REVIEW article
Front. Nutr.
Sec. Nutrition and Metabolism
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1629921
This article is part of the Research TopicKetogenic Metabolic Therapies in Prevention & Treatment of Non-communicable DiseasesView all 18 articles
The role of β-hydroxybutyrate testing in ketogenic metabolic therapies
Provisionally accepted
Cristina Fante1,2*
Franziska Spritzler2
Lori Calabrese3
Nicole Laurent4
Caroline Roberts5Sofia Deloudi2,6- 1MetaboliCo GmbH, Bern, Switzerland
- 2Keto-Check, Napa, United States
- 3Touchpoints180TM, South Windsor, United States
- 4Family Renewal Inc, Vancouver, United States
- 5Virta Health, Denver, United States
- 6Metabolic Health Consulting GmbH, Zurich, Switzerland
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Accurate assessment of dietary adherence and metabolic outcomes remains a critical challenge in most nutrition studies. Ketogenic metabolic therapies (KMTs) provide a unique advantage by inducing nutritional ketosis and enabling the use of ketone bodies as biomarkers to monitor metabolic state.This narrative review investigates the role of ketone testing as an integral component of KMTs. We introduce the key biomarkers and testing modalities currently used and present a comprehensive overview of the use of capillary blood β-hydroxybutyrate (BHB) testing across diverse therapeutic areas.Capillary blood BHB testing plays a multifaceted role in KMTs: it enables objective monitoring of dietary adherence, supports the interpretation of clinical outcomes, and informs personalized treatment adjustments based on individual metabolic responses. Additionally, it may facilitate behavior change through real-time feedback.Broader implementation of ketone testing in both clinical and research settings will require thoughtful protocol design that accounts for individual preferences and tolerability, continued technological innovation to enhance user experience, and further research into the relationship between ketone levels and therapeutic outcomes.
Keywords: β-hydroxybutyrate, Ketone testing, Ketogenic Diet, nutritional ketosis, Dietary adherence, personalized medicine, patient empowerment
Received: 16 May 2025; Accepted: 17 Jul 2025.
Copyright: © 2025 Fante, Spritzler, Calabrese, Laurent, Roberts and Deloudi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Cristina Fante, MetaboliCo GmbH, Bern, Switzerland
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.