Thought Leadership
Stephen Phinney, PhD, RD
What is Euketonemia: Evolutionary Insights for Metabolic Health
2026-01-05
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15 min read
Key Points
Beginning with use of the terms nutritional ketosis and keto-adaptation, the last few decades have seen a quiet but significant explosion in our understanding of the beneficial roles that ketones, under-appreciated metabolites, play in human health and function.
Despite this scientific progress, there remains a linguistic bias in the descriptors applied to the physiologic levels of nutritional ketosis, typically high, increased, elevated, and hyper; all of which tend to carry negative connotations.
More accurate communication of the potential roles of ketogenic therapies, both to colleagues and the public, would be achieved by defining the beneficial range of nutritional ketosis as ‘euketomenia’, reflecting the standard terminology used to define the healthy physiological range for blood glucose as euglycemia.
A Brief History of Ketones
The role of ketosis and ketones in normal human metabolism and disease has a long, interesting, and complex history, yet their functions remain misunderstood. Unfortunately, this topic has been hijacked for the last century by an over-simplified perspective that until only recently labeled any level of ketones in humans as ‘toxic by-products of fat metabolism’, and perhaps sometimes coupled with a touch of bias against aboriginal hunting cultures. Recently, however, there seems to be a growing recognition of the important – and often beneficial – nuances of human ketone metabolism.
Keto-acidosis in humans was first noted over 3500 years ago by a ‘sweet odor (now called ‘ketone breath’) in patients with symptoms of uncontrolled diabetes. In the 17th century diabetes was defined as a disease and linked to sugar in the urine, diagnosed by taste. But it was not until the late 1800s that acetone and the two ‘ketone bodies’, acetoacetate and beta-hydroxybutyrate (the latter two being organic acids), were chemically defined and found to be dramatically increased in patients with diabetic keto-acidosis. Because of this association, ketones were historically regarded as toxic compounds derived from the partial metabolic breakdown of fat.
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1.2%
Average Improvement
8.4kg
Average Change
67%
Success Rate
Clinical Implications
These findings suggest important therapeutic applications. The magnitude of improvement observed provides valuable insights for clinical practice and patient care strategies.
Key Takeaway
This research demonstrates the effectiveness of nutritional ketosis interventions in clinical settings, providing evidence-based support for therapeutic applications.
References
Lead Author, et al. Study title and findings. Journal Name. 2024;41(12):2634-2645.
Researcher, et al. Twelve-month outcomes of randomized trial. Scientific Journal. 2023;7(12):304.
Expert, et al. The effect of nutritional interventions. Medical Research. 2023;5:36.
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