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Aug. 7, 2017 - The Joe Rogan Experience

02:53:32

Joe Rogan Experience #994 - Dom D'Agostino

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dom dagostino

02:24:12

joe rogan

28:05

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Speaker	Time	Text
unidentified		Boom.
joe rogan ▲ ● ▼		And we're live.
		How are you, Dom?
		Welcome to the show.
dom dagostino ▲ ● ▼		I'm doing great, Joe.
joe rogan ▲ ● ▼		Pull this sucker right up close.
		There you go.
		I know you've done the podcast before.
		You did Tim Ferriss' podcast.
		I heard you on that.
dom dagostino ▲ ● ▼		I did, yeah.
		It was excellent.
		Three of them, I think I did.
		I'm on for three.
joe rogan ▲ ● ▼		Three?
		Really?
		Oh, I need to listen to the other two then.
		What is this wine you brought me, man?
		This is crazy.
dom dagostino ▲ ● ▼		That is...
joe rogan ▲ ● ▼		Do you think I'm a drunk?
joe rogan ▲ ● ▼		Is this what this is?
dom dagostino ▲ ● ▼		Maybe the Dry Farm Wines guys think that...
joe rogan ▲ ● ▼		This is a giant magnum.
joe rogan ▲ ● ▼		I'd have to have a party.
dom dagostino ▲ ● ▼		It's a wine that's pretty legit in regards to if you want to stay on a ketogenic diet.
		And I tested this in my office, actually, and just found that it's non-glycemic, for one thing, which means it doesn't impact.
		The sugar content is so low, there's not an elevation in And blood glucose and I can stay in ketosis on this wine.
		If I do one glass, two or three starts to kick me out, but two glasses of wine you can completely stay in ketosis.
joe rogan ▲ ● ▼		Interesting.
joe rogan ▲ ● ▼		Most glasses, most wine will kick you out of ketosis?
dom dagostino ▲ ● ▼		Yeah, I mean, it's highly dependent on like a Merlot, you know, a dry wine typically doesn't.
joe rogan ▲ ● ▼		Is Merlot more dry?
dom dagostino ▲ ● ▼		Most of it, yeah.
		Most of the time, yeah.
		White wines tend to kick me out more.
		And of course, something like a sweet wine will kick you out.
joe rogan ▲ ● ▼		Like a Riesling or something like that.
joe rogan ▲ ● ▼		Really sweet wine.
dom dagostino ▲ ● ▼		Sangria, you know, that'll kick you out very fast.
joe rogan ▲ ● ▼		That's just sugar, yeah.
dom dagostino ▲ ● ▼		And even beer does.
dom dagostino ▲ ● ▼		Even though it's supposed to be low carb, beer tends to kick me out.
unidentified		Really?
dom dagostino ▲ ● ▼		Make a little ultra, maybe one, you know, one or two.
		But other than that, yeah.
		I mean, I get that question a lot.
		So it actually got me interested into studying this.
		So I can answer some of the questions with some level of knowledge.
		And after testing these wines and...
		I came to the conclusion, yeah, you can drink two glasses of wine a day on a strict ketogenic diet.
		And I mean, this is important for, you know, people that are doing it to manage their health long term.
		Right.
joe rogan ▲ ● ▼		Especially people with actual health issues where ketogenic diet benefits them, like epileptic.
dom dagostino ▲ ● ▼		Absolutely.
		Like when I got into this, it was pediatric epilepsy, like in 2007 or 8. And now the applications are expanding, you know, a dozen or more.
		So we hold a conference, a metabolic therapeutics conference, where top tier people in academia And like from Johns Hopkins, they're probably one of the spearheaded ketogenic diet application clinically and top tier scientists like from Yale and Harvard and other places present here.
		And it's, I think the application, it was like 11 or 12 applications for the ketogenic diet where there's good peer-reviewed research to support the efficacy as a metabolic-based therapy for a number of, everything from, you know, polycystic ovary syndrome to acne to rare, even genetic disorders like Angelman syndrome is something that we're studying.
		It's a genetic disorder where a housekeeping gene is mutated and it results in seizures and motor function impairment.
		And the ketogenic diet is remarkably effective.
		It's really drug-resistant seizures that these kids have.
		And even in the presence of a persistent molecular pathology, a genetic pathology, the ketogenic diet through altering metabolism with the ketogenic diet, you can largely silence the pathology and the motor function impairments associated with this disease.
		And that's amazing to me, that you have a disease that is persistently there due to a genetic mutation, and you can largely silence the symptoms, the seizures.
joe rogan ▲ ● ▼		In the interest of addressing people that are probably on the ground floor, and I feel like there's very few people today that don't understand what a ketogenic diet is, but just in case.
		For people who don't know, there are people that use carbohydrates mainly for fuel, and then there's the ketogenic diet, which makes your body run on fats and ketones.
		So just kind of explain that to people, like how this came about, how people started to...
		Researching this and how you got involved.
dom dagostino ▲ ● ▼		Okay.
		I mean, this goes back, if not centuries, like millennia, you know, dating back to the time of Hippocrates when it was observed that fasting was a quote-unquote cure for seizures.
		Really?
		Yeah, so fasting puts you into fasting ketosis, right?
joe rogan ▲ ● ▼		So even intermittent fasting?
joe rogan ▲ ● ▼		Like, I'd do the 14-hour thing.
dom dagostino ▲ ● ▼		Well, 14 hours, you know, that's, I mean, technically, that's kind of, I call that a semi-fasted state when you achieve that.
		You know, when you're eating breakfast, it could be, you know, 12 hours or more since you've eaten last, and you're breaking the fast, essentially.
		But with severe epileptic patients, it was found that...
		When they restricted food, and in some cases water, after about two or three days, you had profound seizure control, or it silenced even the worst seizures.
		And this was observed, you know, for millennia, like I said.
		There was some work done in the early 1900s and 1920s.
		There was some work done at the Mayo Clinic that observed the presence of these ketone bodies in people that were eating a carbohydrate-restricted diet that was primarily based on eating fat.
		And with a minimal amount of protein, just enough to Ensure there's not protein, you know, malnutrition.
		And it was observed that there was an elevation of ketone bodies, beta-hydroxybutyrate and acetoacetate in the blood.
		So they called it, physiologists called it the ketogenic diet.
		Even technically, maybe beta-hydroxybutyrate's not a ketone, but physiologists called these ketone bodies beta-hydroxybutyrate, acetoacetate, and acetone.
		And it mimicked the physiological state of fasting in many ways.
		So if you were to draw blood off someone on a ketogenic diet, it would sort of look like they had been fasting a few days because it's mimicking the way I think about it.
		It's suppressing the hormone insulin.
		And kind of mimicking the fuel, the substrate utilization that you would be using in a state of being fasted, which is primarily fats, ketones, and to a lesser extent, glucose from amino acids, from protein.
		You are mobilizing some gluconeogenic amino acids from your skeletal muscle when you are fasting.
		Ketones are protein sparing though, so they are anti-catabolic in that way.
		So because we make ketones and our large brain has a massive demand for energy, And the ketones fulfill that, for the most part, when fasting.
		It prevents us from breaking down muscle.
		It prevents us from liberating the gluconeogenic amino acids that would otherwise, you know, be chewed up and used to maintain our glucose levels.
		So the ketones sort of replace glucose.
		The brain has the metabolic flexibility to adapt from using glucose to using primarily ketone bodies.
		And those ketone bodies really have a protein-sparing, anti-catabolic effect.
joe rogan ▲ ● ▼		Now is this an ancient system that was in place back when people obviously couldn't go to the store and your diet varied depending upon what was available and it just allowed people like say like maybe Inuits that lived off a lot of fats because they really don't have many carbohydrates if you're living off a whale blubber and things along those lines like they had to back then?
dom dagostino ▲ ● ▼		Yeah.
		I mean, it's hardwired in humans and obviously in other animals.
		My wife studies manta rays, and they're like the Einsteins of the sea.
		So they're the fish with the biggest brains of all animals.
		And we've done metabolomic studies on them and looking at the blood, and they produce a significant amount of ketones, like 2 millimolar.
		They dive really deep so it may help protect them from that.
		So yeah, animals will go into ketosis during fasting or even if you manipulate their food source.
		The Keto Pet Sanctuary actually treats dogs that have cancer and they implement a ketogenic diet in dogs in addition to some other things to help.
		And many of these are dogs taken from kill shelters and put them on an anti-cancer Therapy program, and they can get into ketosis.
joe rogan ▲ ● ▼		For the most part, most dog food is not ketogenic.
joe rogan ▲ ● ▼		It's like dog foods have grain in it, right?
dom dagostino ▲ ● ▼		Yeah.
joe rogan ▲ ● ▼		For fillers and things along those lines.
dom dagostino ▲ ● ▼		Yeah, it's really interesting.
		I was talking with Ron Penna yesterday from Quest Nutrition, the CEO of Quest Nutrition, and he brought to my attention that if you look on a package of dog food, you won't see carbohydrates listed, even though it's the primary, because there was some...
		Some laws or policy put into action to prevent carbohydrates from even being listed on kibble, on dog food.
unidentified		Why?
dom dagostino ▲ ● ▼		You know, there's a lot of reasons why.
		Mostly because dogs really shouldn't be eating a carbohydrate-based diet.
		And that's probably part of the reason, but there's sort of other reasons why.
		But it's really important that, so the food that the Keto Pet Sanctuary gives the dogs that have cancer and they confirm that they have cancer with a A glucose PET scan, and they do it before, during, and after, is basically kind of like a raw foods, ketogenic diet that's almost completely restricted in what we would call glycemic carbohydrates, things that would elevate the glucose levels.
		And it's very high in fat, relatively speaking.
		Yeah, but dogs really should not be eating any kind of grains at all.
joe rogan ▲ ● ▼		Yeah, I feed my dog grain-free dog food, but I don't know if it's carb-free.
joe rogan ▲ ● ▼		I don't know what's in there.
dom dagostino ▲ ● ▼		Is it kibble?
joe rogan ▲ ● ▼		Yeah, it is kibble.
dom dagostino ▲ ● ▼		It's hard to find out.
		Right, yeah.
		I mean, you know, dog food that has like some peas and sweet potatoes and things like that is okay.
		But ideally, you know, you want to give your dog like a whole food...
		Nutrition, just like humans.
		You know, they say, don't give your dog human food.
		But that's, there's no evidence for that.
		And, you know, I've given talks where I talked about giving dogs raw food.
		And there'd be a reaction from the audience, well, it's dangerous to give your dog, like, raw food.
		Well, what do they eat in the wild?
		I mean, if it's ground beef that's been sitting around in a processing plant for a while, yeah, maybe.
		But fresh meat from a butcher or fresh meat, I mean, it's probably the ideal thing for a dog.
		Ideally, organ meats, like liver, heart, kidneys, things like that.
		Grind it up.
		You know, and some greens, too.
		Some things like spinach.
		You can buy, like, spinach powder.
		So the Keto Pet Sanctuary has an e-book that's completely free if you go to ketopetsanctuary.org, I believe.
		And you can download its e-book, and it tells you very precisely how to make your dog food, not only to...
		You know, if your dog gets cancer, but to maximize its overall performance.
		And you are preventing cancer by virtue of putting them on a diet that optimizes their metabolic health.
joe rogan ▲ ● ▼		Well, that's got to be very difficult to package, though, in something that's sort of evergreen.
		Sits on the shelf in a paper bag you can rip open and just pour into a bowl.
		That's what everybody wants.
		It's like this convenience thing.
		Yeah.
dom dagostino ▲ ● ▼		There's a way to do it.
		And I know those guys, Epigenics Foundation, they are working.
		They basically support the Keto Pet Sanctuary.
		And they're working out not only the macronutrient ratios that need to go into the food, but also the types of food and also being able to package it in a way to ultimately come up with a food It may not be on the shelf, and probably ideally shouldn't be on the shelf, but it'll be in the refrigerator section of your pet food store.
		So you go there, and for our dogs, we get a tube of freshly ground up steak or whatever, and we feed that.
		We take the ground meat and mix it with organ meat and mix it with...
		Different greens like broccoli and things like that and give it to them and they love it.
		We put a little bit of coconut oil on it sometimes.
		So you would go to the grocery store or it could be shipped to your house and it's basically kept refrigerated and it has the complement of organ meats to the proper types of fats, fish oil fats and fiber and it fits that macronutrient ratio of the ketogenic diet.
unidentified		Your dog must have horrific farts.
dom dagostino ▲ ● ▼		One of them does.
		Yeah, we have a Great Dane.
		They're both rescue dogs.
		One of them does.
joe rogan ▲ ● ▼		I'm hearing broccoli, organ meats, and coconut oil.
joe rogan ▲ ● ▼		I'm like, whoa, get out of the room.
dom dagostino ▲ ● ▼		Yeah, it's either my wife or the dog.
		I don't know.
		She might be blaming the dog.
		Yeah, might be blaming the dog.
		They're healthy.
joe rogan ▲ ● ▼		How long have you been involved in ketogenic research and research on keto diets?
joe rogan ▲ ● ▼		And how long have you been doing it yourself?
dom dagostino ▲ ● ▼		Yeah, I guess it was I got turned on to it in 2007 or 8 and actually I was communicating online on a nutrition forum on a fitness website and I was a neuroscientist.
		I did my PhD on cellular neuroscience.
		I did something called patch clamp electrophysiology where I electrically record from neurons and it was you know really mostly just neuroscience and my postdoctoral research was studying seizures.
		And I got to the point where we're doing some drug-based research on seizures and other types of research.
		And the types of seizures that I study are powerful tonic-clonic seizures that a Navy SEAL could potentially experience using a closed-circuit rebreather.
		So when they're underwater, a limitation for their time underwater is CNS oxygen toxicity.
		And it's also a limitation for hyperbaric oxygen therapy.
joe rogan ▲ ● ▼		So rebreathers are those ones that don't emit bubbles.
joe rogan ▲ ● ▼		Is that correct?
unidentified		Yeah.
dom dagostino ▲ ● ▼		So there's a bit of a stealth component.
		So you're underwater, and if you're going over a lake to engage the enemy, they can't see you coming.
		So that's the advantage, that they're very stealth-like.
		The disadvantage is that at 50 feet of seawater, in just 10 minutes, you have the potential to get CNS oxygen toxicity.
		Of course, if you follow the guidelines and dive within the guidelines of, you know, the depth and the time, then you're typically okay 99.9% of the time.
		But if you have, you know, someone shooting with a.50 caliber machine gun into the water, you're not going to want to come up.
		You know, you're going to want to stay down there.
		If you have a mind to go down to the bridge or ship or something, you have to likely, in many cases, go down below 50 feet.
		And it puts you at the potential of having a seizure.
		The seizure itself is not deadly, per se, but having a seizure underwater could be fatal to the mission and the warfighter.
		So my research was really developing various technologies where we actually put things inside a hyperbaric chamber, like an atomic force microscope or a laser scanning confocal, where we can look at the mitochondria under pressures that simulate these operational conditions.
		And that was about 10 years ago.
		And out of that research evolved studying various things and looking at the cells and even the mitochondria and observing that ketones essentially enhance brain energy production and resilience in extreme environments of high pressure and high oxygen.
		And from those cellular studies, I became more interested in what people do when drugs don't work for epilepsy.
		And I looked up and found the ketogenic diet.
		This fits in perfect because my background was studying nutrition and I was studying pharmacology at the time but it allowed me to bring nutrition back into my research program.
		And studying the ketogenic diet specifically.
		And the program officer at the time at the Office of Navy Research really liked the idea of the ketogenic diet in a drug.
		So being able to consume something that can elevate these blood ketone levels, which can cross the blood brain barrier and make our brains kind of super brains under physiological extremes.
		I put my efforts into studying the ketogenic diet and also into developing and testing a wide range of exogenous ketone products, which are on the spectrum of drug-like to on the spectrum of kind of natural-based things that can be combined together which are on the spectrum of drug-like to on the spectrum of kind of natural-based things that can be combined together that put you in a
		So you can use it right before an operation, right before a mission or therapeutically.
		So if you have a child, for example, that has status epilepticus, which is continuous seizures that you can't stop, instead of giving them an anti-epilepsy drug that can have side effects and even developmental delays, the ketogenic diet, you know, takes 24, 48, maybe 72 hours to work.
		But if you can tube feed them a ketone supplement and put them into therapeutic ketosis, then you can mitigate these seizures which could have potential long-term effects.
		So that's just one example of a therapeutic application of exogenous ketones.
joe rogan ▲ ● ▼		So you're doing the research on this and you decided to start doing it yourself?
dom dagostino ▲ ● ▼		Yeah, I started doing it myself to get a better understanding.
		Actually, there was a patient in the UK, his name is Mike Dancer.
		And if you just kind of Google Mike Dancer and epilepsy, you'll come up on his story, which is a really remarkable story, because he tried a dozen, a half dozen, maybe even a dozen different types of anti-epileptic drugs and high doses of things like Keppra, like things that are the standard of care.
		And it didn't work for him.
		He connected with me.
		And I mentioned a couple supplements before I embarked on the ketogenic diet.
		And long story short, I gave him the information, kind of, here's the ketogenic diet, here's the scientific rationale.
		It looks like before you go and have brain surgery, they were going to remove part of his hippocampus.
		I said, you know, just use this.
		And that was maybe about 2008 or 2009-ish.
		And long story short, I didn't talk to him because I got really busy.
		I transitioned into a tenure-track assistant professor position.
		I was working very long hours.
		Maybe four months or so went by.
		And then when I contacted him, he was like, I have not had a seizure in this time.
		And he was having multiple seizures sometimes per day and couldn't leave the house.
		And it was almost like a proof of concept.
		And it also caused pretty significant body composition changes in him.
		And he was in the fitness industry and even did a bodybuilding show.
		So he basically was, it saved him.
		It saved his life, actually, because he had what I would call and what the doctors call terminal epilepsy.
		There was no way to control seizures.
		And when the drugs failed, the ketogenic diet worked for him.
		And that was almost like proof of concept.
		I'm reading...
		I thought the ketogenic diet was kind of like this fad diet.
		I just knew about it in the fitness circles as something that I would actually typically avoid.
		But when you read about the history of the diet in the 1920s, early 1920s, and how Dr. Wilder kind of developed this therapy at Mayo Clinic, there's like really legit...
		Peer-reviewed research behind it, an enormous amount of research, and I realized it was a grossly underutilized, what I would call metabolic-based therapy for seizures.
joe rogan ▲ ● ▼		Why would you typically avoid it?
dom dagostino ▲ ● ▼		Because in our healthcare systems, there's really not the infrastructure When a patient comes in and they have uncontrollable seizures, the neurologist or epileptologist typically does not have the skill set in nutrition, knowledge in nutrition, to be able to guide a patient successfully into nutritional ketosis and to do that.
		So they would have to refer them to a registered dietitian, which typically are not Savvy in ketogenic diets.
		But now, the Charlie Foundation is a foundation that works closely with Johns Hopkins, and I think there's about 150 to 200 clinics worldwide that are ketogenic diet clinics that have, you know, registered dietitians that are working to assist patients.
		So now, you know, the infrastructure is kind of there.
		But doctors typically will prescribe a drug whenever they can.
		And even when they know, they may...
		Most of them are probably aware that, you know, it is the standard of care.
		The ketogenic diet is the standard of care when drugs fail.
		And there's things like vagal nerve stimulation and other things.
		But the ketogenic diet has been around so long, it has an amazing track record.
		There are some side effects associated with it, mostly associated with the classical ketogenic diet, which is like 90% fat, like 8% protein.
		But now Eric Kossoff at Johns Hopkins has done a lot of work On what I would call, you know, the modified ketogenic diet.
		He calls it the modified Atkins diet, which is more liberal in protein.
		It's 20 to 30 percent protein and the balance being mostly fats from healthy sources and the carbohydrates are just, you know, completely non-glycemic carbohydrates you get from salads or green vegetables and things like that.
joe rogan ▲ ● ▼		What are those side effects?
dom dagostino ▲ ● ▼		So with the classical ketogenic diet, they found that kids put on the diet, it reduced IGF-1, which if you're into longevity, that might be a good thing, right?
		And it reduced their terminal height in some cases because of the protein restriction.
		So restricting protein can...
		For reasons we know in the longevity field, you know, reduce IGF-1 signaling, insulin IGF-1 signaling.
		And that was found to be the case in kids versus the suspected mechanism.
		But when protein was kind of titrated back in, that was not the case.
		So there's also kidney stones can happen and there's a supplement potassium citrate.
		That can help kind of offset the mild metabolic acidosis that occurs when you go on the ketogenic diet.
		And just simply, I mean, you could do that nutritionally just by formulating your diet and using more salt to balance out, using more minerals.
joe rogan ▲ ● ▼		So essentially the big issue is just the protein.
joe rogan ▲ ● ▼		Yeah.
dom dagostino ▲ ● ▼		Yeah, I think the protein for kids that are growing and developing, and if you restrict protein in kids that have all these growth factors and everything that really kind of require...
		And also, if you go on the ketogenic diet, you may be inadvertently limiting total calories just because of the palatability of the...
		Especially the classical ketogenic diet, whereas the modified Atkins diet...
		Which was studied very rigorously at Johns Hopkins by Eric Kossoff has shown to have like 90% of the benefits of this draconian classic ketogenic diet.
		And when possible, you know, it's better to put, and that's what I follow.
		I follow Modified Atkins, which is just higher in protein.
joe rogan ▲ ● ▼		So let's establish the protocol.
		So the classic ketogenic diet is 90% fats, 8% protein, 2% carbs.
		Is that what it is?
dom dagostino ▲ ● ▼		That's about the macronutrient ratios, yeah.
		And they call it, clinically they call it the 4 to 1 or the 3 to 1 ketogenic diet, and that's really confusing because that 4 to 1 is in grams, right?
		So it's actually like 4 parts fat to 1 part protein and carbohydrates.
		Carbohydrates being a very small part of that 1, that 4 to 1 ratio.
		And a 3 to 1 ratio And that would be like 92% fat.
		I mean, it's really high.
		And then the 3 to 1 ratio is like 88% fat or close to 85% fat.
		So I like to do it.
		It's better.
		It's more easy for me to consider in terms of percentage of calories.
		And about 75% calories from fat is pretty doable and pretty palatable.
joe rogan ▲ ● ▼		So that's how you do it.
dom dagostino ▲ ● ▼		Yeah, 65 to 70%.
		And it's super important for people not only in the clinical realm but also people that are doing this for athletic reasons, for losing body fat necessarily.
		Managing type 2 diabetes is probably the biggest, the low-hanging fruit of all these applications, and I could talk more about that.
		The biggest thing to do is to count your macros and test your ketones, of course, but people are horrible at counting how many calories they are getting in when you tell them to follow a diet.
		So they really need a An app, a software program, an app, and Avatar Nutrition makes the kind of gold standard app for tracking your macros.
		And I'm working with them hopefully to develop...
joe rogan ▲ ● ▼		What's it called?
dom dagostino ▲ ● ▼		It's called Avatar Nutrition.
joe rogan ▲ ● ▼		That's the actual app name?
dom dagostino ▲ ● ▼		That is the app name.
		And it's a very highly innovative app that not only does it, you know, you put in your macro, it's a macro calculator, those That macronutrient profile is in the system and you do body composition measurements weekly and it calculates through what I would call an artificial intelligence system, an AI system in the algorithm, to adjust your calories week by week based on the progress that you're making.
		And it's the only system that I know of its kind that's like a macro tracking system that also gives you feedback on how to titrate your calories and your macros over time to hit specific body composition changes that you want to get.
		And this is the system, it's the ideal platform to incorporate the ketogenic diet into.
		It's going to take some work with the guys that are writing software to design it, but essentially you'll have available a ketogenic diet app that will be able to adjust to whatever output that you want, whether it be managing seizures, maybe a metabolic management of cancer, or body composition changes or performance changes over time, and that's all being written up.
joe rogan ▲ ● ▼		Now I've got a bunch of questions.
		First of all, What are your primary fats?
		When you tell someone that your diet is, forget about the classic 90% fat, but even 75% fat, people just go, Jesus, where's all that fat coming from?
		What do you use for fats and do you vary it?
dom dagostino ▲ ● ▼		Yeah, my diet is pretty...
		I get the same 12 to 15 foods probably pretty much every week.
		My wife kind of eats outside of the range of the ketogenic diet, so sometimes...
joe rogan ▲ ● ▼		How dare she?
dom dagostino ▲ ● ▼		Yeah, how dare she?
dom dagostino ▲ ● ▼		I don't try to...
joe rogan ▲ ● ▼		Does she eat pasta in front of you and mock you?
dom dagostino ▲ ● ▼		She does, but I don't crave it, so that's the thing.
joe rogan ▲ ● ▼		You don't at all?
dom dagostino ▲ ● ▼		She thinks it's really strange.
joe rogan ▲ ● ▼		Aren't you Italian?
dom dagostino ▲ ● ▼		I am.
		So that created a bit of a problem with my family.
		Like when I go home, yeah, I grew up on pasta.
joe rogan ▲ ● ▼		Oh, yeah.
dom dagostino ▲ ● ▼		So my carbohydrate tolerance is actually really good.
		So if I go back to a higher carb diet, you know, I can't throw in three, 400 grams of carbs a day, but I tolerate it very well.
		So me going into a ketogenic diet was a very strange thing for me to do that.
		I had read Rob Wolf's book and knew about the paleo diet.
		And even some of the writings of Gary Taubes, but I was a little hesitant or skeptical about it.
joe rogan ▲ ● ▼		Why were you skeptical?
dom dagostino ▲ ● ▼		Well, I really thought that you need carbs to grow in the gym and maintain your strength and performance.
		And I just felt that the brain needed glucose for fuel.
		And I didn't, you know, I was kind of unaware of the research that was done in Harvard in 1967 by George Cahill.
		And I did get a chance to talk to him before he passed away.
joe rogan ▲ ● ▼		Well, even Rob Wolf is, you know, Rob is really into jujitsu, right?
		And he's having an issue with maintaining a strict ketogenic diet.
		I don't know if he's going with the classical ketogenic or the modified Atkins, but he has a problem with having the carbohydrate restriction when he has really hard training days.
dom dagostino ▲ ● ▼		Yeah, I've talked to Rob about that a little bit.
		The body is incredibly adaptable to switching fuel sources and adapting to that fuel source over time.
		And some people may be a little less adaptable than other people.
		But I think that if he was to give it...
		I think, you know, knowing Rob, he did give it a very legit shot.
		He may benefit from adding some slow carbs in just prior to an intra-workout, you know, during his...
joe rogan ▲ ● ▼		Like yams or something along those lines?
joe rogan ▲ ● ▼		What do you consider a slow carb?
dom dagostino ▲ ● ▼		You know, there are supplements out there, but yeah, if we're going to talk about...
unidentified		Foods.
dom dagostino ▲ ● ▼		I would say, yeah, maybe a little bit of sweet potato in, you know, prior to training or the day before, maybe a few hours before.
joe rogan ▲ ● ▼		So it's some sort of a car with plenty of fiber, something like a...
		Digest slowly?
		Is that the idea?
dom dagostino ▲ ● ▼		Yeah, even a high molecular weight carbohydrates that are on the market now.
		Like what are those?
		You know, I don't use them anymore.
		I know Jeff Follick has a product out, UCAN. I think UCAN starch is the name of it.
		And it just, you know, it will slightly elevate...
		It will elevate your glucose and not trigger an insulin response, so you won't go hypoglycemic after.
		And it will essentially titrate in carbohydrates and glucose into your system over a predetermined period.
		It'll kind of hit your system and sustain it for three or four hours, which is ideal for people engaging in MMA or cycling during that time frame.
		But I think if you're getting in a sufficient amount of calories and if you are using things like creatine monohydrate, which works through the phosphagen system, you are able to generate ATP for those short bursts of power that you need To manage your opponent and sustain it.
joe rogan ▲ ● ▼		So for a supplementation, if you were going to supplement creatine, would you do that prior to the workout?
joe rogan ▲ ● ▼		I know a lot of people take creatine post-workout.
dom dagostino ▲ ● ▼		Yeah, if you're taking creatine and you stop taking creatine, it's in your system for a couple days to a week or more.
		So it's just, you know, on a daily basis, it doesn't matter necessarily when you take it.
		It's just that you take it on, uh, and probably at least three grams per day, uh, for a larger guy, three to five grams per day.
joe rogan ▲ ● ▼		Is that some you take?
dom dagostino ▲ ● ▼		Uh, yeah, it's one of the few supplements that I take.
		I only take maybe three or four supplements.
		I used to take all these different supplements.
		So I'm more of a food guy.
joe rogan ▲ ● ▼		Mm-hmm.
dom dagostino ▲ ● ▼		But maybe I take three or four supplements.
		And I use some of the new food products that are coming out on the market now.
		Ketogenic food products.
		And that allows me to maintain my ketogenic diet when I'm traveling.
joe rogan ▲ ● ▼		Do you ever mess around with beta-alanine?
dom dagostino ▲ ● ▼		Yeah.
		It's something I use to increase carnosine levels, right?
		It's something that I used in the past.
		I don't like the tingles that I get.
		A lot of people like the tingles.
joe rogan ▲ ● ▼		Like niacin-type tingles?
dom dagostino ▲ ● ▼		It's not quite that extreme.
		It's like niacin, but it's working through a different receptor.
		Yeah, the first time I took niacin, I thought I was going to die.
		But yeah, it's unpleasant.
		It's not something that, you know, some people look forward to it.
		I know those people are strange, but the beta alanine makes me uncomfortable.
		But I remember drinking it on the way to the gym.
		It was part of my pre-workout formula.
		And it just made me itchy.
unidentified		Yeah.
dom dagostino ▲ ● ▼		I just didn't like it.
		And, you know, the data's not...
		I think it's a little bit...
		It's not what I would call compelling, but it looks like it may offer a benefit.
joe rogan ▲ ● ▼		It was just recommended to me.
		That's why I brought it up.
		So creatine, three grams per day.
		And what do you weigh?
		About 215, something like that?
		What do you weigh?
dom dagostino ▲ ● ▼		Yeah, on the mark.
		I'm pretty good at that.
		I lost some weight.
joe rogan ▲ ● ▼		Weighing in fighters.
unidentified		Yeah.
dom dagostino ▲ ● ▼		Yeah, that was, like, almost exactly.
		So, I had, a couple weeks ago, I got down, I did a mission with NASA, and I was underwater for a while.
		And when it came back up...
joe rogan ▲ ● ▼		How long was it while?
dom dagostino ▲ ● ▼		I was under for 10 days.
joe rogan ▲ ● ▼		Jesus Christ, that's more than a while.
dom dagostino ▲ ● ▼		Makes me an aquanaut, yeah.
joe rogan ▲ ● ▼		Wow, that's crazy.
dom dagostino ▲ ● ▼		So, and during that time, during the training for it, I was doing a lot of swimming, which was, I sink like a rock.
		I'm kind of negatively buoyant.
		Me too.
		It took a lot out of me, and I tried to get into my file that I was closer to 200. I think maybe you'd be more likely to be an astronaut candidate if you're Like lower, you know, because weight in space is a big thing to me.
		So I tried to get my body weight from 226 down to 207, and I did.
		It took about three months, and now I'm creeping slowly back up.
joe rogan ▲ ● ▼		What did you do to do that?
unidentified		Just high aerobic workout or calorie restriction?
dom dagostino ▲ ● ▼		I did intermittent fasting, really.
		Just transitioned to a diet where...
		I typically eat a ketogenic breakfast that's kind of small, and I would make that a little bit smaller, and two or three days out of the week, on average, I would just kind of not eat until dinner, and then I would eat a substantial dinner, and then maybe do some activity after that, and then kind of nibble at nighttime, maybe an hour or two before bed.
		And that was kind of my routine.
joe rogan ▲ ● ▼		So almost like a warrior diet type deal?
dom dagostino ▲ ● ▼		Pretty close to that, yeah, from what I know.
		That's pretty close to that.
		And I did not in any way feel deprived of food.
		And that's really, you know, people follow a low-carb diet or ketogenic diet.
		They think you don't have to count macros, which is like the biggest mistake.
		They think you just go on this and you don't have to count calories, but you really do.
		I mean, you could sit down in front of the TV with like a bag of cashews and I can polish that off pretty quick.
		And you could do a lot of damage.
		Like that's a lot of calories.
joe rogan ▲ ● ▼		Yeah.
dom dagostino ▲ ● ▼		So it depends on the kind of foods that you're eating.
joe rogan ▲ ● ▼		There's like two handfuls of almonds I think is like 500 calories or something crazy.
dom dagostino ▲ ● ▼		Yeah, yeah.
joe rogan ▲ ● ▼		That doesn't even make sense.
joe rogan ▲ ● ▼		Yeah.
dom dagostino ▲ ● ▼		So I talk to people who follow the ketogenic diet and they're like, the ketogenic diet doesn't work for me.
		I got on it and I gained like three pounds.
		And I was like, well, what was your calories?
		What was your macros?
		Oh, I have no idea.
		I was told I don't have to count that.
		Yeah, that's the most important thing.
		So this is the function of the app I told you about, Avatar, which is kind of a macro counting program.
		Right now, you can set the adjustments to do low carb, but once the software is written up for the keto option, that will be a tremendous resource for people, the average person, that wants to do the ketogenic diet.
		And hopefully we're going to craft it in a way, too, to help the clinical community, too.
joe rogan ▲ ● ▼		Well that's one of the reasons why I wanted to have you on is because you're an actual scientist and there's so many misconceptions when it comes to ketogenic diet, the benefits.
		The problems associated with it.
		And there's a bunch of people that...
		One of the things that I've found really fascinating is recently, because the ketogenic diet has become so popular, there's been these sort of sparsely educated meathead trainer type dudes that are poo-pooing the ketogenic diet.
		And whenever I see that happen, I go, oh, here's a person whose ideas are threatened.
		Whenever someone says the ketogenic diet is not beneficial or it's not really worth it, I'm like, okay, you're not saying anything.
		Where's the science?
		Point to something.
		Because there's a substantial amount of science that shows the benefit of the ketogenic diet.
		But there's a lot of meatheads that have been critical of it.
		And when I read that, I'm like, okay, you're not saying anything.
		There's no substantial reason why you're critical of it.
		This makes me think that you have been pushing a certain type of diet for a long time.
		This comes along, it shows contrary evidence, and you're trying to diminish it in some sort of a way, but without any actual science.
		So what have been the criticisms of the ketogenic diet and how many of them are actually valid in terms of when I'm talking to people, especially if I'm talking to professional athletes, I'm talking to athletes whose very health is very critical that they have energy, right?
		We're talking about fighters.
		So for them, like to recommend a ketogenic diet to a fighter, it's very tricky because you're talking like 1%, 2% performance could be the difference between victory and defeat and maybe even being knocked out or submitted and being successful.
dom dagostino ▲ ● ▼		Yeah.
		So I think most important people need to appreciate that when you transition your body from burning carbohydrates and glucose and forcing it to rely primarily off fat and ketones for fuel, it's not one or the other, but you're shifting for the predominant fuel source to be fat and ketones.
		That's not something that happens overnight, and it doesn't even happen in two or three weeks.
		What I've seen in elite-level cyclists and other types of sports is that it really takes a minimum of three months, ideally six months, and even after a year.
		I think you're getting changes even at the epigenetic level.
		We know that ketones function as a signaling molecule through histone deacetylase activity, that it's actually turning on genes that's causing adaptations in our body.
		And these happen slowly over time.
		The more you follow the ketogenic diet, The easier it gets because there's a learning curve to implementing it.
		But the more you follow it, the easier it gets and the more benefits you derive from it over time.
		And those benefits really don't start to emerge.
		The benefits that I'm thinking about after about two or three months.
		You're talking about I mean, how fast were the benefits?
joe rogan ▲ ● ▼		Well, the benefits, the weight loss was pretty significant pretty quickly.
joe rogan ▲ ● ▼		I lost a few pounds like within the first week or two.
unidentified		Yeah.
joe rogan ▲ ● ▼		Whereas I'm pretty active and it's not, you know, it didn't change much other than that.
joe rogan ▲ ● ▼		But what I was amazed at, like the keto flu, you know, what people call the keto flu?
dom dagostino ▲ ● ▼		Did you get that?
dom dagostino ▲ ● ▼		Yeah.
joe rogan ▲ ● ▼		The dragging.
		Yeah.
		For the first week or two, like I was just dragging and I would do like a hard workout.
		I was like, oh my God, I don't know how I keep doing this.
dom dagostino ▲ ● ▼		Okay.
		Yeah.
		That's normal.
joe rogan ▲ ● ▼		Like, a big one was hitting the bag.
		That's when I would really feel it.
		Because, you know, I do rounds where I'll set, you know, like a certain amount of rounds, a certain amount of time.
		And that's when I could really feel the difference from day to day.
		And I was really struggling.
dom dagostino ▲ ● ▼		Yeah.
		And how long did it take you to adapt to that?
		Or did you adapt to that?
joe rogan ▲ ● ▼		It felt like a month in, it started to normalize.
dom dagostino ▲ ● ▼		Okay.
		I mean, that would be consistent with the literature.
		If you're looking at cyclists and if you're, you know, a number of different athletes, it takes about six weeks.
		I mean, your performance will go down and then start to creep up back to baseline at around the six-week mark.
		And if you adhere to it strictly and really stick with your training, you know, in the...
		The 12-week mark, you could be breaking new PRs, depending on the sport.
		Personal records.
		Yeah, personal records.
		And that's primarily directed to, I would say, endurance athletes, ultramarathon athletes, to cyclists, to runners, to Ironman athletes.
		that emerged out of all the emails that I get of people sending me blood work and their performance measurements is that I used to think it was about, you know, a month or two.
		It's more like three months to six months when they really start hitting their stride.
		Because I think there's pretty profound changes when you alter the fuel that you're giving your body in such a profound way.
joe rogan ▲ ● ▼		Well, one of the first things that I noticed, the benefits, one of the first benefits was cognitive.
		It was clarity, lack of fogginess towards the middle of the day, no desire to take a nap, and no drop.
		Like, you know, I'd have the big meal thing and then the drop, the valley, when, you know, like, oh, your body's like digesting everything.
		I thought that was just how you lived.
		I thought there was no getting around that.
		That's life.
		You eat, then you get sleepy.
		I just, I didn't think that there was any other options.
		Going on a ketogenic diet completely changed that.
		And when I would tell people about it, they're like, nothing?
		I'd be like, I'm telling you, there's no difference.
		I mean, I would eat a meal.
		And go throughout my day.
		And then it'd be like 4 o'clock in the afternoon.
		I'm like, where's this crash?
		It's like the crash is supposed to be here.
		Like, where's it coming?
		No crash.
dom dagostino ▲ ● ▼		Yeah.
		Same thing with me.
		I mean, looking back in undergrad, when I was like task loaded with a lot of classes and stuff, I would make...
		I was trying to, you know, bulk up at the time.
		And I would put like steak or beef on a bagel.
		So I would cut a bagel kind of in half and then put like meat and stuff.
		So I would be getting all the carbs from the bagel.
		And I would just go get a big Starbucks coffee because I had two...
		To mitigate that crash that I would have.
		And now, so the ketogenic diet, when you eat a meal, it essentially, if it does not abolish, it significantly attenuates that insulin response that you get.
		So if you wear something like a continuous blood glucose measurement, like a Dexcon or something, and you look at that and you eat a standard American diet, you see a big spike up in glucose typically.
		And the postprandial dip in glucose, that'll be hypoglycemic.
		And when you do that, not only does your mental and physical performance crash, but you crave food.
		So that will send you running to the refrigerator again to seek a reward to mitigate that dysphoria, I would say, that you get from the hypoglycemia.
		So when you're on a ketogenic diet, you essentially abolish that.
		You don't have this spike in glucose, which spikes insulin, and your energy levels are maintained.
		And the big thing is cognitive.
		So cognitive resilience is a big thing.
		So even if you're hypoglycemic, you could use something to lower your blood glucose, like insulin, and push it down to a level that would put someone into a coma.
		And if their ketones are elevated, they are asymptomatic for hypoglycemia.
		And this was a study actually going back to the work done by George Cahill at Harvard where he fasted subjects for 40 days and he did a battery of cognitive tests and he measured blood going to the brain and blood coming away from the brain.
		And he determined that about 70% of brain energy metabolism is derived from ketones when you're fasting.
		And the same occurs with a ketogenic diet too.
		So you are literally switching the fuel source that your brain is using.
		But in an extension of the study, he injected 20 IUs of insulin and pushed glucose down to one millimolar, which is universally fatal in everyone.
		So you take a crowd of people who are eating a standard diet and push it down to that.
		They'd all die.
		So none of them died in the study.
		I have no idea how they got it passed the IRB, the Ethics Review in Harvard Medical School, but they did.
		What year was this?
		1967. And it was a study I became completely fascinated with because I couldn't believe that they did it.
		Because you can't even do it in animals nowadays.
		You know, the IACUC Committee, the Animal Care and Use Committee would put a stop to that very quick.
		You know, they would probably...
		Send the investigator, you know, out of the university if they even proposed to do some of the studies that were done.
		But when they lowered blood glucose down to that level, which would, you know, put someone into a coma, the subjects were asymptomatic for hypoglycemia because their brains were keto-adapted.
		They had essentially been over a week.
		In a fasted state.
		They were all kind of heavyset.
		They were divinity students.
		And a few, I think, were Harvard medical students.
		So they tend to be overweight.
		So they were liberating a lot of fat from their adipose and making lots of ketones.
		And they were in a state where their brain was tremendously resilient against hypoglycemia because their ketones.
		Relevated.
		And that has practical implications for so many different...
		And I was reading this and couldn't believe what I was reading.
		I called George Cahill.
		We talked about it.
		I called all these old-time physiologists that were in the field just to pick their brain.
		And they were thrilled that a young guy...
		You know, just entering a tenure-track position was going to, like, kind of make this his career.
		You know, it goes back a ways.
		But I saw all the implications, not just for epilepsy, but for things like Alzheimer's disease and traumatic brain injury and a whole host of neurological disorders.
		Like, there's one in particular called glucose transporter type 1 deficiency syndrome, or glut 1 deficiency.
		And the kids that have this literally have a deficiency of the glucose transporter on the blood-brain barrier.
		And their blood glucose is normal, normal levels, but the glucose in their cerebral spinal fluid is under 2 millimolar, which is, I mean, their brains are essentially living in hypoglycemia.
		So they're constantly having seizures.
		They can't move.
		A lot of them, they're confined to a wheelchair.
		You put them on a ketogenic diet.
		Many of them wake up.
		They start walking around.
		Their motor function is reversed.
	So the ketogenic diet restores brain energy metabolism in these kids that can't use glucose as an energy source with this disorder.
	It's called glucose transporter type 1 deficiency syndrome.
	And another very interesting example of a disorder where there's a persistent molecular pathology where The symptoms can be largely silenced with the application of a ketogenic diet that needs to be pretty strict.
	And that's where ketone supplements come in.
	It's difficult for some of these kids to follow a ketogenic diet, so a ketone supplement can potentially circumvent the dietary restriction that's needed for a ketogenic diet and make it easier for parents and kids to implement.
	But I also think that a ketone supplement can just further elevate ketones if you're on a ketogenic diet and further augment the therapeutic efficacy of the ketogenic diet or performance enhancing efficacy.
	So my main application is the warfighter and maybe astronauts too.
	So we just think of it as a way to augment, further augment a therapeutic effect or a safety effect when it comes to divers or performance effect when it comes to warfighters or divers.
joe rogan ▲ ● ▼		Now, when you talk to people about mental performance, have there been studies that have shown any variation between the same individuals on a ketogenic diet or carbohydrate-glucose-based diet in terms of mental function?
dom dagostino ▲ ● ▼		Not good studies.
		Yeah, not really good studies.
		What has been done, I mean, the first study, I would say purely ketogenic study that I'm aware of, used something as simple as medium chain triglycerides.
		And it was actually a substance that the chemical name was AC1202. And that substance, it was in the patent listed as a substance called AC1202. And for people unfamiliar, that's just MCT oil, coconut oil.
		Yeah.
		So if you were to pull this patent, interestingly, my colleague and friend, Dr. Mary Newport, did and wrote a book on Alzheimer's disease about the use of ketones for Alzheimer's.
		She identified that the ingredients in this supplement that help to enhance cognitive function in people with mild cognitive impairment, the ingredient of this, if you dig into the patent, was caprylic triglyceride, which is a medium chain triglyceride, which is MCT oil.
		And they did a study.
		It was a double-blind, placebo-controlled study that showed that people who, interestingly, they were not APOE4 positive.
		That group did not respond, which is another kind of pathway we can go down.
		But their improvement in cognitive function correlated with their elevation in ketone levels.
		With this supplement, it was a fat that when you consume it, independent of the amount of carbohydrates you consume, it converts that fat into beta-hydroxybutyrate, which you can measure with a little blood meter.
		And as that level creeped up, and it didn't even have to creep up that high, it was like 0.6, that they were getting significant improvements in the mini mental status tests and other tests that are sort of like the standard tests for Alzheimer's disease.
		And that really got me interested because I knew that levels could go up way higher than 0.06.
		And they're showing that there's a correlation as ketone levels rise up, that you have a proportional increase in cognitive function.
		So I'm thinking with a ketone ester or other types of ketones, you could elevate that to 1, 2, 3, and 4 millimolar and then get some really robust because that's sending a lot of energy to the brain.
		So every millimolar of beta-hydroxybutyrate that's in your blood, it's been estimated that it gives you, like, your brain about a 10% boost in energy.
unidentified		That's incredible.
dom dagostino ▲ ● ▼		It can restore energy up to 10%.
		If you do an FDG PET scan and a ketone PET scan, so you do a dual imaging for that.
		Dr. Stephen Cunane in Canada has done some work on that.
joe rogan ▲ ● ▼		But that's insane.
joe rogan ▲ ● ▼		So like for college students or someone who's studying for an exam or someone who's about to do something very important, exogenous ketones should be like standard, right?
dom dagostino ▲ ● ▼		Well, yeah, there's some pretty good evidence to show, especially if you have a deficit, right?
		And actually, you know, the application that I'm using it for is in an extreme environment when your brain is already at a deficit.
		Right.
		But we could say we're all at a deficit, right?
		So tomorrow, I'm jumping on a red eye, and I can't sleep on a plane, and I land, you know, and go to my university where I have to teach for a couple hours and then drive a couple hours north and give another lecture at night, and I'll be on zero sleep.
		And I would not even attempt that if I was, you know, wasn't doing what I have been doing.
		Like, I've kind of figured out protocols where I can allow me to function even on extreme lack of sleep and be able to...
joe rogan ▲ ● ▼		I'm sorry to interrupt.
		So when you land, would you immediately take some sort of an exogenous ketone?
		What do you take?
		What are your ketone supplements?
dom dagostino ▲ ● ▼		There's a wide variety of ketone supplements on the market.
		I'm kind of a food guy, so I just use them almost kind of sparingly, but I do tend to use them every day.
		The supplements that I've packed in my bag are the Kegenix supplement is one that I've been using, and also the Pruvit Keto OS product that mixes beta-hydroxybutyrate salt with MCT powder.
		So there's a couple other forms of just beta-hydroxybutyrate, but our studies show that just consuming beta-hydroxybutyrate does not give you, at least in the ketone salt formula, does not give you a lot of the benefits that we see in some of the studies that we're running.
		And the beta-hydroxybutyrate needs to be mixed with medium-chain triglyceride fat, and that's pretty important.
		And I think that...
		That has a number of benefits.
		The medium chain triglyceride delays gastric absorption.
		So it also further boosts ketone levels higher than you could get with ketone salt alone.
		So you get an elevation of ketone levels that's sustained for longer.
		And that probably, that sustainment is due to kind of delaying gastric absorption because the fat kind of delays the release of the ketones into the bloodstream.
		And it also, it's stimulating your own ketone production.
		So you're taking a fat, right?
		And that's what happens when you mobilize body fat.
		You have a wide variety of enzymes that convert that fat into ketones.
		If you take a ketogenic fat, the same thing is happening.
		You're revving up that system in addition to the exogenous ketones.
		So the Pruvit product, KetoOS, Kegenics, And there's a couple other companies emerging on the market.
		We have our own company, Ketone Technologies, and we are partnering with government agencies like Department of Defense, ONR, NASA, to do research, to fund research with these institutes to really nail down the optimal formula for anti-seizure effects, the optimal formula for motor function effects, the optimal formula even for strength.
		And the one with strength will probably involve You know, adding amino acids, adding creatine monohydrates.
		So these will be formulas that will be optimized.
		So our company is working on that.
		We don't have any products yet.
		But if you sign up for the newsletter, we will update people on the newsletter.
		And then when the products do come out and emerge, you know, we will kind of let people know.
joe rogan ▲ ● ▼		So when you say you're a food guy, are there any foods that you can eat that will...
dom dagostino ▲ ● ▼		Sardines, yeah.
joe rogan ▲ ● ▼		Sardines?
dom dagostino ▲ ● ▼		Yeah, so I travel with, this trip it was canned chicken and sardines, so there's a couple, Wild Planet makes a good can, and Tim Ferriss, I kind of turned him on to it, and it really exploded.
		The company kind of emailed me and thanked me, you know, they're Really exploding.
		So, it's a small company.
		They're called Wild Planet?
		Wild Planet Sardines, and they're packed in olive oil, and they're like, might be, depending on what you buy, like a little bit of lemon.
		They might have a slice of lemon or lightly smoked or whatever, but they are really, really good.
		And, I mean, I look forward to eating them.
		For me, I'm kind of weird.
		Like, that is a treat for me.
		And that's...
		I've taken a lot of different things and experimented with a lot of different things.
		And simply just eating sardines, it's like the perfect food.
		And eggs, too, are the perfect food.
		You asked me where I get my fat from.
		I do get a lot from the olive oil that are packed in the sardines.
		So I eat a lot of fatty fish, lots of egg yolks.
		I will make an egg yolk omelet, and I'll give the whites to my dog for protein because they need a little bit more protein.
		I'll make an egg yolk omelet and I will cook it in butter and maybe make some asparagus on the side cooked in butter.
		I get a lot of fat from macadamia nuts, a few nuts, sardines, fatty fish, a lot of salmon, and a lot of egg yolks and fatty cuts of meat.
		We go to the butcher and particularly pick out fatty cuts of meat.
		And olive oil, coconut oil, MCT oil are all things that we use.
joe rogan ▲ ● ▼		Have you ever had issues with sardines and heavy metals?
dom dagostino ▲ ● ▼		No.
		I think heavy metals are more of an issue with larger predatory fish.
		Like, I mean, I think swordfish would be kind of at the top of the chain there.
		Of course, you know, you're eating like a mako shark or something like that.
		You're going to be ingesting.
		And if you do that on a daily basis, I wouldn't want, if you're a pregnant woman, you know, I would stay away from big predatory fish.
		But one thing about sardines is that they can be farmed in a sustainable way.
		And the amount of heavy metals will be typically proportional to the size of the fish and whether it's predatory.
joe rogan ▲ ● ▼		The reason why I'm asking is I was eating sardines like two cans a day for a while and I got my blood work done and there was like a very trace amount of arsenic.
joe rogan ▲ ● ▼		In my system.
dom dagostino ▲ ● ▼		Oh, arsenic.
joe rogan ▲ ● ▼		And the doctor said, like, what are you eating?
joe rogan ▲ ● ▼		And he was going over to different things, and I said, I eat a lot of sardines.
dom dagostino ▲ ● ▼		Do you know where it came from?
joe rogan ▲ ● ▼		He's like, cut those out.
joe rogan ▲ ● ▼		The sardines?
dom dagostino ▲ ● ▼		Yeah.
joe rogan ▲ ● ▼		No, store.
dom dagostino ▲ ● ▼		Okay.
joe rogan ▲ ● ▼		I don't know.
joe rogan ▲ ● ▼		Just whatever was on the shelf.
dom dagostino ▲ ● ▼		I mean, we travel all over.
		We were in Borneo and, you know, Malaysia and Indonesia and all these places, and you see some boats coming in, and those sardines are going to various plants.
		Mm-hmm.
		And even bigger companies will source out wherever is cheapest.
		So I like to be pretty particular about, especially if I'm going to eat something in such a high volume, like where it's coming from, to actually visit the plant and get some information to where it's coming from.
		You know, I do use some of the meats from ButcherBox.
		So ButcherBox offers a wide array of meats from grass-fed animals, and that's a lot of our meals at nighttime are from ButcherBox.
		But that's interesting about the arsenic.
		You know, arsenic can get concentrated in the ground where plants are grown in.
		So if rice is grown in China or whatever plant is grown in China and that soil has arsenic in it, I lived behind our house.
		We had like a peach orchard and apple orchards are notorious for this, for having high levels of arsenic just based on the chemicals, you know, that were used over time.
		Hmm.
		So this is something to consider.
		Maybe it's something you're eating with the sardines, or maybe it was the sardines itself, depending on what the sardines are eating.
joe rogan ▲ ● ▼		Yeah, the nutritionist was pretty convinced it was sardines when I cut them out in one way.
joe rogan ▲ ● ▼		He was saying that it was probably just from pollution.
dom dagostino ▲ ● ▼		Yeah, it could be.
dom dagostino ▲ ● ▼		I mean, that's why it's really important to pick out where your food's coming from.
joe rogan ▲ ● ▼		So this company, you recommend Wild Planet?
dom dagostino ▲ ● ▼		Yeah, it's fantastic.
joe rogan ▲ ● ▼		Are they farming it?
		Is that what they're doing?
		They're farming the sardines?
dom dagostino ▲ ● ▼		Yeah, there's different methods that you can use that would kind of put you in the category of sustainable farming for sardines.
		So it's one of the few fishes that are really low on the spectrum of having heavy metals.
		So if you're, you know, there's women, I get this question a lot, like, you know, if a woman becomes pregnant, you know, should they stop eating fish?
		Should they stop eating, you know, ahi tuna or swordfish and things?
		I would say, yeah, definitely the big predatory fish you'd probably want to cut back on.
		I did take a couple courses in neurotoxicology where we went over like mercury poisoning and every possible chemical and just the take home message was for the normal person, probably not an issue.
		You know, unless you're consuming really high levels.
		In grad school, I was eating these big cans, like 12, I think there were 12 ounce cans of tuna fish.
		And there was like five servings per can.
		And I would eat like three cans a day.
		Like I would take that and add, I was fat phobic at the time, but it would be a chunk like tuna and I would put balsamic vinegar on it.
		And I would literally eat three of these 12 ounce cans a day.
		And that would be 15 servings of tuna per day.
		And I did that day in and day out.
joe rogan ▲ ● ▼		No ill effects?
dom dagostino ▲ ● ▼		Well, I never got tested at the time.
		So nowadays I tend to do a lot of blood work just to check different things.
		But no overt signs of, you know, toxicity or anything.
		Maybe like a little, someone, one of the professors that I was doing something for, she had or her friend had lost a lot of hair due to eating tuna that had high mercury.
		And at the time, like, kind of had a lot of hair loss at the time.
		It was also kind of a stressful period.
		So maybe when I stopped eating, I noticed, like, this is back in my mid-20s now.
		I haven't had, like, a significant amount of hair loss since...
		And a couple people have, you know...
		And actually, that's one of the symptoms, too, of mercury toxicity.
unidentified		Oh, wow.
dom dagostino ▲ ● ▼		Weird tingling and feelings, like, kind of neurological effects.
		So just something to consider.
		But getting tested is probably a good thing to do.
joe rogan ▲ ● ▼		I've heard that from people that just consume ridiculous amounts of sushi.
dom dagostino ▲ ● ▼		Yeah.
joe rogan ▲ ● ▼		But I would imagine, like, sushi, you're dealing with smaller portions of the actual fish itself.
dom dagostino ▲ ● ▼		It might be.
		If you do that day in and day out, it's probably good to get tested.
		And sometimes, you know, it may not show up in the blood, in the serum.
		You may have to look at, like, the red blood cell.
		Because sometimes, you know, some of these metals are more reflective of the levels on the red blood cells.
		Or the hair, too.
		So there's different ways that you can measure it.
joe rogan ▲ ● ▼		I read that you eat, was it canned oysters as well?
dom dagostino ▲ ● ▼		Yeah.
unidentified		Yep.
dom dagostino ▲ ● ▼		That's something I usually bring.
		I think I brought on this trip too, like canned oysters.
		King Oscar.
		There's a few brands out there that I kind of vetted out for things.
		And oysters are really rich in a lot of micronutrients that you could get depleted in on the ketogenic diet.
		So B12 is something.
		I do supplement magnesium too.
joe rogan ▲ ● ▼		How could you get B12 depletion from ketogenic diet?
joe rogan ▲ ● ▼		Where would that come from?
dom dagostino ▲ ● ▼		Well, you know, it could be due to sources of B12 that you're kind of eliminating through food choices on the ketogenic diet.
joe rogan ▲ ● ▼		B12 is basically an animal-based?
dom dagostino ▲ ● ▼		Yeah, pretty much.
		Yeah, and I've...
		I've never met, or I think I did measure that once and it wasn't, but people have reported to me that it was.
		The thing that showed up on my blood work was lower, I was on the low end of magnesium.
		And I was getting cramps at the time.
		And that's the only, you asked about side effects.
		So the only side effect that I experienced was cramps at nighttime, always between three and four in the morning.
		And it would start in my foot and then start to creep up to my calf.
		And, or if I did like legs or something, sometimes my hamstrings.
		And then when I... The magnesium supplementation really prevented much of that for me.
joe rogan ▲ ● ▼		Have you ever used an isolation tank?
dom dagostino ▲ ● ▼		No.
joe rogan ▲ ● ▼		One of the cool things about isolation tanks is that you get magnesium to the water.
dom dagostino ▲ ● ▼		That's right, yeah.
joe rogan ▲ ● ▼		Yeah, because the water's filled with salt, and the salt has magnesium in it, you know?
dom dagostino ▲ ● ▼		I think there's pretty legit science behind that.
		I was traveling in...
		In Israel, and I went to the Dead Sea, which is really high in magnesium, and it has a calming effect, which is reportedly due to the very high magnesium levels and other salts that are in there.
		So the magnesium is relatively small molecular weight.
		Anything with a molecular weight, like under 300-400, I think can get into your bloodstream.
joe rogan ▲ ● ▼		Yeah, I mean, I think that's why people like those Epsom salt baths.
joe rogan ▲ ● ▼		I think that's one of the things that relaxes people.
dom dagostino ▲ ● ▼		Yep.
joe rogan ▲ ● ▼		Yeah, and Epsom salt baths is, you're talking about a very small amount of Epsom salt in comparison to a tank, which has, my tank has 1,000 pounds of Epsom salts in it and 11 inches of water.
joe rogan ▲ ● ▼		So, because you're so buoyant.
dom dagostino ▲ ● ▼		And you do this daily at your house?
joe rogan ▲ ● ▼		No, not daily, but whenever I want, you know, because it's in my basement.
unidentified		Yeah.
joe rogan ▲ ● ▼		I'll go down there and get into it.
joe rogan ▲ ● ▼		But the relaxing effects is pretty profound.
dom dagostino ▲ ● ▼		That's interesting.
		You know what?
		It brings to mind most of the...
		I've had at least a half dozen emails about doing Epsom salt baths from ALS patients.
		Because ALS is associated with a chemical called glutamate, which is excitatory amino acid transporter.
		And high magnesium levels can kind of mitigate some of the excitotoxic effects of high glutamate.
		There's fasciculations that they get and twitching, muscle twitching that they get.
		And they found that dosing magnesium or these Epsom salt baths, higher in magnesium, can calm them down and also maybe mitigate some of the twitching that they had, which is probably a reflection of glutamate-induced neurotoxicity. which is probably a reflection of glutamate-induced neurotoxicity.
		So the cells are dying, they're releasing glutamate.
		So it may be neuroprotective in that way.
		And it definitely, you know, I know magnesium, you can feel it.
		Like if you take a legit source of magnesium that's bioavailable, like magnesium glycinate or other forms of magnesium, you can really feel kind of a calming effect that it has.
joe rogan ▲ ● ▼		Yeah, it makes sense.
joe rogan ▲ ● ▼		A lot of people like to take it before they go to bed.
dom dagostino ▲ ● ▼		Yep.
joe rogan ▲ ● ▼		Yeah, but the tank is just when you get out of there, your whole body just feels relaxed.
joe rogan ▲ ● ▼		I mean, I think part of it is because of the zero gravity effect of floating.
dom dagostino ▲ ● ▼		And you're floating like you're very buoyant in this because the water is very heavy, right?
dom dagostino ▲ ● ▼		Like the Dead Sea, like only maybe a third of your body is kind of floating in it, right?
joe rogan ▲ ● ▼		Yeah, essentially half your body.
		Essentially like your ears are underwater, but your face is above water.
		It's amazing.
		You've got to try it.
		I'm a big proponent of it.
		But the ALS, is there a benefit in the ketogenic diet for people with ALS? Yeah, that's another application.
dom dagostino ▲ ● ▼		There's a guy, Dr. Passanetti, and I think he's in Mount Sinai in New York.
		He's got a couple studies on this, looking at caprylic triglyceride, which is a medium chain fatty acid.
		And he also, prior to...
		That's a clinical trial.
		I think it's ongoing now.
		But prior to that, He demonstrated in a mouse model of ALS, which is the SOD1G93A mouse model, and it has a gene defect that mimics the familial form of ALS, which accounts for maybe about 10, at most 20% of ALS pathologies.
		And he found that a ketogenic diet improved motor function and some neurological effects.
unidentified		scores.
dom dagostino ▲ ● ▼		It did not improve overall survival, though.
		So we actually followed up on that study with a therapy that we call the Deanna Protocol Therapy, after Deanna Tidone.
		And her father, Dr. Vincent Tidone, observed that his daughter responded remarkably well to a few supplements, which was arginine, alpha-ketoglutarate, and GABA, and coenzyme Q10, and a few things that we and coenzyme Q10, and a few things that we actually put into a supplement And we reproduced the same study using this gold standard mouse model.
		And we looked at motor function, we looked at neurological score, and then we looked at total long-term survival, too.
		And we found that Using medium-chain triglycerides, which was ketogenic fat, with arginine alpha-ketoglutarate, which is something that's in pre-workout formulas.
		It's a vasodilator from the arginine.
		We used GABA was in that, or FENIBUT, a ventilated form of GABA that crosses blood-brain barrier.
		And coenzyme Q10 in the form of idebanone, which is kind of like the drug-like form of it.
		I think it's still available.
		You can get it online.
		It might be kind of a drug.
		Or ubiquinol, which is a powerful one.
		So those supplements together, I think, are neuroprotective in a way.
		And it had a therapeutic and what I would call performance enhancing effect on this ALS mouse model.
		And those supplements had a therapeutic effect on Deanna to Doan.
		I mean, there's other things in what's called the Deanna protocol.
		People interested in this can go to Winning the Fight Foundation.
		It's a Tampa-based ALS 501c3 foundation.
		And you can sign up on the foundation.
		And they give you the actual protocol.
		And there's like more than a thousand patients, you know, registered on this that are benefiting.
		And there's several peer-reviewed studies on this.
		Ideally, we'd like to get enough funding to do a human study, but the mouse work's pretty compelling.
		And it's an extension of work that has already been done, really, and further compelling support for this proof of concept for using a metabolic-based approach, like targeting energy metabolism, preserving mitochondrial function so the cells work better.
joe rogan ▲ ● ▼		Now, when you were talking about epileptic kids and supplementing their diet with ketone supplements, because a lot of them have a hard time following a ketogenic diet, can you get the same benefits of a ketogenic diet by following a standard American diet and supplementing with exogenous ketones?
dom dagostino ▲ ● ▼		I doubt it at this time with the ones that are commercially available, but I do think that with some of the ketone esters in development right now, we've observed using a range of different animal models that the thing is that these things are not very palatable, they're pricey to make, but we're working with various companies and doing what's required for the FDA to be generally recognized as safe for some of these compounds.
joe rogan ▲ ● ▼		I don't think they taste bad.
		I've heard people complain about Kegenix.
		I didn't think it was bad at all.
dom dagostino ▲ ● ▼		Kegenix actually tastes pretty good.
		Don't let it sit.
		If you mix it up, that's one problem with a Kegenix.
		If you mix it up and let it sit, then it tastes like battery acid for a while.
		So I mix it up, and if you just keep it with some ice cubes in it, you can keep it around for about a half hour.
		But I generally try to drink it pretty quick after I mix it up.
joe rogan ▲ ● ▼		Yeah, I don't have a problem with it at all.
joe rogan ▲ ● ▼		But some of them are nasty.
dom dagostino ▲ ● ▼		Yeah.
		Well, the ketone esters.
		So these are things that if I gave you right now, you would gag.
		You would not be able to drink it.
joe rogan ▲ ● ▼		Yeah, somebody sent me some.
		Where's that jazz?
		Do we still have that laying around here?
		That little thing of ketone esters that some dude sent?
		It was in like a sealed, a little foil, sealed plastic thing.
		I don't think I did.
dom dagostino ▲ ● ▼		I'd be curious.
dom dagostino ▲ ● ▼		I know all the people behind this.
joe rogan ▲ ● ▼		Oh, here it is.
		It was here somewhere.
		This place is a mess.
		Who knows?
		So if someone had a big bowl of pasta, And then they took something like Kegenix.
		Would that knock you back in the state of ketosis?
dom dagostino ▲ ● ▼		Yeah.
dom dagostino ▲ ● ▼		You could eat a bowl of pasta and then consume a Kegenix product and then test your blood ketones and it would look like you're on a strict ketogenic diet.
unidentified		That's fascinating.
dom dagostino ▲ ● ▼		A mild, like what I would call a modified Atkins diet.
		Whereas, so the ketone ester, you could eat a bowl of pasta and then take a ketone ester and it would look like you fasted for 10 days.
		So it puts you into starvation level ketosis.
		So interestingly, another application of ketones is that it lowers blood glucose.
		And we don't know why we're studying that right now.
		And it may do it by, your liver is like the main regulator of what your glucose is.
		So your liver has glycogen in it and it's constantly being broken down and kind of spilling glucose into.
		It may be affecting that process or it may be enhancing insulin sensitivity, which means you take ketones and your cells use the glucose that's there becomes more readily available to the cells.
		There's greater uptake.
		So we're looking into precisely why, when you consume exogenous ketones, why glucose goes down.
		We've replicated it many times with different forms of ketones.
joe rogan ▲ ● ▼		So would that be a way for a person who maybe is just not so good at being disciplined with their diet to just throw it in there?
		Like, say, God, I want some ice cream, but I've been really good with my diet.
		Fuck it, I'll just have the ice cream and then have some Kegenics or something like that afterwards?
dom dagostino ▲ ● ▼		Well, I firmly believe there's no shortcuts.
		And I think of ketones, and I think I mentioned this on Tim Ferriss, too, and he put it in there, that ketones are just another source of energy.
		So if you're eating 2,000 calories of food and then taking lots of ketone supplements, you are eating a lot more than 2,000 calories of food.
joe rogan ▲ ● ▼		Right, but as far as fat, but as far as gaining weight, but as far as keeping your body into a state of ketosis, it actually does work.
dom dagostino ▲ ● ▼		Absolutely.
		And the benefits of that would be maybe not weight loss, but...
		By elevating your blood ketone levels, there's a lot of beneficial effects, even from a signaling standpoint, like completely independent of metabolism.
		We know that it's a super fuel, essentially, for the brain, that your brain cells can generate energy from ketones in a more efficient manner than glucose.
joe rogan ▲ ● ▼		That's crazy.
		That's really hard for people to believe, because that's the one thing that people always would say.
		You need glucose to fuel your brain.
dom dagostino ▲ ● ▼		Under certain conditions.
		So there are a few stipulations to that.
		And I could get a little bit technical.
		But for example, I mean, obviously, if you have glut one deficiency syndrome, you know, you're transporting it.
		But your brain has a number of things that can prevent it from using glucose effectively.
		So in many cases, ketones would be the preferred source of fuel.
		For example, there may be Like with Alzheimer's disease, or maybe even if you have traumatic brain injury, there's an internalization of the GLUT3 transporter.
		So that you have cells, right, and glucose is trying to get in, but the GLUT3 transporter isn't on the membrane.
		Or you can have a dysregulation or an inhibition of pyruvate dehydrogenase complex, PDH complex.
		And that enzyme is really the gatekeeper.
		It's almost like the governor.
		It's a throttle that lets the glucose into the cell to create, to feed into what we call anaplerotic pathways to drive the TCA cycle, the Krebs cycle.
		And that makes reduced intermediates that drive the electron transport chain to make ATP. It's like a gatekeeper.
		And ketones completely bypass that process.
		So if you have no GLUT3, if you have impaired activity of this PDH complex, which a lot of people who are carb or hydrate components say, well, you're inhibiting the PDH complex if you're on a ketogenic diet.
		And I don't think there's evidence of that.
		But the ketones essentially bypass those steps and can restore and preserve brain energy metabolism, even if those things are dysregulated or dysfunctional.
		And a number of pathologies make them dysfunctional.
		And this is a general state of aging.
		It's thought that as we age, we have a proportional decrease In glucose energy metabolism in the brain, but that's not the case with ketones.
		So as we age, the data that has been collected so far shows that we have essentially the same ketone energy metabolism from young to adults.
unidentified		Wow.
dom dagostino ▲ ● ▼		So that's a major implication.
dom dagostino ▲ ● ▼		You can graph it out, and we've had speakers at our conference that did that, and you can see kind of like a plateauing effect and a decrease in brain energy consumption from glucose, whereas with the ketones, it bypasses many of the rate-limiting steps that are associated with impaired glucose metabolism in the brain.
joe rogan ▲ ● ▼		It's almost hard to believe, when you rattle off the laundry list of benefits, Of the ketogenic diet, you know, for a lot of people, they're like, well, how is this?
		It seems crazy.
		It seems like everyone should be on it.
		And it seems crazy that so many benefits are attributable to this fat-based, fat-burning diet.
dom dagostino ▲ ● ▼		There's a lot of benefits.
		I don't, you know, like my wife does not eat.
		I mean, she eats a relatively high-carbohydrate diet with sugar and things like that.
joe rogan ▲ ● ▼		But that's because people enjoy it.
dom dagostino ▲ ● ▼		That's because she enjoys it, and that's because her carbohydrate tolerance is really remarkably high, and some people do really well on high carbs.
joe rogan ▲ ● ▼		When you say that, you're testing her?
dom dagostino ▲ ● ▼		Yeah.
		Well, I've tested her blood and her ketones, too.
		And she can get rapidly into a state of ketosis.
		I mean, we're testing some products now for ketone technologies for our company and various products.
		And it's the first time I've actually seen her ketones levels up where mine are and sustain it over a period of time.
		And she's like, this is awesome.
joe rogan ▲ ● ▼		And this is just from taking a product.
dom dagostino ▲ ● ▼		For taking, yeah, just formulation of specific products.
		Yeah.
		And so there are a lot of benefits, but it's just, I think of it as like one tool in a toolbox, you know, simple carbohydrate restriction.
		Like it doesn't have to be a ketogenic diet, but simply restricting your carbohydrates is a powerful hammer, for example, for type 2 diabetes.
		And Virta Health is doing more for the medical management of type 2 diabetes than any other entity that I know of.
		I mean, I think their goal is in the next decade to reverse 100 million cases of type 2 diabetes.
		Like, our government spends way more...
		It's like $200 billion of funding for managing diabetes.
		And, you know, NASA's budget is something like...
		like 19 billion per year or something like that.
		So compare that.
		And we know that type 2 diabetes, for example, which is an obesity, the major problem for type 2 diabetes is carbohydrate intolerance.
		So why would a registered dietitian administer a carbohydrate-based diet to a type 2 diabetes person who has a problem with carbohydrate intolerance?
		And that's reflected in their elevated hemoglobin H1C or glucose levels or insulin levels.
		So Virta has created a platform of people who, using an app, will allow you to follow, adhere to carbohydrate restriction and a ketogenic diet to essentially not just manage it, but just completely reverse it.
		And I think the numbers are something like 89, almost 90% of people from the data they collected so far and published, almost 90% of people, maybe 89 or 87%, Can either completely get off insulin or reduce it down to very low levels just simply by using a carbohydrate-restricted ketogenic diet.
		And that's profound.
		I mean, imagine the number of people that can get off medication, what that can do to the healthcare system, the healthcare burden of paying all these dollars for drug management of type 2 diabetes, which is going up to epidemic proportions.
		So if people are out there and they have type 2 diabetes, just go to Virta Health and you'll see an amazing array of clinicians, basic scientists, and registered dietitians that assist people for the medical management of type 2 diabetes.
joe rogan ▲ ● ▼		It's just stunning.
joe rogan ▲ ● ▼		I mean, the list is...
dom dagostino ▲ ● ▼		The low-hanging fruit is definitely type 2 diabetes, so I'm glad to see the field go into that direction.
		But for many, many years, many decades, the only application, when I got into this research, the only application was pediatric epilepsy.
		And then two years after that, it was like, it works for adult epilepsy.
		So it's taken so much time for the science to prove kind of what we already knew, right?
		That therapeutic ketosis was supplying ketones to the brain.
		That's an alternative form of energy.
		And obviously that has more implications than just helping your brain for epilepsy.
		There's so many other applications.
joe rogan ▲ ● ▼		You know, when you're uncovering all this and when you're doing all this research and studying it and you're finding all these benefits, have you tried to figure out or contemplate, like, what is the cause?
		Like, why is it so beneficial for your body to live off fats versus your body to live off glucose?
		Is this something that we evolved to live off fats?
		Is this, like, is it a Is it a better primary source?
		Is it something that our body can exist off of glucose, but really we're designed to live off fats?
		Like what is the cause?
dom dagostino ▲ ● ▼		Well, it's multi, I mean, there's many answers to that question, but I'll tell you kind of what I think.
dom dagostino ▲ ● ▼		That many people do really well on a carbohydrate base with no overt signs of, you know, pathology.
joe rogan ▲ ● ▼		Especially really active people, right?
dom dagostino ▲ ● ▼		Yeah, so I would, in that class, like, I always kind of joke, like, the people that are most interested in the ketogenic diets, or many of them are athletes that contact me, but a lot of people have health problems, too.
		But the athletes are typically not the ones who necessarily need it.
		But they can benefit of it.
		I mean, a lot of, you know, if there's football players out there and people that are predisposed to concussion or brain injury, I think it's really good to be on a ketogenic diet.
		That's kind of like a whole other area we can go into.
joe rogan ▲ ● ▼		Now for athletes, when you're talking about people that maybe they don't need it for weight loss or they don't need it for a lot of...
joe rogan ▲ ● ▼		Is it because the massive amount of calories that they're burning and their nutritional requirements almost mitigates the negative effect of having a glucose-based diet?
dom dagostino ▲ ● ▼		Yeah, it really does come down to calorie control.
		So if you have a surplus amount of calories coming in, you know, even with an athlete, you're going to start to get some over, you know, metabolic effects and negative, you know, biomarkers kind of showing up.
		And if you do that chronically, it'll ultimately lead to chronic inflammation, maybe some, you know, brain fog and other things.
		What I've observed is that, you know, I mean, you're asking like...
		What was your question?
		Like, why aren't people not following this?
		Or what's the benefit?
joe rogan ▲ ● ▼		My question was, like, because you're studying this so deeply, like, have you ever contemplated, like, what is the root cause?
		Like, why are we so good at burning fats?
		Why is it so beneficial?
		There's so many health benefits, and it seems like there's so many negative consequences of having a high-carbohydrate diet, especially for sedentary individuals.
dom dagostino ▲ ● ▼		Yeah, I think you really, to put this into context, you have to think the negative effects from a high-carbohydrate diet are due to a calorie surplus.
		So I think a carbohydrate-based diet could work fantastic for a lot of people who...
		People are horrible predictors or estimators of how many grams of carbohydrates.
		You know, they walk into the kitchen, they grab some grapes, they grab a chocolate.
		They don't...
		So that's why it's really good if they want to get a handle on this to optimize their total health and performance and things to really have an app where they can calculate their macros in an easy, you know, to-do format like Avatar Nutrition does.
		So I think when you are bolusing glucose or bolusing carbohydrates a couple meals a day, you have that scenario that I talked about.
		And a release of insulin.
		And for many people, which I had, was this postprandial dip in blood glucose where you'd go hypoglycemic after two or three hours, and that would have me searching for food again.
		I would get irritable.
		I would get sleepy.
		My performance would drop.
		When you go on...
		It doesn't even have to be a ketogenic diet.
		Just low-carb can completely, in many cases, if not abolished, significantly attenuate that rise in glucose and that release in insulin.
		And with a carbohydrate-based diet, you can throw in more fat and fiber and buffer that too.
		But a purely ketogenic diet is kind of non-glycemic.
		You don't have any rise in that.
		And the practical effects of that is that it tends to...
		allow the person to control their appetite instead of their appetite controlling them and appetite suppression and just Kind of and that's how it's thought that the ketogenic diet works too is that you don't have these spikes in glucose and hormones and things like that That could set off a seizure is that?
		the leading scientists in this field are I really believe that it helps put the brain into a state of homeostasis better.
		And if there's less kind of energy spikes and less kind of noise in the system from a physiological standpoint, that the brain's energy system and the neuropharmacology of the brain itself, the neurotransmitters, the balance of GABA to glutamate and serotonin and other things, will be balanced in a way that would make seizures much less likely to occur.
		And I think that's what it does from a feeding behavior, from a neuroendocrine point of view, is that it helps to, when you have all these hormones and metabolites going all over in the blood, the ketogenic diet keeps it into a range where there's a lot less noise in the system.
		And you can see this by a patient, a type 1 diabetes patient, for example, who goes from eating a high-carbohydrate diet to a ketogenic diet, where their DEXCON continuous glucose measurement is all over the place, if you look at several days of data, and if they transition to a ketogenic diet, I mean, the highs, there's way few highs and way few lows, and it's within a tight range, and they stay within the range where they're optimized, I would say.
		So they're in a glucose range Where they're optimized.
		And that's what happens.
		That happens, obviously, with a type 1 diabetic who's trying to chase the glucose with insulin.
		But for the average person, the same thing happens.
		And that's why a lot of people feel better, they have less cravings, and they're more likely to adhere and stick to their diet and not kind of fall off the wagon and Kind of overeat and you have surplus calories.
		So high-carbohydrate diet is completely manageable in people who know how to manage their calories, but that's really hard for most people to do.
		So I think the app-based programs that are coming out are really, really handy, and I think they'll be kind of the wave of the future for people who want to optimize their...
		Their body composition and their performance and to have a keto option of that too, where you can titrate and optimize your keto diet.
		And then there's an AI system that tells you how to improve those ratios over time to hit your goals.
		I think that's really the future.
joe rogan ▲ ● ▼		The cravings, that's a huge factor.
		Not just the energy crash, but also the lack of hunger.
		It's really weird.
		I always felt like if you didn't eat for a few hours, you just started getting, God, I gotta eat.
		And you have this weird feeling.
		But that weird feeling is entirely connected to glucose.
		When you're on a fat-based, fat-burning diet, even knowing that you're hungry is a different knowing.
		It's like it's in the other room.
		It's not like it's like...
		You're next to you, sitting on your shoulder, yelling in your ear, come on, man!
		Let's eat!
		There's a frantic feeling that a lot of people get.
dom dagostino ▲ ● ▼		I've seen it.
		My wife, I've seen it.
		When she's hungry, we've got to stop.
		We've got to pull over.
		When she needs ice cream, I just give in and say, okay, we're going to pull over.
		And I remember feeling that way, too, when I would kind of go off the wagon and eat a Half of a box of Toll House cookies.
		But yesterday, I ate three packets of something called keto cookies.
		And I put some in your little gift bag there.
		Yeah, and these keto cookies, I had never eaten three packets together.
		So I was curious.
		Oh, that's Energy Bits.
unidentified		What's this?
dom dagostino ▲ ● ▼		Energy Bits is, I think, a fantastic supplement.
unidentified		Spirulina.
dom dagostino ▲ ● ▼		Algae.
		Spirulina has...
		An enormous amount of research behind it, and it's one of the products I used on the NASA NEMO mission because we didn't really have access to fresh vegetables or phytonutrients down there.
joe rogan ▲ ● ▼		This is a snickerdoodle, huh?
dom dagostino ▲ ● ▼		Yeah, it's a snickerdoodle bar.
dom dagostino ▲ ● ▼		And then there's a chocolate chip bar and a fudge chip bar.
joe rogan ▲ ● ▼		Where could one get these?
dom dagostino ▲ ● ▼		Just go to ketocookie.com.
		So that's like my keto comfort food.
		So when I travel with that, I might have another box out there for you.
		So you have chocolate chip, you have snickerdoodle, you have fudge chip.
		So you can eat that.
		Typically, if I eat like a Toll House chocolate chip cookie, I would have that crash that we were talking about, and I would be ravenous after.
		There you go.
unidentified		Pretty good.
dom dagostino ▲ ● ▼		So no sugar.
		It's completely like low glycemic.
		For me, they're like non-glycemic.
		So I measured my glucose after eating three packets of them because I went...
		Yeah, there's the guys behind it.
		So I actually just saw them at the Low Carb USA Conference where a number of speakers there were on the show.
		Gary Taubes was there.
		Rob Wolf was there.
		I didn't get to speak to him because it was just so busy.
		But Keto Cookie is one of those foods that's evolving out of this...
		You know this kind of movement I would say that the ketogenic diet is becoming a lifestyle so not something that's used for pediatric epilepsy but something like the average person can follow to just feel better and for me I can eat a keto meal in the morning and I can hammer out 12 hours of work in the lab and not even get any cravings to eat at all and that for me that translated into you know more grants more publications more work done in the lab And I kind of attribute it in some way that,
		you know, my career has gotten a really big boost because I'm more cognitively aware and resilient.
		Even during periods of sleep deprivation, I can just work longer periods and I kind of utilize keto to my advantage in that way.
joe rogan ▲ ● ▼		That's really fascinating.
		I really had no idea about exogenous ketones improving mental function.
		It would be a good idea to take them before anything taxing.
		I'm going to try taking them before podcasts and taking them before comedy shows or UFC events and see if maybe my brain fires better.
		I mean, that's just amazing.
dom dagostino ▲ ● ▼		My wife spearheaded a program looking at absence seizures.
dom dagostino ▲ ● ▼		So a lot of people who have seizures don't have tonic-clonic seizures, but they'll just look and stare into space and then wake up out of it.
joe rogan ▲ ● ▼		That's me all day.
		I'm having seizures, Jamie.
		I didn't even know.
		These cookies are good, man, but they feel like an illusion.
dom dagostino ▲ ● ▼		You just got to try them.
		Try them.
		Do you have a glucose ketone measurement?
joe rogan ▲ ● ▼		Yeah, you know what?
joe rogan ▲ ● ▼		I did have that, but I have a lot of calluses, and I was like, I had to really stab the shit out of my fingers.
dom dagostino ▲ ● ▼		Yeah, you do.
		I thought I had calluses.
		I got pretty bad calluses, but I think...
		Yeah, so what was I going to say?
		Is there a better way to do it?
joe rogan ▲ ● ▼		Other than the glucose meter?
		The one that stabs you?
		Because it wasn't really working that well.
dom dagostino ▲ ● ▼		Not really.
joe rogan ▲ ● ▼		They say go to the side of your hand.
		I'm like, fuck, what the fuck, man?
		Can't even go to the fingertips?
dom dagostino ▲ ● ▼		I just take an actual syringe, like needle, and just plug it in.
		I don't really feel it.
		I've done it so many times.
		But...
		But yeah, taking exogenous ketones can help.
		We published a paper in Frontiers.
		It reduced anxiety behavior about 25 to 30 percent in our rats.
		So they would go out into what's called an elevated plus maze into the open arm where they're like on a catwalk and they could fall off or be exposed to the environment.
		It typically produces a fear response or they could run back into the little cave.
		And the beta-hydroxybutyrate salt plus the medium-chain triglyceride combination actually reduced that fear behavior.
		Maybe it would be, I mean, I'm sure you're completely comfortable being out on front of the stage, but for people that have anxiety problems, which is a big part of people who have stress, it kind of exacerbates anxiety.
		I mean, I felt it early on in my career.
		I know that being in a state of ketosis just makes me more mellow.
joe rogan ▲ ● ▼		Well, you know, one thing that would help me with is I bow hunt.
dom dagostino ▲ ● ▼		Yeah.
joe rogan ▲ ● ▼		And bow hunting is...
dom dagostino ▲ ● ▼		I used to bow hunt, yeah.
joe rogan ▲ ● ▼		Do you?
unidentified		Really?
dom dagostino ▲ ● ▼		My brother, he was a big bow hunter.
dom dagostino ▲ ● ▼		He writes for Peterson Bowhunting Magazine.
unidentified		No kidding?
unidentified		Wow.
dom dagostino ▲ ● ▼		I saw Hoyt.
		Yeah, we had the Hoyt Pro Force Extreme, I think, bows.
		Yeah, I grew up in a hunting family.
unidentified		Oh, okay.
dom dagostino ▲ ● ▼		So I quickly noticed some of the stuff out in here.
joe rogan ▲ ● ▼		So that's probably one of the most stressful things I do.
		People think that doing stand-up is stressful or live podcasts or UFC broadcasts.
		Those are nothing compared to bow hunting.
		Drawing back on a live animal.
dom dagostino ▲ ● ▼		And your heart starts racing.
dom dagostino ▲ ● ▼		Pounding.
joe rogan ▲ ● ▼		Adrenaline rush.
		And people have target panic where you can't remember what you're doing and you go into autopilot and there's all sorts of methods to mitigate that by forcing your brain into a closed loop system instead of an open loop system, repeating mantras, going over different facets of your shot process, but maybe ketones and being in a ketogenic state.
		Especially exogenous ketones before you hunt would mitigate some of those issues.
dom dagostino ▲ ● ▼		Definitely help.
		I mean, I think you've had them on the podcast.
		Wim Hof.
joe rogan ▲ ● ▼		Yeah.
dom dagostino ▲ ● ▼		Different breathing methods.
unidentified		Oh, sure.
dom dagostino ▲ ● ▼		Something I'm getting into.
		I was talking with Quest CEO last night about Buteco.
		A guy in Russia designed some system that allows you.
		It's a program of breathing.
		I have the app on my phone.
		I haven't used it yet.
		But it allows you to increase your CO2 threshold.
		So the drive to breathe actually does not come from a lack of oxygen.
		There's CO2 chemoreceptors on the ventral surface of your medulla, in your brainstem, that sense CO2. And when they sense CO2, that's your urge to breathe.
		That's your drive.
		And then you have a backup, sort of like a redundant mechanism.
		The carotid bodies at the bifurcation, the common carotid artery right here, will sense oxygen.
		It's kind of like more of a fail-safe.
		I studied these things for my PhD and these neurons, like how they sense things.
		So you can increase your CO2 threshold over time using various breathing protocols.
		and that can create an enormous effect on kind of reducing anxiety in these situations where a big buck comes up and you're drawing back on it or in general just the level of oxygenation that you have.
		So retaining some CO2, if you do it through training, can actually enhance the vasodilation effect and can maybe reverse even and hyperoxygenate systems in your body.
		So that's the theory, and there's quite a few studies behind it.
		I really have to delve into the studies, but the Wim Hof method is one method.
		I've been fascinated with him.
		I really want to meet him.
		I wish I could introduce you if he was in town.
		I would love that.
joe rogan ▲ ● ▼		He's a great guy.
dom dagostino ▲ ● ▼		I want to bring him to the lab and actually do some research on him.
joe rogan ▲ ● ▼		I'll set it up.
dom dagostino ▲ ● ▼		I'll connect you guys.
dom dagostino ▲ ● ▼		That would be awesome.
joe rogan ▲ ● ▼		These cookies are like a mirage.
		It's like you hold them.
		They have weight.
		They look like a cookie.
		You bite into them.
		You're like, this is going to be like eating a cookie.
		And then you're chewing it and it's almost like it vanishes like fairy dust in front of your eyes.
dom dagostino ▲ ● ▼		But it's good though.
joe rogan ▲ ● ▼		Yeah, it's great.
		Don't get me wrong.
		I'm not saying it's a mirage like they're bullshit.
		I'm saying like...
		It's a very strange texture to them.
unidentified		Yes.
joe rogan ▲ ● ▼		Because obviously there's no grain.
		And there's something about eating them and chewing them where your body goes, hey, what, did you fucking lie to us?
		Where's the cookie, bro?
		Like, it tastes good, but there's something about chewing it and eating it.
		It's like, it vanishes or something.
dom dagostino ▲ ● ▼		It's pretty substantial, too.
		There's a significant amount of fat in it.
		So I was a little...
		Yeah, I was a little skeptical when they came.
		I was like, okay, because people send me so many products.
		And I vet out what actually impacts my blood glucose and ketone levels.
		And then maybe about 10% of the products that people send me, I really like.
		Like the energy bits here, that spirulina tablets, I can take massive amounts and actually get what's a significant amount of protein.
		And there's absolutely no glycemic effect.
		And I'm getting huge amounts of phytonutrients in it.
		So I brought that on...
joe rogan ▲ ● ▼		You just eat these like a snack?
dom dagostino ▲ ● ▼		I down like 30 at a time.
joe rogan ▲ ● ▼		It says 33 servings, 1,000 tablets.
joe rogan ▲ ● ▼		Jesus.
dom dagostino ▲ ● ▼		Yeah, so that would be like a month's supply.
		And, you know, you can chew them.
		They taste kind of grassy.
		You just swallow them usually?
		Yeah.
		Or if you don't chew them, if you just swallow them, you don't taste them.
joe rogan ▲ ● ▼		They don't taste bad.
dom dagostino ▲ ● ▼		And that's what I did.
joe rogan ▲ ● ▼		It tastes almost like sesame seeds.
dom dagostino ▲ ● ▼		Yeah, I like it.
dom dagostino ▲ ● ▼		I like it.
joe rogan ▲ ● ▼		Oh no, sunflower seeds.
joe rogan ▲ ● ▼		That's what it tastes like.
dom dagostino ▲ ● ▼		The lady, Catherine, she was on Shark Tank.
		And actually, they kind of slammed her because I think she evaluated the company high.
		Or they didn't like the taste.
		That was the main reason that they didn't like it.
		So, I mean, guys like you and me and most guys would be totally fine with the taste.
		And the amount of nutrition that's in that and the density of that makes it...
		An awesome food for things like special ops guys or even NASA. I mean, there's a lot of nutrition in that little bag right there.
joe rogan ▲ ● ▼		It's stunning to me how much mouth pleasure factors into people's lives.
dom dagostino ▲ ● ▼		Absolutely.
joe rogan ▲ ● ▼		I don't like the taste.
		Well, something could be fantastic for you.
		I expect that out of my seven-year-old.
		She's like, eh, it tastes gross.
		I don't like it.
		I'm like, I get it.
		You're seven.
		But out of a 37-year-old, Jesus Christ.
unidentified		Yeah.
dom dagostino ▲ ● ▼		90% of people really eat, it's a pleasurable thing to them, and they don't want to restrict that in any way, shape, or form.
joe rogan ▲ ● ▼		Well, that's crazy to me because you don't have to restrict it.
		Just, for the most part, take in healthy nutrients.
		And things like this, like, this is not bad.
		Like, Jesus Christ, if this is the most suffering you get in a day, talk about first world problems.
		You know, these little energy bits.
		Man, they weren't the best thing I've ever had.
		I don't know what I'm going to do now.
		It's not bad.
		It's not bad at all.
dom dagostino ▲ ● ▼		Well, I mean, I see from the general consumer point of view, like I could see maybe, but once they know the science behind it, like the CEO sent me a stack of research papers and they're all off of PubMed.
		And I started looking through them and then double checking on PubMed and realizing there's a lot of science behind this.
		And actually NASA was interested in algae research.
		And making capsules because it's super high in protein, has all these phytonutrients, and you can figure out a way to grow it in space and stuff.
		So I think really that's the future.
		Things like keto cookie will be a gateway for people to say, okay, maybe I can go on this diet and I can have these chocolate chip cookies here too.
		But then eventually your palate changes over time and you don't crave those foods anymore.
joe rogan ▲ ● ▼		That's never happened to me.
		It's gotten close, but man, I smell some fresh bread or a bowl of pasta like linguine with clams.
		I'm in, man.
dom dagostino ▲ ● ▼		But you can maybe control yourself a little bit better.
		Yeah, you still crave it.
		I don't actually crave that at all.
joe rogan ▲ ● ▼		I'm good at controlling myself.
dom dagostino ▲ ● ▼		I will crave like sweets and chocolate maybe sometimes.
joe rogan ▲ ● ▼		Ice cream?
dom dagostino ▲ ● ▼		Not so much.
dom dagostino ▲ ● ▼		I was a big ice cream guy.
joe rogan ▲ ● ▼		They have keto ice cream though, don't they?
joe rogan ▲ ● ▼		Yeah, Chris Bell.
dom dagostino ▲ ● ▼		They do.
dom dagostino ▲ ● ▼		Oh yeah, yeah, they do.
joe rogan ▲ ● ▼		Chris Bell was eating some on his Instagram.
dom dagostino ▲ ● ▼		So the institute that I'm associated with, the Institute for Human and Machine Cognition, IHMC, it's run by the directors, Ken Ford.
		He was a former director in NASA, executive in NASA. And they have a James Beard award-winning chef that they hired into IHMC. And he has a specific keto ice cream recipe, which is using MCT and like a pinch of stevia.
		And when you eat the ice cream, I mean, it just blows your mind that...
		This is ice cream that you could eat every day, a big bowl, and stay on a ketogenic diet.
unidentified		Wow.
dom dagostino ▲ ● ▼		So these kinds of...
dom dagostino ▲ ● ▼		I call this innovative.
joe rogan ▲ ● ▼		You feel like you're eating ice cream?
dom dagostino ▲ ● ▼		Oh, yeah.
		It's really legit.
		My wife, she's really like the litmus test.
		So when I get products, I give...
		The last product I got was the Keto Brownie.
		So if you like Google Keto Brownie, it'll come up.
		And, you know, I gave it to my wife and she was like, yeah, that's pretty good.
		But it had like a shell in it, which kind of got caught on her teeth or whatever.
		And she loved the taste, but it was a little bit, I think because she's so picky, it was like, oh, I liked it, but it just had a shell in it, or whatever.
		But keto brownie is like another food, and I see all these entrepreneurial guys kind of emerging on the scene and being very innovative in the way.
		I mean, it takes a long time to develop and test a product that you can eat that's low-carb, for one thing, and then that allows you to adhere to a ketogenic diet.
joe rogan ▲ ● ▼		Have you had a cave shake?
joe rogan ▲ ● ▼		You know what those are?
dom dagostino ▲ ● ▼		I've heard about it.
joe rogan ▲ ● ▼		Local California company, got a bunch in the fridge back there.
joe rogan ▲ ● ▼		Oh yeah?
dom dagostino ▲ ● ▼		Maybe I can try one.
joe rogan ▲ ● ▼		Oh yeah, for sure.
		100%.
		I'll give you one right now if you want one.
		But we'll wait till after the show.
		But yeah, I'm big on those, man.
		Those are giant.
		They're made with a lot of good stuff in there, but I think a lot of it is coconut milk.
		This keto ice cream company, what's it called again?
dom dagostino ▲ ● ▼		Actually, there's not a company that I know of yet.
		It's just I told them they need to create some IP around this formula.
		But it was the Institute for Human and Machine Cognition, the chef there.
joe rogan ▲ ● ▼		He cooked it up himself?
dom dagostino ▲ ● ▼		Yeah, he has a number of recipes because the CEO there, Ken Ford, I mean he's...
		A huge fan of the ketogenic diet is how I got hooked up with him because he realizes that it enhances his cognition and performance and has actually been a big help in moving things into government agencies and helping them acknowledge that this is a very viable form of Way to fuel the astronaut or fuel the special ops guy.
		So he's been kind of instrumental in that regard.
		And he has, you know, hired a chef that cooks ketogenic and in a gourmet fashion, a James Beard award winning chef, which I didn't even know what that was until I looked it up and I was like, well, these are very high level chefs that are specifically in his expertise, at least at the Institute, is to create these ketogenic recipes that are like ultra gourmet and amazing to eat.
joe rogan ▲ ● ▼		What about pasta?
joe rogan ▲ ● ▼		Is there like an almond flour-based pasta?
dom dagostino ▲ ● ▼		Not that I've...
		You know, I've tried a lot of things, but I would hesitate to recommend anything just because I have not been impressed enough to...
		There's some protein pasta out there that's a little bit low-carb, but a lot of times they kind of fill you up with a lot of soluble fiber and you just become like a gas machine.
		It might be good for your gut microbiome in some ways, but you're feeding all the bugs in there.
		But for a large part, if you get...
		We have a certain threshold for soluble fiber, which gets broken down into butyrate and other things in the gut.
		And if you exceed that, you just become a gas machine.
joe rogan ▲ ● ▼		So maybe it would be good in like a small side dish?
dom dagostino ▲ ● ▼		Yeah, yeah.
joe rogan ▲ ● ▼		Like a little side...
dom dagostino ▲ ● ▼		So that's your weakness then?
		Pasta, yeah.
		And ice cream too?
		Yeah.
joe rogan ▲ ● ▼		No, I mean, I can go without ice cream.
		I'm fine.
		Sweets really don't get me that much.
		I mean, it's not that big of a deal.
		It's not something I massively crave, but I am a big fan of spaghetti.
dom dagostino ▲ ● ▼		Yeah.
joe rogan ▲ ● ▼		It's a problem.
dom dagostino ▲ ● ▼		Yeah.
joe rogan ▲ ● ▼		You know, I think that...
		It's just one of those things where I bet if I just stop taking it for a long time, stop eating it for a long time, but that's been my cheap food for a while.
		So if I just cut it out of my system completely for like six months or something like that, I probably...
dom dagostino ▲ ● ▼		You know, if you...
		There's a book that has ice cream...
		There's a recipe.
		Jeff Volek has a book.
		It's called The Art and Science of Low-Carbohydrate Performance.
		And this will appeal to your crowd because a lot of MMA guys, I refer the book, and they say this book was incredibly helpful to me.
		So The Art and Science of Low-Carbohydrate Performance.
		And there may be a pasta recipe in there.
		I know there's an ice cream recipe in there.
		That's not unlike the recipe I was just talking about.
		So, but the pasta thing, yeah, that would be, if someone could nail that down, that would be a pretty good technological achievement.
unidentified		Yeah, that's a tricky one, right?
joe rogan ▲ ● ▼		That would be filled with some weird stuff that make it taste like pasta.
dom dagostino ▲ ● ▼		You were just in Italy, right?
		I saw some pictures, whereabouts?
		And did you have pasta and pizza?
joe rogan ▲ ● ▼		I went off like a rocket.
joe rogan ▲ ● ▼		Yeah, I got way off the diet.
dom dagostino ▲ ● ▼		Yeah, I do that.
		When I was in Naples, you know, you gotta have pizza.
		That was quite a while ago.
		But, you know, it's moderation too.
joe rogan ▲ ● ▼		Well, they also have different flour.
joe rogan ▲ ● ▼		And I talked to...
dom dagostino ▲ ● ▼		Yes, they do.
dom dagostino ▲ ● ▼		That's right.
joe rogan ▲ ● ▼		Maynard Keenan from the band Tool also has an Osteria, a restaurant, and a vineyard that he runs in Arizona.
		He's a weird guy.
		But he explained on the podcast that I did with him recently the difference between the pasta that we have today and the bread we have today and original heirloom wheat, which is less...
		It's lower yield per acre, and it has less complex glutens in it.
		And he's like, that is what, when people are talking about the difference between how your body tolerates certain gluten, whether it's gluten sensitivity or not, he's like, it's just a different feel.
		And I really noticed that when I was in Italy, when I would eat their pasta.
		I mean, it tastes different.
		It feels different when it's going down, and I actually ordered a bunch of it.
		From Italy.
		And I even cooked it at home and I noticed the difference.
dom dagostino ▲ ● ▼		And did you get any...
		You don't have any...
		So if I go...
		Which I don't...
		If I go to the movie, sometimes I'll get popcorn and I'm completely okay.
		Like eating popcorn and then a day or two later I'm back into ketosis really fast.
		Without even exogenous ketones.
		But if I do eat pizza...
		Or pasta, which I did in the beginning when I would have like these cheat meals occasionally, I would have some major GI issues because your body's, you know, digestion, assimilation, transport of these things you're typically eating on a day to day and then you go without eating them and it's like your body doesn't know what to do with it.
		But when I did go to Italy and we travel around all over the place, my wife loves to travel.
		And we were in Naples and I ate maybe two or three pieces of pizza.
		I had absolutely no problems.
		Whereas that in the US, that would have bothered me.
		And maybe it was just, it may have been the flour.
joe rogan ▲ ● ▼		I guarantee you it's the flour.
		It's just a different kind of flour.
		I think what they call, it's called double O flour.
		See if you can find that, Jamie.
		The flour that they use and they'll specify for imported wheat flour from Italy that it's a special type of flour and that that flour is essentially heirloom flour.
		So the difference between like when you buy a tomato from the grocery store and it's pale and bulletproof and you can throw it down a flight of stairs and it doesn't even get bruised versus heirloom tomatoes which are almost like a fruit.
		I mean it really is essentially a fruit.
		And they're juicy and very delicate and very fragile as well.
		There it is.
		Is 00 flour worth the price?
		Well, that's...
unidentified		I just pulled up one that had the...
joe rogan ▲ ● ▼		Right.
		Got it.
		Yeah, I don't know, man.
		That's my big problem.
		But if someone does do that, say if they follow a ketogenic diet and they eat a bowl of pasta, I can't help it.
		And then they...
		Take exogenous ketones and it knocks them back into ketosis.
		Will it stay that way even though the body digests that pasta and they'll be in ketosis again tomorrow?
dom dagostino ▲ ● ▼		Good question.
		It'll stay that way based upon the pharmacokinetic properties of the supplement you're consuming.
		So, a ketone salt product, you know, the ones that are on the market, if it's mixed with a fat, like medium-chain triglyceride, the keto OS system and the ketogenic system are BHB and MCT. You'll be sustained for longer, but if you do choose to try to get the benefits of ketones and you're on a carbohydrate-based diet, you have to consume, obviously, more exogenous ketones to get the benefits of ketones.
joe rogan ▲ ● ▼		But you could do that, though.
		So, someone could...
		Eat sandwiches and just take exogenous ketones and maintain pretty much the exact benefits.
dom dagostino ▲ ● ▼		Yeah, you can do that and a lot of people are kind of confused.
		They're like, well, what's the body going to do with the glucose?
		You could say the same thing if you eat fat.
		What's the body going to do with the glucose?
		Well, interestingly, glucose goes down, and we don't actually know why.
		We think the liver kind of sends out less.
		And these products are just not really like a huge amount of ketones, right?
		It's just enough to get you maybe into the one millimolar range.
		And we know that's enough to give your brain like a boost and give...
		One millimolar of ketones in your blood actually represents a pretty significant source of energy.
		That your brain can use and that your heart can use.
		We know the heart runs more efficiently off ketones.
		And probably more importantly is that the ketones function as signaling molecules that inhibit anti-inflammatory processes.
		So Deep Dixit at Yale University did a study actually with one of the ketones.
joe rogan ▲ ● ▼		Wait, what's his name?
dom dagostino ▲ ● ▼		His name is Deep Dixit.
joe rogan ▲ ● ▼		Jesus Christ.
dom dagostino ▲ ● ▼		I never thought about it, yeah.
joe rogan ▲ ● ▼		You've never thought of that?
dom dagostino ▲ ● ▼		I never, no.
joe rogan ▲ ● ▼		That's the difference between a scientist and a comedian right there.
		I'm like, wait a minute.
		Hold up.
dom dagostino ▲ ● ▼		I always look at his Indian name, but he always tells me to call him Deep.
dom dagostino ▲ ● ▼		Just call me Deep Dicks.
joe rogan ▲ ● ▼		Dicks it, sorry.
dom dagostino ▲ ● ▼		He's a really good scientist and the leader in...
		In studying the effects of calorie restriction and ketones, and he observed that ketones, elevating ketones, has a signaling-like effect completely independent of the metabolic effect, which everybody thinks of ketones or a source of energy, but they are also like a hormone.
		They're like a drug.
		So they hit specific pathways.
		The pathway that he found at the study at Yale was the NLRP3 inflammasome.
		You don't have to I know that, but when that phlamasome is activated, it releases a lot of inflammatory cytokines in the body, which are...
		And that inflamasome is linked to a lot of age-related chronic diseases, too.
		So as we age, we have more systemic chronic inflammation.
		So I always say...
		The people that can benefit most from the ketogenic diet, you tend to get more insulin resistant and more trunk obesity as we age.
		So they are people that will be more receptive to the benefits of the ketogenic diet as we age.
		We become more carbohydrate intolerant as we age.
		Anyway, the beta-hydroxybutyrate is functioning as an anti-inflammatory, independent of the energy pathways.
		He established that.
		It was actually a diet that helped him formulate with exogenous ketones.
		After that got published, I got a number of Emails from pharmaceutical companies because they wanted to sort of reverse engineer something that had the same effect as a ketone, but to put it into a drug.
		And that was there.
		There's a pretty intense, you know, interest in the signaling properties of ketones in pharmaceutical companies, especially histone deacetylase inhibitors.
		So beta hydroxybutyrate was the ketone you measure from your blood.
		Functions as what we call this HDAC inhibitor, which affects genes.
		So you're actually turning on genes that are neuroprotective, that are cellular protective, that are linked to longevity pathways.
		So think about the rewards of developing a drug that did the same thing.
joe rogan ▲ ● ▼		The financial rewards.
dom dagostino ▲ ● ▼		You can't patent beta-hydroxybutyrate in different forms.
joe rogan ▲ ● ▼		It just shows you whenever something's good, someone comes along and tries to fuck with it.
dom dagostino ▲ ● ▼		Yeah, I mean, you know, you could say it's, you know, probably for the most part driven by greed, but there's a legitimate impact on human health and longevity.
joe rogan ▲ ● ▼		Sure, but wouldn't that just be better suited for the diet?
dom dagostino ▲ ● ▼		Absolutely.
		Absolutely.
		I think it's awesome that our body makes this, you know, natural metabolite.
		So the ketone salt products you buy on the market are, the ketones are derived from natural sources.
		So you are giving, you know, you are elevating a bioidentical form of a ketone that your body makes.
		There's a little bit of the debate because there's a D form of beta-hydroxybutyrate in the L form.
		So we call that racemic.
		If they're together, they're racemic, and the D-form is kind of what your body makes, but it can also convert it to the L in certain tissues, and it can get really complicated.
		The important thing is that the salts that you consume that are commercially available, the D-form is more likely to be broken down and utilized as a source of energy.
		Whereas the L-form probably sticks around more within the cell, and we know the L-form actually also functions in these signaling roles.
		So the L-form has anti-inflammatory effects.
		The L-form, you know, hits these signaling pathways.
		So the racemic mixtures that are in the salts may have extra benefits over just a pure D-form because the L-form can kind of hang around and stimulate all these pathways we know are beneficial before it gets broken down into fuel.
joe rogan ▲ ● ▼		So there might be some sort of a benefit for people even on a ketogenic diet taking exogenous ketones.
dom dagostino ▲ ● ▼		Yeah, absolutely.
		And I think, you know, we work really closely with the Charlie Foundation and I think the ketogenic diet should never be replaced with exogenous ketones at this point because the science, the research is not there yet.
		To validate it.
		But we want to go in that direction because there's some kids who really, like, they're fat intolerant.
		They throw up when they eat, like, the ketogenic diet because it's too high in fat.
		And a portion of the kids are like that.
		Most kids can follow it.
		But even for, like, childhood cancers and stuff, I met with...
		The Max Love Project.
		He was on Jimmy Kimmel.
		Max, he was a brain tumor, a child with a brain tumor.
		His family is treating them with a ketogenic diet and they help many families around the area.
		And they have a foundation.
		Just Google Max Love Project.
		And his family is helping Max adhere to and stick to a ketogenic diet as an adjuvant to his standard of care.
		So not a replacement.
		The ketogenic diet does work remarkably well for some people as maybe a standalone therapy.
		For cancer and has anti-cancer effects, but as an adjuvant to the standard of care, it's remarkably effective.
		And they're working with, I think, with Orange County.
		Yeah, so they have a lifestyle medicine program at Children's Hospital in Orange County, where they're helping a wide variety of families who have kids with cancer stick to and adhere to a ketogenic diet as part of a wellness program after they went through their cancer treatment.
		If you're a child and you get the standard chemotherapy, you are kind of left in a situation where you're far more likely to have a lot of different negative health consequences after that because the chemotherapy wipes out your immune system and can create additional mutations.
		So there's kind of like a fallout from the standard of care.
		And being on a ketogenic diet can be cellular protected, can help you in a neoadjuvant And after, you know, before standard of care and even after standard of care, help you recover and get your body back into like a detoxified state, if you want to use that term.
joe rogan ▲ ● ▼		That's amazing.
		Now, how many cancer research places are adopting this?
		I mean, it seems like that would be gigantic.
		And this is a big shift over to standard care of just a few years ago, right?
unidentified		Yeah.
dom dagostino ▲ ● ▼		Yeah.
		So the idea is, and we wrote a grant with the Moffat Cancer Institute, which is like a tier one cancer research center.
		I mean, they essentially reached out to us and say there's significant interest in this from the National Cancer Institute, National NIH, National Institutes of Health, to use the ketogenic diet as an adjuvant at this point instead of replacing standard of care, which only in situations where the standard of care is not which only in situations where the standard of care is not effective should that be the case, but as an adjuvant to further enhance the efficacy of the standard of
		So the ketogenic diet, we know, limits glucose availability to the tumor, which requires the glucose for growth and proliferation.
		It decreases insulin, I talked about, and insulin signaling drives cancer growth, and it also elevates ketones.
		Ketones may have an anti-cancer effect and for the most part, especially in very aggressive tumors that have dysregulated mitochondria, they can't use the ketones for fuel nearly as well as they do like fuels like glucose and maybe even glutamine, amino acid.
		So it enhances the standard of care and helps them, actually protects them from The healthy cells from the radiation damage from the standard.
		It sensitizes the tumor to radiation and kills off more tumor and it protects your healthy cells.
		So my colleague Adrian Sheck at the Barrow Neurological Institute has done some remarkable work in animal models showing this and that has translated into a human study and actually garnered more interest in this area to use the ketogenic diet As an adjuvant,
		I think in some cases where the standard of care has failed for glioblastoma or advanced metastatic cancer, I think the ketogenic diet can kind of be a base therapy for a more comprehensive metabolic-based program.
		And we wrote an article called The Press Pulse, where the ketogenic diet and maybe something like metformin, And other drugs can be used to weaken the cancer and limit its fuel source, and then you can kind of come in with maybe more aggressive ways, like hyperbaric oxygen therapy, which can reverse tumor hypoxia, or various low-dose chemo regimens.
		So you weaken the cancer, you put your body into a state of ketosis, and then you come in and pulse at predetermined time points, maybe every three weeks, a therapy in a much lower dosing regimen To gradually knock down and reduce the tumor volume over time.
		And you do it in a more gradual way instead of going in there with surgery, radiation, and chemo, which is kind of like slash and burn, and it leaves the patient.
		The patient coming out of that therapy is much, much weaker than when they came in.
		So a therapy can be developed that when the patient comes in and they come out the other side, they're actually in more robust health.
		We know that we can do that.
joe rogan ▲ ● ▼		That's incredible.
dom dagostino ▲ ● ▼		That's possible from a theoretical standpoint with various...
		Research being done in animal models and what we know about nutrition and physiology, that can be done.
		It's just going to take some time to do it.
joe rogan ▲ ● ▼		It's just so interesting when you talk about the shift of information.
		I mean, when you were in college being fat-phobic, you know, to now being like one of the premier guys that's out here preaching the benefits of the ketogenic diet and seeing, you know, this, I mean, up until really recently, cancer research always depended upon these, you know, chemotherapy and radiation and All these different standards that everyone's been having success with, but the idea that you could actually make a person healthier through the ketogenic diet and hyperbaric chambers and things along those lines.
		It's amazing.
dom dagostino ▲ ● ▼		Hyperbaric oxygen therapy actually is FDA approved for things like radiation necrosis.
		When you have radiation on a tumor, you have a lot of necrotic tissue.
		Patients would undergo hyperbaric oxygen for radiation necrosis.
		I would go to these...
		Various conferences over the years and talk to these physicians and these patients would make remarkable recoveries, you know, even after they have the therapy.
		And it seemed like something else was going, kind of going on here.
		And, and if I go back early in my work, I mentioned that we develop these technologies through our work with the Department of Defense and when the office where we, we build a hyperbaric chamber, and then we buy an off the shelf microscope and install it inside the chamber.
		And then We close it up and then we pressurize it to simulate what a dive would be while we're looking at the mitochondria and even the cells.
		And I did that with like healthy cells and neurons and we did it with a glioblastoma cell line and we noticed that the cells were exploding with high levels of oxygen.
		I didn't know what I was seeing at the time, but I looked into it more and started contacting some of the leaders in the field.
		And they reported, one of them was Thomas Seyfried in Boston College, and he was a neurogenetics professor at Yale University and then had moved to Boston to expand a ketogenic diet program for cancer.
		And he told me, you know, what you're observing is damaged mitochondria from cancer cells, which have damaged mitochondria, and if you give them more oxygen, it will produce proportionally more And then we did some work with ketones and saw that ketones were stopping the growth of cancer, too.
		So we had this idea of using nutritional ketosis plus hyperbaric oxygen and studying that in a mouse model.
		Of cancer.
		And we've got some remarkable results that we published.
		And this is, you know, patients are doing this kind of in an off-label way.
		They're doing the ketogenic diet.
		But now we have, if we go to clinicaltrials.gov and you just look up ketogenic diet, you see more than a dozen studies.
		You know, so when I got into this, there was no studies.
		So now there's been an interest in even maybe people like jumping on the bandwagon of You know, if they have a particular drug, will the ketogenic diet enhance it?
		Or let's see if it enhances the standard of care.
		Or let's see where standard of care failed if we can get these patients on this metabolic therapy and see if we can help them with quality of life.
joe rogan ▲ ● ▼		It's so exciting.
		I mean, it's just really amazing, exciting stuff.
		It's so interesting seeing something like this emerge relatively late in terms of medicine and science.
		I mean, 2017, when you're talking about something that's diet.
dom dagostino ▲ ● ▼		Yep.
		So just if you Google ketogenic diet in a Google search, around 2012, it's down here.
		And something happened around 2013 or 14 where it just skyrocketed.
joe rogan ▲ ● ▼		What was that?
joe rogan ▲ ● ▼		Do you know?
dom dagostino ▲ ● ▼		I have no idea.
dom dagostino ▲ ● ▼		I mean, I was on Tim Ferriss and other things, but a lot of my colleagues, too.
joe rogan ▲ ● ▼		When were you on Tim's show?
dom dagostino ▲ ● ▼		Probably dating back to 2014. That's probably it.
		That could be it, but it's really my colleagues.
		I'm being humble.
joe rogan ▲ ● ▼		I'm sure your colleagues have a lot to do with it, but as far as the impact of the reach of something, a podcast...
joe rogan ▲ ● ▼		The impact that a podcast has in terms of the amount of people that are going to Google something is probably many, many magnitudes greater than anything anybody is doing from a professor or some fellow scientist.
dom dagostino ▲ ● ▼		I realize that now.
dom dagostino ▲ ● ▼		And I thank you for letting me have this platform.
unidentified		I'm excited.
dom dagostino ▲ ● ▼		I almost feel like there's guys, like the guy that got me into this was Dr. Jung Rho, and he was at Barrow Neurological Institute.
		He mentored my colleague, Adrian Sheck, into looking at ketones for glioblastoma.
		He runs the Pediatric Center in Calgary right now.
		But Dr. Eric Kossoff from Johns Hopkins was a big help to me.
		A number of people, I feel like they should have this platform, but they're so busy they don't do podcasts.
		But I realized early on it was really important to get the message out because it does no good if you're not hitting a big target.
		And what I focused on was not just one application, but, I mean, we do everything from wound healing to these genetic diseases to cancer to various seizure disorders.
		So I realized this was a lot bigger than just pediatric epilepsy.
		It's great.
joe rogan ▲ ● ▼		It sounds like it's the only way you should eat.
dom dagostino ▲ ● ▼		I mean, I don't tell everybody they should eat ketogenic, but I definitely feel that they should at least go into ketosis a couple times a year, if not for just longevity effects, for anti-inflammatory effects.
		When things pop up and we're under stress, like I had an email yesterday, a person had severe shingles or severe outbreaks of even the Like fever blisters or something like that or cold sores.
		And if they just fast and do the ketogenic diet, it suppresses that.
		Since they've been on the ketogenic diet, they had profound suppression of some viral disorders that when there's viral shedding and you're affected by the virus, it causes profound suppression.
		Inflammation and neuroinflammation.
		So it kind of starts with a headache, and then it will kind of lead to itchiness or whatever associated with shingles.
		But they described it very elegantly in an email, and it was very clear before and after, since they've been doing the QGNK diet, it had a profound effect, even more so than the drugs, antiviral drugs that they're taking.
		Even something like HIV, which contributes to neuroinflammation and even different types of cancers like Kaposi's sarcoma, I think.
		Being in a state of nutritional ketosis could probably offer a lot of benefits to HIV patients that really struggle with some symptoms that are associated with inflammation and arthritis.
		Other things associated.
		So this is another path we're going into.
		So some of those researchers have reached out to us and say, hey, the NIH has a proposal for this.
		Let's write a grant together.
		So it's crazy because I only have so much of a bandwidth.
		But people from Ivy League institutions are reaching out to me and saying, hey, can you help us formulate a ketogenic diet?
		Or can we use your ketone supplement to do a study on things that I never thought nutritional ketosis would be applied to?
joe rogan ▲ ● ▼		Now, what about wound healing?
joe rogan ▲ ● ▼		You brought up wound healing.
dom dagostino ▲ ● ▼		Yeah, that's a big one.
		One of my students, Dr. Shannon Kessel, she actually works for the Epigenetics Foundation now, helping the dogs at the Keto Pet Sanctuary.
		She did her PhD on the effects of ketones on a wound healing model.
		And the model that we use was essentially the back of a rat.
		Hopefully there's animal protection people.
		But in describing what we do, we basically have a wound that's a pretty nasty wound on the back of a rat where one side is ischemic.
		It lacks significant blood flow.
		And the other side is non-ischemic, which has normal blood flow.
		And there's like a chunk of tissue kind of taken out.
		And then we look to see how fast that wound closes up, right, over time.
		And we do it in young animals and we do it in aged animals.
		And we take animals and then we feed them a standard rodent chow, which is high-carbohydrate rodent chow.
		And then we have a number of different groups where we give them various types of ketone supplements.
		And we found that, admitted that the ketone supplements enhance the wound healing, not only in the aged, which was pretty remarkable, and ischemic, but also in the young.
		So it was like for the young healthy guy that has a cut or a wound on the battlefield or something like that, it can help that wound heal up faster.
		And it's doing it through a variety of mechanisms.
		Probably the wound itself is often the wound tissue is deficient in ATP, the energy source, because the blood can't get to it, right?
		So the ketones can restore like 90% of it has 90% less ATP in some cases with ischemic wounds.
		The ketones have the ability to like we think thin out the blood and be able to get to that wound tissue that's lacking oxygen and blood flow.
		And not only does it restore the energy to the wound healing, which can allow cells to replicate and heal up the wound faster, but I talked about the anti-inflammatory effects.
		So persistent chronic inflammation can prevent the wound from healing up, and by suppressing some of the inflammatory pathways, that can kind of open the gate on the activity of various growth factors and healing processes that can heal the wound up.
		And it seems to be, you know, pretty profound in the age but also happens in the young.
joe rogan ▲ ● ▼		Now this is just taking exogenous ketones with a standard chow from rodents?
dom dagostino ▲ ● ▼		Standard chow.
		So we didn't want to kind of, you know, messy up the data in any way.
		We actually should have done, if we had the funding, we could have done a ketogenic diet plus ketone supplementation.
joe rogan ▲ ● ▼		And you think that would be even better?
dom dagostino ▲ ● ▼		Yeah, I definitely think it would because the ketogenic diet alone suppresses some of these inflammatory components that is associated with impaired wound healing, especially impaired wound healing Oh, right.
		It's really a blood flow problem.
		And we did, to answer that question to determine if it was blood flow, we did a Doppler blood flow analysis of the blood flow into wound and showed that it was something like a 25 or 30% increase in blood flow to the wound when we induced acute ketosis.
		So we gavage...
joe rogan ▲ ● ▼		That's incredible.
dom dagostino ▲ ● ▼		You know, we stimulate, you know, ketosis that would mimic ketogenic diet or fasting, and then we do...
dom dagostino ▲ ● ▼		A Doppler blood flow analysis, and we show a pretty remarkable increase in blood flow.
joe rogan ▲ ● ▼		That's a huge increase.
dom dagostino ▲ ● ▼		Yeah.
joe rogan ▲ ● ▼		That seems like that would be the move for someone who's recovering from some sort of a surgery or something like that, hyperbaric chamber, combined with ketosis, ketogenic supplements.
dom dagostino ▲ ● ▼		And for the VA, my collaborator on this project, Dr. Lisa Gould, at one time she was the...
		She was the president of the Wound Healing Society.
		She was like, this is really remarkable.
		To have someone of her stature, she's an MD, PhD, really comment that this profound effect on wound healing really motivated us to follow up on this.
		But we have not gotten funding after this, so we really need to...
		Keep working because we need to follow up on this study and get this as a legitimate wound.
		A lot of people are trying to enhance the wound healing process by putting things on the wound.
		But where wound healing is enhanced, if you alter and optimize your metabolic physiology, that promotes substrate and oxygenation to the wound.
		You know, and that's what ketones do.
		I mean, you have a vasodilation effect.
		There's a big increase in adenosine.
		Adenosine is a pretty profound vasodilator.
		So you have a vasodilation that's improving blood flow to the area where there's not only glucose in there, but there's ketones.
		And the ketones help restore the energy in that wound that is sufficiently depressed from lack of blood flow.
		And it's promoting or reducing a lot of the inflammatory things that preventing it from healing in the first place.
		So, yeah, I mean, this was really, like, it was presented at the Wound Healing Society, and they were, a lot of people were floored by it.
		So it's, Shannon has, my student has went and moved on and doing postdoctoral, you know, work at another place, but I really need to follow up on that.
		We have a lot of projects, you know, we're trying to process in parallel right now.
		But, yeah, I need another student to, because that may have been, you know, that and, you Some of the motor function, glucose lowering, and anti-anxiety effects are all things that kind of jumped out of the data from us that I never would have expected.
		I came in this to look at seizures.
joe rogan ▲ ● ▼		Now, what was the hard data in terms of what is the percentage of increase in healing across the board with the rats?
dom dagostino ▲ ● ▼		So if we look at time, time for that wound to close and heal up, it's about 20 to 25%.
joe rogan ▲ ● ▼		That's significant.
		And that mirrors the amount of blood flow that you were talking about.
		The increase in blood flow being about 20%.
dom dagostino ▲ ● ▼		It does.
		I don't know if you could draw a direct correlation to that.
		But obviously, if you have improved blood flow, that's getting nutrition to the wound.
		And we know that that blood has ketones in it, which have anti-inflammatory effects and things like...
		You know, it stimulates the HDAC, HDAC 1 and 2, which stimulates superoxide dismutase and other antioxidant enzymes, which are often dysregulated, you know, at the wound site.
		So it's doing a lot of, not only just restoring oxygenation and blood flow, but it's having, like, drug-like effects.
		These metabolites are really, like, signaling molecules.
		And it makes sense.
		If we're in a state of starvation ketosis, the ketones would be telling the brain to do certain things and altering different neuropharmacological pathways that should be altering our behavior.
		The person that is deprived of food and becomes tired from hypoglycemia is the person that's going to die.
		So the people that survived in the absence of food availability were the ones that became more lucid and clear and were able to Go and forage or hunt down the animal and kill it and eat it.
		So we are hardwired.
		I mean, to answer your question, I think a while back you asked, you know, why do we have ketones?
		Why?
		I think it's an evolutionarily hardwired system that is, yeah, just built into our DNA. And, you know, with the advent of carbohydrates and frequent feedings and, you know, a deli on every corner here, we've largely silenced that genetic program that becomes activated upon food deprivation that can stimulate a host of beneficial things from extension of longevity to autophagy.
		And I know Rhonda Patrick, you know, I'm a big fan of her.
		She's talked about this quite a lot.
joe rogan ▲ ● ▼		She's awesome.
dom dagostino ▲ ● ▼		And yeah, she's super awesome.
		She actually visited the lab and we did a Oh, really?
		Oh, amazing.
joe rogan ▲ ● ▼		She scares the shit out of me.
joe rogan ▲ ● ▼		Every time I talk to her, I'm like, I'm basically a monkey that knows the same language as her.
dom dagostino ▲ ● ▼		She's like an encyclopedia of information.
		And she always comes prepared.
		So I came prepared.
		I was like, yeah, I should do what Rhonda does.
		So I wrote down some notes here.
		There's probably things I'll forget.
		But yeah, so...
		Yeah, it's a system that typically was activated in the normal person, you know, millennia ago.
joe rogan ▲ ● ▼		Which actually enhanced your concentration.
dom dagostino ▲ ● ▼		Absolutely.
joe rogan ▲ ● ▼		It's one of the things to go back to the hunting thing.
		My friend Remy Warren, who's a pretty famous hunter, and one of the things that he says, and he's always said this, that he likes to hunt hungry.
		And one of the things he does, he does these backcountry hunting trips solo, and he purposely brings too little food.
		And one of the things that he's found over his many years is that when he's actually hungry, he is more tuned in, and he does a better job of understanding what's going on.
dom dagostino ▲ ● ▼		Yeah.
		It's amazing.
		The first time I actually started experimenting with fasting or even a calorie-restricted ketogenic diet, I took a walk around my neighborhood at the time, and it's like my whole nostrils opened up.
		I could smell things.
		I could hear things.
		I was more lucid in ways I had not been before.
		I didn't even fasted for seven days and was able to, you know, give a lecture and train in the gym and lift weights that were not hardly much lower than what I typically do.
		So I probably couldn't do, you know, it was just at seven day point after no calories, I was starting to feel.
joe rogan ▲ ● ▼		No calories at all?
dom dagostino ▲ ● ▼		No calories after seven days.
joe rogan ▲ ● ▼		Just water?
dom dagostino ▲ ● ▼		Water and a bouillon cube, so some electrolytes like sodium, potassium, and lots of water.
		And I allow myself about a third of the coffee that I would typically drink, so I'd have a small cup of coffee in the morning.
		And I got a ton of stuff done during that week.
		Because I didn't have to make my food, I didn't have to clean up my food, I didn't have time eating the food, so I saved a lot of time.
unidentified		How much weight did you lose?
dom dagostino ▲ ● ▼		Uh, I think I lost eight to nine pounds.
		And then within a week or two, it all came back again.
		You know, a lot of it's, you're holding glycogen and you lose glycogen.
		But, uh, in regards to, you know, at the time, uh, My deadlift strength was maybe 8 or 10 reps with 565. I was able to do 10 easy reps with 5 plates on each side, which is about 500. Typically, going into this, I was paranoid.
		I listened to Dorian Yates' podcast, and I was a huge follower of Dorian Yates in 1994. I was eating four to six meals a day with shakes in between.
		I remember even having...
		I would wake up in a little nightmare.
		The nightmare would be I didn't have food on me after two hours.
		I would have to eat every two hours.
		I was so obsessed with getting bigger and stronger.
		And so for me to fast seven days and to be out of my comfort zone, that was a big step for me.
		So I kind of just did it to mentally...
		Liberate myself from chronic overfeeding and things and because I was I had just read and studied George Cahill and the Harvard Medical School study where they fasted for 40 days and looking at you know all the parameters on that and I was like it's not gonna kill me it's probably gonna do me well and the more I did it the second and third day were kind of hard for me but after like the fifth day it became it was bizarre it became like really easy I was just kind of floating around.
		My body had no inflammation.
		I wasn't buzzing with energy, but I was very lucid and I didn't feel like I needed to be buzzed.
		I realized I'm so much better.
		A lot of times I feel like I need to drink coffee to amp up to be my best, but I was my best When my brain was really calm, and I was able to put thoughts together, and I wrote a whole lot of research proposals, which later became funded.
		Of the proposals I really worked on, I probably got over a million dollars of funding.
		During that time, I really intensely worked on various proposals because I just transitioned to a tenure-track position.
		So it allowed me to work on manuscripts and proposals and just put thoughts together that maybe I otherwise either wouldn't have the time to or the mental...
		Kind of resources to get into that state of mind.
joe rogan ▲ ● ▼		That seems so counterintuitive that you have more mental resources with less calories.
dom dagostino ▲ ● ▼		It does.
		I mean, you know, I was burning my body fat for fuel primarily.
		Probably lost a little bit of muscle.
		But that fuel, that fat was becoming ketones and that my brain had switched over.
		I was doing low carb but not really full keto at the time.
		But it really, it like quieted my brain in a way that I was able to...
		Maybe I have mild ADHD because I like to do so many different things, but it quieted my mind and I was able to wake up.
		Every morning I was waking up a lot earlier than normal, like 4.35, and I typically sleep until like 7. But I was able to wake up and just focus and get a ton of work done the first three or four hours.
		And then I would go into work actually and just meet with my students or teach or do whatever I had to do.
		But I just remember getting a ton of work done.
		I've never reproduced it.
		I never went back.
		But I did a whole bunch of blood work on me to give, you know, a little bit of insight as to what's going on during the fasting stage.
		And everything was really positive.
		You know, there was a big...
		My insulin was really low at the time.
		My glucose was really low.
		I got down to like 25 at one point because I was experimenting with a couple different things and my ketones were really high.
		My ketones were like double what my glucose was at a couple time points during that.
		So I would encourage people, especially maybe people that are prone to cancer or people who have had cancer in the past and maybe had treated and are kind of in a state of remission, if you get your body into that, what we call the metabolic zone, where the level of ketones are higher than the level of glucose, that puts tremendous metabolic stress on cancer cells or pre-cancer cells that have a huge appetite for glucose.
		And that can initiate autophagy.
joe rogan ▲ ● ▼		So even people who do not have cancer but perhaps want to just make sure they're holding off of it as a preventative maintenance?
dom dagostino ▲ ● ▼		Yep.
		And I think it can stimulate, almost purge your body of cancer cells that are weakened in this fasted state and also precancerous cells.
		That may be in the transition of, you know, de-differentiating into this, you know, cancer-like cell.
		These cells are very energy-demanding, especially if they're replicating.
		And if you deprive them of energy, the quote-unquote energy crisis signal that these cells receive can initiate programmed cell death.
		we call apoptosis and autophagy and that's the benefit of this it's almost like housekeeping so think about it you know you accumulate a lot of you know dead cells that are kind of sluggish your mitochondria kind of sluggish and then you fast for a week and it's like reboot it's like setting it's like a reset button so have you did you I did a podcast with Rob Wolf where he was talking about this one guy who went for a whole year without eating.
joe rogan ▲ ● ▼		Have you paid attention to that case?
dom dagostino ▲ ● ▼		Not only did I pay attention to it, I've presented that at a number of different meetings and people say bullshit, but it's actually in...
		Oh man, I think I may have had it.
		I was going to actually show it at this...
		At this meeting, but I think I took the slide out.
		I had it in the back.
joe rogan ▲ ● ▼		Let's just tell people what this guy did.
dom dagostino ▲ ● ▼		382 days.
joe rogan ▲ ● ▼		Not only did he lose a tremendous amount of weight, he went from being morbidly obese to being like a normal-sized person, but here's the big one.
		The skin loss.
		Shrink, too.
dom dagostino ▲ ● ▼		Yeah, that's right.
joe rogan ▲ ● ▼		To the most part.
		Yeah, for the most part.
		I mean, significantly, where most people have to, when you're that big and you shrink down to a normal-sized person, they have to cut your skin or you just walk around like a flying squirrel.
		I mean, you have like this crazy extra skin, right?
		Well, this guy, somehow or another, through this 380-plus days of fasting, his body shrank accordingly.
dom dagostino ▲ ● ▼		Yeah.
		Yeah, that's right.
		So he was about 500 pounds.
		Actually, Travis Christofferson and I wrote a blog article and it was part one, two, and three, the history of the ketogenic diet, part one, two, and three, and it's on Rob Wolf's website.
		So if you just Google the history of the ketogenic diet and land on Rob's website, you'll have, I think we talk about the story in there.
		It's a remarkable story.
		Yeah, the guy was like 500 pounds and he fasted for like 381 days or 82 days.
		And he went down to 190 pounds.
		And the remarkable thing is that he sustained that over...
		I mean, he maybe went back up like five or six pounds, but largely sustained that weight loss over time.
		So he was running completely off fat, the fat that he had stored up.
		And he was studied pretty intensely.
		And the thing that came out of the data was there was a pretty significant drop in magnesium.
		So that actually convinced me, yeah, I definitely should probably...
		Maybe supplement magnesium if I was fasting.
joe rogan ▲ ● ▼		Was he supplementing anything?
joe rogan ▲ ● ▼		Any vitamins?
dom dagostino ▲ ● ▼		They did give him an electrolyte, so it's in the medical records, and I dug into this as much as we could.
dom dagostino ▲ ● ▼		His glucose levels got down to like 20 or 25 a couple times and maintained it.
joe rogan ▲ ● ▼		He was given potassium tablets to keep his heart healthy and multivitamins every day.
		Is this Rob's?
		Is it Rob's?
unidentified		No.
joe rogan ▲ ● ▼		No, another website?
dom dagostino ▲ ● ▼		Yeah, I think I've seen this.
dom dagostino ▲ ● ▼		Fasted 382 days.
joe rogan ▲ ● ▼		Incredible.
		Lost 275.5 pounds.
		Now, who was calling bullshit on this?
dom dagostino ▲ ● ▼		Well, I did present it to, like, a mainstream, you know, clinicians.
joe rogan ▲ ● ▼		They were scoffing.
dom dagostino ▲ ● ▼		Well, you know, it's actually really funny.
dom dagostino ▲ ● ▼		Like, the first, it might have been the American Epilepsy Society, where they kind of marginalized the Q-dink diet.
unidentified		Really?
dom dagostino ▲ ● ▼		It may have been another.
dom dagostino ▲ ● ▼		It might have been neurology.
joe rogan ▲ ● ▼		The American Epilepsy Society?
dom dagostino ▲ ● ▼		At the time, they're warming up to it just because the data, they can't turn their back on the data because data is data.
		So there's a massive amount of data emerging that this is grossly underutilized and should be really the standard of care, even the frontline therapy.
		Like, we all kind of realize that, but neurologists would have to have, you know, a sidekick registered dietitian or whatever.
		But so during the time, one of my first presentations was to medical doctors, you know, that were in it for CME credits and things like that, like just standard conventional.
		And I talked about, you know, towards the end, I was like, well, I follow the ketogenic diet myself.
		And they're like, they're like, gas.
		They're like, oh, what's wrong with you?
		It's like, When I explained to them that I was normal in the question answering after, they're like, well, why do you do it?
		And it's like, are you okay?
		This is going back like 2009 or 10. That's fairly recently.
		Yeah.
joe rogan ▲ ● ▼		Seven years ago.
dom dagostino ▲ ● ▼		It was really bizarre to them that someone would actually follow the ketogenic diet.
		And I was doing like the classical, I was trying to do like the, you know, the Hopkins protocol.
		I was using Eric Kossoff's book on the Hopkins.
joe rogan ▲ ● ▼		So 98 and 2, is it?
dom dagostino ▲ ● ▼		I was about 80...
		I was a 3 to 1, so it was like 85 to 88% fat, and I was sticking to it.
		Yeah, so people really just think it's really bizarre if you don't have a severe neurological problem at the time.
		And now, that's just evidence of how mainstream, because you see it in mass media.
		Athletes going on, quote-unquote, the ketogenic diet.
		I'd question whether they're actually ketogenic.
		They need to measure their ketones to really...
		So the ketogenic diet, you're in ketosis by virtue, by the definition that your blood ketones are elevated above 0.5 millimolar.
		And typically most people, that's pretty hard to achieve.
		If you're up to one millimolar, which is like mild ketosis...
		You take 100 people out of the population that eat the standard American diet, maybe one, maybe two people will achieve that if they go all day without eating or something.
		It really takes a while to achieve it.
		So you have to be doing something pretty radical to achieve that blood measurement of a state of ketosis.
joe rogan ▲ ● ▼		Are you seeing that in pro athletes?
		I know there's a few fighters.
		Misha Tate, before she retired, she went ketogenic.
		Her boyfriend, Brian Carraway, I know he was ketogenic for a while.
		That's just my experience with athletes.
		But I know that there's a lot of people that are looking at it.
dom dagostino ▲ ● ▼		Yeah, I would, you know, kind of question whether they're, like, ketogenic.
dom dagostino ▲ ● ▼		I'm sure they did low carb.
joe rogan ▲ ● ▼		But if you eat too much protein, that converts to glucose?
dom dagostino ▲ ● ▼		It can kick you out.
		Yeah.
		Then again, some athletes that contact me, their output is really high, so they're actually giving five or six hours of output a day, and they're eating two or three chocolate bars, and they're getting 250 grams of carbs a day, some of them, and they're maintaining a mild state of ketosis, especially post-exercise ketosis, even with...
		Drinking something like the UCAN starch, like a slow burning, like a slow carb, like Tim Ferriss advocates.
		And they stay in ketosis.
		And if they back off more, if they back their carbohydrates down to like 50 grams a day, they start to lose performance on that.
		I mean, these are people with very high output, though.
joe rogan ▲ ● ▼		Ridiculous output.
dom dagostino ▲ ● ▼		Yeah, ridiculous.
joe rogan ▲ ● ▼		We talk about five hours of exercise a day plus.
unidentified		Yeah.
dom dagostino ▲ ● ▼		And they went from 1,000 grams of carbs a day to 250, and they're performing better.
joe rogan ▲ ● ▼		So when you're talking about 50 grams of carbs for the standard average person, this is not applicable for an MMA fighter who's doing three a days.
dom dagostino ▲ ● ▼		Yeah.
		I think you could, especially the older guys.
		Like older guys, I think you could readily adapt them.
		Like I said, though, I think that adaptation should probably occur during training in the off-season and give themselves a buffer zone of three months.
		And actually work with a coach or work with an app like Avatar Nutrition or something where they calculate the macros and they actually know they're hitting the macros.
		And the body is amazing.
		If you actually hit the macros that are calculated, your body will go into ketosis.
		I've never seen – there's very few people that you can't get into ketosis, especially if you use things like MCT and really – Adjust the macros.
		And you could also do ketogenic intermittent fasting, where you kind of don't eat throughout the day, but then eat through a window or time-restricted eating, as Rhonda Patrick calls it, where you basically just eat within a six-hour window.
		I like to do that.
		I'll eat from 5 p.m.
		to 11 p.m.
		and just kind of eat a big meal and just kind of graze a little bit throughout.
		And then I get...
		You know, a pretty good chunk of the time fasting.
		And then after I'm done with work, you know, I'm not frantically running around trying to get stuff done so I can relax, you know, with my wife and just kind of kick back and eat and just, you know, and that's kind of what I want to eat anyway.
joe rogan ▲ ● ▼		So you feel like there's more of a benefit?
		I'm doing a 14-hour thing.
		You think there's even more benefit doing an 18?
dom dagostino ▲ ● ▼		I do.
		I think you...
		I don't...
		I do.
		For me, I definitely think I do.
		Because there's something about a couple hours extra where if I fast for 14 hours but then go...
		My ketones really start to go up from 14 to 18 hours.
		And then I can actually stay in ketosis if I eat ketogenic during that six hours of eating.
		If I pay attention to eating really low carb, I can eat and before I go to bed, test my ketones and bam, I'm hitting like 2.2 or something.
		So I continue to get the benefits of having ketones.
		But when it comes to, like, things like Rhonda talks about, like, autophagy, I think you can even get more benefits with an 18-hour fast, and you do that.
		And you don't have to do it every day.
		I think you could just do it, like, you could actually do it just, like, once, maybe twice a week and get a lot of benefits from that.
		Like, if you do that over the course of a year, and that's not hard to do, right?
		If you could just convince people, hey, take the breads and pastas out and just put in more vegetables and just do intermittent fasting, You know, every Tuesday and Thursday.
		And if they do blood work after like three months, they're going to see a profound effect.
		Probably not even changing the diet.
		They're going to see a profound effect.
joe rogan ▲ ● ▼		Now, someone told me that there is an effective way to measure ketones through breathing.
		There's some sort of a breath monitor.
		Is that real or...?
dom dagostino ▲ ● ▼		Yeah, there's a couple out.
		Some of them were being showcased at the conference I was at, the Low Carb USA. The one that I have the most experience with is a product called Ketonix.
		And now they have a Bluetooth device out where you can blow into it and it reports to your phone and it shows you the parts per million of acetone in there.
		And acetone, so you make beta-hydroxybutyrate and acetoacetate as the two primary ketone bodies that are used for fuel, and also they have signaling properties.
		And acetoacetate can break down spontaneously decarboxylates to something called acetone, which you know is nail polish remover, right?
		So acetone actually has some really interesting...
		effects that calms the brain down sub narcotic levels of acetone open potassium channels that when potassium channels are opened that hyper polarizes the membrane potentials of neurons and makes them kind of more like charged batteries and it also kind of calms your your brain down so it's not firing action potentials as much And that's a good thing.
		So instead of all this kind of fluttering of activity, it helps to kind of synchronize your brain in a way by elevating.
		And this goes back to homeostasis, right?
		So that acetone can correlate with seizure control.
		So, parents who have kids who do not like to get their fingers pricked have used the breath acetone.
		You blow into it, you get a pretty color.
		You know, the kids like it and everything.
		It is kind of hard to, like, set it up.
		You've got to calibrate it.
		So, it's a little bit clunky to work with, but it's a pretty good indicator.
		If you're registering, like...
		Orange or red on that, you are definitely in a state of ketosis.
		But I call it only semi-quantitative.
		So they need to work out some of the bugs.
		And if you just look up breath acetone meters, there's probably about five on the market now.
		And the one that I have experience with is called ketonics.
		And if your acetone is high and you're not taking ketones supplements, you are cranking your fat metabolism.
		So you are really mobilizing fat and burning fat for energy.
		So it's a pretty valid indicator of burning fat for energy.
joe rogan ▲ ● ▼		So it's pretty good, but blood is the best.
dom dagostino ▲ ● ▼		Blood's the gold standard, probably will always be.
		There's technologies emerging out now, at least, you know, small companies that are essentially, you put like a Band-Aid-like thing on your skin, and it's measuring glucose, it's measuring...
		You know, potentially beta-hydroxybutyrate, acetoacetate, and things like lactate.
		And then it'll go to your smartphone.
		So you can look at your smartphone and see your glucose levels, your ketones, your lactate, and maybe some potentially other things.
		You could adjust your diet or drink a supplement to optimize you into a range you know maximizes your strength, maximizes your performance, or It maximizes your brain protection in the extreme environment like high-pressure oxygen for a Navy SEAL or something like that.
		That technology is in development now and will probably surface sometime in the next year or two.
		And I think it'll be pretty cool.
		So think of a Dexcon, but instead of just glucose, it'll give you like a metabolomic profile of your blood and then you can augment it with your diet or with various supplements.
joe rogan ▲ ● ▼		Now, I got two other important questions.
		One, physical performance.
		Have there been studies on reaction time, on all sorts of different variables that I think...
		I mean, if you're looking at all this increase in blood flow, this decrease in inflammation, all those things are what you would want out of a body that you want to perform better.
		It seems like things would fire better, for lack of a better word.
		Have there been studies on putting athletes through a variety of stress tests, reaction times, things along those lines?
dom dagostino ▲ ● ▼		Those studies need to be done.
		And I think some of the marketers out there that are promoting ketone supplements are based on some animal data.
		And I think they're extrapolating some of the effects.
		Well, ketones offer a metabolic advantage.
		You can generate more ATP. It gives your brain resilience under inflammation or hyperglycemia.
		But the bottom line is that these studies need to be done and they need to be funded.
		Some of them are going on right now and some of them I'm kind of involved in.
		And probably most important is...
		What are they actually studying?
		What ketogenic diet are they actually studying?
		What are the macronutrient ratios?
		Not only the ratios, but what types of fats are they using?
		What's their protein source?
		And that's really important.
		And when it comes to ketone supplements, that's a whole other box of worms.
		Are they using just pure sodium beta-hydroxybutyrate?
		Are they using sodium, potassium, magnesium combination, which would offer more benefits?
		Are they using racemic?
		Are they using a ketone ester?
		So there's lots of these considerations.
		There's lots of nuances in the way these things are formulated, in the way they're dosed, and in what type of application.
		Whether it's a pure strength application or what I call strength performance, like push-ups and chin-ups and things like that, or endurance or ultra-endurance or things like that.
		A lot of research needs to be done, so I didn't really give you an answer, but I think the guy who's done the most research on this, clearly, at least with a ketogenic diet, is Jeff Volick from Ohio State University.
		His FASTER study clearly showed that athletes in a state of nutritional ketosis burn almost twice the amount of fat.
		And they maintain that, which is remarkable.
		I mean, there's some elegant studies to show fat oxidation rates are like double of what we even thought were achievable when guys follow a well-formulated ketogenic diet.
		And he recently did a study using a ketone salt product showing that there was an enhancement of 8% performance in work output with a cyclist.
joe rogan ▲ ● ▼		That's a big number.
dom dagostino ▲ ● ▼		8% is pretty big, yeah.
joe rogan ▲ ● ▼		8% for cyclists?
dom dagostino ▲ ● ▼		Yeah, yeah.
		It might have been time to exhaustion.
		He just presented it here.
		I didn't even know he had the data, actually.
		But, I mean, Jeff Volick is the leading researcher on, and he wrote the book, The Art and Science of Low Carbohydrate Performance, which a lot of MMA guys have benefited from because they email me.
		But these are studies that I'm really interested.
		I mean, we've done a lot of work in animal models, and now we're transitioning to human studies.
		We have a study at Duke University.
		So I mentioned oxygen toxicity to study this, you know, in humans in these big environmental chambers.
		At Duke.
		And then we do some stuff with NASA on the NASA NEMO mission I was on.
		But we're really interested in moving a lot of these animal studies, which we've done.
		Now we're ready to move it into humans.
		But we still don't know what the optimal supplement is.
		And that's why Ketone Technologies, the company we developed, is really focused on identifying not the supplement that gives us the best margins for sales, but the supplement that's super optimized for particular applications.
joe rogan ▲ ● ▼		Now, another question I wanted to ask you was about migraines.
		Now, I would assume that people with headaches, headaches, you take non-steroidal anti-inflammatories.
		Someone with migraines, I mean, it would seem to me that that would be something that might be able to help mitigate.
dom dagostino ▲ ● ▼		Yeah.
		There's a student, I'm on her dissertation committee, Elena Gross, and she was a student, graduated from Oxford University and is now doing a clinical trial on ketone salts for migraines.
		So what motivated her to even pursue this as a PhD project is that she had crippling cluster migraine headaches.
		And she reached out to me and she actually presented at our Metabolic Therapeutics Conference.
		And that's her area of expertise.
		When it's happening to you personally, it motivates you in a way that you just immerse yourself in the research and you become a leading expert.
		And I think at the very young age that Elena is, and she's got a great background of education behind her, She's kind of the leading authority on nutritional ketosis for migraines, which is a growing field because a lot of people who had migraines that have contacted me and tried either the ketogenic diet or ketone supplementation have benefited from it when nothing else worked for them.
		It doesn't work for everybody, but in some people that have these crippling headaches, it works better than anything that they've tried so far.
		And migraines, some of the data coming out, there's two sets of data that I've seen showing that migraines are linked to neuroinflammation.
		For example, if it's caused by a viral etiology, there's kind of swelling of the brain that leads to this kind Neuroinflammation and maybe the ketones are working through anti-inflammatory effects.
		Sometimes, like I said before, people get shingles or like a cold blister.
		They'll get like a headache throughout the day.
		And that's probably neuroinflammation.
		And then there's other data to show that these migraines actually may be like a mini seizure.
		Like your brain is actually having a mini seizure that's not manifesting as a grand mal or tonic-clonic seizure or even an absence seizure.
		But it's presenting as a migraine.
		And it's seizure-like, I would say.
		So some of the data is indicating that.
		And ketones seem to be a viable strategy for migraines, from what I've seen.
		And that's why it's being studied right now.
joe rogan ▲ ● ▼		The other question is, what about someone who's on a vegan diet?
dom dagostino ▲ ● ▼		Yeah, I get this a lot.
		I have a really close friend.
		She's vegetarian.
		Dr. Dawn Carnegas at IHMC. We've talked about this a lot.
		For a vegetarian, it's relatively easy, right?
		Because you have dairy and you have eggs, and eggs are a huge staple.
		I buy the Happy Eggs, which actually taste a lot better.
		They're like the free-range eggs.
		But a vegan diet is a little more challenging.
		The Charlie Foundation's dietician, Beth Zupac-Kania is her name.
		If you go to the Charlie Foundation website, I think you may be able to find some information or a pamphlet that describes how to put together a vegan ketogenic diet.
		So there's no way that you can hit the macronutrient ratios of a ketogenic diet that's vegan unless it's in a shake form.
		So in this case, you know, formulating a product that's more of a liquid form that you can drink is probably the way to go.
		If you do do a vegan ketogenic diet whole food, the best that you could do is really about maybe 60% fat, maybe 70% fat.
		And if you formulate the diet with coconut oil and MCT, that'll get your ketones up.
		And then if you consume one of these various products on the market that are essentially medical foods or drinks that you can drink, you can stay in nutritional ketosis.
joe rogan ▲ ● ▼		So it's a struggle.
dom dagostino ▲ ● ▼		It's possible, but it's way, much, much harder.
dom dagostino ▲ ● ▼		People do do it, though, and they follow vegan for ethical reasons or for cultural reasons, and they've been able to do it.
joe rogan ▲ ● ▼		But vegetarian is doable.
unidentified		Yeah.
dom dagostino ▲ ● ▼		Vegetarian is very doable with eggs.
		If you can use eggs and dairy, I tend to minimize dairy in my diet.
		But yeah, so eggs are huge.
joe rogan ▲ ● ▼		Do you minimize dairy because of the effect it has on you?
dom dagostino ▲ ● ▼		Like a lot of dairy protein, like whey.
		It kind of started with whey protein and I drank it for years and maybe I just built up an allergy to it.
		But if I were to drink like a full shake of whey protein right now, it wouldn't agree with my gut.
		Although I can eat butter and I can eat sour cream, fine, no problem.
		And a lot of dairy protein, especially casein, if I eat, not sour cream, cottage cheese.
		Yeah, that's what I'm thinking about.
		That can start to irritate my gut a little bit.
		So I generally just minimize it.
		Cheese is kind of a weakness for me, so I might get a little bite of cheese here and there.
		like almost every day even when I'm home but but I know dairy really was the the cornerstone of the ketogenic diet with the original ketogenic diet with the like what Johns Hopkins was formulating because it's so easy and it tastes good right right but I do find that when people are following the ketogenic diet for weight loss and they kind of pull out the dairy Their fat loss increases.
		So I've observed that kind of anecdotally.
		I'm not sure if people have studied it.
		But if they just, for example, pull out the heavy cream and put in concentrated coconut milk, which I use for my heavy cream, which almost has the same cream-like consistency.
		And they take out the butter, maybe use more coconut oil, and just kind of switch out dairy for other things, their fat loss.
		And something about dairy in some people, not everybody, maybe causes them to retain water.
		It might be like a mild allergen.
		So for me, I'm okay with it as long as I kind of minimize it.
		But I've just heard so many stories.
		One...
		There's a case report now of a mother who had an autistic child and put them on a ketogenic diet and did remarkably well and then made it dairy-free.
		And it was really the dairy that was contributing to some of the symptoms.
		This is in the medical literature.
		It's like on PubMed.
		She used a dairy-free ketogenic diet and had quote-unquote remission.
		In an autistic child, I first saw it presented in an abstract at a meeting, and I was like, wow, I was really blown away.
		And then about a year later, it came out, and it was in a pretty good journal as a peer-reviewed publication and a pretty well-documented case report of putting an autistic child into remission with a ketogenic diet.
		So we talk about emerging applications.
		I know my colleagues, Dr. Jung Rho and Dr. Susan Masino, are studying, and I mention this because I get so many emails about it, the ketogenic diet for autism.
		So I think it could be the next frontier.
joe rogan ▲ ● ▼		So many things are connected to inflammation.
dom dagostino ▲ ● ▼		Yeah, yeah, yeah, it could be linked to inflammation.
joe rogan ▲ ● ▼		And if diet, you know, reduces inflammation, and if diet without dairy reduces inflammation further.
joe rogan ▲ ● ▼		And I know a lot of people are having some great effects with CBD oils, which again, reduce inflammation.
dom dagostino ▲ ● ▼		Something I'm very interested in.
dom dagostino ▲ ● ▼		Yeah, talk to you.
joe rogan ▲ ● ▼		It seems like inflammation is just such a giant factor in negative health consequences.
unidentified		Yeah.
dom dagostino ▲ ● ▼		Ketogenic diet plus CBD plus hyperbaric oxygen therapy plus ketone supplementation is something that I wanted to study in a brain tumor model.
		I've just gotten too many emails from parents that have kids with epilepsy and also people who have cancer who use CBD oil and they felt it was remarkably, you know, effective for them.
		I've talked with the CEO of Charlotte's Web.
		I use that stuff all the time.
		I've never actually tried it.
		Is that their brand?
joe rogan ▲ ● ▼		Yeah, Charlotte's Web.
dom dagostino ▲ ● ▼		So is this standardized for a certain level of THC? It's below a certain level?
joe rogan ▲ ● ▼		Yeah.
dom dagostino ▲ ● ▼		Is each batch standardized?
joe rogan ▲ ● ▼		It doesn't get you high, if that's what you mean.
dom dagostino ▲ ● ▼		Yeah, okay.
		So that was sort of the problem.
		I tried to do this work with our university and then I need a DEA number and it was like all the students had to have a DEA and it became like so much red tape.
		But I'm going to revisit this project and probably reconnect with them.
unidentified		I'm sure they'll send you some.
joe rogan ▲ ● ▼		Yeah, I'll try to connect you if you like.
dom dagostino ▲ ● ▼		Okay.
joe rogan ▲ ● ▼		Because they're actually a sponsor of the podcast.
dom dagostino ▲ ● ▼		Really?
joe rogan ▲ ● ▼		And yeah, they sent me a bunch of it and I tried it out for a while before I took them on as a sponsor.
joe rogan ▲ ● ▼		I'm like, this stuff's legit.
dom dagostino ▲ ● ▼		Wow.
joe rogan ▲ ● ▼		I read up about it.
joe rogan ▲ ● ▼		They use the whole plant as well, so it has all the cannabinoids.
dom dagostino ▲ ● ▼		All the other cannabinoids, yeah, which I think is important.
		There's companies that have patented the specific cannabidiol on there, and I was going to use that, and there's a lot of DEA regulation even on that, I think.
		I'm going to revisit that project because I really think some of the things that we do with the Q-Jank Diet and supplementation will synergize, either be additive or synergistic with CBD. I love this idea of developing very powerful therapies that can Yeah, absolutely.
		absolutely I think it's possible yeah so with cancer it is tricky like every person is different but if you get a robust like healthy person to begin with and you can develop a therapy that manages their tumor And I've seen very healthy people come out severely crippled after rounds of chemo.
		I've seen people killed with chemo.
		I mean, I know quite a few people actually, sadly, that have been killed literally by the standard of care.
		And you should really have my colleague on here.
		He's a very dynamic speaker.
		It's a little bit controversial in some ways, but Professor Thomas Saifert from Boston College, he wrote the book Cancer as a Metabolic Disease, and it's a fantastic book that elegantly documents the theory of cancer as a metabolic disease with a lot of hard data.
		And Travis Christofferson wrote a book called Tripping Over the Truth.
		And I wrote the foreword to the book, which discusses why we view cancer as a genetic disease and kind of lays out the data and, you know, all the evidence to support cancer as a metabolic disease and what we should, most importantly, like what we can do about that in regards.
		And that has...
		Major implications for not only how we treat cancer, but how we prevent cancer.
		So I talked about, you know, fasting to purge your body of precancerous cells.
		So it would fall in line with that.
		But there's really good hard data behind, you know, this idea that cancer is not, maybe not necessarily all cancers are, you know, metabolic in origin, but a large majority of them appear to be.
		And I think the National Cancer Institute and other organizations are aware of this.
		And now they're funding more grants that actually target cancer metabolism and even developing metabolic therapy clinics for, you know, targeting tumor metabolism.
		So this was never, this never happened, you know, seven, eight years ago when I got into this.
		It was kind of unheard of.
		But there's a lot of interest now in pharmaceutical companies developing these target molecules that inhibit specific glycolytic sugar consuming pathways.
		So as evidenced.
		So, the ketogenic diet is great, right?
		Because it hits many pathways in synergy.
		Like, one of my slides, you know, that I have in my conversation or in the presentations that I do is clearly shows, like, you can see all the boxes there.
		So, this is the ketogenic diet and these are all the different signaling pathways that it's working through.
		And I would say pharmaceutical companies may put billions of dollars just into one of those little boxes.
		You know, the ketogenic diet works.
		It's so powerful because it's many different signaling, many different pathways kind of working in synergy for a common output.
		And this particular slide was the neuropharmacological effect that it has on suppressing seizures, the anticonvulsant effect.
joe rogan ▲ ● ▼		Wow.
dom dagostino ▲ ● ▼		And each one of these is validated with a number of peer-reviewed publications that you can bring up on PubMed.
		So it's not like something some guy put together.
		I mean, it's published and it's like you go to PubMed, oh, HDAC activity?
		There's like a half dozen publications to support each one of these.
		So that's what's really exciting to me because there's just like so much to be...
		Kind of discovered in so many different applications.
		And like I said, it feeds back to nutrition, which was one of the main things that motivated me early on in college.
		So I can go back to something I'm really passionate about.
joe rogan ▲ ● ▼		It's all fascinating, man, across the board.
		And thank you for sharing this, man.
		Thank you, really.
dom dagostino ▲ ● ▼		Thanks for giving me the platform.
joe rogan ▲ ● ▼		Thanks for going on the Tim Ferriss Show, and without that, I would have probably never heard of you.
dom dagostino ▲ ● ▼		I gotta thank Tim for that, yeah.
joe rogan ▲ ● ▼		Thanks, Tim.
		And if somebody wanted to get started with this, what's the best resource?
		Like, what do you think would be the best way to read into it?
dom dagostino ▲ ● ▼		I got a few.
		So I would say just go to our website.
		I have a website, ketonutrition, all one word, dot O-R-G. Okay.
		And on that website, I have a list of resources from e-books to, I mean, there's ketogenic pizza.
		What?
joe rogan ▲ ● ▼		How do you make ketogenic pizza?
unidentified		What's that?
dom dagostino ▲ ● ▼		Yeah.
		Is it almond flour or something?
		The crust is essentially like chicken and Parmesan cheese pounded into a crust where they put the...
		The cheese and the low-carb sauce on top of that.
		I love this stuff.
		It's Real Foods Company.
		Someone told me that they're in Ralph's here, so I guess they're doing really well.
		But I'll have one or two of those for breakfast in the morning, especially if I'm on the go.
		They're legit.
		They're really, really good.
		I've vetted out a lot of things and just very particular towards things that I really like and actually tested.
		So this is something that I've tested with Bloodwork.
		So ketonutrition.org.
		I have a link there.
		If you click on that link, you get a discount on the product.
		Max Love Project is really...
		I mean, if there's families out there, parents out there that have cancer, please contact the Max Love Project.
		And they're helping so many families through...
		Innovative application of the ketogenic diet for childhood cancers.
		Virta Health.
		So type 2 diabetes is like the elephant in the room.
		It's a massive project.
		Virta Health is basically tackling this project by curing, literally, quote-unquote, reversing type 2 diabetes in up to 100 million people in the next decade, I think.
		And I talked about people who are just embarking just on diet alone or the ketogenic diet afterwards.
		Avatar nutrition is a way that allows people to not only calculate their macros, because people are horrible calculating what they eat, but it has an algorithm in it that if you put in body composition changes on a weekly basis, it will tell you.
		You know, it will guide you step by step to your ultimate goal.
		And as far as I know, there's no other system like that.
		I mean, it's like, think of Weight Watchers, but like a version like 5.0 in Weight Watchers that actually works with you.
		So I think I'm going to have all these resources on ketonutrition.org.
		But if you Google any of those terms, Keto Pet Sanctuary for people who have dogs that have epilepsy or dogs that have cancer, look up Keto Pet Sanctuary.
		There's an e-book on there.
		It's completely free.
		You can download it and get the recipe on how to put your dog food together that can not only prevent or help treat cancer or seizures, but also just get your dog as healthy as possible.
		The Charlie Foundation, I really have to give, I acknowledge the Charlie Foundation in my TEDx talk, and they were probably one of the leading foundations that really convinced me in talking with Hollywood producer Jim Abrams and really convinced me that the ketogenic diet was legitimate outside of the peer-reviewed papers that I was reading.
		And there's a movie by Meryl Streep actually called First Do No Harm.
		So Meryl Streep did a movie on the ketogenic diet.
		What?
		Look it up.
unidentified		Really?
dom dagostino ▲ ● ▼		It's called First Do No Harm.
joe rogan ▲ ● ▼		Wow.
dom dagostino ▲ ● ▼		So Meryl Streep starred in a ketogenic diet movie.
		That's incredible.
		And that movie really floored me because I had no idea that she did it actually.
		But it's that movie and meeting Jim Abrams and what the Charlie Foundation is doing through global...
		Education has really inspired me to pursue this path, all the people that they're helping.
		So it was so cool that I feel really blessed to be able to get into a field of research that is in line with what I was funded to do, which was enhance safety, performance, and resilience in the warfighter, but apply it to so many other things.
		And also apply it to myself, which has been kind of a journey in and of itself that I've really enjoyed.
joe rogan ▲ ● ▼		Amazing stuff, man.
		Again, thank you very much.
		Thank you really.
dom dagostino ▲ ● ▼		Thanks for having me, Joe.
joe rogan ▲ ● ▼		I can't thank you enough for being here.
		It just blew me away.
		It was awesome.
dom dagostino ▲ ● ▼		Thank you.
joe rogan ▲ ● ▼		Thank you.
joe rogan ▲ ● ▼		All right, everybody.

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