The illustration below is from Vol. 80, pp 50A-64A, 1997 of the American Journal of Cardiology.
![Ketone Bodies and Insulin Increase the Efficiency of Mitochondria Energy Production](https://webarchive.library.unt.edu/eot2008/20090506074732im_/http://www.niaaa.nih.gov/NR/rdonlyres/A84DA7DA-59FD-4A28-8E27-64AB6A5ADCC4/0/mito2_med.gif)
Ketone bodies or insulin increase the efficiency of hydraulic work in heart by 30%. They change most critical parameters of mitochondrial function, most notably, by reducing free NAD and oxidizing the coenzyme Q couple thus increasing the delta-G of ATP and decreasing free radical generation.
Updated: August 2002