Ketogenic diet attenuates cardiac aging via CD36/MAPK inhibition: comparable effects in aged male and female mice
In aged humans, lower plasma β‑hydroxybutyrate correlated with poorer systolic and diastolic function. An 8‑week ketogenic diet in 22‑month‑old mice raised cardiac β‑HB, improved functional indices, preserved mitochondria, and reduced myocardial lipid accumulation in both sexes, an effect linked to suppression of CD36 membrane translocation and MAPK activation.
Study and findings
The authors first examined a cross‑sectional human cohort (n=241) and found that circulating β‑hydroxybutyrate declined with age and was positively associated with ejection fraction, fractional shortening and the E/A diastolic ratio. To test causality, they fed 22‑month‑old male and female mice either standard chow (3.79 kcal/g) or a ketogenic diet (7.24 kcal/g) for eight weeks. Ketogenic feeding raised cardiac β‑HB, improved systolic (EF, FS) and diastolic (E/A) parameters, preserved mitochondrial respiration, and lowered myocardial triglyceride content and serum lipids. Molecular analysis showed reduced CD36 membrane presence and MAPK phosphorylation; overexpression of CD36 reversed these benefits, implicating the CD36/MAPK axis as necessary for the diet‑induced cardioprotection.
Clinical interpretation
The mouse data suggest that dietary ketosis can counteract age‑related cardiac remodeling by modulating lipid uptake pathways, specifically CD36‑mediated fatty‑acid transport and downstream MAPK signaling. Because the functional improvements were observed in both sexes, the intervention appears not to be sex‑dependent in this model. The human association between β‑HB and cardiac performance supports the notion that circulating ketones may serve as a biomarker of cardiac health in older adults, although causality cannot be inferred from the observational component.
Limitations and open questions
The study is limited to a single animal species and a relatively short dietary exposure; translation to human therapy requires confirmation in longitudinal interventional trials. The human cohort provides only correlational evidence, and the sample size does not allow stratified analysis of comorbidities or medication use. Moreover, the ketogenic diet was energy‑dense, raising the possibility that caloric effects contributed to the observed benefits. Future work should test whether modest ketosis achieved without excess calories yields similar cardiac protection and should explore the relevance of CD36/MAPK modulation in human cardiac tissue.
Source
Source: Sensen C et al., Experimental Gerontology, 2026.