The Shocking Truth About The Keto Diet | Dom D'Agostino on Health Theory

everyone thanks for tuning in to this amazing episode of health theory sponsored by our friends at butcher box right in today's episode with DOM D'Agostino we discuss how the ketogenic diet can be used to treat Alzheimer's why ketones are a way better fuel source than glucose why the military is implementing keto for soldiers and how an insecure kid came to be known as the king of keto everybody welcome to health theory today's guest is dom D'Agostino PhD he is a neuroscientist and physiologist who's pretty much established himself as the king of keto he's also a researcher who's not only helped some of the world's most extraordinary athletes push their limits but he's also worked with cutting-edge organizations such as NASA and the US military to develop protocols to help ultra elite operators thrive in some of the most hostile conditions imaginable not one to just sit on the sidelines he himself has gone through some of these protocols including becoming a full-fledged Aquanaut by spending 10 full days underwater and on what I want to know is it'd be pretty easy for you at this point to just sit back do some research what drives you to do things like spending ten days underwater well I've always had an interest in environmental extremes and pushing the limits you know outside of academia outside of my kind of normal wheelhouse to go out in the field and experiment with the things that we're doing in the lab and on rats and mice and in cell culture see the real-world applications when it comes to implementation I was focused on how our brain controls our physiology so that was really the main focus of my PhD work I transitioned into studying why the brain actually has seizures so the mechanisms and sort of the molecular mechanisms why we have seizures under those conditions and as I moved along in that research it became more interesting to me to develop not only how to predict these seizures why they occur but to develop mitigation strategies and I discovered that the ketogenic diet was used when drugs fail and and I didn't know that I thought the ketogenic diet was a fad diet i thought it was i just associated it with atkins or diabetic ketoacidosis and then I discovered that ketone esters were being studied by DARPA for warfighter performance enhancement so and the military organization I was dealing with the office of Navy research did not like the ketogenic diet so it sent me down a path to develop things that could circumvent the restrictions of the diet to elevate blood ketones to confer that neuro protective effect you know under certain conditions where you can rapidly be in a state of ketosis and then do a dive or you know if you have traumatic brain injury or areas you know situations where you'd have seizures you could rapidly implement that and that I started my career path why didn't they like the diet to slow in terms of getting into ketosis is it's thought that military personnel at the time if you put them on a ketogenic diet it would decrease their performance their physical and maybe even cognitive performance and it was very hard to implement it like the military has MREs they have they already have the food covered and it all depended on the diet which was very hard to follow but a keto nester organs ketones supplementation could rapidly induce it within 30 minutes and then get your ketone levels up you need beta-hydroxybutyrate and a co acetate and maybe your listeners know about the ketogenic diet already to certain threshold and you need to do that very quickly before going into a mission so that's sort of the idea is to circumvent the dietary restriction but also have tight control so you're using a metabolite that your body already makes elevating it to some extent artificially although they're kind of bio identical to what we have and you're elevating it to levels that literally change the neuropharmacology of your brain like it's shifting brain energy metabolism it's shifting the glutamate to gaba ratio it's shifting you know various neurotransmitter systems to have an anticonvulsant effect and it's also giving your brain a source of energy that you could probably say is objectively superior to glucose so just fight that's gonna be a pretty controversial statement so why is it superior to glucose well I could use the example of the working perfused heart system where you literally have a beating heart outside of the body but you can give it a variety of fuels and you can look at hydraulic efficiency in the presence of glucose glucose and insulin ketones ketones and insulin and it was discovered that the hydraulic efficiency of the heart is enhanced when it's burning ketones relative to a fuel like glucose so there were some studies and they need to be reproduced in brain cells but studies in the heart suggested that it was a superior fuel and the heart and the brain in particular are very good utilizers of ketones and that really fascinated me that there was this alternative energy substrate that our body uses under periods of fasting but the only way to elevate that in the blood is with prolonged fasting or starvation or this weird you know ketogenic diet that was very strict and that was the place I was in a little over 10 years ago when you know I was interested in this as a neuro protective anti-seizure approach so how was I going to package it and pitch it to the government essentially to fund a program to look into this the science was you couldn't really argue with it from an anti-seizure point of view it was a very legitimate anti-seizure neuroprotective strategy but I just had the kind of conceive of a way to implement it in a practical way kind of out in the field and that began my sort of experimenting with the ketogenic diet and dozens of different types of you know ways to induce ketosis over time the way that you're talking about it is is actually helping me understand I feel like I have a pretty robust understanding at ketogenic so a hearing the way that you're talking about it I'd never heard the thing about the efficiency of the heart the ability to create more ATP per molecule of oxygen like that's really it's another fuel it's the fourth macronutrient if you will like I like to call it ketones do you have you know carbohydrates as a fuel protein of course for rebuilding and also some extent and fuel fat and then fat derived ketones but now we have ketones that are in and of itself you know it can be put you know given as a fuel and they are a metabolic they're a calorie containing substance that your body can use for energy we're just at the cusp of understanding the real world applications we have this technology and we have to figure out you know how to best use it what form is best what's bioavailable what the dosages would be what the applications are the tolerability even the safety of these things all need to be and that's why I'm kind of deep into that research and but we don't really have any agenda we just I just want to find out what works you know maybe other people have all their eggs in one basket for a particular ketone formulation but we're just trying to figure out you know we know they're infinite amount of ketone salts and even even different types of ketone esters that can be developed do is a news sort of circulating around at the time in Tampa that dr. Mary Newport was using MCT oil coconut oil and then later ketone esters to sort of manage the Alzheimer's system symptoms of her husband so I became interested in using ketogenic fats you know into the ketogenic diet and really went down the path of exploring and understanding exogenous ketones kids talk about that so yeah for sure Alzheimer's is becoming super terrifying some of them I know and care deeply about has their mother is struggling with Alzheimer's my grandmother in law passed away from complications due to Alzheimer's so why does it work how do you use it in somebody's life because they're gonna be super resistant to being compliant especially cuz they don't understand what's happening right so why you making me eat all this stuff I want to eat a Snickers bar the etiology of Alzheimer's is largely unknown and it's kind of controversial but I think that lifestyle factors particularly associated with the gut and also inflammation so neuro inflammation is almost like an attack on the brain it was has been described that Alzheimer's disease is type 3 diabetes and that the brain is insulin resistant and a hallmark characteristic of people with Alzheimer's disease is if you do a glucose PET scan they have hypo metabolism of the brain and ketones are a way to help restore brain energy metabolism in the face of impaired glucose utilization in the brain the only sort of the standard of care is the ketogenic diet because the ketones go around the glucose transporter to give energy to the mitochondria the ketones can go around pyruvate dehydrogenase complex to actually stimulate the metabolic pathways to make ATP so the two pathways are distinct enough that if one gets damaged you can still go the other way yeah there's glucose hypometabolism in meaning patient oh yeah another tab ilysm yeah in patients who have Alzheimer's disease that is known that you people don't argue that what what people argue is what led to the initiation of Alzheimer's disease so glucose hypometabolism may actually contribute to the production or processing of amyloid plaques and and ultimately Towel plaques that form in the brain over time the breakdown of these proteins are is a very energy dependent pathway or process right so if the brain is kind of starved of energy it can't undergo normal proteolytic pathways and enzymatic pathways that it normally does right so these the processing of these proteins tend to accumulate in the brain as we age our glucose metabolism in the brain goes down but ketone metabolism does not go down so glucose is having a problem getting in it's having a problem being metabolized through for glucose oxidation in the mitochondria where ketones readily cross membranes through different transporters mono carboxylic acid transporters and it's it's a fuel that can be more readily utilized by neurons and can sort of rescue in the way the metabolic activity and help to restore it to normal function and when you restore normal metabolic function you balance out sort of brain homeostasis is restored and the energy of the brain is also dependent upon making neurotransmitter systems so you tend to boost up all these neurotransmitter systems in addition to accelerating ATP production if you give a metabolic substrate like ketones which in brains of people who have Alzheimer's disease can use readily where its glucose they can't everyone with advanced Alzheimer's disease typically has glucose hypometabolism with that in mind I would say that people who do have advanced Alzheimer's disease probably only a third of them respond in a robust fashion to a metabolic intervention like nutritional ketosis and in the beginning I was thinking that this would sort of be the end-all be-all for for Alzheimer's disease that if you elevate ketones into the one to two to three millimeter range it's going to have a positive effect and it usually does but the the people who are like hyper responders to this are kind of going to be at most maybe twenty to thirty percent they're going to have an objective increase in scores like the mini-mental status tests or the clock tests or things like that and the others just probably won't respond even though glucose hypometabolism is a consequence of Alzheimer's disease not everyone will respond favorably and robustly to a metabolic intervention targets with your energy I hate that answer it's true and so that we have to deal with it but now I'm going to ask the really hard question yes okay so let's say that your mom tomorrow is diagnosed with Alzheimer's yeah what do you do on a day to day basis where do you put her in around-the-clock care what what are you feeding her if she's refusing it are we like you know we're tying down their arms and spoon feeding do we get an IV drip like what are we doing mm-hmm well you look at like where they're starting from and what are their food choices because there are some people who just simply won't change your diet I mean their diet is part of their quality of life what would you really do at that moment like for real well you know your mom's resistant yeah she's not gonna change your diet like what other options do we have like assumed the most I would have an intervention like I would you know bring the family together and say we know this about you we know that if you do this it will produce this outcome life it's past that point about being able to rationalize with them though well I I think implementation now is so much easier than it was five 10 years ago you know MCT oil exhaust ketone supplementation ketone esters so there are tools that are available that can be tried one at a time to ease that person into something and then you can you know you want to do an assessment of that person's sort of activity mental cognitive status before during and after various things are added to that protocol and and it's likely that's not it's going to be one thing that's even going to be helpful that it's going to be a combination of things used together and whether or not that moves the needle is going to be dependent on that patient so let's walk through some of those specific things we try I would start you know if they're willing to make the changes and they personally believe that this system is gonna work even if it doesn't work I think it would make it work it would make it work to some from like placebo effect I believe so yeah and if they want to implement it I would go towards a lower carbohydrate diet would you just lower carbs are you eliminating carbs like how low are we talking well you got to look at like what their diet is right now maybe the first step would just be elevating their ketones by any means possible that we know so from my perspective the easiest way to do it is to use something like an exogenous ketone formulation that can elevate your your ketone levels to one to two to three millimeter that amount of energy in the blood we'll be supplying the brain with a source of fuel and then you kind of can sit back and see objectively through tests if that has any effect I'm going to throw it a few things that I think is in that answer but I just want to really put a fine point on it so like you said we're gonna reduce carbohydrates I'm assuming were killing sugar the first step would be to just give the brain an alternative form of energy and reduce glucose and insulin spikes as much as possible because that can contribute to insulin resistance cut out sugar as much as possible or process carbohydrates if they're eating to 300 grams a day you want to bring that down to under a hundred grams a day of lower glycemic carbohydrates essentially vegetables and and go from there but if you abruptly take out glucose from the diet of someone who's you know drinking lots of sugary drinks and things like that that may initially cause even a greater deficit in cognitive function because their brain is being fuelled off glucose and may take a while to to induce the adaptations associated with transporting the ketones utilizing the ketones and switching your brain to an alternative form of energy evolutionarily speaking we are hard-wired to use that for fuel but there are adaptations that happen over time that optimize the brain and the body's ability to use that fuel efficiently so you have to kind of stick with it and elevate that fuel in the blood so it will ultimately get to the brain there's no argument about that and then allow that to happen for at least I say two months and then to firmly evaluate if this is a valid therapy all right so sticking on this line of sort of personal dietary protocols I'm obsessed with trying to live forever and I know that I'm fighting it a very uphill battle the test point yeah so if you just had to get me to 120 what does that idealize protocol for longevity look like a live as long as my well I'm I'm I'm gonna go out of my rate and say probably focus on relationships and your support network I would actually say yeah that would probably be one of the most important if you just okay that's now going back into like what you understand at the physiological level why is it so important what's happening your relationships will change the neuropharmacology of your brain it will change you know your only way that's neuroprotective I absolutely I mean just by decreasing your stress allowing yourself may be more creative down time instead of always having to be on or in a fight-or-flight mode you know living in a city so I think and some people may be living in the city what well we were just came from New York City maybe last week and and that if you were to monitor for example my heart rate variability or my stress levels that that would push my physiology to a state that is not conducive to living forever so I think everybody's everyone's a unique metabolic entity things are gonna work different for different people and some people thrive off that some people you know that releases their dopamine that drive that fast life but I think you need to find out what kind of works for you but most importantly let's surround yourself among people who are supporting you and I think from an evolutionary perspective that's going to be really important to have that because if you're if you don't have that support system you're going to probably in a be in a chronic state of stress and lowering stress from a psychological standpoint maybe as more important than it is from a physiological standpoint and we know psychologically we can impact our physiology that's what I studied you know in grad school the neural control of autonomic regulation if your sympathetic system is dominant and then you're going to be in trouble you know over time so I would focus on that and really nailing down nutrition exercise getting outdoors when a colleague of mine dr. Susan masse you know just got a fellowship at Harvard studying basically nature as a therapy right so actually going back to nature and living in nature to to basically restore and enhance our psychological health Mental Hygiene if you will so there are things that we can kind of control and then there's things outside of our control so genetics right I don't think we are necessarily destined to our genetic you know our genetics in general we know that for example beta-hydroxybutyrate has an epigenetic function by by functioning as something called a histone deacetylase inhibitor it can actually change the activation of genes that when kicked on can confer a benefit over time resilience against dress do you think there's anything useful that people should be testing for in their own genetics to understand like genomic eating and things like that is there a viable test yeah that's I'm not fully convinced at this point that that is something that could be leveraged right now you know do a genetic testing based on our 23andme data if that's what you're talking about to do a nutritional prescript prescription based on that data so my wife is for example a pretty good card burner so I know genetically I think she's kind of set up to metabolize utilize and be carbohydrate tolerant if you will and other people undoubtably from various geographical regions maybe the Native American population for example are very carbohydrate intolerant even if their calories are maintained their glycemic response or insulin response to a given amount of carbohydrates is much different than someone else who tolerates carbohydrates well so I think that's a really important consideration so people really do need to self experiment and study and not just keep eating a particular diet or a particular foods and feeling fatigue lethargy you know skin rashes things like that that's a red flag like I ate dairy and wheat for so long and had eczema for and that's an autoimmune that's your immune system being hyper activated by something that the body is perceiving as a foreign substance right and when I transitioned to phasing out any kind of grains or even a lot of dairy protein the eczema disappeared ten years ago when I got into this area and has never occurred and that's something I dealt with my entire life and had to go to the dermatologist for a long time it wasn't like a macro thing it wasn't a calorie deficit thing it was going on to the ketogenic diet eliminated some foods maybe by elevating beta-hydroxybutyrate it completely cured what I had was pretty severe eczema for a long time and it's never come back over a decade it's really interesting talk to me about the difference between macros and how you're sourcing your macros like well they're actually coming from why does that matter quantity will kind of trump quality to some extent so if you are running a calorie deficit of a high carbohydrate diet that has processed foods that calorie deficit will produce a lot of beneficial things you know for a lot of that people are looking forward like weight loss insulin sensitivity even a lowering of inflammation could be achieved simply by calorie restriction and this is you know there's different you know areas of thoughts on this but I'm of the opinion that nutritional ketosis but not even necessarily that just low carbohydrate diets allow one to have the discipline necessary to implement a dietary strategy that allows for you to induce and sustain a calorie deficit for one thing and even if you're not out of calorie deficit simply by not spiking glucose or spiking insulin and by elevating beta-hydroxybutyrate that you know that comes with a whole host of other advantages so including the anti-inflammatory effects including perhaps the autoimmune effects perhaps the gut microbiome if the ketogenic diet is well formulated with soluble probably most importantly insoluble fiber that can help restore gut health over time the foods that are part of the ketogenic diet some people will argue you know against GMOs or against you know grass-fed beef first corn-fed beef and if you look at the lipid composition of fatty meats that are from animals that were grass-fed there's a significant you know difference and for example pro-inflammatory fats or much less than grasping me so I do think that if you can budget it in to go with foods ketogenic strategy it's going to be you want to get fatty fish meat and poultry to go with grass-fed relative to maybe industrial farming practices I want to take a really hard right for a second okay he said that you grew up watching the movie commando a lot and then it actually had a big impact on the trajectory of your career why is that why commando first of all I can win why not commando so I think every kid and just gonna go back into that 12 13 year old mentality where you just want to be a super you want to be larger than life you know comic book character right when you're at that age 13 12 13 14 you that's when a lot of insecurities start to settle in and I was a pretty insecure kid I say I was so shy I was paranoid to read and read out loud in school like I would literally freeze and have like a sympathetic kind of overload and and later on even when I went to go pursue a PhD I would petrified of giving an oral defense of my PhD so it was actually influencing my ability to like sign the application to do a PhD so I think Arnold Schwarzenegger and just having muscles allowed me to get to a state where I had power in control when that led me down a path to sort of be like my brother who is very strong at the time and pretty dominant in football and just as a strength athlete and I wanted to be like him I wanted to be like Arnold so I immerse myself into lifting and I was a poor student at the time but to achieve gains and lifting you know I was reading muscle and fitness and all these magazines and I realized that to make progress in what I wanted to do which was just build big muscles I really had to learn biology and nutrition so towards the end of high school the last two years I challenged myself with an academic path that really forced me to learn and I think the discipline that I learned through weight training and reading books about Arnold I parlayed that into my academics and then my grades went from very poor or mediocre to pretty good as I went down the college path and I continued to train and that gave me a sense of kind of self-worth and you know the bigger I got the more control I had over my body and I realized that nutrition is an incredible tool not only to add muscle and strength but to change my energy levels and my physical state and my health that's really interesting I love that I want to go back really fast - one thing that you said about placebos and how effective they are do they work on you so knowing what you know are you able to get yourself into a certain mindset to say this is going to work and just really invest in that I think as a neuroscientist I would have to say yes even when I was visiting my parents I had some decaf coffee and I drank it and I'm like yeah I'm ready to work and I went back maybe and I realized that oh this is decaf decaf and I was all you know I'm saying I could only like start working on this thing I was not very sometimes there's a lot of obnoxious paperwork you get in academia where it's like okay I'll just have a big cup of coffee and I'll just bang through it through all this so it's like I woke up I was going to work I was like okay let me on my coffee first I was like okay I'm ready and I did it and that was total bow effect you know then I needed my coffee to complete that work and I had a decaf so it was actually pretty nice to know you know I did all that work on decaf I'm not immune to the placebo effect scientist my real question then is do you use it like if I were any time I go into something I say to myself this is going to work I'm gonna go all in because I know that most things don't work anyway or they certainly don't work as well as you want but if you're also fighting against your own mindset that it's really not gonna work so even though I'm hyper aware of somebody who's gone pretty deep into psychology in the brain I'm very aware of the placebo effect so in some way it shouldn't work on me but because I invest so much not in saying Oh placebos are a thing and it's gonna work I don't think about that I just think this is gonna work I totally believe this I'm going to give myself over to it I'm gonna do everything perfectly and it's going to have a massive result and I was just wondering if you do something similar if you think that kind of thing can boost something's efficacy I totally believe that even if we're if we're hesitant if a certain system will work if the ketogenic diet if the supplemental work or anything if some kind of technique will work or whatever you have to be in a hundred percent or it's not gonna work right so if you have a hesitation if you go up to a bar in your deadlifting 700 and you're you know you're thinking that I might not I might slip a disc I might not be able to pull this up then it's already done like it's not gonna happen so you need to go into every challenge in life with the understanding that you're already there it's already done like you just have to go through the motions you just have to execute so that should be sort of your mindset that you can use the placebo effect to your advantage so I feel like I validated a lot of the the benefits of nutritional ketosis on myself before they're validated in various animal model systems like the lowering of inflammation my joints feeling better eliminating certain things to get rid of like my eczema the calming effect I think the ketogenic diet that has my wife observed that when animals are in a state of ketosis they were easier to handle easier to to deal with so it was her idea why aren't we studying anxiety behavior so that was something that I wasn't really personally interested in studying but it was an observation sort of as a side effect that this is and I felt it in myself too and it's something that we need to study you know in the context of nutritional ketosis so that led to a number of some of some of our most important work I think is looking at the behavioral effects of being in ketosis which really wasn't a big personal interest of mine but is for my wife and then that has kind of shot us off in different directions of things to look at that's super interesting all right before I ask my last question tell these guys where they can find you online keto nutrition all one word RG and on there I have a blog I have a podcast on there and there's products on there we do not have our own products but there are products on there that I have tested that our legitimately products that can help you induce and sustain nutritional ketosis so that's on there but it's more an informational website so keto nutrition arg and yeah that's like a one-stop kind of shop website all right perfect my last question people are gonna change one thing to have the biggest positive impact on their health what one thing should they change on their health well man I have to go kind of out of my comfort zone and just say really relationships like get your relationships right you could devote yourself to work where you work yourself to death right but you have to allocate creative downtime you know with your significant other with your family to really get the most out of life because otherwise it just goes by in a flash and that creative downtime is probably the most important thing for your mental health mental hygiene which really can I can look at my sleep and my heart rate variability and see major changes in that and even my glucose levels come down when I removed myself from stress environments and get out into nature things so I think that's the most important thing it's not being in ketosis it's not intermittent fasting that's not that so it's it's really focusing on relationships and and giving back so being passionate about something where the outcome is that you are serving and giving information that can help other people that's kind of fulfilling oh the scientists really delving into mechanistic things but to work on something where we get a scientific effect and published a paper and I can do that something myself and then people can read that paper and implement it and get beneficial effects from it that's very rewarding and satisfying to me and I didn't really have that ten years ago so I don't know I probably went way beyond the question that you just asked but yeah being passionate about something you're doing and and having that something serve other people and I think is it's really important we are very aligned on that thank you so much for coming there there's a reason this man is known as the king of Quito but I'm telling you that he's so much bigger than that and what he's really earned a reputation for in the industry is never being dogmatic he's always trying to figure out what is true and never over investing in something and somebody like that that's always trying to push the frontiers by just really looking at what is the data showing us what are we learning where could we be wrong and being willing to admit that they're wrong and change and grow like I love that so much and somebody that can go and talk about something you know as intricate as what's going on inside the body and then flip it and start talking about that you should be connecting and that there's a whole world that opens up to you when you recognize fulfillment as something that should be important to you as well and being able to do all of that and to really try to live a true full human experience is pretty extraordinary and I think that that's why he's really become a voice for this new generation of scientists that are really pushing to push the envelope of what we know and what we understand and what the body is capable of and pushing the limits and boundaries but also recognizing that we're trying to give back and help people and touch lives and he spends so much time just doing that and we were talking before if this was all just a part of what he does is curriculum but he does it when his free time he had to take a vacation day to come here and do this and I think it's extraordinary that he's that moved to help and reach people that he does that and I think it's really really extraordinary I highly encourage you guys to dive in his world support him in any way that you can he changed my life this is about eight years ago when he and Peter Atia introduced me to fat which I had been fat phobic of until that moment I owe these guys such a debt of gratitude so please if there's anything that you can do a kind word retweet a tweet whatever it is that you can help in the longest journey that'd be absolutely extraordinary right if you guys haven't already be sure to subscribe and until next time my friends be legendary take care hey everyone I hope you loved that episode and I want to take a quick second to share about our amazing friends at butcher box butcher box delivers 100% grass-fed and grass-finished beef free-range organic chicken and heritage breed pork straight to your door every month when it comes to cooking it is super hard to find high quality meat you can actually trust and you guys know how important that is to me because of what Lisa's going through the microbiome and I'm telling you right now it matters where your food comes from it matters what your food ate it's crazy and I've really enjoyed butcher box not only for my burgers but for everything here at impact house because you can trust where it comes from and every box comes with at least 9 to 11 pounds of meat and that's enough for 24 individual size meals and they should for free everywhere nationwide except Alaska and why you guys just look too far away we have an amazing offer for everyone if you want to try butcher box you're gonna get $20 off your order by using the link in the description below so guys I'm telling you give butcher box a try they are amazing use the link in the description below enjoy and be legendary thank you guys so much for watching and being a part of this community if you haven't already be sure to subscribe you're gonna get weekly videos on building a growth mindset cultivating grit and unlocking your full potential

Channel: Tom Bilyeu

Views: 401,176

Rating: 4.7824163 out of 5

Keywords: Tom Bilyeu, Impact Theory, ImpactTheory, TomBilyeu, Inside Quest, InsideQuest, Tom Bilyou, Theory Impact, motivation, inspiration, keto diet, the keto diet, keto, keto diet exposed, truth about keto diet, ketosis, dom d'agostino, health theory, alzheimers, neuroscientist, ketogenic, diet

Id: hu1mF8_QGJE

Length: 37min 0sec (2220 seconds)

Published: Thu Oct 25 2018

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[u/Yakatonker]

Link to his personal website. https://www.ketonutrition.org/