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Part I of II: Ketogenic diet, Exogenous Ketones, and Exercise | AMA with Dom D’Agostino, Ph.D. on The Drive with Peter Attia #116

Key Takeaways

  • A ketogenic diet stimulates metabolic flexibility and functions similarly to muscle memory: the more you do it, the more your body will remember
  • The target of a restricted ketogenic diet is to achieve glucose-ketone index between 1 and 2
  • Biosense breathe acetone meter is the ketone measurement device of choice for Dom if he can’t measure blood


Bob Kaplan, Head of Research at Attia Medical, PC sits down with Dr. Dom D’Agostino for a special Ask Me Anything about all things ketogenic diet, exogenous ketones, and exercise. Note, this is only a preview. The full episode is only available to subscribers.

Dr. Dom D’Agostino (@DominicDAgosti2) is an academic researcher and expert on ketones and the ketogenic diet

Hosts: Peter Attia (@PeterAttiaMD) and Bob Kaplan Bob Kaplan (@bobkaplan)

Should I Try a Ketogenic Diet if I am Healthy and Can Digest Carbs?

  • A lot of ketogenesis and fat insulation for fuel is a function of insulin suppression
  • Intermittent ketosis is beneficial because it promotes metabolic flexibility and adaptation
  • Metabolism functions like muscle memory – the more you do it, the more your body will remember
  • Could implement similar methods used in fasting and implement 5-7 days of restricted ketogenic diet every month in combination with time-restricted feeding
    • Benefits: suppressed mTor, suppressed insulin, potentially stimulate autophagy
  • Target is to achieve glucose-ketone index between 1 and 2

Updates on Ketone Measurement Devices

  • Urine strips: Siemens Multistix
    • Cons: doesn’t quantify as well but good to quickly assess the to whether the state of ketosis has or hasn’t been achieved
  • Blood: Precision Xtra Blood Glucose & Ketone Monitoring System by Abbott Lab
  • Newer: Keto Mojo GKI with glucose-ketone index incorporated with an algorithm
    • Pros: strips are cheaper and easy to use
  • Breathe acetone meter: Biosense – exceptionally good in a fasted state
    • This is Dom’s choice if he can’t measure blood because acetone tells you about ketones you are burning
    • Cons: Gives a false positive if you have an alcoholic beverage; takes some time to calibrate

Recommended Reading for Modified Ketogenic Diet

Drive with Dr. Peter Attia : ,
Notes By Maryann

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