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#023 Dominic D'Agostino, Ph.D. on Modified Atkins Diet, Ketosis, Supplemental Ketones and More

Mar 23, 2016 1h 54m 28 insights
<p><strong>Dr. Dominic D'Agostino</strong></p> <p>This podcast is with Dr. Dominic D'Agostino, an assistant professor at the University of South Florida in Tampa and all-around expert on ketosis.</p> <p>In this podcast we discuss:</p> <ul> <li><strong>(00:00)</strong> Introduction</li> <li><strong>(03:46)</strong> Ketosis has abundant therapeutic potential </li> <li><strong>(10:20)</strong> What to eat to maintain nutritional ketosis</li> <li><strong>(19:58)</strong> Does a high-fat diet harm the gut?</li> <li><strong>(29:14)</strong> Adaptations to a ketogenic diet expand mitochondrial capacity</li> <li><strong>(38:45)</strong> How the brain uses ketones</li> <li><strong>(46:36)</strong> Ketones improve Alzheimer's symptoms (unless you have an APOE4 allele)</li> <li><strong>(57:17)</strong> Are ketone supplements a "magic pill?"</li> <li><strong>(01:07:32)</strong> Why cancer cells may need sugar</li> <li><strong>(01:23:51)</strong> Metformin is more than a diabetes drug</li> <li><strong>(01:30:33)</strong> The body creates sugars while in ketosis</li> <li><strong>(01:36:21)</strong> Restricting glutamine to slow cancer growth</li> <li><strong>(01:43:24)</strong> Ketone supplements taste awful, but likely improve health</li> </ul> <p><span style="font-weight: 400;">If you're interested in learning more, you can read the <a href="https://www.foundmyfitness.com/episodes/dominic-dagostino">full show notes here</a>.</span></p> <p><span style="font-weight: 400;">Join over 300,000 people and get the latest distilled information straight to your inbox weekly:</span> <span style="font-weight: 400;"><a href="https://www.foundmyfitness.com/newsletter">https://www.foundmyfitness.com/newsletter</a></span></p> <p><span style="font-weight: 400;">Become a FoundMyFitness premium member to get access to exclusive episodes, emails, live Q+A's with Rhonda and more:</span> <a href="https://www.foundmyfitness.com/crowdsponsor"><span style="font-weight: 400;">https://www.foundmyfitness.com/crowdsponsor</span></a></p>
Actionable Insights

1. Measure Blood Ketones

To confirm you are in a state of ketosis, measure your blood ketones and aim for levels between 1 and 3 millimolar, with a minimum of 0.5 millimolar. This helps verify if a ketogenic diet or intervention is effective.

2. Prioritize Diverse Raw Vegetables

To optimize gut health and microbiome diversity on a ketogenic diet, ensure you include a diverse variety of raw vegetables as carbohydrate sources.

3. Optimize Carb & Fat Sources

Beyond macronutrient ratios, optimize your ketogenic diet by focusing on the sources of fats, the type of protein, and the quality and type of carbohydrates, as these factors are crucial for individual health and gut microbiome diversity.

4. Avoid High Protein on Keto

When following a ketogenic diet, ensure your protein intake is moderate to low, not high, as many people mistakenly consume a high-protein, moderate-fat diet instead of a true ketogenic diet. High protein can hinder ketosis.

5. Consult a Savvy Dietitian

If you plan to try a ketogenic diet, start by consulting a savvy dietitian who can tailor and tweak the diet to your specific needs, as their experience is invaluable.

6. Consider Modified Atkins Diet

For a more accessible approach to therapeutic ketosis, consider the Modified Atkins Diet, which is 65-70% fat, 20-30% protein, and 5-10% carbohydrates, allowing for more protein and incorporating medium-chain fatty acids while maintaining therapeutic potency.

7. Personalize Ketogenic Diet

Tailor your ketogenic diet to your individual sensitivities, such as avoiding dairy or nuts if you have allergies or intolerances, to optimize your personal health and adherence.

8. Include Liberal Vegetables on Keto

To support gut health while on a ketogenic diet, ensure your diet includes a liberal amount of vegetables, as this has been associated with better gut health for some individuals.

9. Use Vegetables to Slow Digestion

Incorporate vegetables into your ketogenic diet as carriers for fat, as they help slow protein digestion, minimize insulin spikes, and aid in maintaining ketosis.

10. Use MCT Powder for Mild Ketosis

To achieve a mild state of ketosis with better GI tolerance than liquid MCT oil, use MCT powder, consuming 4-8 scoops daily mixed with water, coffee, or tea.

11. Prioritize Whole Foods with Ketones

Even when using ketone supplements, prioritize a whole-food diet free of refined crap and processed foods, as a poor diet will significantly diminish the benefits of ketones.

12. Cycle Metabolic Strategies for Flexibility

To promote metabolic flexibility and enhance the long-term effectiveness of interventions, cycle between different dietary strategies like a paleo diet, a low-carb ketogenic diet, and intermittent fasting on occasional days, rather than strictly adhering to one continuously.

13. Maintain Ketosis to Preserve Muscle

Maintain a state of ketosis to leverage its anti-catabolic and protein-sparing effects, which help protect gluconeogenic amino acids and skeletal muscle from degradation.

14. Ensure Ample Fat on Ketogenic Diet

When on a ketogenic diet, ensure you consume ample amounts of fat, as insufficient fat intake can lead to a more catabolic state.

15. Use Ketones for Appetite Control

Utilize ketones to help control appetite, as they have a satiating effect by sending energy to the brain and can shut off hypoglycemic triggers that lead to food cravings or binges.

16. Consider Ketogenic Intermittent Fasting

For potential cancer prevention or post-treatment care, consider a ketogenic intermittent fasting protocol where you consume ketogenic fats and ketone supplements for 20 hours, followed by a four-hour window to eat a well-balanced ketogenic meal rich in vegetables and healthy fats and protein.

17. Metformin for Cancer Prevention (Consult Doctor)

Discuss with your doctor the potential of metformin as a preventative therapy, especially if you are at risk for certain cancers like pancreatic cancer, given studies showing a significant reduction in risk for type 2 diabetics taking the drug.

18. Monitor B12 with Metformin

If taking metformin, be aware of potential vitamin B12 deficiency and consider supplementing with a sublingual form or B12 injections, especially as B12 absorption decreases with age.

19. Enhance Drug Delivery with Ketosis

If taking drugs that need to cross the blood-brain barrier (e.g., chemotherapeutics), consider inducing ketosis through fasting or a ketogenic diet, as this may increase blood-brain barrier permeability and facilitate faster drug transport.

20. Avoid Glutamine for GI/Liver Cancer

If you have gastrointestinal or liver cancer, avoid supplementing with glutamine and minimize high glutamine-containing foods, as these cancers may utilize glutamine for growth.

21. Glutamine for Impaired GI Function (Non-GI Cancer)

If you have impaired GI function due to systemic treatments (e.g., for a brain tumor) and do not have GI or liver cancer, a small amount (5-10 grams) of oral glutamine may be helpful to repair your gut.

22. Lower Glutamine on Ketogenic Diet

A classical ketogenic diet (low to moderate protein) can help lower blood glutamine levels, which may be beneficial in certain cancer contexts.

23. Select Low-Glutamine Protein Sources

To further suppress glutamine levels, select protein food sources that are lower in glutamine and consider avoiding glutamine supplementation, opting instead for supplements high in essential amino acids (excluding glutamine).

24. Lauric Acid Suppresses Hunger

Consider consuming lauric acid (C12) as it has been shown to suppress ghrelin, a hunger hormone, in the gut.

25. Classical Ketogenic Diet Ratios

To achieve nutritional ketosis, a classical ketogenic diet typically involves a 4:1 or 3:1 ratio of fat to combined carbohydrates and protein, often translating to 85-90% fat, 8-10% protein, and minimal carbohydrates, historically relying heavily on dairy fat.

26. Ketone Supplements for Cancer (Research)

Research suggests that ketone supplementation, even on a high-carbohydrate diet, can reduce tumor growth and proliferation and increase survival time in aggressive metastatic cancer models, indicating potential anti-cancer effects.

27. Avoid Antioxidant Supplements for Cancer (Research)

Studies suggest that giving mice supplemental vitamin E or N-acetylcysteine (NAC), which potently sequester reactive oxygen species, can actually allow tumors to grow faster, implying caution with antioxidants in cancer contexts.

28. Ketone Esters for Potent Ketosis (Future)

For a powerful form of exogenous ketones, look for ketone esters (currently in development for human use) which have shown significant effects, such as preventing CNS oxygen toxicity.