecticut.
Verdin cautions that all of this is still well within the world of speculation and far from being proven in humans.
Following their studies in mice, Verdin and his team must now be able to show that they can duplicate the same beneficial effects on cognition, memory, and lifespan using a supplement rather than diet.
“There is no evidence to date that the ketogenic diet will increase your lifespan or healthspan in humans. We need to do the experiments,” said Verdin.
Verdin’s team needs to figure out exactly what the threshold — the quantity of BHB in the bloodstream — is before those effects happen.
If you’ve spent any time in a health store, you may have already noticed keto and BHB supplements on shelves. Researchers aren’t the only ones aware of the public’s interest in ketosis.
Those supplements, usually sold as “keto salts” or something similar, are supposed to help speed you into ketosis and all its myriad health benefits.
The problem, as it so often is with supplements, is that there’s little — or perhaps nothing — to substantiate their claims.
“Many of these products, you would have to eat so much of them to get your ketone body levels in an area that is significant,” said Verdin. “They probably don’t give you the ketone levels necessary to give you a biological effect.”
And, since the supplements are most often sold as a salt, consuming too much could lead to the detrimental effects of consuming too much salt, like high blood pressure.
So, while the keto supplements on shelves today probably aren’t worth their salt, a real, clinically studied BHB supplement in the future could be.
A small 2004 study found that individuals with Alzheimer’s or mild cognitive impairments that were fed certain saturated fats to promote ketone production had greater memory improvement than a control group.
Since then, more studies have also looked at the ketogenic diet as a remedy for Alzheimer’s.
Epilepsy, lifespan, cognitive ability, and Alzheimer’s are all part of a growing list of conditions that BHB appears to affect beneficially.
But demonstrating its effectiveness in humans, particularly in a supplement form, is still a long way off.
Nonetheless, both Verdin and Masino are optimistic. They do caution the public in getting too excited about the next miracle supplement, though.
“A BHB pill should be added to a healthy diet — not taken as a shortcut,” said Masino.
“I’m completely excited about [BHB] and its potential,” said Verdin. “There is a lot of skepticism about whether the metabolism of mice applies to humans, but the effects we are seeing are robust, so I predict that they will apply to humans.”