Physiological Ketosis

Physiological hyperketonemia is found in the suckling neonate (high-fat diet of the milk; Figure 1), postexercise (depletion of hepatic glycogen reserves), and after prolonged fasting (more than 24 h; Figure 7). All these situations have in common a low hepatic carbohydrate status (depletion of glycogen and/or activation of gluconeogenesis) and therefore from a physiological standpoint one would expect an increased rate of ketogenesis. Comparison of the factors which can influence ketogenesis in suckling and fasting (Table 2) shows the expected broad agreement.

Table 1 Range of blood ketone body concentrations in humans


Ketone body concentration (mmol l-1)

Fed normal diet

about 0.1

Fed high-fat diet

up to 3

Fasted: 12-24 h

up to 0.3

Fasted: 48-72 h

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