Dom D'Agostino

00:07boom and we're live alright dumb welcome to the show I'm doing great Jeff let's start her ray up close yeah there you go I know you've done a podcast for you did Tim Paris's podcast I heard you on that I didn't like three of them I think I did four three three really guys oh I need to listen to the other two then um what is this wine you brought me man this is crazy that is you're taking a drunk just what this is hi maybe the the dry farm wines guys think that this is a giant Magnum I'd have to have a party it's uh it's a wine that's pretty legit in regards to if you want to stay on a ketogenic diet yeah and I tested this and in my office actually and just found that it to be it's non glycemic for one thing which means it doesn't impact the sugar content is so low there's not an elevation and in blood glucose and I can stain ketosis on this wine if I do one

01:02glass two or three starts to kick me out but two glasses of wine you can completely say in ketosis interesting most glasses most wine will kick you out of ketosis uh yeah I mean it's highly dependent on like a merlot you know a dry wine typically doesn't but it's more a little more dry most of it yeah that's the time yeah white wines tend to kick me out more and of course something like a sweet wine will go Riesling or something like that really sweet yeah sangria you know that's just sugar yeah and even beer does even though it's supposed to be a little card beer tends to kick me out really and make a little ultra maybe one you know one or two but other than that yeah I mean I get that question a lot so it actually got me interested into studying this so I can answer some of the questions with some level of knowledge and after testing these wines and I came to the conclusion yeah you

02:00can drink two glasses of wine a day on a strict ketogenic diet and I mean this is important for you know people that are doing it to manage their health long-term right and especially people with actual health issues we're ketogenic diet benefits them like yeah plastic absolutely like when I got into this it was a pediatric epilepsy like in two thousand seven or eight and now the applications are expanding you know a dozen or more so we hold a conference in metabolic therapeutics conference we're taught top tier people in academia and like from Johns Hopkins they're probably one of the spearheaded ketogenic diet application clinically and top tier scientists like from Yale and Harvard and other places present here and it's I think the applicator is like 11 or 12 applications for the ketogenic diet where there's good peer-reviewed research to support the efficacy as a

02:59metabolic based therapy for a number of everything from you know polycystic ovary syndrome to acne to rare even genetic disorders like Angelman syndrome is something that we're saying it's a it's a genetic disorder where a housekeeping gene is mutated and it results in seizures and motor function impairment and the ketogenic diet is remarkably effective not it's really drug resistant seizures that these kids have and even in the presence of a persistent molecular pathology a genetic pathology the ketogenic diet through altering metabolism with the ketogenic diet you can largely silence the the pathology and the motor function impairments associated with this disease and that that's amazing to me that you have a disease that is persistently there due to a genetic mutation and you can largely silence the symptoms in the interest of addressing people that are probably on the ground floor

03:59and I feel like there's very few people today that don't understand what a ketogenic diet is but just in case for people who don't know there are people that use carbohydrates mainly for fuel and then there is the ketogenic diet which makes your body run on fats and ketones so I just try to explain that to people like how this came about how people started researching this and and how you got involved okay I mean this goes back if not centuries like millennia you know to dating back to the time of Hippocrates when it was observed that fasting was a quote unquote cure for seizures and with the observation yeah so fasting puts you into fasting ketosis right so even intermittent fasting like I do the 14-hour thing where 14 hours you know that's that's clinical I mean technically that's kind of I call that semi a semi fasted state when you achieve that you know when you're eating

04:57breakfast it could be you know twelve hours or more since you've eaten last and you're breaking the fast essentially but with severe epileptic patients it was found that when you when they restricted food and in some cases water after about two or three days you had profound seizure control or it silenced even the worst seizures and this was observed you know for millennia like I said and the there was some work done in the early 1900's and and 1920s there was some work done at the Mayo Clinic that that observed the presence of these ketone bodies and people that were eating a carbohydrate restricted diet that was primarily based on eating fat and with a minimal amount of protein just enough to ensure there's not protein you know malnutrition and it was observed that there was an elevation of ketone bodies beta-hydroxybutyrate and acetyl acetate in the blood so they

05:54called it a physiologist called that the ketogenic diet even technically maybe beta-hydroxybutyrate it's not a ketone but physiologist called these ketone bodies beta-hydroxybutyrate acetyl acetate and acetone and it mimicked the physiological state of fasting in many ways so if you were to draw blood off someone on a ketogenic diet it would sort of look like they had been fasting a few days because it's mimicking the way I think about it it's suppressing the hormone insulin and kind of mimicking the fuel the substrate utilization that you would be using in a state of being fasted which is primarily fats ketones and to a lesser extent I mean a glucose from amino acids from protein you are mobilizing some gluconeogenic amino acids from your skeletal muscle when you are fasting ketones are protein sparing though so they are anti catabolic in that way so

06:49because we make ketones and our large brain has a massive demand for energy and the ketones fulfill that for the most part when fasting it prevents us from breaking down muscle it prevents us from liberating the gluconeogenic amino acids that would otherwise you know be chewed up and used to maintain our glucose levels so the ketones sort of replace the glucose the brain has the metabolic flexibility to adapt from using glucose to using primarily ketone bodies and those ketone bodies really have a protein sparing anti catabolic effect now is this an ancient system that was in place back when people you know obviously couldn't go to the store and your diet varied depending upon what was available and it just allowed people like say like maybe Inuits that lived off a lot of fats because they really don't have many carbohydrates if you're living off a whale blubber and things

07:38along those lines like they had to back then yeah I mean it's hardwired in in humans and obviously and other animals my my wife studies manta rays and and they they're that they're that like the Einsteins of the see that so they're the fish with the biggest brains of all animals and we've done metabolomic Studies on them and looking at the blood and they produce a significant amount of ketones like two milli molar they dive really deep so it may help protect them from that so yeah animals will go into ketosis during fasting or even if you manipulate their food source the keto pet sanctuary actually treats dogs that have cancer and they implement a ketogenic diet in dogs in addition to some other things to help and many of these are dogs taken from kill shelters and and put them on an anti-cancer therapy program now they can get into ketosis for the most harder but not most

08:34dog food is not ketogenic is like documents of grain in it right yeah for fillers and things on those lines yeah it's really interesting I was talking with Ron Penna yesterday from quest nutrition the CEO of quest nutrition and he brought to my attention that if you look on a package of food you won't see carbohydrates listed even right it's the primary because there was some some laws or policy put into action to prevent carbohydrates from even being listed on kibble on dog food which I find if you know there's a lot of reasons why mostly because dogs really shouldn't be eating in carbohydrate based diet and it's probably part of the reason but there's sort of other reasons why but it's really important that is so the food that the keto pet sanctuary gives the dogs that have cancer and they confirm that they have cancer with a glucose PET scan and they do it you know

09:27before during and after is basically kind of like a raw foods ketogenic diet that's almost completely restricted in what we've called glycemic carbohydrates things that would elevate the glucose levels and it's very high in fat relatively speaking yeah but dogs you know really should not be eating any kind of greens at all yeah I feed my dog grain free dog food but I don't know if it's carb free I don't know what's in there yeah its kibble it's not to find out right yeah I mean you know dog food that has like some peas and sweet potatoes and things like that is okay but ideally you know you want to give your dog like a whole food nutrition just like humans you know they say don't give your dog human food but that's there's no evidence for that and you know given talks where I talked about giving dogs raw food and there's a there'd be a reaction from the audience well it's

10:25dangerous to give your dog like raw food well what are they in a wild you know I mean if the if it's ground beef that's been sitting around and a processing plant for a while yeah maybe but fresh you know meat from a butcher fresh meat I mean it's probably the ideal thing for a dog ideally organ meats like liver heart kidneys things like that grind it up you know and some some greens to sand things like spinach you can buy like spinach powder so the keto pet sanctuary has an e-book that's completely free if you go to keto pet sanctuary dot o-r-g i believe and you can download its ebook and it tell very precisely how to make your dog food not only to you know if your dog gets cancer but to maximize its overall performance and you are preventing cancer by virtue of putting them on a diet that optimizes your their metabolic health but that's got to be very difficult to package though and

11:19something that's sort of evergreen sits on the shelf and you know paper bag you can rip open and just pour into a bowl that's what everyone that's like this convenience thing but there's a way to do it and you know I know I know those guys you know epigenetics Foundation they are working they basically support the Quito pet sanctuary and they're working out not only the macronutrient ratios that need to go into the food but also the types of food and also being able to package it in a way to ultimately come up with a food that you can go it may not be on the Shelf and probably ideally shouldn't be on the shelf but it'll be like in the refrigerator section of your pet food store so you go there and like for our dogs we'd get like a tube of freshly ground up steak or whatever and we feed that we take you know the ground meat and mix it with organ meat and mix it

12:09with different greens like broccoli and things like that and give it to them and they love it with a little bit of coconut oil on it sometimes so you would go to the grocery store or it would be could be shipped to your house and it's basically kept you know refrigerated and it has a the complement of like organ meats to you know the proper types of fats fish oil fats and fiber and and it fits that macronutrient ratio of the ketogenic diet the dog must have horrific farts yeah one of them yeah we have a Great Dane they're both rather rescue dogs one of them does I'm here in broccoli organ meats and coconut oil I'm like whoa get out of the room yeah it's either my wife or the dog they're healthy how long have you been involved in ketogenic research and research on keto diets and and how long have you been doing it yourself yeah I I guess it was I got turned on to it in two

13:11thousand seven or eight and actually I was communicating line on a nutrition form on a fitness website and I was a neuroscientist I did my PhD on cellular neuroscience I did unless something called patch-clamp electrophysiology where I electrically record from neurons and it was you know really mostly just neuroscience and my postdoctoral research was studying seizures and I got to the point where we're doing some drug based research on seizures and other types of research and and the types of seizures that I study are powerful tonic clonic seizures that a Navy SEAL could potentially experience using closed-circuit rebreather so when they're underwater a limitation for their time underwater is CNS oxygen toxicity and it's also a limitation for hyperbaric oxygen therapy rebreathers are those ones that don't in emit bubbles yeah yeah so there's a bit of a stealth component so you're

14:09underwater and if you're going over a lake to engage the enemy they can't see you coming so that's the advantage that they're very stealth like the disadvantage is at 50 feet of sea water in just 10 minutes you have the potential to get CNS oxygen toxicity of course if you follow the guidelines and dive within the guidelines of you know the depth and the time then you're typically okay 99.9 percent of the time but if you have you know someone shooting with a 50 caliber machine gun into the water you're not going to want to come up you know you're going to want to stay down there if you have a mind to go down to the bridge or ship or something you have to likely in many cases go down below 50 feet and it puts you at the potential of having a seizure and a seizure underwater the seizure itself is not deadly per se but having a seizure underwater could be fatal to the

15:04mission and you know the warfighter so my research was really developing various technologies where we actually put things inside a microscope inside a hyperbaric chamber like an atomic force microscope or a laser scanning confocal or we can look at the mitochondria under pressures that simulate these operational conditions and and that was about ten years ago and out of that research evolved studying various and looking at the cells and even the mitochondria and observing that ketones essentially enhance brain energy production and resilience in extreme environments of high pressure and high oxygen and from those cellular studies I became more interested in what people do when drugs don't work for epilepsy and I looked up and found the ketogenic diet and this fits in perfect because my background was studying nutrition and I was studying pharmacology at the time

15:58but it allowed me to bring nutrition back into my research program and studying the ketogenic diet specifically and the the program officer at the time at the office of Navy research really liked the idea of the ketogenic diet in a drug so being able to consume something that can elevate these blood ketone levels which can cross the blood-brain barrier and make our brains kind of super brains under physiological extremes so that's what I really I put my efforts into studying the ketogenic diet and also into developing and testing a wide range of exogenous ketone products and which come which are on the spectrum of drug like - on the spectrum of kind of natural based things that can be combined together that put you in a state of therapeutic ketosis within like 30 minutes to 60 minutes so you can use it right before an operation right for mission or therapeutically so if you

16:56have a child for example that has status epilepticus which is continuous seizures that you can't stop instead of giving them an anti epilepsy drug that can have side effects and even developmental delays the ketogenic diet you know takes 24-48 maybe 72 hours to work but if you can tube feed them a ketone supplement and put them into therapeutic ketosis then you can mitigate these seizures which could have potential long-term effects so that that's this one example of a therapeutic application of exogenous ketones but so you're doing the research on this and you decided to start doing it yourself yeah I started doing it myself to get get a better understanding actually the there was a patient in in the UK his name is Mike dancer and if you just kind of google Mike dancer and epilepsy you'll come up on his story which is a really remarkable story because he tried

17:48a dozen a half-dozen maybe even a dozen different types of anti epileptic drugs and high doses things like keppra like things that are the standard of care and it didn't work for him he connected with me and I mentioned a couple supplements before I embarked on the ketogenic diet and long story short I gave him the information kind of here's the ketogenic diet here's a scientific rationale it looks like before you go and have brain surgery they were gonna remove part of this hippocampus oh I said you know just use this as it was maybe about two thousand eight or nine ish and long story short you know I didn't talk to him cuz I got really busy I transitioned into a tenure-track you know assistant professor position was working very long hours maybe four months or so went by and then when I contacted him he was like I have not had a seizure and this time and he was having multiple seizures

18:35some times per day and couldn't leave the house and it was almost like a proof of concept and it also caused pretty significant body composition changes in him and he was in the fitness industry and even did a bodybuilding show so he basically was it saved him has saved his life actually because he had what would I would call and what the doctors called terminal epilepsy there was no way to control seizures and when when the drugs failed the qje diet worked for him and that was almost like proof of concept I'm reading I thought the Q genetic diet was kind of like this fad diet I just knew about it in the fitness circles is something that I would actually typically avoid but when you read about the history of the diet in the 1920s early 1920s and how dr. Wilder kind of developed this therapy at Mayo Clinic there's like really legit peer-reviewed research behind it an

19:29enormous amount of research and I realized it was a grossly underutilized you know meant about what I would call metabolic based therapy for for seizures why would you typically avoid it because they're in our healthcare systems there's really not the infrastructure when a patient comes in and and they have uncontrollable seizures the the neurologists or epileptologists typically does not have the skill set in nutrition knowledge and nutrition to be able to guide a patient successfully into nutritional ketosis and to do that so they would have to refer them to registered dietitian which typically are not savvy and ketogenic diets but but now the Charly foundation is a foundation that worked closely with Johns Hopkins and I think there's about a hundred and fifty to two hundred clinics worldwide that are key to genic diet clinics that have you know registered dietitians that are working

20:21to assist patients so now you know the infrastructure is kind of there but doctors typically will prescribe a drug whenever they can and even when they know they may most of them are probably aware that you know it is the standard of care the cage a diet is a standard of care when when drugs fail and there's things like vagal nerve stimulation and other things but the ketogenic diet has been around so long it has an amazing track record there are some side effects associated with it mostly associated with a classical Kijang diet which was like 90 percent fat like eight percent protein but now Eric Kossoff at Johns Hopkins has done a lot of work on what I would call you know the modified ketogenic diet he calls it the modified Atkins diet which is more liberal and protein it's twenty to thirty percent protein and the balance being mostly fats from healthy sources and the

21:13carbohydrates are just you know completely non glycemic carbohydrates you get from salads or green vegetables and things like that what are those side effects so with the classical ketogenic diet they found that kids put on the diet it reduced igf-1 which if you're into longevity I think that might be a good thing right and it reduced their terminal height in some cases because of the protein restriction so restricting protein can for reasons we know in the longevity field you know reduce igf-1 signaling insulin igf-1 signaling and that was found to be the case in kids there's a suspected mechanism but when protein was kind of titrated back in that was not the case so there's also kidney stones can happen and there's a supplement potassium citrate that can help kind of offset the mild metabolic acidosis that occurs when you go in the ketogenic diet

22:07and just simply I mean you could do that nutritionally just by formulating Dyanne using more salt to balance out we using more minerals so actually the big issue was just the protein just yeah I think the protein and for kids that are growing and developing and and if you restrict protein and kids that you know have all these growth factors and everything that really kind of require and also if you go on the ketogenic diet it you may be inadvertently limiting total calories just because of the palatability of the especially the classical Kijang diet whereas the modified Atkins diet which was studied very rigorously at Johns Hopkins by Eric Asif has shown to have like ninety percent of the benefits of this draconian classic ketogenic diet and when possible you know it's better to put and that's what I follow I follow modified Atkins which is just higher in

23:01protein so let's it let's establish the protocol look so the the this classic ketogenic diet is 90% fats eight percent protein 2 percent carbs as though it is that's about the macronutrient ratios yeah and they call it clinically they call it the four to one or the three two one ketogenic diet and that's really confusing because that four to one is in grams right so it's it's actually like four parts fat to one part protein and carbohydrates carbohydrates being very very small part of that one that four to one ratio and a three to one ratio would be and that would be like 92% fat I mean it's really high and then the three-to-one ratio is like 88 percent fat or close to 85% fat so I like to do it it's it's it's it's better it's more it's more easy for me to consider in terms of percentage of calories and and about 75 percent calories from fat is pretty doable and pretty palatable so

24:02that's how you do it yeah 65 to 70 percent if and it's super important for people not only in a clinical realm but also people that are doing this you know for athletic reasons for you know losing body fat managing type 2 diabetes is probably the biggest the low-hanging fruit of all these applications and I could talk more about that the biggest thing to do is to count your Mac and test your ketones of course but people are horrible at counting how many calories they're getting in when you tell them to follow a diet so they really need a an app a software program an app and Avatar nutrition makes the kind of gold standard app for tracking your macros and I'm working with them hopefully to divisible it's called Avatar nutrition that's the actual app name that is the app name and that's it's a very highly innovative app that not only does it you know you put

25:01in your macros it's a macro calculator those that macro nutrient profile is in the system and you do body composition measurements a weekly and it calculates through what I would call an artificial intelligence system and then I system in the algorithm to to adjust your calories week by week based on the progress that you're making and and it's the only system that I know of its kind that's a like a macro tracking system that also gives you feedback on how to titrate your calories and your macros over time to hit specific body composition changes that you want to get and and this is the the system it's the ideal platform to incorporate the ketogenic diet into so it's going to take some work with you know the the guys that are writing software to design it but essentially you know you'll have available a ketogenic diet app that will be able to adjust to whatever output that you want

26:02whether it be managing seizures maybe a metabolic management of cancer or you know body composition changes or performance changes over time and that's all being written up now I've got a bunch of questions um first of all what do you what are your primary fats like when you when you tell someone that your diet is I'm gonna forget about the classic 90% fat but even at 75 percent fat people just go Jesus like where where's all that fat coming from like woody what do you use her fats and you vary it yeah my dad's pretty I get the same 12 to 15 foods probably pretty much every week my wife kind of eats outside of the range at the ketogenic diet so sometimes of dare she yeah how dare she I don't try to lost in front of you and mock you uh she does but I don't crave it so that's the thing I don't thinks it's really strange don't you Italian I am so that created a bit of a problem

26:58with my family like when I go home yeah oh yeah Mike carbohydrate tolerance is actually really good so if I go back to a higher carb diet you know I can't throw in 3 400 grams of carbs a day but I tolerate it very well so me going into ketogenic diet was a very strange thing for me to do that I had Reb Rob Wolf's book and knew about the Paleo diet and and even some some of the writings of Gary Taubes but I was a little hesitant or skeptical about about it and why were you skeptical well I'd really thought that you need carbs to grow in the gym and maintain your strength yeah and in performance and I just felt that the brain needed glucose for fuel and I didn't you know I was kind of unaware of the research that was done in Harvard in 1967 by George Cahill and I did get a chance to talk to him Rob Wolfe is you know Rob is really into jiu-jitsu right yeah yeah and he's

27:55having an issue with maintaining strict ketogenic diet I know he's going yeah with the classical ketogenic or the modified Atkins but he has a problem with like having the the carbohydrate restriction when he has really hard training days yeah I would too I've talked to rob a little bit the body is incredibly adaptable to switching fuel sources and adapting to that fuel source over time and some people may be a little less adaptable than other people but I think that if he was to give it I think you know knowing Rob he did give it a very legit shot he may benefit from adding some slow carbs in just prior to an intra workout you know during these yams or some lunch what do you consider a slow carb you know there are supplements out there but yeah if we're gonna talk about I would say yeah maybe some a little bit of sweet potato in you know prior to training or the day before or maybe a

28:48few hours before so it's some sort of a car with plenty of fiber something like yeah digest slowly yeah even a high molecular weight carbohydrates that are on the market now like one of those you know I don't use them anymore in a jiff Bullock has a product out you can I think you can starch is the name of it and it just you know it will slightly elevate your glucose and not trigger an insulin response so you won't go hypoglycemic after and it'll just you know essentially you know titrating carbohydrates and glucose into your system over a predetermined period you know so they know that your it'll kind of hit your system and sustain it for you know three or four hours which is ideal for people engaging and you know MMA or cycling during that during that timeframe but I think I mean if you're getting in a sufficient amount of calories and if you are using things

29:47like creatine monohydrate which knows or you work through the phosphagen system you are able to generate ATP for those short bursts of power that you need to manage your opponent and and sustain it so for a supplementation if you in the supplement creatine would you do that prior to the workout would like a lot I know a lot of people take creatine post-workout yeah I just you know if you're taking creatine yeah and you stopped taking creatine it's in your system for you know a couple days to a week or more so it's just you know on a daily basis doesn't matter necessarily when you take it is just that you take it on and probably at least three grams per day for a larger guy three to five grams per day is that some you take it's one of the few supplements that I take I only take maybe three or four supplement I used to take all these different supplements so I'm more of a food guy

30:38but maybe I take three or four supplements and I use some of the new food products that are coming out on the market now accusing food products and that allows me to maintain my catering diet when I'm traveling okay do you ever miss around beta alanine yeah it's something I used to increase carnosine levels right it's something that I used in the past I don't like the tingles that I get a lot of people like to take a listen type 2000 it's not that extreme it's like niacin but it's working right through a different receptor yeah the first time I took nice and I thought I was gonna die unpleasant it's not something that I know some people look forward to it and I don't those people are strange but it's not the big alanine is it makes me uncomfortable but I remember drinking it on the way to the gym it was it part of my pre-workout formula and it just made

31:29me itchy yeah I just didn't like it and you know that the data's not it's a little bit it's it's not I wouldn't it's not what I would call compelling but it looks like it may offer a benefit it was just recommended to me that's why I held it up so you creatine three grams per day and what do you weigh out to 15 something like that what do you weigh yeah on the mark yeah I lost some waiters yeah almost exactly I had a couple weeks ago I got down I did in a mission with NASA and I was underwater for a while and when it came back how long as a while I was under for ten days Jesus Christ that's more than a while makes me an Aquanaut yeah Wow that's crazy so and during that time during the training forage I was doing a lot of swimming which was I sink like a rock I'm kind of negatively buoyant it took a lot out of me and I tried to get into my file that I was then closer to 200 I

32:24think maybe you'd be more likely to be an astronaut candidate if you're like lower you know his weight in space is a big thing to me so I tried to get my body weight from 226 down to 207 and I did it took about three months and now I'm creeping slowly back up and down and what did you do that just high aerobic workout yeah I did intermittent fasting really just transitioned to a diet where I typically do a ketogenic breakfast that's kind of small and I would made that a little bit smaller and two or three days out of the week on average I would just kind of not eat until dinner and then I would eat a substantial dinner and then maybe do some activity after that and then kind of nibble at night time I mean an hour or two before bed and that was kind of my routine so almost like a warrior diet type deal pretty close to that yeah from what I know that that's pretty close to that

33:14and I did not in any way feel deprived of food and that's really you know people follow a low-carb diet or ketogenic diet they think you don't have to count macros which is like the biggest mistake they think you just go on this and you don't have to count calories but you really do I mean you could sit back you could sit down in front of the TV with like a bag of cashews and I can polish that off pretty quick and you could do a lot of damage like that's a lot of calories it depends on the kind of foods that you're eating two handfuls of almonds I think is like 500 calories or something yeah yeah that's like yeah so I talked to people who follow the kitchen diet and they're like the catering diet doesn't work for me I got on it and I gained like three pounds and I was like well what was your calories what was your macros oh I have no idea I don't I was told I don't have

33:59to count that yeah that's the most important thing so this is the function of the app I told you about avatar which is kind of a macro counting program right now you can set the adjustments to do low-carb but the once the the software is written up to for the keto option that will be a tremendous resource for people the average person that wants to do the congenic diet and hopefully we're going to craft it in a way to to help the clinical community - well that's one of the reasons why I wanted to have you on is because you're an actual scientist and this is there's so many misconceptions when it comes to ketogenic diet the benefits the problems associated with it and and there's a bunch of people that one of the things that I found really fascinating is recently because the ketogenic diets become so popular there's been these sort of sparsely educated meathead

34:53trainer type dudes that are pooh-poohing the ketogenic diet and whenever I see that happen I go oh here's a person whose ideas are threatened and you know like whenever someone says the ketogenic diet is not beneficial or it says this is it's not really worth it I'm like okay you're not saying anything like where's the science like point to something because there's a substantial amount of science it shows the benefit of the ketogenic diet but there's a lot of meatheads that are there have been critical of it and when I want to read that I'm like okay there's you're not saying anything like there's no substantial reason why you're critical of it this makes me think that you have been pushing a certain type of diet for a long time this comes along it shows contrary evidence and you're trying to diminish it in some sort of a way but without any actual science so what have

35:42been the criticisms of the ketogenic diet and how many of them are actually valid in terms of when what I'm talking about when I'm talking to people especially the I'm talking professional athletes I'm talking to athletes whose very health is it's very critical that they have energy right we're talking about fighters yeah so for them like to recommend a ketogenic diet to a fighter it's it's very tricky because you're talking about 1% 2% performance could be the difference between victory and defeat and maybe even being knocked out or submitted and being successful yeah so I think most important people need to appreciate that when you transition your body from burning carbohydrates and glucose and forcing it to rely primarily off fat and ketones for fuel or not it's not one or the other but you're shifting for the predominant fuel source to be fat ketones and that's not happen that's

36:36not something that happens like overnight and it doesn't even happen in two or three weeks so what I've seen an elite-level cyclist and and other types of sports is that it really takes a minimum of like three months I nearly six months and even after a year I think you're getting changes even at the epigenetic level we know that ketones function as a signaling molecule through histone deacetylase activity that it's actually turning on genes that's causing adaptations in our body and these these happen slowly over time the more you follow the huge egg diet the easier it gets because there's a learning curve to implementing it but the more you follow it the easier it gets and the more benefits you derive from it over time and those benefits really don't start to emerge the benefits that I'm thinking about after about two or three months and you're talking about benefits on a

37:29cellular level a lot of performance okay from performance level a minimum of two months like your performance will go down so you have to accept I mean this is something that fighters would have to do in the off season I was taught leads I was stunned at how much of impacted help me I mean I thought yeah I didn't thought how fast were they were the benefits well the benefits that the weight loss was pretty pretty significant pretty quickly I lost a few pounds like within the first week or two yeah whereas I'm pretty active and it's not you know I didn't change much other than that but what I was amazed at like the keto flu you know what people call the keto yeah dragging yeah yeah the first week or two like I was just trapped and I would do like a hard workout I was like oh my god I'm not hard keep doing this okay that's normal like like a big one was hitting the bag

38:20that's what I would really feel it because you know I do rounds or I'll set you know like a certain amount of rounds a certain amount of time and that's when I can really feel the difference from day to day and I was really struggling yeah and how long did it take you to adapt to that or did you adapt it felt like a month in it started to normalize okay I mean that would be consistent with the literature if you're looking at cyclists and if you're you know a number of different athletes it takes about six weeks I mean your performance will go down and then start to creep up back to baseline at around the six week mark and if you adhere to it strictly and really stick with your training you know in the the 12-week mark you could be breaking new PRS depending person awards yeah yeah yeah non personal records and that's primarily directed to I would say endurance athletes ultra marathon

39:17athletes two cyclists two runners - you know Ironman athletes and the thing that had merged out of all the emails that I get of people sending blood work and their performance measurements is that I used to think it was about you know a month or two it's more like three months to six months when they really start hitting their stride I think there's pretty profound changes when you when you alter the fuel that you're giving your body in such a profound way well one of the first things that I noticed the benefits one of the first benefits was cognitive I was like a clarity lack of fogginess towards the middle of the day the no desire to take a nap and no no drop like it you know I'd have the the big meal thing and then the drop the valley when you know your body's like digesting everything I know people I thought that was just how you lived I thought there was no getting around that

40:09that's life you eat then you get sleepy I just yeah I didn't think that there was any other options going on a ketogenic diet completely changed that and what I would tell people about I feel like nothing I'd be like I'm telling you there was no difference I mean I would eat a meal and go throughout my day and then it'd be like four o'clock in the afternoon I'm like where's this crash and the crash is supposed to be here like where's it coming no crash yeah same thing with me I mean looking back at in undergrad when I was like tasks loaded with a lot of classes and stuff I would make I was trying to you know bulk up at the time and I would I would put like steak or beef on a bagel so I would cut a bagel kind of in half and and then put like meat and stuff so I would be getting all the carbs from the bagel and I would just go get a big Starbucks coffee cuz

40:51then to to mitigate that crash right I would have and now so the ketogenic diet when you eat a meal it essentially if it does not abolish it significantly attenuates that insulin response that you get so if you you know wear something like a continuous blood glucose measurement like add ex-con or something and you look at that and you eat a standard American diet you see a big spike up and glucose typically and the postprandial dipping glucose that'll be hypoglycemic and when you do that not only does your mental and physical performance crash but you crave food so that will send you searching send you running to the refrigerator again you have to seek a reward to mitigate that that dysphoria I would say that you get from the hypoglycemia so when you on a ketogenic diet you essentially abolish that you don't have this spike in glucose which spikes insulin and your

41:43your energy levels are maintained and the big thing is cognitive so the cognitive resilience is a big thing so even if you're hypoglycemic you could like use something to lower your blood glucose like insulin and push it down to a level that would put someone into a coma and if they're ketones are elevated they are asymptomatic for hypoglycemia when this was a study actually going back to the work done by George Cahill our we fasted subjects for 40 days and he did a battery of you know cognitive tests and he measured blood going to the brain and blood coming away from the brain and he determined that about 70% of brain energy metabolism is derived from ketones when you're fasting and the same occurs with a ketogenic diet - so you are literally switching the fuel source that your brain is using but in an extension of the study he injected 20 I use of insulin and pushed glucose down

42:38to 1 millimolar which is universally fatal and everyone so you take a crowd of people who are eating a standard diet and push it down to that they'd all die so none of them died in the study I don't have no idea how they got it passed the IRB the ethics review in Harvard Medical School but they did what year was a 1967 and it was a study I became completely fascinated with because I couldn't believe that they did it because you can do it in animals nowadays you know the aya Cook Committee of the Animal Care and Use Committee would would you know put a stop to that very quick you know they would probably send the investigator you know out of the university if they even proposed to do some of the studies that were done but what they when they lowered blood glucose down to that level which would you know put someone into a coma the subjects were asymptomatic for

43:22hypoglycemia because they their brains were keto adapted they had essentially been over a week in a fasted state they were all kind of heavyset there were divinity students and a few I think we're Harvard medical students so they were tend to be overweight so there they were liberating a lot of fat from their adipose and making lots of ketones and they were in a state where their brain was tremendously resilient against hypoglycemia because their ketones were elevated and that has practical implications for so many different and I was reading this and couldn't believe what I was reading I called George Khao we talked about it I called all these old-time you know physiologist that were in the field just to pick their brain and they were like thrilled a young guy you know just entering a tenure-track position was going to like kind of make this his career moving back always but I

44:10saw all the implications not just for epilepsy but for things like Alzheimer's disease and traumatic brain injury and a whole host of neurological disorders like there's one in particular called glucose transporter type deficiency syndrome or gland deficiency and the kids that have this literally have a deficiency of the glucose transporter on the blood-brain barrier and their their blood glucose is normal normal levels but the the glucose in their cerebal spinal fluid is under two milli molar which is I mean their brains are essentially living in hypoglycemia so they're constantly having seizures they can't move a lot of them they're confined to a wheelchair you put them on a ketogenic diet many of them wake up they start walking around their motor function is is reversed so it the ketogenic diet restores bringing energy metabolism in these kids that can't you

45:03know use glucose as an energy source with this disorder it's called glucose transporter type 1 deficiency syndrome and another very interesting example of a disorder where there's a persistent molecular pathology where the symptoms can be largely silenced with the the application of a ketogenic diet that needs to be pretty strict and that's where ketone supplements come in so I was you know one it's it's difficult for some of these kids to follow occasion a diet so a ketone supplement can potentially circumvent the dietary restriction that's needed for ketogenic diet and make it easier for parents and kids to implement but I also think that a ketone supplement can just further elevate ketones if you're on a ketogenic diet and further augment the therapeutic efficacy of the ketogenic diet or performance enhancing efficacy so my main application is the warfighter and

45:56maybe astronauts too so we just think of it as a way to augment further augment a therapeutic effect or a safety effect when it comes to divers or performance effect when it comes to war fighters or divers now when you when you talk to people about mental performance have there been studies that have shown any variation between the same individuals on a ketogenic diet or carbohydrate glucose based diet in terms of mental function not good studies yeah not really good so what has been done I mean the the first study I would say purely ketogenic study that I'm aware of used something as simple as medium chain triglycerides and it was actually a substance that the the chemical name was AC 1202 and that substance it was in the patent lissa as a substance called AC 1202 for people unfamiliar that's just MCT oil coconut oil yeah so if you were to pull this patent interestingly my my

47:01colleague and Fred dr. Mary Newport did and wrote a book on Alzheimer's disease about the use of ketones for Alzheimer's she identified that the ingredients in this this supplement that helped to enhance cognitive function and people with mild cognitive impairment the the ingredient of this if you dig into the patent was caprylic triglyceride which is a medium chain triglyceride which MCT oil and they did a study it was a double-blind placebo-controlled study that showed that people who interestingly they were not a pony for positive that group did not respond but which is another kind of pathway we can go down but they their improvement and cognitive function correlated with their elevation and ketone levels with this supplement it was a fad that when you consume it independent of the amount of carbohydrate you consume it converts that fat into beta hydroxy butyrate

47:55which you can measure with a little blood meter and as that level creeped up and it didn't even have to creep up that high it was like point six that they were getting significant improvements in the mini Mental Status tests and other tests that are sort of like the standard tests for Alzheimer's disease and that really got me interested because I knew that levels could go up way higher than point zero six and they're showing that there's a correlation as ketone levels rise up that you have a proportional increase in cognitive function so I'm thinking with a ketone ester or other types of ketones you could elevate that to one two three and four millimolar and then get some really robust because that's sending a lot of energy to the brain so every millimolar of a beta hydroxy butyrate that's in your blood could it's been estimated that it gives you like your brain about

48:46a 10% boost in energy it can restore energy up to up to 10% if you look at if you do a an fdg-pet scan and an a ketone PET scan so you do a dual imaging for that dr. Steven Kunene in Canada has done some some work on that but that's insane that it was so like for college students or someone who's studying for an exam or someone who's about to do something very important yeah exogenous ketones should it be like standard right well yeah there's some pretty good evidence to show but it especially if you have a deficit right so and actually you know the application that I'm using it for is in an extreme environment when your brain is already at a deficit but we could say we're all a deficit right so tomorrow I'm jumping on a red-eye and I can't sleep on a plane at night land you know and go to my university where I have to teach for a couple hours and then drive a couple

49:43hours north and give another lecture at night and I'll be on zero sleep and I would not even attempt that if I was you know wasn't doing what I have been doing like I've kind of figured out protocols right can allow me to function even on extreme lack of sleep so well the you know motor through it I'm sorry to interrupt but so when you land so what will you immediately take some sort of an exogenous ketone some sort of what do you take what are you keep telling supplements right there's a wide variety of ketone supplements on the market so I'm kind of a food guy so I just use them almost kind of sparingly but I do tend to use them everyday the supplements that I have packed in my bag are the key genex supplement is one that I am been using and also the pruvit keto OS product that mixes beta hydroxy butyrate salt with MCT powder so there's a couple other forms of just beta

50:38hydroxy butyrate but our studies show that just consuming beta hydroxy butyrate does not give you at least in the the ketone salt formula does not give you a lot of the benefits that we see in some of the studies that were running and the beta hydroxy butyrate needs to be mixed with medium-chain triglyceride fat and that's pretty important and I think that that has a number of benefit the medium chain triglyceride delays gastric absorption so it also further boosts ketone levels higher than you could get with ketone salt alone so you get an elevation of ketone levels that's sustained for a longer and and that probably that sustainment is due to kind of delaying gastric absorption because the fat kind of delays the release of the ketones into the bloodstream and it also it's stimulating your own ketone production so you're taking a fat alright and that's what happens when you mobilize

51:27body fat you have a wide variety of enzymes that convert that fat in the ketones if you take ketogenic fat the same thing it's happening you're revving up that system in addition to the exhaustion ski tones so the the privat product keto OS key geniux and and there's a couple other companies emerging on the mark we have our own company ketone technologies and we are partnering with government agencies like Department of Defense Owen our NASA to do research to fund research with these Institute's to really nail down the optimal formula for anti-seizure effects the optimal formula for motor function affects the optimal formula even for strength and the one with strength will probably involve you know adding amino acids adding creatine monohydrate so these will be formulas that will be optimized so our company is working on that we don't have any products yet but if you sign up for the

52:20newsletter we we will update people in the newsletter and then when the products do come out and emerge you know will kind of let people know so on you when you say you're a food guy are there any foods that you can eat that will sardines yeah sardines yes I I travel with this trip it was canned chicken and sardines so there's a couple wild planet makes a good content Faris I kind of turned him on to it and it really exploded the company like kind of emailed me and thanked me you know they're really exploding so it's a small company they do glass while planet sardines and they're packed in olive oil and they're like might be depending on what you buy like a little bit of lemon they might have a slice of lemon or lately lately smoked or whatever but they are really really good and I mean I look forward to eating them for me I'm kind of weird like that is a treat for me and

53:18that's you know I've taken a lot of different things and experimented with a lot of the different things and simply just eating sardines like it's like the perfect food and eggs too are the perfect food you asked me like where I get my fat from I do get a lot from the olive oil that are packed in the Sardi and so I eat a lot of fatty fish lots of egg yolks I will make an egg yolk omelet and I'll give the like the whites to my dog for protein you know because they need a little bit more protein so I'll make an egg yolk omelet and I will cook it in butter and you know maybe make some asparagus on the side like cooked in butter so I get a lot of fat from macadamia nuts a few nuts sardines fatty fish a lot of salmon and a lot of egg yolks and fatty cuts of meat so we go to the butcher and particularly pick out fatty cuts of meat and olive oil coconut oil MCT oil are all things that we have

54:11used have you ever had issues with sardines and heavy metals no I think heavy metals are more of an issue with larger predatory fish like I mean I think swordfish would be kind of at the top of the chain there of course you know you're eaten like a mako shark or something like that you're gonna be ingesting and if you do that on a daily basis I wouldn't want out if you're a pregnant woman you know I would stay away from big predatory fish but one thing about sardines is that they can be farmed in a sustainable way and the the amount of heavy metals will be typically proportional to the size of the fish and whether its predatory the reason why I'm asking is I was eating sardines like two cans a day for a while and I got my blood work done and there was like a very trace amount of arsenic and my sister arsenic and the doctor said what are you eating and he was going over two different

55:06things I said I eat a lot of sardines do you know where it came from those out the sardines yeah no story I don't know yeah whatever was on the show I mean we travel all over we were in Borneo and Malaysia and Indonesia and all these places and you see some some votes coming in and those sardines are going to various plants so and even bigger companies you know will source out wherever wherever you know it's cheapest right so I like to be pretty particular about especially if I'm gonna eat something in such a high volume like where it's coming from to actually like visit the plant and where's coming and get some information to where it's coming from you know we I do use some of the meats from butcher box so butcher box offers a wide array of meats from grass-fed animals and and that's a lot of our meals at nighttime are from butcher box but that's interesting about

56:03the arsenic you know arsenic can get concentrated in the ground where plants are grown in so if if rice has grown in in China or whatever plant is grown in China and that that soil has arsenic in it I lived behind our house we had like a peach orchard and apple orchards are notorious for this for having high levels of arsenic just based on the chemicals you know that were used over time and so there's something to consider maybe it's something you're eating with the sardines or maybe it was the sardines itself depending what the sardines were eating yeah the nutritionist was pretty convinced it was sardines when I cut them out into one way yeah he was saying that it was probably just from pollution yeah it could be yeah I mean that's why it it's really important to pick out you know where your foods come so this company you recommend wild planet yeah in the farm in the sardines yeah they

56:59have there's different methods that you can use that would kind of put you in the category of sustainable farming for sardines so it's one of the few fishes that are really low on the spectrum of having heavy metals and things so if you're you know there's women I get this question a lot like you know a woman's becomes pregnant you know should they stop eating fish should they stop eating you know ahi tuna or swordfish and things I would say yeah definitely the big predatory fish you just probably probably want to cut back on I did take a couple courses in neuro toxicology where we went over like mercury poisoning and and every possible chemical and and just the take-home message was for the normal person probably not an issue you know unless you're consuming really high levels in in grad school I was eating these big cans like 12 I think there were 12 ounce

57:51cans of tuna fish and there was like five servings per can and I would eat like three cans a day like I would take that and add I was fat phobic at the time but it would be a chunk like tuna now to put balsamic vinegar on it and I would literally eat three of these twelve ants ounce cans a day and that would be fifteen servings of tuna per day and I did that day in and day out and no ill effects well I never got tested at the time so nowadays I tend to do a lot of blood work just to check different things but no overt signs of you know toxicity or anything maybe like a little someone one of the professors and I was doing something for she had or her friend had lost a lot of hair due to eating tuna that had high mercury and at the time like kind of had a lot of hair loss at the time it was also kind of a stressful period so maybe when I stopped eating I know it's like this is back in

58:40my mid-20s now I haven't had like significant amount of air loss since since uh and a couple people of you know and actually that's one of the symptoms to of mercury toxicity Wow we are tingling in feelings like kind of neurological effects so just something something to consider but getting tested is probably a good thing to do yeah I've heard that from people that just consume ridiculous amounts of sushi yeah but I would I would imagine like sushi you're dealing with smaller portions of the actual fish itself it might be if you do that day in and day out is probably good to get tested and sometimes you know may not show up in the blood in the serum you may have to look at the like the red blood cell because sometimes they you know some of these metals are more reflective of the levels on the only red blood cells or the hair too so there's different ways that you can you can

59:29measure it I read that you eat was a canned oysters as well yeah yep it's something I usually bring in I think I brought on this trip to like canned oysters King Oscar there's a few brain it's out there that I kind of vetted out things and oysters are really rich and a lot of micronutrients that you could get depleted in on the ketogenic diet so b12 is something I do supplement magnesium to get beat b12 decision from kids Jenna what would that come from well you know it could be due to sources of b12 that you're kind of eliminating through food choices on the occasion ik diet b12 was basically an animal-based yeah for pretty much yeah and I've I've never met her I think I did measure that once and it wasn't but people have reported to me that it was the thing that showed up on my bloodwork was lower I was on the low end of magnesium and I was getting cramps at

60:28the time and that's the only you asked about side effects so the only side effect that I experienced was cramps at nighttime always between 3:00 and 4:00 in the morning and it would start in my foot and then start to creep up to my cab and or if I did like legs or something sometimes my hamstrings and then when I the magnesium supplementation really prevented much of that have you used an isolation tank know one of the cool things about thanks is that you get magnesium to the water that's right and yeah because the waters filled with salt and no I think there's there's a pretty legit science behind that I was traveling in in Israel and I went to the Dead Sea and which is really high in magnesium and it has a calming effect which is reportedly due to the very high magnesium levels and other salts that are in there so the magnesium is relatively small molecular weight

61:25that anything with a molecular weight like under three four hundred I think can can get into your bloodstream yeah I mean I think that's why people like those Epsom salt baths I think that's yeah one of the things that relaxes people yep yeah and Epsom salt bath is you're talking about a very small amount of Mebane salt in comparison to a tank which has my tank is a thousand pounds of epsom salts in it and 11 inches of water so because you're so boring you do this daily hey no not daily but whenever I want you know because it's in my basement let's go down there and get into it but it's the relaxing effects is pretty profound that's intrat you know what it brings to mind most of the I've had at least a half-dozen emails about doing Epsom salt baths from ALS patients because ALS is associated with a chemical called glutamate which is excitatory amino acid

62:15transporter and high magnesium levels can kind of mitigate some of the excited toxic effects of high glutamate and they were there's fasciculations that they get and twitching muscle twitching that they get and they found that you know dosing magnesium or these Epsom salt baths you know higher in magnesium can calm them down and and also maybe mitigate some of the twitching that they had which is probably a reflection of glutamate induced neurotoxicity so the cells are dying they're releasing me so may be neuroprotective in that way and it definitely you know I know magnesium you can feel it like if you take a legit source of magnesium that's bioavailable like magnesium glycinate or or other forms of magnesium you can really feel kind of a calming effect then has yeah makes sense a lot of people like to take it before they go to bed yep yeah but the the tank is just when you get out of

63:10there your whole body's feels relaxed I mean I think part of is because the zero gravity effect of floating and you you're floating like you're it you're very buoyant yeah in this because the water is very heavier and like like the Dead Sea like only a maybe a third of your body is kind of floating in it right half your body essentially like your ears are underwater your face is above water it's amazing you got trying I'm a big proponent of it but the ALS is there a benefit in the ketogenic diet too for people with ALS yeah that's another application there's a guy dr. Paz and Eddie and I think he's at Mount Sinai in New York he's got a couple studies on this looking at caprylic triglyceride which is a medium chain fatty acid and he also prior to that's a clinical trial I think is ongoing now but prior to that he demonstrated in a mouse model of ALS which is the sod1 G 93 a mouse

64:09model and it has a gene defect that mimics the familial form of ALS which accounts for maybe about 10 at most 20% of ALS pathologies and he found that a ketogenic diet improved motor function and some neurological scores it did not improve overall survival though so we actually followed up on that study with a therapy that we call the Diana protocol therapy after Diana Ted own and her father dr. Vincent - don't observe that his daughter responded remarkably well to a few supplements which was arginine alpha ketoglutarate and gaba and coenzyme q10 and a few things that we actually put into a supplement and we reproduced the same study using this gold standard mouse model and we looked at motor function we looked neurological score and then we looked at total like long-term survival - and we found that using medium chain triglycerides which was a ketogenic fat with arginine alpha

65:14ketoglutarate which is something that's in pre-workout formulas it's a vasodilator from the arginine we used gaba was in that our Fenny beautif ventilated form of gamma that crosses the blood-brain barrier and and coenzyme q10 in the form of idebenone which is a little kind of like the drug like form of it I think it's still available you can get it online it might be kind of a drug or ubiquinol which is a powerful warm code so those supplements together I think offer our neuroprotective in a way and it had a therapeutic and what I would call performance enhancing effect on this ALS mouse model and those supplements had a therapeutic effect on the entity don't I mean there's other things in the what's called the Diana protocol people interested in this can go to winning the fight foundation it's a Tampa based ALS 501c3 foundation and you can sign up on the foundation and

66:11they give you the actual protocol and there's like more than a thousand patients you know registered on this that are benefiting from and there's several peer-reviewed studies on this ideally we'd like to get enough funding to do a human study but the mouse works pretty compelling and it just it's just it it's an extension of work that has already been done really and further supporting compelling support for this proof of concept for using a metabolic based approach like targeting energy metabolism preserving mitochondrial function so the cells work better now when you were talking about epileptic kids and supplementing their diet with ketone supplements you know because a lot of them have a hard time following ketogenic diet can you get the same benefits of a ketogenic diet by following a standard American diet and supplementing with exogenous ketones I

67:01doubt it at this time with the ones that are commercially available but I do think that with some of the ketone esters and development right now we've observed using a range of different animal models that the thing is that these things are not very palatable they're pricey to make but we're working with various companies and doing what's required for the FDA to be generally recognized as safe for some of these compounds I don't think they taste bad like I've heard people complain about like deke genex I didn't I think it was probably oh no key genex actually tastes pretty good yeah don't let it sit if you mix it up that's one problem with a ketogenic if you mix it up and let it sit then it's like tasted like battery acid for a while but so I mix it up and if you just keep it with some like ice cubes in it you keep it around for about a half hour but I generally try to drink

67:49it pretty quick but some of them some of them are nasty yeah well the ketone esters so these are things that if I give you right now you would gag you would not be able to drink it yes somebody sent me some where's that jazz we still have that laying around here that little thing at ketone esters and some dudes sent it was in like a sealed little foil sealed plastic thing I'd be curious I know all the all the people behind this it was here somewhere okay this place is a mess who knows um so like if someone had a big bowl of pasta and then they took something like Key genex would that knock you back in the state of ketosis yeah you could you could eat a bowl of pasta and then consume a key genex product and then test your test your blood ketones and it would look like you're on a strict eugenic diet a mild like what I would call modified Atkins diet whereas so the

68:49key to an ester you could boil pasta and then take a ketone ester and it would look like you fasted for 10 days so it puts you into starvation level ketosis so interestingly another application of ketones is that it lowers blood glucose and we don't know why we're studying that right now but and it may do it by your livers like the main regulator of what your glucose is so your liver has glycogen in it and it's constantly being broken down and kind of spilling glucose into it maybe affecting that process or it may be enhancing insulin sensitivity which means you take ketones and your cells use the glucose that there it becomes more readily available to the cells which greater uptake so we're looking into precisely why when you consume eggs are just ketones why glucose goes down we've replicated it many times with different forms of ketones so would that be a way for a

69:43person who maybe is just not so good at being disciplined their diet they just throw it in there like said I kinda wanted up some ice cream but I've been really good with my diet it I'll just have the ice cream we then have some key chanak's or something like that afterwards well I firmly believe there's no shortcuts like and I think of ketones and I tried I think I mentioned this on Tim Ferriss too and he put it in there that ketones are just another source of energy so if you have if you're eating 2,000 calories of food and then taking lots of ketone supplements you are eating a lot more than 2,000 calories food because as far as fat but it might as far as like gaining weight but the bar is like keeping your body into a state of ketosis yeah it actually does work absolutely and the benefits that would be maybe not weight loss but by elevating your blood ketone levels

70:31there's a lot of beneficial effects even from a signalling standpoint like completely independent of metabolism we know that it's a super fuel essentially for the brain that you can you know your brain cells can generate energy from from ketones in a more efficient manner than than glucose that's crazy that's really hard for people to believe because that's the one thing that people always would say you need glucose to fuel your brain under certain conditions so there are a few stipulations to that and I could get a little bit technical but for example I mean obviously if you have a lot one deficiency syndrome you know you are you're transporting it but there your brain has a number of things that can prevent it from using glucose effectively so in many cases ketones would be the preferred source of fuel for example there may be like with Alzheimer's disease or maybe even if you

71:23have traumatic brain injury there's an internalization of the glut 3 transporter so that you have cells right and glucose is trying to get in but the glut 3 transporter isn't on the membrane or you can have a dysregulation or an inhibition of pyruvate dehydrogenase complex pdh complex and that enzyme is really the gatekeeper it's almost like the it's the governor it's a throttle that lets the glucose into the cell to create the feed into what we call anaplerotic pathways to drive the TCA cycle the Krebs cycle and that makes reduced intermediates that drive the electron transport chain to make ATP so that it's like a gatekeeper and ketones completely bypass that process so if you have no glut 3 if you have you know impaired activity of this pdh complex which a lot of people who are you know carbohydrate components say well you're inhibiting the PTH complex so if you're

72:16on a cage a diet and I don't think there's evidence of that but the ketones essentially bypass those steps and can restore and preserve brain energy metabolism even if those things are just regulated or dysfunctional and a number of pathologies you know make them dysfunctional and this is a general state of aging it's thought that as we age we have a proportional decrease in in glucose energy metabolism the brain that's not the case with ketones so as we age the data that has been collected so far shows that we have essentially the same ketone energy metabolism as from young to adults Wow so that that's major implication you can graph it out and you know we've had speakers at our conference that did that and you can see kind of like a plateauing effect in a decrease in brain energy consumption from glucose whereas with a ketones it bypasses many of the

73:13rate limiting steps that are associated with impaired glucose metabolism in the brain it's almost hard to believe when you rattle off the laundry list of benefits of the ketogenic diet you know for a lot of people they're like well how is this it seems crazy I mean it seems like it well it seems like everyone should be on it and it seems crazy that so many benefits are attributable to this fat base fat burning diet there's a lot of them I don't you know like my wife does not G it's a relatively high carbohydrate diet that's because she enjoys it and that's because her carbohydrate tolerance is really remarkably high and some people do really well on high carbs and when you say you're testing her yeah like a wife tested her blood and her ketones too and she can get rapidly into a state of ketosis I mean we're testing some products now for ketone technologies for

74:05our company and various products and she can it's the first time I've actually seen her ketones levels up where mine are and sustain it over a period of time and she's like this is awesome no just from taking a product for taking himself yeah just a formulation of specific products yeah and so there are a lot of benefits but it's just I think of it as like one tool in a toolbox you know simple carbohydrate restriction like it doesn't have to be a ketogenic diet but simply restricting your carbohydrates is a powerful hammer for example for type 2 diabetes and Verta health is doing more for the medical management of type 2 diabetes than any other entity that I know of I mean I think their goal is in the next decade to reverse a hundred million cases of type 2 diabetes like our government spends way more it's like 200 billion dollars of funding for managing diabetes and you know

75:06NASA's budget is something like like 19 billion per year or something like that so it compared that and the you know we know that type-2 diabetes for example which is a main obesity the major problem for type 2 diabetes is carbohydrate intolerance so why would you why would a registered dietician administer a carbohydrate based diet to a type 2 diabetes person who has a problem with carbohydrate intolerance because and that's reflected in their elevated hemoglobin a1c or glucose levels or insulin levels so subvert is created a platform of people who using an app will allow you to to follow adhere to carbohydrate restriction and a ketogenic diet to essentially not just manage it but just like completely reverse it and I would I think the numbers are something like 89 almost 90% of people from the data they collected so far and published almost 90% of people might be 89 or 87 percent can

76:11either completely get off insulin or like reduce it down to very low levels just simply by using a carbohydrate restricted ketogenic diet and that has that's profound I mean imagine the number of people that can get off medication you know what that can do to the healthcare system the healthcare burden of you know paying all these dollars for drug management of type 2 diabetes which is going up to epidemic proportions so yeah so people are out there and they have type 2 diabetes just go to Verta health and you'll see an amazing array of clinicians basic scientists and registered dietitians that assist people for the medical management of type 2 diabetes it's just stunning then the list is always good like the low-hanging fruit is definitely type 2 diabetes so I'm glad to see the field go into that direction but for many many years many decades the only application when I get

77:09into this research the only the Asian with pediatric epilepsy and then two years after that it was like it works for adult epilepsy so it's taken so much time for the science to prove kind of what we already knew right that you know therapeutic ketosis was supplying ketones to the brain that's an alternative form of energy and obviously that has more implications and just helping your brain for epilepsy there's so many other applications you know when you're uncovering all this and when you're doing all this research you're studying it and you're finding all these benefits have you tried to figure out or contemplate like what is the cause like why is it so beneficial for your body to live off fats versus your body to live off glucose is this something that we evolved to live off fats is this like is it a better primary source is it something that our body can exist off of

78:01glucose but really we're designed to live off fats like what is the cause well it's multi I mean there's many answers to that question but I'll tell you kind of what I think that many people do really well on a carbohydrate base with no overt signs of you know pathology especially really active people yeah so I would in that class like I always kind of joke like the people that are most interested in the ketogenic diets or many of them are athletes that contact me but a lot of a lot of people have health problems too but but the athletes are typically not the ones who necessarily need it but they can benefit of it I mean a lot of you know if there's football players out there and people that are predisposed to concussion and brain injury I think it's really good to be on a ketogenic diet that's kind of like a whole nother area we can go into now for athletes when

78:50you're talking about people that like maybe they don't need it for weight loss or they don't need it for a lot of is it because the massive amount of calories calories that they're burning and their nutritional requirements almost mitigates the negative effect of having a glucose based diet yeah it really does come down to calorie control so if you have a surplus amount of calories coming in you know even with an athlete you're gonna start to get some over you know metabolic effects and and negative you know biomarkers showing up and if you do that chronically it'll ultimately lead to chronic inflammation maybe some you know brain fog and other things what I've observed is that you know I mean you're asking like why was your question like why aren't people not following this or what's not my question was like because you're studying this so deeply like have

79:42you ever contemplated like what is the root cause like why are we so good at burning fats why is it so beneficial there's so many health benefits and it seems like there's so many negative consequences of having a high carbohydrate diet especially for sedentary individuals yeah I think you really to put this in context you have to think the negative effects from high carbohydrate diet are due to a calorie surplus so I think in carbohydrate based diet could work fantastic for a lot of people who count their macros who manage their calories but people are horrible predictors or estimators of how many grams of carbohydrates you know they welcome to the kitchen they grab some grapes they grab a chocolate they don't so that's why it's really good if they want to get a handle on this to optimize their total health and performance and things to really have an app where they

80:36can calculate their macros in an easy you know to do format like you know avatar nutrition does so that's so I think when you are bola Singh glucose or bolus in carbohydrates a couple meals a day you have that scenario that I talked about you have a spike in glucose and a release of insulin and for many people which I had was this postprandial dip in blood glucose where you'd go hypoglycemic after 2 or 3 hours and that would have me searching for food again I would get irritable I would get sleepy my performance would drop when you go on doesn't you have to be like can you drink diet just low carb can completely in many cases if not abolish significantly attenuate that rising glucose and that release and insulin and you know with a carbohydrate based diet you can throw in more fat and fiber and buffer that too but a purely ketogenic diet is you know kind of a non glycemic

81:33like you don't have any rise in that and the practical effects of that is that it tends to allow the person to control their appetite and so they're athletic controlling them and appetite suppression and just kind of and that's how it's thought that the ketogenic diet works too is that you don't have these spikes and glucose and hormones and things like that that could set off a seizure is that the leading scientists in this field really believe that it helps put the brain into a state of homeostasis better and if there's less kind of energy spikes and less kind of noise in the system from a physiological standpoint that the brains the brains energy system and then the the neuropharmacology of the brain itself the neurotransmitters the balance of GABA to glutamate and and Nursery tone and other things will be balanced in a way that would make seizures much less

82:28likely to occur so and I think that's what it does from a from a feeding behavior from a neuro endocrine point of view is that it helps to when you have all these hormones and and metabolites you know going all over in the blood the ketogenic diet keeps it in to a range where there's a lot less noise in the system and you can see this by a patient a type one diabetes patient for example who goes from eating a high carbohydrate diet to a ketogenic diet where their Dex con continuous glucose measurement is all over the place if you look at you know several days of data and if they transition to a ketogenic diet I mean the high is there's way few highs and way few lows and it's within a tight range and there they stay within the range where they're optimized I would say so they're in a glucose range where they're optimized and that's what happens that's you know

83:18that happens obviously with a type 1 diabetic who's trying to chase the glucose with insulin but for the average person the same thing happens and that's why a lot of people feel better they have less cravings and they're more likely to adhere and stick to their diet and not kind of fall off the wagon and kind of overeat and you have surplus calories so so a high carbohydrate diet is completely manageable and people who know how to manage their calories but that's really hard for most people to do so I think the app-based programs that are coming out or really really in there I think they'll be kind of the wave of the future for people who want to optimize their their body composition and their performance and to have a Kido option of that too or you can tighten it titrate and optimize your keto diet and then there's an AI system that tells you how to improve those ratios over time to

84:07hit your goals I think that's really the future the cravings that that's a huge factor not just the energy crash but also the lack of hunger it's it's really weird like I always felt like if you didn't eat for a few hours you just started getting to eat you have this weird feeling but that weird feeling is entirely connected to glucose and when you're on a fat based fat burning diet the the even knowing that you're hungry is it different knowing it's like it's in the other room yeah it's not like it's like next to you sitting on your shoulder yelling in your ear come on man deep you know that there's a frantic feeling that a lot of people get why I've seen it yeah my wife I've seen it you know when she's hungry we got to stop we got a mover like she needs ice cream I mean it's it's I just you know give in and say okay we're gonna we're gonna pull over and I

84:59remember feeling that way too and I would kind of go off the wagon I need a half of a box of Tollhouse cookies but yesterday I three packets of something called keto cookies and I put some in your your little gift bag there yeah and these keto cookies I just I had never eaten three packets together so I was curious let me oh that's energy bits so energy bits is I think a fantastic Selena sospiri spirulina has an enormous amount of research behind it and it's one of the products I used on the NASA NEEMO mission because we didn't really have access to fresh vegetables or phytonutrients down there so snickerdoodle huh at the snickerdoodle bar and then there's a chocolate chip bar and a fudge fudge chip bar where could one jobs just go to kedo cookie comm and so they are that's like my keto comfort food so when I travel with that I might have another box out there for

85:57you so you have chocolate chip you have snickerdoodle yet fudge chip so you can eat that typically when if I eat like a Toll House chocolate-chip cookie I would have that crash that we were talking about and now would be ravenous you know after there you go so no sugar it's completely like low glycemic for me they're like non glycemic so I measured my my glucose after eating three packets of them because I went yeah there's the guys behind it so I actually just saw them at the low carb USA conference where a number of speakers there were on the show Gary Taubes was there Rob wolf was there I didn't get to speak to him because it was just so busy but keto cookie is you know one of those foods that's evolving out of this you know this kind of movement I would say that the ketogenic diet diet is becoming a lifestyle so not something that's used for pediatric epilepsy but something

86:54like the average person can follow to just feel better and for me I could eat a keto meal in the morning and I can hammer out twelve hours of work in the lab and not even get any cravings to eat at all and that for me that translated into you know more grants more publications more work done in the lab and I kind of attribute it in some way that you know my career has gotten a really big boost because I'm more cognitively aware and resilient even during periods of like sleep deprivation I can just work longer periods and I kind of utilize Kido to my advantage in that way that's really fascinating I really had no idea about exogenous ketones improving mental function like taking them to actually it would be a good idea to take them before anything taxing I'm gonna try taking them before podcast and taking them before comedy shows or UFC events and see if maybe my brain fires better

87:46because I mean that's just amazing yeah my my wife was actually she spearheaded a program looking at absence seizures so a lot of people have seizures don't have like tonic-clonic seizures but they'll just look and stare into space and then wake up out of it let's play all day I don't even know these cookies are good man but I feel like an illusion and you just got to try them try them Raj do you have a glucose ketone measure yeah you know what I did have that but I have a lot of calluses and I was like I had a really stabs out of my fingers yeah you do I thought I had calluses I got I got pretty bad calluses but I think yeah so I was I gonna say Oh anxiety do it other than glucose meter laughs the one that stabs you because it wasn't really working that well not really I mean they say go in the side of your hand I just take an actual syringe like needle and just plug it in I have

88:44yeah so I just I don't really feel it I've done it so many times but uh but yeah taking czaja does ketones can help we published a paper and frontiers it reduced anxiety behavior about 25 to 30 percent in our rats so they would go out into what's called an elevated plus maze into the open arm where they're like on a catwalk and they could fall off or be exposed an environment it typically produces a fear response or they could run back into the little cave and the beta-hydroxybutyrate salt plus the medium chain triglyceride combination actually reduce that fear behavior maybe it would be I mean I'm sure you're completely comfortable being out on front of the stage but for people that have anxiety problems which is a big part of people have stress it kind of exacerbates anxiety I mean I felt it early on in my career I know that being in a state of ketosis just makes me more

89:37mellow well you know one thing that would help me with is at bowhunt yeah and bowhunting is I used to bohon yeah really my brother uh he's a big boat owner he writes for Peterson Wow and I saw wait I saw yeah we had quite Pro Force extreme I think booze yeah I grew up in a boat I grew up in a hunting family Oh I quickly noticed some of the stuff out here so that's probably one of the most stressful things I do like people think that like doing stand-up is stressful or live podcasts or HD broadcast those are nothing compared to bow hunting when is roaring back on a live animal and your heart starts racing now you start yep and people have target panic where you can't remember what you're doing and you're going autopilot and there's all sorts of methods to mitigate that by forcing your brain into a closed-loop system instead of an open-loop system yet repeating

90:32mantras going over different facets of your shot process but maybe ketones and being in a ketogenic state especially exogenous ketones before you hunt would mitigate some of those issues definitely help I mean I think you've had him on the pocket wim HOF yeah different something I'm getting into I was talking with a quest CEO last night about boutique oh guy in Russia designed some some system that allows you it's a it's a program of breathing I have the app on my phone I haven't haven't used it yet but it allows you to increase your co2 threshold so the drive to breathe actually does not come from a lack of oxygen it through co2 chemoreceptors on the ventral surface of your medulla in your brainstem that sent co2 and when they send co2 that that's your urge to breathe that's your drive and then you have a backup sort of like a redundant mechanism the carotid bodies at the

91:30bifurcation the common carotid artery right here will sense oxygen it's kind of like more of a fail-safe that's I studied these things you know for my PhD and these neurons like how they sense how they sense things but so you can increase your co2 threshold over time using various breathing protocols and that can create an enormous effect on kind of reducing anxiety in these situations where a big buck comes up and you're drawing back on it or in general just the level of oxygenation that you have so retaining some co2 if you do it through training can actually enhance the vasodilation effect and can maybe reverse even in hyper oxygenating systems in your body so that's the theory and there's some there's quite a few studies behind it I really have to delve into the studies but the wim HOF method is one method I've been fascinated with him I really want to

92:24meet him actually I wonder issue I would love that I would I want to bring into the lab and actually do some research on him oh yeah okay connect you guys would be awesome yeah these cookies are like a mirage yeah it's like you hold them they have weight they look like a cookie you bite into them you're like this is gonna be like eating a cookie and then you're chewing it and it's almost like it vanishes like fairy dust in front of your eyes but it's good yeah don't get me wrong yeah I'm not saying it's a mirage like they're I'm saying like they're it's a very strange texture to them yes obviously there's no grain and there's something about eating and chewing them where your body goes hey would you lie to us yeah thank you bro I think it tastes good but there's something about chewing it and eating it it's like it vanished it's pretty substantial - there's a significant

93:14amount of fat in it so I was a little worried yeah I was a little skeptical when they came I was like okay cuz people send me so many products and I'll what actually impacts you know my blood glucose and ketone levels and then maybe about 10% of the products that people send me I really like like the energy bits here the that spirulina tablets I can take massive amounts and actually get what's a significant amount of protein and there's absolutely no glycemic effect and I'm getting huge amounts of phytonutrients in it so I brought that on just eat these are a snack I like thirty at a time since 33 servings of thousand tablets Jesus yeah so that would be like a month's supply and you know you can chew em they taste kind of grassy and there's a little kid bin there yeah or if you don't chew if you just swallow them you don't taste them they don't taste bad yeah and

94:09that's what I did tastes like um almost like sesame seeds yeah I like I like it yeah it actually sunflower seeds that sort of tastes like the Lady Katherine she was on a shark tank and actually they kind of slammed her because I think she evaluated the company high or they didn't like to taste that was the main reason that that they didn't like it so I mean guys like you and me and most guys would be totally fine with the taste and the amount of nutrition that's in that and the density of that makes it an awesome food for things like Special Ops guys or even even NASA I mean there's a lot of nutrition in that little bag right there so I stunning to me how much like mouths pleasure factors into people's lives absolute I don't like the taste well something could be fantastic for you like like I expect that out of my seven-year-old you know she's like it

94:59tastes gross I don't like it I'm like I get it you're seven well not out of a 37 year old Jesus Christ 90% of people really eat it's a pleasurable thing to them and they don't want to restrict that in any way shape or form well that's crazy to me because you don't have to restrict it just for the most part take in healthy nutrients and he's like this is not bad like Jesus Christ if this is the most suffering you get in a day talk about first world problems ya know these little energy bits there weren't the best thing I've ever had I don't know what I'm gonna do now it's not bad I mean I see from the general consumer point of view like I could see maybe but once they know the science behind it like the CEO sent me a stack of research papers and are all off of PubMed and I started looking through them and then double-checking on PubMed and realizing there's a lot of science

95:53behind this and actually NASA was interested in algae and making capsules because it's a super it's super high in protein has all these phytonutrients and you can you know grow it you could figure out a way to grow it in space and stuff so I think really that's the future like things like keto cookie will be a gateway for people to say okay maybe I can go on this diet and I can have these chocolate chip cookies here too but then eventually your palate changes over time and you don't crave those foods anymore like I never happened to me it's gotten close but man I smell some fresh bread or a bowl of pasta like linguini with clams I'm a man man but you can maybe control yourself a little bit better yeah you still crave it I don't actually crave that at all I'm allowing myself sweets and chocolate maybe sometimes or less cream not so much I was a big ice-cream guy not ice cream

96:44yeah they Bou oh yeah was eating some on his Instagram so the Institute that I'm associated with the Institute for human and machine cognition IHMC it's run by the directors ken Ford he was a former director in NASA executive in NASA and they have a James Beard award-winning chef that they hired into IHMC and he has a specific Kido ice cream recipe which is using this MCT and like a pinch of stevia and when you eat the ice cream I mean it just blows your mind that this is ice cream that you could eat every day a big bowl and stay on a ketogenic diet Wow these kinds of unity I saw I call it innovative like you're eating oh yeah yeah it's like really legit like my wife my wife she's really like the litmus test so when I get products I give the last product I got was the keto brownie so if you like google keto brownie it'll come up and you know I give it to my wife and she was like yeah

97:43that's pretty good but it had like a shell in it which kind of got caught on her teeth or whatever and she loved the taste but it was a little bit I think because she's so picky it was like I liked it but just had a shell in it or whatever but keto brownie is like another food and I see all these entrepreneurial guys kind of emerging on the scene and being very innovative in the way I mean it takes a long time to develop and test a product that you can eat that's low carb for one thing and then that you could allows you to adhere to a ketogenic diet have you had a cave shake you know what those are I've heard about it company got a bunch the fridge but yeah oh maybe I can try one oh yeah for sure okay I'll give you one right now if you want one but uh wait laughter show oh yeah I'm big on those yeah those are giant they're made with a lot of good stuff in there but I

98:34think a lot of is coconut coconut milk um yeah um this keto ice cream company what's it called again yeah actually there's not a company that I know of yet it's just I told them they need to create some IP around this this formula but uh it was that the the Institute for human and machine cognition that the shuttle there himself yeah he has a number of recipes because the CEO there Ken Ford I mean he's a huge fan of the ketogenic diet and how I got hooked up with him because he realizes that it enhances his cognition and performance and has actually been a big help in moving things you know into government agencies and helping them acknowledge this is a very viable form of a way to fuel the astronaut or fuel the special ops guy so he's been kind of instrumental in that regard and he is you know hired a chef that cooks ketogenic and in a gourmet fashion a James Beard

99:32award-winning Wow which I didn't even know what that was until I now looked it up and I was like well these are very high-level chefs that are specifically and his expertise at least at the Institute is to create these ketogenic recipes that are like ultra gourmet and amazing to eat what about pasta is there like an almond flour based pasta not that I've you know I've tried a lot of things but I would hesitate to recommend anything just because I have not been impressed enough to to really there's some protein pasta out there that's a little bit low carb but a lot of times they kind of fill you up with a lot of soluble fiber and you just become like a gas machine you know might be good for your gut microbiome in some ways but you're feeding all the bugs in there but for a large part like if you get you know every we have a certain threshold for soluble fiber which gets broken down

100:21into butyrate and other things in the gut and if you exceed that you just become you know a gas machine and so maybe it would be good in like a small side dish yeah yeah so that's your weakness N+ an ice cream - oh no I mean I can go without ice cream I'm fine sweets really don't get me that much I mean it's not that big of a deal so it's not something like massively crave but I am a big fan of spaghetti yeah it's a problem yeah you know um I think that it's just one of those things where I bet if I just stop taking it for a long time stop eating it for a long time but that's been my cheap food for a while yeah so if I just cut it out of my system completely for like six months or something like that I probably you know if you there's a book that has ice cream there's a recipe Jeff Bullock has a book it's called the art and science of low carbohydrate performance and this will

101:15appeal to your crowd because a lot of MMA guys I refer the book and they say this book was incredibly helpful to me so the art and science of low carbohydrate performance and there's arrest there may be a pasta rest I know there's an ice cream recipe in there that's not unlike the recipe I was just talking about so but the pasta thing yeah that would be weak if someone can nail that down that would be pretty good yes yeah we filled with some weird stuff that make you adjust in Italy yeah right I saw the pictures whereabouts and did you have pasta and pizza when I went off like a rocket I do that and when I was in Naples I gotta have pizza it was quite a while ago but you know it's moderation too well they also have different flour and I talked to yeah they do that's right Maynard Maynard Keenan from the band tool also has an Austria a restaurant and a vineyard that

102:13he runs in Arizona weird guy but he explained on the past on the podcast rather but I did with him recently the difference between the pasta that we have today in the bread we have today and original heirloom wheat which is less it's lower yield per acre and it has less complex glutens in it and he's like that is what when people are talking about like the difference between how your body tolerates like certain gluten whether it's gluten sensitivity or not he's like just it's just a different feel and I really noticed that when I was in Italy like when I would eat their pasta I mean it just it tastes different it feels different when it's going down and I actually ordered a bunch of it from from Italy and I even cooked it at home and I noticed the difference and did you get any you don't have any so if I go which I don't okay if I go to the movie sometimes I'll get popcorn and I'm

103:08completely okay like eating popcorn and you know a day or two later and back into ketosis really fast without even excited as ketones but if I do eat pizza or pasta which I did in the beginning when I would have like these cheat meals occasionally I would have some major GI issues because your body's you know digestion assimilation transport of these things you're typically eating on a day to day and then you go without eating them and it's like your body doesn't know what to do with it but when I did go to Italy and we travel around all over it's my wife you know loves to travel and we were in Naples and I ate maybe two or three pieces of the pizza I had absolutely no problems whereas that in the u.s. that would have bothered me and maybe it was just it may have been the flour I guarantee you the flour it's it's just a different kind of flour I think what they call it's called double

103:59O flour see if you can find that Jamie the flour that they use and they'll specify for imported wheat flour from Italy that it's a special type of flour and that that flour is essentially heirloom flour so the difference between like when you buy a tomato from the grocery store and it's pale and bulletproof and you can throw it down a flight of stairs and it doesn't even get bruised versus heirloom tomatoes which are almost like a fruit me really is essentially a fruit yeah and they're juicy and very delicate and very very fragile as well there it is is double O flour worth the price well that's the one that's I pulled up one that had their bride a mint somewhere got it yeah I don't know man I mean that's my that's my big problem but if I if someone does do that they say if they follow a ketogenic diet and they eat a bowl of pasta that I can't help it and

104:53then they take exogenous ketones and it knocks them back into ketosis is that will it stay that way even though they've bought the body digests that pasta and they'll be in ketosis again tomorrow a good question it won't it'll stay that way based upon you know the pharmacokinetic properties of the the supplement you're consuming so a ketone salt product you know the ones that are on the market if it's mixed with a fat like medium chain triglyceride the keto OS system and the ketogenic system are bhp and mcg you'll be sustained for longer but if you do choose to try to get the benefits of ketones and you're on a carbohydrate based diet you have to consume obviously more exogenous ketones to get the benefits of ketones and but you could do that though so someone could theoretically do that sandwiches and just take exhaust as ketones and maintain pretty much the exact benefits

105:46and yeah you can do that and a lot of people are kind of confused or like well what's the body going to do with the glucose or what's like the same thing you could say the same thing if you eat fat you know what's the body going to do with the glucose well well interestingly glucose goes down and we don't actually know why we think the liver kind of sends out less and these products are just not really like a huge amount of ketones right it's just enough to get you maybe into the 1 millimolar range and we know that's enough to give your brain like a boost and give its it 1 millimolar of ketones in your blood actually record represents a pretty significant source of energy that your brain can use and that your heart can use we know the heart runs more efficiently off ketones and probably more importantly is that the ketones function as signaling molecules that

106:33inhibit anti-inflammatory processes so deep dixit at Yale University did a study actually one of the theme is deep Dixit Jesus Christ I never thought about yeah now he's got a I never hold up I always look at his Indian name but he always tells me deep dicks hey he's a really good scientist and the leader in in studying the effects of calorie restriction and and ketones and he observed that ketones elevating ketones has a signaling like effect completely independent of the metabolic effect which everybody thinks of ketones are a source of energy they but they are also like a hormone they're like a drug so they hit specific pathways the pathway that he found at the study at Yale was the nlrp3 inflammasome you don't have to know that but when that flam is ohm is activated it releases a lot of inflammatory cytokines in the body which are and that inflammasome is linked to a lot of

107:41age-related chronic diseases too so as we age we have more systemic chronic inflammation so I always say the people that have that can benefit most from the ketogenic diet you tend to be get more insulin resistant and more trunk obesity you know as we age so they are people that will be more receptive to the benefits that the ketogenic diet as we age we become more carbohydrate intolerant as we age but anyway it's the beta hydroxy butyrate is functioning as an anti-inflammatory like independent of the energy pathways so he established that and it was actually a diet that helped you know him formulate with exogenous ketones and after that got published I got a number of emails from pharmaceutical companies because they wanted to sort of reverse engineer something that had the same effect as a ketone but to put it into a drug and that was their there's a pretty intense

108:36you know interest in the signaling properties of ketones and pharmaceutical companies especially histone deacetylase inhibitors so beta-hydroxybutyrate was the ketone you measure from your blood functions to as what we call this H tach inhibitor which affects the genes so you're actually turning on genes that are neuro protective that our cellular protective that are linked to longevity pathways so think about the rewards of developing a drug that did the same thing the financial you can't patent beta-hydroxybutyrate and well in different forms and shows you whenever it's something's good someone comes along and tries to with it yeah I mean you know you could say it's you know probably for the most part driven by greed but there's a legitimate impact on human health and sure evident that just be better suited for the diet absolutely I think it's awesome that our

109:31body makes this you know you know natural metabolite so the keto and salt products you buy on the market are the ketones are derived from natural sources so you are giving you know you are elevating a bioidentical form of a ketone that your body makes there's a little bit of the debate because there's the D form of beta hydroxy butyrate in the L form so we call that racemic if they're together they're racemic and the D form it's kind of what your body makes but it can also convert it to the L in certain tissues and it can get really complicated the important thing is that the salts that you consume that are commercially available the D form is more likely to be broken down and utilized as a source of energy whereas the L form probably sticks around more within the cell and we know the L form actually also functions in these signaling roles so the elf form has anti-inflammatory

110:23effects the elf form you know hits these signaling pathways so the racemic mixtures that are in the salts may have extra benefits over just a pure d form because the elf form can kind of hang around and stimulate all these pathways we know are beneficial before it's gets broken down into fuel so there might be some sort of a benefit for people even honest or ketogenic diet of taking sahjhan is key yes absolutely and I think you know we work really closely with the Charly foundation and I think the ketogenic diet should never be replaced with exotic ketones at this point because the science the research is not there yet to validate it but we want to go in that direction because there's some kids who really thought like they're fat intolerant they throw up when they like the ketogenic diet because it's too high in fat and a portion of the kids are like that most

111:13kids can follow it but uh but even for like childhood cancers and stuff we I met with the the max love project he was on jimmy kimmel max he was a brain tumor a child with a brain tumor that is his family is treating them with a ketogenic diet and they help many families around the area and they have a foundation just google max love project and and his family is helping max adhere to and stick to a ketogenic diet as an adjuvant to his standard of care so not a replacement the huge ank diet does work remarkably well for some people as maybe a standalone therapy for cancer and has anti-cancer effects but as an adjuvant to the standard of care it's remarkably effective and they're working with I think with Orange County yet so they have a lifestyle medicine program at Children's Hospital in Orange County where they're helping a wide variety of families who have kids with with cancer

112:14stick to and adhere to a ketogenic diet as part of a wellness program after they went through their cancer treatment because if you're a child and you get the standard chemotherapy you are kind of left in a situation where you're far more likely to have a lot of different health negative health consequences after that the chemotherapy wiped out your immune system and can create you know additional mutation so there's kind of like a fallout from the from the standard of care and being on a ketogenic diet can be cellular protect it can help you a neoadjuvant and and after you know before standard of care and even after standard care help you recover and get your body back into like a detoxified state if you want to use that term that's amazing now how many cancer research places are adopting this I mean it seems like that would be gigantic and this is a big shift over the standard

113:13care of just a fuse a few years ago right yeah so the idea is and we wrote a grant with the Moffitt Cancer Institute which is a T like a Tier one Cancer Research Center I mean they essentially reached out to us and say there's there's significant interest in this from the National Cancer Institute National NIH National Institutes of Health to use the ketogenic diet as an adjuvant at this point instead of replacing standard of care which only in situations where the standard of care is not effective should that be the case but as an adjuvant to further enhance the efficacy of the standard care so the ketogenic diet we know limits glucose availabe availability to the tumor which requires the glucose for growth and preparation it decreases insulin a dr. Bell and insulin signaling drives cancer growth and it also elevates ketones and ketones may have an anti-cancer effect

114:08and for the most part especially in very aggressive tumors that have dysregulated mitochondria they can't use the ketones for fuel nearly as well as they do like fuels like glucose and maybe even glutamine amino acid so it enhances the standard of care and helps them actually protects them from the healthy cells from the radiation damage from the standard it sensitizes the tumor to radiation and kills off more tumor and it protects your healthy cells so my colleague Adrian check at the Barrow Neurological Institute has done some remarkable work in animal models showing this and that has translated into a human study and actually garnered more interest in this area to use the ketogenic diet as an adjuvant I think in some cases where the standard of care has failed for glioblastoma or advanced metastatic cancer I think the the ketogenic diet can kind of be a base therapy for a more

115:06comprehensive metabolic based program and we wrote an article called depressed pulse where the ketogenic diet and maybe something like metformin and other drugs can can be used to weaken the cancer and limit its fuel source and then you can kind of come in with more maybe more aggressive ways like hyperbaric oxygen therapy which can reverse tumor hypoxia or various low dose chemo regimens so you weaken the cancer you know you put your body into a state of ketosis and then you come in and pulse at predetermined time points maybe every three weeks a therapy in a much lower dosing regimen to gradually knock down and reduce the tumor volume over time and you do it in a more gradual way instead of going in there you know with surgery radiation and chemo which is kind of like slash-and-burn and it leaves the patient the patient coming out of that therapy is much much weaker

116:01than when they came in so a therapy can be developed that when the patient comes in and they come out the other side they're actually in more robust health we know that they can you know we can do that that's incredible that's possible from a theoretical standpoint you know with various research being done in animal models and what we know about nutrition and physiology that can be done it's just going to take some time to do it it's just so interesting when you talk about the shift of information I mean when you were in college being fat phobic you know to now being like one of the premier guys it's out here preaching the benefits of the ketogenic Diane seeing you know this I mean up until really recently cancer research always depended upon these you know chemotherapy and radiation and all these different standards that everyone's been having success with but the idea that

116:48you could actually make a person healthier through the ketogenic diet hyperbaric chambers and things along those lines that's a it's amazing it's just an yeah hyperbaric oxygen therapy actually is FDA approved for or things like radiation necrosis like when you have radiation you know on a tumor you have a lot of necrotic tissue and patients would undergo hyperbaric oxygen for radiation necrosis and you know I would I would go to these various conferences over the years and talk to these physicians and these patients would make remarkable recoveries you know even after they have therapy and it seemed like something else was going kind of going on here and and if I go back early in my work I mentioned that we develop these technologies through our work with the Department of Defense and when the office of me where we we build a hyperbaric chamber and then we

117:39buy an off-the-shelf microscope and install it inside the chamber and then we close it up and then we pressurize it to simulate you know what a dive would be while we're looking at the mitochondria and even the cells and I did that with like Kelsey stem cells and neurons and we did it with a a glioblastoma cell line and we noticed that the cells were exploding with high levels of oxygen I didn't know what I was seeing at the time but I looked into it more and started contacting some of the leaders in the field and and they reported one of them was Thomas safer in Boston College and he was a neuro genetics professor at Yale University and then had moved to Boston to expand a ketogenic diet program for cancer and he told me you know what you're observing is damaged mitochondria from cancer cells which have damaged mitochondria and if you give them more oxygen it will

118:30produce proportionally more reactive oxygen species and that oxidative stress would essentially trigger necrosis and apoptosis in the cells so there'd be able to cell death at a level of oxygen that was relatively non-toxic to the healthy cells so and then we did some work with ketones and saw that ketones were stopping the growth of cancer too so we had this idea of using you know nutritional ketosis plus hyperbaric oxygen and studying that in a mouse model of cancer and and we've got some remarkable results that we published and this is you know patients are doing this kind of in an off-label way they're doing the Q genic diet but now we have if we go to clinical trials gov and you just look up ketogenic diet you see more than a dozen studies you know so when I got into this there was no studies so now there's been an interest and even maybe people like jumping on

119:24the bandwagon of you know if they have a particular drug well huge egg diet enhance it or let's see if it enhances the standard of care or let's see where standard of care failed if we can get these patients on this metabolic therapy and see if we can help them with quality of life it's so exciting I mean it's just really amazing exciting stuff it's so it's so interesting seeing something like this emerge it a relatively late yeah in terms of like medicine and science I mean 2017 we talked about something that's diet yep so just if you google like ketogenic diet in a Google search around 2012 it's down here and something happened around two thousand thirteen or fourteen or just skyrocketed what was that you know i have no idea i mean i was on Tim Ferriss and and other things but a lot of my colleagues do you want to throw probably dating back like to 2014 probably yeah I mean 20 that

120:18could be it but it's really Mike Ross I mean there's so many mumble well you know I'm sure you colleagues have a lot to do with it but as far as like the impact of the things are something a podcast the impact that a podcast has in terms of like the amount of people that are coming right Google something that's probably yeah many many magnitudes greater than anything anybody is doing and you know from professor or you know some I realize that now yeah so and I thank you for letting me have this platform but I I almost feel like those guys like the guy that got me into this was dr. John Rowe and he was that Barrow Neurological Institute he mentored my colleague Adrian check into looking at ketones for glioblastoma he's runs the pediatric Center in Calgary right now but dr. Eric Asaf from Johns Hopkins was a big help to me a number of people I feel like they should

121:11have this platform but you know they're so busy they don't do podcast but I realized early on it was really important to get the message out because it does no good you know if you're not hitting a big target and what I focused on was not just one application but I mean we do everything from wound healing to the genetic diseases to cancer to various seizure disorders so I realized this was a lot bigger than just pediatric epilepsy and it's a great it sounds like it's the only way you should eat it I mean I don't you know tell everybody they should be kidded Renick but I definitely feel that they should at least go into ketosis a couple times of year if not for just longevity effects for anti-inflammatory effects when when things pop up and we're under stress like I had an email yesterday a person had severe shingles or severe like outbreaks of even the like fever

122:06blisters or something like that or cold sores and if they just fast and do the ketogenic diet it suppresses that or when they since they've been on the ketogenic diet they had you know profound suppression of some viral disorders that when the virus when there's viral shedding and there's you know you're affected by the virus it causes profound in inflammation and neuro inflammation so it kind of starts with a headache and then it will kind of lead to the genus or whatever associated with shingles but they described it very elegant you know elegantly in an email and it was very clear you know before and after since they've been doing the Q genic diet had a profound effect even more so than the drugs and I've I wrote drugs that they're taking so even something like HIV which contributes to neuro inflammation and and even different types of cancers like Kaposi's sarcoma I

123:01think being being in a state of nutritional ketosis could probably offer a lot of benefits to HIV patients that really struggle you know with some symptoms that are associated with you know inflammation and and other things associated so this is another path we're going into so some of those researchers have reached out to us and say hey the NIH has a proposal for this let's write a grant together so I'm in the like it's been it's crazy because I only have such so much of a bandwidth but people from Ivy League institutions are reaching out to me and saying hey can you help us formulate a ketogenic diet or can we use your ketone supplement to do a study on things that I never you know nutritional ketosis would be applied to now what about wound healing you brought up wound healing yeah that's a big one one of my students dr. Shannon Kessel she actually works for the

123:52epigenetics foundation now helping the dogs at the Quito pet sanctuary she did her PhD on the effects of ketones on a wound healing model and the model that we use was essentially you know the back of a rat laters you know animal protection people but but in describing what we do we basically have a wound that's a pretty pretty nasty wound on the back of a rat where one side is ischemic it lacks significant blood flow and the other side is non ischemic and then which has normal blood flow and there's like a chunk of tissue kind of taken out and then we look to see how fast that wound closes up right over time and we do it in young animals and we do in aged animals and we take animals and then we feed them a standard rodent Chow which is high carbohydrate rodent chow and then we have a number of different groups where we give them various types of ketone supplements and

124:48we found that admitted that the ketone supplements enhance the wound healing not only in the aged which was pretty remarkable and ischemic but also in the young had a vent so it was like for the young healthy guy that has a cut or a wound on the battlefield or something like that it can help that wound heal up faster and it's doing it through a variety of mechanisms probably the wound itself is often the the wound tissue is deficient in ATP the energy source because the blood can't get to it right so the ketones can restore like ninety percent of it has 90% less ATP in some cases where was skimming wounds the ketones have the ability to like we think thin out the blood and be able to get to that wound tissue that's lacking oxygen and blood flow and not only does it restore the energy to the wound healing which can allow cells to replicate and and heal up the wound

125:45faster but I talked about the anti-inflammatory effects so persistent chronic inflammation can the wound from healing up and by suppressing some of the inflammatory pathways that can kind of open the gate on the activity of Eros growth factors and healing processes that can heal the wound up and it seems to be you know pretty profound in the age but also happens in the young now this is just taking exhaustion and not even entered Chow from rodents standard Chow so we didn't want to kind of you know messy up the the data in any way we actually should have done it well if we had the funding we could have done a ketogenic diet plus keno supplementation and you think that wasn't better yeah I definitely think it would because the ketogenic diet alone suppresses some of these inflammatory components that that is associated with impaired wound healing especially impaired wound healing in

126:37like a diabetic model so right so I talked about hyperbaric oxygen therapy the main application is that is for diabetic wounds that just don't heal up because the oxygen and glucose doesn't get to it so in the diabetic wound the problem is that it's really a blood flow problem and we did to answer that question that determine if it was blood flow we did a Doppler blood flow analysis of the blood flow into wound and showed that it was something like a 25 or 30 percent increase in blood flow to the wound when we induced acute ketosis so we gavage Din credible we you know we stimulate you know ketosis that would mimic ketogenic diet or fasting and then we do a Doppler blood flow analysis and we show a pretty remarkable increase and that's a huge increase yeah that's mean that seems like that would be the move for someone who's recovering from some sort of a surgery or something that

127:30hyperbaric chamber yeah combined with ketosis yeah PT genic supplements and for the VA my collaborator on this project dr. Lisa Gould at one time she was the she was the president of the wound healing society and I mean even she was like this is really remarkable I mean to have someone at her stature she's an MD PhD really comment that this is profound you know effect on wound healing really motivated us to follow up on this but we have not gotten funding after that so we really need to keep working because we need to follow up on this study and get this as a legitimate wounde a lot of people are trying to enhance the wound healing process by putting things on the wound you know but were wound healing is enhanced if you alter and optimize your metabolic physiology that promotes you know substrate and oxygenation to the wound you know and that's what ketones do I mean you have a

128:26vasodilation effect there's a big increase in adenosine adenosine is a pretty profound vasodilator so you have a vada dilation that's improving blood flow to the area where there's not only glucose in there but there's ketones and the ketones help restore the energy in that wound that is sufficiently depressed from lack of blood flow and it's promoting or reducing a lot of the inflammatory things that preventing it from healing in the first place so yeah I mean this was really like it was presented at the wound healing society and they were a lot of people were floored by it so it's Shannon has my student has went and moved on and doing postdoctoral you know work at another place but I really need to follow up on that we have a lot of projects you know we're trying to process in right now but yeah I need another student too because that may have been you know that and you know

129:17some of the motor function glucose lowering and anti-anxiety effects are all things that kind of jumped out of the data from us that I like never would have expected you know as I came in this to look at seizures now what was the hard data in terms of like what is the percentage of increase in healing across the board with the rats so if we look at time time for that wound to close and heal up it's about 20 20 to 25 percent that's significance that mirrors the amount of blood flow that you're talking about this increase in blood flow 20 does I don't know if you could draw a direct correlation to that but obviously if you have improved blood flow that's getting nutrition to the wound and we know that that blood has ketones in it which have anti-inflammatory effects and things like you know it stimulates the H doc H Chuck one and two which stimulates superoxide dismutase and other

130:11antioxidant enzymes which are often dysregulated you know at the wound site so it's doing a lot of not only just restoring oxygenation and blood flow but it's having like a drug like affects these metabolites are really like signaling my like you know if we're in a state of starvation ketosis the ketones would have you know be telling the brain to do certain things and altering different neuro pharmacological pathways that should be altering our you know behavior in ways you don't want to the person that is deprived of food and becomes tired from hypoglycemia and can't is the person that's going to die mmm so the people that survive in the absence of food availability were the ones that became more lucid and clear and we're able to go and forage or hunt down the animal and kill it and eat it so we are hardwired I mean answer your question I think while back you asked you know why

131:02why do we have ketones why I think it's an evolutionarily hardwired system that is yeah just built into our DNA and you know with the advent of carbohydrates and frequent feedings and you know deli on every corner here we've largely silenced that genetic program that becomes activated upon food deprivation that can stimulate a host and beneficial things from extension of longevity to auto fuji and no Rhonda Patrick you know I'm a big fan of her she's talked about this quite a lot she's awesome and yeah she's super awesome she actually visited the lab and we did it with her lab yeah yeah she scares the out of me every time I talk to her my basic alia monkey language is her he's like an encyclopedia of information and she always come prepared so I came prepared I was like yeah I should do it Rhonda does so I wrote down like some notes here I probably there's probably

131:58things I'll forget but but yeah so yeah it's it's a system that typically was activated in the normal person you know there were periods of millenia ago yeah and which actually enhanced your concentration absolutely that's one of the things to go back to the hunting thing my friend Remy Warren who's a pretty famous hunter and one of the things that he says and he's always said this that he likes to hunt hungry and one of the things he does he does these back punt backcountry hunting trips solo yeah and he purposely brings too little food yeah and one of the things that he's found over his many years is that when he is actually hungry it is more tuned in and he does a better job of understanding what's going on yeah yeah it's immediately the first time I actually started experimenting with fasting or even a calorie restricted diet I took a walk around my

132:56neighborhood at the time and it's like my whole nostrils opened up I could smell things I could hear things I was more lucid in ways I had not been before and even fasted for seven days and was able to you know give a lecture and train in the gym and lift weights that were not hardly much lower than what I typically do so I probably couldn't do you know it's just at seven-day point after no calories I was snorting no calories after seven days just waters water and some like a bouillon cube so some electrolytes like sodium potassium and lots of water and I allow myself about a third of the coffee that I would typically drink so I'd have a small cup of coffee in the morning and I got a ton of stuff done during that week like I had you know because I didn't have to to make my food I didn't have to clean up my food at naptime eating you know the food so I saved a lot of time I think I

133:52lost eight to nine pounds and then within a week or two it all came back again you know a lot of its you're holding glycogen and you lose my kitchen but in regards to you know at the time like my deadlift strength was maybe eight reps for eight or ten reps with like 565 and I was able to do ten easy reps with five plates on each side which is about 500 and you know typically going into this I was paranoid when I was you know I followed I listened to Dorian eats his podcast and I was a huge follower of during eights in 1994 and I was eating so I was eating for six meals a day which shakes in between and I remember even having like nightmares I would wake up in the nightmare like the nightmare would be I didn't have like food on me after two hours like I would have to eat like every day I was so obsessed with getting bigger and stronger and so for me to fast seven days and to be out of

134:50my comfort zone that was like a big step for me so I kind of just did it to mentally liberate myself from chronic overfeeding and things and because I was I had just read and studied George Cahill and the Harvard Medical School study where they fasted for forty days and looking at all the parameters on that and I was like it's not going to kill me it's probably gonna do me well and the more I did it the second and third day were kind of hard for me but after like the fifth day it became it was bizarre it became like really easy and I was just kind of like floating around like like my body had no inflammation I wasn't buzzing like with energy but I was very lucid and I didn't feel like I needed to be buzzed like I realized I'm so much better a lot of times I feel like I need to drink coffee to amp up to be my best but I was my best when my brain was really calm and I

135:44was able to put thoughts together and I wrote a whole lot of research proposals which later became funded you know and I got probably of the proposals I really worked on it probably got over a million dollars of funding during that time I really intensely worked on on various proposals because I just transitioned to like a tenure-track position so it allowed me to work on manuscripts and proposals and just put thoughts together that maybe I otherwise either wouldn't have the time to or the mental kind of resources to get into that that's the amount or intuitive that you have little resources with less calories it does I mean you know I was burning my body fat for fuel primarily probably lost a little bit of muscle but that fuel that fat was becoming ketones and that my brain had switched over I was doing low carb but not really full full keto at the time but it really it's like quieted

136:33my brain in a way that I was able to really maybe I have like mild you know ADHD because I'd like to do so many different things but it quieted my mind and I was able to wake up like every morning I was waking up a lot earlier than normal like four thirty five and it typically sleep till like 7:00 but I was able to like wake up and just focus and get a ton worked on the first three or four hours and then then I would go into work actually and just you know meet with my students or teach or do whatever had to do I just remember getting a ton of work done during that period I've never reproduced it I never went back and but I did a whole bunch of a blood work on me to give you know a little bit of insight as to what's going on during during the fasting stage and everything was really positive you know there was a big my insulin was really low at the time my glucose was really

137:23low I got down to like 25 at one point because I was experimenting with a couple different things and my ketones were really high my ketones were like double what my glucose was at a couple time points during that so it's an issue I would I would encourage people especially maybe people that are prone to cancer or people who have had cancer in the past and maybe had treated and are kind of in a state of remission if you go if you get your body into that what we call the metabolic zone where the level of ketones are higher than the level glucose that puts tremendous metabolic stress on cancer cells or precancerous cells that have a huge appetite for glucose so and that contribute can can initiate Auto Fujii so even people who do not have cancer been perhaps you know want to just make sure they're holding off of it as a preventative maintenance yep and I think

138:15it can stimulate almost purge your body of cancer cells that are weakened by in this fasted state and also precancerous cells that may be in the transition of Trent's you know D differentiating into this node cancer like cell it these cells are very energy demanding especially if they're replicating and if you deprive them of energy the quote-unquote energy crisis signal that these cells receive can can initiate program cell death we call apoptosis and Altaf adji and that's the benefit of this it's almost like housekeeping so think about it you know you accumulate a lot of you know dead cells that are kind of sluggish or mitochondria kind of sluggish and then you fast for a week and it's like reboot it's like setting it's like a reset button so did you I had I did a podcast with Rob wolf what he was talking about this one guy who went for a whole year yeah out eating

139:10did you piss in that case not not only did I pay attention to it I've presented at a number of different meetings and people people say but this is it's actually it's in oh man okay I may have had it I was going to actually show it at this at this meeting but I think I took the slide out I had it just died people what this guy did not eat law in 82 days not only did he lose a tremendous amount of weight he went from being morbidly obese to being like a normal sized person but here's the big one the skin shrink yeah yeah that's right they normally went to the most part yeah for the most part I mean significantly where most people have to when you're that big and you shrink down to a normal sized person they have to cut your skin or you just walk around like a flying squirrel yeah I mean you have like this crazy extra skin right yeah this guy somehow or another through

140:05this 380 plus days of fasting his body shrank accordingly yeah yeah that's right so he was about me 500 pounds actually Travis Kristofferson and I wrote a blog article and it was part 1 2 & 3 the history of the ketogenic diet part 1 2 & 3 and it's on Rob Wolf's website so if you just google the history of the ketogenic diet and land on Rob's website you'll have I think we talked about the story in there it's a remarkable story yeah the guy was like 500 pounds and he fasted for like 381 days or 82 days and he went down to 190 pounds and the remarkable thing is that he's sustained that over I mean he maybe went but went back up like five or six pounds but largely sustain that weight loss that's a grow over time so he was running completely off fat the fat that he had you know stored up and and he was studied pretty intensely and the thing that came out of the data was there was

141:06a pretty significant drop in magnesium so that I actually convinced me yeah I definitely should probably maybe supplement magnesium was fasting anything any vitamins or they did give him an electrolyte so it's in the medical records and ID into this as much as we could his glucose levels got down to like 20 or 25 a couple times and maintained it he was given potassium tablets to keep his heart healthy and multivitamins every day yep this done is it Rob's no another one yeah yeah I think I've seen this but yeah fast at 382 days incredible I lost two hundred seventy five point five pounds now who was calling on this well I did present it to like a mainstream you know clinicians even was coughing oh well I know it really felt like the first it might have been the American epilepsy society where they kind of marginalized the ketogenic diet or may have been another it may have

142:05been eligible lepsy Society at the time they're warming up to it just because the data they can't you know they can't turn their back on the data because data data so there's a massive amount of data emerging that this should this is grossly underutilized and should be really the standard of care even the front line therapy like we all kind of realized that but neurologists would have to have you know a sidekick registered dietitian or whatever but but so during the time one of my first presentations was to medical doctors you know that were in it for CME credits and things like that like just standard conventional and I talked about you know towards the end I was like well I followed the ketogenic diet myself and they're like they were like gasps they're like oh what's wrong with you it's like when I explained to them that I was normal in the question-answering

142:50after like well why do you do it what you miss are you okay this is going back like 2009 as recently yeah it was really bizarre to them that someone would actually follow the ketogenic diet and I was doing like the classical I was trying to do like that you know that ignited the Hopkins protocol was using Eric Kossoff spoke on that on the opposite of 98 and - I was I was about 80 I was a three to one so it was like 85 to 88 percent fat and I was sticking to it and yeah so people really just think it's really bizarre if you don't have a severe neurological problem to be at the time and now that's just evidence of how mainstream because you you know you see it in mass media you know athletes going on quote-unquote the ketogenic diet I'd question whether they're actually ketogenic they need to another measure their ketones to really so the ketogenic diet you're in ketosis

143:47by virtue by the definition that your blood ketones are elevated above 0.5 million molar and typically most people that's pretty hard to achieve if you're up to 1 millimolar which is like mild ketosis you take a hundred people out of the population that eat the standard american diet maybe one maybe two people will achieve that if they like go all day without eating or something like it really takes a while to achieve it so you have to be doing something pretty radical to achieve that blood measurement of state of ketosis and know are you seeing that in pro athletes a lot I know there's a few fighters me should take before she retired she went ketogenic her boyfriend Bryan caraway I know he was ketogenic for a while yeah that's just my experience with athletes but I know that there's a lot of people that are looking at it yeah I would you know kind of question whether they're

144:35like ketogenic I'm sure they did low-carb but if you eat too much protein that converts to glucose it can kick you out but then again I mean I some some athletes that contact me their output is really high so they're actually giving like five or six hours of output a day and they're eating like two or three chocolate bar and they're getting like 250 grams of carbs a day some of them and there's maintaining a mild state of ketosis especially post exercise ketosis even with drinking some something like that you can starch like a slow-burning like a super like a slow carb like Tim Ferriss advocates and they thank you ptosis and if they back off more if they back their carbohydrates down to like 50 grams a day they start to lose performance on that I mean these are people with a very high output though ridiculous helpful yeah and they went from a thousand grams of carbs a day to

145:29to 250 when you're performing better fifty grams of carbs for the standard average person this is not applicable for an MMA fighters to in three days yeah I think you I think you could especially the older guys and like older guys I think you could readily adapt them like I said though I think that adaptation should probably occur during training in the offseason and give themselves a buffer zone of three months and actually work with a coach or work with an app like Avatar nutrition or something where they calculate the macros and they actually know they're hitting the macros and the body is amazing if you actually hit the macros that are calculated your body will go into ketosis I've never seen there's very few people that you can't get in the keto especially if you use things like you know MCT and really adjust the macros and you could also do keto

146:19ketogenic intermittent fasting where you kind of don't eat throughout the day but then eat through a window or time restricted eating as Rhonda Patrick calls it where you basically you just eat within you know a six-hour window I like to do that I'll eat from you know 5:00 p.m. to 11 p.m. and just kind of eat a big meal and just kind of graze a little bit throughout and then I get you know a pretty good chunk of the time fasting and then after I'm done with work you know I'm not frantically running around trying to get stuff done so I can relax you know with my wife and just kind of kick back and eat and just you know and that's kind of what I want to eat anyway so you feel like this is more of a better I'm doing a 14-hour thing you think is even more benefit doing an 18 I do I think you and you know I don't I do I effort for me I definitely think I do because there's

147:11something about like a couple hours extra where like if I fast for 14 hours but then go like my ketones really start to go out from 14 to 18 hours and then and then I could actually stand ketosis if I eat ketogenic during that six hours of eating in my kind of pay attention to you know eating really low carb like I can eat and before I go to bed test my ketones and bam I'm hitting like 2.2 or something so I continue to get the benefits of having ketones but when it comes to like things like Ronda talks about like Auto Fuji I think you can even get more benefits within 18 hour fast and you do that and you'll have to do it every day I think you could just do it like you could actually do it just like once maybe twice a week and get a lot of benefits from that like if you do that over the core of the year and that's not hard to do mm-hmm right if you could just convince

148:03people hey take the breads and pastas out and just put in more vegetables and just do intermittent fasting you know every every Tuesday and Thursday and if they do bloodwork after like three months they're gonna see a profound effect probably not even changing the diet there they're gonna see a profound effect now is the someone told me that there is an effective way to measure ketones through breathing there's some sort of a breath monitor yeah is that riolearn yeah there's a couple out some of them were being showcased at the conference out with that the low carb USA the one that I have the most experience with is a product called ketone --ax and now they have a Bluetooth device out where you can blow into it and it reports to your phone and it show you shows you the parts-per-million of acetone in there and acetone so you make beta hydroxy butyrate and acetoacetate as the two

148:56primary ketone bodies that are used for fuel and also they have signaling properties and acetoacetate can break down spontaneously decarboxylate to something called acetone which who knows nail polish remover right so acetone actually has some really interesting brain effects that comps the brain down a sub narcotic levels of acetone open potassium channels that when potassium channels are opened that hyperpolarizes the membrane potentials of neurons and makes them kind of more like charged batteries and it also kind of calms your your brain down so it's not firing action potentials as much and that's a good thing so instead of all this kind of fluttering of activity it helps to kind of synchronize your brain in a way by elevating and this goes back to homeostasis right so that acetone has can correlate with seizure control so parents who have kids who do not like to

149:55get their fingers pricked have used the breath acetone you blow into it you get a pretty color you know the kids like it and everything it is kind of hard to like set it up you got to calibrate it and so it's a little bit clunky to work with but it's a pretty good indicator if you're registering like orange or red on you are definitely in a state of ketosis so but I call it only semi-quantitative so they need to work out some of the bugs and if you just look up breath acetone meters there's probably about five on the market now and the one that I have experience with is called key tonics and if your acetone is high and you're not taking ketone supplements you are burnt you are cranking your fat metabolism so you are really you know mobilizing fat and burning fat for energy so it's a pretty valid indicator so it's pretty good that but in your blood is the best but the gold standard

150:46probably will always be there's a technologies emerging out now at least you know small companies that are essentially a you put a like a band-aid like thing on your skin and it's measuring glucose it's measuring you know potentially beta-hydroxybutyrate acetoacetate and things like lactate and then it'll go to your smartphone so you can leave your smartphone and see your glucose levels your your ketones your lactate and maybe some potentially other things you could adjust your diet or drink a supplement to optimize you in to a range you know maximizes your strength maximizes your performance or maximizes your brain protection in the extreme environment like high pressure oxygen or a navy seal or something like that that technology is in development now and will probably surface sometime in the next year or two and I think it'll be pretty cool so think of it Dexcom but

151:40instead of just glucose it'll give you like a metabolomic profile of your blood and then there'll be you know you can augment it and with with your diet or with various supplements now I got two other important questions one physical performance have there been Studies on reaction time on all sorts of different variables that I think I mean if you're looking at all this increase in blood flow this decrease in inflammation all those things are what you would want out of a body that you want to perform better it seems like things would fire better as well yeah lack of a better word well they've been Studies on putting athletes through variety stress tests reaction times things on those lines those studies need to be done yeah I think some of the marketers out there that are promoting ketone supplements are based on some animal data and I think they're extrapolating some of the

152:36effects well ketones offer a metabolic advantage you know they can you can generate more ATP you can it gives your brain resilience under you know inflammation or hyperglycemia but the the bottom line is that these studies need to be done and they need to be funded some of them are going on right now and some of them are kind of involved in and probably most important is you know what are they actually studying like what what ketogenic diet are they actually studying like what are the macronutrient ratios not only the ratios but what types of fats are they using you know what type what's their protein source right know and that's really important and when it comes to ketone supplements like that's a whole other box of worms I mean are they using you know just pure sodium beta-hydroxybutyrate using like sodium potassium magnesium combination which would offer more benefits are they using

153:30racemic versus the DNA and Amir are they using a ketone Esther so there's like lots of these considerations there's lots of nuances you know in the way these things are formulated in the way they're dosed and in what type of application whether it's a pure strength application or what I call strength performance like push-ups and chin-ups and things like that like or you know endurance or ultra endurance or things like that so do a lot of research needs to be done so I didn't really give you an answer but I think the guy who's done the most research on this clearly at least with the ketogenic diet is Jeff bollock from Ohio State University his faster study clearly showed that athletes in a state of nutritional ketosis burn like you know almost twice the amount of fat you know and they maintain that which is remarkable I mean does some elegant studies to show fat

154:21oxidation fat oxidation rates are like double of what we even thought were achievable when guys follow a well formulated ketogenic diet and he recently did a study using a ketone salt product showing that there was enhancement of 8% performance in work output with a cyclist so he's big number aprons pretty big for cyclists yeah yeah it might have been time to exhaustion he just presented it I didn't even know he had the data actually but I mean Jeff Bullock is the leading researcher on and he wrote the book the art and science of low carbohydrate performance which a lot of MMA guys have benefited from because they email me but these these are studies that I'm really interested I mean we've done a lot of work in animal models and now we're transitioning to human studies we have a study at Duke University so I mentioned oxygen toxicity to study this you know in humans in these big

155:20environmental chambers at Duke and then you know we do some stuff with NASA on the NASA Nemo mission I was on but we're really interested in moving a lot of these animal studies which we've done now we're ready to move it into humans but we still don't know what the optimal supplement is and that's why ketone technologies a company we developed is really focused on identifying not the supplement that gives us the best margins for sales but the supplement that's super optimized for particular applications now another question I wanted to ask you was about migraines you know I would assume that people with headaches headaches mutation on stored away entire inflammatories yeah someone with migraines I mean it would it would seem to me that that would be something they might be able to help mitigate yeah yeah there was a student I'm on her dissertation committee Alaina gross and

156:12she was a student graduated from Oxford University and is now doing a clinical trial on a ketone salts for migraines so what motivated her to even pursue this as a PhD project is that she had crippling cluster migraine headaches and she reached out to me and she actually presented at our metabolic therapeutics conference and that's her area of expertise like when it's happening to you personally it motivates you in a way that you just immerse yourself in the research and you become like a leading expert and I think at the at the very young age that Elena is and she's got a great you know background of education behind her she's kind of the leading authority on nutritional ketosis for for migraines which is a growing field because a lot of people who had migraines that have contacted me and tried either the queue jenk diet or ketone supplementation have benefited

157:07from it when nothing else worked for them it doesn't work for everybody but in some people that have these crippling headaches it works better than anything that they've tried so far and migraines some of the data coming out there's two sets of data that I've seen showing that migraines are linked to neuro inflammation for example if it's caused by a viral etiology there's kind of swelling of the brain that leads to this kind of low systemic neuro inflammation and maybe the ketones are working through an anti and anti-inflammatory effects sometimes like I said before people get shingles or like a cold blister they'll get like a headache throughout the day and and that's probably neuro inflammation and then there's other data to show that these migraines actually may be like a mini seizure like your brain is actually having a mini seizure that's not manifesting as a grand mal or

158:05tonic-clonic seizure or even an absence seizure but it's but it's presenting as a migraine and it's seizure like I would say so some of the data is indicating that and ketones seem to be a viable strategy for you know for migraines from what I've seen that's why it's being studied right now the other question is what about someone who's on a vegan diet yeah I get this a lot I have a really close friend she's vegetarian doctor dong Carnegie gasps hm see we've talked about this a lot for a vegetarian it's relatively easy right because you had a dairy and you have eggs and eggs are a huge staple i buy the happe eggs which actually tastes a lot better they're like the free-range eggs but a vegan diets a little more challenging the Charlie foundation's dietician Beth zoo Pat Kenya is her name if you go to the Charlie foundation website I think you may be able to find some information or

159:01a pamphlet that describes how to put together a vegan ketogenic diet so there's no way that you can hit the macronutrient ratios of a ketogenic diet that's vegan unless it's in a shake form so in this case you know formulating a product that's more in a liquid form that you can drink is probably the way to go if you do do a vegan ketogenic diet whole food the best that you could do is really about maybe 60% fat maybe 70% fat and if you formulate the diet with coconut oil and MCT that'll get your ketones up and then if you consume you know one of these various products on the market that are essentially medical foods or drinks that you can drink you know you can stay in nutritional ketosis so it's a it's a struggle it's but it's possible but it's way much much harder people do do it though and they follow vegan for ethical reasons or for cultural reasons and they've been able to do it but

160:03vegetarian is doable a vegetarian is very doable with eggs if you can use eggs and dairy I tend to minimize dairy in my diet but yeah so eggs are huge so you minimize dairy because the effect it has on you or like a lot of dairy protein like whey it kind of started with whey protein and I drank her for years and maybe I just built up an allergy to it but if I was a drink like a full shake of whey protein right now it would like it wouldn't agree with me good although I can I can eat butter and I'm getting a sour cream find no problem and a lot of dairy protein especially casein if I eat sour cream cheese cottage cheese yeah so something about that can start to irritate my gut a little bit so I generally just minimize it I do like cheese is kind of a weakness for me so I might get a little bit of cheese here and there like you know almost every day even when I'm home but but I know dairy

161:00really was the the cornerstone of the ketogenic diet with the original ketogenic diet with the like what Johns Hopkins was formulating because it is so easy and it tastes good right right but I do find that when people are following the ketogenic diet for weight loss and they pull out the dairy their fat loss increases so I've observed that kind of anecdotally I'm not sure people have studied it but if they just for example pull out the heavy cream and put in a concentrated coconut milk which I use for my heavy cream which almost has same cream like consistency mm-hmm and they take out the butter maybe use more coconut oil and just kind of switch out dairy for other things their fat loss and something about dairy and some people not everybody may be closed in to retain water might be like a mild allergen so for me I'm okay with it as long as I kind of minimize it but I've

161:55just heard so many stories one there's a case report now of a mother who had an autistic child and put them on a ketogenic diet and did remarkably well and then made it dairy-free and it was really the dairy that was contributing to some of the symptoms so I think in this went this is in the medical literature it's like on PubMed she used a dairy-free ketogenic diet and had quote-unquote remission in an autistic child I first saw it presented an abstract at a meeting and I was like wow I was really blown away and then about a year later it came out and it was in a pretty good pretty good journal as a peer-reviewed publication and a pretty well documented case report that's of putting an autistic child into remission with the ketogenic diet so we talked about emerging applications I know my colleagues a dr. John Rowe and dr. Susan masse you know are studying and I

162:48mentioned this because they get so many emails about it the ketogenic diet for autism could be the next frontier information yeah yeah yeah it could be if diet you know reduces inflammation and if diet without dairy reduces inflammation further yeah I know a lot of people are having some great effects with CBD oils which again reduce inflammation something very interested and yet information it's just such a giant factor in in negative health consequences yeah ketogenic diet plus CB d plus hyperbaric oxygen therapy and plus ketone supplementation is something that I wanted to study in a brain too model I've just gotten too many emails from parents that have kids with epilepsy and also people have cancer who use CBD oil and they felt it was remarkably you know effective for them so I've talked with the the CEO of a Charlotte's Web and another see I've never actually tried is that the

163:50Charlotte brand yeah so is this standardized for a certain level of THC it's below a certain level yeah standardized it doesn't get you high yeah okay so that was sort of the problem I tried to do this work with our University and then I need a DEA number and it was like all the students had to have a dia and that keeps red tape but I'm going to revisit this project I'm sure okay because they're actually a sponsor of the podcast well and yeah they sent me a bunch of it and I tried it out for awhile before I took him on as a sponsor like this stuff's legit yeah read up about it you know they use the whole plant as well yes all the other cannabinoids yeah which i think is important you know there's companies that have patented specific cannabidiol on there and and that's kind of I was going to use that and there's a lot of you know DEA regulation even one that I

164:47think but yeah I'm gonna revisit that project because I really think some of the things that we do with the Q genic diet and supplementation will synergize either be additive or synergistic with CBD and I mean I love this idea of developing very powerful therapies that make the patient come out more healthy or does not their immune system or their general health when they come out the other side especially with cancer yes absolutely incredible that you could have a more robust person yeah therapy absolutely I think it's possible yeah so with cancer it is tricky like every person is different but if you get a robust like healthy person to begin with and you can develop a therapy that manages their tumor and I seen very healthy people come out severely crippled after a round of chemo I've seen people killed with chemo I I know quite a few people actually sadly

165:43that have been killed literally by the standard of care and this you should really have my colleague on here he's a very dynamic speaker a little bit controversial in some ways but doctor professor Thomas hayford from Boston College he wrote the book cancer as a metabolic disease and it's a fantastic book that you know elegantly documents the the theory of cancer as a metabolic disease with a lot of hard data and Travis Kristofferson I wrote a book called tripping over the truth and I wrote the forward to the book which discusses why we view cancer as a genetic disease and kind of lays out the data and you know all the evidence to support cancer as a metabolic disease and what we should most importantly like what we can do about that in regards and that has major implications for not only how we treat cancer but how we prevent cancer I talked about you know fasting to purge

166:43your body of precancerous cells it would fall in line with that but there's really good hard data behind you know this idea that cancer is not maybe not necessarily all cancers are you know metabolic and origin but a large majority of them appear to be and and I think the National Cancer Institute and other organizations are aware of this and now they're funding more grants that actually target cancer metabolism and even developing metabolic therapy clinics for you know targeting tumor metabolism so this was never this never happened you know 78 years ago when I got into this it was kind of unheard of but there's a lot of interest now in pharmaceutical companies developing these target molecules that inhibit specific glycolytic sugar consuming pathways so as evidence so the cue shank diet is great right because it hits many pathways and synergy like one of my

167:40slides you know that I have and my conversation or in the presentations that I do is clearly shows like you can see all the boxes there mm-hmm so this is the ketogenic diet and these are all different signaling pathways that it's working through and I would say pharmaceutical companies may put billions of dollars just into one of those little boxes you know the ketogenic diet works it's so powerful because it's many different causes many different signaling is many different pathways kind of working in synergy for a common output in this this particular slide was the neuro pharmacological effect that it has on suppressing seizures the anticonvulsant effect Wow so and each one of these is validated with a number of peer-reviewed publications that you can bring up on PubMed so it's not like something some guy put together I mean it's published and it's like you go to PubMed OAH DAC

168:36activity but you know like a half dozen publications to support each one of these so that's what's really exciting to me because there's just like so much to be kind of discovered in so many different applications and like I said it feeds back to nutrition which was like one of the main things that motivated me you know early on in college so I can do you know go back to something I'm really passionate about it's all fascinating man across the board and thank you for sharing this man thank you really it's for getting back fun thanks for going on the Tim Ferriss show and without that I would have probably know I got think Tim for that yeah thanks thanks Tim and if somebody wanted to get started with this what's the best resource like what do you think would be the best way to do it and I got a few so I would say just go to our website I have a website keto Nutrition all one

169:24word Arg okay and on that website I have a list of resources from ebooks - I mean there's ketogenic Pizza there's uh there's what Pizza what's uh yeah I mean the almond flour the crust is essentially like like chicken and Parmesan cheese pounded into like a crust where they put you know the the cheese and the sauce on our little caramel sauce on top of that I love this stuff it's real foods company is I think someone told me that they're in Ralph's here so I guess they're really doing they're doing really well but I'll have like one or two of those for breakfast in the morning especially if I'm kind of on the go they taste they're legit they're really really good vetted out a lot of things and just kind of very particular towards things that I really like and actually tested so this is something that I've kind of like tested with blood work so Kido nutrition

170:16or GI have a link there if you click on that link it's you get a discount on on the on the product max love project is really I mean if there's families out there parents out there that have kids that have cancer please contact the max love project and they are helping so many families through innovative application of the ketogenic diet for childhood cancers Verta health so type 2 diabetes is like the elephant in the room there's a massive project berta health is basically tackling this project by curing literally quote-unquote reversing type 2 diabetes in up to 100 million people in the next decade I think that's really and I talked about people who are just embarking just on diet alone or the ketogenic diet our nutrition is a way that allows people to not only calculate their macros because people are horrible calculating what they eat but it has an

171:15algorithm in it that if you put in body composition changes on a weekly basis it will tell you you know it will guide you step-by-step to your ultimate goal and as far as I know there's no other system like that I mean it's like think of Weight Watchers but like a version like 5.0 and Weight Watchers it actually works with you so I think I'm gonna have all these resources on keto nutrition orgy but if you google any of those terms keto pet sanctuary for people who have dogs that have epilepsy or dogs that have cancer look up keto pet sanctuary com there's an e-book on there it's completely free you can download it and get the recipe on how to put your dog food together that can not only prevent or help treat cancer or seizures but also just get your dog as healthy as possible and you know the Charlie foundation I really have to give I acknowledge the Charlie foundation in my

172:09TEDx talk and they were probably one of the leading foundations that really convinced me in talking with Hollywood producer Jim Abrams and really convinced me that the ketogenic diet was legitimate outside of the peer-reviewed papers that I was reading and and there's a movie by Meryl Streep actually called first you no harm so Meryl Streep did a movie on the ketogenic diet that look it up it's called first do no harm Wow so Meryl Streep starred in a ketogenic diet movie that's great and and it was that movie really floored me because I had no idea that she did it actually but uh it's that movie and meeting Jim meeting Jim Abraham's and what the Charlie Foundation is doing through global education has really inspired me to pursue this path all the people that they're helping so it was so cool that I could I feel really blessed to be able to get into a field of research that is

173:09in line with what's funded to do which was enhanced safety performance and resilience and the warfighter but apply it to so many other things and and also apply to myself which is has been kind of a journey in and of itself that I've really enjoyed amazing stuff and again thank you very much thank you really thanks for having I can't thank you enough for being here it just blew me away it was awesome thank you thank you alright everybody see ya