Bicarbonate Unlocks the Ergogenic Action of Ketone Monoester Intake in Endurance Exercise

Med Sci Sports Exerc. 2021 Feb 1;53(2):431-441. doi: 10.1249/MSS.0000000000002467.

Abstract

Purpose: We recently reported that oral ketone ester (KE) intake before and during the initial 30 min of a 3 h 15 min simulated cycling race (RACE) transiently decreased blood pH and bicarbonate without affecting maximal performance in the final quarter of the event. We hypothesized that acid-base disturbances due to KE overrules the ergogenic potential of exogenous ketosis in endurance exercise.

Methods: Nine well-trained male cyclists participated in a similar RACE consisting of 3 h submaximal intermittent cycling (IMT180') followed by a 15-min time trial (TT15') preceding an all-out sprint at 175% of lactate threshold (SPRINT). In a randomized crossover design, participants received (i) 65 g KE, (ii) 300 mg·kg-1 body weight NaHCO3 (BIC), (iii) KE + BIC, or (iv) a control drink (CON), together with consistent 60 g·h-1 carbohydrate intake.

Results: KE ingestion transiently elevated blood D-ß-hydroxybutyrate to ~2-3 mM during the initial 2 h of RACE (P < 0.001 vs CON). In KE, blood pH concomitantly dropped from 7.43 to 7.36 whereas bicarbonate decreased from 25.5 to 20.5 mM (both P < 0.001 vs CON). Additional BIC resulted in 0.5 to 0.8 mM higher blood D-ß-hydroxybutyrate during the first half of IMT180' (P < 0.05 vs KE) and increased blood bicarbonate to 31.1 ± 1.8 mM and blood pH to 7.51 ± 0.03 by the end of IMT180' (P < 0.001 vs KE). Mean power output during TT15' was similar between KE, BIC, and CON at ~255 W but was 5% higher in KE + BIC (P = 0.02 vs CON). Time to exhaustion in the sprint was similar between all conditions at ~60 s (P = 0.88). Gastrointestinal symptoms were similar between groups.

Discussion: The coingestion of oral bicarbonate and KE enhances high-intensity performance at the end of an endurance exercise event without causing gastrointestinal distress.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Appetite
  • Bicarbonates / administration & dosage*
  • Bicarbonates / adverse effects
  • Bicarbonates / blood
  • Blood Gas Analysis
  • Blood Glucose / metabolism
  • Cross-Over Studies
  • Dietary Supplements*
  • Double-Blind Method
  • Electrolytes / blood
  • Esters
  • Gastrointestinal Diseases / chemically induced
  • Heart Rate
  • Humans
  • Hydrogen-Ion Concentration
  • Ketones / administration & dosage*
  • Ketones / adverse effects
  • Ketones / urine
  • Lactic Acid / blood
  • Male
  • Perception / physiology
  • Performance-Enhancing Substances / administration & dosage*
  • Performance-Enhancing Substances / adverse effects
  • Physical Endurance / physiology*
  • Physical Exertion / physiology
  • Pulmonary Gas Exchange

Substances

  • Bicarbonates
  • Blood Glucose
  • Electrolytes
  • Esters
  • Ketones
  • Performance-Enhancing Substances
  • Lactic Acid