Danny Jones Podcast - #36 - Starving to Live: How to Beat Cancer | Dom D'Agostino
Aired: 2020-03-18
Duration: 02:11:11


=== Meet Dr. Dominic DeAgostino (02:10) ===

[00:00:02]  Hello, world.
[00:00:03]  On this episode of the Concrete Podcast, I talk to Dr. Dominic DeAgostino.
[00:00:08]  Dom is an associate 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 of Human and Machine Cognition.
[00:00:22]  Dom's primary focus is developing and testing metabolic therapies, like the ketogenic diet, which can effectively treat many forms of cancer and epileptic seizures.
[00:00:32]  In addition to being one of the smartest people I know, he is also one of the strongest.
[00:00:36]  He has deadlifted 500 pounds for 10 reps immediately after a seven day fast, as fitness and weight training has always been a huge part of his life.
[00:00:45]  Some of his research has been funded by the Department of Defense, the Office of Naval Research, and many other private organizations.
[00:00:51]  If you have any questions about diet and nutrition, cancer prevention, or longevity, you will enjoy this conversation with Dr. Dominic DeAgostino.
[00:01:00]  Enjoy the show.
[00:01:10]  So, uh, so yeah, how did you get into initially getting, get into talking about your work on podcasts and like in on the internet and mainstream media?
[00:01:21]  Yeah.
[00:01:21]  I, uh, well, I knew about the ketogenic diet and my research took me in the direction of using a ketogenic diet for, uh, oxygen toxicity seizures, which is a limitation for, uh, uh, hyperbaric oxygen therapy, which we can talk about.
[00:01:38]  And also, uh, It is a limitation of Navy SEAL divers that use a closed circuit rebreather because they breathe high concentrations of oxygen in closed circuit.
[00:01:48]  And that research, the technologies that we developed to do that type of research were essentially hyperbaric chambers that had technologies inside that I had used for years, including confocal microscopes, atomic force microscopes, patch clamp electrophysiology.
[00:02:09]  These are all techniques that a neuroscientist uses.

=== How The Ketogenic Diet Worked For Arnold (15:43) ===

[00:02:12]  And I was a.
[00:02:13]  A neuroscientist for my PhD and also my postdoc.
[00:02:17]  And to do the research that the military wanted, we needed to put these things inside a hyperbaric chamber, these types of techniques.
[00:02:27]  And in doing so, we started looking at different cell types, and one was a cancer cell type.
[00:02:35]  And ultimately, that project led to looking at the ketogenic diet and hyperbaric oxygen as a cancer therapy.
[00:02:42]  And I did a TEDx talk about that.
[00:02:45]  And that got The publication and the TEDx talk got exposure, and you can look at that to see without going into too much science detail.
[00:02:56]  That particular topic, not so much the oxygen toxicity for a Navy SEAL topic, but the topic of using a ketogenic diet and also hyperbaric oxygen therapy for cancer got attention.
[00:03:10]  And I did a couple smaller podcasts, but Joe Mercola reached out to me.
[00:03:15]  I didn't know much about him, I didn't know that he had a really big reach.
[00:03:19]  Yeah.
[00:03:19]  And I did a little bit.
[00:03:21]  I just associated him with like things that I know he had sort of a, he was very controversial.
[00:03:31]  And he, especially in regards to things like EMF or GMOs and glyphosate and things that I really was on the fence about and didn't really have a strong negative opinion towards.
[00:03:46]  So, but I looked at his podcast and the information that he was putting out there and saw a lot of it was relevant.
[00:03:51]  And he had some bigger names on there.
[00:03:53]  So I decided to do it.
[00:03:54]  And within 24, 48 hours, it had like a quarter million views.
[00:03:58]  And I think a lot of opportunities came out of that.
[00:04:01]  And as an academic scientist who had just transitioned into a tenure track position, kind of mainstream conventional scientist, some of my academic peers may have looked down on doing a Joe Mercola podcast, but I really think that he puts out a lot of information.
[00:04:22]  That's good.
[00:04:23]  Some of it's on the edge of fringe, but some of the stuff that he was really a leading kind of.
[00:04:30]  He does a lot of outreach and information, and a lot of it really was looking forward or had a lot of foresight into things like that we know now, like glyphosate, for example, or Roundup.
[00:04:43]  And I grew up on a farm spraying tons of that.
[00:04:46]  I was a sprayer kid, you know.
[00:04:47]  Oh, really?
[00:04:48]  Get up on the thing and put the concentrate in and spray without a mask.
[00:04:54]  GMO crops were grown all around.
[00:04:56]  So I never gave any of this stuff a second thought.
[00:04:59]  And even as an academic scientist, I didn't.
[00:05:01]  But when it was actually his website that I stumbled upon, and a lot of stuff that I was not aware of in regards to the toxicity of some of these agents and things like that.
[00:05:15]  So he put a lot of things on my radar that were kind of interesting.
[00:05:19]  And he took a particular interest in metabolism, ketogenic diets, and hyperbaric oxygen therapy.
[00:05:24]  And that was essentially the first podcast that maybe got me into the influencer space in this category.
[00:05:30]  Wow.
[00:05:31]  And so that thing kind of blew up and got over a million views.
[00:05:33]  I think that led to doing Tim Ferriss and Joe Rogan.
[00:05:37]  Yeah.
[00:05:38]  Oh, you know what?
[00:05:39]  Tim Ferriss, a friend of mine, Peter Tia, who also has a great, really good podcast that has incredible podcast notes.
[00:05:47]  And it's actually a very good resource for people just interested in science and want to go super deep on a topic.
[00:05:54]  He had, I believe, introduced me to him through an email, and we started communicating.
[00:06:01]  And I didn't actually know of Tim Ferriss either.
[00:06:04]  At the time, maybe 2012 or 13.
[00:06:07]  And then I did his podcast and I actually did two more.
[00:06:11]  I did a total of three podcasts with Tim and have since become a huge fan of the content that he puts out.
[00:06:19]  So he's very sort of like Rogan, very eclectic in the types of people he has on.
[00:06:26]  Yes.
[00:06:28]  The first podcast really, I was enamored by that first podcast you did with Tim, even though it was kind of.
[00:06:35]  A lot of stuff to digest, like a lot of the way the terms you guys use.
[00:06:38]  He's obviously very educated when it comes to you know science and the stuff that you guys are talking about.
[00:06:44]  And some of the words that you guys are using is kind of hard for someone like me, kind of like a normal everyday guy to understand.
[00:06:51]  But he breaks it down, he does break it down towards the end.
[00:06:54]  Yeah, yeah, to do that.
[00:06:56]  Uh, you know, I didn't really prepare at all for that podcast, and that has been sort of a trend.
[00:07:01]  Like, I just don't really prepare for it.
[00:07:04]  He didn't really give me a lot of like, I'm gonna ask you this or that.
[00:07:07]  I know I asked you before I came on here.
[00:07:08]  Yeah.
[00:07:09]  What questions?
[00:07:09]  Just so I preemptively know what's going on.
[00:07:13]  But yeah, I remember I was teaching and I had to run to get on the Skype call or whatever.
[00:07:19]  And I was just like, okay, I got to put on another hat here and just talk.
[00:07:22]  And I just, I felt like I babbled at the end of it.
[00:07:24]  Yeah.
[00:07:24]  It was only supposed to be 90 minutes.
[00:07:26]  And I think I went like two and a half or two, two or three hours.
[00:07:28]  It was like almost three hours.
[00:07:30]  Yeah.
[00:07:30]  And I was thinking, oh, man, I hope he edits this up because I just rambled on.
[00:07:34]  I just, but yeah, the feedback has been pretty good on that.
[00:07:38]  So I guess I rambled in.
[00:07:40]  That were helpful.
[00:07:41]  That was amazing.
[00:07:42]  Did you prepare it all for the Joe Rogan podcast or was that just sort of like on a whim as well?
[00:07:46]  Yeah, I became a little bit more prepared because I knew, you know, he had such a big platform.
[00:07:52]  And there was, because sometimes you just get into a topic or he leads you into discussion, you forget some of the reasons, you know, why you're doing what you're doing.
[00:08:02]  So I try to kind of plug the Office of Navy Research, the Charlie Foundation, which was probably the first website I ever stumbled upon with a ketogenic diet.
[00:08:12]  And that got me.
[00:08:13]  That sort of revealed to me that the ketogenic diet was a medical therapy for epilepsy.
[00:08:18]  And I was sort of contracted by the Office of Navy Research to develop a neuroprotective anti seizure strategy.
[00:08:25]  And I had done an undergrad in nutrition science at Rutgers University.
[00:08:29]  And it became an opportunity for me to revisit nutrition and actually make that the basis of my whole scientific sort of progress or platform as a research scientist at USF.
[00:08:45]  So I could introduce that.
[00:08:47]  And kind of reduce some of the drug related research that I thought I was going to do, looking at like drug compounds that were antioxidants or anti seizure drugs.
[00:08:57]  And it became refreshing to just reintroduce nutrition back in because I've always been, I majored in nutrition and biology in neuroscience or in Rutgers before going into a neuroscience program and kind of left nutrition out of my whole PhD, but always wanted to go back to it.
[00:09:15]  So my postdoctoral fellowship and then transition into a tenure track position really gave me that opportunity to revisit food as medicine, you know, or nutritional compounds that we developed too.
[00:09:30]  Therapies and medicine.
[00:09:32]  That's amazing.
[00:09:32]  And how did you get?
[00:09:34]  Can you give me the story on how you initially got involved with the Department of Defense in developing what you developed for the Navy SEALs and what the implementation was for the Navy SEALs?
[00:09:47]  Like, what were their missions that were specifically involved with?
[00:09:50]  Well, this research was really basic science research and it's still ongoing.
[00:09:54]  And the stuff that we're doing now in humans is actually done as a subcontract with Duke.
[00:09:59]  So they have these environmental chambers there where we.
[00:10:03]  Kind of dive people in and out of a ketogenic diet and look at their response.
[00:10:09]  So, looking back, it was kind of a circuitous route to it.
[00:10:15]  But as a PhD student, I knew I was going into a lab that was funded by the military.
[00:10:22]  And two or three years before I actually graduated, I started writing proposals to the Office of Navy Research.
[00:10:29]  And one got funded that developed the technology, which was hyperbaric microscopy.
[00:10:35]  And the The results from that experiment kind of led me down the path at like targeting mitochondria, energy metabolism, those sorts of things.
[00:10:48]  And the whole basis behind that first postdoctoral fellowship grant was to understand the molecular mechanisms of oxygen toxicity seizures.
[00:10:58]  Okay.
[00:10:58]  So the technologies that we developed help us understand it in ways that we didn't know before.
[00:11:03]  And I kind of realized that nutrition targeting energy metabolism was the way to go.
[00:11:10]  And then I stumbled upon the ketogenic.
[00:11:12]  Diet, which was a diet used for drug refractory epilepsy.
[00:11:16]  When the drugs did not work to control epilepsy, the standard of care actually was to put a patient on a ketogenic diet.
[00:11:25]  And then, in about 60% to 70% of patients who do a ketogenic diet, when drugs fail, the diet can work remarkably well in people, has a positive effect.
[00:11:39]  And in like 15 to 20%, or maybe 10 to 15 percent are super responders, meaning that they never have a seizure again.
[00:11:45]  They follow the diet and they wean themselves off and then they never get seizures again.
[00:11:49]  So, it is some people have labeled it a cure for epilepsy in that subpopulation.
[00:11:54]  So, to me, that I didn't know that.
[00:11:57]  And I majored in nutrition, and we didn't talk about the ketogenic diet, only the negative effects of like the Atkins diet or low carb diet or high protein diets, which I actually at the time I thought the ketogenic diet was a high protein diet.
[00:12:08]  You know, having gone through a top tier nutrition program, I still did not have any idea what a ketogenic diet was.
[00:12:15]  So, only I took it upon myself to do the research.
[00:12:18]  I connected with the people who were doing the research at Johns Hopkins mostly.
[00:12:22]  I bought Dr. Freeman, who was alive at the time, and Dr. Eric Kossoff, who had done work with the ketogenic diet and the modified ketogenic diet, which was higher in protein.
[00:12:34]  And it was like almost a diet that I could follow.
[00:12:36]  So, it was much more liberal in protein instead of the restricted 8% to 12%.
[00:12:40]  It was like 20% to upwards of 25% or 30% protein.
[00:12:44]  So, I decided to do the ketogenic diet.
[00:12:47]  I was learning about it.
[00:12:49]  I connected with patients like Mike Dancer.
[00:12:51]  We connected in a nutrition forum, and he was a patient with epilepsy in the UK.
[00:12:57]  He did the diet, and it worked for him.
[00:12:59]  And this is all while I was researching the diet.
[00:13:01]  I connected with Dr. Mary Newport, whose husband had Alzheimer's disease, and she was using a ketogenic strategy, which was like MCT oil and coconut oil, which can elevate your ketones.
[00:13:13]  And later, a ketone ester that was developed by Dr. Richard Veach at the NIH, who passed away about a month ago, actually.
[00:13:21]  And these are all key people that.
[00:13:24]  Were really the reason why I went into this area.
[00:13:28]  So I realized Hopkins was doing research, there was a lot of publications.
[00:13:32]  I connected with people here in the Tampa Bay area, people abroad, and it motivated me to contact the program manager at the Department of Defense or the Office of Navy Research and say, hey, here, look at all the science here.
[00:13:49]  You have top tier academic institutes doing research on the ketogenic diet.
[00:13:55]  For a broad range of seizure disorders.
[00:13:59]  So it seemed to be independent of the seizure type.
[00:14:01]  The ketogenic diet worked remarkably well for many different seizure types.
[00:14:05]  So, oxygen toxicity seizures is a type of seizure that causes these grand mal or toniclonic seizures.
[00:14:13]  So, the science was there on this diet that I didn't even really know existed as a medical therapy.
[00:14:18]  And I realized that the military did some research.
[00:14:23]  It wasn't too public, but I did find some of it on PubMed where they fasted.
[00:14:28]  Rats for 24 and 36 hours, and it made them like super rats.
[00:14:32]  So it made them resistant to oxygen toxicity up to 200.
[00:14:37]  And I think a 36 hour fast was like 250% delay in the time that they get seizures.
[00:14:45]  And the best seizure drugs only work to that.
[00:14:47]  And you have to dose them up so high, the animal's basically like in a sedated state.
[00:14:53]  So you could not load up a Navy SEAL with anti seizure drugs because they reduce cognitive and physical performance and then throw him into battle.
[00:15:02]  Right.
[00:15:03]  So the next question was the ketogenic diet appears to not really alter your performance that much.
[00:15:10]  Cognitive, it may enhance it.
[00:15:12]  And physical performance was still, I didn't know too much about it, but I realized that Jeff Volick, who is now at Ohio State University, built a whole sort of academic career studying the performance effects of low carb ketogenic diets.
[00:15:26]  So that gave me more ammunition, sort of, so to speak, to give the program officer to say, hey, there are all these different applications of a ketogenic diet.
[00:15:37]  Can you give me, you know, I'm proposing to get a million plus dollars to really fund this.
[00:15:43]  So it was a lot of back and forth and maybe about a year and a half before I actually got like the grant awarded.
[00:15:50]  And then when money started coming in to the University of South Florida, they like it.
[00:15:56]  You know, it's federal funds that pay indirects, which, you know, they can use for different things.
[00:16:02]  And it was a significant amount of money equivalent to like an NIH kind of grant.
[00:16:06]  So that set me up academically into my tenure track position.
[00:16:11]  To do a whole decade now of research on the ketogenic diet.
[00:16:15]  So it started with oxygen toxicity.
[00:16:17]  We developed ketogenic agents like exogenous ketone supplementation, ketone esters, you may have heard of.
[00:16:24]  Yeah.
[00:16:26]  So these things sort of developed and were utilized in our research and we published about them.
[00:16:32]  And ultimately, I was part of bringing ketone salts, which are exogenous ketones, to the market.
[00:16:38]  Okay.
[00:16:38]  We had a number of patents and then different organizations got these patents and then commercial products started showing up.
[00:16:45]  So I was actually me and Patrick Arnold were part of that.
[00:16:49]  And Patrick Arnold was, he was also on Tim Ferriss' show.
[00:16:54]  If you haven't listened to him, I haven't heard his yet.
[00:16:57]  A good guest to have on, an interesting background.
[00:17:00]  But his background was performance enhancement.
[00:17:02]  So I was like physical performance.
[00:17:05]  Yeah.
[00:17:06]  So he was involved in, well, you can just look up Patrick Arnold.
[00:17:11]  Okay.
[00:17:12]  He did as a chemist.
[00:17:13]  So he has a very interesting background, but he was very willing and interested and able.
[00:17:20]  To develop a compound that I needed, whereas all my connections in academia were not really willing or to develop this particular ketogenic compound.
[00:17:30]  So, when he did develop a series of sort of prototype compounds, one particular compound that he purified worked remarkably well for oxygen toxicity seizures.
[00:17:46]  And then we went on to use that compound in everything from cancer to Angelman syndrome.
[00:17:54]  which is a genetic disorder.

=== Changing Glutamate To GABA Ratios (14:48) ===

[00:17:56]  We now have Angelman syndrome clinical trials at Vanderbilt is being done on exogenous ketones, glucose lowering effects, anti-inflammatory effects.
[00:18:06]  It enhances, it has behavioral effects that can reduce anxiety.
[00:18:10]  So this is work that my wife did as a behavioral neuroscience person.
[00:18:17]  So yeah, we develop sort of novel agents and then novel agents that when you give them orally, they mimic the effect of the ketogenic diet or mimic the effect of fasting.
[00:18:26]  Okay.
[00:18:27]  So if I was to consume a ketone ester right now, if I was eating carbohydrates, but I follow a ketogenic diet most of the time, and you take a person and you give them a ketone ester and you measure their metabolic markers, it would look like they've fasted for a week or more and within 15 to 20 minutes.
[00:18:45]  So these agents are really remarkable and they shift the metabolism to basically burn a different fuel.
[00:18:51]  So your brain is like a hybrid engine, it can use glucose.
[00:18:54]  And in periods of fasting, it can use ketone bodies after about a week, about 60%.
[00:18:59]  Of brain energy comes from ketones.
[00:19:02]  So, the technologies that we developed basically put somebody into that state very rapidly, and it's giving the brain an alternative energy that makes the brain resilient against extreme environments and can also have an anti inflammatory effect, enhance certain metabolic processes in the brain.
[00:19:21]  It can also change the neuropharmacology of the brain.
[00:19:25]  And what I mean by that is like we have neurotransmitters in our brain, like glutamate and GABA, serotonin, dopamine, and other things.
[00:19:34]  We do know that being in a state of ketosis, even produced acutely with an exogenous ketone, can change the ratio of glutamate to GABA.
[00:19:43]  So, GABA being hyperexcitatory, and many neurodegenerative diseases are pathophysiologically linked to excess glutamate production.
[00:19:55]  So, glutamate is excitatory, and GABA is inhibitory.
[00:19:59]  But we make GABA from glutamate with an enzyme called glutamic acid decarboxylase.
[00:20:03]  So, the ketogenic diet and exogenous ketone seem to activate this enzyme that takes a neurotoxic neurotransmitter when it's at high levels and converts that into a brain stabilizing neuroprotective neurotransmitter or the ratios of this.
[00:20:20]  So, this is some of the work that evolved out of our mouse studies, but actually, other people have shown this in mouse models.
[00:20:28]  I think in humans, too.
[00:20:29]  We just recapitulated it, not with a ketogenic diet, but with a ketone ester.
[00:20:34]  So, this gives us kind of.
[00:20:38]  From a fundamental standpoint, you're changing brain energy metabolism, reducing oxidative stress, reducing inflammation, and changing brain neuropharmacology.
[00:20:48]  So, this was early on in our experiments that we were doing these things.
[00:20:52]  So, I realized it has major implications for not just, it has implications for everybody.
[00:20:57]  Right.
[00:20:58]  So, that because I was studying something that people could read a paper or hear me talk, it was relevant to their lives, whether they're trying to lose weight, control blood glucose, have more energy.
[00:21:14]  You know, most people know someone with cancer, like it was maybe something that they could use as an adjuvant or if.
[00:21:21]  Chemotherapy fails or something like that.
[00:21:23]  So there became more public interest in what I was doing.
[00:21:27]  And I took advantage of outreach opportunities because podcasts were, I mean, prior to maybe 2010 or 11, I'd never even heard of podcasts.
[00:21:39]  These things were happening.
[00:21:41]  But the more I did, the more opportunities came to me and the more I took advantage of using that platform to get our research out.
[00:21:50]  And I think when you really, I wasn't as passionate about the drug research or the compounds I was studying, even though I was fascinated.
[00:21:58]  You know, I would read paper after paper and it would be this compound was going to be remarkable.
[00:22:03]  It never really would live up to its expectations and experimentally.
[00:22:10]  But the ketogenic diet not only lived up to my expectations, it exceeded it in everything that we studied the ketogenic diet or exogenous ketones.
[00:22:19]  So that was very exciting to me because I'm in a pharmacology department.
[00:22:23]  I don't.
[00:22:23]  I don't think it was very, maybe my chair and maybe committees were very enthusiastic of maybe one of their faculty is going into basically basing their whole career on this high fat diet, you know?
[00:22:39]  So, but I knew it worked.
[00:22:41]  So I was very passionate about it and I knew the science was there.
[00:22:45]  It was very marginalized and grossly underutilized as a therapy for epilepsy.
[00:22:52]  And I felt that it had a similar.
[00:22:55]  Capacity, maybe even a greater capacity for other things outside of seizures and epilepsy.
[00:23:00]  So then I kind of embarked on many different experiments to test and evaluate nutrition, in particular the ketogenic diet and using nutritional ketosis as medicine.
[00:23:12]  And that was a springboard.
[00:23:13]  How specifically did the ketone esters affect Navy divers?
[00:23:18]  So they have not, well, they have not been used in Navy divers in a registered clinical trial.
[00:23:25]  Okay.
[00:23:25]  So right now we have a registered clinical trial with Duke.
[00:23:29]  And the protocol is there are people in the field using it that communicate with me in various capacities and they measure blood.
[00:23:39]  So they are sort of their own end of one experiments, but there are many end of one experiments going on.
[00:23:45]  And that feedback has been very helpful for me to understand what works, what doesn't work, what maybe does not work optimal as far as dosing.
[00:23:54]  And then I sort of apply that to like our animal studies and our animal studies that are published.
[00:24:01]  Some of that information helps us to develop the clinical trials we have at Duke now.
[00:24:07]  And the protocol for that is very simple, it's kind of simple in that they just do a modified sort of Atkins diet, Atkins like diet, or modified ketogenic diet that's pretty liberal.
[00:24:21]  And I think most people in the fitness community follow a similar ketogenic diet type approach.
[00:24:26]  And the requirement is that you just get ketones up to 0.5 millimolar.
[00:24:31]  And they choose people that.
[00:24:34]  Are sort of in an age range of the Navy SEALs, I guess you could say, and have maybe more of an athletic background.
[00:24:40]  So, they're kind of surrogates for the seals, I guess you could say.
[00:24:43]  And they measure everything from cardiovascular, EEG, brain activity.
[00:24:49]  They put an arterial cath in, and that goes to a mass spec, and they look at blood gases and everything you think of.
[00:24:57]  And they're inside probably the most advanced hyperbaric system on the planet.
[00:25:02]  And they're also submerged, and they're also playing a flight simulator, and they're pedaling a bike at the same time.
[00:25:09]  So, it's a very, It's a very complicated setup and a very, very cool experiment.
[00:25:16]  You could only do these sorts of experiments at Duke University, but they just put them on a ketogenic diet for three days and they give a supplement right before they get in and it puts them into a mild state of ketosis, like maybe a state that I'm in right now, but not a huge whopping dose of a ketone ester because they're not FDA approved yet.
[00:25:34]  Actually, we're in the process and I think maybe they are now, but and then in the future, we can do that for the particular type of ketone ester that prevents seizures.
[00:25:43]  So we're working.
[00:25:44]  With that now.
[00:25:46]  So, the studies that are being done now with oxygen toxicity are to basically replicate what a diver would experience on a mission in regards to the partial pressure of oxygen that's being inhaled.
[00:26:03]  And so, they're inside a hyperbaric chamber and they have a mask on and they have people assisting them if they actually have a seizure.
[00:26:10]  They push them to the edge of a seizure and there's basically EEG.
[00:26:17]  Signatures that will tell you, warn the person looking at the data that an impending seizure is about to happen.
[00:26:25]  And that's when they cut off the experiment.
[00:26:26]  Oh my God.
[00:26:27]  I was amazed that something like this got IRB approved, but it is a registered clinical trial and clinicaltrials.gov.
[00:26:35]  And it's a testament to Duke and their staff.
[00:26:39]  Bruce Derrick is one, and Richard Moon and Claude Pianodosi.
[00:26:43]  These are all icons in the field of dive medicine, you would say.
[00:26:51]  So, if I tried to do it, it wouldn't get passed.
[00:26:53]  So, they have the expertise and the background and decades of experience doing this kind of research.
[00:26:58]  So, that research is ongoing.
[00:27:00]  The pilot study has been done, and now 40 participants are going through this protocol.
[00:27:05]  And then, the next round, what we want to do is do sort of an extended ketogenic diet because we do think special operations guys, we do think the diet is feasible for special operations people to follow.
[00:27:18]  Maybe not the whole general military, but for special ops, a low carb diet.
[00:27:23]  Modified ketogenic diet is feasible.
[00:27:25]  And now exogenous ketones are palatable, tolerable, and efficacious for elevating ketones.
[00:27:31]  So we have sort of two technologies one being a specialized diet, another being a specialized supplement that, if consumed, will protect the individual likely better than anti convulsant drugs that we have.
[00:27:45]  And not only would it protect them from oxygen toxicity seizures, which makes diving safer, we think it also has a capacity after you're adapted to the diet.
[00:27:56]  Has the capacity to preserve performance resilience.
[00:28:02]  So if you're at one atmosphere on land and you follow a ketogenic diet, your performance is probably not going to increase that much.
[00:28:11]  So some people advocate that a ketogenic diet will enhance performance under certain conditions in certain types of athletes, or a ketone ester will enhance performance.
[00:28:21]  I'm not totally convinced of that data, and I'm a ketogenic diet researcher, so I should be biased.
[00:28:27]  But I do think that when you take an elite level warfighter and put him into a situation where his performance will be compromised and he's in a state of nutritional ketosis, that his performance will be maintained in that extreme environment.
[00:28:43]  We call that performance resilience.
[00:28:45]  So we do research with NASA on NASA extreme environment mission operations where we live in a hyperbaric habitat or we live in an environment that's an extreme environment.
[00:28:56]  And in these cases, we are looking to.
[00:28:59]  Basically, maintain a level of performance or prevent a performance decrement.
[00:29:05]  Right.
[00:29:05]  So that's sort of the idea here.
[00:29:08]  There's, you go on social media, there's lots of discussion and chatter and arguing about is a ketogenic diet best for strength athletes, bodybuilders, elite level marathon runners, cyclists, things like that.
[00:29:22]  That's where most of the discussion is, it's not so much in the.
[00:29:25]  I think I'm glad I'm not studying the ketogenic diet for sports performance.
[00:29:30]  It's kind of interesting and I keep up on it.
[00:29:33]  And I contribute even to some papers.
[00:29:36]  But I think the real low hanging fruit of benefits of the ketogenic diet are for people who really need it, like people that are overweight, people with type 2 diabetes, people who have seizures, of course.
[00:29:47]  And then also the warfighter who's subjecting themselves to particular extreme environments where we know the diet can be followed in this operational setting.
[00:29:58]  And we know from animal data and emerging human data that it would be beneficial in that environment.
[00:30:03]  So, Where did this diet, the ketogenic diet, originate from?
[00:30:07]  Like, when did humans start eating this way?
[00:30:11]  Yeah.
[00:30:12]  Well, it depends on who you ask.
[00:30:15]  But we knew that, you know, going back from scriptural times, I think, you know, the Gospel of Mark talks about fasting and seizures, right?
[00:30:25]  So, fasting produces a state of ketosis that's therapeutic fasting or starvation ketosis or fasting ketosis.
[00:30:34]  So that we knew for millennia that fasting had an anti seizure effect.
[00:30:41]  And Hippocrates talked about, you know, food is medicine and also knew about fasting and seizures.
[00:30:47]  But it really, and some people will argue the ketogenic diet came at this point, but it was really the Mayo Clinic in the 1920s, 2021, 22, where Wilder and colleagues really understood that fasting produced these ketone bodies in the blood and that.
[00:31:07]  If you took a diet and gave almost pure fat with just a little bit of protein, so enough protein to prevent protein malnutrition, and the patient ate that diet, their corresponding hormones like insulin and biomarkers or blood metabolites like glucose and, most importantly, its ketone bodies were shifted in a direction that looked like fasting, even though it was eucaloric, which means you can't fast.
[00:31:36]  You can only fast for so long to control your seizures.
[00:31:39]  But if you follow a ketogenic diet, You're getting all the calories that you need for energy and enough protein to maintain body tissues and function and to prevent protein starvation.
[00:31:51]  We do not need carbohydrates.
[00:31:53]  There's essential amino acids from protein and essential fatty acids from fats.
[00:31:56]  There's no essential sugars, carbohydrates.
[00:31:59]  So we could eat a diet that completely eliminates carbohydrates and feed that diet with a macronutrient ratio, which means fat to protein to carbs, carbs being almost non existent.
[00:32:13]  And maintain the patient on that, and they would sort of mimic the effects of fasting.
[00:32:19]  It's much different than fasting.
[00:32:21]  Well, it's different than fasting, but it shared many of the metabolic, physiological, and neurochemical effects of fasting, the anti seizure effects of fasting.
[00:32:32]  So that was in the 1920s.
[00:32:33]  And then the diet was actually used as an epilepsy therapy until about the 1960s, late 50s to 1960s, and anti seizure drugs came along.

=== Targeting Amyloid And Tau Plaques (08:32) ===

[00:32:44]  And they kind of dominated epilepsy or seizure therapies.
[00:32:50]  And for quite a while, but they never really work that well.
[00:32:53]  They do, there's about a third of patients who just don't respond at all.
[00:32:56]  They just, and the patients that do respond still get a lot of side effects.
[00:33:00]  In some cases, the drugs are remarkably well.
[00:33:03]  Some people will say that, you know, will be advocates of the, some people who are advocates of the ketogenic diet will say the drugs don't work at all.
[00:33:11]  And that's not the case because I meet people where the drugs are really life saving to them.
[00:33:15]  But I also meet people like Mike Dancer, who I connected with.
[00:33:20]  If you just look up Mike Dancer and epilepsy, you'll, Find his remarkable story of, you know, a dozen or half dozen or more medications that failed.
[00:33:28]  And the ketogenic diet was really the only thing that controlled his seizures.
[00:33:32]  And you run into a lot of people like this.
[00:33:35]  And the story that probably dominates is the story of Jim Abrams' son, Charlie Abrams.
[00:33:43]  Charlie was on a half a dozen different medications for drug resistant seizures.
[00:33:50]  And his father, Jim Abrams, Took it upon himself to educate himself about the ketogenic diet and going to the library of all things and showing his doctor, telling his, telling Charlie's doctor that he needed to be on this diet, but he faced resistance because the doctor did not even want to put his son, you know, this doctor's patient on the ketogenic diet because they thought it was going to be too difficult to follow.
[00:34:18]  And the doctor probably just didn't know enough about it.
[00:34:23]  But even though it was the standard of care, So essentially, he switched doctors.
[00:34:27]  Charlie got treated at Johns Hopkins, I believe.
[00:34:30]  And within a very short amount of time, it controlled his seizures to the point where Charlie could be weaned off the diet over a year or two.
[00:34:40]  And the story was so remarkable, it made Dateline NBC.
[00:34:44]  And I saw that back in maybe 1996 or something.
[00:34:49]  And Jim Abrams was friends with Meryl Streep.
[00:34:52]  So Meryl Streep did a movie about the ketogenic diet called First Do No Harm.
[00:34:56]  And it was the Charlie Foundation and this movie, First Do No Harm, which really got me motivated.
[00:35:03]  I sent like all these links to my program manager at the time.
[00:35:06]  And it was, I connected with the leading scientists, including Dr. Jung Ro, who was at the Barrow Neurological Institute at the time, treating patients and also doing science.
[00:35:15]  So it was a combination of things in the media, personal stories, people that I knew.
[00:35:24]  And I think most importantly, I mean, there was really solid PubMed, you know, peer reviewed academic research supporting.
[00:35:31]  This therapy, it was working as an anti seizure effect because it made the brain work better.
[00:35:40]  So I knew it had implications for other things, but nobody else was really looking at these other things.
[00:35:45]  So, actually, one of the first experiments that we did was actually a mouse model of Alzheimer's disease.
[00:35:51]  We started the intervention, the ketogenic diet intervention, kind of after these mice sort of have the Alzheimer's pathology, which is these amyloid plaques, toxic plaques form.
[00:36:04]  And once that happens, it's hard to reverse.
[00:36:06]  But our studies did not show it was therapeutic in the realm of preventing Alzheimer's disease because these mouse models really are not very well suited to study the disease.
[00:36:18]  But we did see an increase in motor performance.
[00:36:20]  So they would run faster and farther on like a treadmill device we call a rotorod.
[00:36:25]  So that was very interesting.
[00:36:27]  And then, but other people have published, including NIH, showing that the ketogenic diet and most of the research is on a ketone ester delayed the progression of these amyloid and tau plaques, which are the hallmark characteristic of Alzheimer's disease.
[00:36:43]  But I believe they got ketone levels higher and they started the intervention a little bit early.
[00:36:48]  So, the take home message is that if you are predisposed to Alzheimer's disease, it would be prudent to start the intervention early.
[00:36:59]  And that could be a diet, that could be supplementation.
[00:37:01]  What is the plaque that you mentioned?
[00:37:03]  And how does that plaque bring on Alzheimer's?
[00:37:06]  Yeah.
[00:37:07]  Yeah, a really good question.
[00:37:08]  This is like there's amyloid beta plaques and tau plaques.
[00:37:14]  And the etiology of this.
[00:37:20]  Tauopathy or amyloid plaque accumulation, the reason for it happening is an academic question that has not been sufficiently answered yet.
[00:37:31]  Okay.
[00:37:31]  And it's very ambiguous how these things develop.
[00:37:34]  But you only have Alzheimer's disease.
[00:37:37]  Alzheimer's disease is defined more or less post mortem by showing when you open up, you know, dissect the brain and find these plaques.
[00:37:47]  There are new technologies that are emerging that are essentially.
[00:37:51]  Positron emission tomography or PET scans that can scan for amyloid and tau.
[00:37:56]  And so we have technologies now that can actually image the presence of these plaques and the progression of the plaques over time with different therapies.
[00:38:07]  So this is relatively new, but some institutes are doing this.
[00:38:12]  So it is not really understood.
[00:38:15]  Genetically, there are molecular things that are being turned on that accumulate these that cause the body to form these toxic plaques.
[00:38:24]  But The question is, why does the body produce these plaques at all?
[00:38:30]  Right.
[00:38:31]  I think it's, and this is controversial, but these amyloid and tau plaques are produced in response to inflammation in the brain.
[00:38:42]  And also at the root of that could be a dysregulation of metabolic control.
[00:38:47]  So another hallmark characteristic of Alzheimer's disease is a decrease in glucose metabolism.
[00:38:54]  So in FDG PET scan, Which looks at glucose metabolism in the brain is very dim in patients who have Alzheimer's disease relative to a normal subject.
[00:39:04]  The image is much brighter, which is indicative of the brain using high levels of glucose for energy.
[00:39:10]  A hallmark characteristic for Alzheimer's is glucose hypometabolism.
[00:39:15]  You need a robust metabolic activity to deal with a number of processes in the brain, including dealing with processing the amyloid plaques and Alzheimer's.
[00:39:27]  And, you know, the body needs to get rid of them through.
[00:39:31]  A series of enzymatic reactions and things that are cleaved, and the lymphatic system, the brain has a lymph, so which you know activates at nighttime when we sleep.
[00:39:41]  So, there's a lot of things that we're learning now that could be the root cause of it.
[00:39:45]  So, it's the disability to burn the you're producing too much plaque or you're not breaking it down, sort of being recycled.
[00:39:54]  But there's some evidence that amyloid plaques have antimicrobial effects.
[00:39:59]  So, if you were to have a viral illness like you.
[00:40:03]  You know, things simple like herpes simplex or HIV or coronavirus.
[00:40:09]  Coronavirus, yeah.
[00:40:11]  Or, yeah, that's a hot topic.
[00:40:13]  Or Lyme's disease, like things like that.
[00:40:17]  So there's evidence that Lyme's disease, that Alzheimer's pathology could be a result of having a microbial, pre existing microbial infection.
[00:40:34]  And it could be viral, it could be bacterial, but it's causing neuroinflammation.
[00:40:40]  Neuroinflammation is causing metabolic dysregulation and the accumulation of these toxic plaques.
[00:40:48]  And you can also be, genetically, you could be predisposed.
[00:40:52]  We have different, if you're an ApoE4, that genotype will make it more likely that you'll have Alzheimer's disease.
[00:41:03]  And if you reach the age of like 75 or 80, there's a pretty high probability that you'll have Alzheimer's disease if you are genetically predisposed and have the ApoE genotype, ApoE4 or 44.

=== Why Fiber Negates A Ketogenic Diet (15:06) ===

[00:41:17]  Yeah, I mean, it makes so much sense as far as like evolution goes and animals go.
[00:41:20]  Like going back to what you said about, Physical performance.
[00:41:24]  If you think of like an animal who hasn't eaten in two weeks, right, it has to have that extra boost of energy to be able to catch its prey and to eat.
[00:41:33]  And, you know, having those ketone bodies, I guess, in their blood really does affect them that way.
[00:41:39]  Well, if I guess put it another way like if an animal is in a starvation state, right, and could not readily use ketone bodies for fuel or be able to function, you know, from a cognitive or mental perspective.
[00:41:54]  You know, point of view or physical point of view in a mildly hypoglycemic state and not have robust access to its body fat and then the ketones that are produced from that, they would not be able to forage and catch their prey, you know, so they would not survive.
[00:42:10]  So they would not, evolution would not favor individuals, animals that did not keto adapt, we say, right over time.
[00:42:19]  So I think there's a pretty big component to that.
[00:42:21]  But I think our modern lifestyle, the foods we eat, our maybe lack of activity, Prevent us from having limited food availability.
[00:42:35]  So we essentially silence that gene program that would otherwise be activated in the face of short term fasting or long term fasting.
[00:42:49]  So when we fast, not only does it completely change our metabolic physiology, it changes our brain chemistry, the neuropharmacology of the brain, but it also activates.
[00:43:01]  So, we say it has an epigenetic effect.
[00:43:04]  And we have pretty good evidence now that once those gene pathways are activated, it can enhance ketolytic enzymes, which are enzymes that allow ketones to be used as energy, ketogenic enzymes, enzymes in the liver that can allow a robust production of ketones under certain states.
[00:43:25]  And then the transport of these ketone bodies, which are through these things called the monocarboxyl acid transporters, like the transporter proteins get upregulated pretty robustly.
[00:43:35]  When you fast a person or when you put them on a ketogenic diet, and then if they go off the diet completely and then go back on again, they are much, they enter into a state of ketosis much, much faster.
[00:43:48]  So there's some animal data that suggests that, and of course, data in people.
[00:43:53]  So the more you do it, the easier it gets, and maybe the more benefits you derive from it too.
[00:43:58]  And I think that is supported in the literature now.
[00:44:01]  And also, you know, and it kind of lends to this idea of metabolic flexibility.
[00:44:09]  So, if we're on a carbohydrate based eating program and we're eating carbohydrates continuously throughout the day with small meals and we never restrict it, then we never are making our body flexible to using other types of macronutrients.
[00:44:26]  So, one thing about humans is that we are remarkably adaptable and we are true omnivores, whether you believe in the carnivore diet or the vegan diet, plant-based diet.
[00:44:36]  I think the truth is that humans have evolved and survived and do so well because of their omnivorous capacity.
[00:44:47]  And we can do fine off eating meat and meat only, but is it optimal?
[00:44:51]  I don't think so.
[00:44:53]  We can live and survive off eating a vegan diet.
[00:44:56]  Is it optimal?
[00:44:56]  I don't think so.
[00:44:58]  So the optimal diet is the omnivore diet.
[00:45:01]  So whether both sides want to agree to that or not, but it's a hot topic.
[00:45:05]  People can do that.
[00:45:06]  You've dedicated your life to it.
[00:45:08]  So it's fair to say, you know.
[00:45:10]  I've actually dedicated my life to a diet that's pretty radical metabolic therapy, a clinical therapy.
[00:45:17]  So the ketogenic diet is very extreme.
[00:45:19]  And I don't think it's, it may, for some people, it may be optimal, obviously, if you have seizures or emblems or something like that.
[00:45:26]  But is it optimal for the athlete?
[00:45:28]  Is it optimal?
[00:45:29]  I admit I follow the diet, but every day I eat dark chocolate and blueberries and.
[00:45:36]  Probably some greens and broccoli every day, too.
[00:45:38]  So it's not a version of a ketogenic diet that a person with epilepsy would follow.
[00:45:44]  Although the science is evolving to the point where the classical ketogenic diet, our understanding of it is being that it's maybe too restrictive and that a more modified or more liberal forms of the diet may be actually better.
[00:46:02]  Definitely better for adults.
[00:46:03]  But in the pediatric population, it's always prudent to start them on a On a classical ketogenic diet with almost 90% fat, and then see how they react, and then maybe be a little bit more liberal and transition them to kind of a diet that I'm following.
[00:46:19]  You can also incorporate different types of fats like coconut oil or medium chain triglyceride oil, perhaps even exogenous ketones, but that's still in a state of being studied now.
[00:46:30]  That the introduction of those types of fats and supplements could make it possible that a much more liberal diet could be followed and still maintain therapeutic ketosis, which would.
[00:46:42]  Be have an anti seizure or neuroprotective effects.
[00:46:45]  So, I'm that's that's like sort of my wheelhouse, and that's what I'm very interested in doing because this therapy, the benefits of the ketogenic diet are not very accessible to people because they don't want to exclude an entire macronutrient from their diet, which would be carbohydrates.
[00:47:03]  So, I think there are true benefits to some of these plant based foods like you know, chocolate, blueberries, coffee, arugula, broccoli, things like that.
[00:47:15]  There's definitely some real benefits to eating these foods.
[00:47:19]  And I think that excluding them is not a great idea, especially for following it for the duration of your life.
[00:47:25]  And some people have to do that for their disorder.
[00:47:27]  So we're trying to work and engineer diets that would be feasible for someone to follow.
[00:47:35]  But their feasibility, their efficacy may only be efficacious when ketogenic fats and ketone supplements are also incorporated into the diet.
[00:47:47]  And we think of those things as food.
[00:47:49]  Like exogenous ketone.
[00:47:51]  A ketone ester is a calorie containing molecule that is kind of unique.
[00:47:57]  It's like a fourth macronutrient, but it can be incorporated into the food and make that ketogenic diet more efficacious.
[00:48:06]  It can augment the therapeutic potential of the diet in different ways.
[00:48:10]  So, this is an area that I study and that we are doing research on now.
[00:48:15]  So, what do you believe the optimal diet is for just the average person who may not be a professional athlete, maybe goes to the gym a couple days a week, has a desk job, or has just a normal nine to five?
[00:48:28]  What would you, what would you, what is your opinion on the optimal diet for that kind of person?
[00:48:33]  Yeah.
[00:48:34]  Well, the diet that's not optimal is probably like the majority of people after a certain age eat too many calories, right?
[00:48:42]  And surplus calories will result in sort of metabolic derangement and type 2 diabetes and just being overweight.
[00:48:50]  So we are more likely to eat surplus calories if it comes from processed carbohydrates and a combination of sugar and fat.
[00:48:59]  Right.
[00:49:00]  So, sugar and fat are two things that you want to limit in your diet, the combination of the two.
[00:49:08]  But, fat.
[00:49:09]  Yeah.
[00:49:09]  The combination of like salt, sugar, and fat.
[00:49:12]  But a ketogenic diet is extremely high in fat.
[00:49:16]  And if you, if a ketogenic diet is by definition devoid of carbohydrates, it's the carbohydrates that can spike the insulin and kick you out of ketosis that makes the benefits of.
[00:49:31]  A ketogenic diet, it negates it.
[00:49:34]  So, if you're on a ketogenic diet and you have, you follow the ketogenic diet perfectly, but have, you know, a couple pieces of candy a day, you're not going to be getting the benefits of the diet from a neurological standpoint, at least from an anti seizure standpoint.
[00:49:51]  Okay.
[00:49:51]  Because a child could eat one piece of candy and have a seizure.
[00:49:54]  And this has been shown many times.
[00:49:56]  So, it kicks you out of ketosis and then your brain goes right back into, uh, It activates your brain in a way that triggers a seizure.
[00:50:04]  We don't know exactly why this happens.
[00:50:06]  Okay.
[00:50:09]  But it depends on the individual, I guess is my point is that if you're trying to lose weight, a diet that is formulated, and that could be a vegan diet, it could be, I don't think it's optimal, or it could be a carnivore diet.
[00:50:24]  But I think the optimal diet for, if we're just going to make a blanket statement, is a low carbohydrate, a diet that's low in carbohydrates.
[00:50:35]  But is sufficient enough in plants that you're getting phytonutrients and fiber.
[00:50:39]  I do believe in fiber.
[00:50:42]  Early man had sometimes 100, 150, 200 grams of fiber in their diet, if you look at it.
[00:50:49]  It depends on the period, too, if you look back in history.
[00:50:52]  But having studied, I did study the evolution of the human diet through college and read a number of books on it.
[00:50:59]  And one thing that was really apparent is that a lot of fiber was eaten.
[00:51:03]  But, you know, An optimal diet would be devoid of processed carbohydrates and sugars and sufficient in protein from fatty cuts of beef, fish, poultry.
[00:51:18]  The beef, ideally, not everybody can afford it, but from pasture raised grass fed animals.
[00:51:24]  Okay.
[00:51:25]  I think that's obviously much better for the environment.
[00:51:30]  Concentrated feed law operations are very destructive to the environment.
[00:51:36]  And when you're You make a statement when you buy your food if you're supporting this kind of agriculture.
[00:51:43]  I do believe that GMO foods can be destructive too, having come from a farming background.
[00:51:48]  We are farmers too.
[00:51:49]  We have had to feed the cows in the morning and get them.
[00:51:52]  So I spent a lot of time on the farm and feeding cows before coming here today.
[00:51:56]  And I know there are proper ways to farm and improper ways to farm.
[00:52:02]  So I think when you purchase your food, you're kind of making a statement, but also you're choosing a type of food that's inferior if you're going in the direction of your food from factory farms.
[00:52:15]  So that's one consideration.
[00:52:18]  People put a lot of time and effort looking into this subject.
[00:52:22]  That's all I'm going to say about it for now.
[00:52:24]  But I think that the macronutrient comp, The macronutrients are most important in regards to just like human nutrition, right?
[00:52:33]  So, I believe in a higher protein diet, anywhere from I think 15, 10 to 15 percent is, or 15 percent is like what's recommended by the USDA or ADA.
[00:52:45]  And I'm kind of more along the lines of, you know, 20 to 30 percent.
[00:52:50]  And with the balance being 50 to 70 percent of my calories from fat, just because I do ketogenic diet research, I tend to follow the ketogenic diet.
[00:53:00]  And I do get, Probably anywhere from 5 to 15% of my calories from carbohydrates.
[00:53:06]  And I can stay in ketosis with that level of carbohydrate consumption, especially if I'm incorporating ketogenic fats or I'm pretty active.
[00:53:16]  And I have a lot of blood work to back up that that is working for me.
[00:53:23]  Right.
[00:53:24]  Everyone's different.
[00:53:25]  Yeah.
[00:53:25]  If you look at my blood work now, I'm 45 ish.
[00:53:30]  And if I go back to I'm 25, my blood work at 45 is much better.
[00:53:35]  When I was 25, I was probably getting about 300 grams of carbs a day, not like crazy amounts, but I was eating a lot more food too.
[00:53:44]  So that's a big part of it.
[00:53:47]  And the reason the ketogenic diet works remarkably well for losing weight and weight maintenance, a lot of people can lose weight, but not a lot of people can follow an eating program that maintains that weight loss.
[00:54:00]  And I think a ketogenic diet can do that remarkably well.
[00:54:05]  By maybe some may argue, is that it's unpalatable, so you're just less likely to eat more, right?
[00:54:13]  If you're excluding carbohydrates, but it has an appetite suppressing effect, so that's pretty clear in the literature.
[00:54:20]  So, that's one reason most of the people who are interested in the ketogenic diet are interested in its weight loss effects, right?
[00:54:28]  So, I think people need to know that it's not a magic diet.
[00:54:32]  I think Dr. Atkins advocated that there was a metabolic advantage.
[00:54:37]  That suppressing the hormone insulin can allow you to eat actually more calories and you're burning more calories.
[00:54:45]  I don't think the science supports that.
[00:54:49]  Some evidence, there may be some evidence that that's true, but it's very negligible.
[00:54:53]  The big effects of the ketogenic diet for weight loss really come down to its ability to produce inadvertently calorie restriction and allow people, and you're getting the benefits of ketones too, which after you adapt to the diet, you feel more lucid, you have more energy.
[00:55:11]  Yeah.
[00:55:11]  Over time.
[00:55:11]  But you feel crappy the first month, typically.
[00:55:14]  That's the keto flu, right?
[00:55:15]  That people typically get.
[00:55:16]  Yeah.
[00:55:17]  I never really had that.
[00:55:20]  And I think maybe athletes, especially elite level athletes, not that I'm definitely not an elite level athlete, but I did go through periods where I would go through calorie restriction and then calorie surplus and stuff when I was tinkering more with weightlifting stuff.
[00:55:35]  But I think that athletes enter something called post exercise ketosis.
[00:55:40]  So, if they go out on a bike for four to six hours, they burn up all their glycogen, they tap into their fat, they come back, they're in a state of ketosis, even though they're eating, you know, three, four hundred grams of carbohydrates a day, you know, they can enter that state.
[00:55:54]  So, it's, you know, this is a phenomenon.
[00:55:58]  And so I think they are just by definition more metabolically flexible.
[00:56:01]  So when they follow the ketogenic diet, many of them do quite well and don't have a keto flu.
[00:56:08]  Keto flu is probably also due to electrolyte imbalances or.
[00:56:13]  Diuretic effect, a mild diuretic effect, or a hyponatremic effect.
[00:56:16]  You excrete excess sodium, things like that.
[00:56:20]  Magnesium may be a little bit low too.
[00:56:22]  Mine was a little bit low.

=== Achieving Metabolic Flexibility With Fat (05:11) ===

[00:56:23]  And probably the only supplement that I take for the QJank diet is a magnesium supplement.
[00:56:28]  Now, I don't think I need it now because I think I've adjusted my diet, but it's something that was a little bit below normal at a point in time.
[00:56:38]  I was probably not putting my diet together well.
[00:56:40]  And that struck me as kind of odd and explained some of the cramps I was getting, which is a potential side effect.
[00:56:45]  The keto jank diet.
[00:56:47]  And I've always used magnesium at nighttime.
[00:56:49]  So, can you walk me through what your day looks like as far as what you eat and like for breakfast, lunch, dinner?
[00:56:55]  And can you also give me kind of a beginner's grocery list for someone that wants to get started and that's someone who's really interested in the keto diet?
[00:57:03]  Yeah.
[00:57:04]  Well, today I didn't eat anything.
[00:57:06]  So, okay, nothing yet.
[00:57:07]  Yesterday I did.
[00:57:08]  If we use yesterday as an example, or maybe tomorrow, I'm trying to think of my schedule tomorrow.
[00:57:14]  But about two or three days a week, I do intermittent fasting.
[00:57:17]  And that's a subject we didn't really talk about, but.
[00:57:20]  Intermittent fasting is something a lot of people are doing, and it's eating within a predetermined window, also called time restricted eating.
[00:57:28]  So, you could eat within an eight hour window, say from 12 noon to 8 p.m., and nothing after that time or before that time.
[00:57:38]  That pushes your body into a mild state of ketosis.
[00:57:41]  And if you're on a ketogenic diet, since you've already adapted to using fat and ketones for fuel, it's easier to follow intermittent fasting.
[00:57:48]  So, today I am doing intermittent fasting, and my meal.
[00:57:53]  My first meal will probably be about 2 p.m. in the afternoon.
[00:57:56]  And in my bag, I have wild planet sardines.
[00:58:01]  And I have wild planet sardines.
[00:58:04]  And maybe we'll go out and have a salad somewhere.
[00:58:07]  And I'll probably put that on the salad.
[00:58:09]  And that'll be my first meal of the day.
[00:58:12]  But yesterday, we have chicken sausage and eggs.
[00:58:18]  I think I had sausage and eggs for breakfast.
[00:58:22]  But my food list, I kind of wrote down what my wife does shopping.
[00:58:26]  Like fatty cuts of meat, uh, poultry, and we get like the whole chicken usually with a bone.
[00:58:32]  Oh, really?
[00:58:33]  So, my wife's Hungarian and she introduced me, uh, which is pretty big in the carnivore, uh, crowd, is eating organ meats.
[00:58:42]  So, all the organs.
[00:58:43]  So, mostly we eat hearts and livers, and that's a big staple in our diet.
[00:58:47]  So, we eat a lot of heart, a lot of liver, uh, a lot of beef tallow, like beef fat.
[00:58:53]  We'll use that for different things.
[00:58:55]  We'll make stews.
[00:58:56]  Um, I get most of our beef actually through Butcher Box, which is an online service.
[00:59:03]  And you just order it, you subscribe to it, and it just comes to you.
[00:59:06]  Yeah, it's grass fed, grass finished.
[00:59:09]  Yeah, Butcher Box Meats.
[00:59:11]  The other company that has superior meat is U.S. Wellness Meats.
[00:59:19]  Their products are very good too.
[00:59:20]  And they also have like organ meats that you can buy.
[00:59:22]  They have like you can get ground heart and make like heart burgers.
[00:59:25]  It's ground up with like beef fat and things like that.
[00:59:29]  So.
[00:59:30]  That and fish, a lot of fatty fish, like sardines, like I said, will be my next meal.
[00:59:35]  Which are delicious, by the way.
[00:59:36]  I tried them recently after hearing the Tim Ferriss.
[00:59:38]  Yeah, Wild Planet has, so they reached out and sent me sort of, I didn't know that they had like all these different fish varieties.
[00:59:46]  So Wild Planet actually has all different types of sardines that you can go, and they have all many different types of tuna fish too in cans and packets, and they also have chicken, and they're super big on sustainability.
[01:00:01]  So they've done their homework in regards to sort of regenerative farming for fish and sustainability.
[01:00:11]  So I feel good.
[01:00:13]  Supporting them, purchasing their products.
[01:00:15]  Butcher Box, U.S. Wellness Meats are sort of where we get a lot of our food from.
[01:00:19]  We go to the local butcher too and get like big bones for the dogs and ground meat and stuff like that occasionally.
[01:00:26]  We feed our dogs what we eat.
[01:00:29]  Sour cream is something I have every night to fill, basically to get in extra calories.
[01:00:34]  So at the end of the day, I'm usually calorie deficient just because my days are pretty busy.
[01:00:40]  But I make like a chocolate mousse at night using coconut cream, sour cream.
[01:00:47]  Cream and dark chocolate baking cocoa.
[01:00:50]  But now I have different powders that are like collagen powder, like chocolate collagen powder that's like lightly sweetened with stevia.
[01:00:57]  So I like throw a scoop of that in with sour cream and blueberries and something really simple.
[01:01:03]  Like every night's like a different recipe, but that's what I had last night.
[01:01:06]  And I'll stir that up and it'll be probably like 70 grams of fat just from the sour cream and then a scoop or two of chocolate collagen with wild blueberries.
[01:01:18]  So, I get a couple different companies sell wild blueberries and I buy those.
[01:01:25]  That and salad creams, olive oil, MCT oil, you know, butter, grass fed butter.

=== My Morning Coffee Cocktail Secrets (02:45) ===

[01:01:34]  What about the coffee?
[01:01:36]  What's your coffee cocktail?
[01:01:37]  What do you put in your coffee?
[01:01:38]  Yeah.
[01:01:38]  So, today, well, I'm drinking, I'm not advertising for them, but Purity Coffee, let coffee be thy medicine.
[01:01:46]  It's really good coffee and I'm not trying to advertise for that.
[01:01:49]  But, But I have, you know, people send me different coffees that I like to try.
[01:01:55]  So I typically have a French press and I make about almost a liter of coffee in the morning.
[01:02:03]  Not super strong and not super weak, just kind of.
[01:02:05]  And I have one cup and then I pour the rest in this.
[01:02:08]  And then I typically finish this before noon.
[01:02:11]  And I try to get no caffeine, definitely no caffeine after like 2 p.m., but usually try to cap my caffeine by 12 noon because I'm really big into sleep.
[01:02:21]  Sleep hygiene, sleep.
[01:02:22]  I monitor these things as part of what we study.
[01:02:24]  I saw that on your Instagram.
[01:02:25]  Yeah.
[01:02:26]  So a lot of times I don't put anything in my coffee, but there's a particular product out that's really good.
[01:02:32]  It's called Momento.
[01:02:33]  It's really marketed towards cognitive function and Alzheimer's disease.
[01:02:40]  And it's got everything from MCT to theanine to versions of choline that can enhance acetylcholine, acetylcholinergic function.
[01:02:53]  So I've been putting.
[01:02:55]  One serving of that in there.
[01:02:56]  So it supplies some MCTs, which, but it's not a whole lot of calories.
[01:03:01]  So this, that's the only sort of calories that I had in my coffee today.
[01:03:04]  So I've been, because we've been really busy in work and on the farm and everything, a little bit less sleep than normal.
[01:03:12]  And I notice when I have that, the, I do notice this particular supplement is sort of giving me the caffeine and the theanine seems to take the jitters off of the extra caffeine that I'll get in the morning.
[01:03:24]  Okay.
[01:03:24]  So that's what I've had today.
[01:03:28]  Um, So, the MCT and the butter?
[01:03:31]  Yeah, I don't always use butter.
[01:03:32]  Like, I don't have butter in this because it has a blend of essential fats.
[01:03:39]  DHA, EPA, MCT.
[01:03:43]  Again, the company is called Momento.
[01:03:45]  And it's a new product that I'm trying.
[01:03:47]  I met them at the Metabolic Health Summit, which is, I'd encourage your listeners to go to the Metabolic Health Summit if they're interested in anything that I'm doing.
[01:03:55]  It's like a top tier, you know, academic, clinical, and also entertainment.
[01:04:01]  We had JP Sears there.
[01:04:02]  Oh, wow.
[01:04:03]  JP Sears.
[01:04:03]  Yeah.
[01:04:03]  So he was our entertainment for the gala.
[01:04:05]  It's an amazing event.
[01:04:06]  But Momento was, they had a booth there and it was the first time I'd heard, I knew it was coming out.
[01:04:12]  And I had two samples of it, and I've been using it, and I love the product.
[01:04:15]  So, only about 20% of the things I actually try do I like say something like this.

=== Preparing For Space Analog Missions (07:21) ===

[01:04:20]  Okay.
[01:04:20]  So, you try a lot of stuff.
[01:04:21]  I do.
[01:04:22]  I have a lot of stuff that I still need to try.
[01:04:25]  A lot of things I shelve.
[01:04:27]  But yeah, I love to try products.
[01:04:29]  I do a lot of testing on myself, you know, and we have various technologies where we can look at things like reaction time and like decision making.
[01:04:38]  And there are things that were experiments that we were putting together for the next.
[01:04:45]  NASA NEMO mission and also high seas mission, which would be in Hawaii.
[01:04:49]  So we're gearing up to do, to study a lot of things as far as performance wise on those missions.
[01:04:56]  And so it'd be kind of fun to, yeah, test myself.
[01:05:00]  Oh, yeah, definitely.
[01:05:01]  I remember you mentioned something about you spent like 10 days underwater for some sort of study.
[01:05:05]  Was that a NASA study or?
[01:05:07]  Yeah.
[01:05:07]  So NASA has, to prepare astronauts for space, you know, they have what they call space analog missions.
[01:05:16]  And There's about 14 space analog missions.
[01:05:20]  And the mission, the only mission that I know of that actually uses astronauts is the NASA Extreme Environment Mission Operations.
[01:05:28]  And this, I was on mission, my colleague, Dawn Carnegis, was on mission 21, NEMO 21.
[01:05:37]  And I had the amazing opportunity to be on NEMO 22.
[01:05:40]  And my wife was on mission 23, actually.
[01:05:43]  So we're like super lucky.
[01:05:44]  That's crazy.
[01:05:46]  And she ran a lot of the science my wife did on mission 22 when I was underwater.
[01:05:50]  So, they pair you up with a crew, and typically they have a couple astronauts on there.
[01:05:57]  My commander was Shell Lindgren, and he's been on the space station about a half a year.
[01:06:02]  And also Pedro DeQue, who is now the science minister of Spain, but he flew with John Glenn, I think, in 95.
[01:06:10]  So, he was a very accomplished ESA astronaut.
[01:06:12]  And then the NASA astronaut was Shell, and he was also a medical doctor.
[01:06:19]  And also Trevor Graff, who is sort of a Planetary biologist, geologist at NASA.
[01:06:24]  So that was the three crew members.
[01:06:26]  And then there's two habitat techs who just make sure we're safe when we do our EVAs, when we go outside of the habitat.
[01:06:33]  So we live in saturation in this, you know, if you're a scuba diver, you know, you can only go down for so long before you get the bends or yeah.
[01:06:42]  So nitrogen narcosis, if you go down to or you get DCS or the bends, right?
[01:06:47]  Decompression sickness.
[01:06:49]  So we kind of throw out the tables, right?
[01:06:53]  When we were in saturation and you dive down there and you stay down there.
[01:06:56]  and you cannot come up, you know, if you come up mid-mission, you'll die a very painful death.
[01:07:02]  Right.
[01:07:02]  Right.
[01:07:02]  So you live down there for, we live for 10 days.
[01:07:06]  Each mission is a little bit different.
[01:07:07]  Some, I think my wife's was nine days, some are 14 days, some are seven days.
[01:07:12]  So, but what NASA holds these missions to basically vet out procedures, technologies, you know, different things that can be used for deep space missions.
[01:07:26]  The idea is to look at crew dynamics, to look at different widgets that monitor sleep, that monitor cardiovascular function, that monitor exercise devices.
[01:07:36]  We'll test down there.
[01:07:37]  We had a device to rescue an astronaut who's been incapacitated.
[01:07:41]  And we live inside the habitat, but during the day, we go outside of the habitat.
[01:07:46]  And that's called an extravehicular activity or an EVA.
[01:07:49]  And then we'll have a whole list of tasks to do that could take anywhere from four to six hours.
[01:07:55]  So we are in a suit.
[01:07:57]  We maintain, you know, we're living in the saturation state.
[01:08:02]  And everything is done, you know, pretty much how it would be if you're living on Mars or how they envision it would be.
[01:08:08]  There's this thing called playbook.
[01:08:10]  So, everything is organized from day one.
[01:08:12]  What you're doing, what the next guy's doing, everything is very organized.
[01:08:15]  The safety and the crew at the mission control that's run by FIU.
[01:08:25]  So, there's like mission control, and there's a lot of scientists and engineers that are on mainland.
[01:08:32]  We're out in the Atlantic at the bottom of the Atlantic, a couple miles out.
[01:08:36]  But mission control really calls all the shots.
[01:08:39]  So, we have communications all the time, you know.
[01:08:43]  Telling us what to do, and we have a pretty demanding schedule from the time we wake up.
[01:08:50]  You know, they give you like two hours of personal time at the end, but that's really just preparing for the next day.
[01:08:54]  Okay.
[01:08:55]  So it's probably one of the most amazing experiences of my life being able to do this and be among those people who are such high achievers and operating at such a high level.
[01:09:06]  I was able to learn from them, you know, up my game.
[01:09:09]  I mean, so we all have to do the same thing.
[01:09:11]  You know, my first task was using.
[01:09:13]  The mini DNA analyzer and sequencer when I got down there, and it broke when I was using it.
[01:09:18]  My device didn't, so they had to like bring another device down.
[01:09:22]  So I was starting like a couple hours late, and that screwed up the guy who was coming after me.
[01:09:27]  So it was like you're put into the stress environment, but stress is one thing that we measure, right?
[01:09:31]  We do salivary cortisol, we wear monitoring systems, a Polar V800 chest strap at nighttime, looks at things like heart rate variability, our sleep.
[01:09:42]  So, and my wife is interested in looking at like crew dynamics and what they call, um, Cognitive or team cognition.
[01:09:52]  So the group functions together as sort of a team.
[01:09:55]  There's certain dynamics.
[01:09:56]  And when stress, when things break down and when things just go awry, that can influence team cognition.
[01:10:03]  So when things go bad and things break, or, you know, within reason, you know, you don't want someone to get injured, but some people have like little cuts and bruises and little things like that.
[01:10:15]  It stresses the team out.
[01:10:16]  And, but the, Behavioral scientist people or the people who study stress, then that day becomes more interesting to them if something goes wrong because they can collect all the sound bites of the communication.
[01:10:30]  They can look at the HRV, they can look at salivary cortisol.
[01:10:35]  So, a bad day for the crew when things go wrong, it becomes an interesting day for the behavioral neuroscientist.
[01:10:40]  You know what I mean?
[01:10:41]  So, there are so many teams working on this, most of them from NASA, some from ESA, and some from outside institutes.
[01:10:49]  University of South Florida, which we operate through.
[01:10:52]  Actually, I did it sort of as more or less took vacation time to do it because it was sort of like an independent thing that we were doing outside of the university.
[01:11:02]  But we want to, we think that the Aquarius habitat is where the NASA, these space analog missions happen, is an amazing opportunity for someone like the Office of Navy Research or NAVC or the Department of Defense to do research in this habitat because it simulates.
[01:11:21]  Sort of the life that a person on a submarine would have, or you can simulate saturation diving, which is super important commercially, right?
[01:11:30]  There's so many things that you could study scientifically in this environment.
[01:11:34]  We think that the federal government would be interested in funding other academic projects on that.
[01:11:40]  So, yeah, definitely.

=== Regenerating The Immune System Through Fasting (04:45) ===

[01:11:41]  So, I did it.
[01:11:42]  I did as a crew member on this space analog mission, sort of independent from my university, but we are sort of gearing up to hopefully compete for funding from like DARPA, DOD, Office of Navy Research, NAVC.
[01:11:56]  We think that these types of missions that could be independent from NASA and on their own really offer a lot to federal agencies to understand these extreme environments for the warfighter.
[01:12:07]  For the astronaut, for the commercial diver, things like that.
[01:12:10]  So, we plan to do a lot more missions undersea.
[01:12:13]  That's incredible.
[01:12:14]  That's fun.
[01:12:15]  Yeah, I can imagine.
[01:12:16]  I'm very fortunate to be able to do it.
[01:12:18]  Long term fasting.
[01:12:20]  Yeah.
[01:12:21]  How often do you do long term fasts, like over three days or more?
[01:12:27]  And maybe that's not the amount of time you do it for.
[01:12:31]  Basically, how often do you do them, and how many days do you do them for?
[01:12:35]  And can you explain some of the benefits or the Low hanging fruit, per se, benefits to a human to practice these kind of fasts.
[01:12:42]  Yeah, for fasting.
[01:12:44]  Well, I became interested in fasting because of the work that George Cahill did at Harvard Medical School, where he fasted subjects for 40 days.
[01:12:54]  And this was published, and I kind of delved in and read everything I could.
[01:12:58]  And that was sort of my introduction.
[01:13:01]  This is probably going back to 2008, like reading this paper.
[01:13:04]  And then a big review was written about him in 2006, which I was aware of, but didn't really read it thoroughly.
[01:13:09]  Until 2008.
[01:13:11]  Then it became apparent to me that once your body is after about three days, I mean, your brain is basically, your body's just cranking on ketones, which is being released from your fat stores.
[01:13:26]  So your fat gets into your blood, it goes to your liver.
[01:13:29]  Your brain can't really use the fats for fuel, so it converts them to ketones.
[01:13:33]  And there's a gradual shift from glucose to ketones.
[01:13:37]  So I became very interested in.
[01:13:40]  In doing it myself.
[01:13:41]  And it was probably about, again, about 10 years ago after reading this that I decided to fast for seven days.
[01:13:46]  And I've never fasted that long since.
[01:13:50]  But I have done a lot of three day fasts, especially when I'm traveling, if I'm by myself.
[01:13:56]  My wife and I like to sit down to dinner every night and have that.
[01:13:58]  So sometimes, you know, I do the intermittent fasting, but I only typically, when I'm by myself or doing some kind of experiment, will I do three or four days.
[01:14:08]  And sometimes if I'm sick too, if I feel something coming on, I'll fast and then I never get sick.
[01:14:12]  Really?
[01:14:13]  So, I believe, you know, fasting can rejuvenate the immune system.
[01:14:20]  70% or more of your immune system is kind of in your gut.
[01:14:23]  And a lot of immune system energy is spent dealing with the stuff that we're eating, right?
[01:14:29]  So, especially if you have leaky gut.
[01:14:31]  So, you're eating food and say your gut's not in the best health, right?
[01:14:35]  The tight junctions that hold the epithelial cells together in your gut, if they become loose or whatever, you're letting small particles and things get into your bloodstream that otherwise would not be there.
[01:14:44]  And your immune system has to work.
[01:14:46]  They recognize these things as antigens.
[01:14:50]  So, your immune system is working hard to neutralize some of these antigens, right?
[01:14:54]  When you're fasting, your immune system is like, it's like looking for something to do, right?
[01:14:59]  So, it's just like hanging out.
[01:15:01]  So, if you have a little bug or virus or something, then it becomes more vigilant to basically deal with that.
[01:15:07]  So, that's how I think of it.
[01:15:08]  Okay.
[01:15:10]  But after I've been delving into how fasting affects the immune system, so the way I envision it, and I'm not an immunologist, but it's very apparent that.
[01:15:20]  You know, food it puts massive demands, especially if your gut health is not optimal.
[01:15:24]  On your immune system.
[01:15:25]  Even if you have optimal gut health and everything, a lot of time and energy is spent, a lot of immunological resources are spent dealing with food.
[01:15:34]  So, fasting is a way to sort of regenerate the immune system.
[01:15:37]  It stimulates things like autophagy, right, which could be beneficial.
[01:15:42]  Calorie restriction could sort of do the same thing, but fasting does it sort of in a hyperactivated state.
[01:15:48]  So, it can improve your metabolic health.
[01:15:52]  It can lower insulin, lower blood glucose, elevate ketones, which can be beneficial.
[01:15:58]  Mm hmm.
[01:16:00]  Fasting can be a way of sort of just maintaining your calories, like through intermittent fasting.
[01:16:05]  But long term fasting really puts the body into a state of stress, and the hormetic response or adaptive response to that stress is where we get the benefits.
[01:16:17]  You know, you might feel good when you're fasting, you might have a headache, you might feel crummy, but after, if people stick with it, after about the third or fourth day, you start feeling almost normal.

=== Training Hard While In Ketosis (11:16) ===

[01:16:27]  It's a little bit scary.
[01:16:29]  And actually, at the seventh day, I felt Fine.
[01:16:32]  I just felt my energies were kind of low.
[01:16:34]  I felt a little bit cold.
[01:16:35]  Like, you know, the AC was too cold.
[01:16:37]  Like, my metabolism was shutting down, but I was still clear.
[01:16:40]  I was writing grants and actually the work that I did during that time, that grant ended up getting funded.
[01:16:46]  And I think I got a couple manuscripts out during the week that I didn't eat anything.
[01:16:50]  You know, I taught classes and stuff too.
[01:16:52]  Did I hear correctly that you deadlifted an absurd amount of weight after like a seven day fast?
[01:16:58]  Yeah, that was on the seventh day.
[01:17:00]  Yeah.
[01:17:01]  I think I taught in the morning and I Did some like a fitness camp later in the day, and that night, you know, I knew I was like, Well, let me work out.
[01:17:10]  I had done some light workouts, just like chin ups and push ups throughout, uh, because I do think it's important to do resistance training if you're fasting to help maintain muscle.
[01:17:18]  But if you do something too strenuous, right, you're accelerating catabolic processes, and you don't want to necessarily do that.
[01:17:26]  But I did find it very interesting as a litmus test for my strength.
[01:17:30]  Strength deadlifts are pretty good litmus test for that, and uh.
[01:17:34]  And I was kind of cautious not to go too crazy because I didn't want to break form and get injured at the end of this.
[01:17:40]  That would be like really bad.
[01:17:42]  And people were like, don't.
[01:17:44]  But as you're warming up, you have an idea of how much you know.
[01:17:47]  So it's like 135, 225, 315.
[01:17:49]  And then 405 felt really easy.
[01:17:52]  And then so I did like five plates and the collars and stuff.
[01:17:55]  So it was about 500 pounds.
[01:17:56]  And yeah, I did that for 10.
[01:17:57]  I just kind of stopped at 10.
[01:17:59]  And I didn't really feel, I didn't even get sore the next day or anything like that.
[01:18:04]  But I can typically do more.
[01:18:05]  But so I didn't push myself.
[01:18:07]  So maybe I could do 585 at that time for about 10.
[01:18:10]  So I did wow for 95 or 500 pounds.
[01:18:12]  I usually do like six plates per 10, but I did five plates per 10.
[01:18:15]  And it was not hard, it was about how it normally feels.
[01:18:18]  Okay.
[01:18:19]  So that was kind of it.
[01:18:22]  If I was to do it again, I would take something like creatine monohydrate.
[01:18:26]  I would probably, that's like a supplement, you know, that can help with training.
[01:18:30]  I would probably take, I did take electrolytes, but I do plan to do it again.
[01:18:35]  I just need to time it.
[01:18:37]  Right, you know, with I don't, I feel like I'm ostracizing my wife.
[01:18:40]  I'm not eating dinner or something like that.
[01:18:42]  It's like more of a social thing.
[01:18:43]  I think when I was doing it before, I would just like have tea, like green tea in the morning.
[01:18:47]  I tried to cut back on my caffeine too.
[01:18:49]  Yeah, that's like, that's one of my questions I really had for you.
[01:18:51]  Yeah.
[01:18:52]  Was during those long term fasts, what do you, can you, do you have tea?
[01:18:56]  Do you drink, what specific things do you consume?
[01:18:59]  Yeah.
[01:19:00]  Beef bouillon cubes, I had those.
[01:19:02]  I would make, I would just boil some water and throw one in that.
[01:19:05]  And that was actually like pretty satiating.
[01:19:08]  I would look forward to that.
[01:19:09]  But I would have half of my normal cup of coffee because I didn't want to jack myself up on caffeine.
[01:19:18]  But I didn't want to eliminate it because that was part of it.
[01:19:21]  I'm habituated to caffeine, whether you like it or not.
[01:19:25]  I think we all are.
[01:19:26]  We wake up and have our first cup of coffee to basically deal with the caffeine withdrawal side of it.
[01:19:32]  So when I first started training, I used caffeine like twice a week and the effects were pretty big.
[01:19:37]  But I didn't want to completely get off of it and then start caffeine again.
[01:19:41]  So I just did less of it with green tea in the afternoon.
[01:19:44]  But that's all I had minerals, electrolytes, some beef bullion.
[01:19:49]  And I felt fine.
[01:19:51]  I think the third day was the hardest, but after that, it was pretty easy.
[01:19:54]  And I encourage people to do it, especially if they have any kind of hereditary predisposition for cancer, Alzheimer's disease, or type 2 diabetes, things like that.
[01:20:06]  I mean, it's also more of there's physiological effects that are beneficial, there are psychological effects, and there's just kind of like behavioral effects, right?
[01:20:19]  I was writing down.
[01:20:21]  Somewhere, oh, not on this, but I was just kind of writing down all the benefits of fasting, and there's really a lot.
[01:20:30]  Yeah, I noticed I've done two seven day fasts in my life.
[01:20:34]  The first one I did was the beginning of 2019, and the second one I did was just this past January.
[01:20:40]  The first time I did it, I played an hour game of basketball, and it was on the third day, I believe.
[01:20:47]  And I normally get extremely fatigued after about 15 minutes, and I can get that like that side stitch cramp, you know what I mean?
[01:20:54]  Where I have to stop and take a couple.
[01:20:55]  Couple breaths, drink some water.
[01:20:57]  And I noticed after 30 minutes of playing, I had literally zero fatigue.
[01:21:01]  I felt like Terminator.
[01:21:03]  You know what I mean?
[01:21:03]  I felt like I could go forever.
[01:21:05]  Another thing is, I went to the gym and I was able to do about three times as many pull ups as I normally can.
[01:21:11]  Wow.
[01:21:12]  Three times.
[01:21:13]  That was before I ever learned about you, before I had listened to any talks on it.
[01:21:17]  I didn't know what ketosis was.
[01:21:20]  This was last year in 2019.
[01:21:23]  And I just literally was explaining this to people and I could not wrap my brain around how I was able to.
[01:21:29]  To do so many pull ups and play basketball for so long with zero fatigue.
[01:21:33]  Yep.
[01:21:34]  This kind of explains it.
[01:21:35]  Yeah.
[01:21:35]  Body weight exercises, too.
[01:21:37]  I didn't push myself to the edge, but I think I would jump up and do like 20 chins, like outside our house or whatever, like on a tree.
[01:21:46]  Yeah.
[01:21:47]  And I didn't want to push it, but those 20 reps, which are like fairly strict chin ups, felt pretty easy.
[01:21:53]  Like if I go all, I could do about 36 or 37 chin ups or something like that.
[01:21:57]  Wow.
[01:21:57]  But the 20 just felt really easy.
[01:21:59]  And you can make them a little bit harder.
[01:22:01]  You can kind of like stretch the lats.
[01:22:03]  At the bottom and then contract the top.
[01:22:05]  And towards the end of it, I was like trying to make the chin ups harder.
[01:22:08]  So I would do the 20, but like super strict and contract.
[01:22:11]  And I knew I didn't want to sort of stress out the body too much because, you know, I was worried that, you know, fasting, but I probably didn't need to worry.
[01:22:18]  But yeah.
[01:22:20]  But yeah, when I do a big lift, I don't fast seven days, but I do like to go into it relatively fasted.
[01:22:29]  And I feel that if my body's not dealing with digesting, assimilating, Mechanically, you know, enzymatically, it's not dealing with a meal that I have more energy and resources to activate muscle.
[01:22:46]  And I feel my feeling intuitively is that my central nervous system can activate the muscle better.
[01:22:57]  It's almost like those pathways, neurological pathways, are activated when I'm in a semi fasted state.
[01:23:04]  I think if I fast for more than like 24 or 48 hours, my energy reserves are generally going to be a little bit lower.
[01:23:10]  And that might be not, it might not be advantageous for a max lift, but maybe for like bodyweight exercise.
[01:23:16]  But when it comes to doing a max lift, I would never go into it.
[01:23:20]  Like a lot of guys eat right before they get to the gym or whatever.
[01:23:23]  I would typically fast probably at least six to eight hours, sometimes 10 or 12 hours before if I'm like really going for a max lift.
[01:23:33]  Yeah.
[01:23:34]  But I would eat up the weeks, the days before.
[01:23:37]  Maybe even start out three or four days before and start eating like a lot of red meat.
[01:23:43]  And so, whenever I set a PR, I kind of have this whole sort of thing that I go through where I eat up and I ramp up like 25% more calories, like kind of two days out, and I kind of adjust the protein and everything.
[01:23:57]  And it's not super scientific, but I kind of, you know, portion things out a little bit different.
[01:24:04]  I go into a calorie surplus the day before.
[01:24:08]  But that day of, I go into that max lift fasted.
[01:24:13]  Okay.
[01:24:14]  Like where some people would think it's insane.
[01:24:16]  Right.
[01:24:17]  You know, 12 hours fasted.
[01:24:19]  But my strength is definitely more.
[01:24:22]  My nervous system is better at recruiting muscle.
[01:24:24]  I'm pretty sure of that.
[01:24:26]  I need to do the EMGs to show it, but I think it would be an interesting study to do.
[01:24:30]  Yeah, definitely.
[01:24:31]  Do you find that in the scientific community, people look at you differently based on, you know, If you look at your Instagram, for example, I mean, you're deadlifting weight, you're eating tons of meat.
[01:24:42]  I mean, it doesn't look like you're a scientist.
[01:24:45]  I don't think that.
[01:24:46]  Well, if you're studying like sports science, you know, I mean, there's a lot of meatheads, I guess.
[01:24:51]  You go to like a sports science thing, like bodybuilder, powerlifter kind of guys.
[01:24:57]  This is something I've always done since the age of like 13, 14, you know, lifting weights.
[01:25:02]  My brother was like a huge bench press monster.
[01:25:05]  You know, I don't think I've ever even caught up to him on that.
[01:25:08]  I mean, and he's not even, he's never even drank a protein shake.
[01:25:11]  Before.
[01:25:12]  I mean, he's just into hunting and fishing.
[01:25:14]  And just when he's passing by the bench, he'll just put four plates on it, a weight of like 185.
[01:25:20]  He's repping with like 405.
[01:25:21]  So I think the genetics were there for that.
[01:25:24]  Although he doesn't train legs or back even, but he's still, we worked on a farm together for a while.
[01:25:29]  He always was just like that farm strength and just like a crazy bench strength.
[01:25:33]  So that really motivated me as a kid to sort of try to be as strong as him.
[01:25:37]  But also when I played football, I got into it.
[01:25:40]  So that's always been part of like who I am.
[01:25:42]  But I don't necessarily, especially now, want to make it my Persona to do that, but I want it.
[01:25:48]  I want people to know for me, strength training is really an anti aging therapy, and I think for me, it's also like a psychological therapy.
[01:26:00]  I don't know, I took a year off of training with weights, but I was working heavy on the farm, doing a lot of labor, and I'd take the dogs for a walk every night and jump up and do a couple sets of chin ups and push ups and dips.
[01:26:12]  So I was doing all that kind of stuff, but I took a year or more completely away from weight, so I didn't even pick up a weight.
[01:26:19]  But when I got back to it, I realized, you know, there is a difference between sort of like lifting weights and just kind of playing around on the farm and doing push ups and shins.
[01:26:28]  I mean, that stuff, I still do that stuff.
[01:26:30]  But lifting like serious weight where the bar is bending and you're, it's almost like a life or death kind of thing.
[01:26:36]  Yeah.
[01:26:37]  And the whole mentality of approaching the lift is kind of what I enjoy.
[01:26:43]  It's like I actually envision a scenario where it is life or death.
[01:26:50]  And I'm kind of a calm person.
[01:26:52]  So, I do things, I do some mental gymnastics to basically create like a life or death scenario or something that kind of gets me my sympathetic nervous system activated where I can do that.
[01:27:04]  And I miss sort of that whole routine of doing that.
[01:27:07]  So, now I'm kind of embracing that.
[01:27:09]  I've been doing that for the last couple of months now, back in the gym.
[01:27:12]  I built my wife and I used to go to the gym, but then we just didn't have time.
[01:27:17]  So, I was like, okay, I'm just getting some weights, I'm going to put it in the house.
[01:27:19]  And so, I'm enjoying the home gym or barn gym a lot now, and doing that probably about three times a week.
[01:27:27]  So that, but I don't think I get really a stigma or sometimes people criticize me online for doing certain podcasts or doing research on a fad diet.

=== Farming To Create Carbon Sinks (07:19) ===

[01:27:43]  I try not to sensationalize the results that we have, and I talk within the realm of the published science.
[01:27:49]  I think that's important, especially when you're doing things research related to cancer, because I do get lots of emails from Alzheimer's patients, cancer patients, patients with rare disorders.
[01:28:00]  And I do not try to over promote or oversell the diet in any way, shape, or form.
[01:28:06]  I try to do the opposite, actually.
[01:28:08]  And there are a lot of people who are advocates of the ketogenic diet that just go too far.
[01:28:12]  And I try to be a voice of reason that's somewhere in the middle.
[01:28:17]  There's a lot of antagonistic people who really maybe are out to get me too.
[01:28:22]  And they just say the ketogenic diet is dangerous.
[01:28:25]  It's not.
[01:28:25]  Yeah.
[01:28:26]  Why do you think that is?
[01:28:27]  I think there's different reasons.
[01:28:28]  I think maybe they actually believe that.
[01:28:31]  But I'm coming at it from the perspective that the diet was a very powerful medical therapy for epilepsy.
[01:28:37]  And that's really, I study seizures.
[01:28:39]  That's most of my funding comes from studying seizures.
[01:28:42]  So I'm convinced of that.
[01:28:44]  I guess the pushback comes from the ketogenic diet as a lifestyle.
[01:28:49]  And like I said, it might not be optimal for most people.
[01:28:52]  It's probably not the clinical ketogenic, but a modified form of a low carb diet is undoubtedly, I feel, optimal, getting back to your question, for humans.
[01:29:02]  And At no point in history did we have access to the level of sugar, processed carbohydrates that we do now.
[01:29:10]  So it just makes, I mean, it's like, it just makes obvious sense to not necessarily eliminate these things, but to minimize them in our diet.
[01:29:19]  So right now, they are the predominant source of calories in the diet.
[01:29:23]  So the, yeah, they really are.
[01:29:24]  It's crazy.
[01:29:25]  The federal government gives out like food stamps or they give out supplements to people to buy food and they're using those supplements for, Sugary drinks, and they're using it for processed carbohydrates.
[01:29:41]  So, this we need to subsidize vegetable growers, you know, fruits and vegetables, predominantly fruits, are a pretty good part of that, too.
[01:29:51]  But our government is basically their programs are supporting the purchase of heavily subsidized commodities that are sort of linked to the corn industry and soybean.
[01:30:07]  And these are all things I grew growing up.
[01:30:09]  On a farm.
[01:30:10]  Yeah.
[01:30:10]  Right.
[01:30:10]  So I'm kind of keenly aware of it, but policy needs to change.
[01:30:15]  Mark Hyman wrote a great book and is really on top of this.
[01:30:19]  I would recommend, you know, his recent podcast with Peter Tia kind of covers that area.
[01:30:24]  I mean, I could talk about that a lot because I'm very passionate about it, but it's not my wheelhouse.
[01:30:29]  It's more of a sort of just a hobby of mine that we are farmers to, and we're trying to do things the right way.
[01:30:36]  Transitioning from a crop farm, a lot of people who follow a vegan diet may, and I respect them for following it for ethical reasons, but I think they're a little bit misdirected because even our farm, when we grew crops and having grown wheat and hay and things like that, when you're running the hay baler, In there.
[01:30:57]  I mean, you're chopping up lots of animals.
[01:30:59]  You're chopping up bunnies.
[01:31:00]  You're chopping up field mice and things like that.
[01:31:03]  So, you know, transferring a crop field into a field that we have now just of cows with weanlings and calves running around, just growing tons of grass, which is a huge carbon sink.
[01:31:21]  And you're, you know, you're doing it to the point where max you have one cow per two acres.
[01:31:27]  And you are also, most importantly, rebuilding the soil, right?
[01:31:32]  So you are not using chemicals and you are, you know, raising.
[01:31:38]  We have like basically four rescue cows that didn't come from very good conditions when the mom died when it was like only a month or two.
[01:31:48]  That is actually from a carnivore perspective, you are doing the earth a much bigger service by basically developing a carbon sink.
[01:31:59]  And the animals will, we may rescue the animals and keep them for, we may not sell them off, but we're basically raising beef and killing a lot less animals by raising a carnivore food source.
[01:32:12]  Right.
[01:32:13]  So, yeah.
[01:32:14]  I do know from the perspective of, I think a lot of when we talk about different diets, the vegan diet versus the carnivore diet.
[01:32:23]  And I understand an ethical reason not to kill animals intentionally.
[01:32:29]  For food.
[01:32:30]  But when you grow crops and you harvest those crops, you're killing a lot of animals.
[01:32:38]  And I just remember very vividly just seeing like a nest of bunnies, just, and there's no way around it.
[01:32:45]  I mean, when you're growing Timothy hay, for example, or soybeans and things like that, there's tons of animals that live there.
[01:32:52]  And when you have just a pasture, I mean, the animals are free to roam.
[01:32:56]  It's like perfect conditions.
[01:32:58]  Like I can show you pictures I took on my phone this morning of the Spanish moss and The cows love to eat the Spanish moss, and you know, they're growing in the most idyllic conditions and they're free to roam.
[01:33:11]  Other things are in the pasture, and everything is growing crazy, especially when the rain starts.
[01:33:15]  It becomes an incredible carbon sink, and also rebuilding the soil too.
[01:33:21]  That's part of it.
[01:33:22]  But prior to what we have now, it was intensively farmed, heavily treated with glyphosate, GMO type crops, lots of fertilizer, lots of chemicals, things like that.
[01:33:34]  So we're trying.
[01:33:35]  We really need to rebuild the soil.
[01:33:37]  So we just kind of, you know, with the tractor, just kind of just moving the soil around, planting grass now, just getting everything growing.
[01:33:47]  So I think when it comes to like food politics and what diet is optimal for humans, and some people may favor a particular kind of diet, I think there's arguments on either side, you know, what, because when you talk about a carnivore diet and you're talking about concentrated feedlot operations, So that is very destructive.
[01:34:09]  What is it?
[01:34:10]  Concentrated what?
[01:34:11]  Like CAFOs, when you have concentrated agricultural kind of feeding lots where the pigs, chickens, or cattle, I mean, being the thing that's probably most destructive, they are put into concentrated quarters and they're basically not fed grass.
[01:34:36]  They may come when they're born, they may, for the first year or so, they may be in a pasture.
[01:34:42]  But they're shipped off to feedlot operations where all their nutrition comes from sort of corn and soy, and their forced stomach system is not really designed to digest, assimilate, and use this as an energy source.

=== Supporting Local And Organic Farms (06:43) ===

[01:35:02]  So that's what those animals are sick.
[01:35:04]  You got to give them like a lot of antibiotics, and they're concentrated in areas where a lot of the manure and everything, there's significant runoff, and if there's Runoff is near crops, then E. coli can contaminate, for example, the romaine lettuce or the spinach and things like that.
[01:35:25]  And then you have a massive outbreak.
[01:35:28]  Also, you're more likely to get E. coli from the food from this type of feedlot operation because all the meat is mixed together.
[01:35:40]  So if you have ground beef, you're eating beef from that package of beef, could be from hundreds of animals.
[01:35:48]  Right.
[01:35:48]  So if one is contaminated with E. coli or another bug, you are potentially contaminating a lot of people.
[01:35:57]  Whereas if you support like a food co op or a local small farm, right, and you go there, and you know, I've talked to many people who run these farms, I've watched many documentaries, read many books.
[01:36:12]  No one gets sick typically from these operations that have been going on.
[01:36:16]  And the federal government tries to crack down on them because.
[01:36:20]  You know, meat is supposed to be USDA inspected.
[01:36:22]  It has to go through certain, uh, the paperwork just to be an organic farm.
[01:36:26]  Just so you can buy it on the shelf at Publix.
[01:36:28]  Yeah.
[01:36:28]  Just to, uh, because, too, like, uh, you know, only a couple companies really, there's a couple companies that monopolize this industry and the small farms are taking away from that.
[01:36:40]  So the federal government is actually, it hits their bottom line, right?
[01:36:44]  So there, uh, there's a lot of partnerships, like people work for these companies.
[01:36:49]  Yeah.
[01:36:49]  They're on federal, Scientific advisory boards and they hold they're influential in the policy associated with this.
[01:36:59]  But the small farms, and we're trying to be a hobby farm now, but people listening really need to go out and buy locally, support small farms.
[01:37:11]  And it's going to be better for their health, like overall, but really important for the environment too.
[01:37:17]  And I think if you go to a local farm, You know, there it may be a little bit more expensive, like up front, but in the long run, I think it's going to save everybody money if you support these.
[01:37:32]  I think food will eventually get a little bit uh cheaper if uh policies start to subsidize these smaller farms, so it really has to start with government.
[01:37:44]  I think a movement has already started, but I think maybe in the next five to ten years, government subsidies can help out a lot of these smaller farms that I think are going to be really essential for.
[01:37:55]  Building back the environment.
[01:37:59]  And I think food will probably be much better, undoubtedly, but I think it'll be more affordable too, because that's usually the pushback.
[01:38:07]  Well, people can't afford grass fed, grass fed beef, or organic eggs, you're paying $3 or $4 a dozen.
[01:38:15]  But I could go to Walmart and I think I can get 60 eggs for like, and I do, and I've done that for like $4.50 because we give our dogs like eggs or something like that.
[01:38:26]  But when we can, I mean, we try to support these smaller farms whenever possible, like locally.
[01:38:32]  So we're trying to do that more, and we're trying to basically be sustainable just on our farm.
[01:38:37]  You know, from an energy standpoint, too, with solar panels and stuff like that.
[01:38:41]  Oh, that's amazing.
[01:38:41]  Yeah.
[01:38:42]  Where, so where do you get your eggs?
[01:38:45]  Uh, my wife buys them now.
[01:38:47]  Okay.
[01:38:48]  But we, we buy them locally occasionally, but they could be as much as five dollars for a half dozen.
[01:38:55]  Jeez.
[01:38:55]  But she goes, she's a big, uh, she comes from Europe and she's, uh, loves to shop at Aldi.
[01:39:01]  So Aldi has certain standards.
[01:39:03]  So, which was it because I was kind of getting on her buying like all this plastic and stuff, but we recycle everything.
[01:39:09]  But Aldi has a new program now.
[01:39:11]  They're Phasing out all their packaging is going to be like biodegradable.
[01:39:15]  Oh, wow!
[01:39:16]  The next couple years.
[01:39:17]  So, I mean, they are usually, and it's like I think they're like uh non GMO, like uh organic options and stuff too.
[01:39:27]  And it was always kind of cheaper too.
[01:39:29]  Have you shopped at Aldi?
[01:39:29]  I have just grab a box, yeah, yeah.
[01:39:32]  So, we get a lot of stuff from there.
[01:39:33]  Occasionally, we'll go to Publix and stuff, but like I said, we get a lot of the meat from uh some of these companies like US Wellness Meats is great.
[01:39:40]  We're eating their stuff now, okay?
[01:39:42]  Butcher Box too, butcher box, yeah, pretty good, yeah.
[01:39:44]  And I think.
[01:39:45]  It's really hard to find grass finished.
[01:39:48]  Like you can get grass fed, but grass finished.
[01:39:52]  A lot of times, what happens is cows will, the last month or two of their life, they'll be put on the feedlot.
[01:40:00]  They'll be raised like their entire life in a pasture, right?
[01:40:02]  So they're pasture raised, but they'll be fattened up towards the end.
[01:40:08]  And it does make them happy.
[01:40:10]  I mean, you could take some of the pellets and stuff, and, you know, I've taken a handful and our cows, I mean, it's like, Candy and it's like high protein and it's like everything, but it's a mixture of grains and things like that.
[01:40:21]  So we just try to let them, uh, if we feed them, if the pasture's not suitable enough, like this time of year is like the driest part.
[01:40:29]  Now we're getting into the rain season, but we'll just get some, uh, hay, like a combination of, uh, Timothy and alfalfa and things like that and spread it around and just make sure, you know, we don't feed them corn or.
[01:40:41]  How do you tell if it's grass finished or not?
[01:40:43]  Grass finished?
[01:40:44]  Uh, well, it'll say it.
[01:40:45]  Oh, it will say it?
[01:40:46]  Okay.
[01:40:46]  So, uh, butcher box is, uh, uh, They have grass finished beef and it's very hard to find.
[01:40:52]  If you find it at the stores around here, you know, sometimes I post and promote Butcher Box because some of the affiliate links do come back and support our research.
[01:41:02]  Okay.
[01:41:02]  So I kind of justify it with that.
[01:41:04]  But I also justify it that when they criticize, it's not that expensive.
[01:41:09]  It comes out to like $7 a pound or $8, but it's really quality beef.
[01:41:14]  And if you bought similar grass finished beef at a store, it would probably be more.
[01:41:19]  It's just so hard to find.
[01:41:22]  But another thing is that they have to, the company sources some of their beef from Australia.
[01:41:28]  So some of it, but now they're working with small, or they did about a year or two ago, because I was asking them where they're getting their beef as a cattle farmer.
[01:41:36]  But I think they're working with smaller farms now to basically, because it's becoming more popular and the demand will kind of influence the supply.

=== Enhancing Chemo With A Ketogenic Diet (13:54) ===

[01:41:46]  Personally, if you were to be diagnosed with some form of cancer, How would you treat yourself personally?
[01:41:54]  Would you use the standard of care with chemotherapy, depending on what cancer it is?
[01:41:59]  And how would you alter your lifestyle and your diet?
[01:42:02]  It's a bit of a loaded question, but I know.
[01:42:04]  Sorry.
[01:42:05]  No, I'm glad.
[01:42:06]  I guess I get asked this question a lot.
[01:42:09]  It really comes down to the type of cancer.
[01:42:11]  Like I know friends and colleagues of mine kind of feel that cancer is sort of, you know, all one disease.
[01:42:19]  And I think there's a lot of truth to that.
[01:42:21]  But also understand that, you know, I have people that are close to me that have cancers, for example, leukemia, acute myeloid leukemia is an example.
[01:42:35]  I know people with multiple myeloma, lymphoma.
[01:42:40]  Testicular cancer had one or two or three students or three people that I know responded very well to the standard of care.
[01:42:48]  And some of them did the KJN diet, some didn't.
[01:42:51]  So it really depends on the type of cancer.
[01:42:54]  I got into this looking at brain cancer.
[01:42:56]  So it made sense to me because I realized, oh, brain cancer patients have seizures and they're on heavy doses of anti-seizure drugs sometimes, but they're also put on something called dexamethasone, which is a corticosteroid that really. disrupts your metabolism and elevates your glucose in a way that's feeding the cancer.
[01:43:17]  These corticosteroids do.
[01:43:19]  So I thought the ketogenic diet could be used for that.
[01:43:21]  And then the more I started looking into it, I saw that Thomas Seyfried had published that a calorie-restricted ketogenic diet targeted tumor metabolism in a way that was highly efficacious, at least in animal models.
[01:43:37]  So it really, I'm just saying this because it really depends on the type of cancers.
[01:43:42]  A couple of reviews have been written.
[01:43:44]  About the types of cancers.
[01:43:46]  So, things that are really metabolically demanding cancers.
[01:43:52]  And these are cancers that would show up on a PET scan, an FGG PET scan.
[01:43:56]  So, if someone has a type of tumor, a solid tumor in particular, that's really hot on a PET scan, and that means that it's sucking up massive amounts of glucose relative to the healthy tissue surrounding it.
[01:44:08]  So, what a ketogenic strategy does, and it could be used as an adjuvant to the standard of care, is that it lowers.
[01:44:18]  Glucose availability to the tumor, and most tumors really have accelerated glucose metabolism, and that's driven in part by insulin and insulin signaling, like IGF 1, the PI3 kinase, AKT, mTOR pathway.
[01:44:36]  I don't want to go down that road, but it's activated, it's driven by glucose, insulin, and the insulin sort of pathway, right?
[01:44:46]  So if we suppress the hormone insulin, We can do that with nutritional ketosis, especially if it's calorie restricted.
[01:44:54]  That basically is knocking down a major driver of most cancers.
[01:45:00]  Like it's pretty safe to say that I would say 80% or more cancers are really driven by this PI3 kinase, AKT, mTOR pathway.
[01:45:08]  When these pathways are hyperactivated and insulin being a driver for that, it accelerates cancer growth and proliferation.
[01:45:16]  So, one way to take the foot off the gas pedal of this cancer growth and proliferation is to knock down.
[01:45:23]  One of the main pathways accelerating it, which is insulin.
[01:45:28]  And how do we knock down insulin?
[01:45:29]  Through carbohydrate restriction and to some extent, protein restriction.
[01:45:33]  Also, fasting, intermittent fasting, where we go through periods of time restricted eating.
[01:45:38]  So, if we were to do this prior to the standard of care, like chemotherapy or radiation, it makes the tumors more vulnerable to modalities that kill through what we call an oxidative stress mechanism.
[01:45:54]  So, if you limit glucose availability to a tumor and if you're in a fasted state, the tumor's ability to create its own antioxidants, glutathione being a major one, is a bit impaired.
[01:46:07]  So, you can enhance the cancer killing effects of chemo and radiation if the patient is in a fasted state or on a ketogenic diet.
[01:46:21]  We also think that hyperbaric oxygen therapy, which increases the partial pressure of oxygen in the tissues, And thereby also enhances oxidative stress.
[01:46:31]  And the oxidative stress is higher in cancer cells because of the aberrant mitochondria that they have.
[01:46:38]  They spit out more something called superoxide in response to increasing levels of oxygen relative to normal cells.
[01:46:46]  So you'll have enhanced oxidative stress in cancer cells, also more free heme.
[01:46:53]  And when you, it creates, it drives something called the fentanyl reaction.
[01:46:56]  You don't need to know that, but listeners may be familiar with these pathways.
[01:46:59]  But it creates a scenario where, Oxidative stress is higher just by using something that's relatively non toxic, like hyperbaric oxygen therapy within defined limits.
[01:47:10]  And then, if you give radiation or chemo, that could enhance the efficacy of that, especially in the context of a ketogenic diet.
[01:47:18]  So, radiation and chemo could essentially boost the effects of hyperbaric treatment?
[01:47:25]  Yeah, well, the efficacy of radiation is proportional to the PO2 of the tumor, right?
[01:47:29]  So, if you radiate a tumor that's hypoxic, the radiation killing effect of the tumor will be dependent on molecular oxygen that's inside the tumor.
[01:47:38]  So if you hyper-oxygenate a tumor or if you reverse tumor hypoxia, because a lot of tumors, they grow so fast, it outstrips their ability.
[01:47:48]  The vascular church can't keep up with expanding biomass.
[01:47:51]  So the inside of the tumor, the core of the tumor becomes anoxic or hypoxic.
[01:47:56]  But if you, with hyperbaric oxygen, the oxygen is transferred to the tumor, not by blood vessels, but it's in plasma.
[01:48:05]  Hemoglobin is already saturated.
[01:48:06]  So it gets oxygen to the plasma, and then you hyperoxygenate the tumor, reverse a tumor hypoxia, and then apply the stimulus, the killing stimulus.
[01:48:17]  So that could be chemotherapy, it could be radiation, it could be an immune based drug, too.
[01:48:21]  We call this the press pulse theory.
[01:48:23]  So if you Google press pulse theory and a publication, nutrition metabolism, this idea that you create a stress on the cancer cells by nutritional ketosis, drugs like metformin, intermittent fasting, Exercise, meditation, things like that create an environment that compromises the tumor's ability to grow or decreases its ability to grow.
[01:48:49]  Being in a facet state will also make the tumor more vulnerable by weakening its antioxidant defenses and also suppressing certain growth pathways, that PI3 kinase pathway.
[01:49:00]  And then other modalities will work better.
[01:49:03]  So that could be hyperbaric oxygen therapy, could be used, but chemo, radiation, and immune based therapies too.
[01:49:11]  Will be more efficacious in the context of a press.
[01:49:15]  So, a press and then a pulse therapy can be delivered ideally like two or three weeks on, you know, three weeks off, something like that.
[01:49:24]  It depends on the particular agents, but there's also metabolic drugs that can be used too.
[01:49:29]  And some of these drugs are toxic, like 2 deoxyglucose, 3 bromopyruvate, lonidamine.
[01:49:35]  These are things that target the glycolytic pathways.
[01:49:39]  And we use these sort of things experimentally.
[01:49:43]  But I think what patients who are listening maybe can go and look up the press pulse concept.
[01:49:49]  And we just basically put a paper out as a concept.
[01:49:52]  Here's an idea.
[01:49:54]  We are working with different people that are moving this into the clinic.
[01:49:58]  And some people are just doing it because right now there's not a whole lot of clinical trials that are incorporating this.
[01:50:03]  Although I have to say that when I started studying this, the ketogenic diet, there was maybe two clinical trials.
[01:50:10]  And now I looked this morning before coming, there were 39 clinical trials.
[01:50:14]  What?
[01:50:15]  Yeah.
[01:50:15]  And about many of them are ongoing or recruiting too.
[01:50:19]  So now these are, you know, many of them, a lot of them are top tier institutes like doing things.
[01:50:24]  And then I looked up fasting.
[01:50:26]  I had never.
[01:50:26]  Like, went on to clinicaltrials.gov and put in cancer and then fasting, and like hundreds of trials came up.
[01:50:33]  Not all of them are relevant, but there were dozens of trials looking at the effects of fasting before chemo and radiation.
[01:50:40]  Many, the first like couple were using the fasting mimicking diet.
[01:50:44]  So, Walter Longo, who's on the West Coast, developed a diet that's essentially used five days per month.
[01:50:52]  And it's a hypocaloric diet that puts the body into a state of ketosis, mild ketosis.
[01:51:00]  And this type of diet can be used in conjunction with a standard of care.
[01:51:05]  And it's sort of a commercialized version of a ketogenic diet, and it's mostly plant based.
[01:51:11]  So it has some unique aspects to it.
[01:51:14]  One could formulate their own ketogenic diet or their own fasting mimicking diet just by going to the grocery store and formulating the foods.
[01:51:25]  So the science is really ongoing and it's emerging, but to have dozens of registered clinical trials looking at the effects of fasting and cancer.
[01:51:33]  As a means to enhance standard of care.
[01:51:36]  And patients should also, if they're interested in being part of these clinical trials, clinicaltrials.gov.
[01:51:43]  That's basically the site that has registered clinical trials.
[01:51:47]  So look up ketogenic diet and then whatever cancer you have, whether it be lung cancer, endometrial cancer, liver cancer, something like that.
[01:51:56]  So look up to see if maybe a clinical trial is in your area and you might be able to participate in that.
[01:52:02]  When they talk about the hyperbaric oxygen treatment, do they use those like?
[01:52:07]  Tube things that like LeBron James gets into after his basketball games where he lays down in like it's kind of like a coffin shaped tube.
[01:52:13]  Yeah.
[01:52:14]  Is that what they use?
[01:52:16]  That would be a monoplace chamber.
[01:52:18]  Okay.
[01:52:19]  Yeah.
[01:52:19]  So that could be one of ways.
[01:52:22]  There's also a multi place chamber that you could use.
[01:52:25]  But if you go to a hyperbaric oxygen clinic, what they may do is most of these clinics actually, there's 14 different FDA approved applications for hyperbaric oxygen therapy.
[01:52:35]  Oh, really?
[01:52:36]  One is decompression sickness.
[01:52:38]  If you're a diver, you know, you come up with the bends, you go inside a hyperbaric chamber.
[01:52:42]  The other is for, I mean, there's a lot, but the top ones would be diabetic wounds.
[01:52:48]  So, wounds, people who have diabetes, their blood is like sludge.
[01:52:51]  So, they're not getting enough oxygen and nutrition to the wound.
[01:52:56]  So, it begins to fester and grow.
[01:52:58]  And hyperbaric oxygen therapy hyperoxygenates the wound.
[01:53:02]  A wound is hypoxic, and the energy levels in that tissue are knocked down by like 90%.
[01:53:09]  So, hyperbaric oxygen therapy can restore metabolism.
[01:53:13]  We also believe if you put someone on a ketone supplement, or, and one of my students, Dr. Shannon Kessel, did her PhD dissertation on the effects of nutritional ketosis and wound healing, and it's remarkably effective at enhancing the wound healing process.
[01:53:26]  Wow.
[01:53:27]  And we think if you couple it with hyperbaric oxygen, it would be, you know, diabetic wounds or chronic wounds, it's like a multi, multi billion dollar health problem right now that people have, typically with type 2 diabetes, but people have bed sores, right?
[01:53:43]  Like these wounds, they don't heal.
[01:53:45]  Nutritional ketosis is one.
[01:53:46]  So hyperbaric oxygen is used for that.
[01:53:48]  So you have multi place chambers.
[01:53:50]  You can get in, you go in, you read a book, you listen to music.
[01:53:53]  Sometimes the walls of the chamber are transparent so you can see what's going on in the room.
[01:53:58]  And then you have a multi place chamber where you get inside the chamber.
[01:54:01]  It's pressurized to, like, say, 2 or 2.5 atmospheres at hyperbaric air.
[01:54:06]  And then you put the mask on, and that's 100% oxygen.
[01:54:10]  And you breathe that mask, and then you reach hyperbaric oxygen therapy levels.
[01:54:15]  You take the mask off.
[01:54:16]  So if you have a seizure, you could take the mask off, and then You go from hyperbaric oxygen to hyperbaric air, which the partial pressure of the PO2 will be low enough that you won't have a seizure.
[01:54:29]  Does that make sense?
[01:54:30]  Yeah, that makes sense.
[01:54:30]  So, we're breathing 20% oxygen now, a hyperbaric oxygen chamber.
[01:54:34]  You're breathing in a monoplace chamber, you're breathing 100% oxygen typically or thereabouts.
[01:54:41]  And when you get inside a multi place chamber, it's 20% oxygen, but you put the mask on, that becomes 100% oxygen.
[01:54:49]  And hemoglobin is already saturated, right?
[01:54:51]  But the oxygen gets into the plasma.
[01:54:54]  And that's the benefit to wound healing.
[01:54:57]  That's the benefit to attacking a tumor is that tumor vasculature is like erratic and not very good.
[01:55:03]  So the tumor becomes hypoxic, but if it's in the plasma, it can penetrate that tumor.
[01:55:07]  Oh, wow.
[01:55:07]  And then oxygen can kick on reactive oxygen species that can start to kill the tumor inside out.
[01:55:13]  And then you apply most chemotherapeutic drugs to kill cancer cells through an oxidative stress mechanism.
[01:55:19]  So if you've already caused oxidative stress and you apply oxyplatin or cisplatin or something like that, and then radiation too.
[01:55:29]  Then you have like it creates a lot more die off in the tumor.
[01:55:33]  Okay.
[01:55:34]  And then being in ketosis will protect your healthy cells and also sensitize the tumor cells to more.

=== Boosting Vigilance Against Viruses (07:28) ===

[01:55:41]  So that was sort of, you know, some of the first publications that we did.
[01:55:44]  And people are following up on that.
[01:55:46]  Wow.
[01:55:46]  It's amazing how many more studies have come out on how many, how do you mean the clinical trials you were saying that they're doing?
[01:55:51]  Yeah.
[01:55:51]  The clinical trials is really, yeah, it's amazing.
[01:55:53]  You know, we're not doing any because we're more of a basic science, but people look at the research that we're doing and they say, hey, you know, just.
[01:56:02]  Some people give us a heads up and it's like, you know, your research kind of inspired this clinical trial.
[01:56:07]  Other people were doing this research too.
[01:56:08]  Dr. Thomas Seyfried was a huge pioneer, and I just followed in his footsteps and just used his model system.
[01:56:16]  Lou Cantley is doing some work with the ketogenic diet and targeting this PI3 kinase pathway with different drugs.
[01:56:25]  Dr. Adrienne Sheck, she was at Barrow Neurological Institute, is really a pioneer in glioblastoma, which is the A deadly form of brain cancer.
[01:56:34]  And her work has inspired, you know, the Barrow Neurological Institute and the lead clinician there, Chris Smith, to sort of advocate that patients with glioblastoma follow the ketogenic diet prior to them coming in and having surgery because it helps shrink the tumor.
[01:56:51]  It makes it a smaller target that they can resect it and they get better outcomes, you know, after surgery, too.
[01:56:58]  So I've been communicating with some of those patients.
[01:57:01]  And obviously, it's a super hot topic right now the coronavirus.
[01:57:05]  Yeah.
[01:57:06]  What sort of knowledge do you have about viruses like that and kind of like what's going on with it right now?
[01:57:11]  There's a couple of cases in Florida.
[01:57:15]  What would you say to people about that kind of virus and sort of like mitigating it?
[01:57:21]  Or, you know, what is your knowledge or research, if any, on stuff on viruses like this and how to avoid them?
[01:57:28]  Well, you know, I've taken the basic course like human or, you know, pathogenic microbiology, virology, stuff like that.
[01:57:35]  So, from what I know, probably.
[01:57:39]  You know, the people most concerned are people immunocompromised, they're very young and they're very old.
[01:57:45]  So, just the standard sort of things wash your hands, stay away from people that are sick.
[01:57:51]  There are many people that are asymptomatic.
[01:57:53]  So, we could be walking around and be a coronavirus carrier, but be asymptomatic and not be presenting.
[01:58:00]  So, in that case, then it might be good to just stay at home when you can, because you don't know who a carrier could be.
[01:58:13]  So, I think that's important information.
[01:58:16]  Our immune systems are really a function to some extent on our systemic and metabolic health, right?
[01:58:24]  So I think nutrition is really key.
[01:58:26]  We want to not over nutrition compromise the immune system, lack of sleep compromise the immune system, elevated blood glucose can compromise the immune system.
[01:58:36]  So things like intermittent fasting, low carb diets, ketogenic diets can make the immune system more vigilant to be able to deal with these types of things, you know, if they happen.
[01:58:46]  So we're better off to fight it.
[01:58:49]  You know, in the context, I think there's some studies out there, you know, showing, I know there's studies.
[01:58:55]  Adrian Scheck, the researcher that I mentioned, showed that the immune system becomes more vigilant with a ketogenic diet in regard to anti cancer immunity.
[01:59:04]  So, increasing natural killer cells and things like that that can better attack, you know, the cancer.
[01:59:12]  I believe that that's the case for viruses and microbes too.
[01:59:16]  I know you mentioned earlier that when you feel like something coming on, like any sort of bug or something, you will automatically go into like a Two day fast or something to kind of.
[01:59:24]  Yeah, I do.
[01:59:25]  I actually pay a lot more attention to my sleep, staying hydrated.
[01:59:30]  If I don't completely fast, I cut way back on calories and just go into a calorie restriction state.
[01:59:37]  But typically, yeah, that's when I'll start and say, okay, well, time to do a short term fast and I'll fast for a couple of days.
[01:59:44]  Yeah.
[01:59:44]  And I just hardly ever get sick.
[01:59:46]  My wife will get sick, you know, multiple times and I'll get, I feel a little something come on and it'll never really hit.
[01:59:53]  Or our lab just went to LA.
[01:59:55]  It was kind of alarming that some of them got sick about half of them.
[02:00:00]  And I didn't really get anything.
[02:00:02]  And, or I felt a little scratch in my throat, a little sniffles, but nothing ever happened.
[02:00:07]  So I think my immune system is definitely a lot better now than it was when I was not doing the Q Genic diet.
[02:00:13]  Like in the 20s.
[02:00:14]  Like in college?
[02:00:14]  Yeah.
[02:00:16]  Like clockwork, when I would, you know, finals would come, I would almost always get sick the end of November, right around that time.
[02:00:23]  It was like clockwork.
[02:00:25]  And sometimes even in the spring with finals.
[02:00:27]  So, our immune system is really tied to psychological stress, I think can wipe our immune system out.
[02:00:33]  I mean, looking back, there were periods of time where, I mean, physically, I was doing everything right, but I was just put under a lot of psychological stress and it just like crushed me.
[02:00:44]  Really?
[02:00:45]  Yeah.
[02:00:45]  And just a couple of times, you know, that I can remember when certain life things just come up, you know?
[02:00:51]  So, I think people really need to pay attention and just kind of harder to, a little bit harder to manage, right?
[02:00:57]  But be cognizant that.
[02:00:59]  Our mental state and behavioral effects, behavioral health probably have the biggest impact on our immune system.
[02:01:08]  So, something a lot of people don't think about.
[02:01:10]  Stated otherwise, yeah, psychological stress can be in a very powerful immunosuppressant and make you a vulnerable target to something like coronavirus.
[02:01:18]  So, our kind of philosophy is that we're like nature people.
[02:01:23]  So, I allocate a certain amount of time each day for creative downtime where we get out.
[02:01:29]  We go in the woods, we explore things.
[02:01:33]  We have a lot of property around us that are just mostly forest.
[02:01:39]  So, we do forestry too, and spend a lot of time just outside with our pets and unplug too from your devices.
[02:01:47]  So, I think it's important, you know, a certain time of night, I just put my cell phone on airplane mode and just unplug and we do some downtime stuff.
[02:01:57]  Like, yeah, yeah, two hours before bed.
[02:01:59]  Yeah, and we sleep better.
[02:02:00]  So, like, super important, I think, for people's psychological health because we're so wired and just so attentive to our phones.
[02:02:09]  And that's kind of, we're very reactive.
[02:02:12]  Sort of species here, and we do it, and we don't even know that it's compromising our health.
[02:02:18]  Yeah, so I think it's important for people to recognize that.
[02:02:20]  Yeah, I think I also it really resonates with me when you talk about sleep and how much you pay attention to sleep.
[02:02:27]  I recently started, I recently got a sleep number bed, and it tells you how you slept, gives you like a score, and how restless you were, or whatever.
[02:02:35]  And it's paying attention to that.
[02:02:36]  I've really noticed a huge difference in like, you know, my cognitive clarity, you know, how well I feel during the day, and you know.
[02:02:45]  Getting sick less.
[02:02:45]  It's a huge difference.
[02:02:47]  And I keep going back for some reason on this podcast to basketball references, but LeBron James, I read all his interviews where he talks about his number one thing that's most important to him when training or anything like that, or nutrition or practice, even.
[02:03:04]  Like the number one thing, most important thing to him is sleep.
[02:03:06]  Like sleep cannot get in the way of anything.

=== Treating Brain Injury With Hyperbaric Oxygen (08:02) ===

[02:03:09]  And he rigorously sleeps nine to 10 hours a night and takes two to three hour naps every day.
[02:03:15]  Wow.
[02:03:16]  And it's like, it's the ultimate.
[02:03:18]  And he has his own personal hyperbaric oxygen chambers he travels with.
[02:03:21]  And like, yeah, that's a big topic.
[02:03:24]  So hyperbaric oxygen can increase stem cell production.
[02:03:28]  It also stimulates the release of those stem cells.
[02:03:31]  And those stem cells can go in and hone in on sites of injury and inflammation and enhance the repair processes.
[02:03:40]  So it's debated on how that works.
[02:03:43]  But if they hone in and they collect in a certain area, they also release various growth factors that can help in.
[02:03:51]  Skeletal muscle protein synthesis and repair, maybe anti inflammatory effects.
[02:03:55]  Yeah.
[02:03:56]  So I'm not convinced of the science, but a lot of people send me papers and say, look at this.
[02:04:00]  Should I be using a hyperbaric, like NFL players and things like that?
[02:04:03]  For that kind of stuff.
[02:04:04]  Yeah.
[02:04:05]  And I say, you know, it looks like I haven't seen any big but clinical trials, but the basic science kind of says it's there.
[02:04:11]  I know Stephen Thom, who's also funded by the Office of Navy Research, was one of the first to show that hyperbaric oxygen therapy almost works like this drug, GMCSF.
[02:04:22]  Which is a sort of an activator of our stem cells and can recruit increased levels, and it's used therapeutically in cancer patients and different patients.
[02:04:32]  That it almost has the same ability as this drug, which is extremely expensive, to actually influence the production and the release of stem cells.
[02:04:42]  Really?
[02:04:42]  So, there's a drug called there GMCSF, and I think it's leukine or nupogen.
[02:04:51]  You know, if you go, these are very expensive drugs that are used for.
[02:04:56]  A number of applications, some of them experimentally for like neurological diseases, but also cancer patients and stuff use them for different applications.
[02:05:07]  So, granulocyte, mono, yeah, GM, GMCSF.
[02:05:13]  And there's GCSF and GMCSF.
[02:05:15]  So, leukine and nuprigen.
[02:05:18]  So, these are drugs I'm not super familiar with, but I became familiar with it when some discussions were about hyperbaric oxygen, referencing these drugs.
[02:05:27]  In relation to the ability of hyperbaric oxygen to recruit and stimulate the production and release of stem cells that can enhance tissue injury and repair.
[02:05:41]  So, there is, I get a lot of questions about hyperbaric oxygen therapy in athletes.
[02:05:47]  And I think there's some, I just say the jury's still out.
[02:05:50]  But I think, and I do that to be protective because my contracts are actually to study the negative effects of hyperbaric oxygen.
[02:05:58]  So, I study oxygen toxicity seizures.
[02:06:01]  Which are the seizures that are generated from hyperbaric oxygen being too high?
[02:06:06]  So, I studied the negative effects, I built my whole career studying the negative effects of high pressure oxygen and why we need to avoid it and develop mitigation strategies against it.
[02:06:15]  But understand that hyperbaric oxygen therapy is within a defined limit, and that limit is set by the potential to get oxygen toxicity seizures.
[02:06:26]  So, within that therapeutic limit, it can have anti cancer effects that I talked about, you know, it can have.
[02:06:33]  There's 14 different FDA approved applications.
[02:06:36]  So, an emerging application could be recovery of athletes from this.
[02:06:41]  And I think there are these home hyperbaric chambers that you can get on eBay for like $1,500 to $2,500.
[02:06:50]  They may provide some benefit.
[02:06:51]  If you're a high end athlete and it gives you that 0.5% benefit, or if you're recovering faster, it may be something to invest in.
[02:07:00]  I mean, science is pointing it to it, but I'm not completely sold on it.
[02:07:04]  Is there any benefit to someone like.
[02:07:06]  You know, like you or I to have that in their home, kind of like as a therapeutic thing for someone who just casually works out or wants to be healthier.
[02:07:15]  Yeah.
[02:07:15]  Well, you know, I communicate a lot with vets.
[02:07:19]  So people with traumatic brain injury and concussions.
[02:07:23]  And I think sadly, this is an area that's not FDA approved.
[02:07:28]  So I would encourage people to check out, you know, the use of hyperbaric oxygen for traumatic brain injury, concussions.
[02:07:39]  We know that.
[02:07:41]  Hyperbaric oxygen at very high levels is a stimulant to the brain, and you can overstimulate it to have a seizure, right?
[02:07:50]  But when it's done at lower levels, lower therapeutic levels, it can augment and it can reduce inflammation.
[02:07:58]  It can stimulate processes where the adaptive response is the repair of the injury.
[02:08:04]  And when you have a concussion or a blast injury, it's rupturing blood vessels.
[02:08:10]  So you have these hypoxic pockets.
[02:08:12]  And when you go like these, Areas of the brain that don't have enough oxygen.
[02:08:16]  That's what I mean by that.
[02:08:18]  So, hyperbaric oxygen therapy can restore oxygenation into those areas and start to enhance the healing process in the brain.
[02:08:26]  So, there's a lot of data to support it.
[02:08:29]  And we will be presenting at the Hyperbaric Oxygen Therapy Conference 2020.
[02:08:37]  And a lot of vets will be talking about this, NFL players.
[02:08:43]  And I think we need more research, but I think the research is pretty good with stroke.
[02:08:48]  Injury and hyperbaric oxygen in animal models, and now some evidence in patients.
[02:08:53]  So it's not an FDA approved application, but another consideration that needs more attention, federal funding.
[02:09:02]  If you have a traumatic brain injury, a concussion, or stroke, I think people should look into it.
[02:09:08]  I'm not going to advocate it because I need to stay within the realm of it, but I think people really need to look at the potential for hyperbaric oxygen therapy.
[02:09:15]  And we're always trying to get research to study this because I feel it's one of the most important topics.
[02:09:20]  That needs to be studied brain injury, traumatic brain injury, and using hyperbaric oxygen in addition to ketosis.
[02:09:27]  So, the two together we feel would be very therapeutic for recovery of patients, especially if it's done immediately after.
[02:09:35]  But even patients maybe that had the injury a while back, we think it would have some benefit if they start.
[02:09:41]  Wow.
[02:09:41]  Well, that's been a bunch.
[02:09:42]  That's been an incredible amount of knowledge you just dropped.
[02:09:45]  I really appreciate you doing this, man.
[02:09:47]  I've kept you here for about two hours now.
[02:09:49]  Well, thanks for having me.
[02:09:50]  I appreciate it.
[02:09:50]  I love platform and speak about this stuff.
[02:09:52]  Yeah, man.
[02:09:53]  Absolutely.
[02:09:54]  It's a privilege to be able to have someone like you on here.
[02:09:56]  So, hopefully, we will get the opportunity to do it again in the future.
[02:10:00]  And, uh, And oh, yeah, tell everyone where they can find you online and learn more about what you're doing.
[02:10:07]  Yeah, go to, we have a company, Ketone Technologies LLC, but that company is more research and development.
[02:10:13]  But we have a website that talks about what we do as a company.
[02:10:19]  And also, Keto Nutrition is really my main information website.
[02:10:23]  I don't sell any products on that, but there's products on there that I've used and recommend and that I use personally.
[02:10:30]  And there's consultants on there.
[02:10:32]  There's podcasts on there, like the Tim Ferriss Joe Rogan podcast, are on there and stuff.
[02:10:37]  So it's more of an information website for people.
[02:10:40]  And it's kind of like a one stop shop.
[02:10:42]  And we also have a blog.
[02:10:43]  So check out the blog.
[02:10:44]  We've hit a lot of topics that we've discussed, and the blog will go into more depth and detail on each of those topics.
[02:10:50]  What is the blog called?
[02:10:52]  If you go to ketonutrition.org, it's a.org site.
[02:10:56]  It's just the blog.
[02:10:57]  So just on the bar at the top, just click on blog, and it hits things from different types of ketone supplements to diabetes to.
[02:11:06]  All sorts of topics on there.
[02:11:08]  So, yeah, but it gets into a little bit more detail.
[02:11:11]  Awesome, man.