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A metabolic byproduct of sugar metabolism called methylglyoxal has been linked to age-related diseases such as type 2 diabetes, Alzheimer’s disease, and cancer. People that were fasted for one night and had higher levels of acetoacetate also had higher levels of a compound called 3-HHD which forms through the detoxification process of methylglyoxal.

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    Ever wondered why vinegar intake has consistently been shown to have strong anti-inflammatory and anti-obesogenic effects, both in animal and human studies?

    https://www.ncbi.nlm.nih.gov/pubmed/19661687 https://www.ncbi.nlm.nih.gov/pubmed/27595296 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4438142/

    Despite those compelling result, there is little research into the actual mechanistic effects of dietary acetic acid. May an increased synthesis of acetoacetate due to the substrate availability be a part of the explanation? There is a curious study from 1940(!) showing that if rats and dogs are feed acetic acid, there is indeed an increase in blood acetone bodies. Surprisingly, this line of reasearch was never continued:

    http://www.jbc.org/content/135/1/157.full.pdf