If ketones are present in urine, what is the exercise recommendation?

• A. Exercise should be increased
• B. Only low-intensity exercise is allowed
• C. Exercise can be continued with monitoring
• D. Exercise is contraindicated

Answer: (D)

Ketones in urine signal the body is relying on fat for energy because glucose utilization is impaired or carbohydrate intake is insufficient. This creates a metabolic state that can quickly worsen with exercise, increasing the risk of dehydration, electrolyte imbalance, and acidosis. Because of these safety concerns, continuing activity is not advised and the athlete should be referred for medical evaluation before returning to exercise. The other options would allow ongoing metabolic strain or insufficient risk mitigation, which is not appropriate when ketones are present.