Peter Attia

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My guest this week is Dom D'Agostino.

Dom is a neuroscientist and professor at the forefront of metabolic therapies, including ketogenic strategies, exogenous ketones, and hyperbaric oxygen.

In this episode, we discuss nutritional versus supplemental ketosis, clear definitions, thresholds for clinical ketosis, and practical ways to achieve it while keeping protein adequate.

Why the early transition into a ketogenic diet can be challenging and how electrolytes and ketone salts can smooth that on-ramp.

The growing landscape of exogenous ketones, the salts versus the esters, 1,3-butanediol, taste and insulin effects, and simple effective pairings such as caffeine, MCT, and alpha-GPC.

Ketogenic diets as metabolic therapy for cancer, especially glioblastoma.

the prospects for ketogenic diets in neurodegenerative diseases, including dementia and Alzheimer's disease specifically, hyperbaric oxygen chambers, Dom's recommended protocols, practical barriers, and the rigor of ongoing trials, when fasting and ketones shine as a situational tool for cognition, workload, travel, and inflammation, and the carnivore diet as a ketogenic variant and what it implies for certain autoimmune and metabolic conditions.

So without further delay, please enjoy my conversation with Dom D'Agostino.

Hey Dom, thank you for making the trip out to Austin.

It's, boy, it has been a long time since we've been in person.

I'm afraid to hazard a guess as to when, but I know you and my brother see each other a lot more and I'm always getting pictures of you visiting him and him visiting you.

Well, the same can be said for you.

Dom, you've been on the podcast a couple of times, but I know that in podcast land, A, we've probably got hundreds of thousands of listeners today that weren't listeners the first and second time you were on the podcast.

And frankly, those that were, I think it would be understandable that they've forgotten most of what we've spoken about.

And maybe just by way of background, I'll let folks understand how you and I connected.

I believe Ken Ford connected us back in 2011-ish, thereabouts.

At the time, I was about a year into experimenting with a ketogenic diet, having all sorts of interesting success with it for the most part, once I got over the hump of figuring out how to do it.