Transcription
So, let's talk about ketosis and ketones. Um, the diet, the keto diet is becoming increasingly popular from what I've seen. It's actually the diet that I'm on at the moment. How does that play into everything we've talked about? Yeah. Yeah.
So, it it this is an opportunity for me to do a little bit of um bio nutrient biochemistry or a little discussion of metabolism so that people appreciate what ketones even are and where they come from. So the the entirety of the human body is a metabolic hybrid in that the body is largely burning fuel from two sources. It is burning blood glucose or sugar blood sugar or it's burning fat. Those are the two main fuels for the body by extension. Now the brain was an exception. The brain is glucose or ketones and but I'll get to where the ketones come from. the rest of the body isn't really relying on ketones as much. It's fats or glucose or blood sugar. Insulin is what decides which fuel is used. So, as much as the metabolic engine has two fuel sources, insulin will decide which one is opened and which one is closed. If insulin is high, the body is sugar burning. And you can measure this in the whole body level by measuring the amount of o uh oxygen and CO2 that the body is producing because different biochemistry or the burning of the fuels will produce a different amount of CO2. So if I'm burning glucose I might be producing more CO2. Yes. Yeah. So we could hook you up to something called an indirect calerimeter and measure that your reer the respiratory exchange ratio the balance between CO2 and oxygen would go higher. So we we increase your insulin like if I infused you with insulin in the next few minutes we would see that your rear would go up and we'd say boy you're sugar burning or we allow insulin to come down and then the rear goes down which is reflective of fat burning. So it's insulin that determines whether the body is sugar burning or fat burning.
Now when insulin has been low for about 16 or so hours something interesting starts happening at the liver. So the liver with insulin being low is burning a lot of fat including its own fat that the liver can store. The liver can store fat but also fat coming from fat cells because if insulin is low the fat cells are just leaking out fat to be burned by the body and because insulin is low the liver keeps burning it. And the liver essentially burns continues to burn so much fat that it it fills its own needs. it meets its own needs and says to itself, "Hey, I don't need to keep burning fat. I have all the energy I need. I'm I'm doing great." But it can't stop burning fat because insulin is low. And if insulin stays low, fat burning keeps going. And so because the body doesn't have enough glucose. Well, it's acting. Yes. So, in this sense, it's doing it to help replace the glucose that isn't coming in. That's the value of the ketone. So, as the liver is continuing to burn fat, it essentially gets to a point of fat burning where it's burning more fat than it needs. And that excess, if you will, is what becomes ketones. So, ketones are kind of a metabolic release valve for the liver cell to say, I I can't I don't know what to do with all this fat burning. Okay, I know what I'm going to do. There's not a lot of glucose coming in, and so the brain may start to get hungry, so I'm going to start making ketones. And so ketones are nothing more than a product of a lot of fat burning. And anyone who even fasts for 24 hours, you wake up that next morning, you're in some degree of ketosis. Lest anyone think it's an extreme thing. People are going in and out of ketosis.
Ideally, often, now why do I say ideally? It's because ketones are, as we've already outlined, perhaps the best fuel for the brain. The brain thrives on ketones. You can take a person with early stage Alzheimer's disease and have them go through a series of cognitive tests and they do horribly on them. Like one example is you ask the patient with Alzheimer's to draw the face of an analog clock, a circle with one two through 12 and then some hands on it and it is utter chaos. This is published reports. You then put them into ketosis, ask them, can you please draw the face of a clock? It's still sloppy, but it is absolutely the face of a clock. You ask them when they're not in ketosis to try to tie their shoelaces, they can't think through the puzzle of tying the shoelaces. Ask them to do it again when they're in ketosis, all of a sudden they can tie their shoelaces. More than that, they can get themselves dressed. All of these are published case reports. It's just my long-winded way of saying the brain thrives when it has ketones as a fuel source. But the benefits don't stop there. My lab published a report finding that when humans were in ketosis, which is just a term for ketones being elevated. We pulled out small pieces of belly fat and measured the metabolic rate of that belly fat. And we found that in ketosis, the metabolic rate of that belly fat was three times higher than when the people were not in ketosis. What does that mean? Yeah. So that means that the fat was suddenly behaving in a much more energetic way. that fat tissue has a very low metabolic rate and that all of a sudden when the ketones came into them, they started getting much more active and they started burning more energy, which is going to be very helpful for someone who wants to lose fat. If your fat cells now have a three times higher metabolic rate, that means that the fat cells are starting to act a little bit more like your muscle cells and they're just burning more energy. So, does that mean that I'm going to lose fat faster? What does that mean? Yes, absolutely. And that is what happens. There are very well done controlled studies to show that if you control for all calories, when a human is in ketosis, their metabolic rate goes up. Your body, your whole body is just burning more. Um, it it's just everything's kind of been turned on a little more. The the the the furnace of the metabolism is just been it's you have a little more fuel kind of stoking the fire. So, ketones will increase metabolic rate of fat tissue. We found a paper that we published documenting how we took muscle cells and kind of insulted the muscle cells to determine how tough the muscle cells were. When we incubated the muscle cells with ketones, they were much more resistant to injury. So the ketones act to protect muscle tissue and in a way that is reflective of a function of ketones. Ketones are a defender of muscle. Ketones are basically the way to tell the brain saying brain you think you need a lot of glucose and if you don't get enough glucose you would start stripping the protein from muscle to turn it into glucose but I'm here as a ketone so you can eat me instead and not and leave the muscle alone. So, we published again a direct report finding that ketones actually make muscle more resistant to injury. And this could be why you're seeing more and more elite athletes using ketones as an actual erogenic aid or like a supplement to help them better be better. So, at my university at BYU, just this year, our men's and women's cross-country team took the national championships, the best college runners in the nation. Pretty impressive. One of the things they do is they take these ketone drinks before they train and before they they race some more and more of the to France teams take ketone supplements because it is just another fuel. It is something that the body can burn that we always say well if once you start running out of glucose you're going to bonk or you're going to hit the wall. Well, what if you don't really use glucose because you're burning a lot of fat and a lot of ketones instead and that keeps your glucose kind of untouched or you're not you're not relying on the glute. And we see this in humans. If there's a human that has adapted to a ketogenic diet, they burn fat at a higher rate than was ever thought humanly possible. That that fat is basically fueling all of their muscle movement during the exercise session rather than relying predominantly on glucose. The body has adapted. It's burning fat for fuel and when available, it's burning ketones for fuel and it's leaving the muscle as sort of a last resort when it really needs a big kick.
I've seen these keto drinks, these little they're almost like little shots. Well, there's a bunch of different types. If you look at the spectrum of ketones, you on one end you have the cheapest, most readily available, although less effective called ketone salt where it takes a molecule of ketone and binds it to a mineral like calcium or magnesium. um not as effective and it's a lot of mineral so people will find that they might get a lot of plaque on their teeth. Yeah. Maybe increased risk of kidney stones. So comes with some consequences. Then you have the ketone esester which often comes in shots. Yeah. Then you have the bioididentical BHB or the bio identical ketone. One company which is original ketone um they make it. Now these ones are more effective. You take a little bit of these and you will get an increase in ketones. They're a little more expensive too. But as the space is becoming more competitive, the price is coming down. And what exactly does it do? So if I took a shot of a bio identical ketone drink, what would go on in my body and how would I how would that impact my cognitive performance or athletic performance? Yeah. Yeah. So it would result So you're drinking it in, you're immediately absorbing it from your gut. Yeah. So, if you were not in ketosis, let's say you had, and I'm not encouraging people to do this, you had just eaten two bagels and a cup of sugary coffee, you're no ketones, undetectable, because insulin has come up, it's inhibited ketone production. And then you drink a shot of the ketone. Within an hour, we would detect your ketones. They would have gone up maybe to 1 mill, which is a pretty significant bump. Yeah. And they're capable of that kind of movement. And maybe you do so because you're thinking, I really need to be sharp right now. Would that make me sharper? Well, that's where we have to speculate. There's no I my lab published animal evidence suggesting that yes indeed it makes you sharper. That we had these animals navigate mazes and recognize objects. And when the animals were on a ketogenic diet, they were much sharper. They were much quickly much better at solving problems and remembering solutions to previous problems. It's one of the I asked this in particular because as my team know because I've said it to them a lot over the last couple of weeks since I've been on the keto diet and I've been literally pricking my finger to check confirming yeah my keto levels and the highest I've gotten to is like 2.5 which is high. Is it high? That's not problematic. I mean that is just proof positive that you're in ketosis which itself is proof positive that you're burning a lot of fat. Yeah. And three that your insulin levels are low. Fat dropped off my body like I've never seen in my life. Exactly. Yeah. It's crazy.
So, the power there is like if you'll allow me to kind of springboard off of that comment, the power of So, so if someone is listening to this and they're thinking, "Okay, I need to shrink my fat cells." Yeah. Unfortunately, they don't realize that there's two variables to what caused their fat cells to grow in the first place. They have no awareness of the value of insulin in this in this um um formula. All they do is pay attention to the calories. And so the average individual is looking down the road of this fat cell shrinking journey and they're thinking, "Okay, what I have to do is just cut my calories." And what do they do to cut their calories? They do the exact wrong thing. And before I even answer that, let me just present the scenario. Let's imagine that Stephen and I, everyone listening is invited. Stephen and I are hosting a buffet. We have the world's best chefs. It is going to be a table filled with the most delicious food you can imagine. You're in our invitation. we say come hungry because you're going to want to try a little bit of everything. Everyone listening, ask yourselves, what would you do to come as hungry as possible? You'd probably do two things or think, how did you go to your Thanksgiving or your your Christmas dinner as hungry as possible? You would eat a little less in some period of time before the event and you would exercise a little more and it would work. You would be very hungry. That's why the traditional advice given for weight loss doesn't work because we tell people eat less, exercise more. Sure, you maybe lose a little bit of weight in the short term, but all that does you've given them the perfect recipe to promote hunger and hunger always wins. As a good example, uh in the US we have a game show, maybe there was some version of this in the UK called the biggest loser. It was essentially who can lose the most weight and it was through a punishing regiment of caloric restriction. Eat less, exercise more. That is like the perfect embodiment of that approach. They were starving and they were exercising to insane degrees and oh my goodness did they lose a lot of weight and yet you never see them again. They don't do a reunion tour 5 years or 10 years later because they gain it all back. Do do you know they gain it all back? They do. In fact, a paper published in the US from the National Institutes of Health documented not only the degree to which they gain weight back, but also how it almost literally breaks their metabolism that normally a person's metabolic rate is connected to their body mass. A bigger body has a higher metabolic rate. A smaller body has a lower metabolic rate. This is just human physiology. And no surprise, when someone loses weight, there's less of body and so metabolic rate goes down. As they gain weight back, metabolic rate will typically go back up as well. Except for the contestants and the biggest loser. They started with a high metabolic rate because of a high body fat level. They lost a substantial amount of weight. No surprise, metabolic rate went down substantially. But it's this is such a dramatic change that as they started gaining weight back, metabolic rate did not come back with it. It stayed lower than it should have. Normally it's connected sort of one to one wherever body weight is going metabolic rate is going except in these people that method of dramatic weight loss through such severe restriction which is based purely on the caloric theory of obesity leads to such it leads to significant hunger. So no surprise if a person's attempting to shrink their fat cells or lose weight if the first step is I'm going to cut my calories and they don't address their high insulin they're never going to lose weight in the long run. they're going to step right back to where they were because if they start cutting calories but insulin is still high that's going to make them very hungry because insulin wants to be storing energy. A a professor from Harvard named David Lewig found this. If you have people eating a lower calorie meal that spikes their insulin, it makes them much hungrier than a lower calorie meal that doesn't spike insulin. So that's the key. Anyone listening, if you're thinking, I need to be on a fat cell shrinking journey, let the first step of that journey be, I'm going to lower my insulin, which means which means I'm going to control my carbohydrates. I'm going to stop eating carbohydrates that come from bags and boxes with barcodes. And while I am restricting those carbohydrates, I'm going to focus more on protein and fat. So, control carbs, prioritize protein, and don't fear the fat that comes with those proteins. Fat and protein together is a a miraculous combination of helping you feel full, and it is literally giving everything you need. There are such things as essential proteins. There are such things as essential fats. So, focus on those. And that will be the key to helping insulin come down. Then, as you have found, you haven't and when you're hungry, eat. If you're not hungry, don't eat. But what the person will find is they're lowering their insulin all while their metabolic rate is going up. They're learning how to burn their own fat for fuel. Because remember the metabolic hybrid, that metaphor that if you want to lose fat, you need to burn fat. You're not going to lose fat if you're always burning glucose. It's fat that you need to burn. And as you start burning more fat, you realize that it's like the hump on a camel. That hump exists because it is a big source of fat for that animal to be using its own fat for energy. We have our own version of that. So where you think about the average individual who's chubby, they have hundreds of thousands of calories waiting to be burned in those fat cells. It's just that they're chronically elevated insulin is never letting them burn it. And so as the person starts making these changes in their diet to lower insulin, they now can finally start relying on their own fat for fuel. So, it's no surprise that their hunger starts to come down. Let that be the natural way in which you're controlling your calories. Don't control your calories because you're forcing yourself to be hungry and eat less. Control your calories because you simply aren't hungry.
So, I have to I'll overlay this with my own sort of anecdotal experience. So, I every year do a keto diet for usually for about eight weeks. This time it's going to go on for a little bit longer. Um, the reason in part why it's going to go on a little bit longer is I've just learned more about what's going on in my body. And also because I podcast now and do a lot of speaking on stage and those kinds of things, I see tremendous variance in my ability for my brain to articulate what I want to say. The same way it's like it's absurd. Yes. I I was saying this the other night to the the team that with me here in Los Angeles and I've tried to say it to so many people as someone that can spend nine hours a day trying to think of the next question to ask or trying to remember the research or on stage in front of a thousand people trying to deliver a story or a point. I get to see varants which I've never been able to explain. Yeah. um where some days I'll go up on stage or I'll be in a podcast and it's like my brain and my mouth aren't connected and then on other days specifically when I started doing ketosis or having a ke ketogenic diet it just flows. Yeah, it just flows so well. And I was saying to my team, it feels like I'm looking at the world like this these days. Like I've got this intense for anyone that can't see me, I just stretched my eyes, but like I've got this intense focus on the world. Um, the other thing I've noticed with my diet is I I get hungry, but not like I used to get hungry and then very quickly after I start eating, I stop. Mhm. I don't seem to be like doing like these I used to kind of binge a little bit. Yeah. I used to have like a longer eating sessions and my hunger goes very quickly. Um, I also found that I didn't have these like fluctuating energy levels throughout the day. I don't crash anymore. I used to get like slumps. Yeah, for and I don't slump anymore. And then the other thing which a lot of people care mostly about is the the fat. So like belly fat. I have never seen anything that has stripped belly fat off me faster. And I'm talking in a matter of weeks that I could, you know, count on one hand. Yeah. Than doing the ketogenic diet. And if I I could literally show a picture of my scales because I have these digital scales on the screen and it's just trenling along and then there's this cliff edge where it goes directly down and it and so much so actually that one of my concerns with the ketogenic diet is how the hell do I keep my muscle? Oh, that's a great question because my girlfriend, to her credit, when I did ketosis the first time, she was like, "I've never ever seen you look like this, when I took my top off, but also it was quite clear that my my muscles had got smaller. I was lean as but my muscles were smaller." Yeah. Yeah. So, with with with caution this time, I did ketosis again, and I've been thinking, how the do I keep my muscles? Yeah. Yeah.
Okay. So, first of all, let me just add a hearty amen. I'm an advocate of a ketogenic diet, although it can be applied differently across different people, but I would say anyone would benefit from having some modest period of time of elevated ketones, at least in some portion of the day. Now, how do you maintain muscle mass in the midst of such obvious weight loss? I can only speculate. Now, there are peer-reviewed studies that I can cite which do support the idea that a human can be on a ketogenic diet and have a total maintenance of muscle and strength that is published. So, we know it's possible. Although that isn't that doesn't seem to be what happened with you. I would suspect that there were two things two things happening possibly. Now, I'm speculating here and I'm pretending to be your coach or your expert here. One could have been that you had relatively lower energy during your workouts because of a slight degree of dehydration. And then the other one would be calories, which I'll come back to in a moment. I just wanted to put it out there. So when insulin comes down, one of the other one of the many effects in the body is that another hormone comes down called eldoststerone, which is one we've never invoked yet. But low insulin leads to lower aldoststerone. When eldoststerone comes down, the kidneys become much uh begin to eliminate salt and water much more rapidly. Now, that's not problematic, but it does mean that a person does have to focus more on hydration and salts. So if someone's going on this strategy and they exercise fairly often, you need to be much more focused on your hydration, literally drinking more because you will be urinating more, which is partly why people's blood pressure gets so good so quickly. And just to pause on that point, there if if someone is on one or two blood pressure medications and they adopt a ketogenic diet, they usually have to stop their medications within two days because their blood pressure goes to normal so quickly that if they stay on the medication, they're going too low. So, one could be that you were actually working out a little less intensely because of the dehydration, but then two, it's possible that you were eating too few calories to actually maintain muscle. Muscle is a hungry organ. It is metabolically expensive for the body to keep that muscle on. And as you start to get leaner and leaner, it gets harder and harder for the body to defend that muscle. In fact, that's the difference between fasting and starvation. The longest known evidence of a fast was a man in the UK who fasted for 384 days, literally not eating or drinking a single calorie. He was under medical supervision getting vitamins and minerals and water and he was went to live on went on to live a perfectly healthy life. Um so but what was the difference? Why was that not starvation? Starvation is when you run out of fat. So you might have gotten to the point of so lean that you didn't have enough fat to burn to make enough ketones to fuel the brain. If you don't have enough fat to burn to make enough ketones and the brain is saying, "All right, well, I wanted to switch to ketones so that I could spare the glucose, but I can't. There's not enough ketones here. So, I have to rely 100% on glucose. But if you're not eating glucose, now the body has to start stripping the protein from muscle." And it sends those amino acids to the liver. Then the liver is so capable, it will turn those amino acids into glucose. So, it turns my muscle into glucose to feed the brain. So my comment then getting finally getting to my answer is in your version of a ketogenic diet with your level of muscle mass and your inherent metabolic rate based on your body size and your activity you probably ought to eat more fat. I wasn't actually doing the blood test at that point. I'm doing it this time around but I wasn't doing the blood test so I can actually see my keto levels. Yeah. So maybe I wasn't even in ketosis because I wasn't You might have been, but it could have been that you were simply not eating enough calories that I have to. So this is an instance where that's what I'm trying to do this time. I'm trying to eat more fat. Like every time you're making a steak, put butter on there and when you're drinking a cup of coffee, as crazy as it sounds, I drink yerba mate every morning. I will put a big dab of butter, like a big dab of butter in my tea and I'm sipping on it while the world's still asleep and the kids are haven't woken up yet. And so I know because I want to keep my muscle as a guy who'sif almost 50. Um I I find that when during my strict ketogenic phase and I'm currently in it as well. Every January I go to kind of a carnivore diet to and I mostly do it to one lean down but also to check any addictions and habits. I don't like feeling addicted to things. And and my wife will comment and even as an almost 50-year-old it's fun to see my six-pack coming. I don't want to lose my mass, my muscle mass, because you have to work so hard to get it. Yeah. And what I find is if I increase my fat, I always get plenty of protein, but if I increase my fat content, I have an easier time maintaining my bulk.
Are there any downsides of following a ketogenic diet that we need to be aware of? The only downside I can articulate. So in fact I didn't even finish because I distracted myself mentioning some of the benefits of ketones but ketones are further anti-inflammatory like they directly reduce inflammation in the body by inhibiting inflammatory processes and they also improve antioxidant defenses. So it helps reduce oxidative stress. So ketones do have benefits that go beyond even what we've taken the time to articulate. If there's any negative to a ketogenic diet, it could be that you start you acutely or you temporarily become less metabolically flexible. Now, that's me invoking a term we haven't brought up yet, but metabolic flexibility is is a term to refer to the body's ability to when it eats glucose to burn glucose. When it's not eating glucose, it burns fat. So, you're shifting between the two metabolic fuels that we outlined earlier. When someone has been adhering to a ketogenic diet for some time, it's almost as if their body is stuck in fat burning mode. And that if you and I being in such adapted ketogenic state as we are, if we were to go to lunch and eat two bagels and a sugary drink, it would take us a very long time to clear that glucose from our blood. Much longer than otherwise. Like let's say we go out with the production team. They're eating a normal higher carb diet. All things equal, same body size, same activity. Their glucose levels would come up and down in 90 minutes for perhaps yours and mine may take 180 minutes to come back down. So the person may say, well gosh, Stephen and Ben are no longer burning glucose very well. And that's true. In that one moment, um, our bodies had almost forgotten what it was like to burn a bunch of glucose because we had adapted to fat burning.
So, what about the gut microbiome? Oh, yeah. Cuz cuz I told someone who is a nutritionist that I was doing a keto diet at the moment, and they said, "Oh, your poor gut." Ah, yes. Well, what a naive um thing to say, if I may gently reprimand your friend. There's no evidence to support that there's any harmful change in the microbiome. In fact, a paper was just published that looked at a man who went from a normal omnivorous human diet with abundant plant matter to a purely carnivorous diet, literally zero carb. And they documented precisely no change in his microbiome. None whatsoever. But is he eating plants? No. Well, he had been eating plants. So the case study was a person eating a normal diet of of plants and meat, a normal omnivore diet and adop and then looked at the microbiome and then adapted to a purely carnivorous diet, purely meat and the microbiome didn't change at all. What's the time period? Months. I think the problem with the microbiome, the reason I don't take microbiome research too seriously as a scientist is that it is a big black box. you you came from the UK to London uh to to to LA to California. If we took a microbiome sample analysis of your time in the UK now, it would be different now. Even though you're eating the same, but you're drinking different water, you're breathing different air things. I was just on a plane from Utah to California. Give me a day or so, I would have some sort of shift in my microbiome. So, the microbiome can change in response to all kinds of things. The idea that you somehow have decimated your microbiome because you aren't eating fiber is absolutely false. That is that is completely false. Now, there might be a change in some of the population of your microbiome. More of one, less of another, but there's no evidence to suggest that's problematic. Your microbiome is intact. Those bacteria do not die. They're just simply metabolizing other things. Maybe they're relying more on short- chain fatty acids. Maybe they're relying more on amino acids. They're not eating as they're not eating fiber, but there's still stuff in the meat or the eggs that the microbiome will eat. But if if if eating lots of plants does give me a more diverse gut microbiome, then if I stop eating plants, I'm going to have a less diverse gut microbiome. Yeah. But but Stephen, but even then, there's a bit of an assumption built into the question because it's do we know that the microbiome will be less diverse? The case study I just mentioned found that in this one single man, it didn't change his microbiome at all. It was the exact same populations in all the same proportions because isn't the aren't the plants like feeding the bacteria? Yeah. Yeah. So the the fiber is So fiber will but again it's not that's not the only thing bacteria can eat. Bacteria can eat fats. Bacteria can eat amino acids. They can eat glutamine for example. they um they can even meat will have a little bit of glucose in it where the muscle has something called glycogen and so there's you know trace amounts of glucose in even the meat that you're eating. So I do not look at the argument that you know you're destroying your microbiome that has no that has no scientific support. You may be changing your microbiome but who's to say that's a bad change? Maybe it's a better change. You certainly are feeling better. You're thinking better. You're getting leaner. Your insulin sensitivity is improved, cognition's improved. I would argue if there is a change in your microbiome, it's probably one that's for the best.
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