african american girl being handed a gift by her grandfather

Fasting Ketone Levels Vary By Age

It is with great  pride we can share the latest publication from Dr. Komalben Parmar, Dr. David Weinstein and team on ketone formation with fasting.

Read the publication here: Fasting ketone levels vary by age: implications for differentiating physiologic from pathologic ketotic hypoglycemia” – Pubmed.


Who were involved?

Dr. Kombalben Parmar is a member of the Emerging Researchers Board, and David Weinstein is a the chair of the Scientific Advisory Board of KHI.

“We hope this is the first of many articles which will lead to the differentiation of physiologic and pathologic ketosis” .Dr. David Weinstein:

Lay abstract

Ketones are formed when fat is broken down by the body as fuel. Normal (or physiologic ketones) are produced with prolonged fasting, with illness, or when people are attempting to lose weight. They may also be formed when there is an energy problem in the body, and the body uses fat as a source of energy
when there is an underlying medical disorder. There has been very little research or literature on the topic of distinguishing between normal ketone production and ketones produced from an underlying medical condition.

In this study, we attempted to address this question by measuring ketones in the blood of normal children undergoing surgery. Prior to surgery, children are instructed to fast overnight, and this allowed assessment of glucose and ketones in 94 children after an average of a 12.5 hour fast. Even with prolonged fasting, no hypoglycemia was documented with an average glucose of 90 mg/dL (5.0 mmol/L).

Ketones also remained low with an average beta-OH-butyrate concentration of 0.25 mmol/L. Ketone values over 1.0 mmol/L occurred in only 2 children, and 74% of children had ketone levels under 0.3 mmol/L.

Based on the result of this study, we propose that 1.0 mmol/L will be used as a threshold to determine which child needs an evaluation for underlying medical disorders. A future larger study is needed to determine if different thresholds are needed for different ages and to determine if this is the appropriate level.

This article is free

Thanks to the incredible support from our families and sponsors for the conference in 2023, KHI was able to sponsor the Open Access of this publication.This has helped ensure that families and healthcare professionals from all over the world can freely access this important publication.