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What happens when a Silicon Valley startup markets a mysterious drink with nonspecific health claims, couched in the aesthetic of a tech product launch?
The latest example is perhaps the most egregious. HVMN Ketone claims to be a performance-enhancing beverage that alters metabolism by flooding the bloodstream with a molecule called D-β-hydroxybutyrate(D-βHB). Chances are you’re familiar with someone who’s tried out the ketogenic diet, but HVMN promises you can achieve ketosis without dieting. However, the benefits of calorie restriction and exercise can’t be reduced down to a double-shot of D-βHB.
“HVMN Ketone is the result of 10+ years of research and $60 million in funding,” states HVMN’s website. But time and money simply aren't surrogates for validated and reproducible clinical results. Drinking ketones will certainly boost levels of ketone bodies in the blood; however, the actual effects of HVMN Ketone are fleeting, underwhelming, and embellished by the company. Because D-βHB is "generally recognized as safe," HVMN can sell Ketone as a "foodstuff" with little or no evidence of athletic or cognitive benefit to consumers.
A $33 bad taste
To contextualize that indictment, consider whence the emergence of low-carb and ketogenic diet trends evolved. Over the past 30 years, America’s obesity rate ballooned from about a sixth to over a third of the population. Total caloric consumption per person increased in people of all BMIs, with a macronutrient distribution shifting to proportionately more carbs and less fat and protein. These data don’t causally indict carbohydrates, but rather correlate them with a diet trend in which Americans consume more calories and grow more obese.
The standard Western diet consists of around 50 percent of calories from carbohydrates and 35 percent from fat. When controlling for caloric intake, diets that reduce carbohydrates to less than 20 percent often show a benefit over reduced-fat diets, though these findings are often contradictory. In adults with high blood pressure, substitution of carbohydrates with either protein or fat improved markers of cardiovascular health. Low-carb dietary intervention was also helpful in ameliorating diabetes. A recent, smaller study found that low-carb diets were more effective than low-fat for both heart health and weight loss. However, a meta-analysis of multiple studies comparing low-carb vs. low-fat diets found that both diets led to similar weight loss over longer timeframes. This trend held true in later studies as well.
This evidence modestly supports the effectiveness of diet strategies that cut down on carbs, but the goal of the ketogenic diet is to nearly eliminate them. Ketosis occurs when the liver exhausts carbohydrate-derived fuel sources, causing its metabolic machinery to instead break down fatty acids to generate ketone bodies, including D-βHB. These metabolites diffuse freely through the blood to other tissues, including the muscle and brain, where they can be used as an energy source. This effect is amplified by intermittent fasting (IF), which helps lower blood glucose.
Ketogenic dieting reduces the carbohydrate intake threshold to roughly 10 percent of total calories, requiring strict dietary discipline. For example, a ketogenic 2,000-calorie diet calls for less than 25 grams of carbohydrates per day- the amount that's in two cups of cooked Brussels sprouts, or two slices of whole wheat bread, or a single pear. But avoiding other incidental carbs, such as the two grams per serving in keto-friendly mushrooms, asparagus, and avocados, is practically impossible. Therefore many foods are completely off limits: no bread, no beer, no pizza, and no sugar.
The fast and the spurious
On top of what you eat are considerations of when and how you eat, which is where fasting comes in. IF can be executed in a few different ways, including fasting for an entire day at a time. But the most common method is to restrict meals to a small daily window, effectively skipping one entire meal as well as all snacks outside that timeframe. In addition to the blood glucose effect previously mentioned, IF helps instill the self-disciplinary aspect of reducing caloric intake by reducing hunger cravings.
And self-discipline is key, as evidenced by the high dropout rates in strict diet-control studies: between 30 and 50 percent. This implies survivor bias in the results of dieters who make it to six and 12 months or beyond, which are not representative of those that abandoned their diet early and drop out.
This leads us back to the allure of simply drinking your ketones rather than going to all the trouble of the diet and lifestyle to produce your own. Product reviews following HVMN Ketone's late October launch were more intrigued than skeptical, with headlines such as "The Perks of Fasting, With None of the Work" and "Could HVMN Ketone mean that you’ll never have to go on a diet again?" HVMN stops short of saying its product takes the place of ketogenic dieting, but that's OK: the media says it for them.
Instead, HVMN markets Ketone as a performance enhancer for elite athletes … or anyone who feels like one. But the studies HVMN touts to support the athletic benefits of D-βHB come from the lab of biochemist Kieran Clarke at the University of Oxford, who is named on a patent for performance-enhancing D-βHB beverages. A study published by unaffiliated Australian researchers recently found that a group of professional cyclists that consumed a ketone beverage before a time trial actually performed worse than the control group. These studies of ketone drinks are in their nascency, but so too should be your confidence in their findings.
As a company that also dabbles in drugs that allegedly enhance cognition, HVMN also attests its product “could help with mental focus,” a finding that to date has only been shown in rats fed a ketone ester in their chow, not rats drinking HVMN Ketone. Rat and mouse studies should be a stepping stone to well-controlled clinical trials in humans. Unless performance benefits are demonstrated repeatedly, stay skeptical when considering whether you'd like to be a guinea pig at your own expense.
For the love of all that is starchy, there is just no shortcut to weight loss. And unlike sustained ketosis established by dieting, the benefits of a gush of ketones, if there indeed are any, are gone in a few hours. That expensive bottle of awful-tasting liquid is not good for you just because it’s trendy and patented and decorated with frilly jargon like “superfuel” and “ultra-bioavailable.” Those terms are slick marketing for an interesting idea that should be more thoroughly vetted. Until then, it’s a gimmick.
And it surely won't be the last one with venture capitalists in on this new spin on unsubstantiated supplements. The profitability of HVMN Ketone, regardless of efficacy, could portend an expansion in commercial nootropics with the weakest of evidentiary support. Now more than ever, consumers need to be wary of the potential for exploitation. Don't drink the Kool-Aid.