Nutritional Ketosis Increases NAD+/NADH Ratio in Healthy Human Brain: An in Vivo Study by 31P-MRS

"The NAD+ requirement of the glycolytic and ketolytic pathways is illustrated in Figure 3. Glycolysis requires 4 NAD+ to make 2 Acetyl-CoA, while ketolysis consumes no NAD+ to make Acetyl-CoA from AcA, and only one NAD+ to convert BHB to AcA (6). This is to the best of our knowledge the first interventional study that shows that ketones can have a NAD+ sparing effect in healthy human brain."

https://www.frontiersin.org/articles/10.3389/fnut.2018.00062/full

Notable Limitation: funded by Nestlé.