FIGURE 1.

Effects of ketogenic diet and ketone body supplementation and downstream metabolism, exemplified for skeletal muscle. The liver produces ketone bodies during fasting, starvation, in carbohydrate restriction, or prolonged intense exercise. These ketone bodies can be used for input in the TCA cycle in various tissues, including the muscle to generate ATP. The Cori cycle, also known as lactic acid cycle, is the pathway in which lactate is transported to the liver and converted into glucose. Glucose-alanine cycle is the pathway in which alanine is transported to the liver and converted into glucose. KB, ketone bodies (acetoacetic acid/acetoacetate, acetone and beta-hydroxybutyric acid); TG, triglycerides; FFA, free fatty acids; Acetyl CoA, Acetyl coenzyme A; TCA, tricarboxylic acid; ATP, Adenosine triphosphate.