{"id":12994,"date":"2023-04-19T09:51:14","date_gmt":"2023-04-19T09:51:14","guid":{"rendered":"https:\/\/foodpunk.com\/blog\/how-do-ketone-bodies-become-energy\/"},"modified":"2025-10-06T14:26:02","modified_gmt":"2025-10-06T12:26:02","slug":"how-do-ketone-bodies-become-energy","status":"publish","type":"post","link":"https:\/\/foodpunk.com\/en\/blog\/how-do-ketone-bodies-become-energy\/","title":{"rendered":"How do ketone bodies become energy?"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row][vc_column][vc_column_text]<em>Ketone bodies are produced in the liver and then enter the blood. They are small and well soluble in water. This allows them to be wonderfully transported throughout the body. But how do the organs that normally burn glucose suddenly gain energy from ketone bodies?<\/em><\/p>\n<p>In the last article, I introduced ketogenesis &#8211; the <a href=\"https:\/\/foodpunk.com\/de\/blog\/wie-entstehen-ketonkoerper\/\" target=\"_blank\" rel=\"noopener\">production of ketone bodies<\/a> in the liver. You do not know yet? With a click on the link quickly read again! I&#8217;ll wait until then.[\/vc_column_text]<div class=\"vmb-3 wpb_content_element\" ><div class=\"index-list\"><p class=\"h4 index-list__title\"> Table of contents<\/p><ul><\/ul><\/div><\/div><div class=\"vmb-3 wpb_content_element\" ><div class=\"heading heading--h2 \"><h2 class=\"heading   \" >1. the liver cannot do anything with ketone bodies<\/h2><\/div><\/div>[vc_column_text]<\/p>\n<p>The liver itself lacks a specific enzyme to produce energy from ketone bodies. 3-Keto Acid CoA Transferase is the name of the colleague. Going back to our theme park comparison, you can think of the liver as a specific park. There just aren&#8217;t the same attractions and roller coasters at Europapark as there are at Disneyland. Neither are the same employees. The liver is the European Park. The attractions are certain metabolic pathways and the employees the enzymes. If I really want to have an attraction from Disneyland, I can whine to the staff at Europapark for as long as I want, but it won&#8217;t help. I just have to go to Disneyland. And that&#8217;s what our ketone bodies think too. Europapark? No Disney castle? Well, then I&#8217;ll just get out of here. We&#8217;ve probably made the staff at Rust so angry by now that we&#8217;ll be kicked out anyway. And so the liver throws out the ketone bodies. Off into the blood.<\/p>\n<p>[\/vc_column_text]<div class=\"vmb-3 wpb_content_element\" ><div class=\"heading heading--h2 \"><h2 class=\"heading   \" >2. ketone bodies are highly soluble in water<\/h2><\/div><\/div>[vc_column_text]<\/p>\n<p>On the trip to Disneyland, the ketone bodies have a decisive advantage: they are traveling by car. This means that they can take the highway completely self-sufficient. From Rust to Paris. Others, like the fatty acids, have to wait for the bus first or spend way too much money on a cab. Ketone bodies are highly soluble in water, which is their car. Because fatty acids are not readily soluble in water, they need a means of transport. Their bus is the transport protein albumin. They are bound to these and can thus travel through the blood. Grease simply does not mix well with water.<\/p>\n<p>[\/vc_column_text]<div class=\"vmb-3 wpb_content_element\" ><div class=\"heading heading--h2 \"><h2 class=\"heading   \" >3. if the ketone body concentration in the blood increases, it also increases in the organs<\/h2><\/div><\/div>[vc_column_text]<\/p>\n<p>As soon as some ketone bodies are on the way in the blood, some press through the cell walls of the organs again and again. The more ketone bodies there are in the blood, the more crowded it becomes. They push and shove and more and more are pushed through the cell wall into the cells of the organs. The cells of the organs, such as muscles and brain, have not had such guests for a long time. Normally, they only get visits from glucose. At first, they don&#8217;t really know what to do with these strange ketone bodies.<br \/>\n10-20% of ketone bodies do not even make it to the organs. These are lost en route and are excreted in the urine. There is always a little shrinkage. Therefore, &#8220;ketosis&#8221; can be measured in urine.<\/p>\n<p>[\/vc_column_text]<div class=\"templatera_shortcode\"><div class=\"vc_container vc_maxwidth \"><div class=\"vc_row wpb_row vc_row-fluid vc_row-o-content-bottom vc_row-flex bg--color--bg-secondary bg--image--pos-br bg--image--size--contain\"><div class=\"wpb_column vc_column_container vc_col-sm-7 vc_col-lg-7\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\"><div class=\"vc_row wpb_row vc_inner vc_row-fluid vpt-3 vpb-3\"><div class=\"wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\"><div class=\"vmb-1 wpb_content_element\" ><div class=\"heading heading--p \"><p class=\"heading h3  heading--center\" >Du m\u00f6chtest dich auch <span class=\"deco-underline\">ges\u00fcnder ern\u00e4hren<\/span>?<\/p><\/div><\/div><div class=\"wpb_content_element\" ><div class=\"btn__wrapper \"><a href=\"https:\/\/foodpunk.com\/de\/ernaehrungsplaene\/clean-eating\/?utm_source=website&utm_medium=banner\" target=\"\" rel=\"\" title=\"\" class=\"btn--full btn--primary btn--md \"><span>Jetzt durchstarten!<\/span><\/a><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"d-none d-md-flex wpb_column vc_column_container vc_col-sm-4 vc_col-lg-5\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\">\n\t<div  class=\"wpb_single_image wpb_content_element vc_align_left vmb-3 wpb_content_element\" >\n\t\t\n\t\t<figure class=\"wpb_wrapper vc_figure\">\n\t\t\t<div class=\"vc_single_image-wrapper  \"><img loading=\"lazy\" decoding=\"async\" width=\"900\" height=\"865\" src=\"https:\/\/foodpunk.com\/wp-content\/uploads\/hero-manu2.png\" class=\"vc_single_image-img attachment-large\" alt=\"\" title=\"hero-manu2\" srcset=\"https:\/\/foodpunk.com\/wp-content\/uploads\/hero-manu2.png 900w, https:\/\/foodpunk.com\/wp-content\/uploads\/hero-manu2-300x288.png 300w, https:\/\/foodpunk.com\/wp-content\/uploads\/hero-manu2-768x738.png 768w\" sizes=\"auto, (max-width: 900px) 100vw, 900px\"><\/div>\n\t\t<\/figure>\n\t<\/div>\n<\/div><\/div><\/div><\/div><\/div>\r\n<\/div><div class=\"vmt-3 vmb-3 wpb_content_element\" ><div class=\"heading heading--h2 \"><h2 class=\"heading   \" >4. the organs must learn to burn ketone bodies<\/h2><\/div><\/div>[vc_column_text]<\/p>\n<p>If you were handed an unusual vegetable &#8211; say okra &#8211; would you immediately know what to cook with it? Do not google!!! I guess not everyone would have an idea right away. But the more often you cook with okra, the better your dishes will taste with it. You learn to use the vegetables that were so foreign to you before. It is similar in the organs. In the beginning, they don&#8217;t really know what to do with ketone bodies. You could also say: Disneyland suddenly has a particularly large number of visitors from the land of Okra. Unfortunately, none of the staff speaks okra. First, the employees can only guide their guests into the attractions with hand signals. The theme park needs to hire competent employees who understand the language of the new guests. It takes time to hire enough Okra-speaking staff to competently serve all ketone bodies.<\/p>\n<p>The right enzymes must first be formed in the organs to break down ketone bodies. Slowly but surely, the degradation is going better and better. The trigger for the formation of new enzymes are the ketone bodies themselves. Just as at Disneyland, Okrarians were the catalyst for hiring Okra-speaking employees.<\/p>\n<p>[\/vc_column_text]<div class=\"vmb-3 wpb_content_element\" ><div class=\"heading heading--h2 \"><h2 class=\"heading   \" >5. ketolysis is ketogenesis backwards. Almost!<\/h2><\/div><\/div>[vc_column_text]<\/p>\n<p>In ketogenesis, the production of ketone bodies, the ketone bodies were produced from crushed activated fatty acids (acetyl-CoA). During ketolysis, the breakdown of ketone bodies, they become acetyl-CoA again. This enters the so-called citrate cycle (also known as the Krebs cycle or citric acid cycle), where it is completely broken down into its individual components. Energy is generated in the process. The energy is stored in the form of ATP. This is the universal energy currency of the body. Something like the euro for Europe. Don&#8217;t worry, it works fine in the body!<\/p>\n<p>(The body has namely understood that energy can always be transformed only from another form. Energy cannot simply be created, cannot be manufactured anew. Energy inflation does not exist).<\/p>\n<p>[\/vc_column_text]<div class=\"vmb-3 wpb_content_element\" ><div class=\"heading heading--h2 \"><h2 class=\"heading   \" >6. 3 enzymes are needed for the degradation of ketone bodies<\/h2><\/div><\/div>[vc_column_text]First, the ketone body 3-hydroxybutyrate must be converted back into acetoacetate. The canoe just magically changes shape again. You can read again how acetoacetate became 3-hydroxybutyrate in the article<a href=\"https:\/\/foodpunk.com\/de\/blog\/wie-entstehen-ketonkoerper\/\" target=\"_blank\" rel=\"noopener\">&#8220;How are ketone bodies formed?<\/a>&#8220;. If these mind games are too colorful for you, and you would rather have serious science, then scroll down a little further. Below the picture you will find the biochemical processes explained again seriously in scientific language.<\/p>\n<p>You are still here? Well then, the colorful mind games continue for you for now:<\/p>\n<p>The worker responsible for this magical conversion (the enzyme) is 3-hydroxybutyrate dehydrogenase. Subsequently, the employee 3-keto acid CoA transferase activates the acetoacetate. It turns on the switch, so to speak, of the acetoacetate canoe tandem. It then becomes acetoacetyl-CoA, the activated form of acetoacetet. It seems to me that the ketolysis staff are all too good for nicknames. Too bad actually.<\/p>\n<p>In ketogenesis, after all, two canoes were connected to form a canoe tandem. Here, at ketolysis, the two canisters are now separated again. Now we are back to the individual canoes, acetyl-CoA. The worker\/enzyme acetoacetyl-CoA thiolase is responsible for this step. As already mentioned, this enters the citrate cycle and energy is extracted from it.[\/vc_column_text]<div class=\"vmb-3 wpb_content_element\" ><div class=\"heading heading--h2 \"><h2 class=\"heading   \" >7. this complicated process is a clever move<\/h2><\/div><\/div>[vc_column_text]<\/p>\n<p>Okay, so what&#8217;s the point of all this effort? First, fatty acids are released from the adipose tissue into the blood, then they are converted into ketone bodies in the liver. However, the liver cannot do anything with the ketone bodies and therefore throws them out again. Via the blood, they reach the muscles, brain and other organs. There, the ketone bodies are broken down again and converted into energy. Can&#8217;t we save this act and directly burn the fatty acids in the organs?<\/p>\n<p>The answer is &#8220;well&#8221;. The muscles burn fatty acids to some extent. However, as written above, these are not very soluble in water and must therefore be transported bound to albumin. The transport capacity is limited. The brain cannot use fatty acids at all because they do not pass through the blood-brain barrier. Ketone bodies, on the other hand, can pass the blood-brain barrier.<\/p>\n<p><strong>In times without food, the body of our ancestors had nothing but its fat reserves. Since the brain could not use them directly, the &#8220;detour&#8221; saved us. The brain had a fuel at its disposal that you always had with you. Ketone bodies obtained from body fat.<\/strong><\/p>\n<p>I&#8217;ll explain in the next article exactly how the brain uses ketone bodies, how it changes its metabolism and how effective the whole thing is.<\/p>\n<p>Now follows a biochemical scheme with the described metabolic pathway, followed by the &#8220;serious&#8221; description of the processes and the source reference.<\/p>\n<p>[\/vc_column_text][vc_single_image image=&#8221;9818&#8243; img_size=&#8221;large&#8221;]<div class=\"vmb-3 wpb_content_element\" ><div class=\"heading heading--h2 \"><h2 class=\"heading   \" >8. ketolysis in extrahepatic organs<\/h2><\/div><\/div>[vc_column_text]<\/p>\n<p>The hepatocytes themselves cannot utilize the ketone bodies &#8211; they lack the enzyme 3-keto acid-CoA transferase &#8211; which is why the ketone bodies are released into the blood. While fatty acids are not water-soluble and are therefore transported bound to albumin in the circulation, ketone bodies are readily water-soluble. AcAc and 3HB diffuse into extrahepatic tissues along their concentration gradient and the rate of their oxidation in tissues is directly proportional to their concentration in blood. Nevertheless, 10-20% of ketone bodies in ketogenic metabolic state are excreted in urine. During ketolysis, the ketone bodies are converted back to acetyl-CoA, which then enters the citrate cycle and is completely oxidized. In this process, the oxygen consumption per mole of ATP produced is lower than in the complete oxidation of glucose.<\/p>\n<p>For metabolization, 3HB must first be converted back to AcAc. The reaction is catalyzed by 3-hydroxybutyrate dehydrogenase, as was previously the case for interconversion in the liver. Subsequently, 3-ketoacid-CoA transferase activates AcAc to acetoacetyl-CoA.<\/p>\n<p><strong>Acetoacetate + Succinyl-CoA \u2192 Acetoacetyl-CoA + Succinate<\/strong><\/p>\n<p>This is followed by the cleavage of acetoacetyl-CoA into two molecules of acetyl-CoA by acetoacetyl-CoA thiolase.<\/p>\n<p><strong>Acetoacetyl-CoA \u2194 2 Acetyl-CoA<\/strong><\/p>\n<p>Like ketogenesis, ketolysis is localized in the mitochondria. The resulting acetyl-CoA is oxidized to <sub>H2O<\/sub>and<sub>CO2<\/sub> in the citrate cycle. The &#8220;detour&#8221; of fatty acid oxidation via ketone bodies costs additional energy, but it is a way of transporting the energy content of the fatty acids from the liver to extrahepatic organs by a water-soluble route. The main reason may be that ketone bodies are the only alternative energy source to glucose for the brain during periods of food deprivation.<\/p>\n<p>Ketone bodies can be metabolized by numerous organs including the brain, heart, and skeletal muscle, with ketolysis in the brain being quantitatively the most significant and best studied.<\/p>\n<p>[\/vc_column_text]<div class=\"templatera_shortcode\"><div class=\"vc_container vc_maxwidth \"><div class=\"vc_row wpb_row vc_row-fluid vpt-3 vpb-3 bg--color--bg-primary vc_boxpadding\"><div class=\"wpb_column vc_column_container vc_col-sm-12 vc_col-lg-10\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\"><div class=\"vmb-1 wpb_content_element\" ><div class=\"heading heading--p \"><p class=\"heading h3  \" >Always stay up to date with our <span class=\"deco-underline\">Newsletter<\/span>.<\/p><\/div><\/div><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar 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is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){jQuery('#gform_wrapper_3').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_3').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_3').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/ jQuery(document).scrollTop(jQuery('#gform_wrapper_3').offset().top - mt); }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_3').val();gformInitSpinner( 3, 'https:\/\/foodpunk.com\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery(document).trigger('gform_page_loaded', [3, current_page]);window['gf_submitting_3'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}jQuery('#gform_wrapper_3').replaceWith(confirmation_content);jQuery(document).scrollTop(jQuery('#gf_3').offset().top - mt);jQuery(document).trigger('gform_confirmation_loaded', [3]);window['gf_submitting_3'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_3').text());}else{jQuery('#gform_3').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"3\", currentPage: \"current_page\", abort: function() { this.preventDefault(); } }]);        if (event && event.defaultPrevented) {                return;        }        const gformWrapperDiv = document.getElementById( \"gform_wrapper_3\" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( \"span\" );            visibilitySpan.id = \"gform_visibility_test_3\";            gformWrapperDiv.insertAdjacentElement( \"afterend\", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( \"gform_visibility_test_3\" );        let postRenderFired = false;        function triggerPostRender() {            if ( postRenderFired ) {                return;            }            postRenderFired = true;            gform.core.triggerPostRenderEvents( 3, current_page );            if ( visibilityTestDiv ) {                visibilityTestDiv.parentNode.removeChild( visibilityTestDiv );            }        }        function debounce( func, wait, immediate ) {            var timeout;            return function() {                var context = this, args = arguments;                var later = function() {                    timeout = null;                    if ( !immediate ) func.apply( context, args );                };                var callNow = immediate && !timeout;                clearTimeout( timeout );                timeout = setTimeout( later, wait );                if ( callNow ) func.apply( context, args );            };        }        const debouncedTriggerPostRender = debounce( function() {            triggerPostRender();        }, 200 );        if ( visibilityTestDiv && visibilityTestDiv.offsetParent === null ) {            const observer = new MutationObserver( ( mutations ) => {                mutations.forEach( ( mutation ) => {                    if ( mutation.type === 'attributes' && visibilityTestDiv.offsetParent !== null ) {                        debouncedTriggerPostRender();                        observer.disconnect();                    }                });            });            observer.observe( document.body, {                attributes: true,                childList: false,                subtree: true,                attributeFilter: [ 'style', 'class' ],            });        } else {            triggerPostRender();        }    } );} ); \n\/* ]]> *\/\n<\/script>\n<\/div><\/div><\/div><\/div><\/div><\/div>[vc_column_text elem_margin_top=&#8221;vmt-3&#8243;]<strong>Sources and interesting literature:<\/strong><\/p>\n<p>Owen OE, Felig P, Morgan AP, Wahren J, Cahill GF. 1969. <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/5773093\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">liver and kidney metabolism during prolonged starvation<\/a>. J Clin Invest, 48(3): 574-583.<\/p>\n<p>Veech RL, Chance B, Kashiwaya Y, Lardy HA, Cahill GF. 2001. <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/11569918\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">ketone bodies Potential Therapeutic Uses<\/a>. IUBMB life, 51(4): 241-247.<\/p>\n<p>Stipanuk MH, Caudill MA. 2013. <a href=\"https:\/\/evolve.elsevier.com\/cs\/product\/9781455746293\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">biochemical Physiological and Molecular Aspects of Human Nutrition<\/a>. Third ed. Philadelphia: Elsevier Saunders, 379-381.[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Ketone bodies are produced in the liver and then enter the blood. They are small and well soluble in water. 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