What are Exogenous Ketones? (BHB Salts, Esters & MCT)

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Exogenous ketones are rising in popularity as a supplement. Amongst other benefits, they are claimed to help with the transition into ketosis when following a keto diet. This should help eliminate the groggy/ brain fog experience that is common during the transition. It has also been suggested that people can experience all the benefits of ketosis without the extremely restrictive diet by taking exogenous ketones. So, in this article I’ll go through what exogenous ketones are, how they work in the body, and look at the evidence supporting their claims.

 

What are exogenous ketones? (Salts, esters & MCT)

 

Beta-Hydroxybutyrate (BHB)

The most common exogenous ketone is BHB (which is not strictly a ketone). BHB is naturally produced in the liver during fasting states. It gets converted into acetoacetate (a true ketone) in cells, and ultimately into energy. The BHB molecule in supplements is the same as the liver naturally produces. It generally comes in 2 different forms:

BHB salts – These are BHB bonded to a mineral, usually sodium, calcium, potassium or magnesium. There isn’t much difference between the mineral variations in terms of absorption, so there is no need to look for a specific BHB salt. However, BHB sodium salts will obviously increase sodium levels, which could be a concern for some. Equally, the BHB magnesium salts would also increase magnesium, which you could see as being beneficial. In terms of BHB digestion and delivery there is no difference. BHB salts are easily absorbed, and are the most common form.

The minerals will slightly impact the amount of BHB you get in a given serving. A 15g serving of BHB salts for example will contain roughly 1g of minerals, whereas BHB esters (see below) won’t. This is worth bearing in mind when making detailed price per dosage comparisons.

BHB esters – This is ‘raw’ BHB. These esters are absorbed faster than salts, but because they taste horrible, they are not commonly used. BHB esters are not bonded to minerals or other carrier molecules.

 

Medium chain triglycerides (MCT)

MCTs are a special group of fats that can move straight into the mitochondria and get converted into ketones with relative ease. Both MCT powder and MCT oil can cause stomach discomfort (which ranges from a bloaty feeling to severe cramp), and so taking MCTs in large dosages isn’t recommended. Some people have reported that MCT powder doesn’t cause as much stomach discomfort as liquid MCTs do, but both do pose this problem to some extent. MCTs are often taken alongside BHB. MCTs do not come bonded to carrier molecules.

 

Why take exogenous ketones?

You’d take exogenous ketones such as beta-hydroxybutyrate (BHB) for a number of reasons:

1. Help the body transition into ketosis easier/ quicker than if you just adopted a ketosis diet.
2. Avoid the groggy feeling that you experience during the transition into ketosis.
3. Experience the health benefits of ketosis without the restrictive diet.

 

BHB vs MCT

Both BHB and MCTs are talked about in a similar context, but there are some key differences. BHB is chemical the liver produces when going into ketosis. It not only acts as a signalling molecule for the body that fat is to be the primary fuel source, but acts as precursor for ketones. Amongst other things, it is the BHB molecule that signals to lower blood glucose, and the presence of BHB is thought to benefit the body in a number of ways, even if the body is not truly in ketosis. Think of BHB as a signalling molecule first, and an energy source second.

MCTs on the other hand are simply a good energy source. They can pass straight into the mitochondria and get converted into ketones for energy. The presence of MCT and the ketones it is broken down into will undoubtedly do some signalling too, and can stimulate natural production of BHB in the liver. Think of MCT as an energy source first, and a signalling molecule second.

 

There is obvious synergistic potential to taking both MCT and BHB together.

 

How do exogenous ketones work?

Once ingested the minerals are cleaved off the BHB (in the case of BHB salts) and they are absorbed into the blood stream. Here they can enter cells throughout the body (including brain cells as it is able to cross the blood/ brain barrier) and act as precursors to ketones. The ketones are then used as a source of energy.

The body only ever produces BHB during times of starvation or carbohydrate restriction. It signals the body that fats are the new source of energy rather than carbohydrates. By artificially increasing BHB levels in the body it can ‘trick’ the body into thinking it is already in ketosis, and so starts metabolising fats, even though it may not need to.

MCTs are a type of fat that is easily converted into ketones (and so energy) without being in a ketosis state. With this in mind, BHB/ MCTs should be able to help reduce or completely eliminate the ‘groggy’ feeling you get from transitioning into ketosis.

As BHB is a source of energy, it will obviously have a calorific value. Oddly, (and interestingly), there seems to be some discrepancy about what this actually is. KetoSports BHB salts offer 55kcals per 11.7g of BHB, whereas Perfect Keto’s BHB salts offers 15kcals per 11.38g of BHB. This represents a difference of about 73%, which is quite a lot. There isn’t a satisfactory explanation for this difference other than testing for calorie difference in ketones may not be as simply as that of fats/ carbs etc.

It is worth mentioning that although the products vary dramatically in calorie content, both provide essentially the same amount of BHB per serving, and I would say that neither is better than the other. The variation in calorific value is just something that stands out as unusual, and worth highlighting – there are still some blind spots.

 

Do they work?

There is a reasonable amount of evidence to suggest that BHB and MCTs do work.

 

BHB

Taking BHB for 4 weeks significantly lowered blood sugar in rats (see graph)¹.

You can see that in the first week, blood glucose was on average around 100mg/dL, and after 4 weeks, it drops to around 80 mg/dL. This represents roughly a 20% drop in blood glucose. Interestingly, after 4 weeks of BHB supplementation blood BHB levels also went down. This could be because the body had transitioned into using BHB as a source of energy, and so less was circulating the body.

In another study blood BHB levels rose to just under 1mmol/L an hour after consuming BHB salts, before dropping down to normal levels after 4 hours. In this example the subject was a 100kg male and they took a 18g blend of BHB salts. This represented a 5 fold increase in blood BHB².

 

 

The reduction in circulating glucose and increased blood BHB levels are clear signals that the body thinks it is going through a fasting/ carbohydrate restrictive phase. The lower blood BHB levels shown in the rats after 4 weeks strongly suggests that the body is easily using the BHB as a source of energy, suggesting a transition into a ketogenic state.

 

MCTs

In the same rat study mentioned above, supplementation with MCT oil had some interesting results. MCT supplementation clearly did increase BHB levels, which is correlated with a lower blood glucose level. However, the results are much less consistent than with BHB salts. Even after 4 weeks of taking MCTs there were blood glucose readings of 100mg/dL with very low circulating BHB levels. The results are quite spread, but do show that MCT supplementation has the ability to increase BHB levels, although unreliably.

 

In human tests, 30ml of MCT oil was able to raise blood BHB levels to about 0.55 mmol/L. This is just over half the effect that BHB salt supplementation had. MCT oil supplementation spiked blood BHB levels at just under an hour, and drops to normal levels after 3 hours. Interestingly, BHB levels continue to fall below normal levels of 0.20mmol/L to 0.12mmol/L. The low blood BHB levels show no real indication of normalising after 8 hours.

So MCT oil supplementation does look like it can increase blood BHB for a short time, but may also reduce it below normal levels over a long period of time. This may be detrimental to those trying to transition into ketosis. Perhaps regular administration of MCTs would prevent this, but there isn’t the research to support it (and there is the risk of digestive discomfort). Although there clearly could be more research on MCTs, it looks like in isolation, they are not as effective as BHB salts.

 

 

BHB + MCTs

BHB and MCTs are commonly taken together. BHB + MCT (the green line) raises blood BHB levels much higher than BHB or MCT in isolation, with a peak just over 1.30mmol/L. Even more important is that blood BHB levels do not seem to readily fall back to the normal levels of 0.2mmol/L. Even after 8 hours blood BHB levels are 0.5mmol/L, which is over double the normal level, and they look to be only very gradually falling. Blood BHB levels look like they will be elevated for the best part of a day, but the most significant rise being between 1 and 4 hours after ingestion.

 

 

What does elevated blood BHB do?

All this supplementation is tailored towards increasing BHB in the blood without (or alongside) the usual extremely carbohydrate restrictive diet. But why do you want high levels of BHB?

The most common reason is to help transition into ketosis, which it does help with. The below graph shows how blood glucose changes after taking BHB salts. Blood glucose levels drop to the lower end of what is considered to be normal and healthy (72-106mmol/L)³. This is a result of the body no longer wanting/ needing carbohydrates, and using ketones as an energy source to replace them. BHB and MCTs certainly do help to transition into a ketosis state, and help the body ‘run’ on fats.

 

 

In addition to supporting ketosis transitions, there are other benefits. Even when not truly in ketosis, elevated BHB levels reduce circulating glucose levels can help people lose weight. It can even offer some help to diabetics, and could reduce the risk of blood clots through the reduction of atherosclerosis⁴. BHB also has the potential to boost moods by acting as a weak agonist for GABA receptors⁵. It can also help protect against seizures and other similar disorders⁶, which shows it could be good for brain health overall. BHB also inhibits pro-inflammatory pathways. Seeing as inflammation is often a cause (or a propagator) of many problems, this could benefit a whole host of people.

 

Summary

Exogenous ketones offer a number of benefits. First and foremost, BHB helps the body transition into ketosis by tricking the body into thinking it is already in a ketosis state, and that fats need to be metabolised. In addition to this, BHB salt supplementation can give people some of the benefits of being in ketosis, without eating a highly carbohydrate restrictive diet. These benefits include weight management, mood improvement and even cardio-protective properties.

When taken in isolation, but BHB and MCTs do offer some benefit in transitioning to ketosis. However, they are most effective when combined and compliment each other very well. How they impact blood BHB levels, and the resulting impact on the body is quite well documented. However, there is always room for more research.

 

References:

1. Shannon L. Kesl. (2016). Effects of exogenous ketone supplementation on blood ketone, glucose, triglyceride, and lipoprotein levels in Sprague–Dawley rats. Nutr Metab (Lond). 13 (9).
2. Patrick Arnold. (2015). Compositions and methods for producing elevated and sustained ketosis. Available: http://ift.tt/2fnb77D. Last accessed 3/8/17.
3. (2017). Blood Sugar Level Ranges. Available: http://ift.tt/V2Iltq. Last accessed 3/8/17.
4. Clay F. Semenkovich. (2006). Insulin resistance and atherosclerosis. J Clin Invest. 116 (7), 1813–1822.
5. Brown AJ. (2007). Low-carb diets, fasting and euphoria: Is there a link between ketosis and gamma-hydroxybutyrate (GHB). Med Hypotheses. 68 (2), 268-71.
6. Andrew Lutas. (2013). The ketogenic diet: metabolic influences on brain excitability and epilepsy. Trends Neurosci. 36 (1), 32-40.

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Bountiful Sea Conference – Giveaway!

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This September the University of Oxford is hosting The Bountiful Sea Conference – a blend of historic information, culinary delights and academic discussion. To support the event, we are giving away tickets and accommodation for 2! (see details below).

 

The conference

Over 3 days, attendees will learn about the history of fishing and fish processing by the Romans, and enjoy some of the food and drinks they created. You will even get to enjoy a Roman Seafood Dinner. It will be an exciting experience for both the mind and the body, where you will undoubtedly experience tastes that you have never known before.  The conference starts at 3pm on the 6th Sept, and the full program can be downloaded here.

Aside from learning about history and tasting some interesting foods, the conference will offer a unique insight into historic food preparation and production. Before the time of preservatives, freezers and farmed fish, people had to find different ways to keep their food nutritious and safe to eat. Seafood posed one of the biggest challenges of all. It is a source of highly nutritious but very reactive omega-3 fatty acids, and the Romans discovered some very novel (and sadly largely forgotten) ways to preserving it. The foods they created through these preservation methods were extremely nutritious, and were the inspiration for the creation of Green Pasture’s Fermented Cod Liver Oil. We have long been advocates of Green Pasture’s Cod Liver Oil – it is unique among all other cod liver oils, and I believe the extent of its health benefits have not yet been fully realised yet.

 

The giveaway

The information provided in this conference is of great importance and relevance to the understanding of good health. Not only do we want to support the conference and the message they are giving, but we also want to help spread the information. So, in collaboration with Green Pasture, we are offering a conference give-away for 2 people, which includes:

• Tickets to the entire conference (Wednesday 6th – Friday 8th September) worth £100 each.
  • Including keynote lecture, Roman fish tasting dinner, conference pack, academic sessions, sauce tastings, wine receptions, two lunches, tea & coffee.
• Accommodation for 2 for the duration of the conference (in the historic Oxford University). More information on these rooms can be found here.
• Some financial contribution for travel.

 

How to enter

To enter, simply comment on this article with which Green Pasture product you like the most, and why. We will pick the winner at random on the 17th of August, by replying to their comment. The winner should automatically get an email notification when we reply to their comment. When you sign up to comment, use an email address that you check.

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Oceans Alive Phytoplankton

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Oceans Alive Marine Phytoplankton is the latest algae sourced health supplement. It follows the great (and continuing) popularity of similar products such as spirulina and chlorella, both of which spearheaded public interest in the health benefits of phytoplankton. It has its differences from these products of course – and I’ll get to those – but it has claims such as ‘superfood’ and ‘powerful antioxidant’, which we (sadly) see on many pseudo-health products. As people (hopefully) get more wise to marketing buzz words it can be difficult to understand what this product is, and if it does any good for your health. So in this article we will have a good look at Oceans Alive Marine Phytoplankton, and see how it stacks up against similar, and more familiar phytoplankton products.

 

What is in Oceans Alive Marine Phytoplankton?

It was surprisingly difficult to get a definitive answer to this, but after some time I can say with a high degree of confidence that it is a type of phytoplankton called Nannochloropsis. Or more specifically, 2 strains of Nannochloropsis (one of which is proprietary to Oceans Alive). They also add sea minerals to their product too. The ingredients list is quite small (when you can find it), which is always nice to see.

 

Oceans Alive vs other plankton

Although 2 strains of Nannochloropsis are included in the Oceans Alive product, we can assume they are relatively similar in terms of nutritional content. In most literature various strains of Nannochloropsis are studied together, which gives a good all round picture of their contents/ benefits. So for the purposes of this article, it is quite safe to assume they are similar. Unsurprisingly, Nannochloropsis contains a very broad spectrum of nutrients, from minerals to fatty acids, which is typical of phytoplankton.

 

Minerals

Below you can see a table of how Nannochloropsis stacks up to chlorella in terms of mineral content. There obviously will be some natural variation in both, but it gives a good picture of the potency of the phytoplankton.

Nutrient	Oceans Alive content/100g dry weight) (% RDA)	Chlorella
Calcium	972mg (138%)	221mg (32%)
Potassium	533mg (15%)	1360mg (39%)
Magnesium	316mg (105%)	315mg (105%)
Zinc	103mg (1084%)	71mg (747%)
Iron	136mg (1511%)	130mg (1444%)

^{*references 1,2,3}

For the minerals tested, they are pretty similar. There isn’t anything to make a song and dance about for either product. Both are good, but neither stands out from the other. The additional sea minerals that Oceans Alive add to their supplement may increase the overall concentration of some minerals.

 

Vitamins

Like other types of phytoplankton, Nannochloropsis contains a range of vitamins including vitamin C, vitamin A (as beta-carotene), B vitamins, and vitamin E. Nannochloropsis doesn’t contain any vitamin D, but this is common in phytoplankton.

The vitamin content in Nannochloropsis is similar to other phytoplankton, and some are found in quite reasonable quantities. It will contain up to 3mg/g (8% RDA) of vitamin C and 0.29mg/g (6% RDA) of vitamin E. These values are all quite similar to other types of phytoplankton⁴, and so there is little that makes Nannochloropsis stand out. The vitamin content is nutritionally significant, just nothing particularly special in terms of phytoplankton.

 

Omega-3

Nannochloropsis does beat all other algaes, including chlorella and spirulina, when it comes to omega-3 content. Nannochloropsis comprises of up to 40% omega-3 fatty acids, the most abundant being EPA⁵. Tests on rats have show that supplementation with this algae can raise blood EPA levels, which may mean it has cardioprotective properties.

 

Other nutrients

Sadly, this is a grey area, not only for Nannochloropsis, but all phytoplankton. I can say with some confidence that these phytoplankton will contain a variety of polyphenols, and there is a very good chance that they will be quite highly concentrated. Polyphenols are a large group of non-essential nutrients found in plants that have demonstrated a number of health benefits in clinical trials. They are what give green tea its health benefits, and are often responsible for the pigments of fruits such as berries. As they are non-essential (and also quite complex), they tend not to attract as much attention as essential nutrients like vitamins and minerals. However, they have demonstrated cardioprotective, antioxidant, anti-cancer and even prebiotic properties^6,7. Although they are non-essential, they have great significance for health.

Phytoplankton like those found in Oceans Alive will be highly concentrated in a variety of polyphenols. Which ones they contain, and in what concentration isn’t known, but it is likely that any health benefits attributed to these phytoplankton will largely be from the polyphenols they contain. It is possible that Nannochloropsis contains a higher concentration or some unique polyphenol that isn’t found in other phytoplankton, but we don’t know.

 

Additional information

Oceans Alive claim that their product has an enhanced nutritional profile due to their growing technique, which is altogether possible, although equally, it may be marketing. Growing phytoplankton in optimal environments can improve the nutritional profile though. They also claim that the nutrients are more bioavailable and natural because the phytoplankton cells do not undergo any kind of extraction or processing, and are simply stabilised in a mineral solution. Other algaes, like spirulina will be freeze dried and powdered to increase shelf life and make easier to take.

Again, it may be true that Oceans Alive’s delivery system is superior to powder forms, but we cannot say for sure. It certainly is a novel, and more natural way to ingest phytoplankton though.

This lack of information is not a criticism of Oceans Alive, and merely an observation. Finding out if Oceans Alive actually does have a superior nutritional profile and delivery system to others isn’t something that can easily be done. It would require quite a lot of research, which costs money, and the only company which would be interested in doing it would be Oceans Alive, who would have a conflict of interest that would taint any results. It is a catch 22.

 

Summary

Overall, it is an interesting product which has lots of mystery surrounding it. There is nothing to say that it is significantly different from other marine algae in terms of vitamins and minerals, although it does contain more omega-3s. This of course isn’t to say it isn’t rich in other nutrients – it is, but only on the same level as other algaes, as far as I can tell. It is possible that the way Oceans Alive grown and process their product makes its nutrients more bioavailable, but exactly how much differences this makes is difficult to determine.

I’d have thought that any significant difference in health benefits between Nannochloropsis and other phytoplankton will come from any polyphenol difference, if indeed there is one.

 

References

1. Unknown author. Chlorella’s Nutritional Analysis. Available: http://ift.tt/2uOjAmF. Last accessed 5/7/17.
2. Abeille d’Or. Chlorealla – The most exciting nutritional discover on planet Earth. Available: http://ift.tt/2tQdqoX. Last accessed 5/7/17.
3. H. Beheshtipour. (2013). Supplementation of Spirulina platensis and Chlorella vulgaris Algae into Probiotic Fermented Milks. Comprehensive Reviews in Food Science and Food Safety. 12 (2), 144-154.
4. M.R. Brown. (1999). The vitamin content of microalgae used in aquaculture. Journal of Applied Phycology. 11 (3), 247-255.
5. Megan Kent. (2015). Nutritional Evaluation of Australian Microalgae as Potential Human Health Supplements. PLOS. (2).
6. Yue Zhou. (2016). Natural Polyphenols for Prevention and Treatment of Cancer. Nutrients. 8 (8), 515.
7. Kanti Bhooshan Pandey. (2009). Plant polyphenols as dietary antioxidants in human health and disease. Oxid Med Cell Longev. 2 (5), 270-278.

Image courtesy of NOAA MESA Project

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Is Mercola’s Liposomal Vitamin C Fake?

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Dr Mercola has enjoyed a long reputation of developing a range of high quality supplements, and is generally well trusted. However, one product, his liposomal vitamin C, has had some criticism and confusion around it. After spending plenty of time looking at liposomal vitamin C and the issues revolving around Dr Mercola’s product, I’d like to shed some light on the issue of if Mercola’s liposomal vitamin C is fake, and if so, what alternatives are available.

 

Overview of liposomal vitamin C

Liposomal vitamin C differs from other vitamin C products because the vitamin C is encapsulated in a phospholipid layer. This helps to bypass the digestive system and deliver the vitamin C directly into the bloodstream by fusing with the cells of our digestive system, which are also made up of a phospholipid layer. There is some reserach showing that this can improve the delivery and increase absorption of many substances, including vitamin C. To understand how liposomal vitamin C differs from conventional vitamin C supplements you can read this comparison article, which discusses their various pros and cons.

 

Mercola liposomal vitamin C – fake?

If you are expecting the capsules from this product to contain liposomes of vitamin C, then yes, the product is fake, or at least, very misleading. Mercola’s product is called ‘liposomal vitamin C‘ and so it is only natural to expect vitamin C liposomes. However, despite a misleading name, Dr. Mercola has made no secret of the fact that his product doesn’t contain liposomes. In his long product description he says: “phospholipids in the capsule can form liposomes in the stomach“¹. In other words, he is giving you all the ingredients to form a vitamin C liposome in your stomach, but not actually giving you vitamin C liposomes. Customer support at Mercola.com have even suggested to people that they should take their vitamin C with water to help support the production of liposomes in their gut².

This process is relatively similar to how liposomes are created commercially,sup>3, but only slightly. It is more closely related to home-made liposome methods⁴ but the amount of liposomes that are actually made like this is very poor, and it isn’t a reliable way to produce liposomes. Some even claim that these home-made methods produce no liposomes. The point is, they are unreliable, and not stardardised.

There is no research to suggest that mixing these ingredients in the stomach would create any liposomes. If it does (which it may) you can be sure that it will not create many, and it is unreliable.

So Dr. Mercola’s liposomal vitamin C is really a vitamin C emulsion, not a liposomal product. This doesn’t mean it is useless – it is still a potent and easily absorbable vitamin C supplement. However, even if it does produce a small amount of liposomes, it won’t produce enough to achieve the high blood vitamin C concentrations that people expect from liposomal vitamin C.

 

Alternative liposomal vitamin C supplements

Vitamin C liposomes are quite a new and innovative product, so there are not too many manufacturers to choose from. Aside from Mercola, which isn’t really a liposomal product, there are 2 other brands that I am aware of:

Lipolife – Founded in 2009, Lipolife creates a range of liposomal products, including vitamin C. They manufacture their products in Europe. The quality, as far as you can tell without going to a lab, is good. Their liposomes are provided in a liquid form.

LiveOn Labs – A USA based company that was founded in 2002. LiveOn also produce a liquid liposomal vitamin C. Again, their product seems to be of a high quality. They trade in Europe under the Altrient brand.

There are no manufacturers that I know of that produce liposomal vitamin C in a capsule – perhaps this isn’t something that is easily done.

 

Summary

Dr. Mercola’s liposomal vitamin C does not contain any liposomes. Dr Mercola suggests that liposomes of vitamin C will form in the stomach when taken with water. Whilst this may be possible, there is no scientific evidence to suggest that it would happen. If it were to happen, there would be very few liposomes formed, and it would not be the same as taking a real liposomal product. Mercola’s liposomal vitamin C is still a good source of vitamin C, but it will not give you the high spike of vitamin C that many people want from a liposomal product. This is a real shame, and casts a shadow on the Dr Mercola range, which is known for producing very high quality supplements.

If you are looking for a liposomal vitamin C, then there are still some options. Lipoife and LiveOn labs/ Altrient are both companies that specialise in producing liposomal products.

 

References:

1. Dr Mercola. Beware: Many Vitamin C Supplements Contain These 6 Red Flags. Learn Why Liposomal Vitamin C Is a Superior Form. Available: http://ift.tt/2rU14sZ. Last accessed 9/6/17.
2. Unknown author. (2013). Dr Mercola Liposomal Vitamin C is fake. Available: http://ift.tt/2r9udTM. Last accessed 9/6/17.
3. Unknown author. Liposome Preparation. Available: http://ift.tt/2rU3JTr. Last accessed 9/6/2017.
4. Philip . (2017). Liposomal Vitamin C – Mixing Formula. Available: http://ift.tt/2r9CQxv. Last accessed 9/6/17.

 

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