Impact of Exercise on the Presence of Urinary Ketones Based on Korea National Health and Nutrition Examination Survey Data, 2014–2015

BACKGROUND: Ketone bodies are a well-known metabolite from the utilization of fatty acids in the fasting state. Some studies have demonstrated the metabolic benefits of urinary ketones in a specific population in whom ketone bodies were detected. However, other studies described the influence of associated factors on the presence of urinary ketone bodies. In the present study, we analyzed lifestyle factors that are hypothesized to be related to the presence of ketone bodies in urine. METHODS: Data from the Korea National Health and Nutrition Examination Survey (KNHANES, 2014–2015) were analyzed. The urinary ketone-positive group was defined as the population in whom urinary ketones were detected. We compared differences in metabolic characteristics as well as lifestyle characteristics such as smoking, alcohol intake, education levels, and exercise between the urine ketone-positive and -negative groups. RESULTS: Of the 9,379 identified eligible subjects, the urine-ketone group showed metabolic benefits with respect to several factors such as body mass index, waist circumference, triglyceride, and high density lipoprotein cholesterol after adjustment for sex and age. A higher proportion of urinary ketones was associated with current smoking (P=0.050), high education level (P=0.008), and aerobic exercise (P=0.021). CONCLUSION: Aerobic exercise was identified as a factor associated with the presence of urinary ketones. It is also an important lifestyle intervention factor for the recovery of urinary ketones in patients with obesity.