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Dominic D’Agostino on Ketogenic Diets, Exogenous Ketones, Brain Health, and Cancer Metabolic Therapy
Dr. Ben Weitz introduces the Rational Wellness Podcast and interviews ketogenic diet researcher Dr. Dominic D’Agostino of the University of South Florida. D’Agostino explains how his work on CNS oxygen toxicity and seizures led him from antioxidants—which showed limited benefit in whole-body models—to ketogenic diets and exogenous ketones. He reviews proposed anti-epileptic mechanisms of ketosis including improved mitochondrial ATP, reduced oxidative stress, increased GABA, adenosine effects, and epigenetic signaling, and discusses age-related declines in brain glucose utilization and insulin resistance. He defines ketogenic diets by measurable ketone elevation and describes emerging continuous ketone monitoring. D’Agostino compares ketone esters, salts, MCTs, and 1,3-butanediol, cautioning about potential liver effects and dependency with butanediol, and favors ketone salts plus MCTs. He outlines a sustainable, fiber-inclusive keto approach, discusses lipid/LDL considerations and therapies, and summarizes research and observations on ALS, Parkinson’s, and combining ketogenic metabolic therapy (including hyperbaric oxygen and glutamine targeting) with cancer care.
00:59 Meet Dominic DAgostino
04:52 Antioxidants vs Ketosis
07:48 Ketosis for Epilepsy
10:16 Ketones and Brain Fuel
13:52 Continuous Ketone Monitors
18:25 What Drives Keto Benefits
24:22 Best Keto Supplements
31:24 Protein Targets and Ketosis
32:31 Keto Foods and Daily Staples
34:59 Saturated Fat and LDL Debate
36:45 Cholesterol Drugs and Statin Risks
41:13 Natural Lipid Lowering Options
43:00 KetoFlex for Brain Health
45:44 Ketogenic Therapy for ALS
50:03 Parkinson’s and Ketone Support
51:20 Cancer Metabolism and Keto Research
52:51 Targeting Glucose and Glutamine
57:21 Fasting Mimicking Diet and Muscle
58:54 Wrap Up and Where to Learn More
Dr. Dominic D’Agostino is one of the world’s leading researchers on the ketogenic diet. Dr. D’Agostino is an associate professor at the University of South Florida’s Morsani College of Medicine and a research scientist at the Institute for Human and Machine Cognition. Here is his listing at USF which includes his list scientific publications: https://health.usf.edu/medicine/mpp/faculty/ddagosti He also has a website: KetoNutrition.org.
Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure. Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.
Dr. Weitz: If you’re looking for clinically useful insights, not wellness hype, then this is the place for you. Welcome to the Rational Wellness Podcast, the podcast for functional and integrative practitioners who want to practice with greater clarity and precision. I’m Dr. Ben Weitz, and each week, I sit down with the leading clinicians, researchers, and lab innovators to explore the science, lab testing, and clinical reasoning behind modern root cause medicine. This is a show focused on practical, evidence-informed insights that you can actually use in patient care. Please subscribe to the Rational Wellness Podcast on Apple, Spotify, or YouTube. Please tell your friends and colleagues, and if you could give us a ratings and review on Apple or Spotify, we would certainly appreciate it. Finally, to access the show notes and the full transcript, please go to my website, drweitz.com.
Today, I’m excited to welcome Dr. Dominic D’Agostino to the Rational Wellness Podcast. He is one of the world’s leading researchers on the ketogenic diet. Dr. D’Agostino is an associate professor at the University of South Florida and a research scientist at the Institute for Human and Machine Cognition. His research focuses on the mechanisms and therapeutic applications of ketogenic diets, ketone supplementation, and other metabolic interventions. His work has explored how ketosis influences brain energy metabolism, neuronal excitability, oxidative stress, neurological conditions, including epilepsy and neurodegenerative diseases, and he’s also investigated the potential role of ketogenic metabolic therapy in cancer.
[00:02:00] Today, we’ll explore the science behind nutritional ketosis, the differences between ketogenic diets and exogenous ketone supplements, and potential implications for brain health and cancer. Before we get started, I just wanted to let listeners know that if they would like to book an appointment with me for a functional medicine consultation, they can request an appointment online by visiting my website, drweitz.com, and click on Appointments.
Dr. D’Agostino, welcome to the Rational Wellness Podcast.
Dr. D’Agostino: Great to be here. Thanks for having me, Ben.
Dr. Weitz: So what initially led you to investigate ketones?
Dr. D’Agostino: Yeah, I, majored in nutrition. I always had an interest in nutrition and biology as an undergrad at Rutgers University. And then, I was at Robert Wood Johnson Medical School. They had a PhD program and I studied the effects of hypoxia on the brain, majored in [00:03:00] neuroscience and in physiology. And then I did a post-doctoral fellowship in Ohio, looking at the effects of high oxygen levels, oxygen toxicity, more for military applications. And in the process of trying to understand The cellular and molecular mechanisms of CNS oxygen toxicity, which is kind of rare and kind of, you know, it’s something Navy SEAL divers, it limits their diving for certain covert dive operations. It’s, also a limitation of hyperbaric oxygen therapy, which some of your listeners may know. and I know, you know, it’s gaining popularity. Dr. Perlmutter has been talking about it for brain health and, you know, it’s an expanding field. so, so oxygen toxicity can cause seizures and, and the, the posited mechanism was that it was an overproduction of oxygen free radicals.
So I focused on antioxidants. I always was fascinated with antioxidants, in particular alpha-lipoic acid and vitamin C and vitamin [00:04:00] E and, glutathione, those things. And those things actually work really well to, to preserve brain function or neuron function in cell culture. but they did not work for oxygen toxicity. There, there was always like a slight benefit. so I looked at various antiepileptic drugs and things like that, and ultimately discovered that, and somehow this missed my whole education when I studied nutrition science, you know, at, at, at Rutgers, that a ketogenic diet was used for drug for epilepsy and drug refractory epilepsy. So I pivoted my research from drug research really to understanding the ketogenic diet, and that later, resulted in the development of exogenous ketones that can mimic the diet for that particular application and, works remarkably well, actually.
Dr. Weitz: That’s really interesting. I’m kind of surprised that antioxidants, nutrients that reduce oxygen stress [00:05:00] didn’t work to block the negative effects of high-dose oxygen.
Dr. D’Agostino: Yeah. You know, in cell cultures and also in the hippocampal brain slice preparation, which I did a lot of, I did, you know, confocal microscopy looking at the mitochondria and, electrophysiology patch clamp, you know, whole cell perforated patch clamp, you know- … sharp electrode. All these advanced techniques always showed a benefit at the cell level and the mitochondria level. but you know, when we’re, when our bodies are exposed to whole, you know, whole body physiology, that’s different in that you get, you know, stimulation of the autonomic nervous system or sympathetic tone, and there’s a lot of things happening. And I think that underlies the benefit of a nutritional metabolic intervention because you are hitting so many different things simultaneously.
And as a cellular neuroscientist that I was trained, I didn’t really appreciate that [00:06:00] until You know, my mentor was a physiologist, and she always said, “Just know physiology and then you know, that you’ll have an edge on everybody else if you just- … really understand physiology.” And I teach medical physiology and I teach, you know, those things, and I think it helps me understand mechanisms better.
But ketones, and that could be elevated with fasting, the ketogenic diet, or exogenous ketones really change our metabolic physiology, and that has profound effects on our brain energy metabolism and also signaling and these things. Not that antioxidants are not beneficial. I do think, and I still want to go back to that research, and we’re still continuing the antioxidant research because there’s always, like, a little benefit, but to get a statistically significant benefit, you have to do, like, you know, 30 animals, right?
But you could get statistically significant benefits with ketones with like three or four animals. Like it’s so, you don’t even need- … stats to like do it. So, so we, focused on that, and I always had kind of a negative view of the ketogenic diet in 2006, [00:07:00] so, a- as did the military at the time. So they were interested in, M- It’s funny because I’ve been follow- I’ve been on a ketogenic diet for 15 years, but, but the military kind of wanted… They’re like, “Well, we’re not going to fund, you’re, we’re not going to fund your proposal, but if you could develop a ketogenic diet in a drug.” So I spent about three or four years to do that, and, we…
Some things we shelved and other things worked remarkably well, and then we stuck with those things. And we’re further advancing many different molecules that I think, are way less side effects than anti-epileptic drugs, and they have, you know, many benefits for other applications, so we’re…E- even cancer. So I know you had Dr. Thomas Seyfried on, and we published exogenous ketone research with him, too, so.
Dr. Weitz: And can you explain the mechanism by which ketogenic diets help with epilepsy?
Dr. D’Agostino: Yeah. that’s a good question. And, you know, there’s actually, like, you [00:08:00] know, conferences and special interest groups trying to figure this out. And, you know, everybody has their own mechanisms. Everybody’s saying, you know, it’s the gut microbiome because it increases Akkermansia and that, you know, that it, And, you know, I haven’t studied that partic- we’re studying that now. But, what we can, what we do know is that when the brain is metabolizing ketones for energy, oxidative stress goes way down.
And if you have even, like, a, a brain slice in a dish, y- we cut a, we cut the brain like a piece of bread, actually, very thin slices, and we can keep it alive with something called artificial cerebrospinal fluid. And you can hit the brain with all sorts of chemicals, hypoxia, hyperoxia. And what’s interesting, when you’re feeding it ketones, it can maintain ATP levels in the mitochondria.
So that was an interesting observation. So there’s the energy component. There’s the GABA component. We convert more glutamate to GABA, and GABA stabilizes the brain a- the brain [00:09:00] networks. adenosine is something that we’ve published at least six papers on, and there’s all sorts of adenosine receptors.
But when you hit adenosine, it’s neuroprotective, but it also, it vasodilates, so you get more blood flow to the brain. and then there’s, you know, one of my students just focused on ketone epigenetic effects, and that has been, like, everybody’s focusing on that now, you know. Kind of fields change because we’re all about epigenetic drugs and things like that.
And she convinced me, you know, with her dissertation that, that ketones directly interact with the histone to actually change gene, gene, str- activation. So epigenetic effects, you know, is basically gene, certain genes, neuroprotective genes can be turned on, and I don’t think that’s unique to ketones because lactate can do it, and probably other metabolites, but ketones tend to do it very well.
It’s called beta-hydroxybutyrylation. And then, beta-hydroxybutyrate, the ketone, can also activate different enzymes, like histone [00:10:00] deacetylase, enzymes, a- and function in ways that can then, you know, affect gene transcription. So, you know, I’m probably telling too much, and it, gets kind of complicated, but I think there are multiple mechanisms in synergy that contribute to that.
and I think as we age, our brain’s capacity to use glucose as a fuel also declines. And there’s a blood flow effect. It’s, a- It’s the transport of glucose across biological membranes with the glucose transporters. It’s also enzymes. The pyruvate dehydrogenase enzyme is less active, and there’s less of it.
So ketones bypass everything I just mentioned there, right? And they just, they can easily cross membranes, and they bypass these bottlenecks, these rate-limiting enzymes and can be gener- and they can generate ATP in the mitochondria, much easier and more, it’s more readily available. The, the brain is very opportunistic, so if you give it ketones, even [00:11:00] on a standard diet if you give ketones with exogenous ketones, or I love MCT oil too if you can tolerate it, that can give the brain an alternative fuel and help to restore and preserve brain energy metabolism.
Dr. Weitz: It also gets around the difficulty of the brain to get glucose given insulin resistance.
Dr. D’Agostino: Yeah, that’s a big one, too. Yeah, and, there’s insulin sort of resistance in the brain. you know, some people call type, 3 diabetes, you know, diabetes of the brain. And, I’ve communicated with the, the authors that kind of coined that, that term, and I do believe that’s happening and I think that’s a factor, too. And then, you know, I think there’s a prescription intranasal insulin that people are using, and it produces a little bit of a beneficial effect. and now ketones are not like the cure- I-
Dr. Weitz: is that intranasal, so it gets into the brain?
Dr. D’Agostino: Yeah, There’s, you know, that you have You can get access to the brain almost through the [00:12:00] nasal passage in a way that, if the peptides are kind of small enough and you have a good delivery transdermal system, it could, you can readily, uptake, small amounts of different chemicals. So intranasal has been out there a while. We have not done studies with that, but I think it’s a demonstration that if you know, you can deliver things intran- You wouldn’t want to do that with ketones.
People are probably trying to do that. Because you do need to d- deliver quite– Ketones are acidic, too. Or the free acid form. But they, you do need to have sufficient quantities in your body to elevate the blood levels into the millimolar range, and that represents a significant amount of energy to really get, to get an improvement in, like, outcome measures, you know, that we see cognition, reaction time, strength, resilience. I mean, that’s what our lab study is, like, brain resilience under extreme environments.
Dr. Weitz: Are ketogenic diets beneficial? Well, [00:13:00] first of all, why don’t we define what a ketogenic diet is and- Mm-hmm … and, perhaps also talk about what is a good ketogenic diet.
Dr. D’Agostino: Yeah. There’s a lot of confusion and a lot of misinformation about ketogenic- … diets. many people think that it’s a, a high protein diet and, and many people think that, you know, it’s just bacon and eggs or… So a ketogenic diet is the only diet that’s, to my knowledge, defined by an objective biomarker, and that biomarker is the elevation and sustainment of ketones that can be measured in the urine, in the breath, in the blood, and also, I’m wearing a device on the back of my arm that’s a continuous ketone monitor and a continuous glucom- glu- glucose monitor, and that measures the ketones in the interstitial fluid, you know, around the tissues.
Dr. Weitz: So, Is, that commercially available now?
Dr. D’Agostino: almost. Yeah. I, you know, I work with different [00:14:00] companies, and then I test and evaluate them, and some pass the test, some do not. But- Huh … I can tell you that the technology’s just about there. and it’s about, you know, the ketone monitors are almost as good as the glucose monitors now. the sensitivity kind of tapers off a little bit towards the end of the life, and so I think they need to, you know, maybe improve some of the, the hardware a little bit. but I think, I think it’s, there, and it’s a, for me, for a researcher- So
Dr. Weitz: when you say- … it’s been cool … when you say, tapers off during the life, y- most of these sensors are for, like, two weeks. So you’re saying towards the end of the two weeks it’s less accurate?
Dr. D’Agostino: Yeah, the first three or four days I find that they are remarkably accurate, actually. and then for example, by the end of the week, if my continuous ketone monitor is reporting one millimolar, my blood is at two. So one way to go about that, to change it, and I- By
Dr. Weitz: the way, is that the same for the glucose monitoring effect?[00:15:00]
Dr. D’Agostino: Now, the glucose monitors are, they change sensitivity over time. Like, the Dexcom, you can actually go into the app and then calibrate it with your blood. So it, that simple feature would basically make the ketone monitor more useful if they can add that feature, and I’ve been telling them that for about two years now. So hopefully they do that. but you know, the Dexcom does that. The Abbott Libre, I don’t think they have that function yet. maybe they do. I’ve been telling them to do it. but the simply, because I do think blood is the gold standard, and I do think that, you know, if we can periodically just calibrate it, you know?
And some people are, very picky about precision, accuracy and precision, and if we can do that, especially as a researcher, that’ll, that, that would help us. That would help patients too. And that would help not just patients, but the everyday person who wants to use this monitor to just optimize their metabolic health.
Dr. Weitz: So how would you do that? You would have to prick your finger, but then the finger prick [00:16:00] monitors have some issues with accuracy too, right?
Dr. D’Agostino: That is true. Yep, that’s true. So, I, tend to use, and this is a little bit overkill, but I will– I have, the Keto Sense meter, the Abbott Precision Xtra, the Keto Mojo device, and then another device. I will take a, a big drop of blood, and then I will put it on all of them. And then, what I find is that the Keto Mojo device is, probably, is, pretty accurate and it correlates with their assays that we run in the lab, and that’s a good indication. And then the k- the, the Abbott Precision Xtra device is also good, with a, I would say an error of about 10%, give or take 10%. And, that’s significant, but, I think, you know, it’s relative changes that we’re after. And for the general user, I think that’s fine, right?
Dr. Weitz: Interesting. Yeah.
Dr. Weitz: looking [00:17:00] forward to having continuous ketone monitors.
Dr. D’Agostino: Yep. And I think they will be– I mean, they’re going to be great for like type 1 diabetics, for ketoacidosis, and things like that, but I think they’re going to be a very valuable research tool, if we are going to correlate ketone levels with outcome measures. So that’s from my standpoint from like, you know, federally funded research to help validate, you know, w- you know, the levels of ketones to certain applications, to brain function, or even we have a clinical– we have a NIH R21, funded clinical trial at Moffitt Cancer right now– Cancer Center right now.
So and I think that, you know, these, these tools will really help, us as researchers understand the, h- how to correlate the, ketone levels to the outcome measures. So if we have like 100 patients and they all wear these devices, we can go back and look at outcome measures and see, oh, these patients didn’t do so well because they weren’t really in a state of ketosis, whereas these patients, you know, they [00:18:00] maintain ketosis 80% of the time and they have much better outcome measures.
So they have shown that actually in metabolic psychiatry, which is a- another field that we can talk about. But the general– the gist is that for bipolar, schizophrenia, and major depression, that the benefits of the ketogenic diet correlates, with the ketone levels
Dr. Weitz: Do you think that the benefits of the ketogenic diet are mostly attributed to elevated ketones, reduced glucose and insulin, or caloric restriction, or to weight loss, or some combination?
Dr. D’Agostino: Yeah, you hit on… Yes. y- and you, I, and you nicely hit on pretty much I think all the important mechanisms right there. yeah, it’s interesting. A low-carb diet can bring down glucose and help to reduce insulin resistance, and people on low-carb diets [00:19:00] generally are not in ketosis. So that’s just showing that. I do think for the average person, a low-carb Mediterranean, if you want to call it that, diet, can do the heavy lifting and get people, healthy and help to…
There’s a satiating effect to, you know, eating more pr- a little bit more protein, a little more fat, You know, protein, fat, and fiber are, all very kind of satiating and can help, lower blood glucose. many ketogenic diet practitioners and carnivore practitioners, nothing against carnivore per se, because I think it’s, it has its place, but they, have a very limited amount of fiber and a limited amount of, phytonutrients and things like that.
And I do think for the average person, that’s not a good thing, long-term just because there’s so much epidemiological data, you know, on the benefits of fiber. That’s hard to argue with, but it’s also hard to argue with the person who goes on a carnivore diet and basically cures like, you know, ulcerative colitis [00:20:00] or, you know, helps restore their, guts and autoimmune diseases.
I, yeah, I’ve seen that too, and there’s some research going on that. but, yeah, to, so, a keta- the optimal ketogenic diet is one that someone will sustain. Yeah. And, and my, position now is that for most people, a, a clinical ketogenic, you know, and I say clinical, which means, you know, one that actually produces and sustains continuous ketosis, is not the best diet per se for the individual.
The best diet would be, you know, a, a mixed low carb diet for sure, unless, you know, even with athletes, they can sustain, you know, a lower car- lo- lower than they think they can. And, but to, to elevate ketones with, you know, medium chain triglycerides, so you get the benefits of, you know, low carb and there’s many benefits to staying low carb on glycemic variability, [00:21:00] inflammation, brain function, insulin resistance, you know, the list goes on.
and then, you know, those people will not be in a state of– their blood glucose may go low, and their brain may be a little bit hungry for glucose, especially when they start. And one way to mitigate the brain energy gap is to basically you could, work in MCT oil three times per day. Start with one tablespoon, you know, three meals, spread that out or even a half if you’re sensitive to it.
And I mean, that’s ju- that’s like the, that’s like the poor man’s ketone ester or ket- exogenous ketone. And then, and then you can work up to a ketone salt, and I do think that the ketone salts are my go-to because they taste good and there’s probably more data behind them historically. They’ve been around for a long time.
And then also your body tends to like dump a lot of sodium and dump a lot of minerals. You know, when you are low carb, because lower insulin, you have a, diuretic and a, natriuretic effect you lose, and you can replace that with, sodium [00:22:00] beta-hydroxybutyrate. And I do believe that the two different enantiomers are also really important.
So your liver primarily makes D beta-hydroxybutyrate, that enantiomer. in circulation, you get about 4% of that is the, opposite molecule, the L beta-hydroxybutyrate. So it’s like a mirror image. So now we know, that L beta-hydroxybutyrate stays in circulation about five times longer. So if you give it as a supplement, it’s almost like a, it’s like a time-released ketone, and that, that molecule then has a much greater signaling effect simply because it stays in circulation and is not broken down by ketolytic enzymes as rapidly.
And if, someone’s on a ketogenic diet and you just pull the heart out, about 34% of the heart’s ketones are this L beta-hydroxybutyrate. So people, researchers in the field are trying to figure out, like, why this is, and but they, but when they infuse pigs or animals with D and [00:23:00] the L, increases cardiac output about four times more than the D.
And you, and that’s due to a relaxation of the blood vessels. Peripheral vascular resistance goes down, and cardiac output goes out, and that can increase brain blood flow, and it also has a stronger anti-inflammatory effect. So,
Dr. Weitz: And it could have an anti-hypertensive effect as well.
Dr. D’Agostino: It does, yeah. It, interestingly, when you give sodium DL beta-hydroxybutyrate, even at 30 grams of sodium DL BHB- Wow blood pressure go- blood pressure goes down. Wow. well, you know, I mean, I teach renal physiology and GI physiology and know quite a bit of renal physiology. And s- salt sensitivity is associated with sodium chloride, so if we give, like, sodium citrate, or we give sodium bicarb, like, these things don’t increase, you know, they don’t, result in the expansion of the plasma volume in a way that causes [00:24:00] hypertension like sodium chloride.
That chloride, you know, we know, you know, with cystic fibrosis and things like that or cholera, for example, water follows the chloride. So it’s the chloride component of the sodium that is really associated with that salt-induced h- we call them ketone salts, but it’s not, a type of salt that will increase, make you salt sensitive or hypertensive
Dr. Weitz: Let me, for some listeners who might not be following this part of the conversation, you’ve brought up the idea of supplements that can help generate, putting you in a, a, having ketones in your blood. And, so there is several different types of supplements, and so you mentioned ketone esters, ketone salts, and then there are precursors to ketones, like medium-chain triglycerides from- Yep … coconut oil, and I guess coconut oil could also be [00:25:00] considered a precursor. Yep. And then there’s also ketone IQ, which is another molecule that gets converted into ketones.
Dr. D’Agostino: Yeah, so and that’s an interesting story there with 1,3-butanediol. 1,3-butanediol is a fascinating molecule, and actually, you know, early experiments in the ’50s and ’60s proposed to use 1,3-butanediol as a long-duration space fuel because it’s high energy density. It produces ketones. the only pr- the main problem was that it tasted like, it tasted really bad-
like almost like jet fuel, and it had a narcotic effect. So 1,3-butanediol is what we call a dialcohol or a glycol. When you consume 1,3-butanediol, it goes to the brain, and it activates networks that ethanol also. So there is, when you consume 1,3-butanediol at a high dose chronically, at a level that you, that sufficiently elevates beta-hydroxybutyrate, [00:26:00] it can cause dependency and withdrawal symptoms when you get off of it.
Like, you know, that’s not really discussed a lot, but I, think it’s important enough that I’ve pivoted away from 1,3-butanediol. We’ve published some nice data with it, but I’ve also pivoted away from 1,3-butanediol-associated ketone esters. For example, the ketone monoester, like Delta G or, you know, KetoneAid.
So that molecule is more than 50% 1,3-butanediol, and when you take it, the levels of 1,3-butanediol in your brain are actually higher than beta-hydroxybutyrate. So and I think that is, going to be problematic, not from the context of, like, the military operation I said, where, you know, we’d give, like, a large dose a couple times during the mission.
But for, like, that person who’s using it, like, you know, every day chronically or using it at a high dose to manage something, the continuous exposure of the 1,3-butanediol, it needs to get metabolized in the liver, and it does [00:27:00] that through two enzyme systems. That’s alcohol dehydrogenase and aldehyde dehydrogenase, and that sucks up a lot of your NAD.
So your liver ATP levels drop really quick, and you want your liver to be a high energetic state- Just like ethanol, if you drink enough of it, it de-energizes the liver. And if you– You can take hepatocytes out and expose them to 1,3-butanediol or feed it to an animal and take the liver out, and the ATP levels are like fifty, sixty percent down.
So I, do think that’s problematic, and we’ve published a couple papers Showing that when you give the, the 1,3-butanediol associated ketone ester and 1,3-butanediol, we see histological changes in the liver that are not good. so, you know, I’ve actually published and have a lot of patents on 1,3-butanediol and associated es- esters, but I’ve kind of pivoted away from that and we’re actually developing molecules that are not, that [00:28:00] put the beta-hydroxybutyrate onto another carrier molecule.
That could be glycerol, for example. We have triglycerides. you can get glycerol and it, that can accept three ketones. It could be acetoacetate or beta-hydroxybutyrate. So these molecules look to be very promising. and but just straight up 1,3-butanediol is kind of like a fun molecule because you’ll get buzzed from it.
And you’ll get… And, you know, I, you know, I have… To be honest, I mean, this was 1,3-butanediol. So and I’ve, used it, but at the same time, I’ve also saw pr- changes in my liver. My transaminases pop up and, one, one thing that pops up is that I tell people to measure is GGT. You get AST and ALT.
Dr. D’Agostino: always measure- And
Dr. Weitz: GGT … GGT, yeah.
Dr. D’Agostino: Yeah, and you probably see that even in the person that’s drinking, like, two or three glasses of wine per night, you’ll see that kind of elevated and, you know, it’ll be double or triple of what it should be if they’re drinking, like, five or… And that gets [00:29:00] elevated with 1,3-butanediol.
So that’s kind of like the canary in the coal mine. It just means that your liver is working harder and, you know, w- we don’t want our liver to work harder, you know, especially
Dr. Weitz: over the population. So, so it sounds like for those who are trying to either augment a ketogenic diet or get some of the benefits of the ketogenic diet by having ketones, the best supplements are either the ketone salts or the MCT oil in your opinion?
Dr. D’Agostino: Yeah. Yeah, absolutely. and actually, if you combine those two, you could get levels that, that, you can get with a ketone ester. And, and actually higher is not better, so that’s another thing. You don’t want to spike your ketone levels to, like, you know, three, four, five, because that represents an energy surplus, and it also increases insulin.
When we quickly spike our ketone levels above a delta of two, for example, then the body will secrete some insulin, and that’s, it, th- the [00:30:00] counter, right? You want to avoid that. So MCT, you don’t get that with MCT, and you don’t get that with the ketone salts. And the ketone salts also have the two different enantiomers I talked about, the D and the L.
So, so that’s a good, combination to use and, I mean, that’s what we were using in our clinical trials. I’ve evaluated… I pulled everything on PubMed- NIH RePORTER, clinicaltrials.gov, and we evaluated everything with a team of people and also with AI, and the thing that came out is the, you know, the ketone salts and MCTs.
you know, the data on that is probably better than the ketone esters, so we kind of pivot towards that. And you don’t… And ketone esters, if You get levels up really high, you can get, ketoacidosis. You can get toxicity. And we inadvertently, you know, in the early days, unfortunately kill- killed animals because we-
we didn’t know, we didn’t know the original doses, and we had to work down. and, you know, we never saw that, for example, with MCT or the ketone salts. [00:31:00] We never saw toxicity. So, so this is something to, consider.
Dr. Weitz: So getting back to the ideal ketogenic diet, what does it look like? How much is fat?
How much is protein? Some people, feel it’s really important that you not have too much protein, because protein can be converted into carbs. Mm-hmm. What is, w- in your opinion, what is the ideal ketogenic diet look like?
Dr. D’Agostino: Yeah. In the world of epilepsy, it’s 90% fat. But I think for everyday, you know, metabolic optimization and for prevention of chronic diseases, keeping a, a fat of anywhere between 80 to 60, is good.
and a fat level of 60 would be maybe better for that older person who needs to put on some muscle. So you’d, you know, you need to fill the gap with more protein. So, I’m, you know, I would say someone with, that’s older, maybe having some sarcopenia, or someone that wants to put on muscle should really be getting about [00:32:00] 20 to even upwards of 30% of their calories from protein.
That may not produce a state of ketosis, but they could fill that gap simply by taking an MCT supplement, you know, at each meal and, getting levels up to .5 or one millimolar, which is easily achievable with that. And, you know, if they don’t see the meter reading that, they could just take a, a ketone supplement too, and to keep that level up, and that will…
The ketones also have a, a muscle-sparing effect, a brain energy effect, and a anti-inflammatory, and a muscle-sparing effect. But, you know, I, you know, if I’m describing the optimal ketogenic diet, I tend towards more fish. that could be salmon, mackerel, sardines, anchovies, you know, and then, you know, tuna fish sometimes too.
and, poultry, you know, beef, maybe like twice a week. you get a lot of beef, and that could be maybe not settle well for some people. and then from the other foods would [00:33:00] be, extra virgin olive oil is, like, a staple. MCT oil for your fats. Butter is fine, in moderation. and something that I, like sour cream a lot.
And a lot of times I need to fill that fat gap with sour cream, especially if you can get a good active culture sour cream. And even like the, you know, the generic Daisy brands of sour cream are, pretty good. Full-fat sour cream. You know, one dessert that I do, I’ll put chocolate keto, Keto Spike cocoa.
So that’s actually has- high, polyphenol cocoa powder with DL-beta-hydroxybutyrate and a little bit of monk fruit, and I put a packet of… Audacious Nutrition makes the Keto Spike cocoa, and I put that into a small bowl of sour cream, and then, like, a handful of wild blueberries and some walnuts, and that’s, like, my snack every night.
You know, I’ll, have that, you know, a pinch of, you know, extra monk fruit or, sometimes I use allulose too, which is a, a, a good [00:34:00] sweetener. So, and then I, you know, usually have broccoli or a salad, asparagus. And I do like fruit, so I do have… I buy, like, small organic apples, and I eat, like, one apple a day just for the fiber.
but I do try to get about 20, 20 to 25 grams of fiber per day, and that could be from mixed green vegetables, salads, wild berries, walnuts, and, yeah, and even, you know, little odds and ends here and there. But I’m not super strict with my diet, but, I’m a creature of habit, so I just tend to eat the same things every day.
And, I’ve gravitated to optimizing it for my body based on blood work, based upon my ApoB, my, you know, H- HDL, triglycerides, hsCRP. I measure these things three times a year, and I’ve adjusted my diet over the years to sort of optimize, what I think are, you know, the ideal biomarkers for, longevity and health
Dr. Weitz: When you [00:35:00] were describing the ketogenic diet, you, mentioned butter, red meat in moderation. Is that because of the concern for, cardiovascular risk?
Dr. D’Agostino: It can be for some people, and I know that I’ve, gravitated… I do get quite a bit of dairy fat from the sour cream, the butter-
Dr. Weitz: So for, so, so- Yeah … for those who are listening, the id- the concept is that, it’s generally thought, especially in the conventional medical community, that high saturated fat is going to raise your LDL cholesterol, which will increase your risk of atherosclerosis plaque formation in the arteries.
Dr. D’Agostino: Yeah, and you know, that is being debated. I’d encourage people to watch the movie Cholesterol Code. it’s pretty good and, it offers a, an alternative explanation, especially for people who do see, who are in very good health. Otherwise, we call them lean mass [00:36:00] hyper-responders. a bit of an odd term, but the hyper-responder is, they are lean, and when someone goes on a low-carb diet, the leaner they get and the better metabolic, you know, fitness that they get over time correlates, interestingly, with an elevation of LDL cholesterol.
But you know, their triglycerides go down and, HDL goes up, blood pressure goes down, all these benefits. and I think that could be a potential concern if s- one has cardiovascular hi- a history of cardiovascular risk in their family, if they’ve had a previous heart attack, and most importantly, if they have, plaque.
So that would be, you know, calcified plaque or soft plaque. in those situations you would want to explore lipid-lowering drugs, the first one being Ezetimibe, Zetia, and that blocks the NPC1L1 receptor in the gut and also in the liver, and that’s for people who [00:37:00] hyper-absorb cholesterol. So that works very well for me because I have a genetic mutation for, hyper-absorbing cholesterol. Bempedoic acid is another. That, that combination-
Dr. Weitz: now let me just stop you for a second. Yeah. I heard you mention, the Zetia. Mm-hmm. And for you, because you’re a hyper-absorber- Yeah … and people can be hyper-absorbers or they can be hyper-producers, but it’s generally thought that most of the cholesterol in the bloodstream is being produced by the liver, which is- That’s true
the mechanism by which statins and Red Yeast Rice work. Yeah. So therefore, for m- most people, I would think if they wanted to lower their cholesterol, reducing liver production would probably be more important.
Dr. D’Agostino: Yeah. So a statin will definitely reduce liver production of cholesterol, but it also produces, systemic. So all your cells, like, you know, the Leydig cells of the [00:38:00] testes, the brain, the muscles, have the capacity, even independent of any cholesterol in circulation, our tissues themselves are actually, you know, making cholesterol. And when, And that’s important, you know, for repair of the tissues. And when you take a, a statin, especially for the brain, a lipophilic statin that crosses the blood-brain barrier, you’re inhibiting the cholesterol in, that organ, and that cholesterol plays an extremely important role for neurotransmission.
So, so a large dose of a lipophilic statin, can cause, you know, significant harm and damage. I-
Dr. Weitz: Okay. Yeah. Let me, stop you again real quick- Yeah, sure … because there’s a popular, expert in the functional medicine health world that you know well, who, claims that, getting your LDL ApoB very low is very important, including using statins, including using, [00:39:00] PCSK9 inhibitors because- and there is, and also argues that there’s not really a risk with taking statins, and there have been several studies that claim that statins don’t affect the brain, even though I’ve talked to Dr. Bredesen and other experts on brain health who say that they definitely do. the argument is that statins block the liver from producing cholesterol, but they don’t affect the brain’s production of cholesterol.
But you’re saying that statins do affect brain- Oh, yeah … production of cholesterol.
Dr. D’Agostino: Yeah. Yeah, the lipophilic ones do. I don’t think any cardiologist would actually, you know, argue that, or anyone ex- you know, any statin- Okay … researchers. But that is specific to the-
Dr. Weitz: Now, what about the water-soluble ones?
Dr. D’Agostino: Yeah. The less so, but the brain is not always in- c- completely impenetrable to, to, you know, to, certain- No.
Dr. Weitz: Now- Yeah … now we know that brains harbor, bacteria, and [00:40:00] viruses, and, toxins, and-
Dr. D’Agostino: Yep You know, the, dose or i- it’s very dose-dependent, and I do think, you know, a baby dose, I like to use the word baby dose, is probab- is okay for some people. a baby dose of statin is I think fine and maybe preferred in people who have had a cardiovascular event, who have high risk, who have, high Lp, for example, high ApoB, and they’ve had a prior heart attack. I mean, those people should be on the minimum dose possible. But before starting a statin, my…
You know, I, this is not recommend- this is not advice, medical advice. I’m a PhD, but I do, I’m the person who teach the medical students- … the kind of good stuff. my, my advice is to start dietary modification. that may do a little bit. You could use like something like psyllium fiber and in combination with ezetimibe, sold as [00:41:00] Zetia, bempedoic acid, and maybe even before, if you can, your insurance covers it, a PCSK9, inhibitor could be a good idea, especially for those high-risk people.
Because I do think that drug class is, has, has some benefits. You know, just by activating, you know, receptor and getting LDL clearance i- is going to be… But you can also achieve a PCSK9 inhibitor effect with, with, like something like Dihydroberberine, right? Right. So, and that can help lower your… You know, I didn’t know that actually until a couple months ago, and someone mentioned that to me, and I looked at the literature, and it’s pretty well-established in the literature that these things have PCSK9-like effects. and there is Berberine, berberine has a lot of RCTs behind it too.
Dr. Weitz: Yeah. And there, there’s some evidence that it may even reduce plaque.
Dr. D’Agostino: Yeah. Yep, I think so. Yep. and also ezetimibe may be working independent of the cholesterol too. It seems to have, just like independent effects on brain health and plaque formation.
Dr. Weitz: So what about plant sterols, which might be considered a natural Zetia?
Dr. D’Agostino: Yeah, you know, I know less about that than I should- Sure … and I haven’t taken a deep dive into the research. I do think that for some people, plant sterols can be a good option. m- my thing is to just do comprehensive blood work, you know, at the very least Lp, ApoB, LDL, triglycerides, you know, maybe an NMR lipid profile- Yeah
sort of, scan Absolutely. Yeah
Dr. Weitz: Do particle count and stuff like that I think that’s, that should be standard.
Dr. Weitz: What about Red Yeast Rice versus statins?
Dr. D’Agostino: So that’s a good point. I think it could be a good option to go to Red Yeast Rice, before the statin and to try that, and if that doesn’t work, I do know people who’ve used that, and they’ve prevented them from having to take a statin, and they have no side effects. So that could be a good… Yeah, that’s a good suggestion, I think. [00:43:00]
Dr. Weitz: So when it comes to brain health and the potential benefits of ketogenic diet for, preventing, Alzheimer’s disease, Dr. Bredesen often recommends what he calls a KetoFlex diet. And his- Mm-hmm … so it’s a mildly ketogenic diet, so he’s pushing people towards a ketogenic diet, but not as hardcore, which you might describe a- I think you just described as a, a Mediterranean low-carb approach, I think- Mm-hmm, yep is probably a good way. And so what he’s saying is he’s trying to… He calls it KetoFlex because he wants the brain to be able to use both sources of fuel, glucose and ketones.
Dr. D’Agostino: Yeah. Well, the brain’s going to use glucose no matter what, right? Right. So, the idea is that to drop carbohydrates low enough and give sufficient dietary fat to get ketogenesis, you know, going, and [00:44:00] you can achieve that with exercise, too, right? Like, a low-carb diet, and if you’re exercising or you’re doing, time-restricted feeding, maybe called intermittent fasting, and these things are not mutually exclusive, right? So you could do, you could do time-restricted feeding with a low-carb Mediterranean diet and then add some MCT or ketone supplementation and, well, I just described what I do, actually.
So that, that, could be the better approach than, like, you know, the calculated epilepsy ketogenic diet, which is, you know, obviously very effective. I mean, we have our, you know, randomized controlled trials on that for brain health and, for seizures and stuff. But for the every– I do like the KetoFlex diet. I’ve read his books and, think that’s a good, you know- And
Dr. Weitz: I guess potentially- … complement, yeah … you could be cycling in and out. Your- Mm-hmm … your brain’s working on ketones. Now it’s working a little more on glucose and back and forth. Is there potentially- Yeah … some benefit to that?
Dr. D’Agostino: Yeah, I think the, the main benefit is that diet can improve metabolic [00:45:00] physiology. And simply by improving our metabolic physiology and cardiometabolic biomarkers, we know that those cardiometabolic biomarkers are tightly associated with better brain health. You know, and I’m just describing a dietary intervention and maybe some supplements too, but exercise is also a big lever to pull, and I think is maybe underrepresented, you know, by people who talk about diet a lot that, And I do think that the diet and supplement plus exercise is synergistic, meaning it’s like a, you know, a one plus one equals three kinda thing. And I do think that, And that exercise could be cardiovascular, or resistance training, and I think a combination of both is ideal
Dr. Weitz: so I know you’ve published also and looked into the use of the ketogenic diet for other neurodegenerative diseases. I know you looked into ALS. What do you think about the potential [00:46:00] for either, ketone supplements or ketogenic diet to help with that pretty horrific condition?
Dr. D’Agostino: Yeah, it is a horrific condition, and yeah, I’ve communicated with quite a few ALS patients. And I do think, it was Matthew Phillips in New Zealand has p- did a– posted a, clinical trial, published a clinical trial on that, that the benefits of, a ketogenic diet for ALS can improve, like, for example, symptom management of ALS, and actually help reduce the ALSFRS score, which is sort of the standardized score that we know of.
there’s less of a reduction over time. also I’d like to mention that I’m a, a consultant for Winning the Fight Against Neurodegenerative Disease Foundation, and that started out as an, ALS foundation. with, people can look up the Deanna Protocol, which is a metabolic-based protocol that gives alpha-ketoglutarate, GABA, [00:47:00] coenzyme Q10, and we also use MCT oil.
but the Deanna Protocol core supplements are alpha-ketoglut- glutamate– alpha-ketoglutarate and GABA. And those two supplements, seem to be very beneficial for ALS patients. There is a unbiased website called Patients Like Me where they evaluate everything, including drugs, and the AL- the Deanna Protocol for ALS has gotten significantly more positive feedback and reviews than, for example, the standard of care for ALS, and it’s, like, hundreds of reviews.
I think for the standard of care, there’s, like, thousands of reviews for that. But I think the– it’s, like, almost, like, double or triple the, the positivity rating for that. So I would direct people to Winning the Fight Against Neurodegenerative Diseases. that founda- foundation also explores the etiology of ALS, which we don’t have time to go into, but I think is– and I, do think infections ca- can, in some people activate, [00:48:00] neurodegenerative diseases.
But that’s all I’ll say about that because that’s a whole nother- I’d like to do a whole nother podcast on it maybe.
Dr. Weitz: Did you see the paper that came out towards the end of last year where, some researchers at Duke University reversed ALS?
Dr. D’Agostino: No. it reversed ALS in patients or animal models?
Dr. Weitz: In, a patient. And, the- Oh … the main researcher, Dr. Abreu, and the patient both were on Perlmutter’s podcast.
Dr. D’Agostino: Oh, cool …
Dr. Weitz: I have an interview coming up next week with Dr. Abreu. He’s got some sort of device that’s able to specifically heat up some part of the brain that plays a big role in this.
Dr. D’Agostino: I know what you’re talk- Okay, yeah. I’m familiar with this. I think he’s actually in, near the Tampa area too, and he’s someone I’ve been wanting to reach out to about this. so yeah. Thanks for putting me- that on my radar. I’ll definitely look into that. You know, there, there’s a number of [00:49:00] one-off cases like that, and I don’t know what to make of them.
but I do know his scientific… he’s scientifically credible and has done some nice work. So I think, you know, these things, people, we- people need to look into this as a viable option, because yeah, because there really are no viable options outside of, you know, the Deanna protocol and standard of care offers very minimal benefits
Dr. Weitz: Yeah, I know people have explored the idea of infections, and Mm-hmm. I’ve talked to some functional medicine practitioners who, found Lyme disease to play a role in some patients who were diagnosed with ALS.
Dr. D’Agostino: Absolutely. Yep. Yep. Yeah, tick-borne diseases, Bartonella, Babesia, you know, Borrelia, and also viruses like CMV, Epstein-Barr, HSV. I think these things are pathophysiologically linked i- in, in many people to, to disease processes, and that could be [00:50:00] neurodegenerative, and that could be, you know, a whole host of what we call autoimmune.
Dr. Weitz: Well, what about Parkinson’s? Is there any application?
Dr. D’Agostino: yeah. I think… Well, ketones definitely. Yeah, th- there’s promising data on ke- ketogenic diets and even exogenous ketones. for Parkinson’s, the exogenous ketone studies showed m- like, significant improvements in physical performance, and that’s where ketones tend to shine, when there’s some kind of deficit.
Dr. D’Agostino: Right? so- Meaning like
Dr. Weitz: with the tremor or the, Yeah … some of the other- For sure … physical.
Dr. D’Agostino: Yeah, for the tremors, yeah, I’m definitely kind of observed that myself in patients, that immediately after they take it, the, the tremors stop, and,
Dr. Weitz: And would you think the ketone salts or the MCT oil would be better for that?
Dr. D’Agostino: Well, I would use… I would start maybe with the MCT, but I would use both.
Dr. D’Agostino: and I would use both, and I do think, yeah, supplying energy to those dopaminergic neurons in the substantia nigra that are degenerative, [00:51:00] you know, that, that can help with that, and also just overall energy levels, and many people with Parkinson’s get fatigue and, can activate, you know, dopa.
So, you know, do that in combination with, you know, the L-doba- L-DOPA and carbidopa combination, I- which I think is the standard of care.
Dr. Weitz: Interesting. we- we’re running out of time, but I wanted to at least, just touch a little bit on the cancer topic, and I know you’ve done a lot of research on ketogenic diets for cancer, and you’ve worked with Dr.
Thomas Seyfried, who I’ve had on the podcast talking about the metabolic theory of cancer.
Dr. D’Agostino: Yeah, for sure. Yeah, I’ve had, many PhD students go through my lab, do their dissertation on, you know, ketogenic therapies, hyperbaric oxygen therapies. We’ve also looked at drugs like DCA and metformin. a- above and beyond the ketogenic diet, a well-formulated ketogenic diet that’s a bit [00:52:00] higher in protein, 20 to 22% protein, is remarkably effective for slowing the growth of metastatic cancer.
Dr. Seyfried has this model of metastatic cancer that’s super aggressive, and it’s, like, probably, like, one of the most aggressive models that we have. And it’s, good to work with because, you know, if you get an effect, you can be more, more confident with it, and not too many, m- too many animal models have true metastatic, you know, potential.
So his does. And, so with Dr. Seyfried, our first was hyperbaric oxygen and ketogenic diet, and that worked really well in combination. And then we did a– we published a study with ketogenic diet plus ketone supplementation plus hyperbaric oxygen, and that even, you know, extended life in that model, I think, beyond anything that maybe he’s ever tested too.
So that was good. And then the next frontier is really targeting, you know, elevating ketones, lowering glucose, but also targeting glutamate. So [00:53:00] glutamate is used in these tumor-associated macrophages that we think are part of the metastatic process, and I think it’s going to be really important, if we really want to manage this disease process to target glucose, glutamine, in, in, the presence of elevated ketones.
And then you can come in with some of maybe the bigger guns, you know, i- if that doesn’t manage it, like, you know, radiation, chemo, and immune-based therapies. I know Dr. Seyfried is kind of opinionated negatively towards some of those things, but I do think, certain contexts, you know, these things, the standard of care can work really well, and it works much, better in the– in, you know, when you combine it with a metabolic therapy
Dr. Weitz: not that I have anywhere near the knowledge or, that you guys have, but I’m a little skeptical about the glutamate, ab- about the, yeah, glutamate, concept.
A- people keep picking out one amino acid and say, “Well, [00:54:00] if we just limit methionine, that promotes cancer. If we just…” and there have been probably four or five different amino acids that people have said, “Okay, this is the amino acid. This one, if it’s elevated- you have an increased risk of cancer.” And if people are eating proteins, they’re getting all these amino acids, and it’s hard to believe … that one particular amino acid is really promoting cancer.
Dr. D’Agostino: Well, it’s a good point, because we have a methionine PET scan, we have a choline PET scan, and these are actually better than an FDG PET scan for glioblastoma. A- actually, for astrocytoma and, oligo, oligo, cancers too. So a really good point that you bring up. I will say that, that cancer metabolism is, absolutely essential, to sustain in, only in the presence of glucose and glutamine. but that is not the case for methionine, [00:55:00] alanine, other gluconeogenic amino acids.
However, methionine, as you can use in a radiolabeled methionine scan, that what the cancer does, it uses mes- methionine for biosynthesis, and it uses alanine for bi- and also tyrosine and tryptophan. but for fuels, where if we’re just talking about energetic fuels, glutamine is by far, like far more important for the fuel for cancer, than any other amino acid.
It’s also more, available, like, you know, in circulation, most, abundant. So, so by that, you know… And, there’s no, You know, and ketones, some cancer cells can use ketones too, but ketones are not required fuel. So whereas glucose and glutamine are required fuels for can- and methionine’s important, but you could do methionine restriction and still cancer grows like crazy.
But you restrict, you cut out glutamine, and you’re going to cut off, you know, [00:56:00] cancer metabolism. So glutamine with, glucose. So that’s hard to do though, and I think, you know, we’re working on different drugs that could hopefully site-specifically do that.
Dr. Weitz: Yeah, I know Dr. Seyfried’s talked about using some drug that you pulse to reduce glutamine.
Dr. D’Agostino: Yeah. Yeah, that drug is called DON and, there’s some toxicity to it. But there’s other ways to lower glutamine with, sodium phenylbutyrate, for example, can conjugate it, and then you kind of p- pee out the conjugate. You could drop glutamine by about 20%. And also, EGCG can inhibit, glutaminase- Green tea
a little bit. Yeah, green tea. Green tea, that– A, a high dose of EGCG can be toxic to the liver, though, so you got to be a little bit careful with that. But, you know, there are other ways to target glutamine. one way would just do the, you know, moderate protein, do a lower protein ketogenic diet with the two things that I mentioned, and, exogenous ketones. Exogenous ketones also [00:57:00] reduce glutamine metabolism, so they… And then they have an effect on reducing glutamine metabolism, and that just could be through their, anaplerotic mechanism, so
Dr. Weitz: Yeah, a lot of times when I see discussions about methionine and some of these other amino acids, they’re usually in the context of this is why a vegetarian diet is best.
Dr. D’Agostino: Yeah. I’m glad you bring that up because I do think that Valter Longo’s ProLon therapy, which is a, methionine-restricted fasting-mimicking diet is, can be a good option for patients. Like, maybe they’re on a keto diet and they’re following this, and prior to, you know, radiation or chemo, they drop down to this, you know, extra like basically methionine, zero methionine, diet.
And, you know, it’s a proprietary formula, but he, they do have some data. They do have a lot of clinical trial data, and they have some data to suggest that it has some, sparing, muscle sparing effects too. So I’m a fan of, [00:58:00] Dr. Valter Longo’s approach- Mm-hmm … although I’m not a fan of low protein. and that could be, you know, bad for the cancer patients in some contexts.
But, I do think that a periodic fasting mimicking diet, And you could use, you know, his commercially available kits, which I think could be a great option for people, or you could sit down with AI and try to mimic the profile as much as possible and then, you know, make it in your kitchen. although the kits are not that expensive, so I usually just tell people, you know, “Get the ProLon kits.”
and I could say that people, it’s pretty much positive feedback from people that try that. the, the cancer patients. The, for the average person, they kind of don’t like the taste of some of the things, but it’s an option. It’s a good option potentially.
Dr. Weitz: Yeah, I do always worry about the loss of muscle. Sarcopenia is a real problem- Yeah … in general, especially for cancer patients and older patients.
Dr. D’Agostino: Yep, yep.
Dr. Weitz: Thank you very much for your time. This was an excellent discussion.
Dr. D’Agostino: Yeah. Thank you. Appreciate you having me on, Ben, and you know, glad to come on again and- Yeah … looking forward to this information coming out and sharing it with, you know. And if people want to learn more about what I do, ketonutrition.org … is, my website, information website. I don’t sell any products or services on there, just information. So, but you know, try to put information on there. Many things that we talk about on this podcast will be on there.
Dr. Weitz: Great. Absolutely. Thank you so much. Yeah, I look forward to maybe having another discussion about some of the other aspects of keto, like for longevity and some of the other potential benefits, exercise performance.
Dr. D’Agostino: Mm-hmm. Okay, glad to cover those topics next.
Dr. Weitz: Okay. Great. Thank you so much, Dom.
Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would very much appreciate it if you could go to Apple Podcasts or Spotify and give us a five-star ratings and review. As you may know, I continue to accept a limited number of new patients per month for functional medicine. If you would like help overcoming a gut or other chronic health condition, and want to prevent chronic problems, and want to promote longevity, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310-395-3111 and we can set you up for a consultation for functional medicine. And I will talk to everybody next week
