Dom D'Agostino is a neuroscientist & professor at the forefront of metabolic therapies, including ketogenic diets, exogenous ketones, & hyperbaric oxygen. In this episode, Dom breaks down nutritional versus supplemental ketosis, defines meaningful ketone thresholds, & outlines practical ways to achieve ketosis. He explains how a ketogenic diet can support metabolic health & weight loss, & advises on how to maintain adequate protein & avoid common mistakes. Dom surveys the growing landscape of exogenous ketones—from salts & esters to 1,3-butanediol—& effective pairings like caffeine, MCT oil, & alpha-GPC. He highlights the role of ketogenic therapy in cancer (particularly glioblastoma) & its promise for neurodegenerative diseases. The conversation also covers recommended hyperbaric oxygen protocols for brain injuries & cognitive function, situations where fasting or ketones offer cognitive & anti-inflammatory benefits, & touches on the carnivore diet as a ketogenic variant with potential relevance for autoimmune & metabolic conditions. View show notes here: https://bit.ly/4rNx9Af Become a member to receive exclusive content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ 0:00:00-Intro 0:00:11-Dom & Peter’s shared interest in ketosis 0:05:40-Dom’s work for the Navy on oxygen toxicity 0:14:20-Nutritional ketosis defined & how fasting & diet generate therapeutic ketones 0:18:58-History of ketogenic diets for epilepsy, & evidence showing ketones reduce seizure activity & strengthen brain resilience 0:25:08-Dom’s personal experience on the ketogenic diet: tracking macros, protein, & ketone levels 0:33:05-Using a ketogenic diet for weight loss: guidance on protein, fiber, calorie tracking, lipid monitoring 0:41:02-Protein on ketogenic diets: rationale for higher intake 0:44:56-Incorporating carbohydrates into keto 0:48:21-The carnivore diet 0:53:10-Early exogenous ketones 1:06:31-The progression of exogenous ketones: why BHB monoesters & ketone salts emerged as better alternatives 1:11:46-Ketone salts: easing the transition into ketosis, dosing, & how they compare to esters 1:18:06-The differences between D- & L-β-hydroxybutyrate, & how racemic mixtures may elevate ketones longer 1:25:54-How ketosis may boost NAD 1:30:34-Emerging evidence for using a ketogenic diet to treat anorexia & other psychiatric disorders 1:34:18-Potential cognitive & performance benefits of ketone supplementation, & why pushing ketones too high can be dangerous 1:40:25-Applications for ketone esters, & why ketone salts or MCT-blended formulations may be safer & more practical 1:46:37-The role of a ketogenic diet in treating cancer 1:59:31-The potential of a ketogenic diet for treating Alzheimer’s disease 2:09:45-Tools for cognitive enhancement: ketones, alpha-GPC, MCT, caffeine, strategic fasting 2:11:26-Hyperbaric oxygen therapy for concussion, TBI, PTSD, & cognitive function 2:20:30-Peter’s takeaways -------- About: The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, & all that goes into that from physical to cognitive to emotional health. With over 90 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health, & much more. Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan & simultaneously improving their healthspan. Learn more: https://peterattiamd.com Connect with Peter on: Facebook: http://bit.ly/PeterAttiaMDFB Twitter: http://bit.ly/PeterAttiaMDTW Instagram: http://bit.ly/PeterAttiaMDIG Subscribe to The Drive: Apple Podcast: http://bit.ly/TheDriveApplePodcasts Overcast: http://bit.ly/TheDriveOvercast Spotify: http://bit.ly/TheDriveSpotify Google Podcasts: http://bit.ly/TheDriveGoogle Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed. The use of this information and the materials linked to this podcast is at the user's own risk. The content on this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they have, and they should seek the assistance of their healthcare professionals for any such conditions. I take conflicts of interest very seriously. For all of my disclosures and the companies I invest in or advise, please visit my website where I keep an up-to-date and active list of such companies. For a full list of our registered and unregistered trademarks, trade names, and service marks, please review our Terms of Use: https://peterattiamd.com/terms-of-use/