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doi: 10.1016/j.jpsychires.2008.10.007

Conclusion: Acute ketosis increased skeletal muscle work capacity and ATP consumption in older but not young individuals without affecting metabolic economy or overall mitochondrial function

The FDA also recommends examining hard clinical endpoints such hepatic decompensations, transplant free survival, and all-cause mortality, although these results are not necessarily needed prior to drug approval given the long length of follow up potentially required