Ketogenic diets play an important role in histone acetylation and deacetylation by inhibition of histone deacetylases (HDAC). Ketone bodies have been shown to inhibit HDAC 1, 3 and 4 at various concentrations (mmol/l). The anti-aging gene Sirtuin 1 (NAD+) class III histone deacetylase is critical for survival and ketone body inhibition will inactivate the anti-aging gene that leads to programmed cell death. The use of ketogenic diets and nutritional supplements to induce ketosis should be carefully evaluated. Exogenous ketone drinks that contain ketone ester may rapidly elevate plasma ketones and lead to Sirtuin 1 inhibition in peripheral cells and the brain that may lead to multiple organ disease syndrome.
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