Cover Story: A conceptual model is presented on adaptive balance which defines the transition from fixed homeostasis to flexible homeodynamics, with a consequential progressive contraction of this adaptive capacity associated with the ageing phenotype. From metabolic flexibility to rigidity, this framework links mitochondrial dysfunction, impaired autophagy, NAD+ depletion, and oxidative stress to chronic disease. Ketosis, principally defined by the production of β-hydroxybut

Cover Story: The KetoSAge human trial examined ten lean, healthy, pre-menopausal women who were habitually in ketosis (~3.9 years). Participants suppressed ketosis-inducing hypoketonaemia for 21 days via a higher carbohydrate intake, aligned with standard healthy eating guidelines, before returning to euketonaemia. Hypoketonaemia resulted in significant increases in ALT (~1.9-fold), GGT (1.3-fold), ALT/AST (1.30-fold), GKI (22.23-fold), and HOMA-IR (2.13-fold). These metaboli