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In 2013 I gave a presentation at the Institute for Human and Machine Cognition (IHMC) in Pensacola, Florida. Ken Ford, the CEO and Founder of IHMC, is a remarkable person and I could not wait to meet his team and see their research. IHMC does cutting edge work, primarily for the Department of Defense (DoD). I had an exhilarating day which culminated with a presentation I gave to the team and also the public.
Want more content like this? Check out our interviews with Kristin Neff on the power of self-compassion and Esther Perel on the effects of trauma.
The talk I gave was a first timer. (Usually the first two or three times I give a talk it’s not very good, as I need to work out some kinks.) However, since the talk was recorded I’ll set my perfectionist tendencies aside and share it, below. The talk is about an hour, and the Q&A session was also recorded.
A month or so before the talk, I asked Ken what he wanted me to talk about and he suggested I speak about human performance and resilience – both topics of importance for the DoD. I don’t consider myself an expert in either of these topics, but I certainly appreciate the need to maximize, or least optimize, both. Rather than give a highly technical talk, I chose to give a slightly technical talk that focused more on my own journey in this space and some of the experiments I’ve done on myself, specifically those around energy utilization. This talk does not present all of the data on my self-experiments, of course, but hopefully it gives you a sense of what kind of data can be gathered for studying energy utilization. In subsequent posts I’ll likely delve further into the data that support these findings and expand on a few of the tangents not fully explored here. For “regular” readers of this blog, the first half of this presentation is pretty basic, but the second half should offer novel info. For new readers, hopefully the entire talk will be informative.
For those reading via email, here is the presentation:
Photo by Siyan Ren on Unsplash
What an amazing talk. Can you elaborate more why commercially available ketone bodies (raspberry something) are crap? What do you expect from a commercial product to be a good substitute for your own ketones?
Minimal (if any) bioavailability and quantity. A correctly formulated ketone salt or ester could deliver large does of B-OHB or AcAc to augment nutrition.
My husband and I recently watched this talk. It was very informative and I am now going without sugar. I am really excited about the change . My husband,who is a triathlete was wondering if you had an increased amount of fat due to a lot of swimming prior to your diet change. How has your exercise routine changed since your diet change? Also you familiar with the China study which indicates that eating meat and animal products is linked to cancer. I would love to know what you think of this. Thanks so much for sharing your personal journey.
It’s possible I was storing so much fat because of an adaptation to cold water swimming, but I still continued cold water swimming for long distances a year after my weight loss.
I stumbled across this presentation via a tweet from Tim Noakes. I’m no scientist, have limited medical background as nurse and are just starting a career in sports conditioning/nutrition coaching, but this whole thing about metabolic inefficiency and syndrome has completely captured me. I work in a contract research organization where we do pharmaceutical research and most of the research evolves around conditions that contributes to the definition of metabolic syndrome. I’m wondering though – they never capture data around what patients eat during these trials (except for most of the phase I studies where a specific diet is prescribed). How much of the drug effectiveness is really about the study drug and how much might be as a result of a better diet (which the patient might start to follow subconsciously while on the trial). We’ll never know. Just curious.
Interesting and unfortunate limitation.
Great talk – though it seems a case of preaching to the converted going by the Q&A, so it’d be nice to get this info out into more mainstream arenas.
For folks who’ve followed your blog since the start I think they’ll find the first 35 minutes is just trodding over well established ground, but from there things get really interesting with the metabolic ward study stuff – will be good to see how much of the data you can put online for folks to play with – I think it mostly highlights that we still don’t know much about what is going on and how.
Yes, good point, Ash. Probably should have made this point. For “regulars” the first half of this talk may be too remedial. Hopefully, if folks are interested, they can stomach it to get the second half.
BTW – you won’t catch me complaining when I have a friendly audience. It’s really refreshing once in a while. I’m pretty tired of getting yelled at and told I’m an idiot.
Awesome talk Peter! Really like your stuff and what you’re doing. Keep up the good work!!
Thank you, Ted.
in the Q&A part you mentioned BCAA.
Can you elaborate a little bit more on your protocol as far as BCAA is concern ?
When do you take BCAA ? Pre or Post workout ? How much ? Any specific manufacturer you can recommend ?
Kind Regards….
Just addressed, Butch.
Two things:
Where do you get “branch chain amino acids” and what dose?
Please tell your wife there are many people who are following what you
do and appreciate it highly and it is helping them/us. And thank her
for her forebearance. (Urine in the fridge – really!)
Thanks, Bill. After my whole thing on NOT saying which BCAA I use because of my brother, you’re asking me, huh? Puts me in an awkward spot. Since you’re the 10th person to ask between the blog and FB, here is the protocol:
I use a product called BioSteel (https://biosteel.com/product_hpsd.php), specifically (for BCAA), their “high performance sports drink” or HPSD, which not only contains BCAA, but other co-factors that render them more bio-available including glutamine and taurine.
As I have come to learn in helping my brother due diligence them, they are very unique in this space, as they actually use legitimate BCAA, which most products do not contain. I won’t go into details here, but I would encourage anyone who is interested to reach out directly to them and ask all the questions they have.
If you’re wondering why their products are more expensive, which I’ve asked, it’s because they use (and can verify) entirely legitimate ingredients. It’s amazing how cheap you can sell BCAA when you sell crushed bird feathers from a factory in China (sadly, this is not made up…the unregulated nature of this industry makes this a very common scenario).
Protocol: I use at least one scoop of HPSD *during* every single workout I do — high-intensity lifting, swimming, and riding. On the bike, I usually use more than one serving, depending on the ride duration. I always mix one scoop per bottle, but I’ll start with 2 pre-mixed bottles, and bring extra HPSD for re-fills.
You should discuss other protocols with them directly, if you have questions. Some prefer to use before. I take nothing before workouts, except the occasional bulletproof coffee; I use HPCS (+/- plain super starch +/- nuts during for very long rides) during workouts; and the biosteel whey isolate (https://biosteel.com/product_wpi.php) post workouts (low amount, typically <25 gm).
Because I know someone will ask... I do not use their advanced recovery formula. Instead I use their whey isolate combined with super starch (i.e., I make my own).
****NOTE TO ALL READERS:**** I am not going to answer any more questions about BioSteel. You have all read my disclosure, so feel free to dismiss my use of this product if you think I'm stupid enough to use a product because my brother knows the guys who run the company.
After getting skewered by so many people for writing openly about super starch last year (again, I have/had ZERO financial interest in Generation UCAN, the company that makes it), I've decided I'll never again do a deep-dive on a commercial product, regardless of how much I believe in it. If you want to know more about BioSteel, contact the company directly.
I've been working with BioSteel products for several months, and have put every athlete I work with on them, especially the HPSD (i.e., the one that contains the BCAA). If you even partially understand my integrity, that should tell you I personally believe the stuff is superior to any other formulation. Thanks for understanding and not asking further questions.
Peter,
Outstanding talk! I really enjoyed that and learned A LOT. Thanks for sharing.
Mark
My pleasure.
Dana Carvey or not..I wish I could’ve seen the laser pointer. It’s a bummer because I think it would’ve helped.
Even though the first part may be repetitive for some, I found it a great refresher.
Thanks so much Peter.
Glad you caught the joke. Maybe I’ll give the talk again some time, complete with laser pointer and all.
The Keynote presentation app on the iPad has a built-in laser pointer which shows up on the video.
Peter, Thank you so much for taking the time to make all this information available! My goals are VERY different than yours, but I’m still learning from you and your goals (high performance/poor genes). I wish we were blessed to have more outliers like you in the scientific community!!
Ha…very kind. Glad you’re keeping you eye on the important metrics: your goals (vs. those of others).
There is an eye-opening documentary (available through Netflix) called “Food Matters.” Also, the book “Dead Doctors Don’t Lie” is almost shocking, especially Chapter 15, The Age Beaters. Other research and studies are pointing to the lack of essential nutrients (especially trace minerals) as the cause of most poor health concerns. . Once again, read Chapter 15 referenced above and then read whatever else you can find on micronutrients and how there came to be a depletion of them in our food supply. “Healthy,” “Organic,” (maybe, maybe not), “Low Calorie,” “Low Sodium,” “Dietary Fiber,” — BALONEY ! For example, what is a more basic need than plain salt? Read the label on table salt; why is dextrose (sugar) added to salt??? Much of our food supply is no longer supporting our bodies.
Peter,
Could you tell me if you had any deficiencies before, during or after this experiment?
Specifically, Vitamin D and B12.
I am finding some research indicating Vitamin D deficiency could have a role to play in insulin resistance.
Thanks.
Yes, both of the ones you mention, though neither were “severe.” I do supplement B12 and vit D (D3), but only started a year ago, long after IR improved.
Mr Attia,
Would you say that the light B12 deficiency was due to the nutritional ketosis diet? I thought that B12 came in ample supply when eating meat and eggs. I understand why vitamin D is more of a problem because of limited milk intake but I am confused about B12. Is there a link between low carb/high fat and B12 that I am unaware of?
Thank you,
Kevin
That would be atypical.
Peter,
My glucose hovers around 119 while my A1c was just measured at 5.5. I follow a very low carb high protein diet. During the week I usually eat once a day at dinner with the family. Since 2011 I have lost 55 pounds and have never before been this strong…I am 57.
My only concern is the level of glucose. Is one possible explanation the fact that my liver is producing glucose from the protein and that I need to adjust the ratio of fat to protein by increasing the fat % of total calories? Having said that my one remaining vice is my love of several drinks that contain splenda. Do you know of any reputable studies that show consuming splenda drives up glucose?
Is that level of glucose generally considered harmful? All my other markers seem to be in order. I just had a Male Panel Blood test purchased from Life Extension that is interesting reading.
Thank you for your efforts in this field. Between you and Gary Taubes I have my life back…I was seriously feeling old when I started this journey back in 2011. Not anymore.
Great to hear about your transformation, Pierre. To answer your last question, it’s definitely possible that non-nutritive sweeteners can alter glucose and/or insulin, but it’s poorly understood. I wrote a post on this a long time ago you should be able to find. Always interpret home (POC) glucose meters with a grain of salt. They are usually +/- 10 mg/dL, often skewed towards being too high.
When is that TEDMED talk you did a couple of months ago going to be published online?
Next week some time on the TED website. Not sure exactly which day, but should be up no later than the 28th of June.
What an outstanding talk, and it does not bother me to hear the stuff again I already read on the blog. I’m understanding it better every time,meaning I can pass it on to others. 🙂
My 16-year-old daughter, who is a highschool swimmer (no events over 500 free) was listening with interest. Are there performance benefits for this type of swimming of being in ketosis for someone borderline pre-diabetic (HA1c 5.7)? How to find a coach that won’t advocate carb-loading? Would it be better to include longer workouts or lowering carbs to increase ketone levels?
Hope you will buy a second fridge, at least a dorm room size. 😉
Birgit
Birgit, glad you enjoyed. If your daughter has a Hb A1C of 5.7 I would check that she’s not a carrier for thalessemia (a simple blood test called a CBC can confirm this). If she is, then A1C is elevated as an artifact and doesn’t represent the risk is does normally. I’ll try to address your broader question in a separate post, but the short answer is that ketosis may not be necessary, given her age and focus on sprinting. It’s more about cleaning up the quality of the carbs she consumes and getting the timing right. Hope to cover in the next few months.
Peter, thanks so much for the feedback, it helps a lot. My daughter’s hemoglobin levels were tested and found normal so I assume that means no thalessemia. She is cutting out sugar, grains, legumes already and keeping carbs under 80-100 grams/day, a little higher in fruit and rare gluten-free treats. We are retesting HA1c every 3 months with a low-carb/paleo-friendly physician. Interestingly enough body composition is perfect, between 10-15% body fat. I suspect there is an epi-genetic component to her insulin resistance as I was a sugar addict for many years.
Looking forward to more info on this from you in the future. 🙂
Birgit
Actually, Hct or Hb can’t always tell. The diagnosis lies in the MCV and RBC, but I’ll assume her doctor has checked the MCV and RBC numbers.
Thanks for the follow-up. MCV was 81, RBC 4.99, Hct 40.6 and Hb 13.9
My daughter seems to be too young, too much of an athlete and on too healthy a diet to be pre-diabetic, but if that’s what it is I’m sure glad we are catching it early. I had been weight-loss resistant, had cancer several times (Hodgkin’s, melanoma, breast cancer), thyroid issues and memory problems and was unable to improve my cardio until I read your blog and switched to a ketogenic diet. After about 6 months I found out that I had been pre-diabetic as well. I am hoping to spare my daughter the terrible medical history I had. Thanks again for all you do!
I’m spreading the word about it every chance I get.
Birgit
Yup, you’re right. No thal. Glad you’re helping your daughter be proactive.
Another opinion about the A1c for paleo people:
https://chriskresser.com/why-hemoglobin-a1c-is-not-a-reliable-marker
Fantastic presentation, thank you for making it public.
Am I right in thinking that you can only replenish depleted muscle glycogen by consuming carbohydrate?
That is definitely the best way to do so. Less efficient ways involve protein and glycerol (from fatty acid breakdown). At some point, in a follow up to this post, I’ll explain how I calculate my carb need for ideal replacement without getting kicked out of ketosis. Much more art than science.
Thank you for posting this talk. It is a good primer I can share with others who ask me about ketosis.
It was also nice to see your “average” ketones levels between between 1 and 2. After all the discussions I see on the Internet about people saying they are between 4 and 5 all the time I was having “ketone envy” 🙂 I am generally between 1 and 1.5 but higher during/after extended endurance sessions.
In the interest of adding another experimental data points in “how long can I go without food” angle my latest attempt was a 9 hour mountain run with just electrolytes and water and I was still not really hungry until the next day. It really is amazing to push some of this stuff sometimes..
I appreciate the attempt at not seeming like you are pushing ketosis on people I would be interested if someday you could discuss in what cases you have seen where ketosis is NOT ideal for someone. Perhaps some sort of metabolic damage or (epi)genetics that make it not ideal ? It seems like such a ‘base line’ functioning of the body.
Thanks again.
As a follow-up question, do you know if there is any data that describes the rate of glucose generation from the usage of fat (or whatever metabolic leftovers) ?
I am curious, given a certain RQ for someone, we are using a set amount of glucose so I am wondering if there is a ‘threshold’ for RQ where you are outpacing your body’s ability to create glucose from protein/BCAA/fats that would determine when an exogenous source of glucose is required. For example if my RQ rose to .86 that would mean I need to take in glucose to supplement the body’s creation of glucose.
Of course we would not know this while exercising but maybe it could be tied back to heart rate. If my heart rate is over 140+ then I need exogenous glucose.
Thanks again 🙂
I don’t know the exact answer to your first question, but the answer is ‘absolutely’ to your second question.
Very interesting on your attempt. Love the concept of ketone envy… I don’t know how to tell a priori who won’t do well on ketogenic diet, but there are folks who don’t. Trouble is I’m only able to figure it out after a few months. Small investment in time, though, given our lifespan.
Great presentation! Did you ever check if BCAA use ( my be without exercise) change your ketons level? Or what do you think abot that?
No, but impact would be minimal, given doses (re: very low).
Excellent talk/presentation. While you experimented with one meal per day, have you thought about an experiment with two meals per day with total carbs of 100-150Grams ? It might be interesting to see if the biomarkers are any different, and how you might feel exercise and otherwise? Ketosis obviously got our early ancestors through famine; and has short term benefits, but it is unclear to me that a state of ongoing nutritional ketosis for 30 or more years is the way to go.
Unfortunately, successful people and seekers of truth will have critics. Pay them no attention as there are many more out there who are benefiting from your endeavors as they try to maximize their individual health in light of their goals. Thanks for the great effort.
Have not done exactly what you described. Appreciate the encouragement.
Do you think that one could, over time, become bile-resistant from processing too much fat in the same manner that one can become insulin-resistant from processing too much sugar? Or are there pancreatic beta cell equivalents in the liver or gall bladder that might burn out from frequent, heavy production of bile? I’m just wondering if there might be a prolonged lipid-usage syndrome we’re presently not aware of that might show up on the radar after years in ketosis much like metabolic syndrome can rear its ugly head after years (or decades) of heavy carb usage.
Completely different mechanism. Never say never, but the association between eating fat and GB disease is, in my opinion, an association, not a cause.
My husband and I attended this talk at IHMC. BRAVO! We are runners in our mid 50s and, although we are not Elite in stature, we have goals that are meaningful and approriate for us individually. We both left that evening with grateful hearts and knowing we were meant to hear this message. We started with giving up sugar as our single focus. I don’t have any cravings for it and energy is off the charts. I have gone ” GUless ” and my runs feel better. I am almost giddy with excitement for living healthier as we age. We have incorporated other points of your discussion but it all started with removing sugar from the diet. Thank you for the work you do.
Fantastic to hear, Ann. Best of luck to you both as you begin your own journey in self quantification and experimentation.
Hello Peter,
I am very interested in the mental acuity aspect of nutritional ketosis. Do you know of any research in this area that might explain the correlation between high ketone levels and increased cognitive function or of any methods to objectively test if this correlation/ causal relationship is real or imagined?
Thanks,
Nathan
It’s a bit a leap, to my reading of the literature, from two other clinical and scientific observations: 1) ketones, by bypassing PDH in neurons, appear to improve cognitive impairment in AD (well established in mice; less so in humans to date); 2) normalization of blood glucose and insulin levels consistently appears to improve concentration, focus, etc. in human subjects.
There are ongoing efforts to explore this further to see if such a link can be established. More questions than answers at this point (e.g., is it the effect of #1 or #2 that plays a bigger role?).
I wrote my master’s thesis on Alzheimer’s Disease as Type 3 diabetes and the potential therapeutic role for low-carb & ketogenic diets. There’s most definitely something to the link between ketones and cognitive function. Look on PubMed for papers by RL Veech: https://www.ncbi.nlm.nih.gov/pubmed?term=Veech%20RL%5BAuthor%5D&cauthor=true&cauthor_uid=14769489 or ST Henderson: https://www.ncbi.nlm.nih.gov/pubmed?term=Henderson%20ST%5BAuthor%5D&cauthor=true&cauthor_uid=18625458
Mostly it has to do with similar mechanisms in the brain as in the periphery — in a T2 diabetic, the peripheral muscles & organs lose their ability to metabolize glucose effectively. The same can happen in the brain (plus oxidative stress, cholesterol transport issues, and a host of other factors, but the inability to metabolize glucose well is the biggie) — and by providing ketones, we give those struggling neurons an alternative fuel supply. In the same way that obese, chronically inflamed & in pain diabetics often experience high energy levels seemingly out of nowhere when they become ketogenic (because their body finally has access to fuels it can use properly), this happens in the brain — providing ketones to those brain cells gives them that energy boost they were no longer able to get from glucose.
Henderson & others have conducted RCTs in humans using exogenous ketones as well as low-carb diets, but overall, human studies are in pathetically short supply. (Partly because the establishment is still somewhat terrified of the implications of putting subjects on very high fat diets, especially saturated fat. And I suspect the exogenous ketones [usually administered as MCT drinks] are not as effective as a very low-carb diet with a keto supplement as merely an adjunct, so there might be reluctance on the part of researchers [or their funders!] to pay for further research when the outcomes are not as earth-shattering as they’d hoped. Again, this is likely due to people being put on MCT drinks without any guidance regarding cutting way back on CHO intake.)
This stuff is fascinating. And thank goodness, or my research would have been paaaaaainful.
Sorry — the links in my reply are not correct! Disregard them…but the authors’ names are the right ones, so you can just do a search for those.
Although worthy, genuinely bioavailable, ketone bodies are not commercially available as of yet, is it true that MCT oil (and coconut oil to a lesser degree) can assist in stimulating production of ketones? What is MCT oil’s value, if any, in moving, or assisting towards a keto-adapted state and getting ketones fuelling the brain ASAP and the rest of the body? (great talk by the way, thanks!)
Yes, MCT oil does stimulate the synthesis of B-OHB to varying degrees in people. Its use can be limited, in many, due to GI distress.