In today’s interview I get to speak with exogenous ketones researcher, Dr Brianna Stubbs, about the research discoveries of the benefits and risks of taking ketone esters, salts and more.
Brianna shares her knowledge as a scientist researching ketones and their effects on sport performance.
Her PhD research is the first human trial of using a ketone ester to see what benefits or side-effects it has on humans.
Brianna herself is a semi-retired elite athlete. She has been a Team GB rower having won medals at the World Championships in rowing. She has also won the Women’s boat race for the Oxford crew twice. Not only that, but she was the youngest person to row the English channel at age 12!
I discuss a lot of great detail from the basics of ketones to how we can make them, measure them and why we should consider taking them.
Special thanks to Brianna for joining me on the show. Enjoy the episode!
UPDATE: Listen to Brianna explain the benefits of exogenous ketone ester drink now available to the public!
Show Notes with TimeStamps
Highlights of what we talk about during the interview:
Click on one of the timestamp links in the brackets to jump to that point in the interview audio.
[00:11] – About Brianna, her PhD research into ketones at Oxford University and her rowing achievements.
[01:50] – Difference between how our bodies use glucose and ketones for metabolic energy on a standard diet.
[03:41] – Brief evolutionary biology of how the enzymes needed to make ketones appeared at the same time as our brains got bigger and needed more energy.
[05:10] – How babies and infants use ketones as a fuel source. (Have you listened to Marika Sboros on the Prof Tim Noakes banting for babies trial?)
[05:53] – Do we need ketones for our brain to perform well? If ketones are so good for us should we try be in nutritional ketosis all the time?
[06:45] – How impaired glucose metabolism could be the reason how ketones help children with epilepsy & elderly with neurodegenerative brain conditions like Alzheimer’s disease.
[07:34] – How lowered brain glucose metabolism is measurable before the signs and symptoms of dementia appear.
[09:17] – Research evidence shows that ketones can help provide an anti-inflammatory effect in the whole body, be neuroprotective, help protect our mitochondria from oxidative stress & be an anti-aging substance to help prolong our lives.
[11:44] – Do ketones produce more ATP than glucose can in the Kreb cycle? How technically ketones don’t, but they help produce ATP with better electrochemical potential i.e electron transport system
[16:20] – Following a high fat/ketogenic diet for a long time cause the mitochondria to do uncoupling. This means being in ketosis from a high fat diet may not be as chemically energy efficient as taking exogenous ketones.
[17:40] – Explanation of the three major ketones in our bodies – acetoacetate, beta-hydroxybuytrate & acetone. How the liver is the major organ that produces ketones by converting lipids. The liver creates acetoacetate that is converted into either beta-hydroxybuytrate & acetone. How acetone might be smelt on someones breath who is in ketosis.
[18:40] – How to measure beta-hydroxybuytrate and why it is the gold standard for how to measure nutritional ketosis. Why beta-hydroxybuytrate is found in higher blood level concentrations than acetoacetate.
[20:35] – How beta-hydroxybuytrate is an optical isomer which means there are two forms – D-beta-hydroxybuytrate and L-beta-hydroxybuytrate. Why ketone testing strips only measure D-beta-hydroxybuytrate. How our bodies release D-beta-hydroxybuytrate for energy not L-beta-hydroxybuytrate. How exogenous ketones salts and esters are made with 50/50 levels of D-beta-hydroxybuytrate & L-beta-hydroxybuytrate unless the nutritional label states otherwise. How researchers feel L-beta-hydroxybuytrate is not dangerous to ingest. Why not to worry about raising L-beta-hydroxybuytrate levels if raising your bodies ketone levels through a low carb high fat diet or fasting.
[29:25] – How to measure ketones? The difference in testing ketones via blood vs urine vs breath analysis. Pros and cons of urine ketone testing strips. How urine ketone levels aren’t accurate, but how they are cheap and are good for a beginner to know if they are in ketosis or not. (Tip: Check out 3 Recommended Ketone Measuring Devices Here)
[32:37] – Pros and cons of breath ketone testing. Do breath acetone levels correlate well to beta-hydroxybuytrate blood levels? Why when taking exogenous ketones breath and urine ketones don’t show the massive spike in ketone levels like blood ketone testing does. (The Ketonix is best ketone breath analyser for biohackers + listen to inventor Michel Lundell here)
[34:25] – What time of day and how many times a day should we test our ketone levels? Why listeners should wait to hear what Dr Dominic D’Agostino says on his podcast episode.
[36:50] – The three main ways to get into nutritional ketosis. How long do we need to fast from food to achieve 0.5 mmol/L ketone levels? Discussion on the different fasting protocols like intermittent fasting, the 5-2 diet and how Brianna practices a 36 hour fast once a week. The difference between healthy nutritional ketosis and dangerous diabetic ketoacidosis. How fasting for 7 days raises ketone levels to 3-7 mmol/L, but how exogenous ketone esters can do that within 30 minutes! (See low carb flu tips)
[41:25] – How raising ketone levels via a controlled diet can help type 2 diabetic patients get better.
[42:50] – The semantic difference between a low carb high fat diet and a ketogenic diet.
[45:47] – What are exogenous ketones explained. The difference between ketone salts and ketone esters. How people have taking ketone salts via IV drip in the past, but now it is used as a drinkable dissolvable powder sachet. The benefit of ketone esters vs salts for producing more beta-hydroxybuytrate. How the research project Brianna is working on is the only human trial of a beta-hydroxybuytrate ketone ester in the world. How all other studies are animal studies.
[49:48] – Why beta-hydroxybuytrate ester is believed to be better than acetoacetate esters, but maybe not for specific therapeutic applications like treating epilepsy.
[51:47] – What are the ingredients in ketone salt supplements? How ketone salts work and what are risks of ingesting so much salt causing kidney stones or hypertension?
[54:28] – Why Brianna recommends using exogenous ketones mindfully. When to take exogenous ketones like around a workout session or during fasting. How there is limited evidence on effects from long-term usage in humans.
[56:10] – The myth that high ketone levels means you are burning body fat and so losing excess weight. Why going into ketosis using diet or fasting causes fat loss and why exogenous ketones don’t. How raising ketone levels using salt or ester supplements can actually slow down burning body fat loss. How the real benefit how exogenous ketones can help you lose weight is via appetite control (a.k.a feel less hungry). Brianna quote – “If you eat crap & take (ketone) salts you aren’t going to lose any weight”.
[59:10] – How biohacking requires doing the basics right first like good sleep, diet and exercise before taking performance enhancing substances. How this is the same for elite athletes taking exogenous ketones for bigger gains needing a good foundation of training to work off.
[1:00:45] – Possibility of using exogenous ketones and nootropics and maybe adding caffeine will aid performance enhancement in the future.
[1:01:27] – How ketone esters don’t cause gastrointestinal distress side-effects like ketone salts do.
[1:03:60] – What are the known main side-effects from taking ketone supplements? Why it is not advise to try raise ketone levels above 7-8 mmol/L all the time.
[1:05:70] – Are there specific chemical formats of ketone salts that are better than others?.
[1:07:35] – What is a DPhil qualification & how it is the term for PhD from either Oxford or Cambridge Universities.
[1:08:44] – Final point how our metabolism is the control process for health, but also diseases and pathology. How ketones are safe. The exciting future research in using ketones to help cancer treatment and for neuroprotection.
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