In this episode, I sit down with Dr. Joe Friesen, a pediatric epilepsy neurologist at Johns Hopkins University, to talk about his research on ketogenic diets and pediatric epilepsy. We talk about how the ketogenic diet can be used to treat pediatric epilepsy, how to stay ketogenic on a ketogenic Diet, and why you should drink a glass of wine to keep yourself in ketosis. I hope you enjoy this episode and that it helps you find the information you need to make informed decisions about what to eat and how to manage your diet to achieve optimal health and well-being. This episode is sponsored by Dry Farm Wines. Dry Farm is a high-yield, low-glycemic wine company that specializes in single origin wines. You can get 20% off their entire line of wines, but you have to drink at least 2 glasses per day to keep your body in ketogenic ketosis, which is a key part of maintaining optimal brain function and brain health. If you don't drink enough wine, you're not going to be able to maintain optimal brain health and brain function, and you'll need to eat at least 12 hours of solid food a day to maintain proper brain health, which can be done through intermittent fasting. If you're in the mood for a good night's rest, you'll want to join us at Dry Farm Wine! Happy New Year, everyone! . Tim Ferriss (Tim Ferriss is a podcast host, author, speaker, and podcaster. He's on Tim's podcast, Tim Friesens' podcast, and Tim's new book, . . . Tim's book is out now! Tim talks about the benefits of ketogenic eating and how it can improve your brain health in general health. Tim has a book out now and Tim is doing a podcast about it, too. Tim is an amazing book about it. Tim has an amazing podcast on his new book on his book, Tim's newest book, Too Effing Good at Work, Tim is awesome, Tim does a podcast on it, Tim did it on the podcast, so you should check it out. Tim does it out! Tim is a lot, so thank you for listening to the podcast. Tim did a great job on this episode. Tim's a lot of work, and it's great, so don't miss it. Thank you, Tim, thank you so much Tim, and we're listening to it.
00:02:20.000Like when I got into this, it was pediatric epilepsy, like in 2007 or 8. And now the applications are expanding, you know, a dozen or more.
00:02:29.000So we hold a conference, a metabolic therapeutics conference, where 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.
00:02:48.000And it's I think the application is like 11 or 12 applications for the ketogenic diet where there's good peer reviewed research to support the efficacy as a metabolic based therapy for a number of everything from What is that?
00:03:20.000Motor function impairment and the ketogenic diet is remarkably effective.
00:03:25.000It's really drug-resistant seizures that these kids have.
00:03:29.000And 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 pathology and the motor function impairments associated with this disease.
00:03:44.000And 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, the seizures.
00:03:56.000In the interest of addressing people that are probably on the ground floor, and I feel like there's very few people today that don't understand what a ketogenic diet is, but just in case.
00:04:04.000For people who don't know, there are people that use carbohydrates mainly for fuel, and then there's the ketogenic diet, which makes your body run on fats and ketones.
00:04:16.000So just kind of explain that to people, like how this came about, how people started to...
00:04:24.000Researching this and how you got involved.
00:04:28.000I mean, this goes back, if not centuries, like millennia, you know, dating back to the time of Hippocrates when it was observed that fasting was a quote-unquote cure for seizures.
00:04:49.000Well, 14 hours, you know, that's, I mean, technically, that's kind of, I call that a semi-fasted state when you achieve that.
00:04:57.000You know, when you're eating breakfast, it could be, you know, 12 hours or more since you've eaten last, and you're breaking the fast, essentially.
00:05:03.000But with severe epileptic patients, it was found that...
00:05:07.000When 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.
00:05:18.000And this was observed, you know, for millennia, like I said.
00:05:26.000There was some work done in the early 1900s and 1920s.
00:05:31.000There was some work done at the Mayo Clinic that observed the presence of these ketone bodies in people that were eating a carbohydrate-restricted diet that was primarily based on eating fat.
00:05:42.000And with a minimal amount of protein, just enough to Ensure there's not protein, you know, malnutrition.
00:05:49.000And it was observed that there was an elevation of ketone bodies, beta-hydroxybutyrate and acetoacetate in the blood.
00:05:54.000So they called it, physiologists called it the ketogenic diet.
00:05:58.000Even technically, maybe beta-hydroxybutyrate's not a ketone, but physiologists called these ketone bodies beta-hydroxybutyrate, acetoacetate, and acetone.
00:06:07.000And it mimicked the physiological state of fasting in many ways.
00:06:11.000So 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.
00:06:24.000And 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, glucose from amino acids,
00:06:40.000You are mobilizing some gluconeogenic amino acids from your skeletal muscle when you are fasting.
00:06:45.000Ketones are protein sparing though, so they are anti-catabolic in that way.
00:06:49.000So because we make ketones and our large brain has a massive demand for energy, And the ketones fulfill that, for the most part, when fasting.
00:06:57.000It prevents us from breaking down muscle.
00:07:00.000It prevents us from liberating the gluconeogenic amino acids that would otherwise, you know, be chewed up and used to maintain our glucose levels.
00:07:08.000So the ketones sort of replace glucose.
00:07:11.000The brain has the metabolic flexibility to adapt from using glucose to using primarily ketone bodies.
00:07:16.000And those ketone bodies really have a protein-sparing, anti-catabolic effect.
00:07:22.000Now is this an ancient system that was in place back when people 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 along those lines like they had to back then?
00:07:40.000I mean, it's hardwired in humans and obviously in other animals.
00:07:45.000My wife studies manta rays, and they're like the Einsteins of the sea.
00:07:51.000So they're the fish with the biggest brains of all animals.
00:07:54.000And we've done metabolomic studies on them and looking at the blood, and they produce a significant amount of ketones, like 2 millimolar.
00:08:01.000They dive really deep so it may help protect them from that.
00:08:05.000So yeah, animals will go into ketosis during fasting or even if you manipulate their food source.
00:08:11.000The 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.
00:08:23.000And many of these are dogs taken from kill shelters and put them on an anti-cancer Therapy program, and they can get into ketosis.
00:08:32.000For the most part, most dog food is not ketogenic.
00:08:36.000It's like dog foods have grain in it, right?
00:08:41.000I 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 dog food, you won't see carbohydrates listed, even though it's the primary, because there was some...
00:08:55.000Some laws or policy put into action to prevent carbohydrates from even being listed on kibble, on dog food.
00:09:03.000You know, there's a lot of reasons why.
00:09:06.000Mostly because dogs really shouldn't be eating a carbohydrate-based diet.
00:09:10.000And that's probably part of the reason, but there's sort of other reasons why.
00:09:15.000But it's really important that, so the food that the Keto Pet Sanctuary gives the dogs that have cancer and they confirm that they have cancer with a A glucose PET scan, and they do it before, during, and after, is basically kind of like a raw foods,
00:09:31.000ketogenic diet that's almost completely restricted in what we would call glycemic carbohydrates, things that would elevate the glucose levels.
00:09:40.000And it's very high in fat, relatively speaking.
00:09:43.000Yeah, but dogs really should not be eating any kind of grains at all.
00:09:48.000Yeah, I feed my dog grain-free dog food, but I don't know if it's carb-free.
00:11:29.000And I know those guys, Epigenics Foundation, they are working.
00:11:37.000They basically support the Keto Pet Sanctuary.
00:11:39.000And 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 It may not be on the shelf, and probably ideally shouldn't be on the shelf,
00:11:55.000but it'll be in the refrigerator section of your pet food store.
00:11:58.000So you go there, and for our dogs, we get a tube of freshly ground up steak or whatever, and we feed that.
00:12:06.000We take the ground meat and mix it with organ meat and mix it with...
00:12:10.000Different greens like broccoli and things like that and give it to them and they love it.
00:12:14.000We put a little bit of coconut oil on it sometimes.
00:12:16.000So you would go to the grocery store or it could be shipped to your house and it's basically kept refrigerated and it has the complement of organ meats to the proper types of fats, fish oil fats and fiber and it fits that macronutrient ratio of the ketogenic diet.
00:13:00.000How long have you been involved in ketogenic research and research on keto diets?
00:13:05.000And how long have you been doing it yourself?
00:13:08.000Yeah, I guess it was I got turned on to it in 2007 or 8 and actually I was communicating online on a nutrition forum on a fitness website and I was a neuroscientist.
00:13:20.000I did my PhD on cellular neuroscience.
00:13:24.000I did 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.
00:13:38.000And I got to the point where we're doing some drug-based research on seizures and other types of research.
00:13:43.000And the types of seizures that I study are powerful tonic-clonic seizures that a Navy SEAL could potentially experience using a closed-circuit rebreather.
00:13:53.000So when they're underwater, a limitation for their time underwater is CNS oxygen toxicity.
00:13:58.000And it's also a limitation for hyperbaric oxygen therapy.
00:14:02.000So rebreathers are those ones that don't emit bubbles.
00:14:05.000So there's a bit of a stealth component.
00:14:08.000So you're underwater, and if you're going over a lake to engage the enemy, they can't see you coming.
00:14:15.000So that's the advantage, that they're very stealth-like.
00:14:18.000The disadvantage is that at 50 feet of seawater, in just 10 minutes, you have the potential to get CNS oxygen toxicity.
00:14:25.000Of 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% of the time.
00:14:36.000But 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.
00:14:44.000You know, you're going to want to stay down there.
00:14:45.000If 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.
00:14:52.000And it puts you at the potential of having a seizure.
00:14:56.000The seizure itself is not deadly, per se, but having a seizure underwater could be fatal to the mission and the warfighter.
00:15:06.000So my research was really developing various technologies where we actually put things inside a hyperbaric chamber, like an atomic force microscope or a laser scanning confocal, where we can look at the mitochondria under pressures that simulate these operational conditions.
00:15:45.000I became more interested in what people do when drugs don't work for epilepsy and I looked up and found the ketogenic diet.
00:15:52.000This fits in perfect because my background was studying nutrition and I was studying pharmacology at the time but it allowed me to bring nutrition back into my research program.
00:16:02.000And studying the ketogenic diet specifically.
00:16:05.000And the program officer at the time at the Office of Navy Research really liked the idea of the ketogenic diet in a drug.
00:16:12.000So 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.
00:16:25.000I put my efforts into studying the ketogenic diet and also into developing and testing a wide range of exogenous ketone products, which are on the spectrum of drug-like to on the spectrum of natural-based things that can be combined together.
00:17:12.000But 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.
00:17:24.000So that's just one example of a therapeutic application of exogenous ketones.
00:17:29.000So you're doing the research on this and you decided to start doing it yourself?
00:17:33.000Yeah, I started doing it myself to get a better understanding.
00:17:37.000Actually, there was a patient in the UK, his name is Mike Dancer.
00:17:41.000And 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 a dozen, a half dozen, maybe even a dozen different types of anti-epileptic drugs and high doses of things like Keppra, like things that are the standard of care.
00:19:06.000I thought the ketogenic diet was kind of like this fad diet.
00:19:09.000I just knew about it in the fitness circles as something that I would actually typically avoid.
00:19:14.000But 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...
00:19:27.000Peer-reviewed research behind it, an enormous amount of research, and I realized it was a grossly underutilized, what I would call metabolic-based therapy for seizures.
00:19:39.000Because in our healthcare systems, there's really not the infrastructure When a patient comes in and they have uncontrollable seizures, the neurologist or epileptologist typically does not have the skill set in nutrition,
00:19:54.000knowledge in nutrition, to be able to guide a patient successfully into nutritional ketosis and to do that.
00:20:00.000So they would have to refer them to a registered dietitian, which typically are not Savvy in ketogenic diets.
00:20:07.000But now, the Charlie Foundation is a foundation that works closely with Johns Hopkins, and I think there's about 150 to 200 clinics worldwide that are ketogenic diet clinics that have, you know, registered dietitians that are working to assist patients.
00:20:22.000So now, you know, the infrastructure is kind of there.
00:20:26.000But doctors typically will prescribe a drug whenever they can.
00:20:34.000Most of them are probably aware that, you know, it is the standard of care.
00:20:37.000The ketogenic diet is the standard of care when drugs fail.
00:20:40.000And there's things like vagal nerve stimulation and other things.
00:20:43.000But the ketogenic diet has been around so long, it has an amazing track record.
00:20:46.000There are some side effects associated with it, mostly associated with the classical ketogenic diet, which is like 90% fat, like 8% protein.
00:20:54.000But now Eric Kossoff at Johns Hopkins has done a lot of work On what I would call, you know, the modified ketogenic diet.
00:21:03.000He calls it the modified Atkins diet, which is more liberal in protein.
00:21:06.000It's 20 to 30 percent protein and the balance being mostly fats from healthy sources and the carbohydrates are just, you know, completely non-glycemic carbohydrates you get from salads or green vegetables and things like that.
00:21:21.000So with the classical ketogenic diet, they found that kids put on the diet, it reduced IGF-1, which if you're into longevity, that might be a good thing, right?
00:21:31.000And it reduced their terminal height in some cases because of the protein restriction.
00:21:40.000For reasons we know in the longevity field, you know, reduce IGF-1 signaling, insulin IGF-1 signaling.
00:21:46.000And that was found to be the case in kids versus the suspected mechanism.
00:21:50.000But when protein was kind of titrated back in, that was not the case.
00:21:56.000So there's also kidney stones can happen and there's a supplement potassium citrate.
00:22:01.000That can help kind of offset the mild metabolic acidosis that occurs when you go on the ketogenic diet.
00:22:07.000And just simply, I mean, you could do that nutritionally just by formulating your diet and using more salt to balance out, using more minerals.
00:22:15.000So essentially the big issue is just the protein.
00:22:19.000Yeah, I think the protein for kids that are growing and developing, and if you restrict protein in kids that have all these growth factors and everything that really kind of require...
00:22:30.000And also, if you go on the ketogenic diet, you may be inadvertently limiting total calories just because of the palatability of the...
00:22:41.000Especially the classical ketogenic diet, whereas the modified Atkins diet...
00:22:45.000Which was studied very rigorously at Johns Hopkins by Eric Kossoff has shown to have like 90% of the benefits of this draconian classic ketogenic diet.
00:22:55.000And when possible, you know, it's better to put, and that's what I follow.
00:22:59.000I follow Modified Atkins, which is just higher in protein.
00:23:12.000That's about the macronutrient ratios, yeah.
00:23:15.000And they call it, clinically they call it the 4 to 1 or the 3 to 1 ketogenic diet, and that's really confusing because that 4 to 1 is in grams, right?
00:23:24.000So it's actually like 4 parts fat to 1 part protein and carbohydrates.
00:23:32.000Carbohydrates being a very small part of that 1, that 4 to 1 ratio.
00:23:35.000And a 3 to 1 ratio And that would be like 92% fat.
00:24:08.000Not only in the clinical realm, but also people that are doing this, you know, for athletic reasons, for, you know, losing body fat.
00:24:14.000Managing type 2 diabetes is probably the biggest, the low-hanging fruit of all these applications, and I could talk more about that.
00:24:22.000The biggest thing to do is to count your macros and test your ketones, of course, but people are horrible at counting how many calories they are getting in when you tell them to follow a diet.
00:24:33.000So 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.
00:24:47.000And I'm working with them hopefully to develop...
00:24:54.000And it's a very highly innovative app that not only does it, you know, you put in your macro, it's a macro calculator, those That macronutrient profile is in the system and you do body composition measurements weekly and it calculates through what I would call an artificial intelligence system,
00:25:16.000an AI system in the algorithm, to adjust your calories week by week based on the progress that you're making.
00:25:24.000And it's the only system that I know of its kind that's 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.
00:25:39.000And this is the system, it's the ideal platform to incorporate the ketogenic diet into.
00:25:46.000It's going to take some work with the guys that are writing software to design it, but essentially you'll have available a ketogenic diet app that will be able to adjust to whatever output that you want,
00:26:02.000whether it be managing seizures, maybe a metabolic management of cancer, or body composition changes or performance changes over time, and that's all being written up.
00:26:13.000First of all, What are your primary fats?
00:26:18.000When you tell someone that your diet is, forget about the classic 90% fat, but even 75% fat, people just go, Jesus, where's all that fat coming from?
00:26:29.000What do you use for fats and do you vary it?
00:27:32.000Well, I really thought that you need carbs to grow in the gym and maintain your strength and performance.
00:27:39.000And I just felt that the brain needed glucose for fuel.
00:27:42.000And I didn't, you know, I was kind of unaware of the research that was done in Harvard in 1967 by George Cahill.
00:27:49.000And I did get a chance to talk to him before he passed away.
00:27:51.000Well, even Rob Wolf is, you know, Rob is really into jujitsu, right?
00:27:54.000And he's having an issue with maintaining a strict ketogenic diet.
00:27:58.000I don't know if he's going with the classical ketogenic or the modified Atkins, but he has a problem with having the carbohydrate restriction when he has really hard training days.
00:28:09.000Yeah, I've talked to Rob about that a little bit.
00:28:12.000The body is incredibly adaptable to switching fuel sources and adapting to that fuel source over time.
00:28:18.000And some people may be a little less adaptable than other people.
00:28:22.000But I think that if he was to give it...
00:28:25.000I think, you know, knowing Rob, he did give it a very legit shot.
00:28:28.000He may benefit from adding some slow carbs in just prior to an intra-workout, you know, during his...
00:28:35.000Like yams or something along those lines?
00:29:03.000I know Jeff Follick has a product out, UCAN. I think UCAN starch is the name of it.
00:29:09.000And it just, you know, it will slightly elevate...
00:29:14.000It will elevate your glucose and not trigger an insulin response, so you won't go hypoglycemic after.
00:29:19.000And it will essentially titrate in carbohydrates and glucose into your system over a predetermined period.
00:29:28.000It'll kind of hit your system and sustain it for three or four hours, which is ideal for people engaging in MMA or cycling during that time frame.
00:29:41.000But I think if you're getting in a sufficient amount of calories and if you are using things like creatine monohydrate, which works through the phosphagen system, you are able to generate ATP for those short bursts of power that you need To manage your opponent and sustain it.
00:29:59.000So for a supplementation, if you were going to supplement creatine, would you do that prior to the workout?
00:30:06.000I know a lot of people take creatine post-workout.
00:30:09.000Yeah, if you're taking creatine and you stop taking creatine, it's in your system for a couple days to a week or more.
00:30:17.000So it's just, you know, on a daily basis, it doesn't matter necessarily when you take it.
00:30:21.000It's just that you take it on, uh, and probably at least three grams per day, uh, for a larger guy, three to five grams per day.
00:32:18.000It took a lot out of me, and I tried to get into my file that I was closer to 200. I think maybe you'd be more likely to be an astronaut candidate if you're Like lower, you know, because weight in space is a big thing to me.
00:32:30.000So I tried to get my body weight from 226 down to 207, and I did.
00:32:34.000It took about three months, and now I'm creeping slowly back up.
00:32:47.000I typically eat a ketogenic breakfast that's kind of small, and I would make 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,
00:33:04.000and then kind of nibble at nighttime, maybe an hour or two before bed.
00:33:58.000I was told I don't have to count that.
00:34:00.000Yeah, that's the most important thing.
00:34:02.000So this is the function of the app I told you about, Avatar, which is kind of a macro counting program.
00:34:10.000Right now, you can set the adjustments to do low carb, but once the software is written up for the keto option, that will be a tremendous resource for people, the average person, that wants to do the ketogenic diet.
00:34:24.000And hopefully we're going to craft it in a way, too, to help the clinical community, too.
00:34:29.000Well that's one of the reasons why I wanted to have you on is because you're an actual scientist and there's so many misconceptions when it comes to ketogenic diet, the benefits.
00:34:42.000One of the things that I've found really fascinating is recently, because the ketogenic diet has become so popular, there's been these sort of sparsely educated meathead trainer type dudes that are poo-pooing the ketogenic diet.
00:34:56.000And whenever I see that happen, I go, oh, here's a person whose ideas are threatened.
00:35:01.000Whenever someone says the ketogenic diet is not beneficial or it's not really worth it, I'm like, okay, you're not saying anything.
00:35:12.000Because there's a substantial amount of science that shows the benefit of the ketogenic diet.
00:35:17.000But there's a lot of meatheads that have been critical of it.
00:35:22.000And when I read that, I'm like, okay, you're not saying anything.
00:35:26.000There's no substantial reason why you're critical of it.
00:35:29.000This makes me think that you have been pushing a certain type of diet for a long time.
00:35:33.000This comes along, it shows contrary evidence, and you're trying to diminish it in some sort of a way, but without any actual science.
00:35:40.000So what have been the criticisms of the ketogenic diet and how many of them are actually valid in terms of when I'm talking to people, especially if I'm talking to professional athletes, I'm talking to athletes whose very health is very critical that they have energy,
00:35:59.000So for them, like to recommend a ketogenic diet to a fighter, it's very tricky because you're talking like 1%, 2% performance could be the difference between victory and defeat and maybe even being knocked out or submitted and being successful.
00:36:16.000So 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, it's not one or the other, but you're shifting for the predominant fuel source to be fat and ketones.
00:36:34.000That's not something that happens overnight, and it doesn't even happen in two or three weeks.
00:36:41.000What I've seen in elite-level cyclists and other types of sports is that it really takes a minimum of three months, ideally six months, and even after a year.
00:36:53.000I think you're getting changes even at the epigenetic level.
00:36:57.000We 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.
00:39:38.000When you alter the fuel that you're giving your body in such a profound way.
00:39:42.000Well, one of the first things that I noticed, the benefits, one of the first benefits was cognitive.
00:39:48.000It was clarity, lack of fogginess towards the middle of the day, no desire to take a nap, and no drop.
00:39:58.000Like, you know, I'd have the big meal thing and then the drop, the valley, when, you know, like, oh, your body's like digesting everything.
00:40:05.000I thought that was just how you lived.
00:40:07.000I thought there was no getting around that.
00:40:33.000I mean, looking back in undergrad, when I was like task loaded with a lot of classes and stuff, I would make...
00:40:39.000I was trying to, you know, bulk up at the time.
00:40:40.000And I would put like steak or beef on a bagel.
00:40:44.000So I would cut a bagel kind of in half and then put like meat and stuff.
00:40:47.000So I would be getting all the carbs from the bagel.
00:40:49.000And I would just go get a big Starbucks coffee because I had two...
00:40:52.000To mitigate that crash that I would have.
00:40:55.000And 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.
00:41:05.000So if you wear something like a continuous Yeah.
00:41:37.000On a ketogenic diet, you essentially abolish that.
00:41:40.000You don't have this spike in glucose, which spikes insulin, and your energy levels are maintained.
00:41:47.000So cognitive resilience is a big thing.
00:41:52.000So even if you're hypoglycemic, you could use something to lower your blood glucose, like insulin, and push it down to a level that would put someone into a coma.
00:42:00.000And if their ketones are elevated, they are asymptomatic for hypoglycemia.
00:42:05.000And this was a study actually going back to the work done by George Cahill at Harvard where he fasted subjects for 40 days and he did a battery of cognitive tests and he measured blood going to the brain and blood coming away from the brain.
00:42:18.000And he determined that about 70% of brain energy metabolism is derived from ketones when you're fasting.
00:42:23.000And the same occurs with a ketogenic diet too.
00:42:27.000So you are literally switching the fuel source that your brain is using.
00:42:31.000But in an extension of the study, he injected 20 IUs of insulin and pushed glucose down to one millimolar, which is universally fatal in everyone.
00:42:42.000So you take a crowd of people who are eating a standard diet and push it down to that.
00:43:09.000Send the investigator, you know, out of the university if they even proposed to do some of the studies that were done.
00:43:15.000But when they lowered blood glucose down to that level, which would, you know, put someone into a coma, the subjects were asymptomatic for hypoglycemia because their brains were keto-adapted.
00:43:26.000They had essentially been over a week.
00:44:09.000But I saw 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.
00:44:19.000Like, there's one in particular called glucose transporter type 1 deficiency syndrome, or glut 1 deficiency.
00:44:25.000And the kids that have this literally have a deficiency of the glucose transporter on the blood-brain barrier.
00:44:31.000And their blood glucose is normal, normal levels, but the glucose in their cerebral spinal fluid is under 2 millimolar, which is, I mean, their brains are essentially living in hypoglycemia.
00:44:44.000So they're constantly having seizures.
00:44:56.000So the ketogenic diet restores brain energy metabolism in these kids that can't use glucose as an energy source with this disorder.
00:45:06.000It's called glucose transporter type 1 deficiency syndrome.
00:45:09.000And another very interesting example of a disorder where there's a persistent molecular pathology where The symptoms can be largely silenced with the application of a ketogenic diet that needs to be pretty strict.
00:45:24.000And that's where ketone supplements come in.
00:45:28.000It's difficult for some of these kids to follow a ketogenic diet, so a ketone supplement can potentially circumvent the dietary restriction that's needed for a ketogenic diet and make it easier for parents and kids to implement.
00:45:42.000But 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.
00:45:54.000So my main application is the warfighter and maybe astronauts too.
00:45:58.000So 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 warfighters or divers.
00:46:10.000Now, 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?
00:46:31.000What has been done, I mean, the first study, I would say purely ketogenic study that I'm aware of, used something as simple as medium chain triglycerides.
00:46:41.000And it was actually a substance that the chemical name was AC1202. And that substance, it was in the patent listed as a substance called AC1202. And for people unfamiliar, that's just MCT oil, coconut oil.
00:46:56.000So if you were to pull this patent, interestingly, my colleague and friend, Dr. Mary Newport, did and wrote a book on Alzheimer's disease about the use of ketones for Alzheimer's.
00:47:08.000She identified that the ingredients in this supplement that help to enhance cognitive function in people with mild cognitive impairment, the ingredient of this, if you dig into the patent, was caprylic triglyceride, which is a medium chain triglyceride,
00:47:28.000It was a double-blind, placebo-controlled study that showed that people who, interestingly, they were not APOE4 positive.
00:47:34.000That group did not respond, which is another kind of pathway we can go down.
00:47:39.000But their improvement in cognitive function correlated with their elevation in ketone levels.
00:47:46.000With this supplement, it was a fat that when you consume it, independent of the amount of carbohydrates you consume, it converts that fat into beta-hydroxybutyrate, which you can measure with a little blood meter.
00:47:57.000And as that level creeped up, and it didn't even have to creep up that high, it was like 0.6.
00:48:36.000Because that's sending a lot of energy to the brain.
00:48:39.000So every millimolar of beta-hydroxybutyrate that's in your blood, it's been estimated that it gives you, like, your brain about a 10% boost in energy.
00:49:06.000So like for college students or someone who's studying for an exam or someone who's about to do something very important, exogenous ketones should be like standard, right?
00:49:17.000Well, yeah, there's some pretty good evidence to show, especially if you have a deficit, right?
00:49:24.000And actually, you know, the application that I'm using it for is in an extreme environment when your brain is already at a deficit.
00:49:32.000But we could say we're all at a deficit, right?
00:49:34.000So tomorrow, I'm jumping on a red eye, and I can't sleep on a plane, and I land, you know, and go to my university where I have to teach for a couple hours and then drive a couple hours north and give another lecture at night, and I'll be on zero sleep.
00:49:46.000And I would not even attempt that if I was, you know, wasn't doing what I have been doing.
00:49:51.000Like, I've kind of figured out protocols where I can allow me to function even on extreme lack of sleep and be able to...
00:50:09.000There's a wide variety of ketone supplements on the market.
00:50:14.000I'm kind of a food guy, so I just use them almost kind of sparingly, but I do tend to use them every day.
00:50:21.000The supplements that I've packed in my bag are the Kegenix supplement is one that I've been using, and also the Pruvit Keto OS product that mixes beta-hydroxybutyrate salt with MCT powder.
00:50:35.000So there's a couple other forms of just beta-hydroxybutyrate, but our studies show that just consuming beta-hydroxybutyrate does not give you, at least in the ketone salt formula, does not give you a lot of the benefits that we see in some of the studies that we're running.
00:50:51.000And the beta-hydroxybutyrate needs to be mixed with medium-chain triglyceride fat, and that's pretty important.
00:51:00.000The medium chain triglyceride delays gastric absorption.
00:51:03.000So it also further boosts ketone levels higher than you could get with ketone salt alone.
00:51:09.000So you get an elevation of ketone levels that's sustained for longer.
00:51:14.000And 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.
00:51:22.000And it also, it's stimulating your own ketone production.
00:51:26.000And that's what happens when you mobilize body fat.
00:51:28.000You have a wide variety of enzymes that convert that fat into ketones.
00:51:32.000If you take a ketogenic fat, the same thing is happening.
00:51:35.000You're revving up that system in addition to the exogenous ketones.
00:51:38.000So the Pruvit product, KetoOS, Kegenics, And there's a couple other companies emerging on the market.
00:51:45.000We have our own company, Ketone Technologies, and we are partnering with government agencies like Department of Defense, ONR, NASA, to do research, to fund research with these institutes to really nail down the optimal formula for anti-seizure effects,
00:52:03.000the optimal formula for motor function effects, the optimal formula even for strength.
00:52:08.000And the one with strength will probably involve You know, adding amino acids, adding creatine monohydrates.
00:52:14.000So these will be formulas that will be optimized.
00:52:35.000Yeah, so I travel with, this trip it was canned chicken and sardines, so there's a couple, Wild Planet makes a good can, and Tim Ferriss, I kind of turned him on to it, and it really exploded.
00:52:50.000The company kind of emailed me and thanked me, you know, they're Really exploding.
00:54:33.000And if you do that on a daily basis, I wouldn't want, if you're a pregnant woman, you know, I would stay away from big predatory fish.
00:54:39.000But one thing about sardines is that they can be farmed in a sustainable way.
00:54:45.000And the amount of heavy metals will be typically proportional to the size of the fish and whether it's predatory.
00:54:51.000The 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.
00:55:15.000We were in Borneo and, you know, Malaysia and Indonesia and all these places, and you see some boats coming in, and those sardines are going to various plants.
00:55:27.000And even bigger companies will source out wherever is cheapest.
00:55:32.000So I like to be pretty particular about, especially if I'm going to eat something in such a high volume, like where it's coming from, to actually visit the plant and get some information to where it's coming from.
00:55:45.000You know, I do use some of the meats from ButcherBox.
00:55:50.000So ButcherBox offers a wide array of meats from grass-fed animals, and that's a lot of our meals at nighttime are from ButcherBox.
00:56:01.000But that's interesting about the arsenic.
00:56:04.000You know, arsenic can get concentrated in the ground where plants are grown in.
00:56:09.000So if rice is grown in China or whatever plant is grown in China and that soil has arsenic in it, I lived behind our house.
00:56:21.000We 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.
00:56:58.000Yeah, there's different methods that you can use that would kind of put you in the category of sustainable farming for sardines.
00:57:07.000So it's one of the few fishes that are really low on the spectrum of having heavy metals.
00:57:12.000So if you're, you know, there's women, I get this question a lot, like, you know, if a woman becomes pregnant, you know, should they stop eating fish?
00:57:20.000Should they stop eating, you know, ahi tuna or swordfish and things?
00:57:24.000I would say, yeah, definitely the big predatory fish you'd probably want to cut back on.
00:57:29.000I did take a couple courses in neurotoxicology where we went over like mercury poisoning and every possible chemical and just the take home message was for the normal person, probably not an issue.
00:57:43.000You know, unless you're consuming really high levels.
00:57:46.000In grad school, I was eating these big cans, like 12, I think there were 12 ounce cans of tuna fish.
00:57:52.000And there was like five servings per can.
00:57:54.000And I would eat like three cans a day.
00:57:56.000Like I would take that and add, I was fat phobic at the time, but it would be a chunk like tuna and I would put balsamic vinegar on it.
00:58:02.000And I would literally eat three of these 12 ounce cans a day.
00:58:06.000And that would be 15 servings of tuna per day.
00:58:15.000So nowadays I tend to do a lot of blood work just to check different things.
00:58:18.000But no overt signs of, you know, toxicity or anything.
00:58:22.000Maybe like a little, someone, one of the professors that I was doing something for, she had or her friend had lost a lot of hair due to eating tuna that had high mercury.
00:58:32.000And at the time, like, kind of had a lot of hair loss at the time.
00:58:35.000It was also kind of a stressful period.
00:58:37.000So maybe when I stopped eating, I noticed, like, this is back in my mid-20s now.
00:58:41.000I haven't had, like, a significant amount of hair loss since...
01:01:10.000In Israel, and I went to the Dead Sea, 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.
01:01:22.000So the magnesium is relatively small molecular weight.
01:01:25.000Anything with a molecular weight, like under 300-400, I think can get into your bloodstream.
01:01:30.000Yeah, I mean, I think that's why people like those Epsom salt baths.
01:01:33.000I think that's one of the things that relaxes people.
01:01:36.000Yeah, and Epsom salt baths is, you're talking about a very small amount of Epsom salt in comparison to a tank, which has, my tank has 1,000 pounds of Epsom salts in it and 11 inches of water.
01:02:38.000Which is probably a reflection of glutamate-induced neurotoxicity.
01:02:46.000So the cells are dying, they're releasing glutamate.
01:02:48.000So it may be neuroprotective in that way.
01:02:50.000And it definitely, you know, I know magnesium, you can feel it.
01:02:53.000Like if you take a legit source of magnesium that's bioavailable, like magnesium glycinate or other forms of magnesium, you can really feel kind of a calming effect that it has.
01:03:59.000But prior to that, He demonstrated in a mouse model of ALS, which is the SOD1G93A mouse model, and it has a gene defect that mimics the familial form of ALS, which accounts for maybe about 10,
01:04:18.000And he found that a ketogenic diet improved motor function and some neurological effects.
01:04:24.000It did not improve overall survival, though.
01:04:42.000To a few supplements, which was arginine, alpha-ketoglutarate, and GABA, and coenzyme Q10, and a few things that we actually put into a supplement.
01:04:55.000And we reproduced the same study using this gold standard mouse model.
01:05:00.000And we looked at motor function, we looked at neurological score, and then we looked at total long-term survival, too.
01:05:06.000And we found that Using medium-chain triglycerides, which was ketogenic fat, with arginine alpha-ketoglutarate, which is something that's in pre-workout formulas.
01:06:13.000And there's more than 1,000 patients registered on this that are benefiting.
01:06:17.000And there's several peer-reviewed studies on this.
01:06:21.000Ideally, we'd like to get enough funding to do a human study, but the mouse work's pretty compelling.
01:06:26.000And it's an extension of work that has already been done, really, and further 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.
01:06:42.000Now, when you were talking about epileptic kids and supplementing their diet with ketone supplements, because a lot of them have a hard time following a ketogenic diet, can you get the same benefits of a ketogenic diet by following a standard American diet and supplementing with exogenous ketones?
01:07:02.000I doubt it at this time with the ones that are commercially available, but I do think that with some of the ketone esters in development right now, we've observed using a range of different animal models that the thing is that these things are not very palatable,
01:07:18.000they'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.
01:08:36.000You could eat a bowl of pasta and then consume a Kegenix product and then test your blood ketones and it would look like you're on a strict ketogenic diet.
01:08:45.000A mild, like what I would call a modified Atkins diet.
01:08:48.000Whereas, so the ketone ester, you could eat a bowl of pasta and then take a ketone ester and it would look like you fasted for 10 days.
01:08:56.000So it puts you into starvation level ketosis.
01:08:59.000So interestingly, another application of ketones is that it lowers blood glucose.
01:09:04.000And we don't know why we're studying that right now.
01:09:08.000And it may do it by, your liver is like the main regulator of what your glucose is.
01:09:14.000So your liver has glycogen in it and it's constantly being broken down and kind of spilling glucose into.
01:09:20.000It may be affecting that process or it may be enhancing insulin sensitivity, which means you take ketones and your cells use the glucose that's there becomes more readily available to the cells.
01:09:33.000So we're looking into precisely why, when you consume exogenous ketones, why glucose goes down.
01:09:39.000We've replicated it many times with different forms of ketones.
01:09:42.000So would that be a way for a person who maybe is just not so good at being disciplined with their diet to just throw it in there?
01:09:48.000Like, say, God, I want some ice cream, but I've been really good with my diet.
01:09:52.000Fuck it, I'll just have the ice cream and then have some Kegenics or something like that afterwards?
01:09:56.000Well, I firmly believe there's no shortcuts.
01:09:58.000And I think of ketones, and I think I mentioned this on Tim Ferriss, too, and he put it in there, that ketones are just another source of energy.
01:10:06.000So 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 of food.
01:10:14.000Right, but as far as fat, but as far as gaining weight, but as far as keeping your body into a state of ketosis, it actually does work.
01:10:22.000And the benefits of that would be maybe not weight loss, but...
01:10:28.000By elevating your blood ketone levels, there's a lot of beneficial effects, even from a signaling standpoint, like completely independent of metabolism.
01:10:38.000We know that it's a super fuel, essentially, for the brain, that your brain cells can generate energy from ketones in a more efficient manner than glucose.
01:10:59.000So there are a few stipulations to that.
01:11:01.000And I could get a little bit technical.
01:11:03.000But for example, I mean, obviously, if you have glut one deficiency syndrome, you know, you're transporting it.
01:11:09.000But your brain has a number of things that can prevent it from using glucose effectively.
01:11:15.000So in many cases, ketones would be the preferred source of fuel.
01:11:18.000For example, there may be Like with Alzheimer's disease, or maybe even if you have traumatic brain injury, there's an internalization of the GLUT3 transporter.
01:11:27.000So that you have cells, right, and glucose is trying to get in, but the GLUT3 transporter isn't on the membrane.
01:11:32.000Or you can have a dysregulation or an inhibition of pyruvate dehydrogenase complex, PDH complex.
01:11:40.000And that enzyme is really the gatekeeper.
01:11:43.000It's a throttle that lets the glucose into the cell to create, to feed into what we call anaplerotic pathways to drive the TCA cycle, the Krebs cycle.
01:11:54.000And that makes reduced intermediates that drive the electron transport chain to make ATP. It's like a gatekeeper.
01:12:00.000And ketones completely bypass that process.
01:12:02.000So if you have no GLUT3, if you have impaired activity of this PDH complex, which a lot of people who are carb or hydrate components say, well, you're inhibiting the PDH complex if you're on a ketogenic diet.
01:12:17.000And I don't think there's evidence of that.
01:12:19.000But the ketones essentially bypass those steps and can restore and preserve brain energy metabolism, even if those things are dysregulated or dysfunctional.
01:12:28.000And a number of pathologies make them dysfunctional.
01:12:34.000It's thought that as we age, we have a proportional decrease In glucose energy metabolism in the brain, but that's not the case with ketones.
01:12:46.000So as we age, the data that has been collected so far shows that we have essentially the same ketone energy metabolism from young to adults.
01:12:57.000You can graph it out, and we've had speakers at our conference that did that, and you can see kind of like a plateauing effect and a decrease in brain energy consumption from glucose, whereas with the ketones, it bypasses many of the rate-limiting steps that are associated with impaired glucose metabolism in the brain.
01:13:17.000It'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?
01:13:45.000That'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.
01:13:53.000When you say that, you're testing her?
01:14:23.000And 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.
01:14:32.000Like it doesn't have to be a ketogenic diet, but simply restricting your carbohydrates is a powerful hammer, for example, for type 2 diabetes.
01:14:40.000And Virta Health is doing more for the medical management of type 2 diabetes than any other entity that I know of.
01:14:48.000I mean, I think their goal is in the next decade to reverse 100 million cases of type 2 diabetes.
01:14:54.000Like, our government spends way more...
01:14:57.000It's like $200 billion of funding for managing diabetes.
01:15:05.000And, you know, NASA's budget is something like...
01:15:23.000So why would a registered dietitian administer a carbohydrate-based diet to a type 2 diabetes person who has a problem with carbohydrate intolerance?
01:15:36.000And that's reflected in their elevated hemoglobin H1C or glucose levels or insulin levels.
01:15:42.000So Virta has created a platform of people who, using an app, will allow you to follow, adhere to carbohydrate restriction and a ketogenic diet to essentially not just manage it, but just completely reverse it.
01:15:59.000And 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, maybe 89 or 87%, Can either completely get off insulin or reduce it down to very low levels just simply by using a carbohydrate-restricted ketogenic diet.
01:16:24.000I mean, imagine the number of people that can get off medication, what that can do to the healthcare system, the healthcare burden of paying all these dollars for drug management of type 2 diabetes, which is going up to epidemic proportions.
01:16:37.000So if people are out there and they have type 2 diabetes, just go to Virta 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.
01:17:34.000You know, when you're uncovering all this and when you're doing all this research and studying it and you're finding all these benefits, have you tried to figure out or contemplate, like, what is the cause?
01:17:45.000Like, why is it so beneficial for your body to live off fats versus your body to live off glucose?
01:17:51.000Is this something that we evolved to live off fats?
01:17:54.000Is this, like, is it a Is it a better primary source?
01:17:58.000Is it something that our body can exist off of glucose, but really we're designed to live off fats?
01:18:05.000Well, it's multi, I mean, there's many answers to that question, but I'll tell you kind of what I think.
01:18:11.000That many people do really well on a carbohydrate base with no overt signs of, you know, pathology.
01:18:18.000Especially really active people, right?
01:18:20.000Yeah, 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 people have health problems, too.
01:18:32.000But the athletes are typically not the ones who necessarily need it.
01:18:36.000I mean, a lot of, you know, if there's football players out there and people that are predisposed to concussion or brain injury, I think it's really good to be on a ketogenic diet.
01:18:47.000That's kind of like a whole other area we can go into.
01:18:49.000Now for athletes, when you're talking about people that maybe they don't need it for weight loss or they don't need it for a lot of...
01:18:55.000Is it because the massive amount of calories that they're burning and their nutritional requirements almost mitigates the negative effect of having a glucose-based diet?
01:19:06.000Yeah, it really does come down to calorie control.
01:19:08.000So if you have a surplus amount of calories coming in, you know, even with an athlete, you're going to start to get some over, you know, metabolic effects and negative, you know, biomarkers kind of showing up.
01:19:21.000And if you do that chronically, it'll ultimately lead to chronic inflammation, maybe some, you know, brain fog and other things.
01:19:30.000What I've observed is that, you know, I mean, you're asking like...
01:19:49.000There'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.
01:19:58.000Yeah, I think you really, to put this into context, you have to think the negative effects from a high-carbohydrate diet are due to a calorie surplus.
01:20:09.000So I think a carbohydrate-based diet could work fantastic for a lot of people who...
01:20:56.000And for many people, which I had, was this postprandial dip in blood glucose where you'd go hypoglycemic after two or three hours, and that would have me searching for food again.
01:22:00.000I really believe that it helps put the brain into a state of homeostasis better.
01:22:05.000And if there's less kind of energy spikes and less kind of noise in the system from a physiological standpoint, that the brain's energy system and the neuropharmacology of the brain itself, the neurotransmitters,
01:22:21.000the balance of GABA to glutamate and serotonin and other things, will be balanced in a way that would make seizures much less likely to occur.
01:22:29.000And I think that's what it does from a feeding behavior, from a neuroendocrine point of view, is that it helps to, when you have all these hormones and metabolites going all over in the blood, the ketogenic diet keeps it into a range where there's a lot less noise in the system.
01:22:46.000And you can see this by a patient, a type 1 diabetes patient, for example, who goes from eating a high-carbohydrate diet to a ketogenic diet, where their DEXCON continuous glucose measurement is all over the place, if you look at several days of data,
01:23:02.000and if they transition to a ketogenic diet, I mean, the highs, there's way few highs and way few lows, and it's within a tight range, and they stay within the range where they're optimized, I would say.
01:23:13.000So they're in a glucose range Where they're optimized.
01:23:17.000That happens, obviously, with a type 1 diabetic who's trying to chase the glucose with insulin.
01:23:22.000But for the average person, the same thing happens.
01:23:25.000And 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.
01:23:36.000So high-carbohydrate diet is completely manageable in people who know how to manage their calories, but that's really hard for most people to do.
01:23:43.000So I think the app-based programs that are coming out are really, really handy, and I think they'll be kind of the wave of the future for people who want to optimize their...
01:23:53.000Their body composition and their performance and to have a keto option of that too, where you can titrate and optimize your keto diet.
01:24:01.000And then there's an AI system that tells you how to improve those ratios over time to hit your goals.
01:25:29.000An enormous amount of research behind it, and it's one of the products I used on the NASA NEMO mission because we didn't really have access to fresh vegetables or phytonutrients down there.
01:26:04.000Typically, if I eat like a Toll House chocolate chip cookie, I would have that crash that we were talking about, and I would be ravenous after.
01:26:37.000I didn't get to speak to him because it was just so busy.
01:26:40.000But Keto Cookie is one of those foods that's evolving out of this...
01:26:45.000You know this kind of movement I would say that the ketogenic diet is becoming a lifestyle so not something that's used for pediatric epilepsy but something like the average person can follow to just feel better and for me I can eat a keto meal in the morning and I can hammer out 12 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,
01:27:14.000you know, my career has gotten a really big boost because I'm more cognitively aware and resilient.
01:27:22.000Even during periods of sleep deprivation, I can just work longer periods and I kind of utilize keto to my advantage in that way.
01:27:49.000My wife spearheaded a program looking at absence seizures.
01:27:56.000So a lot of people who have seizures don't have tonic-clonic seizures, but they'll just look and stare into space and then wake up out of it.
01:28:52.000It reduced anxiety behavior about 25 to 30 percent in our rats.
01:28:58.000So 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 to the environment.
01:29:07.000It typically produces a fear response or they could run back into the little cave.
01:29:11.000And the beta-hydroxybutyrate salt plus the medium-chain triglyceride combination actually reduced that fear behavior.
01:29:19.000Maybe 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 who have stress, it kind of exacerbates anxiety.
01:29:31.000I mean, I felt it early on in my career.
01:29:33.000I know that being in a state of ketosis just makes me more mellow.
01:29:38.000Well, you know, one thing that would help me with is I bow hunt.
01:30:18.000And people have target panic where you can't remember what you're doing and you go into 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, repeating mantras, going over different facets of your shot process,
01:30:36.000but maybe ketones and being in a ketogenic state.
01:30:40.000Especially exogenous ketones before you hunt would mitigate some of those issues.
01:31:07.000But it allows you to increase your CO2 threshold.
01:31:11.000So the drive to breathe actually does not come from a lack of oxygen.
01:31:15.000There's CO2 chemoreceptors on the ventral surface of your medulla, in your brainstem, that sense CO2. And when they sense CO2, that's your urge to breathe.
01:32:00.000So retaining some CO2, if you do it through training, can actually enhance the vasodilation effect and can maybe reverse even and hyperoxygenate systems in your body.
01:32:12.000So that's the theory, and there's quite a few studies behind it.
01:32:16.000I really have to delve into the studies, but the Wim Hof method is one method.
01:35:35.000Well, 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 they're all off of PubMed.
01:35:48.000And I started looking through them and then double checking on PubMed and realizing there's a lot of science behind this.
01:35:54.000And actually NASA was interested in algae research.
01:35:56.000And making capsules because it's super high in protein, has all these phytonutrients, and you can figure out a way to grow it in space and stuff.
01:36:07.000Things 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.
01:36:15.000But then eventually your palate changes over time and you don't crave those foods anymore.
01:36:47.000Chris Bell was eating some on his Instagram.
01:36:49.000So the institute that I'm associated with, the Institute for Human and Machine Cognition, IHMC, it's run by the directors, Ken Ford.
01:36:56.000He 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 keto ice cream recipe, which is using MCT and like a pinch of stevia.
01:37:13.000And when you eat the ice cream, I mean, it just blows your mind that...
01:37:16.000This is ice cream that you could eat every day, a big bowl, and stay on a ketogenic diet.
01:37:34.000The last product I got was the Keto Brownie.
01:37:37.000So if you like Google Keto Brownie, it'll come up.
01:37:40.000And, you know, I gave it to my wife and she was like, yeah, that's pretty good.
01:37:44.000But it had like a shell in it, which kind of got caught on her teeth or whatever.
01:37:50.000And she loved the taste, but it was a little bit, I think because she's so picky, it was like, oh, I liked it, but it just had a shell in it, or whatever.
01:37:57.000But 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.
01:38:06.000I 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 allows you to adhere to a ketogenic diet.
01:38:54.000Yeah, he has a number of recipes because the CEO there, Ken Ford, I mean he's...
01:39:00.000A huge fan of the ketogenic diet is 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 into government agencies and helping them acknowledge that this is a very viable form of Way to fuel the astronaut or fuel the special ops guy.
01:39:24.000So he's been kind of instrumental in that regard.
01:39:26.000And he has, you know, hired a chef that cooks ketogenic and in a gourmet fashion, a James Beard award winning chef, which I didn't even know what that was until I looked it up and I was like, well, these are very high level chefs that are specifically in his expertise, at least at the Institute,
01:39:42.000is to create these ketogenic recipes that are like ultra gourmet and amazing to eat.
01:39:54.000You know, I've tried a lot of things, but I would hesitate to recommend anything just because I have not been impressed enough to...
01:40:01.000There'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.
01:40:10.000It might be good for your gut microbiome in some ways, but you're feeding all the bugs in there.
01:40:51.000It'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.
01:41:00.000So if I just cut it out of my system completely for like six months or something like that, I probably...
01:42:16.000But he explained on the podcast that I did with him recently the difference between the pasta that we have today and the bread we have today and original heirloom wheat, which is less...
01:42:29.000It's lower yield per acre, and it has less complex glutens in it.
01:42:34.000And he's like, that is what, when people are talking about the difference between how your body tolerates certain gluten, whether it's gluten sensitivity or not, he's like, it's just a different feel.
01:42:45.000And I really noticed that when I was in Italy, when I would eat their pasta.
01:43:18.000Or 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.
01:43:38.000But when I did go to Italy and we travel around all over the place, my wife loves to travel.
01:43:44.000And we were in Naples and I ate maybe two or three pieces of pizza.
01:44:01.000The 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.
01:44:12.000So 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.
01:44:24.000I mean it really is essentially a fruit.
01:44:25.000And they're juicy and very delicate and very fragile as well.
01:45:07.000It'll stay that way based upon the pharmacokinetic properties of the supplement you're consuming.
01:45:15.000So, 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 BHB and MCT. 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,
01:45:33.000you have to consume, obviously, more exogenous ketones to get the benefits of ketones.
01:47:01.000He's a really good scientist and the leader in...
01:47:04.000In studying the effects of calorie restriction 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 or a source of energy, but they are also like a hormone.
01:47:24.000The pathway that he found at the study at Yale was the NLRP3 inflammasome.
01:47:30.000You don't have to I know that, but when that phlamasome is activated, it releases a lot of inflammatory cytokines in the body, which are...
01:47:39.000And that inflamasome is linked to a lot of age-related chronic diseases, too.
01:47:43.000So as we age, we have more systemic chronic inflammation.
01:48:15.000It was actually a diet that helped him formulate with exogenous ketones.
01:48:20.000After 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.
01:48:35.000There's a pretty intense, you know, interest in the signaling properties of ketones in pharmaceutical companies, especially histone deacetylase inhibitors.
01:48:43.000So beta hydroxybutyrate was the ketone you measure from your blood.
01:48:48.000Functions as what we call this HDAC inhibitor, which affects genes.
01:48:52.000So you're actually turning on genes that are neuroprotective, that are cellular protective, that are linked to longevity pathways.
01:49:00.000So think about the rewards of developing a drug that did the same thing.
01:49:05.000You can't patent beta-hydroxybutyrate in different forms.
01:49:09.000It just shows you whenever something's good, someone comes along and tries to fuck with it.
01:49:14.000Yeah, 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 longevity.
01:49:25.000Sure, but wouldn't that just be better suited for the diet?
01:49:55.000If they're together, they're racemic, and the D-form is kind of what your body makes, but it can also convert it to the L in certain tissues, and it can get really complicated.
01:50:03.000The 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.
01:50:13.000Whereas the L-form probably sticks around more within the cell, and we know the L-form actually also functions in these signaling roles.
01:50:21.000So the L-form has anti-inflammatory effects.
01:50:24.000The L-form, you know, hits these signaling pathways.
01:50:27.000So the racemic mixtures that are in the salts may have extra benefits over just a pure D-form because the L-form can kind of hang around and stimulate all these pathways we know are beneficial before it gets broken down into fuel.
01:50:42.000So there might be some sort of a benefit for people even on a ketogenic diet taking exogenous ketones.
01:50:49.000And I think, you know, we work really closely with the Charlie Foundation and I think the ketogenic diet should never be replaced with exogenous ketones at this point because the science, the research is not there yet.
01:51:49.000The ketogenic diet does work remarkably well for some people as maybe a standalone therapy.
01:51:54.000For cancer and has anti-cancer effects, but as an adjuvant to the standard of care, it's remarkably effective.
01:51:59.000And they're working with, I think, with Orange County.
01:52:03.000Yeah, 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 cancer stick to and adhere to a ketogenic diet as part of a wellness program after they went through their cancer treatment.
01:52:22.000If 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 negative health consequences after that because the chemotherapy wipes out your immune system and can create additional mutations.
01:52:39.000So there's kind of like a fallout from the standard of care.
01:52:44.000And being on a ketogenic diet can be cellular protected, can help you in a neoadjuvant And after, you know, before standard of care and even after standard of care, help you recover and get your body back into like a detoxified state,
01:53:16.000So the idea is, and we wrote a grant with the Moffat Cancer Institute, which is like a tier one cancer research center.
01:53:24.000I mean, they essentially reached out to us and say there's significant interest in this from the National Cancer Institute and National Cancer Institute.
01:53:50.000So the ketogenic diet, we know, limits glucose availability to the tumor, which requires the glucose for growth and proliferation.
01:53:59.000It decreases insulin, I talked about, and insulin signaling drives cancer growth, and it also elevates ketones.
01:54:05.000Ketones may have an anti-cancer effect and 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,
01:54:23.000So it enhances the standard of care and helps them, actually protects them from The healthy cells from the radiation damage from the standard.
01:54:32.000It sensitizes the tumor to radiation and kills off more tumor and it protects your healthy cells.
01:54:37.000So my colleague Adrian Sheck 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,
01:54:53.000I think in some cases where the standard of care has failed for glioblastoma or advanced metastatic cancer, I think the ketogenic diet can kind of be a base therapy for a more comprehensive metabolic-based program.
01:55:08.000And we wrote an article called The Press Pulse, where the ketogenic diet and maybe something like metformin, And other drugs can be used to weaken the cancer and limit its fuel source, and then you can kind of come in with maybe more aggressive ways,
01:55:26.000like hyperbaric oxygen therapy, which can reverse tumor hypoxia, or various low-dose chemo regimens.
01:55:33.000So you weaken the cancer, 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.
01:55:50.000And you do it in a more gradual way instead of going in there with surgery, radiation, and chemo, which is kind of like slash and burn, and it leaves the patient.
01:55:57.000The patient coming out of that therapy is much, much weaker than when they came in.
01:56:02.000So 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.
01:56:12.000That's possible from a theoretical standpoint with various...
01:56:15.000Research being done in animal models and what we know about nutrition and physiology, that can be done.
01:56:21.000It's just going to take some time to do it.
01:56:23.000It's just so interesting when you talk about the shift of information.
01:56:26.000I mean, when you were in college being fat-phobic, you know, to now being like one of the premier guys that's out here preaching the benefits of the ketogenic diet and seeing, you know, this, I mean, up until really recently, cancer research always depended upon these, you know,
01:56:42.000chemotherapy and radiation and All these different standards that everyone's been having success with, but the idea that you could actually make a person healthier through the ketogenic diet and hyperbaric chambers and things along those lines.
01:57:17.000Various conferences over the years and talk to these physicians and these patients would make remarkable recoveries, you know, even after they have the therapy.
01:57:24.000And it seemed like something else was going, kind of going on here.
01:57:27.000And, 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 where we, we build a hyperbaric chamber, and then we buy an off the shelf microscope and install it inside the chamber.
01:57:43.000And then We close it up and then we pressurize it to simulate what a dive would be while we're looking at the mitochondria and even the cells.
01:57:51.000And I did that with like healthy cells and neurons and we did it with a glioblastoma cell line and we noticed that the cells were exploding with high levels of oxygen.
01:58:00.000I 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.
01:58:07.000And they reported, one of them was Thomas Seyfried in Boston College, and he was a neurogenetics professor at Yale University and then had moved to Boston to expand a ketogenic diet program for cancer.
01:58:21.000And 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 produce proportionally more And then we did some work with ketones and saw that ketones were stopping the growth of cancer,
01:59:10.000But now we have, if we go to clinicaltrials.gov and you just look up ketogenic diet, you see more than a dozen studies.
01:59:17.000You know, so when I got into this, there was no studies.
01:59:20.000So now there's been an interest in even maybe people like jumping on the bandwagon of You know, if they have a particular drug, will the ketogenic diet enhance it?
01:59:29.000Or let's see if it enhances the standard of care.
01:59:32.000Or 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.
02:00:23.000I'm sure your colleagues have a lot to do with it, but as far as the impact of the reach of something, a podcast...
02:00:28.000The impact that a podcast has in terms of the amount of people that are going to Google something is probably many, many magnitudes greater than anything anybody is doing from a professor or some fellow scientist.
02:00:46.000I almost feel like there's guys, like the guy that got me into this was Dr. Jung Rho, and he was at Barrow Neurological Institute.
02:00:53.000He mentored my colleague, Adrian Sheck, into looking at ketones for glioblastoma.
02:01:00.000He runs the Pediatric Center in Calgary right now.
02:01:03.000But Dr. Eric Kossoff from Johns Hopkins was a big help to me.
02:01:09.000A number of people, I feel like they should have this platform, but they're so busy they don't do podcasts.
02:01:13.000But I realized early on it was really important to get the message out because it does no good if you're not hitting a big target.
02:01:20.000And what I focused on was not just one application, but, I mean, we do everything from wound healing to these genetic diseases to cancer to various seizure disorders.
02:01:31.000So I realized this was a lot bigger than just pediatric epilepsy.
02:01:37.000It sounds like it's the only way you should eat.
02:01:39.000I mean, I don't tell everybody they should eat ketogenic, but I definitely feel that they should at least go into ketosis a couple times a year, if not for just longevity effects, for anti-inflammatory effects.
02:01:52.000When things pop up and we're under stress, like I had an email yesterday, a person had severe shingles or severe outbreaks of even the Like fever blisters or something like that or cold sores.
02:02:08.000And if they just fast and do the ketogenic diet, it suppresses that.
02:02:13.000Since they've been on the ketogenic diet, they had profound suppression of some viral disorders that when there's viral shedding and you're affected by the virus, it causes profound suppression.
02:02:31.000So it kind of starts with a headache, and then it will kind of lead to itchiness or whatever associated with shingles.
02:02:37.000But they described it very elegantly in an email, and it was very clear before and after, since they've been doing the QGNK diet, it had a profound effect, even more so than the drugs, antiviral drugs that they're taking.
02:02:49.000Even something like HIV, which contributes to neuroinflammation and even different types of cancers like Kaposi's sarcoma, I think.
02:03:01.000Being in a state of nutritional ketosis could probably offer a lot of benefits to HIV patients that really struggle with some symptoms that are associated with inflammation and arthritis.
02:04:15.000Pretty 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, which has normal blood flow.
02:04:26.000And there's like a chunk of tissue kind of taken out.
02:04:28.000And then we look to see how fast that wound closes up.
02:05:14.000Is often the wound tissue is deficient in ATP, the energy source, because the blood can't get to it, right?
02:05:21.000So the ketones can restore like 90% of it has 90% less ATP in some cases with ischemic wounds.
02:05:28.000The 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.
02:05:37.000And not only does it restore the energy to the wound healing, which can allow cells to replicate and heal up the wound faster, but I talked about the anti-inflammatory effects.
02:05:48.000So persistent chronic inflammation can prevent the wound from healing up, and by suppressing some of the inflammatory pathways, that can kind of open the gate on the activity of various growth factors and healing processes that can heal the wound up.
02:06:03.000And it seems to be, you know, pretty profound in the age but also happens in the young.
02:06:08.000Now this is just taking exogenous ketones with a standard chow from rodents?
02:06:14.000So we didn't want to kind of, you know, messy up the data in any way.
02:06:19.000We actually should have done, if we had the funding, we could have done a ketogenic diet plus ketone supplementation.
02:06:25.000And you think that would be even better?
02:06:26.000Yeah, I definitely think it would because the ketogenic diet alone suppresses some of these inflammatory components that is associated with impaired wound healing, especially impaired wound healing Oh,
02:06:55.000And we did, to answer that question to 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% increase in blood flow to the wound when we induced acute ketosis.
02:07:25.000That seems like that would be the move for someone who's recovering from some sort of a surgery or something like that, hyperbaric chamber, combined with ketosis, ketogenic supplements.
02:07:35.000And for the VA, my collaborator on this project, Dr. Lisa Gould, at one time she was the...
02:07:42.000She was the president of the Wound Healing Society.
02:07:45.000She was like, this is really remarkable.
02:07:48.000To have someone of her stature, she's an MD, PhD, really comment that this profound effect on wound healing really motivated us to follow up on this.
02:07:59.000But we have not gotten funding after this, so we really need to...
02:08:03.000Keep working because we need to follow up on this study and get this as a legitimate wound.
02:08:08.000A lot of people are trying to enhance the wound healing process by putting things on the wound.
02:08:13.000But where wound healing is enhanced, if you alter and optimize your metabolic physiology, that promotes substrate and oxygenation to the wound.
02:08:29.000Adenosine is a pretty profound vasodilator.
02:08:31.000So you have a vasodilation that's improving blood flow to the area where there's not only glucose in there, but there's ketones.
02:08:39.000And the ketones help restore the energy in that wound that is sufficiently depressed from lack of blood flow.
02:08:45.000And it's promoting or reducing a lot of the inflammatory things that preventing it from healing in the first place.
02:08:52.000So, 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.
02:08:59.000So 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.
02:09:06.000We have a lot of projects, you know, we're trying to process in parallel right now.
02:09:11.000But, yeah, I need another student to, because that may have been, you know, that and, you Some 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 never would have expected.
02:09:49.000I don't know if you could draw a direct correlation to that.
02:09:52.000But obviously, if you have improved blood flow, that's getting nutrition to the wound.
02:09:58.000And we know that that blood has ketones in it, which have anti-inflammatory effects and things like...
02:10:04.000You know, it stimulates the HDAC, HDAC 1 and 2, which stimulates superoxide dismutase and other antioxidant enzymes, which are often dysregulated, you know, at the wound site.
02:10:15.000So it's doing a lot of, not only just restoring oxygenation and blood flow, but it's having, like, drug-like effects.
02:10:22.000These metabolites are really, like, signaling molecules.
02:10:25.000If we're in a state of starvation ketosis, the ketones would be telling the brain to do certain things and altering different neuropharmacological pathways that should be altering our behavior.
02:10:39.000The person that is deprived of food and becomes tired from hypoglycemia is the person that's going to die.
02:10:46.000So the people that survived in the absence of food availability were the ones that became more lucid and clear and were able to Go and forage or hunt down the animal and kill it and eat it.
02:11:04.000I 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, a deli on every corner here,
02:11:20.000we've largely silenced that genetic program that becomes activated upon food deprivation that can stimulate a host of beneficial things from extension of longevity to autophagy.
02:11:31.000And I know Rhonda Patrick, you know, I'm a big fan of her.
02:12:16.000It's one of the things to go back to the hunting thing.
02:12:19.000My 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.
02:12:28.000And one of the things he does, he does these backcountry hunting trips solo, and he purposely brings too little food.
02:12:38.000And one of the things that he's found over his many years is that when he's actually hungry, he is more tuned in, and he does a better job of understanding what's going on.
02:12:49.000The first time I actually started experimenting with fasting or even a calorie-restricted ketogenic diet, I took a walk around my neighborhood at the time, and it's like my whole nostrils opened up.
02:13:03.000I was more lucid in ways I had not been before.
02:13:06.000I didn't 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.
02:13:16.000So I probably couldn't do, you know, it was just at seven day point after no calories, I was starting to feel.
02:13:50.000Uh, I think I lost eight to nine pounds.
02:13:54.000And then within a week or two, it all came back again.
02:13:58.000You know, a lot of it's, you're holding glycogen and you lose glycogen.
02:14:01.000But, uh, in regards to, you know, at the time, uh, My deadlift strength was maybe 8 or 10 reps with 565. I was able to do 10 easy reps with 5 plates on each side, which is about 500. Typically,
02:14:22.000I listened to Dorian Yates' podcast, and I was a huge follower of Dorian Yates in 1994. I was eating four to six meals a day with shakes in between.
02:14:44.000I was so obsessed with getting bigger and stronger.
02:14:47.000And so for me to fast seven days and to be out of my comfort zone, that was a big step for me.
02:14:53.000So I kind of just did it to mentally...
02:14:56.000Liberate 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 40 days and looking at you know all the parameters on that and I was like it's not gonna 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 I was just kind of floating around.
02:15:36.000A 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 was able to put thoughts together, and I wrote a whole lot of research proposals, which later became funded.
02:15:50.000Of the proposals I really worked on, I probably got over a million dollars of funding.
02:15:54.000During that time, I really intensely worked on various proposals because I just transitioned to a tenure-track position.
02:16:01.000So 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...
02:16:09.000Kind of resources to get into that state of mind.
02:16:12.000That seems so counterintuitive that you have more mental resources with less calories.
02:16:22.000But that fuel, that fat was becoming ketones and that my brain had switched over.
02:16:27.000I was doing low carb but not really full keto at the time.
02:16:31.000But it really, it like quieted my brain in a way that I was able to...
02:16:38.000Maybe I have mild ADHD because I like to do so many different things, but it quieted my mind and I was able to wake up.
02:16:45.000Every morning I was waking up a lot earlier than normal, like 4.35, and I typically sleep until like 7. But I was able to wake up and just focus and get a ton of work done the first three or four hours.
02:16:57.000And then I would go into work actually and just meet with my students or teach or do whatever I had to do.
02:17:01.000But I just remember getting a ton of work done.
02:17:23.000I got down to like 25 at one point because I was experimenting with a couple different things and my ketones were really high.
02:17:30.000My ketones were like double what my glucose was at a couple time points during that.
02:17:35.000So 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 get your body into that, what we call the metabolic zone,
02:17:51.000where the level of ketones are higher than the level of glucose, that puts tremendous metabolic stress on cancer cells or pre-cancer cells that have a huge appetite for glucose.
02:19:36.000Not 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.
02:19:49.000I 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.
02:20:00.000I mean, you have like this crazy extra skin, right?
02:20:03.000Well, this guy, somehow or another, through this 380-plus days of fasting, his body shrank accordingly.
02:20:14.000Actually, Travis Christofferson and I wrote a blog article and it was part one, two, and three, the history of the ketogenic diet, part one, two, and three, and it's on Rob Wolf's website.
02:20:25.000So if you just Google the history of the ketogenic diet and land on Rob's website, you'll have, I think we talk about the story in there.
02:22:07.000At the time, they're warming up to it just because the data, they can't turn their back on the data because data is data.
02:22:14.000So there's a massive amount of data emerging that this is grossly underutilized and should be really the standard of care, even the frontline therapy.
02:22:23.000Like, we all kind of realize that, but neurologists would have to have, you know, a sidekick registered dietitian or whatever.
02:22:30.000But 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.
02:22:39.000And I talked about, you know, towards the end, I was like, well, I follow the ketogenic diet myself.
02:23:42.000They need to measure their ketones to really...
02:23:44.000So the ketogenic diet, you're in ketosis by virtue, by the definition that your blood ketones are elevated above 0.5 millimolar.
02:23:53.000And typically most people, that's pretty hard to achieve.
02:23:56.000If you're up to one millimolar, which is like mild ketosis...
02:24:00.000You take 100 people out of the population that eat the standard American diet, maybe one, maybe two people will achieve that if they go all day without eating or something.
02:24:08.000It really takes a while to achieve it.
02:24:10.000So you have to be doing something pretty radical to achieve that blood measurement of a state of ketosis.
02:24:42.000Then again, some athletes that contact me, their output is really high, so they're actually giving five or six hours of output a day, and they're eating two or three chocolate bars, and they're getting 250 grams of carbs a day, some of them, and they're maintaining a mild state of ketosis,
02:24:59.000especially post-exercise ketosis, even with...
02:25:03.000Drinking something like the UCAN starch, like a slow burning, like a slow carb, like Tim Ferriss advocates.
02:25:26.000And they went from 1,000 grams of carbs a day to 250, and they're performing better.
02:25:32.000So when you're talking about 50 grams of carbs for the standard average person, this is not applicable for an MMA fighter who's doing three a days.
02:25:39.000I think you could, especially the older guys.
02:25:42.000Like older guys, I think you could readily adapt them.
02:25:45.000Like I said, though, I think that adaptation should probably occur during training in the off-season and give themselves a buffer zone of three months.
02:25:53.000And 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.
02:26:05.000If you actually hit the macros that are calculated, your body will go into ketosis.
02:26:10.000I've never seen – there's very few people that you can't get into ketosis, especially if you use things like MCT and really – Adjust the macros.
02:26:18.000And you could also do ketogenic 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 just eat within a six-hour window.
02:26:41.000You know, a pretty good chunk of the time fasting.
02:26:45.000And 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.
02:26:56.000So you feel like there's more of a benefit?
02:27:10.000Because there's something about a couple hours extra where if I fast for 14 hours but then go...
02:27:20.000My ketones really start to go up from 14 to 18 hours.
02:27:24.000And then I can actually stay in ketosis if I eat ketogenic during that six hours of eating.
02:27:30.000If I pay attention to eating really low carb, I can eat and before I go to bed, test my ketones and bam, I'm hitting like 2.2 or something.
02:27:39.000So I continue to get the benefits of having ketones.
02:27:43.000But when it comes to, like, things like Rhonda talks about, like, autophagy, I think you can even get more benefits with an 18-hour fast, and you do that.
02:27:51.000And you don't have to do it every day.
02:27:53.000I 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.
02:27:58.000Like, if you do that over the course of a year, and that's not hard to do, right?
02:28:02.000If you could just convince people, hey, take the breads and pastas out and just put in more vegetables and just do intermittent fasting, You know, every Tuesday and Thursday.
02:28:13.000And if they do blood work after like three months, they're going to see a profound effect.
02:28:31.000Some of them were being showcased at the conference I was at, the Low Carb USA. The one that I have the most experience with is a product called Ketonix.
02:28:42.000And now they have a Bluetooth device out where you can blow into it and it reports to your phone and it shows you the parts per million of acetone in there.
02:28:52.000And acetone, so you make beta-hydroxybutyrate and acetoacetate as the two primary ketone bodies that are used for fuel, and also they have signaling properties.
02:29:01.000And acetoacetate can break down spontaneously decarboxylates to something called acetone, which you know is nail polish remover, right?
02:29:10.000So acetone actually has some really interesting...
02:30:18.000So they need to work out some of the bugs.
02:30:20.000And if you just look up breath acetone meters, there's probably about five on the market now.
02:30:26.000And the one that I have experience with is called ketonics.
02:30:30.000And if your acetone is high and you're not taking ketones supplements, you are cranking your fat metabolism.
02:30:36.000So you are really mobilizing fat and burning fat for energy.
02:30:40.000So it's a pretty valid indicator of burning fat for energy.
02:30:44.000So it's pretty good, but blood is the best.
02:30:45.000Blood's the gold standard, probably will always be.
02:30:48.000There's technologies emerging out now, at least, you know, small companies that are essentially, you put like a Band-Aid-like thing on your skin, and it's measuring glucose, it's measuring...
02:31:01.000You know, potentially beta-hydroxybutyrate, acetoacetate, and things like lactate.
02:31:06.000So you can look at your smartphone and see your glucose levels, your ketones, your lactate, and maybe some potentially other things.
02:31:13.000You could adjust your diet or drink a supplement to optimize you into a range you know maximizes your strength, maximizes your performance, or It maximizes your brain protection in the extreme environment like high-pressure oxygen for a Navy SEAL or something like that.
02:31:30.000That technology is in development now and will probably surface sometime in the next year or two.
02:31:39.000So think of a Dexcon, but instead of just glucose, it'll give you like a metabolomic profile of your blood and then you can augment it with your diet or with various supplements.
02:31:51.000Now, I got two other important questions.
02:31:57.000Have there been studies on reaction time, on all sorts of different variables that I think...
02:32:04.000I 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.
02:32:12.000It seems like things would fire better, for lack of a better word.
02:32:17.000Have there been studies on putting athletes through a variety of stress tests, reaction times, things along those lines?
02:33:34.000So there's lots of these considerations.
02:33:37.000There's lots of nuances in the way these things are formulated, in the way they're dosed, and in what type of application.
02:33:45.000Whether it's a pure strength application or what I call strength performance, like push-ups and chin-ups and things like that, or endurance or ultra-endurance or things like that.
02:33:58.000A 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 a ketogenic diet, is Jeff Volick from Ohio State University.
02:34:09.000His FASTER study clearly showed that athletes in a state of nutritional ketosis burn almost twice the amount of fat.
02:34:16.000And they maintain that, which is remarkable.
02:34:19.000I mean, there's some elegant studies to show fat oxidation rates are like double of what we even thought were achievable when guys follow a well-formulated ketogenic diet.
02:34:29.000And he recently did a study using a ketone salt product showing that there was an enhancement of 8% performance in work output with a cyclist.
02:34:51.000I didn't even know he had the data, actually.
02:34:53.000But, I mean, Jeff Volick 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.
02:35:03.000But these are studies that I'm really interested.
02:35:06.000I mean, we've done a lot of work in animal models, and now we're transitioning to human studies.
02:35:23.000And then we do some stuff with NASA on the NASA NEMO mission I was on.
02:35:27.000But we're really interested in moving a lot of these animal studies, which we've done.
02:35:33.000Now we're ready to move it into humans.
02:35:34.000But we still don't know what the optimal supplement is.
02:35:38.000And that's why Ketone Technologies, the 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.
02:35:51.000Now, another question I wanted to ask you was about migraines.
02:35:55.000Now, I would assume that people with headaches, headaches, you take non-steroidal anti-inflammatories.
02:36:01.000Someone with migraines, I mean, it would seem to me that that would be something that might be able to help mitigate.
02:36:08.000There's a student, I'm on her dissertation committee, Elena Gross, and she was a student, graduated from Oxford University and is now doing a clinical trial on ketone salts for migraines.
02:36:21.000So what motivated her to even pursue this as a PhD project is that she had crippling cluster migraine headaches.
02:36:29.000And she reached out to me and she actually presented at our Metabolic Therapeutics Conference.
02:36:37.000When it's happening to you personally, it motivates you in a way that you just immerse yourself in the research and you become a leading expert.
02:36:46.000And I think at the very young age that Elena is, and she's got a great background of education behind her, She's kind of the leading authority on nutritional ketosis for migraines, which is a growing field because a lot of people who had migraines that have contacted me and tried either the ketogenic diet or ketone supplementation have benefited from it when nothing else worked for them.
02:37:10.000It 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.
02:37:18.000And migraines, some of the data coming out, there's two sets of data that I've seen showing that migraines are linked to neuroinflammation.
02:37:29.000For example, if it's caused by a viral etiology, there's kind of swelling of the brain that leads to this kind Neuroinflammation and maybe the ketones are working through anti-inflammatory effects.
02:37:45.000Sometimes, like I said before, people get shingles or like a cold blister.
02:37:48.000They'll get like a headache throughout the day.
02:37:53.000And then there's other data to show that these migraines actually may be like a mini seizure.
02:37:58.000Like your brain is actually having a mini seizure that's not manifesting as a grand mal or tonic-clonic seizure or even an absence seizure.
02:38:48.000But a vegan diet is a little more challenging.
02:38:51.000The Charlie Foundation's dietician, Beth Zupac-Kania is her name.
02:38:56.000If you go to the Charlie Foundation website, I think you may be able to find some information or a pamphlet that describes how to put together a vegan ketogenic diet.
02:39:07.000So there's no way that you can hit the macronutrient ratios of We're good to go.
02:39:33.000It's really about maybe 60% fat, maybe 70% fat.
02:39:37.000And if you formulate the diet with coconut oil and MCT, that'll get your ketones up.
02:39:41.000And then if you consume one of these various products on the market that are essentially medical foods or drinks that you can drink, you can stay in nutritional ketosis.
02:41:19.000So I've observed that kind of anecdotally.
02:41:21.000I'm not sure if people have studied it.
02:41:23.000But if they just, for example, pull out the heavy cream and put in concentrated coconut milk, which I use for my heavy cream, which almost has the same cream-like consistency.
02:41:35.000And they take out the butter, maybe use more coconut oil, and just kind of switch out dairy for other things, their fat loss.
02:41:44.000And something about dairy in some people, not everybody, maybe causes them to retain water.
02:41:59.000There'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.
02:42:07.000And it was really the dairy that was contributing to some of the symptoms.
02:42:15.000She used a dairy-free ketogenic diet and had quote-unquote remission.
02:42:21.000In an autistic child, I first saw it presented in an abstract at a meeting, and I was like, wow, I was really blown away.
02:42:27.000And then about a year later, it came out, and it was in a pretty good journal as a peer-reviewed publication and a pretty well-documented case report of putting an autistic child into remission with a ketogenic diet.
02:42:40.000So we talk about emerging applications.
02:42:42.000I know my colleagues, Dr. Jung Rho and Dr. Susan Masino, are studying, and I mention this because I get so many emails about it, the ketogenic diet for autism.
02:42:52.000So I think it could be the next frontier.
02:42:53.000So many things are connected to inflammation.
02:42:55.000Yeah, yeah, yeah, it could be linked to inflammation.
02:42:58.000And if diet, you know, reduces inflammation, and if diet without dairy reduces inflammation further.
02:43:04.000And I know a lot of people are having some great effects with CBD oils, which again, reduce inflammation.
02:43:18.000Ketogenic diet plus CBD plus hyperbaric oxygen therapy plus ketone supplementation is something that I wanted to study in a brain tumor model.
02:43:28.000I've just gotten too many emails from parents that have kids with epilepsy and also people who have cancer who use CBD oil and they felt it was remarkably, you know, effective for them.
02:43:41.000I've talked with the CEO of Charlotte's Web.
02:44:05.000I 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 DEA and it became like so much red tape.
02:44:14.000But I'm going to revisit this project and probably reconnect with them.
02:44:30.000They use the whole plant as well, so it has all the cannabinoids.
02:44:34.000All the other cannabinoids, yeah, which I think is important.
02:44:37.000There's companies that have patented the specific cannabidiol on there, and I was going to use that, and there's a lot of DEA regulation even on that, I think.
02:44:47.000I'm going to revisit that project because I really think some of the things that we do with the Q-Jank Diet and supplementation will synergize, either be additive or synergistic with CBD. I love this idea of developing very powerful therapies that can Yeah,
02:45:53.000It's a little bit controversial in some ways, but Professor Thomas Saifert from Boston College, he wrote the book Cancer as a Metabolic Disease, and it's a fantastic book that elegantly documents the theory of cancer as a metabolic disease with a lot of hard data.
02:46:14.000And Travis Christofferson wrote a book called Tripping Over the Truth.
02:46:18.000And I wrote the foreword 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,
02:46:33.000most importantly, like what we can do about that in regards.
02:46:47.000But there's really good hard data behind, you know, this idea that cancer is not, maybe not necessarily all cancers are, you know, metabolic in origin, but a large majority of them appear to be.
02:46:59.000And I think the National Cancer Institute and other organizations are I think?
02:47:34.000So, the ketogenic diet is great, right?
02:47:36.000Because it hits many pathways in synergy.
02:47:39.000Like, one of my slides, you know, that I have in my conversation or in the presentations that I do is clearly shows, like, you can see all the boxes there.
02:47:51.000So, this is the ketogenic diet and these are all the different signaling pathways that it's working through.
02:47:57.000And I would say pharmaceutical companies may put billions of dollars just into one of those little boxes.
02:50:46.000Virta Health is basically tackling this project by curing, literally, quote unquote, reversing type 2 diabetes.
02:50:59.000I talked about people who are just embarking just on diet alone or the ketogenic diet.
02:51:05.000Avatar 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 algorithm in it that if you put in body composition changes on a weekly basis, it will tell you.
02:51:20.000You know, it will guide you step by step to your ultimate goal.
02:51:24.000And as far as I know, there's no other system like that.
02:51:27.000I mean, it's like, think of Weight Watchers, but like a version like 5.0 in Weight Watchers that actually works with you.
02:51:35.000So I think I'm going to have all these resources on ketonutrition.org.
02:51:39.000But 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.
02:51:52.000You 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.
02:52:05.000The Charlie Foundation, I really have to give, I acknowledge the Charlie Foundation in my TEDx 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.
02:52:29.000And there's a movie by Meryl Streep actually called First Do No Harm.
02:52:32.000So Meryl Streep did a movie on the ketogenic diet.
02:52:43.000And that movie really floored me because I had no idea that she did it actually.
02:52:48.000But it's that movie and meeting Jim Abrams and what the Charlie Foundation is doing through global...
02:52:59.000Education has really inspired me to pursue this path, all the people that they're helping.
02:53:03.000So it was so cool that I feel really blessed to be able to get into a field of research that is in line with what I was funded to do, which was enhance safety, performance, and resilience in the warfighter, but apply it to so many other things.
02:53:18.000And also apply it to myself, which has been kind of a journey in and of itself that I've really enjoyed.