Ketogenic compositions including beta-hydroxybutyrate (beta-hydroxybutyrate) and acetoacetate are formulated to induce, promote, or sustain ketosis in a mammal. The combined beta-hydroxybutyrate/acetoacetate compositions include an amount of acetoacetate that limits the reduction in available NAD+ in a subject without causing the formation of excess acetone in the bloodstream. In some aspects a composition for promoting and/or sustaining ketosis in a mammal contains a dietetically or pharmaceutically acceptable carrier and a beta-hydroxybutyrate/acetoacetate mixture of about 5% to about 45% acetoacetate by weight of the mixture and about 55% to about 95% beta-hydroxybutyrate by weight of the mixture.
