<p>Back by very popular demand for a special AMA episode, ketosis expert Dom D'Agostino joins Bob Kaplan, Peter's Head of Research, to address many lingering questions about the ketogenic diet, exogenous ketones, and exercise for overall health. Dom also shares valuable insights from his personal experience with training, supplements, intermittent fasting, and other nutritional strategies to optimize his own health and performance. If you're not a subscriber and listening on a podcast player, you'll only be able to hear a preview of the AMA. If you're a subscriber, you can now listen to this full episode on your <a href="https://peterattiamd.com/members/private-podcast-feed/" rel="noopener noreferrer" target="_blank" title="https://peterattiamd.com/members/private-podcast-feed/">private RSS feed</a> or on the website <a href="http://peterattiamd.com/domdagostinoama01" title="peterattiamd.com/domdagostinoama01">show notes</a> page.</p> <p>We discuss:</p> <ul type="disc"> <li>Dom's recent and ongoing projects [3:00];</li> <li>Benefits of a ketogenic diet for an otherwise healthy person [7:00];</li> <li>Book recommendations to become more knowledgeable about a ketogenic diet [11:30];</li> <li>Best devices for measuring ketones [13:45];</li> <li>Genetic factors that influence how someone responds to the ketogenic diet [24:45];</li> <li>Ketogenic diet for those with the APOE e4 allele [28:15];</li> <li>Impact of long-term ketogenic diets on thyroid function [34:25];</li> <li>Low-carb and ketogenic diets for appetite control and weight management [39:00];</li> <li>Ketogenic diet and the microbiome [43:00];</li> <li>Comparing monounsaturated fat versus saturated fat on the ketogenic diet [45:55];</li> <li>Implications of long-term genetic and epigenetic adaptations to a ketogenic diet [47:45];</li> <li>Why some people see a rise in LDL-C and LDL-P when on a ketogenic diet and what they can do about it [50:15];</li> <li>Should someone with familial hypercholesterolemia consider a ketogenic diet? [55:00];</li> <li>Exogenous ketones—benefits, therapeutic uses, and ketone supplements that Dom has tested [56:45];</li> <li>Ketogenic protocols for management of traumatic brain injuries [1:06:00];</li> <li>Comparing the benefits and therapeutic uses of various medium-chain fatty acids—caprylic acid (C8), capric acid (C10), MCT oil, and coconut oil [1:08:45];</li> <li>Nootropics, caffeine, and other stimulants [1:16:15];</li> <li>Supplemental use of testosterone, DHEA, and creatine for muscle growth and performance [1:23:45];</li> <li>Impact of fasted-state training on strength and performance [1:30:15];</li> <li>Stacking exogenous ketones with MCTs for optimal effectiveness [1:33:30];</li> <li>BCAA supplements during a fast for muscle preservation [1:35:45];</li> <li>What app is Dom using to track his macros? [1:42:00];</li> <li>Getting enough micronutrients while on a ketogenic diet [1:47:15];</li> <li>Ideal macros and getting enough protein for strength training in ketosis [1:48:15];</li> <li>Pros, cons, and ideal macros of one meal a day [1:51:15];</li> <li>Dom's take on "carb backloading" [1:54:45];</li> <li>Dom's take on "carb up" days for ketogenic dieters [2:01:00];</li> <li>Dom's thoughts on the carnivore diet and the paleolithic ketogenic diet [2:05:30];</li> <li>Advantages of the ketogenic diet for extreme endurance athletes [2:10:30];</li> <li>Impact on strength, power, and performance during the adaptation period of the ketogenic diet [2:14:00];</li> <li>Fasted-state elevation in growth hormone and its impact on training [2:17:45];</li> <li>Is it possible to build muscle on a ketogenic diet? [2:23:30];</li> <li>Why Dom took a year off from weight training [2:28:00];</li> <li>What does Dom do for cardio exercise? [2:30:45];</li> <li>Protocols for hard training recovery [2:33:15];</li> <li>Dom's personal approach to fasting, time-restricted eating, and sleep [2:35:45];</li> <li>People, books, and other resources that shaped Dom's training and nutrition [2:38:45]; and</li> <li>More.</li> </ul> <p>Learn more: <a href="https://peterattiamd.com/">https://peterattiamd.com/</a><br /> <br /> Show notes page for this episode: <a href="https://peterattiamd.com/domdagostinoama01">https://peterattiamd.com/domdagostinoama01</a><br /> <br /> Subscribe to receive exclusive subscriber-only content: <a href="https://peterattiamd.com/subscribe/">https://peterattiamd.com/subscribe/</a><br /> <br /> Sign up to receive Peter's email newsletter: <a href="https://peterattiamd.com/newsletter/">https://peterattiamd.com/newsletter/</a><br /> <br /> Connect with Peter on <a href="http://Facebook.com/PeterAttiaMD"><u>Faceboo</u></a><u>k</u> | <a href="http://Twitter.com/PeterAttiaMD"><u>Twitter</u></a> | <a href="http://Instagram.com/PeterAttiaMD"><u>Instagram</u></a>.</p>
Actionable Insights
1. Monthly Restricted Ketogenic Diet
If you want benefits similar to fasting but have an aversion to it, try a restricted ketogenic diet for five to seven days once a month. This approach promotes metabolic flexibility.
2. Target Glucose Ketone Index
When implementing a restricted ketogenic diet, aim for a Glucose Ketone Index (GKI) between one to two to derive benefits similar to fasting. This can be achieved by restricting calories by 50% on a ketogenic diet for about six days a month.
3. Combine Keto & Time-Restricted Feeding
For enhanced benefits similar to fasting, combine a restricted ketogenic diet with time-restricted feeding to suppress mTOR and insulin, and potentially stimulate autophagy.
4. Keto Before and After Fasting
To prepare for and recover from a prolonged fast (e.g., one week), implement a ketogenic diet for the week prior and the week after the fast.
To gain foundational knowledge on low carbohydrate performance, read “The Art and Science of Low Carbohydrate Performance” by Jeff Volek and Stephen Phinney.
6. Read “The Ketogenic Bible”
For a comprehensive overview of the ketogenic diet, including recipes and terminology for both laypersons and those interested in science, read “The Ketogenic Bible.”
7. Read “Keto Answers”
For laypersons interested in a modified ketogenic diet, read “Keto Answers” for recipes, tips, and troubleshooting advice.
For those who want to delve deeply into the science of ketogenic diets and metabolic therapies, read the book “Ketogenic Diet and Metabolic Therapies” primarily authored by Susan Masino.
9. Read Dr. Kossoff’s Modified Keto Book
For a clinical perspective on the modified ketogenic diet, look up and read the book by Dr. Eric Kossoff from Johns Hopkins.
10. Use Biosense Breath Acetone Meter
For a quantitative and reliable measurement of fat oxidation and ketosis, especially in a fasted state, use the Biosense breath acetone meter.
11. Prepare for Breath Ketone Measurement
To ensure accurate breath acetone readings, abstain from food, chewing gum, or alcohol for at least an hour before measurement, as these can cause false positives.
12. Calibrate Breath Meter Indoors
To avoid error readings and ensure accuracy, calibrate and use breath acetone meters indoors in a stable environment, as windy conditions can affect measurements.
13. Use Precision Xtra Blood Meter
For reliable and validated blood ketone measurement, use the Abbott Precision Xtra meter, which is often used daily and in published research.
14. Use Keto-Mojo GKI Meter
Consider using the Keto-Mojo GKI device for blood ketone and glucose ketone index measurements, as its strips are cheaper and it incorporates GKI into its algorithm.
15. Use Urine Ketone Strips
Use urine strips, such as the Siemens multi-stick SG, as a simple “yes or no” indicator to determine if you are in ketosis and get a relative reading.
16. Review Dom’s 2018 Podcast
Listen to part of Dom D’Agostino’s first discussion from 2018 to understand his background and how he became a credible voice on ketosis.
17. Access Full AMA Episodes
To access full AMA episodes and other membership benefits, go to peteratiyahmd.com/subscribe.