Podcast

Mastering Nutrition Episode 22: Ketogenesis Isn’t All About Carbs and Insulin

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Chris Masterjohn's thoughts on Ketogenesis that it is not all about Carbohydrates and Insulin

Did you know that adding MCT oil to your pasta is more ketogenic than restricting your carbohydrates to ten percent of calories?

Many people think of carbohydrate and insulin as central to ketogenesis, but the direct biochemical event that initiates ketone formation is actually the oversupply of acetyl groups to the TCA cycle during conditions of oxaloacetate depletion.

While largely a biochemistry lesson, in this episode I also teach you the practical implications of this. There is more than one route to ketogenesis, and while they all produce ketones, they are fundamentally different in important ways.

Adding coconut, MCT oil, or exogenous ketones allows you to reap benefits of ketones without necessarily restricting carbohydrates and insulin, and that may be useful if you are also trying to reap some of the benefits of carbohydrate and insulin.

On the other hand, certain conditions that respond to ketogenic diets, for example refractory childhood epilepsy, need stronger degrees of ketogenesis than you can achieve simply by adding MCT oil to pasta.

Understanding the difference allows you to better make practical decisions about your diet that are most consistent with your priorities.

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Show Notes for Episode 22

In this episode, you'll find all of the following and more (these times refer to the podcast, and they may be different in the YouTube video):

  • 01:00    An announcement about the paleo event I am speaking at in Brooklyn on August 9th.
  • 03:17    The cliff notes.
  • 04:55   The Snapchat discussion that inspired this episode.
  • 05:44   Why the idea that protein suppresses ketogenesis by forming glucose makes no sense.
  • 12:01     Overview of TCA Cycle and burning carbohydrate for energy.
  •  14:48  How we burn fat on a mixed diet.
  • 15:44   The meaning of the phrase, “fat burns in the flame of carbohydrate.”
  • 17:58   Loss of lean muscle mass can occur if dietary carbohydrate and protein are too low; neither fat nor ketones can spare muscle mass from this effect.
  • 22:20  Under carbohydrate restriction, oxaloacetate (OAA) is not repleted by carbohydrate and is used for gluconeogenesis, while more fatty acids reach the liver to make acetyl CoA.
  • 24:38   The oversupply of acetyl groups in excess of OAA initiates ketogenesis.
  • 26:40   Insulin shifts fat to adipose tissue, but this doesn't cause obesity.
  • 28:00   The effect of insulin allows us to look at how medium-chain and long-chain fats differ.
  • 29:41    MCTs go straight to the liver and avoid effect of insulin in the blood.
  • 30:26   Insulin suppresses the carnitine shuttle, but only long-chain fatty acids require it.
  • 33:12    MCTs at breakfast suppress food intake at lunch.
  • 35:14    Pasta topped in tomato sauce and MCT oil increases beta-hydroxybutyrate.
  • 39:05   Two ways of getting ketones: selective deprivation vs. abundance.
  • 42:12    If you are trying to get ketones, but having negative effects of carbohydrate restriction, you can add MCTs (or exogenous ketones) to get the ketones without carbohydrate restriction.
  • 43:45   MCT oil-topped pasta is more ketogenic than a 10% carb diet, but much less ketogenic than the diets used to treat refractory epilepsy.
  • 46:00  Exercise is ketogenic.
  • 46:22  As a gym rat with a fondness for coconut eating the Warrior Diet , my pee turned keto-stix purple even after a three-course carbohydrate-inclusive meal followed by a frozen pizza and a pint of ice cream.

Links Related to Episode 22

If you want to see me, Dr. Akil Palanisamy, and Dr. Kelly Brogan, speak in Brooklyn on Tuesday, August 9th, you can purchase tickets here, and use the discount code “CHRISMASTERJOHN” to receive 20% off.

How to follow me on Snapchat.

The section on ketogenesis from the 5th edition of Biochemistry by Berg, et al. This is not the most recent edition but is freely available on NCBI Bookshelf, as is the case for a number of great second-to-last-editions of textbooks. This book is fantastic if you want something with exhaustive detail to occasionally reference. As a standalone book, though, it's not a great cover-to-cover read.

For something where cover-to-cover reading is a worthwhile goal, I highly recommend the Lippincott Biochemistry Illustrated Review. The Kindle version is called an “e-textbook,” and I would highly recommend it if you have public transit commutes you could use for reading and studying or if you have a need to use the images for teaching.

When Fat Burns in the Flame of Lean Muscle Mass,” an old blog post I wrote on this topic.

The study I discuss showing MCT oil at breakfast is ketogenic and suppresses food intake at lunch.

An example of the beta-hydroxybutyrate levels reached on a 10% carbohydrate diet.

An example of the beta-hydroxybutyrate levels reached on ketogenic diets used to treat epilepsy.

Although it did not compile beta-hydroxybutyrate levels, my article “We Really Can Make Glucose From Fatty Acids After All” compiled blood acetone levels reached on a variety of different conditions.

A Question for You

Do you use any of these approaches to ketogenesis? Have you tried more than one, alternatively, or in combination? What's your experience?

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54 Comments

  1. Vitamin deficiencies and other problems commonly experienced by vegans and vegetarians and how someone on a primarily plant-based diet might guard against them.

  2. Hi,
    A question (maybe dumb) for you. A lot of people say “add” coconut or MCT oil or even eat more fats. I’m wondering how to add it. Are you talking about just taking a tablespoon or two of oil and eating it or just cooking with it or how exactly do you add these oils to your diet?
    Thanks!

  3. I loved your lecture and the detailed biochemistry. I am left with some questions however, in trying to really clarify the fine points: As you have shown, MCT’s go directly to the liver and are able to enter the mitochondrion without the carnitine shuttle, and so undergo beta-oxidation. You pointed out that because MCT’s escape the effects of insulin we can burn the carbohydrate and the fatty acids at the same time. First question is, okay, beta-oxidation proceeds, but this doesn’t mean ketones will be formed. As you pointed out earlier, OAA needs to be depleted, and this would not be the case if you were eating carbohydrate. However, the study you showed about the pasta and MCT oil shows that BHB does increase to 0.3 mmol/L. So why would this happen if plenty of OAA around? Second question, so even if MCT’s raise blood ketone levels, how do you know that the peripheral tissue will be able to utilize the ketones? If glucose is abundant, then why would the cells convert ketones into acetyl CoA and enter into the CAC? NADH levels will be high and inhibit CAC. Also, this could be the reason why the ketone levels are elevated in the blood, because they have nowhere to go and be used? Or would the acetylCoA be used to synthesize new fatty acids?

  4. Great Presentation! I have been diligently researching the Ketogenic Diet and wanted to share a few observations with you. First, the way virtually almost everyone (mercola, perlmutter, bergman etc) present using ketones for energy is that if you don’t go into a full blown ketogenic state your body will never burn a ketone for energy. In fact, it seems as though they imply that anyone who has never gone on a ketogenic diet has never had their body EVER use ketones for energy. From what I understand now after your presentation, this simply isn’t true. This all or nothing approach or what Thomas DeLauer calls Bio-Hacking seems totally unnecessary for people just wanting to be healthy and have more energy. I already do the intermittent fasting, eat the grass fed poultry, beef, cheese etc. Do the Coconut Oil, GF Butter, Olive Oil etc. I eat fresh organic produce from the Farmers Market which meets every Tuesday 4 blocks from my house. You get the idea! Still, these promoters of the Ketogenic Diet give strong impressions that even eating the way I eat, somehow the body throws all those fats aside (and does what with them?) and only burns glucose for energy because that is the way my body is programed (how do they know that?). I think they are doing a disservice to a lot of people who are doing just fine with a high quality diet that provides lots of ketones (as well as glucose) to provide abundant energy. By the way, I feel great at 66! Would love to hear your comments. Thanks! Patrick

    1. Can you? Sure. Will you? Not in any remotely meaningful amount. You make glucose when you need glucose. You don’t make glucose so you can break it down into other things.

  5. Interesting stuff you brought to the attention of many viewers. Thank you for your contribution. May I suggest that you edit your posts and reduce the amount of commas that you incorporate? I found many of your sentences to be convoluted and little flow for the reader. You can say more by writing less.

      1. Well, these are not articles at all and they are not written. The transcript is an extra service to those who prefer to read instead of listen. But this is an audio product and its design is for people who want to hear someone talking.

  6. Awesome episode, Chris! I was wondering if you had any ideas as to why several cold climate dwelling populations would have adaptations to resist the transition into ketosis (https://www.cell.com/ajhg/abstract/S0002-9297%2814%2900422-4)? Also, not sure if you take suggestions at all for possible future podcasts, but I think you could definitely shed a lot of light on the topic of fasting if you were ever interested enough to pursue it. I know suppversity did an overview today (1/12/2017) of some recent papers on the topic and it seems the effects are so far reaching , not to mention the massive amount of possible underlying stimuli involved (e.g. circadian rhythm changes, more frequent exposure to ketosis, autophagy, etc.,), that it would make for a very exciting episode–especially if you take it beyond the boring discussion of weight loss, which has been bludgeoned to death by everyone.

  7. I love the idea of getting ketones without the carb restriction/fasting. However, if the brain prefer glucose as it’s primary fuel, is it possible the ketones won’t actually be used by the brain if there’s glucose available?

    I’m not sure how solid the science is behind ketosis and cancer/alzheimers prevention, but I could handle a week of fasting every year, but daily low-carb would be hard.

    Is it a myth that a low-carb diet leads to the body being less efficient at burning carbs in the future?

    1. Ben,

      I think that ketones do reach the brain even in the presence of glucose (after all, blood glucose doesn’t totally tank on a keto diet and it is the blood concentration reaching the brain barrier that is relevant) and I think that is probably why MCT oil breakfast suppresses appetite at lunch.

      I don’t think it’s a myth that low-carb makes you less efficient at burning carbs, but I suspect that effect is reversible by eating carbs.

      Chris

  8. Hi Chris. I think 99% of people today use ketogenic diet or MCT oil to boost lipolysis, thus using BHB or acetate level as a gauge of enhance beta oxidation.

    Considering that the limiting factors are OAA and acetly-L- carnitine to channel liberated fatty acids and get them into the TCA, what about supplementing them and in parallel use MCT oil to get higher ATP and keep glucagon high ? (and maybe in combination with some cAMP enhancers). What do you think ?

    1. Acetyl-L-carnitine would probably help, but I don’t see how you could supplement with OAA and not block ketogenesis.

      Chris

  9. I’d like to give a huge thanks to the person who is transcribing the podcast – it is so helpful to be able to read and reread the text!
    And to Chris, as always, laser focused on the issue and able to dissect and explain it fully in simple language – thank you.

    1. I totally agree with the tremendous benefit of the transcription. I am a totally ignorant layperson who has to work very hard to grasp Chris’ science but thoroughly enjoy the challenge. Appreciate the effort that Chris goes through to not sensationalize in his reporting but balanced and scientific…even when he bursts my bubble. 🙂

  10. They ate 43 fewer calories? What was the error bar on that measure? That’s like 3 or 4 bites. It’s difficult for me to believe that the caloric consumption could be that accurately measured to place significance of the difference unless a bomb calorimeter was used ahead of time, rendering the meal a bit toasty. I also don’t believe the USDA (or any other) database could be that closely trusted as a guideline for accurate measures.

  11. Dear Chris:
    Thank you very much for the podcast and video (I learn visually). I think what’s missing is the reason why one would be on a ketogenic DIET (and I use that term to mean “lose weight diet” not “everyday eating foods diet”) in the first place: to lose weight. You mention neurological disease and improved cognitive function, but most people on ketogenic diets (like Atkins, etc.) are NOT interested in boosting ketones per se, but merely using that as an indicator that they are burning fat (and hopefully some of that is body fat). Atkins, et al., is necessarily “unbalanced” so that you lose weight – adding MCT oil with carbs just to boost ketone numbers (or deepen the color purple on a strip) totally misses the point. In fact, Atkins has four Phases, with each phase gradually increasing the carbs you can eat. Obviously, going to extremes is bad (as you mention insulin has other functions) but that moderate restriction has short-term benefits to weight, Type 2 diabetes, insulin resistance, etc. It is unfortunate that Dr. Atkins even had to come up with his diet, but due to the American diet, he had no choice. My guess is that after losing weight (or reducing diabetes, etc.), going to a more natural diet, which I would call “balanced”, should be the goal and is probably more healthy. Thanks again, I really enjoy your podcasts and am learning a lot.

    1. Hi John D,

      I think you are correct, but I didn’t talk about weight loss because I think that is not a specific reason to use a ketogenic diet. Certainly, the Atkins diet works. But if someone asked me advice to lose weight I would never tell them “try the Atkins diet” or argue that it had some utility they couldn’t get from, say, Neal Barnard’s vegan diet, or the potato diet, or any of the innumerable diets that cause weight loss.

  12. Hey Chris,

    Real briefly you had touched on the idea of using Ketones to “improve cognitive ability.” This topic interests me quite a bit as an amateur chess player looking to improve.

    Is this generally regarded as fact in the scientific community, that Ketones can improve mental ability? What research demonstrated this, or what research influenced your opinions on this topic?

    What other nutritional factors have you found might impact cognitive ability? Do you use or find any value in “brain-hacks”? (ie. Supplements that might improve cognitive function.)

    Thanks for all your work, im getting right into the biochem!

    1. Hi Ryan,

      No I don’t believe it is “regarded as fact in the scientific community.” There is evidence that it greatly benefits refractive epilepsy, and there is some limited evidence suggesting utility for other neurological issues like Parkinson’s and Alzheimer’s. Then there is anecdotal evidence for improvement in cognitive ability. See whatever Dave Asprey has collected on this. I think it’s something that is reasonable to play around with.

      I think brain hacks can be useful, but it is better to use basic diet and lifestyle first. In other words, it is pretty dumb to sleep six hours a night at irregular hours waking to an alarm and eat a restrictive diet or a junk food diet and then take alpha-GPC and low-dose nicotine to improve cognitive function when your basic diet and lifestyle is wrecking your cognitive function.

      My nutrition choices took me from the bring of total mental collapse to mental health. All of the basic pillars of nutrient density are involved there.

      On top of that, I find the BrainWave app, caffeine, hot/cold contrast showers in the morning, and cold showers in the afternoon when they are not following a strength trainin session are useful.

  13. I’m asking this question out of pure academic interest – there is no personal health question hidden here.

    I did read your links (some of them a few times actually, over the years), in particular :
    https://chrismasterjohnphd.com/2012/01/07/we-really-can-make-glucose-from-fatty/
    https://chrismasterjohnphd.com/2011/05/04/when-fat-burns-in-flame-of-lean-muscle/
    https://www.ncbi.nlm.nih.gov/books/NBK22387/#_A3075_ (Certain Fatty Acids Require Additional Steps for Degradation)
    https://www.ncbi.nlm.nih.gov/books/NBK22591/#A2271 (Glucose Can Be Synthesized from Noncarbohydrate Precursors)

    Referring here to peripheral tissues, not the liver –
    in the setting of low serum glucose–>liver sends out BHB into the blood, BHB then enters into peripheral tissues (let’s say the myocyte) – there it just picks up a CoA from succCoA – then splits in half to make 2 acetyl-CoAs – thereby entering Krebs by exactly the same doorway that the acetylCoA from the beta-oxidation of FFAs is entering.
    Here my question – why would the muscle cell go to all of that trouble to use liver made ketones, when serum albumin-bound FFAs are in abundance, and end up travelling the same highway (the Krebs traffic circle) to make ATP? In the low glucose setting, I would think that the ketones are better utilized in the brain, since neurons cannot readily use FFAs. So, in a low CHO state, is the peripheral tissue Krebs cycle running on AcetylCoA from ketones or FFAs?
    Thank you in advance , if you have the inclination to answer this . I know it may not matter to many people, but I’ve had this question for a long time because the workings of the body have to make sense.

    1. Hi Newbie,

      It’s been a while since I studied this, but I think you are exactly correct. In early carbohydrate deprivation or early stages of extended fasting/starvation, muscles run on fatty acids and ketones are reserved for the brain. I believe they eventually become more adapted to ketones because the supply of ketones rises. But I’ve never seen anyone argue that the *purpose* of ketogenesis is to support *skeletal muscle.* So, I think it is a case of opportunism.

  14. Hi Chris!

    I found your podcast very educative and well explained. I have listened to it 3-4 times and enjoy the same.
    Here is my comment and question, I had tried LCHF diet In the last year and a half and while I can feel the benefits and the extra energy, happens that after a while I get hypothyroid symptoms and insulin resistance. I feel cold all the time, specially my knees and lower back. And, while my insulin levels go down to less than 2.3mg/dL in the fasted state my BS remains in the 100 mark no matter what. Fasted stated 100, after meals may go little bit below to go up to 100 2-3h later to stay there until next meal. I am wondering if this is a combination between so low insulin and the OAA depletion in my liver that is not able to continue burning fat or making ketones? Not to mention my hormones go as low as those in girls before puberty.
    Well based on your presentation my guess is my liver runs out of OAA and have no glucose to burn the fat.
    Any insight is welcome.
    Thanks again!
    Mónica

    1. Hi Monica,

      I think you should listen to chrismasterjohnphd.com/11 if you haven’t already.

      I think the issue is less about OAA and more about not having enough carbs and insulin.

      Chris

      1. Hello again 🙂

        Want to thank you for taking the time to reply to us. It is great to receive advice from someone with such great knowledge on human physiology/biochemistry understanding.
        I listened the 11th episode again and you got the point. There is no point in taking insulin levels as low as possible in expense of some metabolic processes. Insulin and glucose are key to lots of body functions. I did rethink my low carb intake and honestly I feel better adding more carbs. I am increasing the amount of fresh fruit and some legumes to improve my insulin response.
        Our bodies are so amazing that response is immediate.
        Thanks for all.
        Mónica

  15. Any response to Hyperlipid’s post?

    “As Dr M says, fat burns in the flame of oxaloacetate. This does not have to come from glucose. It does not have to come from amino acids. He seems to have forgotten his own post from 2012. Fat provides oxaloacetate. Can anyone imagine that a period of food deprivation would not supply the necessary metabolites to utilise ketone bodies?”

    https://high-fat-nutrition.blogspot.com.au/2016/08/acetone-to-oxaloacetate.html

  16. Chris, I love your enthusiasm for the TCA cycle, you make the biochem sound like a waltz! You did a very clear presentation. Thank you.
    Re – the carb depleted ketogenic state –
    I can see that the availability of OAA in the hepatocyte is the rate limiter for the incorporation of AcetylCoA into the cycle, and if GNG is occurring (drawing off the OAA), that would divert the AcCoA to land of ketogenesis.
    However, in the extrahepatic tissues, where GNG cannot occur (excluding kidneys and intestinal cells), is there plenty of OAA so that the Kreb’s cycle can continue at full speed using beta-oxidation of FFAs. Or do these tissues send their OAA into the bloodstream to feed the liver’s need for GNG, thereby limiting their internal OAA quantity?

    1. Hi Newbie,

      Thanks, I’ve won some ribbons waltzing so I’m glad the skill is spilling over into biochem.

      I don’t know that there is zero flux of OAA from other cells to the liver but it would quite surprise me if that occurred in any meaningful amount. It would be much simpler for glucose flux to account for this effect. In other words, glucose conservation or flux of amino acids to the liver would provide OAA. So, under conditions of glucose deprivation, it is likely amino acid flux from skeletal muscle to liver that helps boost hepatic OAA. But, it’s mostly used for GNG.

      Chris

  17. Chris, great podcast! I have a question regarding what you said about insulin and the carnitine shuttle. You mentioned that insulin prevents fatty acids from entering the mitochondria. So if they don’t enter the mitochondria then what happens to the fatty acids?

    1. Hi Rudy,

      Overall there are far fewer fatty acids entering the liver in the first place because insulin partitions them toward adipose tissue. But if fatty acids enter the cell and not the mitochondrion, they would likely be redirected toward triglyceride synthesis within the liver.

      Chris

  18. Greatly appreciated the ketogenic tutorial. Would like to know if this has any practicality with weight loss. The only reason I have done low carb diets was to lose weight. Can I lose weight on a regular diet & just add MCT oil. If so, that sure would be a lot easier. (42 calories does’t seem to be enough). Also, when I have been on ketosis, I released a lot of sodium & water in urine. The diet experts tell one to add an extra 2 gm of salt while in ketosis. Does just using MCT oil cause sodium lose as well? I have hyperaldosteronism and sodium on a low carb diet is hazardous!

    Thanks

    1. Hi Jim,

      The net caloric deficit is ~145 kcal or so because of decreased food intake. In the context of a weight loss program, it’s a competitive advantage. It’s not the whole weight loss program.

      I believe the sodium loss is likely from carbohydrate restriction rather than ketone production.

      Chris

  19. Dr. M-
    Thanks for taking the time to get into the nuts and bolts of the actual chemistry going on in ketogenesis. I’ve been playing w/ a very low carb diet for over a year now and also exogenous ketones but this gives me a few ideas on ways to tweak my diet even a little more.
    To answer your question:
    The biggest benefits I’ve noticed from cutting carbs out has been the stabilization of fuel to the brain (no mental fatigue or getting hangry if I don’t get to eat for several hours) and the ease with which I can maintain the body composition I had in my 20’s . A close 2nd to these benefits is general ability to tolerate and recover from increased training load.
    Keep up the great work and thanks again,
    BA

  20. Chris, thank you for enlightening the masses! Curious question: when I eat MCT or even coconut oil, I become VERY sleepy. Could you give me a guess why that would be? It happens to my husband, too. Thanks for your help and interest.

    1. Hi Esme,

      Interesting! I honestly have no idea why that would happen. Perhaps poor digestion? Or the brain is saying “ok I have had enough to eat and will sleep now”?

      Chris

  21. Hi Chris, another great podcast. What would be the effects of supplementing oxaloacetate and carnitine with MCT oil and long chain fats? Thanks.

    1. Hi Jon,

      Supplementing carnitine won’t do anything at all to overcome the effect of insulin that I discussed.

      However, if your endogenous synthesis of carnitine is low, supplementing carnitine could be helpful. I find acetyl-L-carnitine to help smooth out my energy between meals.

      I don’t really see the point of supplementing OAA. It is easily derivable from protein and carbs, and in order to improve ketone utilization without suppressing ketogenesis you’d need some way to direct it to the extrahepatic tissues and I’m not aware of any way to do that.

      Chris

  22. First off, thanks, Chris. It takes me a couple hours plus to plow through your 50 minute presentation- but that also attests to the value I find from listening in. Got two requests, for the record:

    One; In that you feel that carbohydrate has value in a ketogenic diet, you’re not mentioning grams (at least in this podcast), which would be really helpful, even if only a general range. When you say ‘low carbohydrate’ I don’t know what level of carbohydrate would keep the supply of oxaloacetate sufficient to support the TCA. Not to mention the balance that supports TCA while still allowing ketogenesis.

    I realize you’re trying to make a case for MCT oil as a way to get to ketosis w/o running the low carb ‘risks’, but I don’t tolerate grain (they knock me out, give me an immediate belly and push my fasting glucose >100). So I eat beyond-large salads twice a day and veggies on the side to get my carbs w/o grain. I just wonder if that is sufficient. I’d think everyone would enjoy your take on quantities (if you’ve covered this in another podcast, please just point me-)

    Two: I also just developed a rare n-degen disease (Moersch-Woltman, I don’t make much GABA (have the SNP for the enzyme and the high anti-GAD Ab along w the associated multi-autoimmunities), and from what I read (and you mentioned) this might be the kind of case where it’d seem to push ketosis might be a good idea- to try.

    So, any thoughts on pushing ketosis to the more therapeutic ranges 2 – 7 millimolar (if I got that right). I’ve heard mention of what they call the 4:1 HKD for epileptics, but while it’s discussed, there’s no information on the foods comprising the diet (beside the 4:1 fat/prot-carb ratio). I know they use these ketone esters now, but seems like it’s more in research than on the market. I use MCT, but if you needed to push beyond that range, what’d you try?

    thanks for being out there and any time you can give to a reply-

    Marshall Winkler

    1. Hi Marshall,

      I didn’t recommend any grams because there isn’t sufficient research to answer quantitative questions on the practical utility of modest ketogenic diets below 1 micromolar.

      Unfortunately I’m not familiar with the disease you have.

      I believe ketone esters are indeed on the market. You might want to look at Dom D’Agostino’s material.

      Chris

  23. Dr. Masterjohn, what nutrients would be supplied by pasta that one couldn’t obtain otherwise? I have chosen not to consume refined or processed foods rather than count carb grams. Don’t concern myself with the number of grams so muc as the form.
    Do you think adequate carbohydrate would be supplied by such a diet?

    1. Hi Linda,

      The point of this was not to advocate the consumption of pasta.

      Yes, I believe you can get adequate carbohydrate without consuming refined grains.

      Chris

  24. Is the message, you can have your cake and ketones too? Or said another way, add MCT oil to a modest carb diet and you will have ketones to burn without oxaloacetate depletion. Hope I got that right.

    Your talk was excellent and I would like to see more like it. The discussion of the second study was rushed, and you may have finished by saying the lowest line was ketogenic when you meant anti-ketogenic. BWDIK.

    What criteria should I use in choosing an MCT oil? Are high C8 oils, such as those sold by Bulletproof, special?

    Somewhere in your talk is the seed of a different, important topic: If a person is trying to lose weight using resistance workouts, how important is carbohydrate in the diet? Can you go too low and lose the benefit of exercise?

    Great work, as usual! Thanks.

    1. Hi Bill,

      I’m not sure why 8C is special in this context. What is Asprey’s rationale?

      I think if you have enough protein, the carbohydrate is not that important for weight loss or body composition, but it can be important for preventing stress hormones from rising too much and for maximizing strength gains.

      Chris

  25. Hi Chris, just listened to podcast 23. Very informative. I wanted to ask you about the carb+mct protocol you mentioned. When you say 10% carbs……do you meal 10% kcal or weight? Also, what ketones level do you get by consuming 10% C + 60% F + 30% P + MCT?

    The reason for my question is that I am trying to maintain a 1-2mmol level of ketones, and I like you proposition of adding mct as a way of better balancing the remaining macronutrients so as to eat a little more carbs.

    Thanks much.

    Carlos

    1. Hi Carlos,

      10% calories.

      Off the top of my head I’m not sure what you get with 10% carb + 30% protein + MCT, and I don’t know that anyone’s studied it, but such a diet would be strongly ketogenic if protein were reduced to 10% as that is not far from the MCT-modified diet used for refractory epilepsy.

      Chris

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