This randomized crossover study examined whether the ketone body β-hydroxybutyrate (BHB) could reduce the muscle wasting that commonly accompanies acute inflammation. Healthy volunteers were given bacterial endotoxin (LPS) to induce a temporary inflammatory response, then received either BHB, free fatty acids, or saline while researchers measured muscle protein metabolism. BHB reduced muscle protein breakdown by more than 70% compared to the other interventions, resulting in a marked reduction in net muscle protein loss. Free fatty acids alone produced no comparable benefit.

The findings suggest ketone bodies do more than provide an alternative fuel—they also help preserve lean tissue during periods of metabolic stress. Although the study involved healthy volunteers under controlled laboratory conditions rather than critically ill patients, it adds to evidence that nutritional ketosis may protect against muscle loss during illness, injury, and other catabolic states.

https://www.sciencedirect.com/science/article/pii/S000291652202994X