Tolerability and Safety of a Novel Ketogenic Ester, Bis-Hexanoyl (R)-1,3-Butanediol: A Randomized Controlled Trial in Healthy Adults.
Oliver Chen, Traci M Blonquist, Eunice Mah...
https://pubmed.ncbi.nlm.nih.gov/34208742/Actively Recruiting
Led by Buck Institute for Research on Aging · Updated on 2026-03-13
180
Participants Needed
3
Research Sites
13 weeks
Total Duration
Researchers are evaluating whether a dietary supplement containing ketones can improve strength and overall wellness in adults aged 65 and older who are experiencing a mild decline in physical function. The study is a randomized, double-blind, placebo-controlled pilot trial designed to assess muscle and immune function in older men and women at risk for decreased strength and mobility. Participants are being enrolled across three sites in the United States and the study is coordinated by the Buck Institute for Research on Aging. Participants are randomly assigned to receive either a ketone ester supplement or a placebo oil daily for 20 weeks. The dosing starts with a lower amount and increases over the first few weeks, eventually reaching 50 grams per day split into two doses taken with the first and last meals of the day. The study includes a screening visit followed by four additional visits, with the ketone ester or placebo consumed at home. Both supplements may cause gastrointestinal side effects in some individuals. Throughout the study, participants provide blood, urine, and stool samples and complete physical performance tests and questionnaires to assess physical function, inflammation markers, cognitive function, mood, sleep quality, and general well-being. Compliance and adverse events are monitored by phone every two weeks between visits. Physical assessments include strength tests, walking tests, and cognitive evaluations. The primary outcome is a frailty composite score measured at baseline, 12 weeks, and 20 weeks, with additional safety and tolerability assessments conducted at multiple time points.
CONDITIONS
Targeting Aging With a Ketone Ester for Function in Frailty
B
Brianna Stubbs, DPhil
C
Chatura Senadheera, MSc
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Buck Institute for Research on Aging
Lead Sponsor
Ohio State University
Collaborating Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | Ketone Ester Supplementation | Placebo Oil Placebo |
|---|---|---|
| What it is | A dietary supplement containing ketone ester (Bis-octanoyl-(R)-1,3-butanediol/C8 ketone di-ester), administered daily for up to 20 weeks to raise circulating ketone levels. | An isocaloric placebo supplement using non-ketogenic canola oil, administered with identical dosing schedule and appearance to match the ketone ester supplement group. |
| Role in the trial | Investigational intervention tested for effects on frailty, muscle and immune function in older adults. | Serves as matched placebo to control for expectancy and nutrient effects in the trial population. |
| Primary use | Designed to improve functional measures of frailty, muscle strength, and immune response in elderly adults by elevating blood ketone levels. | Used to match the intervention for blinding and measuring any effects not attributable to ketone ester itself. |
| How it is given or performed | Participants ingest the ketone ester supplement daily, titrated from 12.5 g up to 50 g (split into two doses), over a 20-week period. | Participants ingest the matched canola oil placebo daily, titrated in parallel to the ketone ester group over 20 weeks. |
| Evidence status | The current trial investigates functional and immunometabolic effects of ketone ester supplementation in frail elderly. Prior acute and short-term studies have shown ketone esters reliably raise circulating ketones and are tolerated in healthy adults, but efficacy for frailty outcomes remains under clinical investigation. | Used to control for placebo and nutritional effects; no direct therapeutic effect for frailty is expected or supported by published evidence. |
| Important risks | Short-term studies in adults report the ketone ester supplement is generally well-tolerated, but long-term safety in frail elderly remains under study; adverse effects reported may include mild gastrointestinal symptoms. | Canola oil placebo supplement is generally safe at studied doses, though gastrointestinal discomfort may occur in some participants. |
| Important limitations | Efficacy in frail elderly for functional outcomes is not yet established; tolerability and safety evidence remains limited to shorter-term studies mostly in healthy adults. No long-term outcome data or guideline recommendations exist for ketone ester use in this population. | Placebo oil is not expected to influence frailty or functional outcomes; serves only as control. Results may not be directly translatable to real-world interventions or nutritional therapies. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person) plus phone screening
Duration - 20 weeks
Participants take a ketone ester supplement or placebo daily at home to evaluate muscle and immune function. They follow a dose escalation schedule over 20 weeks and complete daily study logs and periodic symptom questionnaires. Physical assessments and sample collections are performed during scheduled visits.
4 in-person visits (Baseline, Week 4, Week 12, Week 20) plus biweekly phone calls
Study Type
INTERVENTIONAL
Masking
QUADRUPLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
BASIC_SCIENCE
Number of Arms
2
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Oliver Chen, Traci M Blonquist, Eunice Mah...
https://pubmed.ncbi.nlm.nih.gov/34208742/Brianna J Stubbs, Gabriela Alvarez Azañedo, Sawyer Peralta...
https://pubmed.ncbi.nlm.nih.gov/39292659/Christopher D Crabtree, Thanh Blade, Parker N Hyde...
https://pubmed.ncbi.nlm.nih.gov/35512774/Buck Institute for Research on Aging
Lead Sponsor
Ohio State University
Collaborating Sponsor