Dr. Dominic “Dom” D’Agostino is an assistant professor in the Department of Molecular Pharmacology and Physiology at the University of South Florida Morsani College of Medicine, and a senior research scientist at the Institute for Human and Machine Cognition (IHMC).
Why people frown so much on the ketogenic diet?
- Most people don’t like it because of a lack of education, even in the nutrition branch.
- The diet can help a lot with overcoming type II diabetes and obesity.
- It’s not really feasible for most because there is too much restriction.
- The diet contains a lot of saturated fat, which scares away most people.
- Doctors are not really educated on nutrition, because it doesn’t fit in their busy schedule.
- Nutrition is the pillar of good health, but we lack studies.
- The studies are hard to do and really expensive.
- Without research, there’s no evidence for doctors.
- 10% of the population could benefit from a ketogenic diet.
- 40% of the population could follow a modified ketogenic diet that keeps the ketones in the blood elevated.
What can you use the diet for?
- There are many applications for athletes.
- It’s not optimal for every endurance athlete.
- People over 40 would respond really well.
How much protein intake do you need?
- It takes1 to 1.5g per kg per day to stay in nutritional ketosis.
- Too much protein causes the ketones to decrease.
- If you have a fast metabolism (ectomorph), then you need 2g per kg per day.
- A typical ketogenic diet has a 4:1 ratio, so 4 parts fats, 1 part of protein and carbs.
- In a modified Atkins diet, the amount of protein is increased to 25 to 35%.
- Eric Kossoff is the leader of the modified diet for people with seizures.
Impact of ketogenic diet on type I diabetes
- Dom has a student in his class with type I diabetes.
- That student found that they were perks to being on the ketogenic diet:
- There was a lack of blood glucose fluctuation compared to a high carb diet.
- He was able to reduce his insulin level, while maintaining his weight.
- His insulin sensitivity increased, which protects against hypoglycaemia
- George Cahill induced ketogenic starvation to prove that patients became insensitive to hypoglycaemia.
- It eliminates some downsides of type I diabetes in the short and long-term.
- The Ketogenic Diet for Type 1 Diabetes is a study that supports this diet.
Ketogenic breath analyzer versus blood testing
- The Abbott Precision Xtra Glucose Monitor and the Freestyle Precision Neo Glucose Meter are the best choices on a budget.
- Ketonix Breath Ketone Test Monitor is useful for seizures, but needs more testing.
- The breath analyzer is non-invasive and perfect for kids.
- Looking at other health markers such as oxidative stress, oxygen toxicity and gut microbiome could be possible with a breath analyzer.
- Saliva ketone measurement system could be developed.
How ketosis is affected by high altitude?
- Ketosis increases the brain’s blood flow, so it could inverse the negative aspects of altitude.
- Altitude increases intracranial pressure, which is countered by ketosis.
- Ketones create energy more easily and efficiently.
- ATP hydrolysis also increases when ketones interact with our body.
- Some researches to support those changes:
- How Wasting Is Saving: Weight Loss at Altitude Might Result from an Evolutionary Adaptation.
- Peter Attia’s lecture at IHMC: An Advantaged Metabolic State: Human Performance, Resilience and Health
- Rebecca Rusch’s and Patrick Sweeney’s Climb of the Kilimanjaro for World Bicycle Relief without using any Acetazolamide (Diamox).
- Ketosis can increase performance results in altitude training.
Differences for females who want to try the ketosis diet
- It’s different for females, because they’re more reactive to low blood sugar level.
- It is recommended to slowly change your diet.
- You can also take exogenous ketones to reduce the glucose withdrawal effect.
- Don’t go into calorie restriction right away, it creates fainting, irritability and light-headiness.
- Don’t be afraid to eat fat and eat a surplus of calories.
- Women need at least 100g to 200g of fat a day.
- Overtraining can cause a suppression of hormones such as T3.
Can a female obtain a body fat index lower than 10%?
- A female’s normal physiological functions need around 8 to 12% of body fat.
- Dom doesn’t advice against going lower than 10% body fat, because it creates functional hypothalamic amenorrhea.
- A high level of fat is recommended to keep menstruations.
- Quest Nutrition MCT Powder is a good option for ketogenic athletes.
Can ketosis affect the microbiome?
- There are many variations of ketogenic diet.
- You can train your microbiome to adapt to a ketogenic diet.
- Some bacteria thrive on fat.
- Probiotics, prebiotics, fermented food, green vegetables, VLS3 supplement and cinnamon would be helpful.
- A diverse diet diversifies the bacteria.
- Here are some lectures on diet and microbiome:
- Alessio Fasano’s lecture at IHMC: The Gut Is Not Like Las Vegas: What Happens in the Gut Does Not Stay in the Gut
- The Gut’s Microbiome Changes Rapidly with Diet
Should you count your calories?
- Yes, if you don’t, you’ll gain weight.
- Some ketogenic foods are really rich: nuts, sour cream, etc.
- The volume of food is smaller, because fat is higher in calories.
- Fat controls hunger and you don’t get a “sugar crash”.
- Coconut milk broccoli soup before dinner can help with hunger.
Nutritional tricks to eat healthy at conventions and public events
- You can always find a salad and add butter or olive oil.
- Pack sardines and oysters in your bag.
- Macadamia nuts are also easy to find.
- Frequent travelers would benefit from this diet due to the high amount of energetic foods.
Do stimulants help achieve ketosis?
- 100mg of caffeine is perfect, but 200mg spikes the blood sugar level.
- Caffeine is an antioxidant, it immobilizes fatty acids, it’s an appetite suppressor and it can improve liver functions.
- Ephedrine hydrochloride could aid the release of fat in adipose cells and enhance the beta-oxidation of fat in the liver.
- 25mg of ephedrine hydrochloride helps the physiological effects.
- Don’t use amphetamines.
- Modafinil can be a good idea for people with sleeping disorders.
What about vegans and vegetarians?
- The Charlie Foundation for Ketogenic Therapies help vegetarians and vegans create their ketogenic diet with MCT oil.
- KetoDiet app
- The main problems are the protein and essential amino acids intake.
- Hemp, rice and peas can help.
- MRM Veggie Elite is a protein powder, which you can mix with avocado, MTC oil and coconut milk.
Should I be concerned if my LDL level increases?
- If it stays elevated for a few months, yes.
- It can be caused by infections or stress.
- If you aren’t restricting your calories, you’re more likely to have a high LDL level.
- The Ketogenic Diet: A Treatment for Children and Others with Epilepsy recommends a dairy based ketogenic diet, which can elevate LDL.
- The important thing is to keep your inflammation indicator, your HDL and triglycerides low.
- The ketogenic diet might not be for you.
Is it dangerous to use ketone salts?
- The products don’t just use sodium, but calcium, magnesium, potassium and sodium.
- Some are critical of the use of isomer in certain products.
- Metabolism of (R,S) -1,3-butanediol acetoacetate esters, potential parenteral and enteral nutrients in conscious pigs.
- No proof that the salts are dangerous or ineffective.
- Products available:
- Some think the R antimere is the effective isomer.
- 1,3 – butanediol acetoacetate protects the neurons from oxygen toxicity.
- No scientist or toxicologist would say that ketone salts used in reasonable amounts are dangerous.
What about fatty acid deficiency disorder?
- MADD stands for multiple acyl coa dehydrogenase deficiency, which causes acidosis, glycaemia, weakness, enlargement of the liver and heart.
- It can be effectively treated with racemic beta hydroxide salts.
- The dose of ketone salts doesn’t have a dangerous amount of sodium.
- Even ketone salts taken in high dosages maintain normal liver and kidney functions.
Does Dom really support Kegenix?
- The product contains an unusual high amount of carbs.
- Fat is a better vehicle than carbs.
- The molecules it contains elevate the ketones in a moderate way and they can create gastrointestinal discomfort.
- A blended mix is better.
Which products does he recommend?
- The Pruvit has a higher concentration of sodium and has a good taste.
- Kegenix has a bitter taste and is really strong.
- ForeverGreen is good.
- By using a blend of product, his friend was able to maintain the same level of physical activity with 5% to 8% less oxygen.
- He tests a lot of products.
- His go-to product is the Quest Nutrition MCT Powder.
- He eats WildPlanet sardines and Crown Prince Natural Smoked Oysters because they carry fewer toxins than tuna.
- Fire & Kettle bone broth.
- Civation Xtend Perform, which contains leucine, valine and other important amino acids.
- D3 vitamins: if you’re not in the sun often.
- Melatonin: a sleep hormone.
- Idebenone: a mitochondrial antioxidant.
- It can help in cases of Friedreich’s ataxia.
- Magnesium Citrate, Magnesium Chloride, Magnesium Glycinate to reduce muscle cramping.
- Gaba, which has a calming effect.
Are exogenous ketones only useful in a state of ketosis, or would they benefit anyone?
- If glucose is low in a cell, the body will use ketones for energy.
- The liver produces ketones, but doesn’t use them.
- Ketones can change the insulin’s response by two methods:
- By creating more receptors.
- By enhancing insulin sensitivity.
- Creates a decrease in hepatic glycogenolysis.
Can exogenous ketones combined with a low-carb diet, but not a ketogenic diet, still give some or all of the benefits of a strict ketogenic diet?
- Yes: they tried a single dose 30 minutes before a change in oxygen level, which gave 600% more neuroprotection for 10 minutes up to 1 hour.
- That experiment was done with an animal eating a high-carb diet with ketones supplements and fasting.
- A low-carb diet on it’s own has many benefits, including reducing metastatic cancer.
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