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Ketogenic Diets & Nutritional Ketosis

Clinicians and other medical practitioners are increasingly interested in the proposed performance and other benefits of nutritional ketosis.


Many diets start as one thing before developing into something that becomes a nutritional mainstay. One of the more recent examples of this is the Ketogenic Diet. While Ketogenic diets have roots in the 1920s, they were originally used as a type of anticonvulsant. As anticonvulsant medications became more effective, the diet was basically forgotten about until the mid-1990s.

Since then, Ketogenic diets have spread to most places around the world. Ketogenic diets are high-fat, adequate-protein, low-carbohydrate diets that are used mainly to treat hard-to-control epilepsy in children. The idea behind the diet is forcing the body to burn fats rather than carbohydrates. A lack of carbohydrates forces the liver to convert fats into ketone bodies and fatty acids, which replace glucose as an energy source.

While the body can be forced to create ketones, they can also be introduced externally.

What are Exogenous Ketones?

The term exogenous means coming from outside the body. For Ketones, this means direct ketone supplementation or indirect via supplements that have ketone precursors.

Exogenous ketones can be found as oral supplements. Ketogenic diets and exogenous ketones have many similarities but key differences when it comes to application.

Nutritional Ketosis

Clinicians and other medical practitioners are increasingly interested in the proposed performance and therapeutic benefits of nutritional ketosis. Nutritional ketosis is defined as a nutritionally induced metabolic state resulting in higher blood β-hydroxybutyrate (BHB) concentrations. 

Body tissues readily metabolize ketone bodies. In turn, the ketone bodies regulate metabolism and signals in both a systemic and tissue-specific manner. During fasting, starvation, or undergoing a strict ketogenic dietary regimen, endogenous synthesis of ketone bodies is amplified resulting in a state of natural ketosis. 

Natural ketosis results in a number of potential benefits across health, disease, and performance.  Therefore, interest in how to produce the same effect with supplements, which don’t require the intense dietary regimen or fasting, is of interest. 

Consuming an exogenous ketone supplement will lead to a rapid increase in circulating ketone bodies, which produces a similar apparent metabolic state.  However, understanding if the ketosis produced by exogenous supplementation leads to the same health benefits as natural ketosis is under investigation. 

Ketogenic Diets & Natural Ketosis

Natural ketosis has long been used to manage convulsions. Texts from hundreds of years ago reference the anticonvulsant effects of fasting. Medical records from the 19th and 20th centuries describe ketogenic-type diets that benefit patients with metabolic disorders.  However, these diets are strict in their requirements and not considered pleasant by many people, as they can limit protein and many food choices.

A ketogenic diet can be defined as any diet that amplifies ketogenesis, not just the strict therapeutic ketogenic diets (KDs) found in the early 20th-century medical literature. There are now a number of defined ‘alternative’ keto diets like

  • The medium-chain triglyceride ketogenic diet
  • The Modified Atkins Diet
  • The Low Glycemic Index Treatment Diet.

The approach of each diet induces a state of natural ketosis but is formulated with more liberal allowances of protein to appeal to more people. 

Interest in the performance of natural ketosis has rapidly expanded. Researchers continue to look at both natural ketosis and exogenous ketosis, as well as comparing the effects of each, for better understanding of how ketogenesis can be used in the clinic to promote health and performance. 

Research at Biofortis

Biofortis is dedicated to protecting consumer health worldwide by delivering a wide range of testing and consultancy services to the food, supplement, and nutrition industries. Biofortis supports this mission in two ways—through clinical trials and sensory and consumer insights testing. We specialize in clinical research targeting foods, ingredients, and dietary supplements that affect body structures, function, and overall health. Contact us with any clinical trial or scientific consulting needs.

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