The Peter Attia Drive

#116 - AMA with Dom D’Agostino, Ph.D., Part I of II: Ketogenic diet, exogenous ketones, and exercise


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Back by very popular demand for a special AMA episode, ketosis expert Dom D’Agostino joins Bob Kaplan, Peter’s Head of Research, to address many lingering questions about the ketogenic diet, exogenous ketones, and exercise for overall health. Dom also shares valuable insights from his personal experience with training, supplements, intermittent fasting, and other nutritional strategies to optimize his own health and performance. If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA.  If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on the website show notes page.

We discuss:

  • Dom’s recent and ongoing projects [3:00];
  • Benefits of a ketogenic diet for an otherwise healthy person [7:00];
  • Book recommendations to become more knowledgeable about a ketogenic diet [11:30];
  • Best devices for measuring ketones [13:45];
  • Genetic factors that influence how someone responds to the ketogenic diet [24:45];
  • Ketogenic diet for those with the APOE e4 allele [28:15];
  • Impact of long-term ketogenic diets on thyroid function [34:25];
  • Low-carb and ketogenic diets for appetite control and weight management [39:00];
  • Ketogenic diet and the microbiome [43:00];
  • Comparing monounsaturated fat versus saturated fat on the ketogenic diet [45:55];
  • Implications of long-term genetic and epigenetic adaptations to a ketogenic diet [47:45];
  • Why some people see a rise in LDL-C and LDL-P when on a ketogenic diet and what they can do about it [50:15];
  • Should someone with familial hypercholesterolemia consider a ketogenic diet? [55:00];
  • Exogenous ketones—benefits, therapeutic uses, and ketone supplements that Dom has tested [56:45];
  • Ketogenic protocols for management of traumatic brain injuries [1:06:00];
  • Comparing the benefits and therapeutic uses of various medium-chain fatty acids—caprylic acid (C8), capric acid (C10), MCT oil, and coconut oil [1:08:45];
  • Nootropics, caffeine, and other stimulants [1:16:15];
  • Supplemental use of testosterone, DHEA, and creatine for muscle growth and performance [1:23:45];
  • Impact of fasted-state training on strength and performance [1:30:15];
  • Stacking exogenous ketones with MCTs for optimal effectiveness [1:33:30];
  • BCAA supplements during a fast for muscle preservation [1:35:45];
  • What app is Dom using to track his macros? [1:42:00];
  • Getting enough micronutrients while on a ketogenic diet [1:47:15];
  • Ideal macros and getting enough protein for strength training in ketosis [1:48:15];
  • Pros, cons, and ideal macros of one meal a day [1:51:15];
  • Dom’s take on “carb backloading” [1:54:45];
  • Dom’s take on “carb up” days for ketogenic dieters [2:01:00];
  • Dom’s thoughts on the carnivore diet and the paleolithic ketogenic diet [2:05:30];
  • Advantages of the ketogenic diet for extreme endurance athletes [2:10:30];
  • Impact on strength, power, and performance during the adaptation period of the ketogenic diet [2:14:00];
  • Fasted-state elevation in growth hormone and its impact on training [2:17:45];
  • Is it possible to build muscle on a ketogenic diet? [2:23:30];
  • Why Dom took a year off from weight training [2:28:00];
  • What does Dom do for cardio exercise? [2:30:45];
  • Protocols for hard training recovery [2:33:15];
  • Dom’s personal approach to fasting, time-restricted eating, and sleep [2:35:45];
  • People, books, and other resources that shaped Dom’s training and nutrition [2:38:45]; and
  • More.

Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/domdagostinoama01 Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

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