Ketogenic diet and beta-hydroxybutyrate may combat age-related muscle loss

This review synthesizes current evidence on how ketogenic diets and the ketone body beta-hydroxybutyrate (BHB) might prevent sarcopenia—the progressive loss of muscle mass and strength with aging that affects up to 15% of older adults. The mechanisms are multifaceted: BHB appears to reduce muscle protein breakdown, dampen inflammation, improve mitochondrial function, and potentially act as a signaling molecule that preserves muscle. The ketogenic diet's high fat, very low carbohydrate composition shifts metabolism toward fat-burning and ketone production. While some animal studies show promise, human evidence remains mixed—some trials show muscle preservation, others show no benefit or even muscle loss during initial adaptation. The practical challenge is that strict ketogenic diets are difficult to maintain long-term and may not suit everyone, particularly those with certain medical conditions. The review is valuable for clinicians and aging individuals considering dietary interventions, but readers should understand this is still an evolving area. More rigorous, long-term human trials comparing ketogenic approaches to resistance training—the gold standard for sarcopenia prevention—are needed before making definitive recommendations.