Yesterday I was pleased to hang my “IN WEBINAR” sign on my office door, and tune into a live interview with Dr. Dominic D’Agostino hosted by UK fitness site Smash the Fat. If you’ve done much reading at all on using the ketogenic diet (KD) to treat or prevent various diseases, you’ll have undoubtedly come across Dr. D’Agostino’s research. His rather unassuming website and blog is found at KetoNutrition.org, where you can dig into the “Resources” section and find pretty much all of the key and credible info sources on the KD available out there.
Dr. D’Agostino outlines his research interests in the ketogenic diet, and work his group at the University of South Florida have done to date. Not wanting to simply “repeat” work done by other groups looking at the effect of KD on tumours in animal models, Dr. D’Agostino’s team examined how the metabolic stress that a KD puts on tumour cells weakens them and leaves them susceptible to free radical damage via hyperbaric oxygen therapy. This group is investigating other additional modalities along with the KD, to see how they perform in combination in a number of diseases, including ALS and Alzheimer’s disease.
The interview touches on the concept that KD can be used together with standard of care approaches, and Dr. D’Agostino takes care to point out that he is not advocating rejecting standard of care, but also shares some very interesting firsthand experience of how medical students are simply not trained in nutrition, and he hopes to help “indoctrinate” a new generation of doctors to consider medicine as food.
Near the end of the interview, he addresses a question I sent in about KD and maintaining optimal blood glucose to ketone ratios for cancer management. In another recent post, I’ve shared my concerns about this question, which I’ve been thinking about a lot lately. In Dr. Thomas Seyfried’s amazingly thorough 2012 book Cancer as a Metabolic Disease, Fig. 18.1 sets out the zone of metabolic management recommended for using the KD to manage tumour growth. The figure illustrates that the relative levels of ketones in blood (as measured using a blood meter in mM) should exceed the levels of glucose. To quote, “Blood glucose ranges between 3.0 and 3.5 mM (55-65 mg/dl) and B-OHB [that’s beta-hydroxybutyrate, the particular ketone the blood meter is actually reading] ranges between 4 and 7 mM should be effective for reducing tumour growth in most patients” (Chapter 18.2.1, 80% read in the Kindle edition).
If you think about this, of course it makes sense. The idea behind using KD to manage or limit tumour cell growth – to “starve” tumours – is to take away the tumour cell’s favourite fuel, glucose, and replace it with something the cell cannot use – ketones. It makes sense that even with high ketones, if there is still sugar available to these glucose-loving cells, they’re probably not as stressed out, weakened, and ready to pack in their little boy scout tents as I want them to be.
Other fabulous sources drawing from the work of Drs. Seyfried , D’Agostino and others, such as Ellen Davis’ book Fight Cancer With a Ketogenic Diet, which I recently read and reviewed, as well as Miriam Kalamian’s Get Started With the Ketogenic Diet for Cancer (which I have just received and am devouring – side note, how have I been “on” this diet for a year and not read these, you ask? I’m a total hack. These are fabulous resource, don’t do it the hard way, read them), both refer back to the importance of the glucose to ketone ratio in attaining this management zone. I feel like this is an important point that I want to “self experiment” on further. I wonder whether the levels described by Dr. Seyfried are reasonably reached and maintained in daily living, as an adult human on a KD? I have more to write about this topic, stay tuned!
Thanks to Dr. Dominic D’Agostino for re-fueling my passion for self-experimentation, and a few good supplement tips, and a really informative interview, and to Sam Feltham and Smash the Fat for hosting it.
View Dr. D’Agostino’s interview: