Passion Struck with John R. Miles - Dr. Dominic D’Agostino on Ketogenic Diets, Ketosis, and Metabolic Health EP 182

Episode Date: August 30, 2022

Dr. Dominic ("Dom") D'Agostino is an expert on a wide range of topics related to ketogenic diets, ketosis, metabolic health, and how to thwart chronic conditions with diet and lifestyle. Dom is one of the world's leading experts on the ketogenic diet, studying its effects under the severe conditions of space and undersea. Additionally, Dr. D'Agostino has personally practiced the ketogenic diet for over a decade. In doing so, he brings substantial valuable personal experience along with his human and animal research. He also works with NASA and the Department of Defense, studying how the body performs in extreme environments. -► Get the full show notes: https://passionstruck.com/dr-dominic-dagostino-on-metabolic-health/  --► Prefer to watch this interview: https://youtu.be/CQvGSLIcPs4  --► Subscribe to My YouTube Channel Here: https://www.youtube.com/c/JohnRMiles --► Subscribe to the Passion Struck Podcast: https://podcasts.apple.com/us/podcast/passion-struck-with-john-r-miles/id1553279283    Thank you, Dry Farm Wines, For Your Support Dry Farm Wines Have No Chemical Additives for Aroma, Color, Flavor, or Texture Enhancement. Dry Farm Wines - The Only Natural Wine Club That Goes Above and Beyond Industry Standards. For Passion Struck listeners: Dry Farm Wines is offering an extra bottle in your first box for a penny (because it’s alcohol, it can’t be free). See all the details and collect your wine at https://www.dryfarmwines.com/passionstruck/  In this episode, Dominic D'Agostino and I Discuss How Dom developed his passion for studying metabolic therapies.   How extreme environments impact the human body. The science of ketosis and how to approach a ketogenic diet. Inflammation Biomarkers Why Fasting Boosts Immune System Benefits of Exogenous Ketones Ketone Biomarker For Burning Fat Using Ketones to Hack Biomarkers How ketosis can treat and prevent major diseases and chronic conditions How a Ketogenic diet reduces mid-life mortality Difference between ketogenic diets, ketone esters, and ketone supplements How they each work in supporting or maintaining ketosis  Dom addresses whether you can drink alcohol on a keto diet Where to Find Dr. Dominic D'Agostino * Website: https://ketonutrition.org/ * Instagram: https://www.instagram.com/dominic.dagostino.kt/  * Facebook: https://www.facebook.com/ketonutrition.org  * Twitter: https://twitter.com/DominicDAgosti2    -- John R. Miles is the CEO, and Founder of PASSION STRUCK®, the first of its kind company, focused on impacting real change by teaching people how to live Intentionally. He is on a mission to help people live a no-regrets life that exalts their victories and lets them know they matter in the world. For over two decades, he built his own career applying his research of passion struck leadership, first becoming a Fortune 50 CIO and then a multi-industry CEO. He is the executive producer and host of the top-ranked Passion Struck Podcast, selected as one of the Top 50 most inspirational podcasts in 2022. Learn more about John: https://johnrmiles.com/  ===== FOLLOW JOHN ON THE SOCIALS ===== * Twitter: https://twitter.com/Milesjohnr * Facebook: https://www.facebook.com/johnrmiles.c0m * Medium: https://medium.com/@JohnRMiles​ * Instagram: https://www.instagram.com/john_r_miles * LinkedIn: https://www.linkedin.com/in/milesjohn/ * Blog: https://johnrmiles.com/blog/ * Instagram: https://www.instagram.com/passion_struck_podcast * Gear: https://www.zazzle.com/store/passion_sruck_podcast  

Coming up next on the Passion Struck Podcast. The opportunity to work with astronauts is just unbelievable. They are just such amazing people. Obviously, they're selected for a reason and working with them on a variety of different science projects and engineering projects is just incredible. Basically, you're living underwater. If you live underwater for more than 24 hours, you become an aquanaut. There are, I think, about 60 astronaut aquanauts. So most astronauts will train underwater, and Nemo is part of that. Welcome to PassionStruck. Hi, I'm your host, John Armiles, and on the show, we decipher the secrets, tips, and guidance of the world's most inspiring people and turn their wisdom into practical advice for you and those around you.

Our mission is to help you unlock the power of intentionality so that you can become the best version of yourself. If you're new to the show, I offer advice and answer listener questions on Fridays. We have long-form interviews the rest of the week with guest-ranging from astronauts to authors, CEOs, creators, innovators, scientists, military leaders, visionaries, and athletes. Now, let's go out there and become PassionStruck. Hello everyone and welcome back to episode 182 of PassionStruck,

one of the most popular health and fitness podcasts in the world. And thank you to each and every one of you who come back weekly to listen and learn, had a live better, be better, and impact the world. And if you're new to the show, please go check out our YouTube channel at John Armiles where we have over 370 different videos, both long form content, like today's episode, as well as shorter video clips that we call mindset moments. Please go out there, check it out, and subscribe. In case you missed my episodes from last week, they included Alan Stein Jr., who's a sought-after keynote speaker and performance coach. He's also the author of the book's Razure Game and Sustain Your Game. We also head on

Rare Admiral Den El Barrett, who spent over 30 years in the United States Navy. She's the author of the new book, Rock the Boat, Embrace Change, Encourage Innovation, and Be a Successful Leader. My solo episode from last week were on the five techniques that you can employ to stop making excuses. And I also wanted to say thank you so much for your continued support of the show and all those five star ratings and reviews that you've given us that go such a long way in helping us improve the popularity of the

show and getting both Apple and Spotify to recommend it to their listeners. Now, let's talk about our guest today who for me is a very special one because we're going into one of my favorite topics, which is on ketosis and how a ketogenic diet can help your life in so many ways, from dealing with chronic diseases, getting your metabolism to flow better, to helping you with your overall wellness. So let's jump into it. Dr. Dominic Dagostino is a professor in the department of molecular pharmacology and physiology at the University of South Florida. He's also a research scientist at the Institute of Human and Machine

Cognition. His laboratory develops and tests metabolic strategies for neurological disorders, cancer, and for enhancing safety and resilience of military personnel who are operating in extreme environments. His research is supported by the Office of Navy Research, the Department of Defense, Private Organizations, and Foundations. And, we discuss how we developed his passion for studying metabolic therapies, how extreme environments impact the body, and how he has examined them through personal experience. We go into a deep dive, not only on the science of ketosis, but we also explore the keto diet and depth, including how ketosis can benefit the prevention and treatment of major chronic conditions, as well as how a keto diet reduces midlife mortality. We explore the key differences between ketogenic diets, ketone esters, as well as ketone supplements, and how each of those goes to support or maintain ketosis, as well as so much more.

Thank you for choosing PassionStruck and choosing me to be your host and guide on your journey to creating an intentional life now. Let that journey begin. I am so ecstatic to welcome Dominic Dagestino, to the PassionStruck podcast. Welcome, Dom. Thanks so much for having me, John. I appreciate being on.

I am a static that you're here as I said. And I wanted to ask, we all have moments that define us. Can you tell me about a moment that shaped you and how? Yeah, good question. I'll have to think about that. So there is a lot of defining moments that can change people in different ways, right? So I would describe myself as an extreme introvert going in high school. I think I was voted most quiet in all my high school. And in the yearbook for that for being the most quiet kid and even through college. I ended up doing some research in a lab and my mentor at the time asked me if I wanted to go pursue a PhD in that. And all I knew about a PhD was the PhD defense.

I know you had to make a public defense about that. And up to that point in time, I've never given any kind of public speaking or anything like that. So the big fear that I had was actually believe it or not. And I mean, I do a lot of talking now, I guess, was giving a formal dissertation defense. And that actually was like, I was scared to death. I was scared to death of public speaking. And but I said yes, because I was so passionate about science that I knew I had a pathological fear of speaking like in public and I think saying yes to that put me on a track Where I became not only a scientist, but I've done quite a lot of public outreach on science and later in my career But I think that was defining moment because I was saying yes to not only science and a scientific career

But coming out of my shell as an introvert and being able to disseminate the science in a way that's translatable to the public. So I think that was saying yes, was a big part of that and pursuing a career as a PhD scientist, neuroscientist. Well, I know a thing or two about being an introvert because I'm one myself.

And I remember just struggling with it for a long time because especially in the military and then the civilian corporate world extroverts are rewarded far more than those of us who are introverts. And it was really Susan Keynes' book about a decade ago, Quiet, that really opened up my eyes to what she's talking about a decade ago, Quiet, that really opened up my eyes to what she's talking about as me exactly. So getting a chance to have her on the podcast was truly an honor through her research

it helped me to understand much more about the positives of being an introvert. I wanted to jump to how I got to know about you, which is through a mutual friend of ours, Dr. Scott Schur, who I had on the show recently. And he informed me that you and your wife, like another mutual friend of ours, astronaut, Nicole Stott, are all aquanuts.

And I was hoping you could talk about Nemo, what it is and why it exists. Yeah, thank you. Thanks for asking. Nimo NASA loves acronyms. Clever, the clever acronym they have is for NASA's extreme environment mission operations. So N-E-E-M-O Nimo.

So NASA has 13 or 14 space analog missions. A space analog is a simulation that will simulate what life is like on Earth. And these NASA or space analogs help to train astronauts, vet out technologies, vet out procedures, and vet out people. Although NASA's Nemo is the only, really the only astronaut training analog. So the other analogs like Hira and HICs and there's a few others actually just have everyday people as part of them, whereas the Nemo is quite different.

It is really an extreme environment. So Nemo puts astronauts and occasionally scientists and I was honored and very grateful to be part of the Nemo Mission 22. My wife was on Nemo 23. You live underwater and with astronauts who are, it's part of their training for space. You live in an extreme environment at about two to three atmospheres of pressure in a dry habitat.

And then you go outside of that habitat to do different procedures, test different technologies, where you are also at three atmospheres or lower, you're, you're tethered to a line, but you go and work outside of the habitat on the bottom of the Atlantic. And they set it up. It's a NASA mission. So folks from NASA come at the site, there's NASA mission control. It's got communications. It's got a user's NASA playbook. It's all part of the integrated into it where the mission you have to train for it, it'd be selected for it,

and then train at advance at NASA, and you have to do a swim test. So basically, you're living underwater. If you live underwater for more than 24 hours, you become an aquanaut. There are, I think, about 60 astronaut aquanauts. So most astronauts will train underwater and Nemo is part of that. And you do a variety of different science projects. We've had about a half dozen different projects and some of the things that I was involved in is basically looking at how the microbiome changes

in this extreme environment, looking at my wife is a cognitive neuroscientist, so we look at stress, we look at, you know, do a general anxiety test, we measure cortisol, we measure blood parameters, we measure sleep changes, blood flow to the brain, and then NASA has a whole bunch of objectives and things that they want to test. So that gets incorporated into the timeline. And you are a crew, just like a crew would be on ISS. And you wake up every morning early and you get right to work. And it's just like, almost like being in a lab

with, you're pretty cascoded. So it's kind of a high stress extreme environment. But the opportunity to work with astronauts is just unbelievable. They are just such amazing people. Obviously, they're selected for a reason. And working with them on a variety of different science projects and engineering projects is just incredible in this environment.

So I can talk about different aspects of it. There's a variety of different experiments that we did on it. But it's really different experiments that we did on it. But it's really the experiments that we did is to understand physiologically and psychologically what happens when you put people together in a confined space. Physiologically, it's amazing how adaptable we can be living in what's called saturation. And a normal under recreational diving protocols, you never have to decompress. You go down and with it, you stay within decompression limits, and then you come up to the surface, you do a safety stop. But when you're in living in saturation,

you to come up to the surface, it are being under water for 10 days, involved 17 hours of decompression to get to the top. And my commander, Shell Lingren, who is the commander on ISS right now, actually, he went up on SpaceX Screw 4. He had tweeted, as we were going to decompress to come up to the top at the end of our mission, that it took him five hours to get from the space station back down to earth, but to get from Aquarius habitat back to the surface of earth, it was going to take 17 hours. So it actually takes longer to emerge out of the Aquarius habitat as where an email is conducted.

So it really is an extreme environment. And if something goes wrong in that environment and you need medical attention and things like that, then it becomes very logistically interesting to correct things that go wrong and habitat. So you have that element of danger. Yes, just as it would in space. Yes, absolutely. I didn't realize it took that long to come up to the surface because I understand this is at the NOAA facility that's off the Florida Keys. Yeah, the Aquarius habitat that's been out there and it's used for a variety of different projects

and Navy contracts it out sometimes. It's basically like a 30 foot RV, and you have six bunk beds, and you're down there, a crew of four, the Nemo crew consists of four, but you have two habitat technicians down there to ensure that all the systems are running properly. They actually run fairly complex decompression protocol

to bring you back up to the surface. So the habitat itself is at about three atmospheres, almost, and you can go in and out of the habitat, you can walk up to the steps and jump right into the water. So it's like if you had a cup, right, and you push the cup down into the water and that air is trapped, and then you pump air into the cup from the top,

and bubbles will come out from the bottom of the cup, but that cup basically is a little hyperbaric environment for that you can live in. So you are living and you have hyperbaric air, which is essentially 80% nitrogen. So your body saturated with nitrogen and you really need to do a fairly long decompression protocol to denitrogenate before you get to the top. And prior to denitrogenating in the protocol, you do an oxygen-prebreath, which is breathing essentially pure oxygen for an hour. And then overnight, you decompress. And a lot of the work that I have done for the Office of Navy Research is actually developing mitigation strategies to prevent oxygen toxicity seizures.

So this happens, for example, with Navy SEALs that use a closed circuit re-brither if they dive too deep, then the oxygen is stimulant and can be seizure. So we did an oxygen pre-brief protocol, which you do on the space station prior to doing an EVA. So, Dr. Mike Gernehart, who's also an astronaut, to help develop the protocol that NASA uses, which you get on a bike, and you breathe oxygen and sort of denitrogenate, and then you get in your spacesuit, and then prior to doing an EVA, the spacesuit is really only pressurized to about a quarter to a third of an atmosphere.

So it's a very low pressure environment. The bubbles want to come out of your blood, and this can create a problem known as decompression sickness and diving, we call it the bends, but the prebreed protocol and a lot of these protocols are to prevent the bends, which can be fatal if you get a bubble in your brain, for example, or in your heart or in your pulmonary system. Such an interesting study, and I'm going to come back to it after a couple of questions. But I wanted to ask, how did you develop your passion for studying how extreme environments impact the body? Yeah, it was kind of a slow progression during my training, my PhD, my advisor at the time, still now I believe, was into scuba diving. So I did a lot of my dive training in Dutch Springs in Pennsylvania, which is a landlocked state, but there's a quarry

out there known as Dutch Springs. It's still used as a Dive facility where I did quite a lot of dive training and worked my way up to be an advanced diver, rescue diver, Cape diver, or wreck diver, all that sort of thing. The more I started getting into scuba diving, I realized that there was a lot of questions relating to diving physiology that remained unanswered. And I did my postdoctoral fellowship near Wright Patterson Air Force space at Wright State School of Medicine, and I worked for, still collaborate with Dr. J. Dean, who created some unique chambers and technologies to understand oxygen toxicity, decompression sickness, high pressure nervous syndrome. So I became very interested in the neuroscience and the physiology of extreme environments,

most importantly, how we can understand these environments and create countermeasures and mitigation strategies that would allow us to live and work in the undersea environment and also the space environment. Yeah, it's some really interesting stuff. As I was doing research for this podcast, I understand the University of South Florida has a hyperbaric biomedical research laboratory, which is the only one of its kind. Can you talk about that and why it is so unique? The hyperbaric research started at Wright State, the School of Medicine, and Wright State's a bit of a small school.

It's got a lot of great things going for it, but moving the research to USF, College of Medicine, allowed us to expand the lab space and the program in hyperbaric research. And the hyperbaric biomedical research lab directed by Dr. J. Dean. And I came here, he was the director and now we're basically collaborators on a number of projects funded by O and R, Department of Defense, and other organizations like Divers Alert Network. Within the hyperbaric research facility,

we do not have human chambers. So what we have are a variety of chambers with unique technologies inside. Scanning, confocal microscopy, atomic force microscopy, electrophysiology, and we have a telemetry system where we can implant different sensors in rodent models. We can understand the physiology and the neuroscience associated with changing

the breathing gases from high pressure oxygen to high carbon dioxide, high nitrogen. And as we do the basic science research on everything from mitochondria to cells to brain tissue, and then moving up to animal models, we get a full understanding of the biological effects of these extreme environments. And that allows us to develop, test, and vet out mitigation strategies that would allow us to have resilience, and allow us to actually function in these extreme environments, it'll make it safer.

And I'm also very interested in developing metabolic-based compounds that can enhance physical function and cognitive function under extreme environments. And that could potentially have applications outside of these extreme environments. That can be used for things like Alzheimer's disease. A lot of the research that we did with Department of Defense funding and technologies,

it just happened that we studied some cancer cells and noticed that cancer cells die under high pressure oxygen, whereas the healthy cells would live. We developed ketogenic diets and also ketone supplements as a neuroprotective countermeasure against oxygen toxicity and observed that the neurons, the brain cells, actually function more efficiently when they're burning ketones as an energy source, and it actually prevents oxidative damage and makes the cells more resilient.

So we have moved that those cell experiments to animal models, and now we have studies at Duke, and we have clinical trial with ketogenic diets, ketone, exogenous ketones ketones, ketone supplements. So it's been a fascinating and very exciting thrilling journey to understand the problem develop a countermeasure in cells and then to move that into advancing that science and the human application has been super exciting for us. Yeah, it's fascinating to me. And the interview I did with Scott Sherr,

we talked about how today there are a handful of conditions that are coded and that the medical companies will pay for in the United States. But in Russia, in China, and in some other countries, they're over 70. And as he started to go through some of the things will pay for in the United States, but in Russia, in China, and in some other countries, they're over 70. And as he started to go through some of what hyperbaric therapy can do, such as helping people recover from the scars of radiation or chemotherapy, helping recover from traumatic brain injury, everything related to peak performance, it became amazing to me how

many things HBOT could potentially help people with. So it's very fascinating. I know what you're doing. Absolutely. Yeah, I like to actually just interject real fast. The office of maybe research was asking me to study the negative effects of high pressure oxygen or hyperbaric oxygen. Right? So when you go beyond the limitation for hyperbaric oxygen, right? So when you go beyond the limitation for hyperbaric oxygen therapy, which is about three atmospheres of oxygen. So we actually do our oxygen toxicity studies

at five atmospheres of oxygen, and that reliably produces a seizure in about 10 minutes, right? So in the process of studying oxygen toxicity, we observe the beneficial effects of oxygen, and especially for things like enhancing brain cell function, like stimulating brain energy metabolism, and also decreasing the proliferation of tumors. So one of the things that we have published on is actually the use of hyperbaric oxygen as a means to prevent the spread of metastatic cancer and in combination with a dietary therapy, a ketogenic diet. It is a viable approach. We think for cancer management.

So that's another area that we didn't expect to go down cancer research, but we're quite active in that area with hyperbaric. Well, it's an area that I'm really concerned about because I have a sister who at one point had stage four pancreatic cancer survived it. So she is already approaching many of these diets that we're going to talk about today, but I didn't realize that about HBOD as well. So it's definitely something when I see her here in a couple weeks, I'll talk to her about. Yeah. Well, I'm going to dive deeper into ketosis, and I have no idea how much people in the podcast audience might know about it. So I thought maybe the first thing to talk about is, the keto diet is changing how people think about healthy eating. Like all diet trends, keto is much more complex than it seems. Can you provide the basics of what keto is

and the basic diets that are associated with it? To be honest, when I was a post-doctoral fellow in researching anti-seizure neuroprotective strategies for military operations, I stumbled upon in searching anti-seizure strategies, I saw that the ketogenic diet was actually used when anti-epilepsy drugs failed. And that peaked my interest because I went through a dietetic program at Rutgers University. And we didn't really talk about the ketogenic diet, maybe brushed upon it for pediatric epilepsy.

But the ketogenic diet is really, the definition is a medical therapy that is a macronutrient, which means it has a certain percentage of protein and fat, primarily fat, with adequate protein, moderate protein, and then low carbohydrate. Very restricted to the point when you follow this diet and you do blood work, it looks like you're fasting, meaning that your insulin level is very low, your glucose lowers, your glucose response to a meal is almost non-existent.

I'm wearing a continuous glucose monitor on the back of my arm here. I ate a ketogenic meal for lunch and there was absolutely no effect on my glucose. It's a diet that is a medical therapy that is the only diet that we know of that is objectively defined by an elevation of a biomarker. So that biomarker is urine, blood, or breath ketones. And the ketone bodies are acetoacetate and beta hydroxybutyrate. So there's no other diet that is defined by the elevation of a biomarker. So this makes it very interesting scientifically

because you can precisely adjust the macronutrient ratios fat protein carbohydrates to achieve a certain level of ketosis that then becomes a therapeutic modality for the metabolic management of metabolic disorders, like there's inborn errors in metabolism where the standard of care is this diet, and seizure disorders. And it tends to work for a wide variety of seizure types. So what our lab has done is sort of furthering the science of ketogenic therapies to creating ketone supplements that could then be administered with a standard diet. The ketogenic diet is a diet that has a specific macronutrient ratio and is a diet that is defined

by an elevation of ketones, which can be measured with commercially available technologies that you can get at any CVS or Walgreens or even Wal-Mart and Amazon, a blood ketone meter or ketone strips. So another device that came out recently is the biosense breath ketone meter. And you can blow into it and it registers your breath acetone, which is also a ketone body that you produce when you're metabolizing a lot of fat.

And for people that are following the diet for as a fat loss diet, when you blow into a biosense device and you see the acetone elevated, the carbons from that acetone are entirely from fat. So your level of ketones will directly correlate with the level of fat that you're burning. So independent of epilepsy or Alzheimer's disease or cancer therapy for that, for people who just want to lose fat, your ketone levels are a very precise measurement. I cannot think of a more precise way to measure that your body is in a fat burning state than in elevation of ketones. It directly correlates with fat oxidation in the body. So in that way, a ketogenic

diet and also intermittent fasting, these things elevate ketones and it becomes a good objective biomarker for fat loss. Yeah, so I think my follow-on would be how do you hack those biomarkers? Great question. I would preface this by saying that if you want to start on a ketogenic diet to really do your research, not all ketogenic diets are constructed the same way. There's healthy ways to do it and non-healthy ways to do it. And you want to make sure that your kidney your body to go from burning carbohydrates for fuel to burning fat and ketones for fuel. And this changes our physiologies in ways that are sometimes unpredictable, but the majority of changes that happen rapidly

and a very significant majority of changes that happen long-term are very positive. So there's very, majority of changes that happen. Long-term are very positive. So there's very, very positive changes in cardio-medabolic biomarkers that are responsible for our long-term health. And probably most importantly, ketogenic diets can cause rapid weight loss. That's usually a good thing,

but people tend to do a yo-yo diet. They go on ketogenic diets and then it go completely off. For the large majority of people just wanting to use the ketogenic diet for weight loss, it is highly effective for that, but more importantly, it's very effective for weight loss maintenance. So a lot of diets will allow you to lose weight.

It's harder to sustain that weight loss. So you could potentially use a ketogenic diet to get down to your ideal weight and then gradually add some carbohydrates back in, ideally not in the form of sugar or processed carbohydrates or even starch, but add carbohydrates back in in the form of vegetables and maybe a small amount of fruit. And then you can gradually tweak the diet to maintain that weight loss and to preserve the benefits that are associated with that weight loss. There's different ways to implement the diet and there's healthy ways and there's not healthy ways. So what I

would advise to do more of the Mediterranean style, modified ketogenic diet, which is essentially a ketogenic diet that's rich in fish, poultry, eggs, red meat, limited red meat to some extent, but has a lot of salad greens and what we would call fibrous vegetables. So vegetables that are mostly non-starchy, so above the ground vegetables, not potatoes, not sweet potatoes or white potatoes or things like that, but basically vegetables that grow above the ground, no grains. And what you'll find is that a host of metabolic parameters will increase and improve over time. And this will typically allow weight loss and sustain the weight loss without

having to count calories for the large majority of people. And that's pretty important because the whole basis for diets and weight loss has been to count calories. And a low carbohydrate diet that doesn't even need to be ketogenic diet, which doesn't even need to be severely carbohydrate-restricted. Typically, changes are appetite regulation in a way that allows us to be more satiated with the food that we're eating. And by virtue of regulating glucose, blood glucose control, we call this glycemic variability, and that can be measured with the continuous glucose monitor. Without the wild fluctuations in your blood glucose, people realize that they don't have cravings like they do, eating carbohydrate-based diet, and that has significant effects for long-term

weight management. Since you've brought it up twice now, I have to ask you about the study you're doing on continuous glucose monitoring. What is the purpose of the study? How can you use it to look at daily stress to reduce things like depression and anxiety? We think that there's a high correlation between metabolic health and that there's a high correlation between metabolic health and our mood, our anxiety, and overall mental health. So that has been a big area of research that we're doing now and actually incorporated into that project

is looking at depression, sleep, anxiety, things like that. So I guess taking a step back, the study that we're currently doing with Florida medical clinic and Dr. Allison Hall, who's board certified doctor and pediatrics and internal medicine is spearheading the study in the clinic in partnership with the USF. We're putting continuous glucose monitors on patients and just completed our second cohort. We are looking at glycemic control in patients that wear a continuous glucose monitor and also use the Levels Health app.

So the CGM device is only good as the app that it goes into and the Levels Health app actually gives actionable information on the food that you meet and will score the meal. So if I have a pop tart, that will score me typically like a one or two and that's horrible. But if I have a salmon salad, I almost have a perfect score because it has very little or no glycemic response and all the nutrition is basically readily available for the body without causing glycemic fluctuations. So we are looking at continuous glucose monitor trace. So we analyze that glucose trace

as a continuous trace over time. We're looking at cardiometabolic biomarkers. We're looking at fasting insulin. We're looking at inflammation as high sensitivity, c-reactive protein, we're looking at hemoglobin A1c and correlating that with glycemic control. And then as far as mental health, we're doing tests like the GAD7, PHQ9, which looks at general anxiety test. The Florida medical clinic has a test to assess your overall mood and your outlook and things like that. We have a sleep questionnaire. One of the really interesting things that we

observed in non-diabetic non-obese people is that many people had non-alcoholic fatty liver disease or the precursor to that we call that hepatic stiotosis, which means a fatty liver, essentially. This quickly reversed with the intervention that we're using, which is a low carbohydrate diet, ketogenic diet. So we're measuring ketones and we're measuring glucose too. And a person that can go on two different tracks, they could follow a ketogenic diet or a low carb diet.

The low carb diet is about 65 grams of carbs, and the ketogenic diet is about like 25 grams of carbs. So it's low enough in carbs that you're making ketones. So what we observe is that we have significant improvements in body composition alterations and metabolic biomarkers. The most robust data, I would say, is actually mental health. When people change their body composition and they lose fat, they lose weight, their perspective of their bodies improve, and the blood flow to their brain improves. The

inflammation goes down, and whenever your body has systemic inflammation, that's also causing neural inflammation. And inflammation in the brain contributes to depression. If someone has a disease that causes inflammation, like lupus or fibromyalgia or a viral disorder like shingles or even herpes, simplex or even Lyme disease, these things that cause an immune response and inflammation actually make us depressed and make us anxious and can trigger bipolar disorder. So dietary therapies can improve it to where you can metabolically manage a mental disorder through nutrition.

It's fascinating to me. Earlier this week, I interviewed Katie Katie Milkman who's a behavior scientist at the Wharton's Girl at the University of Pennsylvania. And as we were talking, we were discussing a book that came out last year, which is called How to Change. And what I found alarming in it, in fact, shocking, is her research research and she's partnered with Angela Duckworth and many other scientists in the behavior change for good initiative that 40% of premature deaths are preventable through behavioral change. And so I was wondering, that as a backdrop, how can a ketogenic diet reduce midlife mortality. Yeah, so I think of the ketogenic diet and under the umbrella of that would just be a low carb diet.

So a ketogenic diet is a rather extreme diet in that it limits carbohydrates so low that you would actually limit a lot of foods that are good for you. Like fruits and vegetables even need to be limited, to some extent, with a ketogenic diet. But you could get many benefits of a ketogenic diet simply by reducing total carbohydrate consumption. Good area to start would be like under 100 grams a day. I would say most people can do that pretty easy. And so that would be more of like a higher, higher to moderate protein diet, moderate fat diet, and low carbohydrate diet, and then start with that and then see how you feel.

And then over time, your level of insulin will come down, your glucose variability will be reduced. And most people will probably have a decrease in energy in the beginning, but after your body adapts to a lower glucose set point, then you start burning fat more efficiently. So the real adaptations start to happen after a week. So the second week and third week, and by four to six weeks, your body is burning considerably more fat for energy. And we can even measure this like in the lab with a metabolic cart and looking at something called the respiratory quotient.

The respiratory quotient goes down and showing that you're burning more fat for energy than carbohydrates. Your mood will start to improve as metabolic biomarkers improve and as your body composition improves too. So this is dependent to some extent on what we call insulin sensitivity and markers like for me my HSCRP which is high high sensitivity, seriactive protein fluctuated between one and two and since I've been a low carb ketogenic diet, it's 0.1 or 0.2 or what's non-detectable. The assay can't even measure it. So my inflammation went way down, my joints felt better, the brain fall goes away, but I would like to emphasize for people that if they start on a low carb diet and get your body adapted to a low carb diet and then maybe

experiment with a ketogenic diet where you drop the carbohydrate solo that you're really then burning fat. And for people who are overweight, that is the fastest way to lose fat really with a ketogenic diet. One way to speed progress is to do what's called intermittent fasting in science. What we call this time restricted feeding. It's like the scientific name for it, where essentially you could have breakfast and then stop eating your last meal at like 6 p.m. right? And then not eat again until like 9 or 10 p.m. the next day. And that fasting window will actually put your body into a state of myocutosis.

And what I like to do is actually a couple days a week is I don't have my first meal until 12 noon or 2 p.m. And those days that I do intermittent fasting, the mornings I am most productive, I have the clearest thinking, I have the clearest thinking I have the most energy, I believe it or not. And the beginning, you might feel hungry, but the more you do it, the easier it gets, and then over time, the more benefits you'll derive from this pattern. And there's a ton of research on intermittent fasting by Sachin Panda. He was a speaker at our metabolic health summit,

which is a conference that we hold that many speakers on these topics. There's a lot of data on intermittent fasting and time restricted feeding, and it tends to further augment the ketogenic diet and makes it easier to follow over time. Yeah, intermittent fasting is something that I do maybe too much after looking at some of your research because I do it pretty much six days a week and I don't eat until 12.30

one o'clock and then I cut everything off by about 7.30. Fantastic. But I found for me, just as you're saying, I get up every day at 5 a.m. from 5 a.m. till noon, I'm rock star performance. And I get sluggish maybe right now, as we're doing this interview later in the afternoon. But I have found that since I've been on this diet, which has been about 18 months now, my cognitive performance has improved,

my sleep has improved. I feel most of the time like I have more energy. And then I experimented with new tropics, which in a really augmentative and took it to a next level, along with things like athletic greens, et cetera. So given that you're an expert on this fasting, what are your guidelines about intermittent fasting? And how does combining that with ketosis benefit you even more?

Yeah, good question. We've done work in road models, and now like human studies are being done, to basically show that if you do a low carb diet or ketogenic diet, you could facilitate what's called metabolic switching. I think that's a term coined by Dr. Mark Matson at Johns Hopkins. He's at the NIH too. Metabolic switching is literally the switching of the fuel source that your body is using. And you can measure that with like a metabolic cart,

but you can also measure it with your breath ketones or blood ketones, which is a good indicator that you're burning fat for fuel. What intermittent fasting does is during the fasting window, it suppresses the hormone insulin. And as you suppress the hormone insulin, that signals to your body to stimulate your physiology. So different enzymes like hormone-sensitive lipates. So your sympathetic nervous system will be activated,

your dopamine, your catacolamines will be activated and like adrenaline and norrigenne and this will work to basically cause your fat cells to release fatty acids for fuel during the fasting window. And the brain really cannot use fat for energy. The fat does not cross what we call the blood brain barrier. But your liver has a very high metabolic rate and starts to break down these long chain fats into water soluble fat molecules. And these are essentially ketones, right? So ketones are byproducts of fat metabolism. I think of it like a woodchipper, right?

So you put like a tree or I have a woodchipper at home that I hook onto my tractor and I put big logs in it and it chips it up into little chips and these chips can then be fed into an auger and move. So it makes fat, which is a big molecule, it chops it up into little bits. Fat is not soluble in water, but the ketone derived from fatty acids are soluble in water, and these are transported to all our tissues, our heart functions more efficiently off ketones. And then the ketones most importantly

cross the blood brain barrier. So then in a fasted state, if we were not producing ketones, we would actually go into a coma and we would become very tired. We would go into a coma and then we would have a seizure if our body did not make ketones. So some people make ketones better than others. And when you start a ketogenic diet, it may take a while to ramp up a process

called a ketogenesis. And we can augment this and biohack this by taking exogenous ketones, actually, which we do a lot of work in our lab, we develop and test different forms of exogenous ketones. And this was primarily for the Department of Defense. And in an effort to increase the safety, performance, and resilience for the warfighter. So these are commercially available now.

And if someone wants to further enhance the ketogenic state, they could actually take exogenous ketones and it would help promote the ketogenic state in the body. And then I talked about ketones as an energy source, but they also have anti-inflammatory effects, they have epigenetic effects, they have signaling effects that are that are very important and there are important aspects of the therapeutic effects. One of the effects is actually to increase GABA, which is a neurotransmitter in the brain, relative to glutamate. It will reduce the anxiety promoting effects of excess glutamate and convert that glutamate to GABA through an enzyme called glutamic acid decarboxylase. So the balance of neurotransmitters in the brain will be towards less excitotoxic neurotransmitters and towards more brain calming, relaxing neurotransmitters.

And that is GABA. That's an example of a neuropharmacological shift in being in a state of ketosis. Yes, well, I think you just brought up a couple of things I wanted to explore just a little bit more. What is the difference between ketogenic diets, ketone esters, and ketone supplements, and how they support and maintain ketosis? And part of the reason I'm interested in this is a lot of these ketosis supplements are the rage and I've had coaches at the gym who are pushing this stuff and saying, you don't even need to be on a ketosis or on a keto diet, you just take this a couple times a day.

And as I thought about it, I thought that can't be the right way to do it. So I'm interested in hearing from an expert on your thoughts on them. Yeah, so I'd like to preface it by saying it's very context dependent, right? So just going back to our research real quick, like the military wanted something that could rapidly produce a state of ketosis, just prior to a mission. And with dietary ketosis, it could take a week or two weeks to really get your ketone levels elevated and some people. So we do know that you could acutely administer a ketogenic ester or ketone salt product just 30 minutes before doing a high pressure oxygen

dive that could trigger a seizure and you could delay that seizure up to over 500 percent. So you could basically instead of having a seizure in 10 minutes, you could go up to an hour without having a seizure. That's better than any anti-seizure drug. So let's kind of take a step back again. There's four ways to get into ketosis. One is simply stop eating, right? And then your body will go into what's called fast in ketosis. So you can elevate ketones, and that's your fat making ketones.

And then there's the ketogenic diet, which is a very calculated diet. That's therapeutic. There's also drugs that can inhibit glycolysis. And metformin does this a little bit, 2Doxic glucose, like things that we work with in the lab, can do it. Another way to elevate ketosis is with a type of fat

called MCT oil. So medium chain triglyceride oil is actually derived from coconut oil or palm kernel oil. It's an eight carbon. So when we consume MCT oil, instead of being packaged into chylamicrons, it goes to the liver by a hepatic portal circulation, and then that stimulates fatty acid oxidation to liver to produce ketones. So some of the MCT oil that you drink gets converted to ketones independent

of our diet, so we can elevate it eating a standard diet, but only a small amount. We can only elevate ketones so much with MCT oil. So the next level would be exogenous ketones and that would be ketone salt. And when I'm talking about a salt, I'm talking about an electrolyte like sodium, potassium, magnesium, taking beta hydroxybutyrate, which is the ketone that we measure in the blood, and then ionically binding that to electrolytes. Prior to us starting research, there was only sodium beta hydroxybutyrate, and this was not very feasible, but part of the research that we did is bring attention to you could take ketones and combine it with electrolytes that are very important for athletic

performance, right? So a balanced ratio of sodium, potassium, magnesium, calcium. So some of the work that we have done have led to the development of ketone salts, but that was probably after the work that we did with ketone esters, which we still do work on ketone esters and then ketone salts. When you consume these things, it puts the body into a state of ketosis. And if you draw blood from the person, it looks like you fasted for a week or two weeks. But it's in the context of weight loss, it's important to understand that there's absolutely no substitute for a well-formulated diet. Nutrition is paramount, and it's really important

to optimize nutrition before you start thinking about supplements. So supplements are only that. There's supplements, and there's some supplements that are really important with a ketogenic diet. One is carnitine, because when you're metabolizing fat, you tend to use up a lot of your carnitine that helps transport the fat into the mitochondria.

So if you do start a ketogenic diet, it's probably important to take carnitine, magnesium, and then electrolytes. So a beneficial supplement on a ketogenic diet could be a ketone salt product, which is basically a ketone electrolyte product because you're replacing a lot of the electrolytes that you're losing. And this can help people that have the keto flu. A lot of people, when they start the ketogenic diet, they have a headache, they feel nauseous

from all the fat. And many people just cannot tolerate the high fat intake associated with the ketogenic diet. So this is concerning to them because they want to get the benefits of ketones, but if they don't have enough fat while lowering carbohydrates really low, they're not getting into a state of ketosis.

So one way to get all the benefits of carbohydrate restriction to get that insulin low and glucose low and then get benefits of ketones too is to just do a low carb diet and then incorporate a ketone supplement on top of that. So the ketones will do a number of important things. It changes your brain chemistry, which is in a good way, it lowers inflammation, and it also increases insulin sensitivity,

and tends to have a glucose lowering effect on your blood on top of that. I kind of test that that approach works because about five years ago, I was about 40 pounds heavier than I am now, and I did one of those orange-thirty challenges, and I did a low-carb diet, and then I supplemented it with ketone supplements, and I lost 40 pounds in about two months. with ketone supplements and I lost 40 pounds in about two months. I get many, many emails every day from people who basically follow ketogenic diet and very successful. And then they add supplements on top of that. And it pushes them to a new level. It helps control their appetite.

And some people in the beginning, they lose some energy when they start a ketogenic diet, but the supplements will stimulate energy production. ketones can generate energy in cells. We call that ATP. ATP is the energy currency of cells. And there's lots of very good studies showing that ATP production, the bioenergetics state of cells, including heart cells,

especially membrane cells, can be enhanced when they're metabolizing ketones as an energy source. Yes, well, one of the most drastic examples of this I've seen is a good friend of mine who was having severe arthritis type symptoms, and then he developed throw cancer. And as he was going through the beginning stages of being treated for the cancer, he went on a keto diet, which he's been on now for five or six years. I'm not a medical doctor, so I can't say if this is something that was associated with

the keto diet, but his tumor shrunk to the point that they were able to operate, and he didn't have to get chemo or radiation. But more importantly, he's now been seven years pain free. And I think a lot of it has to do with getting rid of the inflammation that was probably impacting that. Yeah, I mean, it's good that you bring that up because inflammation is one of the hallmarks of cancer. It drives the oncogenic process. So when we have inflammation in our body, that tends to

damage mitochondrial function. Inflammation can increase genetic mutations at the level of the nucleus and this inflammation can basically be a driver for cancer progression and invasiveness and metastasis, which is a spreading a cancer to different organs. People don't die of a tumor per se, unless maybe it's just a consolidated brain tumor. They die of the metastatic spread from the primary tumor to distal locations like the organs, like the kidneys and the liver and other areas, like with pancreatic cancer, it tends to spread to different areas. That is fueled.

We know this in cancer biology that is driven primarily by inflammation. So if someone has cancer and is fighting cancer or they were a cancer survivor, it's super important to track inflammation like HSCRP and to ensure that you're following a dietary approach that keeps inflammation as low as possible. Yeah, probably also taking some tumour, which I like to do on a daily basis. Yep, tumour is great. And taking it with fat increases the bioavailability of tumour. A couple of studies, one, I'm thinking of increasing the bioavailability up to 400% when you take tumour with fat, like you could take it with, if you're cooking with it, you can cook with some coconut oil or something like that. And that will enhance dramatically the bioavailability of that tumouric to get into circulation.

I was also glad to hear you brought up magnesium. I have an upcoming interview with Sarah Medneck. I'm not sure if you're familiar with her, but she's a scientist at University, California, Irvine, and one of the foremost experts on sleep. And she wrote a book on napping and a new one on the down state, but she told me one of the most important supplements that you can take, which a lot of people do not take, is magnesium. And it impacts so many different things. And interestingly enough, as I was reading a book by Dr. Fitzgerald called Younger You, and her studies of looking at biological age, she also found that magnesium

had a huge role to play in DNA methylation. Absolutely. Yeah, great you bring. I think magnesium is the most underrated supplement. If we're just talking about metabolism, the like 400 different metabolic reactions in different enzyme systems. And I mentioned it primarily because when I got

a nutritional status blood work after following ketogenic diet, it showed that my magnesium was low. That's probably because I was so carbohydrate restricted, I was taking out all the greens. So anything that is green, green leafy vegetables, the chlorophyll molecule basically has magnesium like at the center. So you're getting a lot of magnesium if you're eating a lot of greens.

Like you mentioned, athletic greens. So you're probably getting some magnesium. For that, magnesium is super important for sleep. It's important for metabolic reactions. I also teach neuropharmacology. I teach all the excitatory amino acid transmitters and one of the glutamate receptors or transmitters would be the NMDA receptor. So there's the ampere receptor and then the NMDA receptor. For example, in traumatic brain injury, it's an over activation of the NMDA receptor triggers and influx of calcium, which causes brain inflammation

and exciter toxicity in the brain. So it becomes very important to regulate the NMDA receptor and magnesium plays a super important role in blocking the poor of the NMDA receptor. And if we lack magnesium, essentially we're going to have glutamate hyper excitability that can trigger headaches, can trigger seizures, and can trigger a lot of consequences in the context of acute traumatic brain injury and also chronic CTE. So especially in people who have sustained traumatic brain injury,

CTE. So especially in people who have sustained traumatic brain injury, magnesium, making sure that your magnesium is on the high end of normal would be super important. It helps with headaches. It's super sleep supplement. I take it every night for sleep bio optimizers makes magnesium breakthrough, which is a key-lated form of magnesium with an amino acid. It's super potent. There's also a supplement called calm that you can get, and you can mix it. It's like a fizzy supplement that you can take also good magnesium supplement. Yeah, magnesium is probably one of the most underrated supplements out there, and it goes very well with the Q-jank diet.

I'm glad I'm doing that right. I take a chelated magnesium every single night myself. Well, since we're speaking of sleep, I understand through my research that a lack of sleep can impact our telemores, which if someone in the audience doesn't know what they are, they protect the ends of our chromosomes from becoming freight or tangled. And the reason that's important is a shortened telemore is known to be a biomarker for accelerated agent. So I wanted to ask, can contosis impact telemores and really DNA damage? Yeah, so ketones have epigenetic function through something called histone deacetylase enzymes,

so they function specifically as histone deacetylase inhibitors, which can then affect a wide variety of downstream mechanisms on boosting endogenous antioxidants like superoxidizmutez and catalyze, and then also ketones function as epigenetic regulators in the context of that beta hydroxybutyrate can directly interact with the histone through a process called beta hydroxybutyrate can directly interact with the histone through a process called beta hydroxybutyrelation. We know that these metabolites that are elevated in the context of a ketogenic diet have epigenetic function,

and we think to some extent they can regulate telomeres. Although the science is just basic science at this point, and we don't have a whole lot of human studies on this, but from a very general perspective, anything that will improve sleep and anything that improves cardiometabolic biomarkers. Hemoglobin A1C, the biggest driver is probably inflammation. So improving glycemic control, reducing inflammation,

reducing the hormone insulin. We have a chronic problem in the US with hyperinsulinemia insulin resistance. So these things will impact telomeres. Also work was done. Scott share may have mentioned it, but hyperbaric oxygen therapy has been shown to lengthen telomeres or some work done in Israel to show this. So in regards to ketone specifically or the ketogenic diet, I think the jury is still out, but what we do know is that biomarkers and various things that the ketogenic diet improves, that those things can impact and enhance our epigenetic age. And you had mentioned sleep being probably

the biggest contributor or biggest negative contributor, lack of sleep contributes to chronic elevation of stress hormones. And the chronic elevation of stress hormones like cortisol, over activation of the sympathetic nervous system, and a decrease in parasympathetic nervous system, which is more like a relax and rejuvenate, that this is a huge driver for decreasing our telemirs and a rap, we put you on the fast track towards aging. So sleep is very underrated. I actually research that we did on NASA's Extreme Environment Mission Operations used various sleep tracking. We used the oral ring, which is great. I recommend it. We also used the polar V800 to look

at heart rate variability. Some of this we've published. For me, just going back to Nemo real quick, I actually only slept about six hours per night, but I had about two to three hours of deep sleep every night, which is I went into a very deep sleep and then I started my REM cycles early into the sleep pattern and had very consistent REM cycles. So although my total sleep time went down, there was something about that environment that improved my sleep architecture. So my total sleep time went down, but the amount of deep sleep and the amount of REM sleep that I got was actually more than when

I was on land. But sleep is also super important for the glymphatic system. So our brain has a lymphatic system. And when we sleep, the glymphatic system of the brain clears out a lot of metabolites and toxic intermediates that build up during the day and helps to clear like amyloid and other toxic things that build up during the day. So if you're not sleeping, then you're not really activating the brain's mechanism for clearing toxic debris that accumulates throughout the day.

Yes, which, if it's not cleared out, can lead to CTE, dementia, Alzheimer's. That's right. Yes. Unfortunately, I've had a number of traumatic brain injuries. So I have become very well versed on this because I do everything I can, including taking MCT oil to ensure I'm trying to prevent as much of the downside that you can potentially have.

I'm going to end on this question. You brought up Metformin. So I can't hear the word Metformin without bringing up Dr. Davidson Claire. Interestingly, in his book Life Span and in Dr. Carifit's Gerald's book, Younger You, they both bring up something that's interesting, and that is when it comes to eating, they found that there is a sweet spot when it comes to food consumption and how that dictates your response not only to biological aging, but how you're able to ward off chronic diseases and fight infections. In your studies, have you also found this so-called sweet spot when it comes to how much we eat?

Yeah, we did some metformin studies, and I would kind of say that metformin has a mild effect at suppressing cancer growth and reducing metastasis. And as a pretty interesting compound, I experimented with it in the past, but I do not use it as a longevity drug, which some people are doing. It can impair athletic performance too. I think the better way to do it is to optimize your nutrition to get a maximum amount of nutrition in the least amount of calories as possible. I am of the opinion, and this may contrast Dr. Sinclair's opinion. I am of the opinion that protein,

you should get a maximum amount of protein to build and maintain skeletal body lean muscle mass. So I think muscle is probably the most important metabolic organ for sure, but it is probably the most important tissue that we need to build and maintain for longevity. So muscle is not only allows us to be as functional and strong as possible, but muscle also makes, it's an endocrine organ. It actually makes myocons, which have effect on our brain. So I'm of the opinion that you want to adjust your calories to meet and sustain an ideal body weight

and to adjust the protein level. And for some people can grow muscle on relatively small amounts of protein and other people as we age, there becomes a level of what we call anabolic resistance. also on relatively small amounts of protein and other people as we age, there becomes a level of what we call anabolic resistance. So as we age, especially the elderly population experience something called sarcopenia, age related sarcopenia. So it's of my opinion and most people who study protein to actually get more

protein in as we age. So the balance of macronutrients should be just enough calories to maintain an ideal body weight and to adjust the protein level to ensure that you're optimizing your skeletal muscle mass and maintenance of your strength. So if your strength is going down, you're probably losing muscle mass.

So I would use certain exercises like dead lists and pushups or chin ups and dips and things like that to audit your strength. And you want to basically set goals for yourself to get the highest level strength possible. And if you're not getting enough protein, you're going to be losing strength. So if you're losing strength, I would advise people to increase their protein level to ensure that you can build enough muscle to maintain that strength on the least amount of calories as possible. So you want to keep your body fat as low as possible and your lean body mass as much as possible at the ideal body weight.

Well, for the listeners who are on this podcast, I know when people think of ketosis and a keto diet, one of the things you typically can't have is alcohol. I was looking at your website. I actually found that you have a low sugar wine on it that doesn't impact ketosis. What is that? Yeah, glad you asked. I became very curious about this because unexpectedly, when I started studying the ketogenic diet, I started getting so many questions, can I have alcohol? Can I have wine? I was like, no, no alcohol, no wine. And then I saw this company called Dry Farm Wines

and they're advertising that these wines were ketogenic. And I was like, oh boy, here's another company promoting using the keto. Right, so they sent me some wine. I measured my glucose response to a wide variety of wines that they have. And the company is called dry farm wines. They third party test every wine. Actually no wine to the US qualified because most of wines in the US they use irrigation.

They use fertilizers and other, and they use sulfates and preservatives. So all the wines, if dry farms are small, kind of mom and pop wines, and every bottle of dry farm wine has less than one gram of sugar per bottle. So I did an experiment, and then so many other people tested these too. They basically have no effect on your blood glucose. If you're going to drink wine, if you're going to drink alcohol, in general, I would, on a ketogenic diet, you need to choose alcohol that has zero or no sugar. And the only wines that reliably

fit that would be dry farm wine, fermented to be very dry, and they have less than one gram of sugar per bottle, but they're also grown under very high standards. I admit that I have one or two glasses of wine pretty much every night. I cap it at about one and a half glasses of wine. And I noticed that they're the literature supports health benefits to about one glass and for males too, for females it's one, but if you go above that then there's negative effects of drinking alcohol. So if you're going to drink alcohol, do it in very low doses, the dose makes the poison, and I think if you're just going to stick with alcohol, it has to be like something like a dry farm wine and no more than for safe limits, no more than one glass per day. Not a glass that's a 16 or 20 ounce glass, we're talking about,

six to eight ounce glass of wine. Okay, well, in addition to that, yeah, Tom, how can listeners learn more about you and some of the things you're doing if they're interested and I'll be sure to put this in the show notes as well. Sure, thanks for asking, John. So I have an educational website and I have products on there that I don't personally sell the products, but there are products that I've tested. So the things that I test and I like, I help the companies out and put them on our website.

But it's mostly an information website, ketonutrition.org. So ketonutritionalloneword.org. And we have a blog on there and we touch on many topics. We have a couple topics on alcohol and the ketogenic diet. We have topics on ketone supplements, on Alzheimer's disease, Parkinson's disease, cancer. We hit on many topics that we discuss today on there.

We go into very more deep science on the blog. The newsletter. Sign up for our newsletter, the ketone nutrition newsletter, and I tend to put in all the podcast, I'll put this podcast in our newsletter. I put in products that I like that I'm testing and typically, you know, put things in the newsletter that I'm actively doing right now. If the conference I'm going to be speaking at

or various things I'm promoting, I put into our newsletter. We try to put in things that are valuable of value to our followers into the newsletter. So ketonutrition.org. Well, thank you so much for coming on the show. It was truly an honor to get this opportunity to talk to you. And I hope in the future, maybe we can revisit some of this, but I really appreciate it, Tom.

Absolutely. Well, thanks, John, for having me on and for allowing me to use your platform to tell people about what we're doing and hope that spreads the knowledge of metabolic health. And I'd like to make another plug real quick, the metabolic health summit, which we held recently in Santa Barbara, California. We hope to bring that to Tampa and do this conference in Tampa where we have 800 to actually David Sinclair was a speaker in the past. And we have many speakers that really cover this topic.

And we hope to bring it to Tampa. And it would be great to see you there. And if you can make it, that would be awesome. I'd love to get to that one. Thank you. A big thank you to Dr. Dominic Dagostino. And links to all things Dom will be in the show notes at passionstruck.com.

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