Diet Doctor Podcast #20 — Dr. Ryan Lowery

Diet Doctor Podcast #20 — Dr. Ryan Lowery

August 2, 2019 8 By William Morgan


Welcome back to the Diet Doctor podcast
with Doctor Bret Scher.
Today I am joined by Ryan Lowery,
Dr. Ryan Lowery,
who has a Master’s degree in exercise
physiology and nutritional science
and a PhD in health
and human performance
and is the president of ASPI,
Applied Science and Performance Institute.
Ryan is an expert in human performance
and in ketogenic diet,
but also bridges this gap between science,
academia and implementation
for the everyday person,
for health and performance
not just from an athletic stand point
but from just an overall life performance.
He has over 100 published articles
in peer reviewed journals, book chapters,
and then he has also published
his own book “The Ketogenic bible”.
Ryan is a wealth of information and can talk
on a lot of different topics from authority,
and I really appreciate about that,
I really appreciate that about him,
so I hope you enjoy this conversation.
We touch on a lot of different topics
and go a lot of different directions,
but there’s a bunch of nuggets in here
that you can walk away with,
to really help you in your daily life.
So if you want to learn more and see
the full transcripts go to DietDoctor.com,
otherwise sit back, relax and enjoy
this interview with Dr. Ryan Lowery.
Ryan Lowery, thanks so much for joining me
on the Diet Doctor podcast today.
Thanks man,
it’s an absolute honor to be on here.
I’ve really enjoyed learning more
about you and listening to your talks
and you do a fantastic job of sort of bridging
the gap between the academics,
the research and the practical implementation
on how to be healthier,
how to use low-carb lifestyle,
how to train like an athlete,
or just be an average everyday person
and be healthy.
So tell us a little bit about your journey,
how you got to this point,
and how you got to the point where you
can sort of blend these worlds so well.
Yeah, well thank you,
I really appreciate that,
a lot of it stems from a passion for us.
So, I grew up playing sports my entire life
and really wanted to figure out how to take
my performance to the next level,
so I started really reading some of these
research papers,
these influential bloggers for a long time
and I was like oh, this is really interesting.
And then as I went throughout college
I started diving more and more
into the actual literature, actual research
and soon after traveling
to all these different conferences,
I started realizing
there is so much great information,
but the challenge is scientists speak
at this high, high level,
it really just goes over people’s heads.
And
I’m like, how do you take that information,
that such high quality information
and not, I don’t like to use the term
dumb it down,
but how do you make it relatable,
how do you take that information
and translate it,
and be able to put it into practical,
meaningful use.
And ultimately, that’s what we do at ASPI,
the Applied Science and Performance Institute,
we said, you know what, how do we take
this cutting edge research,
look at everything from the full spectrum
of performance, high level athletes
to people with neurological conditions…
how do we take that research
and then be able to get that message
out to the world?
Yeah, you see, at ASPI, you’re working
with professional athletes
who every half of a second could make
the difference between victory or defeat,
and you’re working
with sort of the every day person,
who just wants to think a little clearer,
be a little healthier, live a little longer,
and then you’re dealing with people
with significant severe diseases,
whether it’s Alzheimer’s disease,
Parkinson’s disease,
it must be a very unique mix where you’re not
sure who you’re going to see,
or what you’re going to do in your day.
Exactly, we see a whole host
of different people
and I think at the end of the day it stems
from optimizing human performance.
And a lot of the time,
people think performance and they think–
and they immediately go to athletes,
and like you said, we work
with the most elite athletes in the world
and for them a millisecond can mean
the difference between gold
and not even placing, so, it’s very intense,
but also, at the same token, performance
also is a grandfather being able to get up
and play around with his grandchildren,
like, that’s performance as well.
So how do we work both ends
of the spectrum
and use the science and the technology
to be able to apply it to both?
And that’s what we are trying do today
at ASPI.
Yeah, that’s a great perspective.
Now, one of the things you talk about
is I think when you first started
getting involved in the research
was, can you build muscle
on a ketogenic diet?
And everybody was saying, no, you can’t.
And you did a couple different studies
showing that yes,
you can build muscle on a ketogenic diet,
and then, it brings in the whole concept
of protein.
The thought is we need more protein
to build muscle
and one of the things I’ve ever heard you say
is we need less protein on a ketogenic diet.
So tell us a little bit about what you learned
about building muscle on a keto diet,
and how protein plays into that.
Yeah, absolutely,
I think it was a big question,
it was something
I was really concerned with.
And I was like, “If I do this keto thing,
am I just going to melt away and lose muscle?”
Because everyone, my entire life,
I was taught you need carbohydrates,
insulin is anabolic,
it helps promote muscle growth,
you need it in order to gain any muscle.
So we were really one of the first ones
to look at this
and we say, what if we take two groups,
and we took a Western diet group,
and like we took people
who were eating a healthy Western diet
and a ketogenic dieting group,
we matched them for protein intake.
So, both groups had
about 20% of their calories from protein,
and then we trained them for eight weeks,
and at the end of that period,
we looked at muscle mass
and we did a dexa body composition,
and we looked at their lean body mass
and there were no differences between
the people who were eating carbohydrates
and the people that were eating
a well formulated ketogenic diet.
And their protein was matched and so
it was kind of like this eye opening thing,
and people were like, “There’s no way…
How’s that possible?”
So, we took a deeper dive and started doing
more animal studies
looking at things like muscle protein
synthesis, muscle protein breakdown,
we know that ketones themselves prevent
the breakdown of like leucine,
which is a very important amino acid
for maintaining muscle.
We also found out that–
and this is pretty new,
is that ketones themselves
can stimulate muscle protein synthesis.
So, kind of to your second point is…
Do we need more protein?
Do we need less protein?
I think that two reasons;
one because of the elevation in ketones
themselves being anabolic in nature
you likely probably need less protein
than a normal individual.
And two, just from general
research
we know that the more
insulin sensitive you are,
the more likely you are going
to response to a lower dose of protein
to trigger muscle protein synthesis.
It’s one of the reasons why, if you take
a 20-year-old, who is highly insulin sensitive
and take a 70 year old,
who might be more insulin resistant,
in order to turn on the switch,
or trigger muscle protein synthesis,
the 20 year old might only need
20g of protein,
the 70 year old year might need
double that, 40g of protein.
So what if you were to have that 70 year old
be at the same degree of insulin sensitivity
as the 20 year old,
maybe that’s the difference, in–
the more insulin sensitive you are,
likely the lower the amount of protein
that you need to initiate that response.
So there is some protective effect
from the ketones itself,
but beyond that it’s the insulin sensitivity
that can affect the degree of protein.
Has that study been done,
you have 10% of calories from protein,
20% and 30% and train them
and see their muscle synthesis and–
That would be really interesting
and I think that there’s a lot of factors,
but I think insulin sensitivity
is one of the overarching factors,
is the more you can be insulin sensitive,
the more likely you’re going
to respond to lower doses,
have a lower threshold
for triggering muscle protein synthesis.
Yeah, and when we talk
about muscle building,
we’re not just talking about
the professional athlete to the weight lifter,
we’re talking about the 70-year-old
who wants to get off the couch,
or falls down and wants to get up
off the floor and avoid sarcopenia
and not fall and break your hip and so when
you’re talking about muscle building,
you’re talking
about sort of the whole spectrum.
Exactly and I think that a lot of times
when people hear muscle building,
they immediately think
body builder and weight,
but sarcopenia, like age related
muscle loss,
females, you want to have muscle mass,
a lot of times they think,
“I’m going to start training
and I’m going to gain too much muscle,
so I’ll look too bulky.”
No you need muscle mass because
the more muscle mass you have,
the more insulin sensitive, you’ll likely be.
You need a place to have that storage,
you want to prevent sarcopenia,
because we all know that the minute
that you fall down and break a hip,
it’s like things start spiraling downhill
from there.
So how do you maintain?
And if you’re trying to improve it,
minimum keep the amount of muscle mass
that you have,
I think those are two very important things,
when it comes to how do I keep muscle mass
and utilize a well-formulated
ketogenic diet to do that.
Yeah, so in the keto community
a lot of people come to low-carb
and keto to lose weight.
Their first thought is not muscle mass,
their first thought is not even
cardiovascular health or whatever,
their thought is lose weight,
so as they’re losing weight,
a lot of them are also losing muscle,
do you think, in the beginning?
So, I think a lot of it depends on…
well they lose lean body mass…
And so it’s important to understand
that muscle, like actual dry muscle,
is a component of lean body mass, but like
glycogen is another component of that.
Glycogen is stored inside muscles
and when you first start a ketogenic diet,
sometimes that can be attributed to the water
that’s coming from the fat mass,
lean body mass, whatever that may be,
that can contribute over time,
as you adapt you start to replenish
and upregulate pathways
to increase glycogen,
so it’s like about the same
as it was prior to doing it,
but I think if you’re on a well-formulated
ketogenic diet,
and you’re having
an adequate amount of protein,
people won’t see muscle mass loss.
Yeah.
Do you see risks of too much protein?
I do, I think at some level there
probably is a risk of having too much,
like body builders.
When I was younger, and I was
on a carbohydrate-based diet,
I was eating everything in sight, the worst,
worst diet you could ever imagine.
I was probably having
250 g to 275 g of protein per day.
I was eating Greek yoghurt like
in between classes, everything.
And I was adding protein on top of that.
I think you thought more was better.
I always thought, if I want to put on
as much muscle as possible,
I need to be eating 300g of protein a day.
I think at some level yes,
you will have some conversion over
into like getting some gluconeogenesis from
some amino acids, if you’re having too much.
I’m more concerned,
especially with– females and males,
but I often see it in females,
is them not getting enough.
Because when people switch to a ketogenic
diet and then they’re eating that way,
a lot of times people feel less hungry
all the time,
so they might only eat
one or two meals a day
and they’re not used
to getting in enough protein,
and so sometimes I see people
eating one meal per day,
they might be getting in 20g of protein
in that meal
and people are like,
“Why’s my hair falling out?
Why am I getting keto rash?
I’m like,
those are clear signs of protein deficiency.
So, I encourage people to get enough,
I’m like make sure you’re getting enough,
but just don’t go overboard with it, there’s
no reason to go body builder, 300g per day.
Right and then you probably work
with a lot of body builders
who are trying to go keto
and do they cycle, do they–?
A lot of your athletes, let’s not focus
on body builders, but athletes,
do you cycle a lot of your athletes
in and out of the keto, in and out of carbs
depending on the season
and the competition and so forth?
Yeah, a lot of the athletes
that we work with
use more of a like targeted approach,
and I think it’s an interesting approach for
people that are performing at that high level
is they use carbs as a tool,
it’s not a necessity,
they’re utilizing it
as what we call an ergogenic aid.
So, if we have someone who’s about
to go do an event,
they might have 30 g to 60 g of glucose
right before their event,
but they’re burning
through immediately.
It’s not like they’re taking that in
and they’re doing a cheat day,
sitting on their butt and watching TV,
it’s like they’re actually going in
and utilizing that fuel source
and utilizing the carbohydrates
for what they’re meant to be,
which is this tool
or a potential ergogenic aid
not as a necessity
that I’m just having because.
Right, right.
So, when you look at athletes, I mean we
can’t talk about athletes as one thing;
there’s the ultra-endurance athletes,
there’s the sprinter, the weight lifters,
there’s people doing the jujitsu, so some
are the more steady continuous exercises,
some are the repetitive
glycolytic type exercises,
do you find some are going to do better
or worse on a low-carb ketogenic lifestyle?
Yeah, a lot of times people think
that people who are anaerobic
versus people who are aerobic,
people who are anaerobic like doing those
short high intensity animal type training,
they think they’ll suffer.
We haven’t seen that yet.
It’s possible in like sprinters,
we don’t work as much with like sprinters,
like if you’re doing like, hey you only have
a straight away sprint,
there is a possibility that your performance
may not be as well.
If you’re fully adapted,
I don’t know that yet,
because I think that ketones
can provide some quick energy,
but certainly in the aerobic sports,
I think being a ketogenic fat adapted
in some capacity
is way better than running into the wall
or hitting the wall
and running out of glucose, having all those
gels and goo’s and everything
and it messes up your stomach
and I think for aerobic it’s very clear.
In between is what people–
like I think that Brazilian Jujitsu,
we work with a lot of Brazilian Jujitsu,
MMA is starting to get
a lot of attraction for it.
It’s very big in sports,
that where the weight to power ratio
becomes very important,
wrestling, things like that,
because your goal is how do I fight
or compete at the lowest weight possible,
yet maintain or maximize my power and
output in strength, how do you do that?
I think that being on a well-formulated
ketogenic diet ultimately allows that,
because when you cut down
and you’re not on a ketogenic diet,
you’re at risk for muscle mass loss,
you’re losing strength, you’re losing power,
what if you can preserve that?
And like we were talking about,
maybe due to the elevation of ketones,
maybe even preserve that muscle mass
when you’re dieting down to a different
weight class and still be able to perform.
Right, that’s a great point.
Now you mentioned the term adaptation.
So, we talk about keto adaptation
from a lifestyle standpoint
and there’s that first week or two
of the keto flu and you feel terrible
and you need to hydrate
with those electrolyte supplement.
But from a sports standpoint
and a physical performance standpoint,
that adaptation is a lot murkier
in terms of how long it is.
Some would say six months,
some would say a year.
How do you gauge
whether someone is adapted
and how do you know
when they reach that point?
Is it their respiratory quotient
on a cardio metabolic test
or is it some other testing you can do?
Because this seems very vague
at this point.
It is, it really is big…
I wish there was a– you know what?
One of these days someone has to develop
a way to measure like MCT transport capacity.
I think that would be the best way
to look at it,
we don’t have that technology yet,
but to your point, I think looking at things
like RERC, where they’re at,
they’re closer to like 0.7
or if they’re still up at like 0.9 or 1.0,
meaning that they are
primarily utilizing carbohydrates
or they are primarily utilizing fat,
and we also do like pre–
and then every week we kind of do
these follow-ups
of looking at different measures
of performance, vertical jump power,
bench press power,
see like how much they dwindle
and then how quickly it takes to come back,
and for everyone it’s so individualized.
We know that the keto adaptation,
there are ways to accelerate it,
doing things like intermittent fasting,
making sure you’re supplementing
with the proper electrolytes.
Doing high intensity interval training,
depleting muscle glycogen levels
as fast as possible,
it’s one of the things I tell our athletes
all of the time,
is like if you’re going to do this,
like fight through it,
like try and do it as quick as possible,
like I know you’re not going to–
you’re like hey I want to have
my best work out,
but fight through it,
deplete that muscle glycogen,
because what’s on the other side
is a lot better,
so the quicker you can get through it,
the quicker you can adapt,
the more you’re likely to sustain this
and be able to make it a lifestyle.
So, that’s for an athlete.
What about another everyday Joe,
who says,
“I want to go ketogenic,
I’ve heard terrible things about the keto flu,
so I’m just going to take it easy
for the next couple of weeks,
and drink my bone broth
and get plenty of electrolytes.”
Would you tell him the opposite, even–
not the athlete, but just say you need
to get out there
and you need to burn that glycogen and you
need to be more active during this week
or two weeks
even though you feel like crud?
I still think that’s the best approach.
And I know it’s tough because people
want to take it the easy route
and if that’s the mindset,
if you really want to embark on this,
I’d say go in and you’ve got to make sure
this is something you want to commit to
and go, “Hey, I’m going to go out”,
even if it’s not, “I’m going out
and do high intensity training.”
Just go on a walk, get moving,
try and deplete muscle glycogen levels,
maybe incorporate in
some intermittent fasting,
make sure you’re supplementing
with electrolytes
and having thins like bone broth, make sure
you’re incorporating those things in,
because the quicker you can adapt,
the less likely you are to be
like, you know what, I’m just having
a headache and this isn’t worth it.
And you go back to eating a pop tart
or something else
and then you just fall
into this vicious cycle
that you’re like, “I could never do that,
I can never get over keto flu.”
I want people to bow through it,
get through it as quickly as possible
and then realize the long-term benefit.
I haven’t thought about pop tarts
in a while, you know.
Do you know how many pop tarts
I ate on my bike,
going like just hours and hours, fueled on
pop tarts after pop tarts… it makes me sick!
S’mores were the best.
We’ve got to make a keto one.
Right, keto pop tarts!
Actually, that brings
up an interesting topic right there.
All these keto products that are popping up,
I mean I’m a big proponent
of a real food keto diet
and for some people that still
just doesn’t cut it
and they want the products,
they want the cookies,
they want the packages
and some of that is a mixed bag.
I mean not all of it, our bodies are not going
to respond as it should to a lot of that,
depending on some of the ingredients.
Now I heard you’re doing a whole
certification process now with your company,
to certify these.
So, tell us a little bit about your concerns
of what’s in these keto package products
and how your certification process
is going to help with that.
Definitely and I’m the same way,
like I advocate whole foods, real foods
as much as humanly possible,
but I understand the dynamic
that people are like,
“I want a cookie, occasionally”,
or “I want a brownie or something.”
And that’s fine as long as the product
is built the right way,
or as long as it’s created the right way.
So, it’s not utilizing things like sorbitol
or maltitol, which are sugar alcohols,
but we know not only
they have problems with GI issues,
they also can spike glucose and insulin,
which isn’t very good.
So they can be low-carb, they can be keto,
but still spiking glucose and insulin.
Right, I don’t even consider them keto
if they have high amounts,
like you go down
your traditional grocery aisle,
and I’ve made this mistake very early on
when I first started the ketogenic diet,
I was like wow, all my friends were going
out to the movies,
all my friends were grabbing the regular
Reeses, Kit Kats, things like that,
I go down there and I’m like wow,
this is sugar-free candy,
and I look at the back and I’m like,
this is weird, it has 30g of carbs,
but 28g of sugar alcohol.
So I was like, oh so it’s only two less carbs
because you subtract it out.
So I go to the movie theatre and I have like
four pieces of this sugar-free Reeses going in
and I was like, oh gosh, my stomach
was– it was killing me,
I was like, “There’s no way I’ll do that again”,
but people don’t know that.
And I think it’s sad to see products like that,
that have so much sorbitol and maltitol,
so that’s my biggest concern, is not only are
there sugar alcohols that can cause a spike,
there’s also various different sweeteners,
but there’s also like fibers,
it’s not like fibers are all created equal,
and I think we’re starting to see
some regulations starting to change.
It’s just not fast enough yet.
So I hope
it’s not malicious on the company’s part,
I hope it’s just a lack of understanding
on the RND.
Yeah, it’s easier to make something
with sorbitol and maltitol,
yeah, it’s easier to use a fiber known
as isomaltose oligosaccharide.
IMO.
IMO, but that actually gets digested,
it actually causes a glucose and insulin
response, we published a paper on that,
versus like soluble corn fiber,
which doesn’t.
So, a lot of times they take
the easier route because it’s all they know,
but the companies that are doing it right,
that’s who we’re trying to reward,
we want to make sure the companies
are protected,
but the consumer is protected in going out
and being armed and saying,
“You know what? There’s going to be
this explosion of keto products,
it’s going to happen.”
It’s all about the intent and the research
and development behind the product,
to make sure it’s done the right way
and so we want to be kind of a voice,
a reason to help further that
and say, we’ll not only test these out
and look at all the ingredients,
but we’re actually going to test
this out and do blood testing
to make sure these things
are tested properly.
Right, blood testing, I heard you mention
both glucose and ketones.
Right, because if the glucose doesn’t go up
but the ketones go down,
that could be a sign
that the insulin is going up.
-So you got to make that jump.
-Exactly right.
So for our listeners here, who are going
to go out tonight and look for a cookie,
a keto cookie, look for a keto snack,
what ingredients should they be looking for,
in terms of the fiber?
You mentioned soluble corn fiber
and some of the sugar alcohols.
What are some of the good ones
that they should be able to look for,
if there are “good ones”?
Yeah, when it comes to sugar alcohols
I would like to stay with like erythritol,
xylitol is okay, it’s a lower GI.
I don’t keep it in the house, just because
I have a pet and you have to be careful.
Xylitol is like poisonous for pets.
But erythritol is probably
one of the better ones,
stevia, monk fruit, things like that.
I’m starting to see a new trend,
which I’m excited about,
because we’re starting
to do research on this,
it’s actually a rare sugar and people freak
out because they hear the word sugar,
but it’s called allulose, and we’re starting
to see it pop up more and more,
but it tastes just like sugar.
But we’ve actually done research
where 92% to 97% of it
is completely excreted out of the body
and it causes no glucose response,
no insulin response.
We’re actually collaborating
with someone overseas
that is working with type 1 diabetics
and just giving them allulose
and their glucose is dropping
and no increases in insulin.
Really?
Very, very fascinating stuff,
it’s very new,
but I think we’re going to start seeing
more and more of that emerge
and I hope that one day we’ll start seeing
these big soda companies
start switching over to utilize
something like that,
because it literally tastes just like sugar
but doesn’t have the same metabolic
disaster that tons of sugar has.
Yeah, that’s so interesting because
you can look at it from two ways.
You’re getting rid
of the metabolic disaster of sugar
but you’re still creating that slippery slope
of wanting the sweet taste
in training our taste buds for the sweetness.
And that’s partly why I recommend
whole foods only
and I understand that people are still going
to crave that sweet tooth,
but I love it when someone comes back to me
and says, “Carrots taste so sweet now”,
whereas before they could just pop carrot
after carrot and not even blink,
but now even a carrot tastes sweet,
I’m like yes, you’ve trained your taste buds,
you’re doing it right,
so I think that’s so interesting.
So, we talked about athletes
and athletic performance
and one of the other things
you’ve talked about is longevity
and that’s a huge topic right now,
not just longevity but also health span,
living healthy as long as we can.
And so there’s some thoughts
that a ketogenic diet
and ketones have a positive benefit
for longevity,
obviously we don’t have 20, 30,
40 years studies on it,
but tell us your thoughts
on where the science is for that,
and where the hypotheses are for that
and what you’re most excited about
for ketosis for longevity.
Sure, and if you type in keto for longevity
or keto for health span on google,
you’ll get a very different message, because
most of the people misinterpret the data.
And a lot of the things, there’s meta
analyses done on these long-term studies
that’s kind of like, oh low-carb
isn’t going to be good for you,
it’s going to cut your life expectancy,
but in reality if you dig into those studies,
they’re using 30, 40, 50% carbohydrates
in deeming that low-carb.
So that’s one thing, if you’d just be careful
with what information you’re taking in,
that’s why the Diet Doctor does
an amazing job, you do an amazing job,
putting out this information
that’s legitimate information,
not something that’s just,
“Hey here’s a study.
Let me misinterpret it from media and press
and pump it out there.”
Right.
But what we’re seeing in longevity
is a completely different picture,
so we’re seeing, there’s early studies
with like ketones in C. elegans,
which is like a worm type model
extending lifespan.
We did a research study
where we actually took animals
and about the human equivalent
of about 20 years of age,
we took them at that point
and placed them on a ketogenic diet
and carried them out for their entire lives
and just looked at what happened.
We looked at everything, we looked
at every marker you can think of–
we’re still looking at markers
inside of tissue, everything you can imagine
and what we found was that animals
that were on a ketogenic diet, their half-life,
meaning that the amount of time it took
for half of the animals in that group to die
was almost double the amount
from the Western dieting group.
Which was very, very interesting
and these animals lived significantly longer,
and we just carried them out,
let them live throughout entire lives
and fed them a ketogenic diet
versus like a traditional Western diet
and even though protein was matched,
they still lived longer.
Yeah.
So, there seems to be something unique
about these ketone molecules
that like being in a state of ketosis itself,
and not having that rollercoaster
of glucose and insulin all the time,
seems to promote that.
I wish that we could do a study on humans,
but none of us would be around to see it.
Right.
What’s so interesting is that the benefit
of the ketone,
the ketogenic diet from the ketones
themselves or from the reduction in carbs,
the insulin resistance
or the combination of both,
so there’s studies showing
that ketones can affect genetic expression,
and HDAC inhibition
and what is the level of science
for ketones themselves
as being a beneficial marker of health
and longevity rather than the diet?
Yeah, I think it’s a combination.
I think it’s tough to titrate out which it is,
I think it is the suppression of insulin,
chronic elevated levels of insulin,
I think it’s lowering inflammation,
there’s a lot of systemic inflammation
that happens.
And both ketones themselves can help
with that via through a ketogenic diet
or even ketones themselves, partly because
if you look at studies on ketones,
it downs, it shuts off the
NLRP3 inflammasome,
it blocks the NLRP3 inflammasome,
which is the main marker of inflammation,
so it’s tough to titrate it out,
but it seems to be,
just being in a state of ketosis
seems to be driving that response.
Yeah, because
it’s so interesting for people
to try and figure out,
“Do I need to be in ketosis?
Is a low-carb that’s not quite ketosis,
good enough?”
Of course it depends on your goals,
where you’re coming from
and I think there’s still a lot
that’s unanswered about that,
but certainly interesting to think about.
Yeah, and I think
it’s a moving target for everyone,
like I know people
who are a weave of athletes
that can be eating 80 g to 90 g of carbs
and still be registering 1.0 mmol.
But their calories are go high
and they’re burning so much
because they’re working out
three times a day,
but then you also know people
who are probably eating 20 or 30g
and that’s what they need
in order to stay in ketosis.
It’s very individualized when you’re talking
about like low-carb versus ketogenic,
but like 40% or 30%, which is what some
of those studies are doing,
like mortality studies,
I wouldn’t even consider that low-carb.
To me is still a really high carb.
It’s sad that it’s considered low-carb
compared to the standard Western diet here,
and also there’s the observational studies
that do food frequency questionnaires
and there’s tons of confounding variables
and the healthy user bias…
That’s not science.
Right.
I mean, that is not science,
and that’s why I’m glad you’re doing,
the science you’re doing really is
sort of more rigorous and controlled
and more useful
from an investigative standpoint,
so I hope you do more of that, for sure.
So, then there’s this whole field
of exogenous ketones,
so when we talk about is there something
unique and special about ketones themselves,
then the question becomes, should we just be
pounding extra ketones,
and there I think it’s important to separate
a couple of different concepts.
There’s treating different diseases,
like traumatic brain injury,
Alzheimer’s or Parkinson’s,
there’s athletic performance,
and then there’s general health,
how exogenous ketones fit
into those three categories,
because they’re very different.
So, tell us a little bit about how you see
and how you use exogenous ketones.
Yeah, that’s a great point, I like bucketing
them out into three different buckets.
To look at ketones, I think ketones–
exogenous ketones came out
into the market in a bad light.
I think people were being marketed,
it was like, “Hey just drink this
and you’ll lose 15 pounds,
“it doesn’t matter if you go eat a Big Mac
or you eat whatever,
you’re just going to lose weight doing it”,
and that wasn’t the right approach.
And I think it’s been refined
since of understanding
like, it’s not a magic supplement,
it’s not going to magically melt body fat
off of your body.
If you’re talking about general health
to your point of like inhibiting HDAC
and somebody’s longevity,
there’s a possibility that ketones themselves,
there are studies, like in the C. elegans,
they were utilizing just exogenous ketones.
They weren’t putting them
on a certain diet,
they were utilizing exogenous ketones.
We’ve done studies in animals,
utilizing both a combination of a ketogenic
diet and exogenous ketones
and saw a slightly better result
for like things like increasing brown fat,
decreasing food deficiency,
which is the amount of weight you gain
over the amount of food you consume.
So, for general health
that’s really the application.
The other application where the weight loss
can come from consuming exogenous ketones
it’s when people consume exogenous
ketones they seem to feel more satiated,
so the thought process is like,
if you’re consuming exogenous ketones
and you’re extending that fasting window,
if that’s something,
it’s the same reason why if you have
a little bit of MCT oil inside of your coffee
it can extend your fasting windows,
so you’re eating less within that window,
that ultimately long term will help
with body composition and weight loss.
So, I think a lot more people are starting
to report seeing that
and utilizing it for that benefit,
versus hey just drink this and then I’m going
to go and eat a ton of carbs on top of it,
but to the other aspects we’re starting to see
more and more research on performance,
there’s some early studies with
the ketone ester on performance,
we’re starting to see some now
with ketone salts,
looking at athletic performance,
so there is potentially an application there,
and then to your point I think starting
to utilize some of these interventions
for things like neurological conditions,
where there’s an energy gap, right.
We’re starting to call Alzheimer’s
type 3 diabetes,
and the problem is the receptors
in the brain are insulin resistant,
they’re not able to properly take up and
utilize glucose as effectively as they used to,
prior to having that diagnosis.
So, how do you provide a fuel source
to the brain
that allows individuals
to get something to there?
Doctor Marian Newport, has a great,
great TED talk,
she wrote a book on this,
talking about how with her husband–
He wouldn’t go on a ketogenic diet
and it’s tough when you’re dealing
with family members.
He wouldn’t eat it, but what she would do,
is she would give him
spoonfuls of coconut oil at the time
and then the ketone supplements started
becoming more and more readily available
and she started giving those,
but her, she was just like,
“How do I get some type of elevation
of a substrate that his brain
can actually utilize?”
And she saw amazing improvements,
even with just coconut oil,
utilizing that to try
and get that fuel source to the brain.
So, to your point,
I think there are different applications
and it’s just using it in context
as a tool, not a crutch.
Do you have research studies
ongoing at this point,
for a neurological disorder in athletic
performance so we can actually study it,
so we can see some evidence
coming out of it in the future?
Yeah, we have a case study
that we’ve just published on Crohn’s,
because
of the anti-inflammatory aspect of it.
So, lowered CRP, which we tend to see
with exogenous ketones.
We’re working right now,
I’m fascinated with Parkinson’s
and traumatic brain injury mainly
and Alzheimer’s falls within that realm,
but we have a case study on Parkinson’s,
which is pretty amazing.
We’re starting to replicate that
and see it more and more,
where again I think it’s an energy gap,
and so if you’re providing these individuals
with a fuel source, that they can utilize,
one of the reasons I think exogenous
ketones can play a role is,
say you’re taking a professional athlete,
we work with NFL athletes,
if they’re not on a ketogenic diet
during the season,
what can you give them…
boom, they take a huge hit, they have
a concussion, something immediately after,
yeah you can fast them
but we just talked about,
it takes time to adapt, but they have to play
again the following Sunday.
How do I give them something that will give
their brain a fuel source immediately,
versus delaying that process,
all of a sudden, the brain starts starving
and we start building towel plaques,
we start developing CT?
How do you provide a fuel source
immediately after that trauma?
I’m interested in seeing that,
I think one day we’ll see on the side lines
of some of these contact sports,
like rather than drinking
a huge sugary drink,
we’ll start seeing some incorporation
of like exogenous ketones
to be able to provide a fuel source
to the brain that it can take up and utilize.
Yeah, that would be fascinating
in some way to measure
that the concussion symptoms
or the duration of the concussion is lessening
and then hopefully having
further long-term effects as well.
Right, and we see that in animal models,
we see in in animal models,
we just haven’t been able to look at it yet
in humans, but like in animal models,
they do models where they can induce
concussions in animals,
but they’ve like given them ketones before,
and then looked at the duration
of how long it’s taken to recover,
and it’s improved.
Interesting.
Even on a ketogenic diet,
if you’re able to get them on a ketogenic
diet or utilizing exogenous ketones.
Right.
So, they’re already on a ketogenic diet.
Theoretically they would have
the protection built in.
Exactly.
Very interesting, okay,
so you’d also mentioned fasting.
Fasting is very popular now
and for good reason,
but more sure of the time restricted eating,
not necessarily, you know,
a 5 day, 10 day fast,
that’s its own thing that we can talk about,
but the shorter fast, the 16 hour,
the 20 hour fast,
probably more in line
with sort of how we evolved,
it helps our insulin levels stay low,
it helps us to lose weight,
it definitely seems to be beneficial
for promoting health.
Now when it comes for exercise and fasting,
it can have different effects on the body
depending on what our goals are,
so how do you think about fasted exercise
versus fueled exercise and who’s it right for?
Great point, I think it depends
on the goal of the individual.
If the goal is more fat loss,
then exercising,
whatever that exercising is
in that fasting period,
it probably won’t be,
it’s probably a good idea,
probably not a bad idea to–.
If your goal is to maintain performance
or increase muscle mass,
eating around
that time where you are exercising
it’s probably beneficial,
so you just shift that time point
or that window in which you are eating.
I think one of the most incredible studies
that I don’t think is out there yet,
that would be done,
and I have a theory on this,
but like I when I intermittent fast, most
people do this, they tend to skip breakfast,
they might eat sometime in the afternoon
and then they’ll have something for dinner,
just because it’s convenient,
it’s the convenience.
Based on non-ketogenic studies,
if you look at studies that have given
a larger breakfast meal
and a smaller dinner meal,
there seems to be more benefits.
Eating a larger amount earlier on the day,
versus later on in the day,
in non-fasting, non-ketogenic conditions,
seems to be more ideal.
I think if it were more feasible
for most people, eating in the morning
and then eating at lunch and then probably
not having anything at night
would probably yield better results
than not eating in the morning,
eating at lunch and eating at night.
It’s just my theory based on the fact that
you’re more active throughout the day.
You’re going to be utilizing those calories
and then a lot of those times
people will eat a big meal at dinner
and then two hours later be laying in bed
or sitting on the couch,
watching Netflix or something.
Right.
So, it’s just a theory I have,
something that I want to do at some point
for research study
but the window itself is variable
depending upon the context and the goals.
Yeah, and that makes a lot of sense,
I mean Satchin Panda has done a lot of work
on circadian rhythms of insulin sensitivity,
and you’re less insulin sensitive
in the late afternoon and evening
and if that’s when you’re having
your biggest meal, maybe that’s not ideal,
and also you look
at the “Mediterranean diet”,
so it has do to
with the Mediterranean culture,
which is sort of a lunch, you know,
a mid-afternoon big meal
and not in the evening,
a smaller meal in the evening.
But a lot of these things
seem to go along with that,
but logistically and socially,
it’s just hard
when the big meal, you know, is the social
meal with the family and the kids
and you’re going to skip it,
it makes it hard.
Exactly right.
And a lot of people are more rushed
in the morning,
they don’t want to have time
to make breakfast,
so logistically it’s so much easier to just
skip breakfast for the time restricted eating
and I think it’s a good question…
does it make a big enough difference
when you have it,
that it’s worth the extra,
sort of logistical challenge to make it work?
Exactly, that’s the big question.
I’d rather like people do it
as long as they can sustain it,
I’m one of those people where it’s like
I’m sitting down with friends or family,
like it is more convenient to sit down
at dinner time at night and be like cool,
I just got home from work,
like it’s, it’s calm, it’s… boom,
I’m just going to have dinner…
with family and friends,
it’s like you said interesting,
it would be very, very interesting
to look at how big is that difference,
if there is a difference between morning
and lunch versus lunch and dinner.
Right and a simple change,
if you’re having the lunch and dinner,
just make the lunch the bigger meal
and dinner the smaller meal.
Yeah but so, if I can summarize
what you said though,
if fat loss is your goal then working out
fasted is definitely beneficial,
if added performance and muscle gain
is your goal
then you recommend eating something
prior to your workout,
and any particular composition of the food
you recommend eating before the workout?
Yeah, it could be before or after,
just eating around that window.
Around that workout period,
because you want to train,
you want to initiate muscle growth,
you want to provide recovery
for that exercise belt,
likely you’re going
to be resistance training,
if that is your goal
for performance or muscle building.
So, you want to fuel that, and I think
just getting in a high-quality meal,
I sometimes people over complicate it
and be like, “Oh I need a protein shake
or something after that.”
No, it’s fine,
just go get real food.
Right.
Get a whole meal, get something
that you can get in
that has ample amounts of protein,
maybe 20, 25, 40 g of protein
and just enjoy your meal.
Yeah, so when we talk about fasting
and health and longevity and protein,
the topics that come up again and again
are mTOR and IGF1 and tough to measure,
tough to know what the right balance is,
but the thought is you need some
stimulation of mTOR and IGF1,
they promote growth, muscle growth
health and vitality too much
and it promotes cancerous growth
and shortens life span and health span.
How do you see using ketogenic diet,
intermittent fasting, protein intake
to sort of balance these concepts
of mTOR stimulation, IGF1 levels
and how that applies to health?
Yeah, it’s so interesting, because,
it is very, very difficult to measure,
it’s I think one of the aspects
like intermittent fasting
being on a ketogenic diet.
It gives you this break from constantly
stimulating mTOR all the time,
and I think there’s a lot more
to be studied
and people just think that protein like
initiating mTOR with protein,
if I stimulate it all the time,
it’s going to be cancerous.
I think there are other aspects to mTOR,
because mTOR is a very complex pathway
that multiple things can stimulate it.
But I used to be of the thought process,
like when I was literally trying
to put on muscle mass,
I used to set an alarm in the middle
of the night at like three in the morning
and get up and drink a weight gainer shake
and a bunch of protein,
because I was like, I need to hit
this threshold as much as possible.
And it was like this crazy mindset
like I’m trying to hit this
as many times as possible
throughout the entire day.
And I was eating
probably six meals a day
with branch chain amino acids
in between like each meal.
And I was trying to keep it elevated.
Now doing intermittent fasting,
being on a ketogenic diet,
I think I’m probably stimulating it,
maybe two three times per day,
but I think from my goals and what I’m
trying to accomplish now, that’s plenty.
I mean, I think it’s giving my body a break
from all of the digest
and giving it some time to rest as well.
Right, right.
Now, we’ve covered a lot today.
Give us an idea of what is the day
in the life of Ryan Lowery look like?
Yeah, so I’m a morning person,
I like to wake up early,
I think the hours for me, like I usually
wake up at five o’clock in the morning
and from five until like eight o’clock
in the morning
is when I have my best working time,
whether it’s like writing articles
or reading new research,
I use Google scholar
and I go through and try and find–
I get these alerts for ketogenic
or beta hydroxybutyrate
and I kind of look
at this new study just came out
and I love diving into it and being–
because I think we’re starting to see
an explosion of more and more research,
which is amazing.
Then I go and get a workout in,
I like getting my workout in early,
just because by the end of the day
I’m tired
and I want to go home
and have dinner or something,
so I get my workout in
and go into the office
and either have a bunch of meetings
or just crank out some more work,
and I usually finish
around five or six o’clock at night
and then I get home
and I usually have my meal,
which is like a moderate meal.
My lunch is typically, it’s fairly small–
it’s big in volume
and I think it’s one of the biggest challenges
that people forget about on a ketogenic diet
it’s one of the reasons why people
incorporate in salads or vegetables,
is to get more volume.
So, like my lunch hack for people
that are listening is,
I usually, if I’m on the go,
if I’m in meetings,
I like just having MCT powder with protein,
some creatine,
sometimes unsweetened almond milk
and if I were to put that inside a blender
or like a shaker bottle, or just blend it up,
it might be a small amount of volume.
But if you take that same amount, add
some ice into it and throw it into a blender,
you’re adding air into the equation.
So that little amount now becomes this huge
amount of volume
that I pour into this huge styrofoam cup,
and it takes me like 20 to 30 minutes
just to drink it, because it’s so much volume,
but it’s keeping me satiated
all the way until the end of the day.
I think there’s different
ways or different hacks to increase volume
that I think, it’s sometimes when people
struggle with overeating,
I was one of those people where
I came from eating six to seven meals a day
and then all of a sudden
cutting that back to two, is like wow,
I need to figure out ways to increase
the volume of my foods on a ketogenic diet,
using a blender,
and increasing that can help significantly.
It’s a good hack and what kind
of protein do you use in that?
Is it a protein powder?
I use a protein powder, just I use a whey
protein powder, and just blend it together,
25, 30g and just drink it, it’s delicious.
And what kind of workout
are you doing in the morning?
I usually do resistance training,
sometimes it’s resistance training combined
with some high intensity interval training,
I don’t do as much cardio.
We’ve actually done research looking
at high intensity interval training
versus long duration cardio,
and if you do
high intensity interval training correctly,
it’s the equivalent of like 60–
you can do five to 15 minutes
of high intensity interval training,
it’s like the equivalent of 60 minutes
of long duration cardio.
And you don’t have the muscle loss
that sometimes can be attributed
to like long, long, long duration cardio.
So, I usually just do resistance training
and high intensity interval training.
Right, and then your meal in the evening,
what does that usually look like?
Usually it’s, I like do a salad, sometimes
with like some croutons,
like pork rind croutons…
people are like,
“What are pork rind croutons?
…on top of it, and then some type of meat,
and usually a little bit of vegetable,
that kind of just goes along with it,
I’m like a creature of habit
so it’s just easier for me,
I just prepare it, it’s a done deal.
Yeah, sounds great, sounds good.
Well, any other last thoughts you want
to leave our viewers and our listeners with,
and of course where can they find you
to learn more about you?
Yeah, absolutely and I think
that the one thing I just say
is always go back
to why you’re getting started.
I think a lot of times people will get
frustrated if you’re like, you know,
“I don’t know why I’m doing,
I haven’t lost as much weight as my friend”
or “I’ve struggled and I fell off.”
Always go back to your why
and I think that’s one of the biggest things
to anchor people into this,
you’ve got to think long term.
A lot of times people look at temporary
and then they’re just like–
or they want immediate results,
I’m just like play the long game.
Understand that this is something
that you want to ultimately help you
5, 15, 20, 40 years from now,
you want it to be able to help
and the decisions you’re making today
are ultimately going to contribute to that.
So, yeah, I think on social media,
you can follow me on Instagram,
it’s @ryanplowery.
Sometimes people say “plowery”
but my middle name is Patrick, ryanplowery
and then on Facebook, doctor Ryan Lowery,
we’ve just started to do some YouTube stuff
on Doctor Ryan Lowery on YouTube as well.
Awesome, Dr. Ryan Lowery,
thank you so much for joining me.
Thank you very much,
it’s been an honor.