Urinary ketones reflect serum ketone concentration but do not relate to weight loss in overweight premenopausal women following a low-carbohydrate/high-protein diet

J Am Diet Assoc. 2005 Apr;105(4):608-11. doi: 10.1016/j.jada.2005.01.004.


This study examined the effect of a low-carbohydrate/high-protein diet on serum and urine ketone body concentrations. Thirteen overweight premenopausal women aged 32 to 45 years consumed < or =20 g carbohydrate/day with liberal intakes of protein and fat for 2 weeks; thereafter, carbohydrate intake increased 5 g/week for 10 weeks. Women were weighed and provided fasting urine and blood samples to detect urinary ketones and quantify serum ketone concentrations, respectively, at baseline and weeks 1 to 4, 6, and 12. Women lost 8.3%+/-2.8% of initial body weight by week 12. Serum beta-hydroxybutyrate production was highest at week 1 and declined weekly, with all values higher than baseline (P <.05). Each week, serum beta-hydroxybutyrate was correlated with presence of urinary ketones (P <.05), but no relationship was found between weekly weight change and serum ketone production. Urinary ketones are detected in premenopausal women complying with a low-carbohydrate/high-protein diet and are associated with serum ketone concentration. However, serum ketones do not reflect weight loss.

MeSH terms

  • 3-Hydroxybutyric Acid / blood
  • Adult
  • Biomarkers / blood
  • Biomarkers / urine
  • Diet, Reducing
  • Dietary Carbohydrates / administration & dosage
  • Dietary Carbohydrates / metabolism*
  • Dietary Proteins / administration & dosage
  • Dietary Proteins / metabolism*
  • Female
  • Humans
  • Ketone Bodies / blood*
  • Ketone Bodies / urine*
  • Middle Aged
  • Obesity / diet therapy*
  • Premenopause / blood
  • Premenopause / urine
  • Weight Loss / physiology*


  • Biomarkers
  • Dietary Carbohydrates
  • Dietary Proteins
  • Ketone Bodies
  • 3-Hydroxybutyric Acid