Episode 163 with Dr. Dom Di’Agostino


What’s up everyone? It’s me, Drew Manning, here with another great episode on the Fit2Fat2Fit Experience Podcast. Today’s guest is Dr. Dominic D’Agostino. Many of you have heard him either on the Joe Rogan Podcast or the Tim Ferriss Podcast. He has been on my Podcast once before. I’m bringing him back on a couple of years later to catch up. This is one of the smartest guys you will ever meet, but also one of the nicest guys you will ever meet, that’s what I love about him. We always have a good time when we talk. Today we go deep into keto and he answers a ton of questions about the ketogenic diet that I think will surprise a lot of people. He is an advocate for the ketogenic diet, obviously. He does a ton of studies on the keto diet. His research at USF, out there in Florida, is funded by the government and the Department of Defense. He works with the Navy Seals. So this guy is legit and he knows what he is talking about. I definitely love having him on. We go into a lot of topics about the ketogenic diet, whether keto is great long term or whether keto is great for women. How keto affects your cholesterol levels, all kinds of things. We talk about how he does keto now versus how he used to do it back in the day. We cover a wide variety of topics about the ketogenic diet. We also talk about The Metabolic Health Summit coming up in January of 2019 that I will be a speaker at. Dom will be there. There is going to be a lot of other people there and I think everyone is going to be interested in it. So go to MetobolicHealthSummit.com to check that event out. I think you guys will really enjoy the line of people that will be speaking at this event. It is not only a ketogenic event. It is a health summit, so it’s going to be an awesome event that I am really, really honored to be speaking at. So, check that out in January of 2019.

Drew: Alright, Dom D’Agostino, how are you doing, man? Thank you so much for joining me on the Podcast.

Dom: I’m doing really well. Yeah, thanks for having me.

Drew: Yeah man, it’s been ….

Dom: I appreciate being on.

Drew: Yeah, it’s been over two years since I have had you on the Podcast. *laughing*

Dom: Yeah, wow. Time flies.

Drew: Yeah, I know a lot of things have changed. I guess the first thing that I wanted to talk about with you is over the past two years in the field of research, what has been really exciting for you that is kind of up and coming since the last time we spoke up until now?

Dom: Hmm, it’s so many things I can’t mention obviously one or even five because there is at least ten. But I would say I did get a major grant that I had through the Department of Defense and the office of navy research. Stuff that we do for oxygen toxicity, which limits the navy seal divers, I had a renewed grant on that. To really expand the science and applications of exogenous ketones for enhancing war fighter performance and safety and resilience. So, we are vetting out the formulations of exogenous ketones, looking at things like racemic mixtures versus the esters versus salt’s. Medium chain triglycerides, formulating these things to not only look at oxygen toxicity, but to look at motor function. And look at performance and look at anxiety behavior, you know looking at many different spectrums. Because we don’t want to choose an agent that’s neuroprotective but then it decreases your exercise performance.

Drew: Gotcha.

Dom: So, we want the best of both worlds, so that’s a big, big part of what I am doing. Probably about two thirds of my time and effort is spent doing that. Last year, we did the NASA extreme environment mission operations. I was a crew member. It was a NASA mission. It’s a MARs analog. NASA has like fourteen different analogs. This is the one that actually uses astronauts. It’s a little more relevant I would say. I was really lucky to get on it. I’m supposed to be part of that mission right now, but because of the hurricanes last year, it got pushed out to next year. My wife will actually be a crew member. That has consumed, since the last time we talked, a big part of my chunk of time has been really doing human research with IRD’s and ethics committees and working with NASA in different capacities. That’s been another big chunk.

Drew: What do they have you guys doing or what did you guys do down there? What specifically were they testing?

Dom: NASA Extreme Environment Mission Operations, NEEMO, they come up with these cute little acronyms for everything, you know?

Drew: *laughing*

Dom: Basically we vet out different technologies. We use those technologies inside the habitat, which is a hyperbaric environment. Outside of the habitat is the ocean, right?

Drew: Oh, gotcha.

Dom: Where at the bottom of the Atlantic ocean, so we basically will test. We do what astronauts will do, we do EVA’s. We go outside and collect samples. We analyze the composition of those samples, whether it be the coral reef or whether it be a sponge or something like that. We come back to the habitat and we look at our microbiome. We look at our sleep. We look at our strength. We look at our body composition. My wife is a behavioral psychologist, so she analyzes my stress levels and gives me cognitive tasks and compares me to the astronauts. They are like super responders. They were selected because they scored really high on these kinds of tests. So we collected a lot of data from many different aspects, physiological, psychological, biochemical and metabolism.

Drew: Gotcha.

Dom: That is the big thing. The ketogenic diet is very energy dense. It’s neuro-protected and it has anti cancer properties. I have been giving talks at NASA over the years to basically present an idea that the ketogenic diet is about fifty percent higher energy density. Then it has all these biological properties when you stay in a state of ketosis, or do it intermittently. It’s a nutritional strategy that some astronauts are actually already doing. Because they are already doing it, they are working with their flight doctors to make it maybe an option on the astronaut list of foods that they are doing. I don’t try to change the policy, but what I do is I present to them a nutritional option that I feel personally, and many people even with NASA feels like this should be incorporated into the NASA nutrition program. I am at just the beginning steps of that and doing research on metabolism is part of the initial steps that need to be taken to vet out this nutrition strategy or technology whether it be exogenous ketones for long duration space flight mission to Mars.

Drew: Gotcha. Going back to exogenous ketones with the Navy Seals, you said you are working on different formulations to find out what is the most optimal, specifically for Navy Seals and brain toxicity. Could that be applied to your average person? I guess that is what you guys are testing with exercise performance and body composition and these other things, to find out is there one formula that is great for everybody? Or do you think it has to be tweaked depending on the situation, whether you are trying to help someone that has epilepsy versus someone that’s trying to lose body fat?

Dom: Very good question. I have to do a blog post on that, my keto nutrition blog post, because it is a question I get a lot and I am glad you asked it. I can tell you this so far, the ideal exogenous ketone formulation that is maximally neuroprotective for oxygen toxicity seizures, is not the ideal formulation that will enhance exercise performance. It may increase it just a smidge, maybe 5 or 10%, but there are other formulations that at least in rodent models can increase exercise performance up to 15% or 20% maybe. It may be that we take the anti-seizure formula and then we take the exercise formula and then we blend them in specific ratios to give the best of both worlds. That’s kind of where are at now. We do know that with oxygen toxicity or with any kind of seizure actually, any model of seizure we are studying, you have to elevate beta hydroxybutyrate and acetoacetate more or less in a one to one ratio. That gives profound anti-seizure effects. That’s a very unique formulation that requires a bit of effort on part of the chemist to do things and a bit of the formulator to do things. It’s very clear at this point that different exogenous ketones and formulations of those ketones have different effects whether it be epigenetic effects, anti-inflammatory effects, behavioral modification effects, changing biochemistry, anti-seizures, and the different things we are studying. Age related, so cognitive decline, different types of disorders we are looking at now, like cancer. We don’t know at this point in time we are studying different ketone formulations, but we don’t know what works best at minimizing the growth of cancer and also protecting against cancer cachexia. One of my students, Andrew a PhD student, actually gave a recent ‘Ted Talk’ on his Type 1 Diabetes and managing it with low carb actually. But he is studying muscle wasting. We are basically trying to get insight into muscle wasting as it relates to cancer cachexia to design and optimize the optimal ketogenic strategy to mitigate that. I think the information that comes out of there could be taken into the real world, because bodybuilders who are working out, strength athletes are subjecting themselves to muscle wasting just by virtue of the high intensity training. Military personal, maybe in austere environments or subjecting their bodies to high physical demands. Maybe at a catabolic state.

Drew: Gotcha.

Dom: We are not necessarily trying to increase anabolic state, but we are trying to attenuate or abolish the catabolic state that is really accelerated in things like cancer, metastatic cancer and under different environmental situations.

Drew: Gotcha. Do you foresee in the future with exogenous ketones, there being specific formulas for specific protocols like seizures or anti-cancer or exercise performance?

Dom: There has to be. Just like there are different diets, you know? I view ketones as kind of like the fourth macronutrient. We are just at the cusp right now of learning how to learn that macronutrient. Many people think I am purely a keto guy, but I think that glucose and sugar are actually a performance enhancing compound. It can actually be used, I believe it should be used sparingly. I think it can be used to enhance exercise performance and to enhance your work in the gym, but so can ketones. Ketones have some unique properties that just go above and beyond their capacity as a exercise fuel. They have interesting signaling properties and neuroprotective properties. We are trying to determine how to best formulate what exogenous ketones may be optimal for particular situations, such as therapeutic versus performance and how to formulate that. Even how to incorporate that compound into a diet. Certain compounds may not work best with certain diets. We are looking at a very modified form of a ketogenic diet, a standard diet from a rodent chow perspective. Then we are also doing some of the human studies on the NASA mission just looking at that diet and how that affects metabolism too and ultimately how metabolism will change in the context of being in nutritional ketosis through exogenous ketone implementation.

Drew: Yeah. What are you finding when you take exogenous ketones, but also maybe like a performance enhancing glucose combination at the same time? Is there any new research with upping your ketones but also upping your glucose at the same time? Could that be dangerous?

Dom: Yeah, that’s a good question. There is some data already out there in humans that are consuming a ketone ester, a mono-ester, beta hydroxybutyrate. We’ve been doing rodent studies where we administer the ketogenic agent in a context of a high carbohydrate diet or rodent chow diet. What we do see is that …. and this is maybe one of the most interesting things with exogenous ketones, is that it dramatically lowers blood glucose. It was actually part of the newsletter from our website yesterday that we launched yesterday. We are really delving into that as we say that the elevation of ketones is inversely proportional to blood glucose. Which means that if you administer exogenous ketones in graded amounts, you will see a very characteristic in correlation in decrease in your blood glucose over time. That could be due to a number of different things. At first you are thinking that could be an increase in insulin, so you take exogenous ketones and you spike insulin. It facilitates glucose disposal in peripheral tissues. But so far we don’t really see an increase in insulin, unless the dosages push the ketones up above 2 or 3 ml. I’ve measured insulin in myself drinking a lot of ketone ester and many other things and it budges it only a little bit. It’s not even comparable to carbohydrates or even to protein. So if I eat protein, my insulin is going to elevate more than exogenous ketones. Some people think you throw exogenous ketones on and you spike insulin, well there goes your fat burning. No, that’s actually not the case at all. *laughing*

Drew: *laughing*

Dom: The lowering of glucose is not a result of a ketone induced release of insulin. It may be a small contributor, but it’s more likely facilitating glucose disposal. It’s also decreasing hepatic glucose output. The glucose in your blood right now is actually a result of the liver regulating metabolic processing and regulating gluconeogenesis. That process is a finely tuned, very elegant biochemical series of reactions that are happening in your liver when you throw ketones in. I think of the liver like a brain, it’s a very elegant organism that is actually tied to the neurocontrol of autonomic regulations and is to some extent regulating the livers output of nutrients through sympathetic versus …. well it gets kind of complicated. The release of glucose from the liver is attenuated greatly if blood ketones are elevated.

Drew: Ok.

Dom: That’s really important for Type 2 Diabetes. That’s very important for appetite regulation. That’s very important for maintaining homeostasis and it’s also very important for preventing a high glucose when there is high ketones when you take the two together. If you take ketones and glucose together, the rise in glucose would be less than if you were to take the glucose alone.

Drew: Interesting. Ok, that’s interesting. Obviously people that take exogenous ketones, they are usually doing it for athletic performance. But there are probably like some other therapeutic applications like you mentioned. I think it’s really interesting, because that is a question that I get as well. Like, ‘Well what if I eat donuts and have exogenous ketones?” I guess what you are saying is the glucose response from the donut wouldn’t be as high if you took the ketones with it.

Dom: It’s like what if you eat donuts and you eat protein? *laughing* What if you eat donuts and you take MCT? Think of ketones as like a fourth macronutrient that you can elevate in the blood. But a unique property of it is that it actually helps to buffer that postprandial spike in glucose that typically happens when you feed sugar. I will admit that at this point in time we do not fully understand the glucose lowering effects of exogenous ketones. What we need to do for that is do a lot of metabolic physiology, but we also have to do metabolomic analysis of the liver itself. We do a fasted state, a fed state, with and without exogenous ketones. We end the experiment at that point in time, which would be sacrificing the animal. We take the liver and then we do a metabolomic analysis of the liver state under those situations.

Drew: Gotcha. What do you think about the whole carnivore approach that’s kind of becoming very popular these days? *laughing*

Dom: *laughing* I think many of these diets, including the ketogenic diet, they have their applications, but when it’s done continuously. I’m a big believer in varying things over time. So right now today, I am intermittent fasting, but yesterday I had three solid meals throughout the day. I would say that yesterday was a solid ketogenic diet day. But the day before that, it was just low carb, because I had a lot of vegetables throughout the day. I had a little bit of fruit at night. I think it’s good to mix it up. I think if you go on a strictly carnivore diet, there are vital nutrients that you are missing out on. Not only soluble fiber, which can help the gut microbiome, but insoluble fiber can help digestion. It can help elimination and things. I feel that some people go crazy on the fiber and too much fiber in me just gets me bloated and gassy. But I really do believe that some amount of soluble, and probably more importantly insoluble fiber, is necessary in the diet. So just completely eating a steak everyday, or just a piece of liver or steak or whatever, I don’t think that’s optimal. It may be optimal for some people that are battling autoimmune disorders. But I think it’s more important to look into why is that optimal. I think you have to adjust your diet to work for you depending on your food preferences. If you like steak, then by all means do it, but also carefully …. and this doesn’t get thrown around enough, you need to really do blood work. Just a basic CBC, comprehensive metabolic panel, CMP and do that ideally once a year. Ideally four times a year actually, but at the very least once a year or twice a year to understand what these diets are doing for your inflammation, for your A1C, for you liver function and kidney function and things like that. I think that’s important. I know they are all the rage right now, the carnivore diet and I think it can be beneficial for a lot of people and some days my meal pattern resembles that. Some days I might go all day, especially if I am traveling and I don’t eat all day and I end up at a hotel. I look at the menu and I just get a ribeye steak and that’s it. Usually I have some salad greens with it, but that is pretty close to a carnivore diet.

Drew: I think it’s important for people to realize that what works for you today in this moment might not work for you tomorrow or the next day or five years from now. That’s why it’s important to do blood work to know this works for you for a season but maybe it’s time to change it up and switch things up. Because ten years ago you were feeling good and your blood work was good, but now you need to be open to change. I think that is where people struggle because they get so emotionally attached to these diets and sometimes it almost becomes a religion where they become dogmatic about it. It’s hard for people to let go of that because they have been so mentally focused on one type of diet. Does that make sense?

Dom: I picked up a book 20 years ago and it was called the sardine diet.

Drew: *laughing*

Dom: At the time, I didn’t like sardines, but I picked it up at a conference I believe. It was on my shelf for some time then I picked it up and started reading it. Maybe 10 years after I picked up the book, which was about 10 years ago, I started eating sardines. I love them. They are like a staple. I have a huge stash on the other side of my desk over there. Even though I love them and I think they are a traditional powerhouse, I would not go on a sardine diet. You know what I mean?

Drew: Gotcha. *laughing*

Dom: I think it’s good to vary our foods to the extent that we are getting at least or buying at least 10-12 different foods. Some people go crazy and buy like 50 foods. I tend to be a creature of habit and just pick about 10-12 foods and those are things I buy each time.

Drew: Yeah. Shifting gears just a little bit. What do you think about keto for women specifically? Is there anything in particular that women need to be aware of, especially if they go long term with keto?

Dom: Women’s physiology is a little more reactionary to changes in blood glucose levels and energy balance. So, with that in mind, if you were to create a dietary restriction or to create a decrease in insulin signaling through carbohydrate restriction, that may cause some hormonal changes, especially initially in women. Depending on where they are starting from, right? The issue is I see when a lot of women start the ketogenic diet, they use it for weight loss and they are losing weight and they have created a calorie deficit at the same time. It’s a fantastic, well it can be a great benefit of the ketogenic diet is that it helps to control your appetite. But if you are not getting enough calories, especially for women, that can impact their thyroid. It can impact their hormones. But if you consume a low carb diet, a ketogenic diet, and your calories are sufficient and you actually do eat enough fat, which a lot of women are scared to do, that can be a healthy diet for a women. But I would suggest tracking total blood work, CBC, CMP and look at thyroid, look at hormones to determine how the diet is affecting. Because some people say, ‘Well, it’s just a diet.’ But you are radically changing, especially if you are coming from a background of a high carbohydrate diet, you are radically changing your metabolic physiology when you are doing it. It’s important to understand some of the changes. So not only`objectively but also subjectively, like how do you feel?

Drew: Yeah. *laughing*

Dom: I’ve gotten a lot of women contact me and they are like, ‘I am doing the ketogenic diet. My blood work looks fantastic, but I feel awful. I just don’t feel good. I feel a little bit dizzy when I stand up.’ That’s orthostatic hypotension, that could be mitigated by just some fluids and sodium and things like that. They may feel fantastic or they are excited about the health biomarkers that are improving, but they don’t feel good. I would say that is an equally important reason not to do the ketogenic diet, especially if it’s after about two months of doing it. I really say two months is the bare minimum to really get some of the beneficial adaptations that you should be feeling at about that point in time. Personally, it took about 6 months for me. There is a learning curb to the diet, so maybe I wasn’t doing it completely well. The more you do it, the easier it gets and the more benefits you derive from it over time. That’s what I tell people and you can see that typically in the blood work, typically in how I feel. Also in my performance in the gym, it tends to decrease, stabilize and then improve in that order from one month to the second month to the third month.

Drew: Yeah. Gotcha. Can you go into the whole topic of cholesterol and how it works in the body, specifically with ketosis. Obviously, that’s a lot of people’s concerns. And even when it comes to explaining this to doctors sometimes who still think, ‘Hey, your cholesterol is going to go up if you do keto.’ How do you explain the whole cholesterol thing to people?

Dom: Yeah, well I had early conversations, actually even met Ron Krauss who is really …. I would encourage your listeners, maybe even have him on. I know he’s a busy guy. He was on Peter Attia’s Podcast, as was I. He really delved into the weeds of cholesterol and metabolism. He essentially wrote the book and helped even develop some of the methodologies to measure cholesterol. From a very superficial perspective, I can explain sort of …. maybe if I explain my personal experience, then we could approach it from that context. I personally thought that maybe only 15-20% of people would have an elevation of LDL over time. That was my feeling kind of going into it, until mine really spiked high. I was on primarily a dairy based, dairy-centric ketogenic diet in the beginning. Meaning to get all the fat that was required to meet my calories, I was taking in a stick and a half of butter a day and maybe a pint of heavy cream a day. I needed to put that aside and then I would measure out my protein. So I started out doing a clinical ketogenic diet for research purposes to understand it from that perspective. This was before everyone was doing it, this was back in 2008 I think. After doing that kind of diet for about a year or two and getting some blood work done, my cholesterol about tripled. My LDL cholesterol. Then I took out the heavy cream and added coconut cream and reduced my butter consumption. I started using more monounsaturated fats. My total cholesterol, well my LDL came down a little bit and LDL-p, my particle name was still pretty elevated over time, even 2 or 3 years into it. But I feel it’s at a range now that it’s not dangerously high and we don’t understand, and I think Ron Krauss would even say, we don’t understand what these numbers mean in a context of a ketogenic diet. Because all the data out there that is really looking at the risk associated with these biomarkers, are looking at it in a context primarily of a standard diet. From my perspective, and I’m not a lipidologist, but from my nutrition background, my perspective is that with LDL, you need more little boats sort of carrying, not only the cholesterol, but you are also carrying triglycerides and you are carrying phospholipids. The LDL molecule has a very important role if you get injured, your LDL might spike because it plays a role in the repair process. If you are exercising or over exercising, it might be elevated. A lot of different things can acutely and chronically affect your lipid profile. From my perspective, I think people on a ketogenic diet will always run a little bit higher LDL but I think it’s more important that their triglyceride levels almost always go down. And if it doesn’t go down, they are probably not a good fat metabolizer.

Drew: Yeah.

Dom: There are a lot of disorders that I study that are associated with fatty acid oxidation disorders. There is a range of them and that is something that keto can have a therapeutic effect for. It’s a spectrum. It’s not like you can’t metabolize them or not metabolize them. But you may not metabolize them, you may have a 25 or 40% decrease in this enzymatic pathway that’s preventing your triglycerides from going down. So you need to actually reduce fat in your diet for that particular person. Generally speaking, I think at least 50% of the population would significantly benefit from going on a ketogenic diet, at least intermittently once a year or twice a year. Something like that where they transition for a month or two and just to try it. But I would say, do blood work before and after. You will probably find that if you do the ketogenic diet and transition off of it and you are doing it for body composition purposes and to get your weight to where you want to be, the next time you do the ketogenic diet, it will be easier. We don’t know the science behind it, but I think of it like muscle memory. If you work up to a 500 or 600 pound deadlift and then you stop working out and then you go back to it again, it’s not like it is going to take you 5 or 10 years to get there again. You can probably do it in 5 weeks. Once you have turned on the metabolic machinery that allows you to burn that amount of fat and create ketones and then you stop, if you go back to that, you get into that state quickly. There are some animal data that is not yet published and I can’t talk about it, but we kind of see that in various model systems that when you create a nutritional ketosis and then completely stop and then take some time off, and then go back into it again, the keto adaptation phase is very rapid. This is basic science, laboratory stuff I am talking about. But this has very practical implications for the general population. I’m not a huge fan of the cyclical ketogenic diet when it is done on a weekly basis. Some people may do that. I just tend not to do that. But I do think the ketogenic diet should be sustained over time to force those adaptations. Once those adaptations are made, then you are really changing your metabolism. You can have some long term benefits from that, if it’s done even just periodically.

Drew: Gotcha. What do you think about going keto long term? Does your body ever lose its ability to metabolize carbohydrates efficiently if you never have carbohydrates for say 10-15 years? Does your body lose its ability to metabolize carbs, or maybe even just inefficiently if you do keto long term?

Dom: What I am going to say may upset some people, but I say yes. Well, let me just say this, you need to define long term. So, I will say this, if you go on a ketogenic diet for one year, Layne Norton who is a good friend of mine, people actually think we have differing opinions. He actually in his book, he has got a fantastic book. This is a fantastic book right here. *Showing book ‘The Complete Contest Prep Guide’* This is actually Laynes book. It talks about flexible dieting. It’s actually the book I recommend for people. He considers the ketogenic diet a tool in a tool box and we will be talking about that on Joe Rogan in two weeks.

Drew: It’s coming up! Yeah.

Dom: Yeah. In that book, he has an analogy of a factory. If the factory is building airplanes and then the factory changes their contract to where they start building ships, you need to basically replace some of the engineers and some of the building materials to switch over from an aircraft building factory to a ship building factory. The same thing kind of takes place with your metabolism. Now if that factory goes from building airplanes to building ships, it may take a year for that factory to be churning out the optimal amount of ships. Then it gets another contract to go build airplanes again, it has a lot of that machinery and that expertise to build airplanes so it could rapidly convert. Instead of a year to get back, it could make it back within a month and start building airplanes at a rapid rate. I think that analogy kind of …. I like that analogy because I think the same thing happens with your body. Your body is used to burning carbs. If you transition, I think it may be a little bit difficult because we have trained our bodies through modern eating strategies and eating 4-6 meals a day, which a lot of people do. We have trained our bodies to be dependent on glucose and carbohydrates, so when we stop and force it to burn fat, that causes things like mitochondria biogenesis. It actually forces your metabolic machinery to change fundamentally. So if you go back to eating carbohydrates, there will be a lag time. There will be a deficiency in the glucose transporters probably. You may have the glycolytic pathways that may need a month to basically ramp up their activity. The glycolytic enzymes, the transport systems, and even your hormones may need to adjust like insulin signaling and things like that. But it will be much more rapid than the one year that you were on the ketogenic diet. The same thing happens like if you are a fitness competitor and you have a show where you are going to be on stage. It takes you 12 weeks to diet for that show. You need to have a pretty severe, if you are overweight, a pretty severe caloric restriction during that 12 weeks, because that is really not a lot of time. I would say it takes an equal amount of time, another 12 weeks to get your metabolism back up. It’s not like you diet and you run a 500 calorie deficit everyday for show time and then by the next day your metabolism is up and you can go back to your baseline metabolism. It really takes, if you look at your metabolism, almost an equal amount of time to recover from that. That’s kind of missed by a lot of people. That would be like reverse dieting. I think Layne talks about it in his book. A lot of people don’t understand that you need to methodically sort of titrate your calories back in to accommodate the metabolic, some people call it metabolic damage, I call it metabolic adaptation over time. Your body is a more efficient machine in using the macromolecules that you are giving it, so it takes awhile to come back.

Drew: Yeah.

Dom: Kind of the same thing happens with fat and carbohydrates too.

Drew: So, at the end of the day, it’s important for people to just be patient with their bodies, as their body transitions. A lot of people fear if they go keto, the second they touch a carbohydrate they are going to explode and just blow up in size and weight again and gain weight. I think that is the fear that people have, that is why I wanted to ask that question. From what I am hearing from you is to just give your body time to adjust and adapt to whatever you are doing. If you are going keto, there is an adaptation period. There is a transitionary period where it takes to get used to using ketones efficiently. Then if you go long term keto and you come back, yeah there might be another transition period as well. That’s great information for a lot of people. Really quick, since we are running out of time, The Metabolic Health Summit is coming up in January. Can you talk to us about what that entails and when that is and all the details about The Metabolic Health Summit?

Dom: Yeah. It’s the very last week in January. I’ve got to look at the dates now. I should know it offhand! *laughing*

Drew: *laughing* That’s ok.

Dom: January the 30th to like February 2nd or 3rd. So block out those dates please, because there is so much to be experienced at this event. It’s an amazing synergy of clinical science, which is great because there is continuing clinical education credits. There is education credits for registered dieticians too. So it’s a great synergy between the practical clinical science and the basic kind of PhD science, but also the everyday person who just wants to understand keto. There are going to be influencers there. You are going to be there for sure. There is going to be some big personalities there and some heavy hitters in the field are going to be there to interact with. So, it’s going to be a great synergy of clinic, basic science, influencers and workshops that teach how to implement the ketogenic diet as a lifestyle. I think that’s really important. There is also going to be …. one of the things that I think is super important is for companies that are in this space or even peripherally associated with this space, are going to be at the event. So if you are an entrepreneur or if you are looking to invest in this space, if you are looking to maybe start a company to understand who the players are in the field, you are going to miss out if you are not at this event. You know food companies, supplement companies, if you have an app that can help assist people in this field, please come to this event because you are going to miss out on it if you are not there.

Drew: Yeah.

Dom: I think I am giving a talk sure, but I want to make sure that our speakers too, have face to face time with the attendees.

Drew: Awesome.

Dom: So, there are going to be networking events where I make myself available to answer questions to the audience. We are going to have panel discussions where the experts are up there and answering questions from the audience. We really want to cater to the audience in this and actually create an environment, depending on if you are a medical doctor or a PhD student or an entrepreneur and investor or just wanting to know the space, that you are going to be able to get everything out of this conference. And for entertainment too!

Drew: Yeah! *laughing*

Dom: I forgot to add! I’m not working on that but Dr. Angela Poff and Victoria are working to create and make this event an amazing entertainment experience on top of that. They have been working very hard. The venue is amazing. It’s convenient. There are so many perks to this venue. They have looked at dozens of venues before picking this ideal location.

Drew: Yeah. I have no doubt it’s going to be amazing. I know Victoria and I know Dr. Angela Poff and I know you. I know the three of you and everyone else that’s involved in it is going to make it an awesome event. That’s what I am looking forward to it. I think it’s January …. actually I don’t want to throw the dates out there because I don’t know either. But it’s in January.

Dom: Go to The Metabolic Health Summit website. If you just put that in on google. Also go to …. I’ve got to plug my website ketonutrition.org and the link on there will take you to The Metabolic Health Summit. Also ketonutrition.org has a lot of information on things we talked about on this Podcast too. It’s more of an informational website.

Drew: Gotcha. We will put all the links in the show notes below. But really quick before you go, I know you are going on Joe Rogan with Dr. Layne Norton, who I have actually had on my Podcast. He is actually a good dude. A lot of people don’t know that you guys actually go back 10 years. You’ve been friends for awhile, so it’s not going to be like this debate where you guys hate each other. People are probably setting it up on social media. But I’m really excited about that. Since we are talking about Joe Rogan, I just have to ask because a lot of people ask me as well, when it come to marijuana is marijuana keto friendly? *laughing*

Dom: *laughing* That’s a good question. You know, the meeting I have right after I get off this after talking to you is actually meeting with a company that markets CBD.

Drew: Ok.

Dom: We are looking at the effects of CBD and ketones potentially. I try to do this research, long story like a couple of years ago and the university made it very difficult for me to do any kind of research. But now, I think because the university see’s there is a lot of money and that it’s very legitimate the science supporting the therapeutic effects of marijuana. CBD is what we are going to be studying and it’s very legit. I am approaching it kind of cautiously because I have to be conservative in an academic institution, but I am excited to sort of do some research on this front. That is kind of the next frontier. I don’t know if it will come up in Joe Rogan, but in regards to the anti-seizure effects and the anti-cancer effects, that’s what we want to focus on, from my perspective.

Drew: Sure.

Dom: But I know there may be some health benefits on top of that. That’s pretty cool though that you had Layne Norton on your Podcast. I will have to go listen to that.

Drew: Yeah.

Dom: I did listen to …. just in preparing for this, in my drive here I listened to Ben Greenfield, which was an awesome Podcast. Also Benjamin Hardy, I think it was ….

Drew: Hardy, yeah.

Dom: So everybody listening right now, go listen to that Podcast. It was a fantastic Podcast. It talked about the environmental influence or the environment that you put yourself into. It resonated with me on several levels. I thought it was a great Podcast.

Drew: Yeah and the book is remarkable too. ‘Willpower Doesn’t Work’, which is right up my alley of me trying to help people transform. We think we just have to willpower our way through it. I appreciate you listening to that because that is why it resonated with me. How can people change their environment and adapt to that new environment and that’s how you change your life. Anyways, I really appreciate that and I really appreciate your time Dr. Dom. I really appreciate you coming on here. Have fun with Layne Norton and Joe Rogan. I know you are going to have a blast out there, as always because you have been on his Podcast before.

Dom: Yeah. It’s fun.

Drew: Yeah and keep doing what you do. I really appreciate you and the work that you do. I know you are at the forefront of really transforming people’s lives. We thank you for all that you do for so many people.

Dom: Thanks for having me. I appreciate you giving me this platform to talk about my stuff. I really appreciate the great information that you put out there and getting the word out too. We owe a lot to the Podcasts and people putting them out because they are really helping us as scientists. Because as scientists we wouldn’t really be getting this message out. People have very high levels that only heard about this because of scientific literature, but they hear Podcasts on this. I know most can steer policy. You can actually impact policy making decisions with some of the content you are putting out there. So, I thank you for that. Thanks again for having me on.

Drew: Yeah. Thanks Dr. Dom. We will see you next time.



Hey everyone, thank you so much for listening to this episode on the Fit2Fat2Fit Experience Podcast. I really, really appreciate all the support you have shown me throughout all the years. If you love the Podcast, then please go subscribe to the Podcast on ITunes and also if you love the Podcast, please leave us a review. It definitely helps out with rankings, which means more people listening to this Podcast when they see it. Feel free to reach out to me on social media @Fit2Fat2Fit or at Fit2Fat2Fit.com, with suggestions or comments or concerns. Anything that you guys think that I could do to make this Podcast better for you, I definitely want to bring the highest quality content to you, the most value because I know you are investing 30-50 minutes per day when you listen to the Podcast. I really appreciate all the support and like I said, go follow me @Fit2Fat2Fit on social media, if you want to reach out to me with comments, questions or concerns. Thank you guys so much and we will see you back here next week on the Fit2Fat2Fit Experience Podcast.


  • KetoNutrition.org
  • Peter Attia
  • Ron Krauss
  • Layne Norton
  • “The Complete Contest Prep Guide” – Book
  • Joe Rogan
  • Ben Greenfield
  • Benjamin Hardy
  • “Willpower Doesn’t Work” – Book
  • Dr. Angela Poff

Social Media

Drew Manning

  • Instagram: @FIT2FAT2FIT
  • Twitter: FIT2FAT2FIT
  • Facebook: FIT2FAT2FIT

Dr. Dom D’Agostino

  • Instagram: @drdomdagostino
  • Website: ketonutrition.org