The acetyl-CoA produced by mitochondrial beta-oxidation of fatty acids enters the Kreb's cycle to produce energy, but that is not the only fate of acetyl-CoA. In liver mitochondria, some acetyl-CoA is converted to acetoacetate, beta-hydroxybutyrate, and acetone, collectively called ketone bodies. Ketone bodies are transported to other tissues such as brain, muscle or heart where they are converted back to acetyl-CoA to serve as an energy source. The brain normally uses only glucose for energy, but during starvation ketone bodies can become the main energy source for the brain. In the metabolic condition called ketosis, ketone bodies are produced faster than they are consumed by tissues and the smell of acetone can be detected on a person's breath. The smell of acetone is one indication that a person may have diabetes. The consumption of high-fat/low carbohydrate diets has been used as a weight loss program by many, intentionally inducing ketosis to consume fat stores, but these ketogenic diets can cause unwanted side effects related to increased urea production resulting from protein intake and risk of heart disease from increased cholesterol and fat intake.
Contributor: Glenn Croston, PhD
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