Nutrition

Peak Carnivore: The Ironman Champ Who Only Eats Meat ft. Pete Jacobs

Originally posted on HVMN and authored by Zhill Olonan and Geoffrey Woo on June 27th, 2019

In the world of sports nutrition, a constantly evolving field, more and more athletes are adopting low-carbohydrate diets. Especially in the case of long distance endurance racing, an aerobic-heavy activity, wouldn't it make sense that athletes could benefit from being fueled by fat vs. carbohydrates?

This is a popular debate with conflicting evidence and anecdotes presented from both sides. In this podcast, we capture the personal story from a former Ironman Champion: Pete Jacobs. He's not a carbohydrate athlete, nor a traditionally ketogenic one...Pete is purely fueled by meat.

Pete has faced a life-long battle with his personal health. Ever since he found it nearly impossible to get his heart rate up during high school sports, along with rough bouts of fatigue and gut issues, he knew he was facing an uphill battle. Although he marched on to successfully pursue a sporting career, Pete has struggled in the health department as he pushed his bodily limits in the performance department.

With intuition that the core root cause was linked to his metabolic health, Pete gave the ketogenic diet a spin. He saw notable progress, but eventually found his nutritional calling to be one (or two) steps further...

The carnivore diet.

In this episode, you'll discover:

  • Why the carnivore diet worked for Pete and what health issues were corrected

  • What Pete eats: Organ meats, seasons with salt but no pepper, what animals he's tried, and more

  • Tips for endurance performance: Using ketone esters & caffeine, the power of positive mental reinforcement, and applying endurance ideals to normal life

Transcription

Geoff

Pete, thank you so much for coming on to the H.V.M.N. Podcast. It's really an honor to have you on the program.

Pete J.

I'm excited to be on. Great to meet you.

Geoff

For folks that don't know your full background, 2012 World Champion in the Ironman. Obviously, the top of the top and in that universe, but also a pretty interesting story around diet and nutrition, obviously, at the performance level, you're dialing in for performance, but it sounds like you got into some of the nutritional and physiology side of things from solving a personal problem with health. So, perhaps to start off the conversation, curious to hear about your interest in diet, nutrition, health, and then probably as a segue or maybe a parallel question, how did you get into endurance events or triathlons?

Pete J.

I guess my interest in what's going on in the body was when I was a teenager and I started getting a bit of fatigue, I just would not be able to get my heart rate up. And I was always a good swimmer, did surf lifesaving competition, so I was always swim training. And some days, I just could not push my heart right on my body at all. So that was the beginning of getting tests done. And fast forward through till I was about 30 years old and I'd had a lot of ups and downs and fatigue issues during my racing career so I became a professional triathlete when I was around 21 years old or so. And if I felt good on the day, I would smash it and I could win races and show a lot of promise. But if just body was not responding on the day, I would just dig myself into a hole and then that hole would last for a day or a week. And then I managed that basically progression through till when I was 31, I won the Hawaii Ironman. And in my training, I would have had days where I didn't feel great, but I'd learned to manage it and I'd learned that my weakness was I couldn't do as much as other people. But that also became my focus of my strength.

Geoff

So you were streaky. So there's some really on days and some really off days, it wasn't just like low energy overall, because I can imagine that if you were just always low energy, you wouldn't realize you had a talent for endurance events, right? So you were very streaky it sounds like?

Pete J.

Absolutely. And then some days, I could go from feeling terrible the day before and not being able to get my heart rate up to just jumping on the bike or running or swimming and feeling amazing the next day. And so, yeah, it was pretty tough, but I'd learned a lot of things about controlling ego and not worrying about missing a session when I felt a bit tired. And that's partly what got me to such great shape in 2012. I would have had days where I trained quite poorly but I was happy, I was like, no, this is the best that I can do, I don't need to do as much as everyone else, and just focused on as much as I could do without any ego or guilt and turned that weakness into a strength. I was able to get there and winning in 2012. And then after 2012, obviously I was a bit older, I'd done by then about 30 something Ironman races, and a lot of them not when I was that well. Like I said, just fatigue, there was not a lot of other symptoms other than, excuse me, I developed some psoriasis in my 20s, which is, now I know it's directly linked to leaky gut issues.

Geoff

And usually associate with alcoholism, right? I presume you weren't binge drinking for your psoriasis.

Pete J.

No, no. Now I don't drink at all. I might have one drink once a year sort of thing. But after winning, that fatigue went from a day or a week to a month or two months. And the muscle weaknesses then got a bit worse. So I would have more imbalances that sort of appeared to be sort of just someone would say it's injury or it's weakness or this or that, but it would always come around the time when I was also feeling fatigued. So I'd push through as best I could, got in good shape again for a race every now and then and I kept trying to go back to Hawaii for a few years in a row trying to, after winning, I kept going back to try and do it again, but just couldn't get my body in shape because I couldn't string together more than about six weeks of training. And in six weeks, I could get quite fit and be like, yup, I can still do this, I've still got it. And then I would just fall in a hole for a month or two.

It became a pattern of chasing the answers to my health and also then a period of fatigue. When I was fatigued, like it was brain fog, it's aches and pains, it's depression, just there's no joy in it anything. And it became, I would be okay, let's work this out and I'll figure it out and I'll change something and I'll get better and I'll do testing and I'll change diet. When I'm fatigued, there's nothing that I feel like doing. There were times when Jamie was the one that was really my wife, Jamie, she would, okay, let's get to another doctor, let's try and find someone else. And I just, you know, when I'm fatigued, it's like, I don't care, I just want to lay in bed and I'd have no motivation to try and figure it out.

Geoff

That's a good question. I mean, I'm sure you're as you're talking to all these doctors, different experts, did they ever diagnose you? You sound like you were puzzling through a lot of these doctors and they weren't necessarily able to perhaps help you.

Pete J.

Yeah, no, I've never been diagnosed with anything until recently, the leaky gut is a prime problem definitely. But I've been to a lot of people, done a lot of stool tests since I was 16, 17, all the sorts of hair, urine analysis, everything, you know, lots and lots of dollars worth over about 20 years because I'm now 37. No results ever. I've tried a lot of therapies and some worked somewhat and definitely kept me going. Oh, okay, I'm improving, I can get back into the career again. But then it would be a bit of a false lead where I would feel better for a little while but then I would just reform back into the same old patterns. And so yeah, things eventually came around to diet a few years ago, and I started working with Phil Maffetone. And he's brilliant around health and performance, very holistic approach. And I started cutting out grains and sugars and really getting my diet much better. And again, I saw improvements each time I change something but nothing that really, really stuck.

So, it was in 2000, end of 2017 where I raced again and I just had terrible, terrible feelings in the rice. And I said, okay, I cannot race again until I'm 100% sure that I've gotten like an answer that is going to improve my health. So, I took all of 2018 completely off. And for the first part, I was still feeling very, very achy and fatigued even without training, and finally sort of started seeing a couple of doctors that started giving me a bit more information. And then finally I got into really low carb, and Low Carb Down Under has been a fantastic resource with all the conferences that they've had and all the videos that they post. I've learned so much from that. And I was able to get in contact with Dr. Paul Mason, who's got some amazing videos on their websites for Low Carb Down Under. And being an Aussie and interested in sports as well, he's been able to lead me towards the carnivore lifestyle, and I was already getting it a little bit in about August last year when I had the year off.

I listened to some podcasts and one of them mentioned low fiber can be good for people with irritable bowel syndrome issues. And another one that said that high protein, you won't get out of ketosis or it's not going to raise your blood sugars because I got into ketosis years ago, probably three years ago or so. All the things back then was don't eat protein and fasting and these other things that aren't good for me metabolically. I shied away from protein, ate a lot, a lot of fat. I was feeling better but again it stalled. And then I sort of started to revert back a little bit. And I definitely didn't lose weight and trim up like people say you should on keto. So when I was able to talk to Paul Mason earlier this year, he said, just go 100% keto. So I'd been feeling better with more protein less fiber. And then he said, now just 100%-

Geoff

Carnivore.

Pete J.

Yeah, but then I was only on about coconut cream, cacao powder, coffee. I'd already minimized all my plant inputs but as you would have heard many anecdotes of, that some people just need to be 100% off certain foods to feel better. For me, it's 100% because even now, you know, I'm 99.9% carnivore, but if I have a supplement that has a little bit of something in it or a mouthful of something that isn't 100% plants, then I get a little bit of my psoriasis back, little bit of redness on my face back and dry skin. And it's a direct link to leaky gut. So I just have this really great autoimmune reaction, even though I've never been diagnosed with autoimmune issue or a certain disease. I still have this great reaction, and my mom has a couple of autoimmune conditions. So, there's something genetic there as well.

Geoff

So how long have you been 99.99% carnivore? So this has been four or five months now?

Pete J.

Yeah, yeah, four or five months, but I was still trickling in a little coffee here and there like just decaf because I don't believe that the caffeine is good for me with some other symptoms that I've had with over brain stimulation and that kind of thing. I'd always shied away from caffeine the last six months but I was still giving in I guess, it is that just giving into something, I'd go, maybe it's still okay for me. So I would taste it and then I would get some symptoms back. So, I really do have to be 100%, and that's been yeah three or four months of just fish, meat and eggs. And you know, I'm quite happy with that and I'm experimenting with different ways of cooking meat and aging meats and adding different meats to meet.

Geoff

Or eating organ gut meat, I mean, I know there's like a nose to tail version of carnivore where you try to have not just ribeyes and muscle meat, but you try to have the liver, the kidney, the heart, the gelatin. All of it are or how deep have you gone into this territory?

Pete J.

I eat liver every week or two. And then just in terms of trying to still be creative and taste different foods when it's quite limited, I've tried lambs brains. I eat heart fairly regularly actually, lambs heart, ox heart. Partly because it's the cheaper cuts but they're still quite tasty to me. I can't afford ribeyes and my career had a a year off and I'm still on the comeback trail. So, ribeyes would be lovely for every meal but I definitely can't afford the prices they have here. So I eat those, I eat a bit of game meat, kangaroo meats. What else do I do? I have a little bit of bacon. I hadn't had bacon or pork for quite a while, but as I said, chucking in just a little bit into my slow cooker as I'm using the slow cooker a lot, those extra depth of flavor really, really matter. So it's just salt.

Geoff

And then for seasoning, just salt?

Pete J.

Just salt and bacon is my seasoning. And eggs.

Geoff

Definitely I've heard a lot of people that are going that way. I think there's concerns around black pepper, for example, very popular seasoning, but there are people are concerned with the oxalate content to have an anti-nutrient within pepper. I think this is an entire fascinating space because I think for myself, I've experimented with the carnivore diet but I don't have the reactions of having pepper or vegetables or grains. Unfortunately, and I think most people don't have those harsh reactions to a more classical diet. But absolutely, it sounds like for folks like yourself and we had Mikhaila Peterson on who's a fairly prominent vocal carnivore who talks about having a little bit of pepper will throw her off and there's clearly something going on with autoimmune, leaky gut sort of access that people have been talking about.

Pete J.

And when you're adding the stress of training on top of that and any other stresses in life that affects vagal tone, which is another thing I've worked on to try and get the gut to be more relaxed and accept more things, it's hard when you, yeah, maybe I could tolerate more in the future if I really was like a monk and totally relaxed all the time. Maybe it would improve over time. But as long as I'm still training, I think I'm going to have that heightened sensitivity.

Geoff

Clearly, there's likely some genetic component to having a predilection for autoimmune issues. But I also imagine that if you're doing heavy endurance training and you're fueling in an Ironman, you're probably slamming a ton of carb goo shots, all this stuff, and that's not necessarily good for leaky gut. I'm curious, this is speculation, but curious where you think that it was kind of genetic predisposition that you were a little bit unlucky to have a likelihood for autoimmune or leaky gut issues versus how much did your career as a professional athlete push you further down that line because you were using your body so hard.

Pete J.

I think it's a combination of both, you know, environment and the genetic factors as well. So I got some pretty bad gut issues in my early 20s, like in terms of a virus that hung around for a month or two. And then years later, I was getting tested and had Blastocystis hominis. So antibiotics throughout this time every now and then, as well as taking all the sugary supplements, as well as training very hard and doing hard races. And that blastocyst, then at some point, I got anybody under anesthesia to be placed directly on the side of the blasto. So I had this really powerful antibiotic placed in me. And that didn't even get rid of it but I did feel terrible for a couple of months.

And so, I have a lot of antibiotics, a lot of sugars, and a lot of gut bugs that shouldn't be there over the course of about 10 years or so. And I would always have bad gut symptoms, and I'd try and do what I could to mask them while training so I wasn't stopping on the toilet every every few minutes while going for a run. That hung around for quite a long time. And again, a lot of stool tests, a lot of different people trying to fix it to no avail. But eventually, now, my guts are absolutely great. I feel they're the best they've ever been with the no fiber, high meat diet.

Geoff

Yeah. Which is wild because likely when you were coming up in your career, the dogma or the practical advice was completely the opposite, right? A lot of fiber and carb load like crazy, right? When the average person hears about marathons or Ironmans are like carb load, eat a bunch of pasta beforehand. So, I imagine that's what you were doing. You were focused heavily on carbs and then fueling with all this sugar bombs as you're competing. It sounds pretty amazing that you were able to do well even with your guts, like, you know, I guess blowing out every now and then. I mean, do you have stories where you're competing in a race and you just need to, you know, you have diarrhea? I'm likely sure that you do have some of those stories, I'm just curious, I mean, how bad did it actually get?

Pete J.

It was probably about 2009 or so when during the marathon in Hawaii, I'd run into the top 10, I was having a really good run and I could see the next guys just in front of me, I was gaining on them. But then I suddenly had to stop in a porta loo, take a quick little break, and then get back running. And I could never bridge back up to those guys in front of me again. And another Australian world champion, Chris McCormick said to me after the race, "Mate, that was the most expensive shit I've ever seen anyone take." He felt like having to stop at a loo probably lost me a few places. And I think I finished about ninth that year. So that's one.

But then the following year it was quite tough. I was always having to stop a few times before I could get out the door. But I ended up finishing second that year. But after finishing second, it was like, right, what do I need to do to win and I just stepped up my game big time, mindset and what I was doing, all the boxes I needed to tick. And so, I just was able to take a few supplements, you know, sort of slippery elm and other intestinal helpful supplements. And that year leading into Hawaii, I actually didn't have any gut symptoms for the last couple of months. So, doing a bit extra helped. And obviously, it helped me trying to get better and get the win that year.

Geoff

Incredible. So basically, you had enough of a stable gut to push enough months where you had a clean race and you were world champion that year. And now it's been a struggle to get your body back into that shape where you're not having to go to the bathroom every few hours.

Pete J.

The bathroom thing probably subsided a little bit again because I wasn't even training that hard for that long. It was about five years of trying to get back there without any really good training going on. I just kept trying different things but I'd always eaten pretty healthy. And I think that kept me or helped me win, that I was eating pretty much the same meals regularly. My regular meal was brown rice, some beans and tuna, lots of oil, and maybe a few nuts. But it's not necessarily a great meal for anyone that's got some issues. But, for some reason, it worked because I was eating the same very similar ingredients day in and day out. So that may have had some help that my body just got used to those particular foods and I was able to get through okay.

Geoff

And then when you were shifting more into this low carb lifestyle, were you measuring your blood glucose or hemoglobin? I know a lot of our listeners who are either in keto or eating low carb or exploring it, a lot of folks like to measure and compare stats and all of this. How metrics driven were you with potentially wearing a continuous glucose monitor, were you measuring ketones or was this more intuitive and you were just trying to feel how you're performing?

Pete J.

Yeah, when I first got into it, I didn't really get a lot of blood tests done. Phil Maffetone was just trying to guide me through some of these changes and saying, look, some people are going to feel much better in ketosis on a keto diet. And he did have a strong suspicion that I was, I did have some metabolic syndrome issues. And so, then I did buy a glucometer and started testing, and it was really, really unstable. And that was frustrating, that my blood glucose in the morning would be high and sometimes it would be low. And it was just all over the place. So yeah, very erratic blood glucose for probably a good year and a half or more maybe before I started to see some consistent numbers and it starting to settle down.

And ketones were always low ever since I first did ketosis. It's like .2 is as good as I'll get day to day. Which, chatting with Dr. Paul Mason about the mechanisms there, like, we're both really interested to know exactly what would be going on that, you know, are you using because you're more metabolically efficient or you're not producing enough as as much because you're metabolically efficient? So is it like you're not producing more than you need or you're using it very quickly? A few unanswered questions. But eventually, blood glucose improved as I was more and more on a low carb diet over another year or so. And then ketones, if I would drink MCT oil, basically, I could get ketones up. So there was a period where I was trying to chase ketones. And again, back a couple of years ago when everyone was like do this, do this, don't do that. And since then, I'm aware that MCT oil can be bad for leaky gut and cause issues. Stay clear of that now.

Geoff

Yeah, I've had personal experience where you have a little bit too much and your gut wants to go. I mean, I think that's the fine line with MCT. Obviously useful for its use cases, but a little bit too much, you get diarrhea pants.

Pete J.

Yeah. By that point, I could handle a lot of, quite a bit of fat. But there'd still be times where it's like you have too much fat. And then, I guess as I've increased protein, I've seen it really stabilize. I've seen no drop in ketones. They're still always the same, about .2, except after exercising, a longer low intensity training session.

Geoff

And they'll pick up.

Pete J.

Yeah. So, I've done some good testing lately and I did wear a continuous glucose monitor a couple of months ago for two weeks. And yeah, that was quite interesting just to see what was going on throughout the days. But by that point, it was quite stable. My blood glucose is really stable nowadays. But I did notice a few things such as high intensity training, my blood glucose would go up. So, I was getting a release of glucose from somewhere because I would do these without taking on any carbs or sugars whenever I could. And the next day, it would be higher, a little bit higher all day. And again, I asked Paul about this and he said, it generally it's okay if it's a little bit higher. It's just that the fluctuations of insulin that you want to avoid. If it's stable and the numbers are a bit different, that's fine. It is more the insulin fluctuations you don't want.

Geoff

I mean, glucose is a downstream effect of insulin. It is interesting in terms of reflecting in our experience in my personal experience, yeah, when you're doing heavy and intense exercise, it makes sense that your blood glucose elevates because your glycogen is being released, you're actually using that as fuel.

Pete J.

And stress response from cortisol.

Geoff

Exactly. So it stands to reason. One thing that I was curious to hear about and I think you'd be a good person to ask here is that a lot of people when they talk about shifting into a keto diet or a low carb diet, there's a keto adaptation period where you're going from heavy carbohydrate metabolism into more of a fat dominant metabolism. They feel like that takes a while to shift and maintain performance. So a lot of people feel like a keto flu or any of that. And obviously, you are performing at a very, very high level. Did you feel like you've lost performance in that transition period or did you very quickly transition into being predominantly fat fueled?

Pete J.

It's probably hard to say exactly what I felt because I was having-

Geoff

You were just kind of sick the whole time?

Pete J.

I was still having some health issues at the time. But looking back and if I was saying what other issues are going on, there's so many factors that change when someone crosses over. So yes, there's definitely changes in the mitochondria that they can become better at up-taking ketones and burning fat for fuel. But at the same time, I think it takes a while for people to figure out the nutrition that they need. So like, for me, for example, I'm feeling much better eating higher protein. And I think a lot of people that go into the keto diet perhaps in that first couple of weeks, they are just not eating enough. So they probably have gone low protein because this whole perception, and perception is an amazing thing. You think, oh, that steak that I used to eat, that 200 grams steak, now it needs, you need to eat twice as much of that now, even more than twice.

And so, there's definitely going to be some changes in people's perception that need to occur before they can really dial in their diet. So eating more meat, and obviously the salts and getting used to that change as well, a lot of people have issues with. And then I don't feel like it's so much do with the training, I have seen other people who sort of coach in the low carb area go, oh, well, we need to do high intensity efforts to try and keep you have a high end, to try and keep your legs fast. And it's like, well, that doesn't really make sense because there's nothing really changing in your energy production. It's still just energy. It's just a matter of where is coming from.

So as you said, if you do high intensity efforts, you're going to have a good level of blood sugar anyway. So I don't feel that whether you do high intensity efforts or not or whether you, I think it's more of where you're at in your health and other health issues, like whether it is the calories or whether it is that you're training the wrong type of training in the first place, whether you're just training too hard. But definitely, you would probably want to have a period where you just have a bit more aerobic training perhaps in that transition phase because perhaps you can, in too much high intensity, you will deplete glycogen from your liver or your muscles a bit too much maybe. And that could put strain on your body where your blood sugar's low. After a hard session, your blood sugar could probably drop. And you are just going to feel tired.

But that's where, we might as well mention the Ketone Ester. Ketone Ester, because I've been experimenting with that a bit, and being fully keto adapted. But as I've said, my ketones are generally kind of pretty low and my blood sugar's really stable, but generally a little on the low side as well and I don't even notice that it's in the low fours, I won't even notice. But when I go out for a long aerobic ride nowadays, for example, and keeping my heart rate quite moderate, there can be a little bit lull between the dropping blood sugar that goes quite low and the increase in my ketones that I then find at the end of the session. And I think that's just similar to when people are changing out the diet. You're just getting used to having that lower blood sugar and then when the ketones pick up a little bit. And I think that's all it is, it's just a brain fuel.

So for a lot of people, it's just the perception of effort. So, the ketone drink could be used in that period of adjustment between not using blood sugar as predominantly and also increasing your ketones just like in, you know, so you might need it over a couple of weeks or you can just use it in a particular session as well to get over that little hump. And as I said, I don't do coffee. So, that's something else that can replace that need for caffeine, that need for that stimulation, that perception of how hard is this effort. And I had a friend say that he was feeling a little bit flat on a bike ride the other day. He stopped, he had a hamburger, chilled out, I think he probably had a coffee as well. And then he felt much better after that stop. And it was sort of like, well, was that the blood sugars or was that this or whatever? And I was like, it's probably just because you felt happy. You had a break, your body got a little bit of a rest so it probably just built up a bit of extra energy in storage. Like maybe it was the chemicals that are helping produce your ATP and everything just got a little break. And you're happy, you had a hamburger, you relaxed, you felt like hey, I'm on the way home now. I haven't got as long to ride. So there's all these different factors of mindset that play into how your body is feeling and working.

Geoff

I think that's interesting. I think you're touching on some of the new aspects of our ketone ester that I think are particularly interesting. One, obviously, the fuel partitioning, we think that one of the main benefits is that you're just having an additional fuel that helps you transition between these states. I think one of the points that you're referencing is, if you aren't fully adapted and you go heavy into anaerobic areas of heart rate and fuel usage, obviously, if you have a limited amount of glycogen stored up because you're eating low carb or keto, that might be a difficult transition state where you lose a little bit of top in power.

So I was curious to ask if you felt like you lost some top in power as you're transitioning, but it sounds like you've been able to manage that transition pretty smoothly. And I imagine that your aerobic threshold is probably very, very high. I mean, most of the super elite endurance athletes I see just have, basically, up until VO2 max are still aerobic until like a little bit over and they just completely dropped. So imagine your VO2 anaerobic aerobic threshold's like very, very high. I'm curios if you actually have done that study to see exactly where that turnover point is. But I think the Ketone Ester use is like still very, very, very new. I mean, it's been out for a year, year and a half. But I would say that people are still figuring out exactly how to best utilize it. I mean, it's still like a cutting area of research.

I think one part that you mentioned, the central nervous system, the neurological impact is an exciting area. I think there's some data pending publication around improving content performance and I think part of it is that can you just deliver a little bit of extra fuel into the brain where you feel a bit better, feel a bit sharper. And that might play one of the most interesting roles for boosting performance as opposed to necessarily being a "superior fuel." I mean, I think this is some combination, again, of different factors here because physiology is so complicated. But I thought you hit a couple of different interesting points that I wanted to quickly address. But I guess going back to a specific question, I'm curious, have you looked at your aerobic anaerobic threshold, your VO2, VCO2 turnover point. Because I imagine again, in my experience, your turnover point is probably super, super high. I mean, you can go aerobic almost indefinitely.

Pete J.

Yeah, it's on the cards for July, August sort of thing. Really just want to get a couple of really solid months of aerobic work in to feel that my fitness is really gaining some bigger steps. Getting back to where I was when I was 30, kind of trying to get back there a little bit before we then go, okay, let's see what's happening. Make sure we've got some really consistent results in training so that those days of fatigue here and there, you know, those little supplements that are screwing up my leaky gut a little bit, we've really just cleared out everything and had some really long periods of aerobic training. But yeah, not having coffee is interesting. And obviously, the world of endurance sports and sports in general and everyone in general lives on caffeine and they love it.

Geoff

I have some interesting perspective and thoughts on this topic too. And I think, I mean, is one of the most fascinating stats, two billion cups of coffee consumed a day. And it's been a personal vice that I kind of grapple with because I know I should be cycling off of coffee or caffeine more. But it's addictive, it makes you feel good, it's hard to pull away. I'm used to that ritual. But it sounds like you've been able to wean off of it. And I can tell you my story why I felt this is an important area of self improvement. But curious to hear your story, when did you get to caffeine as a point that you wanted optimize?

Pete J.

I never really drank caffeine much until I was about 30. The smell of it was like, I don't really like this. And eventually I got more and more into it. Living with someone who likes coffee, you start to then have a little sip. And then it goes from a sip to my own cup. But I still have never had a lot. I never, you know, it was always, I could have it every couple of days or something like that. So I was never fully addicted. But seeing a holistic doctor earlier this year who's a brilliant guy. And he is very much about the neurological side of what could be inflaming some of my issues. And he just said the caffeine is just no good for you. He doesn't believe it's good for anyone and then there's no really good time to be overstimulating your brain to that point.

And it becomes that pattern of suddenly, a cup or two is okay in the morning and then it's like, oh, well, I'll just have one in the afternoon as well. And then that's wrecking your sleep. It's a slippery, slippery slope. And I was able to, I cut back to decaf for a while because I wasn't doing it for the caffeine, I was doing it for the placebo. The taste of it, the hot drink, and the placebo of it tastes like caffeine. That was my perception of it. I very rarely got a buzz out of coffee. It was much more the taste that gave my brain the, oh, you've had coffee so you must feel good. I could have decaf and be like, you know, I feel great now, I've had a decaf just from the taste of it.

Geoff

Well, there's still a little bit of caffeine in decaf, there's like 12, 24 milligrams, which is nominal, but just for the folks listening, there's still a little bit.

Pete J.

It was the habit.

Geoff

Yeah.

Pete J.

Absolutely. Which is why I then went okay, I've got to have no decaf, not even, that's too much of a stimulation to try and get everything, vagal tone and body as healthy as I can. And then it became, okay, I've got a not habit because of the inflammatory autoimmune leaky gut issues. But it just, it's just a habit. It helps if you can replace it with something. So if you're not on a no plant diet, then you can easily replace it with some decaf tea very, very easily. Awesome herbal tea that's decaffeinated, caffeine free.

Geoff

But this is very, I would say that almost 99% of athletes that we work with or we talk to, I mean, they pound 200, 400, 600 milligrams of caffeine before the race. I mean, I'm sure you have competitors, colleagues, folks you train with that are just right before the big day, boom, like a huge hit of caffeine. And people swear by that and there's good data on suggesting why that is actually useful. Curious to get your thoughts, I mean, this is, the data for caffeine is very, very good. I would generally say that it's one of the performance enhancing things that generally people accept that work. As you're a competitor, you're an athlete, do you feel like the net gain of not having to rely on caffeine is going to give you more long term performance or do you feel like okay, maybe I just don't train on caffeine and then I just save it for the once every quarter type thing where is use it as a huge hit before race? Curious, as as you start being really thoughtful around caffeine, how do you imagine using this as an ideal protocol?

Pete J.

It's pretty tricky because everybody's different of course and I've chosen the food and the drink and what I do because of I'm trying to get my health best and I've got certain health issues that need to be addressed in a certain way.

Geoff

So you're saying that from the leaky gut perspective, caffeine's just a non starter. So just even getting you gut to normal is going to be a bigger performance gain than any potential risk from the caffeine addition.

Pete J.

Yeah, and just having my brain at a more relaxed state more often and not relying on caffeine. It's also, you know, I think it's an issue when people are saying, I can't get going until I've had my coffee in the morning. And it's like, well, if you can't live like a normal human being without a stimulant every single day, you know, you may as well be addicted to any drug really, it's an addiction, and you need it.

So out of the way, these are my choices for my personal health issues because I don't want to tell everyone that they're doing the wrong thing because it's something that they love and they're very passionate about. But it's sort of like, if there's, as with going carnivore or as with going keto or cutting caffeine out, it's one of those things that you can do if you've got some health issues. So if there's something in your body that is not as good as you need it to be or want it to be, then these are things that you can improve on.

So I went taking it out because I believe that I've still got plenty of room for improvement in my health. But I will use it say towards the end of an Ironman race in the marathon, and I'll just use like caffeine tablets. But I only went I need it and still only in moderation. I wouldn't be taking like hundreds of milligrams. I think the year that I got second, there's a bit of a video of me, and I look like I'm showing my fingernails as I'm running, but I'm actually just biting half a tablet off the other half and then wrapping the other half back up and putting it back in my pocket. So I only had half at a time.

Geoff

Which is what, like 50 milligrams or something?

Pete J.

Yeah, it would have been about 50, 60 I think at a time. So things like that. And then there's the side effects as well of actual having the coffee. And a lot of people, a lot of athletes are getting stress fractures and other issues of so, let's say, first of all, they're not really eating a lot of protein and the bones are made of proteins.

Geoff

Or minerals, calcium, right?

Pete J.

Yeah. Predominantly, it's the proteins that build them up. So a lot of athletes aren't eating enough protein. The coffee can also leech a bit of those minerals out. And then you've got the small amount of protein that they are eating if they're eating red meat with iron in it, chances are they're probably having coffee around some of the food that they're eating, and the coffee can limit the amount of iron that's absorbed as well. So then you might have people with low iron issues as well, those that are drinking a lot of coffee. So a lot of coffee, low red meat intake, a lot of low iron issues as well.

Geoff

On top of I imagine, I mean, just repetitive motion. If you're running marathons, that's a lot of impact. Still, yeah, I mean, I think on the margin, I would agree that after just doing and heavy, heavy training, that's a lot of impact, like a lot of fractured damage, your bones are accruing. And then if you do the nutritional deficiency on top, that's where risk happens. I can see where if you tied those two together, you want to be thoughtful around the caffeine and nutrition intake.

Pete J.

Again, even anyone with osteoporosis type issues or just general people with low iron even if they're not athletes, it's a slightly detrimental, it's a stimulant and it's also not great for your brain. The whole living in the moment.

Geoff

So how often are you taking caffeine then at this point? Like zero times a year?

Pete J.

So I don't have it.

Geoff

None at all?

Pete J.

I'll only have it in racing, like half a dozen times a year in a race. And that's where I'll use the Ketone Ester instead of caffeine. And people could say, oh, it's so expensive for what you get, but I've found I can bump up my ketones by about .5 by having about five mil. It's almost the price of a coffee to get a healthier benefit that's going to do more for my body and my training and better for my brain for basically the same price if I just had five mil at a time. That's my take on it anyway. That's what I'd rather have than the caffeine.

And when people are really addicted to it, it comes back to another big point that I really try and practice and what I was doing when I won in 2012, which was being in the moment and not letting ego rule what you're thinking or feeling like, oh, how far have I got to go or geez, I haven't had my coffee today so I still feel tired. Or you're in the moment and that is all that you know, you don't know anything else outside of this very moment. And it's hard to be, and if you add a little bit of gratitude into this moment, then you can't be feeling like you haven't had your coffee, and therefore, you're still cranky. Oh, my gosh, I've still got this far left of run, therefore, it's going to be such a tough thing to do, I don't think I can do that. So, that's something that I try and practice quite a bit as well, to be in the moment, not rely on the thoughts of the past or the future to rule how I'm feeling.

Geoff

Yeah, I'd love to unpack that more. Over conversations like these and me dabbling into the endurance events and doing marathons or doing ultra marathons and cycling and doing miles on the bike, you just realized that, at least for me, I've found to do these types of events more of training my mind versus training my body. Obviously, I like the aerobic benefits and the body composition benefits and longevity health benefits of exercise. But I think what matters for me because I'm not ever going to be, I'm not going to be a world champion athlete, but I care about my mental performance and mental acuity as a business person and all of that.

I think the most interesting part of talking to folks like yourself is that you're in the pain cave where you're in your own thoughts for five, six, seven, eight, nine, 10 hours at a time. And it sounds like just hearing you talking about gratitude and being the moment I think is something that I've come to appreciate at a deeper level. I'm curious to hear you talk through some of the like maybe the obvious question when even people ask me and I don't think I'm like a big insurance person, but they're saying, you're running for three hours, what do you think about? I mean, even at that level, maybe we unpack it from that level. You're out on a triathlon, you're on Ironman, that's, you know, depending how good you are, six, seven, eight, nine, 10 hour ordeal. What do you think about?

Pete J.

Just trying to be as efficient as possible in every single second of the race basically. So, there's 1000 decisions that need to be made throughout the race as well, as in when to drink, when to pass somebody, when to be patient and stay behind, how hard you should be going, is this hill, you know, should I push over this hill or should I just kind of cruise up? So many decisions that can affect the outcome of the race. And if you're not calm and in control and in the moment, then you're going to make the wrong decision somewhere along the line that can affect the outcome of the race.

Geoff

You're actively in the mind. I mean, do you ever just zone out and just kind of autopilot? Because like sometimes there's, you're out there for like eight hours. So for eight hours straight, you're very much conscious, like I got to keep my form good. Should I try to pass here, should I accelerate here, should I feel here? You're looking at your watch, you're checking your power. So you're very active throughout the entire ordeal?

Pete J.

Pretty much, yeah. And it's a bit like driving a race car. You're kind of going pretty quick so there's always movement, you've got to stay pretty aware of everything. Even on the run where you're not moving as quick. For me, it's really about keeping my form. So, I'm trying to really focus on form and stay completely in the moment. It was a big thing that I practiced in 2012 in training, was getting rid of all doubts and fears so that my mind was not distracted by any of those and that I was able to concentrate on form and technique and getting as efficient as I could. And I'd seen a kinesiologist before the race and he said, through muscle testing, he's like, you need to use the word love more. And I was like, oh, all right.

So sure enough, I'm out there training and I'm, this is the year where I was really doing everything I could because I wanted to win. So I was visualizing the rice a lot and I'd been there quite a few times. So, every time I hit certain hill in training, I was picturing a certain hill in the race. So I was living the race in training all the time. And I would visualize, like, say, a sprint finish between one of my major competitors. And even just visualizing that in training was enough to give myself a little bit of doubt while I'm doing my run effort. And just by saying the word love, that was enough to bring me back into the moment of feeling grateful and feeling that sense of gratitude brought me back into the moment and cleared all the doubts, and I was running strong in my effort again.

So, it's not so much, so the word love was what I used at that point because that's what I'd got. But it's, looking back now that I've learned a lot more about how it was all working, it was just a thing that I'd practiced, a word that got me back into the moment and cleared all my doubts and fears. And there's 1000 different ways that someone can do that but it is something you need to practice to be able to switch it on quite quickly.

Geoff

It's like kind of a totem, like a verbal crutch, or a totem, a reminder that set you back into what I imagine is a flow state where you're sort of calm. And that's interesting because it sounds like when people are in competition and not everyone's competitive, but I imagine people have done some competition or some performance where they feel nervous or nervous energy, and it sounds like that might be beneficial in some cases. But what you're saying especially on these long multi-hour races, you really want to find that flow state of being calm in the moment and almost have this sense of gratitude that you're happy to be moving and alive.

Pete J.

As as you asked though, do I zone out. And being in the moment in a way is kind of zoning out because you have no thoughts in your head whatsoever. I mean, that's when you've really practiced it well. You can clear your mind at the snap of your fingers and there's no thought. So it's not exactly you're zoned out. You're totally aware of everything that you're doing, everything that is around you, but only what exists in that very moment. And in that sense, there is no thoughts because generally your thoughts are the future or present, or our future or our past. So yes, clearing your mind helps you stay calm, helps you make the right decisions, helps your body be relaxed, helps keep their central governor compressed. I loved your-

Geoff

Tim Noakes.

Pete J.

... chat with Tim Noakes the other day. I've listened to a lot of his chats before. I really love the central governor theory. So, that's just one way of minimizing the energy loss I guess and a way of making sure that your body is feeling safe. And that's kind of a word that I use a lot as well is that if you can give your mind the sense and the body the sense that it is safe, that it's not under stress, that it's not starving, that it's not in a worrisome fearful place, then you can just control the central governor reaction and therefore get more out of your body. And so, I was able to be totally calm and in control in 2012. I even, like I'd practice, and I knew that my back would tighten up off the bike when I started running. So, about six or seven K in, I was eight minutes down from the leader in second place and I needed to stop and do some hip stretches because I knew that that would loosen up my back. So I quickly did some dynamic stretching. And looking back, that's such a key point of what helped me win was that I was eight minutes down but still calm enough and in control enough to go, I know what I need to do to get from A to B as quickly as possible with the least amount of stress.

Geoff

And you can make up eight minutes in a marathon even while stretching out, which is incredible.

Pete J.

He'd blowing himself up on the block pretty hard, that's how he had such a big lead, and he got about halfway in the marathon and pulled out right there and ended his race there on the side of the highway.

Geoff

Brutal. I was going to say, making up eight minutes on a marathon.

Pete J.

Well, that's not a lot.

Geoff

But I think it is like, you know, you're shaving off 20 seconds a mile for 26 miles. It's hard to make up that much time for that long.

Pete J.

But when you're at the end of an Ironman and if it goes pear shaped, it goes really pear shaped. Guys will end up walking, you know, I've done plenty of Ironmans where I've ended up walking and that's, seven minutes will go very, in about one or two kilometers, seven minutes will be lost

Geoff

It's a long day out. I think what you talked about with the mindset reminds me a lot of what meditators or folks who practice a lot of the sort of inner mind training with meditation or Zen practices, they talked about very much in the same language you just described, which is, you're 100% clear and have acuity on the world, but you're in flow, you're not really thinking about anything but you are fully present. I think that's one thing that I talked to a lot of my colleagues in the office around endurance athletes, getting that state of flow is very much like being in an enlightened or very meditative state. And I think there's definitely some parallel there. And I wonder, if you have a brain scan of you in that state versus a Zen monk who's in a meditative, enlightened state, if that's a similar brain pattern. That would be an interesting experiment to run. I'm curious, have you thought about meditation or sort of the visualization side of things? I mean, sounds like you've obviously been thoughtful around your mental state. I'm curious, have you done meditation practice and all of that.

Pete J.

Not that I don't believe in it, but it doesn't work for me. The sitting there or laying there doing nothing while quieting my mind, I don't get much benefit from that. But I've worked with a guy who does some amazing tremor therapy, and it's all about quieting your mind while doing gym exercises. So, while you're under load, so while you're putting your body under stress, you've got an incredibly present mind and you're not even acknowledging that the weight is there that you're moving. And that for me is, and I can do the same thing while running or riding or swimming, you're trying to not acknowledge that you're doing an effort while you're doing an effort. So you're getting this much, much more powerful connection and much more powerful adaptation through your mind, your cells, because it's not just about the mind that needs to be trained to relax, you know, everything's connected. So if you can train your muscles to do a heavy load or any effort at all, even just moving without acknowledging that you are doing that effort or that movement, the connection just is like tenfold in terms of the impact that you get, the adaptation for training your body to be relaxed while you are pushing it. And therefore, then your mind is more relaxed because your body's more relaxed and vice versa.

Which one comes first? I don't think you can sort of, you can't separate them. They're very much joined. If you walk around with your shoulders tense, your mind will be tense. And if you have a tense mind and everything is going wrong, then your body will tense. But you can change one by changing the other but you've just got to be aware of at least one of them. But yes, this gym work, his name's Ken Ware and does some amazing rehab with people who have had issues of all sorts, whether it's a friend of mine, John Mclean who's in the Hall of Fame in Ironman. He was the first wheelchair athlete to complete the Hawaiian Ironman. And he was a partial paraplegic. He went and worked with this guy, Ken Ware, and he was able through being completely present in the moment and having the belief that he could move his feet and not letting any other doubts or fears block that pathway, he was able to reactivate more nerves after 25 years in a wheelchair, you know, and he no longer needs a wheelchair. So, it's incredibly powerful if you can trigger the presence of being in the moment, a calm mind with a belief of I can do this, at the same time, not acknowledging that you're doing something that should be difficult or hard. It's an incredibly deep response that you can get. Yet, I just find that type of training much, much more impactful than sitting there or lying there trying to meditate without any movement.

Geoff

Yeah, that seems to be my experience as well and my sort of correlation of this concept is that I think the end mental state is similar if not the same, this sort of flow, calm, 100% sharp acuity state. But there's different ways to get there. One might do that through a sitting meditation versus meditation through sport or practicing your craft. And my sense is that, depending on the personal journey of that person, there's different ways to get to that same sort of enlightened state.

Pete J.

People might just get it from a hobby. Sitting there calmly doing a hobby that just clears their mind of all other thoughts and anxieties, that's why hobbies are so important.

Geoff

I think there's something to that. And hopefully, I'm not sure how one would formally study this. But that is my suspicion that some people really, you know, I imagine that some people can really get to enlightened state with meditation. I think one of the points that really struck me was that how many tens of hundreds of thousands of people are Zen monks spending 12 hours a day sitting there. Are they all super enlightened? I don't think all of them are super enlightened. So I think that, so I think to me, that suggests that's one specific way that might get you there but it's not the only perhaps way to get you there. But I wanted to get to the point around feeling relaxed in that state, because, and maybe this is me being in a state and not feeling relaxed. I mean, I can hold that state of I'm running a marathon, okay, like the first 20 minutes, first 30 minutes, okay, like, I can self talk and motivate myself and, okay, I'm going to keep flow and keep focused.

And obviously, you've been world class at this, to be able to hold this at a very, very high level, world class level. Are there any practical tips for listeners? For me, like how do you, is there self talk or some sort of mantra that you can bring yourself back to that state or is just practice and visualization and just doing it over and over again to break down that magic? That sounds obvious, right? Like, okay, just feel relaxed when you're running a marathon. Okay, I get that. Okay, try to do that when you're 20 miles in and you got six miles to go and you're tired.

Pete J.

Definitely takes practice. But yeah, you need a few cues, as I mentioned before, like, for me, it was the word love back in 2012. Nowadays, it's probably more just an awareness of where my breath is going is a good start. So, if I'm breathing up into my upper chest, I'm more likely to be tense and not letting my body relax. So I focus on breathing into my belly which relaxes everything. And I try and practice that day to day when I'm doing anything, you know, sitting in a car driving or reading a book, I'm trying to do five seconds in, five seconds out. And that's really good for vagal tone as well.But obviously, you're not breathing that slowly when you're running. But just by recognizing where the breath is going, you can relax the rest of your body a bit. Definitely, a lot of it's around the neck and shoulders and the trapezius.

That's a key, like even just a tiny bit of tension there when you're running will give you tension in your mind. So that's super important just around the shoulders and neck. And then in terms of mentally what you can change, I use a sort of trick where I try and pretend I'm already at home on the couch having done the session. And so, you take your mind to laying on the couch totally like relax, let your body go completely floppy as a ragdoll. Now, feel that while you're running. And if you can practice that, so it's particularly towards the end of the run when people in training or in the race, when that's when you'll be most tense and be like, I'm nearly there, I'm nearly there because your ego's starting to get ahead of you. So in training, when I'm getting close to home, and I'm nearly done, I'm nearly done, I pretend I'm already done.

Geoff

You relax even harder into it as opposed to like-

Pete J.

And just be like, just let it go and be, a, be in the moment so that you're no longer thinking how long do I have to go, you are just totally in the present moment. And b, that feeling of how it will feel once you're done. Let that tension go while you're still running because everything's visualization and perception. Perception is everything. So, just perceive that you've already done the run, you're already chilling with your mates or lying on the couch relaxed. Whatever it is that you get that sense of calmness and that release of tension doing, whether it's, the opposite is, if it's a really, really hot day, though, don't visualize jumping in a cold pool at the end of it because suddenly, it will feel much hotter. If that makes sense.

There's a catch 22. If you're in a really hot race and this is what I visualized training for Hawaii Ironman is, imagine telling yourself it's really cool and that you can feel a breeze on your skin. So in training, if I was running in the middle of the day and it was a hot day, I would take my mind out of the heat and put it somewhere where there's a breeze on my skin, the sun is not actually that hot. And I would tell myself it's not that hot. So that's a mental trick if you're struggling with something that is present right now. Just reverse it and just say it's not that hot or this is not that hard.

And that's what, I mean, to me, that's what heat acclimatization is, is the mental side of it more so because the physical aspect of it is you sweat more, which isn't really beneficial come race day. And training in the heat can help increase a little bit of blood volume I think just because it's harder, though. You get the same from altitude training. It's just harder. So potentially, that's good for some people that can handle training harder. But for some people like me, training harder is not necessarily going to be the best way to get my body to respond well. So back to you ignoring that it's hot is a really good way. And it's a bit like listening to the seals who train in the cold. And they're very good at it, you know, they've been pushed in the ocean and stuck out there freezing and they very much have to tell themselves, this is not that cold. So it's the same thing. Mind over matter is absolutely how you can have a better performance.

Geoff

No, these are very good tips and I think some of the concepts that you're mentioning are things that I've been trying to adopt and implement. And I think for the folks listening, it might sound easy. Think about a cool breeze while you're seven hours into an Ironman. It's not that easy when you're actually out there sweating and tired and hurting with blisters on your feet. But I think that's how to get there. I think that's where I talk about endurance sport as really a mental training for other aspects of my life.

Again, I presume that most of our listeners are never going to win an Ironman, right? I mean, just, there's very few people that can even genetically, athletically get there and put all the training on to get there. But most of us have jobs or livelihoods that deal with stress. And I think that if you have confidence to be able to deal with stress in a very physical context, where you can overcome it and train your mind as you're running 10 miles or five miles or whatever miles that you need to do that's challenging for you, some of these same principles I imagine, at least I found for myself personally, translate really nicely into the, I was going to say civilian world but all of us are civilians, the business world or the non sport world.

And I'm curious to get your thoughts there. I mean, clearly, you must have some confidence that you've gained from being the best in your field and perhaps have you been able to translate that confidence or that endurance into other aspects of your life. Do you feel like you're just a more enlightened, calm, efficient person because you've just gotten so deep in, and it sounds like you were clearly self reflective on the process to even get there. Curious to see if you've been able to channel that thoughtfulness to other aspects of life.

Pete J.

Yes and no. There are periods where I'm quite good at, okay, this is what I need to do and I'll practice it, such as just taking five minutes to do some slow breathing and totally be present. And if I can do that a few times a day, I know that I would have a calmer mind for the other 23 and a half hours of the day. But I haven't been doing it lately and I noticed that so if I don't keep up the practice of actively taking a few minutes here and there to calm my mind, then I am noticing that I'm slightly more anxious, slightly more distracted and less in control of my own choices I guess.

So ego starts creeping back in. And your ego, if you're not practicing, staying on top of it for myself, it is creeping back in and it's distracting me, it's giving me anxieties, it's giving me doubts and fears, and I'm not able to concentrate on what needs to be done immediately as well. So, I do need to do that a little bit more often. And even if it's 30 seconds of just breathing and staring at a dot on the wall, and just thinking of completely nothing and being in the moment, when I do that, I feel better. So I just need to bring that practice back in a little bit more. But otherwise, I've got all this information and like I say, I'm really, I know, I understand how it all works, but yet, being in control of it, of myself more often, it's something that I have to practice or else there's no good. I've got the information but without practice, it doesn't come to the forefront at all. So I think that's all I can say is that it takes practice all the time to be aware of it. Some people, it's better and easier.

And I think, as I said, I mentioned before, some issues that I've had with brain activity in the past or issues of feeling depression or just leaky gut issues that are affecting my dopamine and other hormones. So maybe it's not 100% of my own devices, of my own control that sometimes are affecting my hormones that mean I can't do things as well and feel these other fears more often. And certainly, even, let's say, my doctor, he said, your estrogen is quite high because I've had low testosterone for a while as part of fatiguing my body that I've done. And he said, so you might feel a bit anxious or emotional, he said, just try and ignore and let it go because it's just the hormones.

So there are times and for certain people that yes, you do need to practice quite hard and some people will practice, need to practice more than others. And others just have the hormones that are just going to keep them absolutely centered and in control and motivated. And that just comes more naturally for some people because of their hormonal balance. And they don't have to go to the lengths that I have to go to try and work on getting my hormones and getting my cells and energy systems and everything working well.

But when you really look at those people that on the outside, they seem good, sometimes there's just those little things that, they're not, if you don't look at the health in the whole big picture, there'll be some things happening there not attributing to their lifestyle or their nutrition, and they just got, that was bad luck. And it's like, you know, you and I, those that have actually like understood how is all connected, are probably more likely to be able to go, well, I can give you like half a dozen reasons why that's happened to you because of the things that you've done or the things that you've eaten. So yeah, it comes easier for some but others got to work harder at it.

Geoff

No, I think it's well said, and some of my understanding of the experience as well. I mean, no one's a robot who's just perfect. And I think there's times where you need to just, there's effort every single time. I think people that have practiced at a high level. And again, you've very much achieved that to a very high level. It was just a lot of practice and dedication and all the factors that you mentioned. But I think to our listeners here, it's not because Pete is like a robot. It's like, there's effort on your part as you're doing this effort when I'm trying to put myself into very strong, grateful, clear mindset, it's this effort involved.

Perhaps the takeaway message here is that don't be disheartened if it is hard. It is hard. Just get back on the horse and keep trying and it eventually gets easier and easier and easier where it's more of a second nature. But even an expert like yourself, you sometimes have that lows, and it's fine, that just like we're not static, perfect beings. There's some on days and off days where we just got to be, trying to lean more towards the on days, right?

Pete J.

Absolutely. I mean, looking back to what I was doing in 2012, I mean, I trained almost all on my own for two or three months. And that means riding about 17 hours, 15 hours awake, mostly out on the road just with some music playing in my headphones. And that was incredible training for being in the moment and just being present and not concerning myself with any other thoughts. I had nothing else going on in my life back then. Jamie was looking after the food for me. All I had to do is train, eat, sleep, and had no worries or anything. So, there are times in your life when it's going to be easier and times in your life when it's harder. But using exercise as a time to be really calm and relaxed, as I said, that's a really good time to practice that being in the moment and making it easier for those other times to trigger into that state of gratefulness or being in the present moment.

Geoff

I have nothing to add there. 100% endorse that. Curious to hear your plans for the future! So obviously, you're on the comeback trail here. Sounds like you're really healing your body up. What are your plans for rest of 2019? How do people keep track and get your updates?

Pete J.

Yeah, well, they can keep track and get my updates on Instagram and Twitter. Twitter, I'll use mostly for the health side of things. I don't really mention on Instagram the stuff about me, only eating meat and not eating plants because it's not really the platform and people tend to push back quite a bit, particularly in my community, the triathlon community. I mean, they can be quite anti low carb, let alone anti plant as well. So that's quite interesting. But yeah, I love Twitter and getting involved in some of the health conversations that you post and all the other doctors that I follow are into. But I'm racing a couple of races in Asia in June. So Jamie and I actually excited we're getting to race Japan 70.3 Ironman, and then spend a couple of weeks living in Kyoto, we're going to stay there for two weeks. And then race challenge half in Korea. So, that's a couple of good races in June, and then come back and just do a big block of training.

And then the summer here down under, we'll start sort of September, October, November, and start racing quite a bit. And then if I'm continuing to improve, I'll race an Ironman full distance early next year and try and qualify for Hawaii 2020. And I'm only going to go back to Hawaii if I think I can, if I'm in better shape than I ever have been, if I believe that I can run faster than anyone has run there before. Because I know that's what it will take for me to get on the podium again. So, I only want to go back if I'm going to do really well there. So, it's a long way off, it's a long journey to there. I've still got a hell of a lot to learn because it's quite, you always mentioned that there's so many nuances just with the carnival diet or just with looking at ketones or this or that. Then you throw in the trying to train for an Ironman.

Geoff

Yeah, the training. Training itself is another beast.

Pete J.

As basically a zero carb athlete. And I'm trying to google and read articles and not just articles, but trying to read some of the papers around what's going on with gluconeogenesis and all the other factors that is going on, and where's my energy coming from, where's the glucose coming from, where's it going? What's happening to the ketones, where are they going? All of that kind of stuff. And figure out the optimum level for fueling because it's quite hard. Because on race day, the adrenaline, the heart rate, the cortisol, like everything is higher. So, you're going to get a different response in blood glucose in a race than I am in any training that I would do. So even if I can test my blood sugar 24 hours a day in training and my ketones, it's going to be a different story on race day. So just, it's going to be a bit of a journey figuring out how can I get to Kona 2020 with just a complete understanding of what's going to be happening in my body on race day? And how can I fuel it best for that task? And yeah, it's really interesting. There's not a lot of papers on zero carb athletes training to be an Ironman athlete.

Geoff

No, absolutely, you're at the cutting edge.

Pete J.

And I just want to stress, it's not something that I'm like, hey, I just want to do this to test what's going on. It's like, I'm doing this because I've found out that my autoimmune reactions that have plagued me since I was a teenager have ended me up here, not being able to eat plants without getting a leaky gut symptom. I still cop it from athletes that just say, you're just being extreme or you can't do it without carbs or why don't you just do this. And it's like, they just completely overlooked the fact that this is an issue I've been dealing with for 20 years and it's affected my career greatly. I'm just doing everything that I can to try and get back there.

It just so happens that it's on the other end of the spectrum that no one has really even looked at before, let alone tested and figured out, as you talked about, like respiratory quotient tests and how fat adapted can we get and then what do we fuel with to optimize that level of adaptation. But it's a good time. Basically, it's an exciting, I've come along and family sold out at the right time. If I'd found this out 10 years ago, and let's say the esters were still 10 years away, I would be scratching my head about how do I optimize this in a race because it's, it's just exciting to know that I can, I can basically, it's just doubling down and be like, hey, I can take in a minimal amount of carbs in training, which is great for my guts and not have to put in anything much at all. And some days I put in nothing almost. And then to know that on race day, I can not risk blocking up my guts and having cramps or having any IBS type issues and cover that energy with an ester and be like, hey, I know that I'm going to be okay.

I think there's always an aid station. If you get to that point where it's like, oh my God, I've run out of sugar, it's like, oh, there's a coke just here. Okay, great, I'll have that. It's really interesting time anyway. And with all the doctors and all the conferences that are out and published online and podcasts like yourself, and I can listen to all these amazing doctors, and people that have also experienced it and researchers and journalists, it's a really exciting time. So, I don't regret that it's taken me 20 years to figure it out. It's just been a really long learning process. And the timing is right. So, I'd love to get back to the top of the world and show that there's there is a different way to approach it than the high sugar approach that is affecting your health potentially.

Geoff

Incredible journey, incredible story. I think when people realize the extent to which you've understood your body, I think hopefully they understand that this is not just some extreme stunt that you're doing in terms of going completely off plants. I mean, you've almost done every other possible "traditional intervention" here, and this is the only thing that's working and sticking. So, I'm very excited to see the journey, follow the journey and hopefully we'll see you on the podium in 2020 Kona. I mean, that would be an incredible ride.

Pete J.

Like I said, we're a long way off that and I can barely even think about it. I'm just trying to take it basically still day by day. It's still like, I'm still trying to nail down exactly what's going on in training for my blood glucose levels, for my fuel where it's coming from. It's a long process, but yeah, it's a really interesting one and I'm really enjoying learning all that I'm learning.

Geoff

Awesome. All right, thanks so much, Pete. This was a fun conversation.

Pete J.

Thanks so much for having me.

Hi, Fat: Challenging Carbohydrates, Brain-body Connection, & Reversing Diabetes ft. Prof Tim Noakes

Originally posted on HVMN and authored by Zhill Olonan and Geoffrey Woo on May 20th, 2019

Even as the fear of fat declines within the public eye, you've still probably experienced disbelief & bewilderment from co-workers, friends, or family when talking about your ketogenic lifestyle. Imagine being a high-fat, low-carbohydrate proponent as an esteemed scientist nearly two decades ago.

With more than 750 published scientific articles & 70 marathons under his belt, Professor Tim Noakes is well-known for his many contributions to nutrition & exercise science. At the beginning of his research career, he was an advocate for a high-carb diet, which is no surprise given the medical dogma at the time, yet Noakes completely changed his mind when he learned about the value of the high-fat diet.

Not only was he an early leader in the ketogenic movement, a stance that temporarily costed him his medical license, but Noakes actually reversed his own Type 2 diabetes through a low-carb, high-fat diet. Perhaps one of the reasons he has upheld a high reputation is his continued desire to question current scientific theory, even conclusions he first helped define. Rather than turning a blind eye and staying with his preconceived notions, Noakes follows the evidence...a model we should all aspire to have.

In this episode, you'll discover:

  • Central governor theory - How does the brain directly influence physical performance output?

  • Ketogenic diet - Fat-fueled athleticism, improving insulin sensitivity, & becoming metabolically flexible

  • Noakes' commentary on the history, present, & future of nutrition science

Transcription

Geoff

Professor Tim Noakes, really a pleasure to have you on the H.V.M.N. Program.

Tim N.

It's a privilege to be on it with you. Thank you so much.

Geoff

Our honor. So our listeners are probably very familiar with your recent saga, or relatively recent saga, with some South African regulatory folks related to nutrition by your stance and your thoughts around low-carb ketogenic diet for metabolic health and health and wellness. But, on the other hand, you also have really had a storied career as an exercise physiologist. A lot of the common "folk wisdom" around carb-loading or hydration or this notion of fatigue and a central governor theory came from you. Given this storied career and the interesting notion from going from a carb-loading advocate to now talking about low carb, how would you describe yourself at this point in your career?

Tim N.

Well, I'm now every much retired. But I'm not retired, because I'm still very active in promoting low carbs. But if we go back over my career, I trained as a medical doctor. During my training, I realized a couple of things, firstly that I was much more interested in science and discovering new ideas than in simply regurgitating what was already known. I'd rather write the book than have to read it and learn it. I also had saw that the costs of medicine were rising dramatically already in the '70s, and most of it was the treatment of chronic disease. I thought, "Well, that's not a help," because I saw how ineffective the treatments were. And I said, "It would be much better to spend a little bit of the money on prevention." And I said, "Well, there are many good doctors looking after chronic disease. I think there need to be some doctors who try to promote prevention."

So I chose to go that route. I helped develop sports science and sports medicine in South Africa. During that time, as you indicated, I got interested in foods and exercise and how the brain regulates performance, and for a long time thought that carbohydrates were the king; they really were essential for exercise performance. Then, in about 2010, I suddenly realized I got it all wrong and decided that I better stop harming people because the books that I'd written said that high-carbohydrate diets are ideal. I realized I was wrong. If you had insulin resistance and you followed that advice, you were very likely to develop Type 2 diabetes. So I said, "It's time to change." I acknowledged my error, and I said, "I apologize, but we really have to understand that these high-carbohydrate diets are not for everyone." The consequence to that was that I irritated my profession so much that they decided I had to be tried for unprofessional conduct for doing a few things on Twitter which they didn't like. That was actually a front. It had nothing to do with that because everything I said on Twitter was completely correct medically, as we eventually proved.

So I went through 28 days of trial, and what my legal team advised me to do is, "Let's put the high-carbohydrate diet on trial and see which wins." At the end of the day, the low-carb diet won. So we were very happy about that. I managed to save my career because I'd been targeted publicly to be humiliated in South Africa and the world. I decided I wasn't going to let that happen because my whole career would've collapsed, and I felt I had to keep going and make sure that legacy was intact.

Geoff

100%. That just reminds me of Galileo, of these historical scientists. We can let history judge the comparison there, but obviously, within your field... I just want to underline and unpack some of the things we're talking about. Just as a reminder, in the '70s and '80s, sports science wasn't a field. So when you're saying that you helped develop sports science, I don't think it's a far stretch to say that you're one of the first seminal people to really make this a profession, giving the timing and perhaps the... So that's interesting. And then second, which I think is very interesting, is that it's very rare for anyone, but I think especially in academia, to say, "Whoops. I was wrong for 20 years of my career, and I'm going to correct that." I guess we should probably go into the sports field first and then probably unpack just in terms of chronological order here the typical notion of carb loading, hydration, central governor theory. Perhaps we can go through one at a time. Maybe we can talk about carb loading first. That's a meme that's very popular in endurance sports. What is still valid there? Because, obviously, there is some role, potentially, for carbohydrates, especially for performance. What was overstated, and what should we be more nuanced about?

Tim N.

Yeah, absolutely right. Carbohydrate loading came in in the 1960s, and just to remind you that before 1968, there was no real interest in sports science. But that was the year that the Olympic Games were held at altitude in Mexico City, and athletes went to Mexico City not knowing how to compete at altitude. A few countries sent their athletes there to train before the Olympic Games, and people said, "We absolutely don't know what's going to happen to these athletes." That was really the stimulus for the beginning of sports medicine. It was also because the East Germans competed for the first time, and they were successful. They had applied science. Of course, they'd applied drugs as well, but they'd applied science.

Geoff

They're pharmacologically enhanced.

Tim N.

The US realized that here's a real competitor, and we need to get involved in sports medicine. I know that the doctor who went with the US team to the Olympic Games in 1968, he was literally found a couple of nights before the Olympic team went to the games and said, "Would you like to come to the Olympic Games?" I mean, that's how unprofessional, how amateur it all was. I was so fortunate because I started my career in medicine in 1969, a year later. Therefore, the first 20 years of my life, I could actually know most about what was happening in sports medicine because it was still so small you could be knowledgeable about everything. Today, of course, it's such a vast field. Anyway, 1970, I start doing physiology and realize that this is my real passion.

The first studies of carbohydrate loading are starting to come forth, and the people from Sweden are doing muscle biopsies. They're measuring muscle glycogen. And they're coming to the conclusion that this is everything. Carbohydrates in the muscle determines your performance. Of course, we should've been warned. Listen, it's not one thing. You can't reduce all of performance to one thing. But we were so enticed by it that we fell into the trap. When I started becoming a serious exercise physiologist in the 1980s, you had to be able to do two things to be a physiologist. You had to measure an athlete's maximum red oxygen consumption. If you couldn't do that, you were hopeless because that was the one factor that determined performance.

Geoff

Right. VO2 max is a common part in this. People love citing their VO2 max scores.

Tim N.

Absolutely. Our problem was we started looking at VO2 max and we said, "Well, actually, there's such a wide range." You could have the same athlete performance, but their VO2 maxes could be quite different. The other thing was that we were told, and this... If you wanted to publish a paper in those days, you had to say this. You had to say that there was a plateau in oxygen consumption before the athlete terminated exercise. In other words, you were made to see the oxygen consumption goes up, up, up, up like this. Then the athlete tires, and no more oxygen consumption. There's this plateau phenomenon.

That was a gold standard. If you didn't say that, you couldn't publish your papers. And we didn't find that on every athlete. We were using fairly simple systems, and we couldn't find it. So we would say, "We can only find this plateau phenomenon in 10% of the population or of the athletes." So you either had to lie or... We told the truth. Fortunately, then that made me realize that if you don't get a plateau, then it's not the muscle running out of oxygen. And, in time, we realized it's the brain regulating performance, and the system is regulated. It's homeostatically regulated. You can't ever let the system fail because then you're dead. So exercise physiology was based on a false premise that the system failed, and then you got tired. We, over the last 10 years or so, have shown that fatigue is purely an emotion. It's just your brain is using this fake emotion to make sure you don't kill yourself. So that's been a major advance, as you know. But to get back to the muscle... Sorry. So, what I was saying, to be in exercise physiology, first you have to measure VO2 max. Then you have to do a muscle biopsy and measure glycogen in the muscle.

Then you're all systems go. Then you're word class. Now you can do everything. I was the first guy to do muscle biopsies in South Africa. We did muscle biopsies on everyone. We loaded them with carbohydrates. We couldn't find much evidence that carbohydrates were really helpful, but that didn't matter because we knew it was true. We were also the first in the world to develop those goos or squeezes that you run with and you squeeze into your mouth. We know all about those. So we developed them. They're called a Lepin FRN. Fordyce was the great ultra-marathon runner in South Africa. Bernard Rose was the marathon champion, and I was the exercise physiologist. So it was FRN, and if you go and Google Lepin FRN, you'll see that we were the first to develop it. So I'm acutely embarrassed now that we took athletes down the wrong road for so many years that carbs are going to make you go faster. But the end result was, when I wrote my book, Lore of Running, which was very widely read, it said carbohydrates are crucial for performance. The first three or four chapters are all about how nutrition is the key driver of performance, and particularly carbohydrates. I realize now that, actually, the brain is the key driver. So, as I rewrite the book, I'm focusing more on how these chemicals in the periphery, in response to what you're eating and drinking, influence the brain to allow you to go faster. The key is that it has to act through the brain in some way to allow you to go faster.

Geoff

I think we touched upon a couple interesting aspects of the central governor theory. We talked about VO2 max and we talked a little bit about carbohydrate and glycogen. I think I want to say, in the modern era, it seems almost intuitive that the brain is a central governor or critical to performance. I think we all have the intuitive experience that we feel really, really good today; we do better. We feel very depressed; we do worse. Some would say that some of the most interesting findings or results seem intuitive or obvious after the fact. I think it was interesting to hear the history that, in the past, VO2 max and muscle glycogen or carbohydrate availability were the two primal causes. But we're moving towards this notion that, actually, the brain is the central proximal cause, and there's many inputs going into the brain.

So, unpacking specifically on carbohydrates, would you say that... Obviously, if you eat a low-carb diet, you can go through the process of gluconeogenesis, produce carbohydrate from protein, or some of your exogenous nutrition coming in. Given your recent evolution on this topic, is there a role for carbohydrate for heavy weight lifting, anaerobic exercises, or are we very much in the camp now of you don't even need to worry about it; if you eat a well-formulated ketogenic diet or low-carb diet, you can still have maximal performance in anaerobic-style performance?

Tim N.

Yeah. I don't think we have the evidence here to say absolutely one way or the other. I know that there are athletes who can do it, but the reality is that they are probably using carbohydrate whilst they are doing those intense exercise. So it's not as if you don't have any muscle glycogen because you're on a high-fat diet. You do have muscle glycogen. So it would be impossible for us to say that this person is not using carbohydrates when they're doing those explosive events, and almost certainly are. So it's very difficult, but where I think the change has come is, as you become fat adaptive, and what guys like Jeff [Foley 00:13:40] kept showing and our own studies have shown and Louise Burke from the Australian Institute of Sport has shown, is that world-class athletes have an incredible capacity to burn fat and that we've completely underestimated the ability of the muscle to burn fat. I think Louise Burke's study is the one which I really find most interesting because she's not very pro-high-fat-diet.

But, if you look at her data, she shows that within three weeks, she took world-class walkers, race walkers, and she showed that within three weeks of this high-fat diet, during racing intensity at 25k racing intensity, these people were burning 1.5, 1.7 grams of fat per minute and about half a gram of carbohydrate per minute. They will almost completely close down all their carbohydrate metabolism. And they were racing at competitive speeds. My view would be that this is not because they've tooled up the muscles dramatically. It's because all that capacity is there. What they've done is, going on the high-fat diet, they've reduced their insulin and they've allowed, now, the fat to become the major fuel. We have a paper that we've submitted, and I don't want to go too far to say what it's all about, but what we did show was that in high-intensity exercise at any percent of VO2 max, it doesn't matter whether the person's eating a high-fat diet or high-carbohydrate diet. Their performance is the same.

Geoff

Interesting.

Tim N.

So that would be performance of 5Ks, or let's say 3 to 5Ks. So I think we're focusing in now. And if you're running 3 to 5Ks, you've got enough glycogen in the muscle, and you can burn lots of fat. You don't need a high-carbohydrate diet. That's really interesting because I think, once you get beyond that 5, 16, 15, 20Ks, for the average athlete, they can uptool and just burn fats. And they certainly don't need high-carbohydrate diets. That leaves us with people exercising from 100 meters up to, say, 3 to 5Ks. That's where the question remains. Will they benefit by high-carbohydrate diets? That we can't yet answer.

Geoff

Absolutely. I appreciate the nuance there because I think, in the world of Twitter and polarizations, it's easy to be, "Carbs are king," or, "Carbs are useless," and I think, as you're unpacking here for us, a lot of nuance. I would say that one paradigm that I've been thinking a lot about and curious to hear your thoughts is that there is some orthogonality between maximal longevity or metabolic health versus performance. Is there an argument that if you're looking to win an Olympic gold medal at your event, maybe within the sub-5K range as you're describing, is it worth it to spend two years, four years, eight years jamming as much carbohydrate as possible and potentially harming your long-term health? But you maybe get that advantage of having very up-regulated carbohydrate function. Maybe you can do some training around being metabolically flexible; fast a little bit in between.

But the main point is have a lot of carbohydrate during that period for that short-term potential benefit at the cost of potentially decreasing your health span long term. Is there a potential argument to be made there, to basically differentiate or just tease out longevity, health span, versus "I want to just burn the candle real quick, eat a bunch of carbs, maybe give myself diabetes or pre-diabetes in 10 years. But, hey, I have a shot to win the gold medal"?

Tim N.

I think you make the point very clearly. You see, I'm a great example. I was never an elite Olympic athlete, but on checking my own data from when I was 28, I was profoundly insulin resistant. I had a fasting insulin of 30 units, and we like to be below six units. Once you're above six, we know that you've got long-term problems. If you're running with a fasting insulin of six or seven, you will get problems in the long term. And, of course, higher, it'll just come quicker. So I was a walking time bomb, and no one had told me, although I saw the data. We didn't know what insulin resistance was in those days. So I developed my Type 2 diabetes at the age of 60, and I probably had it about 55. But I didn't check for it enough, and my fasting glucose looked okay. It wasn't great, but it wasn't diagnostic of diabetes. But I think if I'd done better testing, I would've known that I actually had had diabetes for 10 or 15 years, or 10 years before I made the diagnosis.

So I'm a really good example of what happens if you take a person who's insulin resistant on a genetic basis and eats a high-carbohydrate diet. You will run into trouble in the long term. So I don't see any advantage of eating one gram more carbohydrate than you need. That's the key. I would like to encourage people to experiment and not to say as I do in the book Lore of Running, that you must just overload on carbohydrates as much as you possibly can. I mean, we were telling people to eat a kilogram of carbohydrate every day. I don't know how they survived on that. Their insulin spiking must have been horrendous.

Geoff

For Americans, that's 2.2 pounds of carbohydrate, which is a lot of food. That's just a lot of food.

Tim N.

Exactly. And I would rather say skid by on the minimum amount of carbohydrates that you need because that's going to be for your long-term life expectancy. That's going to be the ideal. Now, I think athletes are realizing that, that there's no real advantage of over-ingesting carbohydrate. You see, when we were working through this paper about how intense exercise could you do on a high-fat diet, I discovered this study saying that you actually burn quite a lot of fat in high-intensity exercise, even maximal exercise. It's difficult for us to measure it, but it's there. People are burning fat. And the one study by [Larsen 00:20:11], my friend Paul Larsen in New Zealand, showed that the difference between the best sprinters that he studied wasn't because the fastest guys were burning more carbs. They were burning more fat. He used an unusual technique to show it because it's so difficult to measure it. But that was his conclusion. So, again, I just mentioned that sprinters may actually burn quite a lot of fat, and it doesn't fit with the paradigm.

Geoff

How would you explain that? Because, as you said, the paradigm is, okay, if you are sprinting, you're probably reaching VO2 max very, very quickly, and you'll go into fermentation or anaerobic metabolism.

Tim N.

The problem is that a 1920 study is quoted. This is the basis of the fact that you can't exercise on a high-fat diet. There was an intervention where they had athletes or humans exercising on high-carbohydrate or high-fat diets. The guys on the high-fat diet did very badly, and so they said you can't oxidize fat rapidly for high performance. And that's 1920. It's one of those foundation myths on which we build everything. So everyone quotes that study, and then they say that Olympic athletes have to burn carbohydrates to win gold medals. But, when you look for the evidence, it's actually... It's not there. That's point one. Point two is that, as you know, the physiology, as you start to exercise more vigorously and you become more acidotic, you release carbon dioxide from your body's stores. This comes out, and so that falsely raises your respiratory quotient. We use the respiratory quotient to predict how much fat and carbohydrates you're burning. The higher the respiratory quotient, the more carbohydrates you're burning. During exercise, we are biased. We are underestimating how much fat you're burning. That's why we can't really measure it. It took Paul Larsen to show that, actually, we do burn some fat during high-intensity exercise, and it may be much more than we think.

Geoff

Essentially, the argument is that there is... Obviously, you're still breathing. You'll still be able to use fat oxidation, and fat will be a substantial portion of overall fuel expenditure. I think that's a nuance that I think is left out of the Twitter sphere where most... Everyone's always burning a mix of substrate. It's never just sugar, just fat. It's always a mixture.

Tim N.

Let me just add another point which I had some argument with another guy, and then he actually stopped on Twitter. He just went off. I said, "If you're a Tour de France cyclist..." And he's saying, "Oh, but, you see, you've got to have lots of glycogen so you can sprint up the mountains." Well, okay. That's fine. But you could get that glycogen by burning fat. So, if you can exercise at 85% of your VO2 max burning mainly fat, the time you have to go to 90% as you're finishing up these huge hills that they go up, then you've got the glycogen. It's stored in the muscle. It's still there because you stored it the night before, and you haven't used it in the first four hours of this last stage. You're just burning fat. So now you can use more carbohydrates at the final slope.

But that doesn't come into their equation because they're so convinced that you can't burn fat at high-intensity exercise. The question I ask is, so where do you make the cut-off? What is high-intensity exercise? We've studied an athlete, too, at 92% of VO2 max while still burning way more than 50% of his energy was coming from fat. That's how much, if you really adapt... But you have to adapt. You have to do high-intensity training on a high-fat diet. Then you can increase your fat oxidation rates remarkably, even at high intensities. So the future, for me, is that athletes will use less and less carbohydrates in training and do more training on the higher-fat diets to make their muscles burn at 90%. They'll be burning predominantly fat. That's the capacity is there. If it's not there in everyone, the athletes who can do it will be the ones who will be the winners in the long term. In other words, if it's a genetic thing, they'll be selected and they'll start to win as a result.

Geoff

Absolutely. I think that's a good segue into some of the more popular topics in discussion with the folks that we work with in physiology in sport, which is this notion of metabolic flexibility, which you're describing. How much can you switch back and forth between different substrate, and how high can you be burning fat at higher and higher intensity?

Tim N.

The idea has risen that a high-fat diet makes you metabolically inflexible.

Geoff

Really?

Tim N.

It's a high-carbohydrate diet that makes you metabolically inflexible. It's not my idea. My PhD student, Chris Webster, pointed that out to me. We took this athlete who could burn at 90%. He could burn so much fat. And then we did a VO2 max test on him, and he did a great VO2 max in which he burned lots of carbohydrate. So here he was with a capacity to burn 1.7 grams of fat per minute, but he could also burn a huge amount of carbohydrate when he was at VO2 max.

Geoff

Interesting. What I was getting to was that... One, let's talk about adaptation period because I think that's something that a lot of people don't... Or, at least as an open discussion of debate, do you need six weeks to adapt? Do you need two years to adapt? And then part two, which I think was interesting, was that what you're suggesting, what your PhD student described, is that it's kind of a one-way door where, if you're very optimized for fat metabolism, you don't lose your ability to metabolize carbohydrate. But if you're fully optimized towards carbohydrate metabolism, you potentially build up insulin resistance, and that reduces your ability to metabolize fat.

I think that's an interesting point to discuss. But the first part of the question, which is, I think, potentially an open area of discussion and work, is what does adaptation mean? I think some people say they feel really crappy on switching to a keto diet for two weeks. Is that too short? What, in your experience, is the right level to fully adapt, and are there strategies to accelerate that adaptation? Should one consider intermittent fasting, high-intensity interval training on top of reducing carbohydrate intake to potentially accelerate up-regulating fat oxidation?

Tim N.

My general view would be that you don't want to add too many stresses at the same time so that if you are adapting to the diet, just adapt to the diet. Don't now increase your intense training, because it's going to happen. If it happens in six weeks or three months doesn't really matter. In a study we did where we repeatedly tested people over six weeks on short-duration, high-intensity exercise, within two weeks their performance had normalized. So, in this group, just two weeks was good enough. But, on the other hand, I've helped world-class athletes, and some of them say it took them 10 months to really get fully adapted in training. And they notice now the advantages in competition. So I think it can be a long time, and maybe it takes 10 months. But you keep going until you see what the outcomes are.

Geoff

That's a good point because I think if you were to argue or steel-man the opposite argument, it is that "I've been doing this for three months. My performance is still not there. I've been doing this for six months." I guess you could say the argument, could you be in a impossible, looping situation where you just need to adapt longer? Adapt longer. This is argument to regression. How would you counter that argument that "Okay, there's no bar"? There's no true Scotsman. You just haven't done it hard enough. How would you address that concern?

Tim N.

I'd give you six months, and if you haven't adapted after six months, I'd say that's it. You're not going to adapt. And go back to your standard carbohydrate diet.

Geoff

That might be a genetic component that-

Tim N.

There are going to be outliers who don't adapt. That will always happen. I remember one guy phoning me and saying... He was a really good athlete, and he said, "At 20 grams of carbs a day, I can't even get out of bed." I said, "Okay. Maybe we should put you back to 100." On 100 grams of carbs a day, he was perfect. He could do everything that he could do. So we say that carbs are not essential, but it's clear to me that some people do need a little bit of carbohydrate, external carbohydrates, to perform. Why that should be, who knows? But they probably have some sort of slight metabolic difference, and they need carbohydrates to fuel the Krebs cycle and so on.

Geoff

100% agree with that. Now, moving to central governor theory, what are some of the key insights that brought you that notion? Again, going back, it seems intuitive, almost obvious, today that the brain is so important for performance. But, again, rewind 20, 30 years ago. This was a new field of inquiry. Everyone was looking at VO2 max and muscle glycogen as the two drivers of performance. It sounds like you started seeing some data that there was very little correlation between those two markers for performance. What centered you around the brain, and what does that inform us about training? The one thing that's funny to me is that knowing that it's the brain doesn't mean that you can just trick your brain. The best way to almost trick your brain is to exercise a lot and eat well. So it's almost like you might know the mechanism. How do you use that mechanism to inform your training and form your lifestyle to optimize performance?

Tim N.

The key bit of evidence for me was when we started measuring electrical activity in the muscles. For the other model to be true, it predicts that you get tired when you're activating all the muscles in your lower level. That's the point. As you get tired, the muscle fibers start working properly. You have to recruit more muscle and more muscle and more muscle until you've recruited everything, and then you're fatigued and you have to slow down because all the fibers have been activated and they're all getting tired. Now, when we tried to test that hypothesis, we found it was completely wrong, that that's not what happened, that you only recruit up to about 40% of your muscle mass. Then it would decrease as you got tired. In some circumstances, it might increase, but it would never get to 100%. So the model was wrong, and that's where we realized, well then, obviously the brain's in charge.

I think people forget this: that to run faster, you have to recruit more muscle. You can't run faster without recruiting more muscle. That kind of a message still hasn't got through to people. It's "You must eat more something, and then that'll make you run faster." No. You recruit more muscle, and then you run faster. So that was what we began to realize, that that was the case. In time, we realized, where does the brain come in? It's producing this fatigue. And our most recent papers show that the key is that you have an emotional response to how you feel when you're running. So you get all this feedback, and it either makes you feel good or bad or whatever. Then you get an emotional response. In our clinical trials where we race athletes against each other in the laboratory, the moment that one athlete goes ahead, the other guy starts to feel bad. His emotional state gets worse.

That's the first thing that happens. And in the second thing that happens, he starts questioning, why is he doing it? Is it really worth continuing? That's called the stopping wish or the quitting wish. Those are the three components, which we now understand in the central governor model, is that, firstly, there is feedback from the periphery, from your internal, and from your assessment of the environment. Then there's this emotion. How do I feel about what I'm doing? Is it making me happy, or am I not happy? And I'm feeling distressed. Finally, you start asking the question, "What's it worth? Do I really want to continue hurting myself for another hour to win the gold medal? Maybe I can slow down and win the silver medal, and that's acceptable." So that's what's going on in your head. And then you asked about training. Well, I think that training is to convince yourself that you can cope. But much more important than that is, what's the goal? Why are you doing it? That's the key. The coach has to get that across to you that this is really important and that you are the only athlete in the whole world who can do it.

Geoff

Yeah. One of the elegant things that you've written or you've said in the past about this notion is that, well, we've all been to the point that you think you're going to die in performance. But then you just... You go a little bit further, or you take a 30-second break and you can keep going. Obviously, you're not even close to dying. So there is something going on that's preventing you from hurting yourself, which I think is a very intuitive way to explain this physiological model that you're describing. Given that the brain is so central to performance, obviously, traditional exercise is very focused on physical exercise to gain performance. If the brain is so important, could we hypothesize that things like meditation or mental training or working on your mental fortitude to absorb pain and really define what your goals are... Is there a role to just look at the brain as a substantial portion of training where I think that is starting to come into vogue, I would say, in recent years? People start working on the mindfulness of the athlete. Does the model that you have suggest or propose specific protocols to work on the brain? Have you looked at that? Is that something of interest? Are there any potential strategies or hypotheses you have there to optimize training of the mind?

Tim N.

I haven't really thought about that. I've been involved more in the physiology, and I haven't really spent my time, "How do we train people to perform better?" Yeah, because to me, this is a black box still. I have to leave that to other people. I think my contribution was to say you've got to look at the brain. You've got to work on how people can train their brains. I think that there's so much to do with it's either genetic or the way you were brought up as a child that is so critical to performance. I'm reading a book at the moment, and it looks at some of the greatest teams of all time, teams that perform beyond belief. So this is not individual sports. It's the team. An interesting thing that they discover is that when you get a team together, each of them underperform slightly. By themselves, they're able to perform slightly better. But as soon as you get in the team, they all sort of become dependent and let everyone else do the work. That's really interesting. It turns out that the best teams, that all comes down to the leader. It all comes down to the captain, that he's able to lift the team to a different level because of his own leadership skills. So there it is. He just manages to get these guys, or she manages to get the girls or the boys, to perform at a higher level and not to let their performance go down because they're a team.

Geoff

That's interesting. Yeah.

Tim N.

It's fascinating that the natural inclination is to underperform. That's the natural inclination. But there are certain individuals. That's part of point two, is if you look at some of the great athletes of all time, they came from abusive families. They had a family member who abused them. I'm talking about physical, not sexual but physical abuse. It was coping with the physical abuse of the father particularly that allowed them... When they got discomfort in exercise, it wasn't an issue because they'd lived with this abuse for so long. That may be the one, but the other one, of course, is just a father that disappears from the family. These are like psychiatric illnesses that help people do better. So it's very complex, and it's not always the way you think it might be.

Geoff

Yeah. No, it's an interesting proposition where... to have an outlier, extraordinary performance, you have to have some sort of extraordinary starting point or initial condition. Potentially, that's the line between madness and genius. If you are that far outlier, you literally are the best human out of seven billion humans at something. There is some strange initial condition likely, and that might be really, really bad, negative six standard deviation or positive six standard deviation. I think, going back to your story about leaders really buffering up the whole team's performance, I think that really resonates with me in our conversations with groups in the military, groups in sports teams, this notion of leadership. If you have a bad team leader.... People in Navy SEAL training are buds. Talk about that. You swap a team leader. The boat-racing team that would always win with that team leader. You swap the captains with the worst-performing boat. That next boat race, that worst-performing team is now winning those races. Do you have some sense of what are characteristics of that leader? What can we learn from this? What can we model ourselves after? Do you have some sense of pattern there?

Tim N.

I worked with a team that won the Rugby World Cup in 2007. You could walk into the room and know this team was unbeatable. It was this sense of purpose and discipline and character and do the right thing when you have to. It was pervasive. It was astonishing. I think there were four or five great leaders on the team, and they lifted everyone. I must mention that Joe Montana is one of the people in the book, and I know that you have an interest with Joe Montana in San Francisco. One of the reasons I have to get back to San Francisco to meet you again in your offices is to meet Joe Montana.

Geoff

Yes. I remember we talked about that. We will make that happen.

Tim N.

I have a series of football or rugby jerseys, and I have to get him to sign-

Geoff

Okay. Let's coordinate that. We can absolutely make that happen.

Tim N.

I would love to do that. That would be super because I have this one lecture on performance, and I have the catch. I go through the catch in great detail, which is really interesting for South Africans who follow rugby, which is of course not American football. I have to explain exactly what the circumstances were and what it meant and why it was such an amazing moment and how perfection comes down to inches. That just epitomizes that moment.

Geoff

Absolutely. Well, I think it just speaks to the sport broadly. I think one part of me is that, who cares about other humans playing some artificial game? But I think it's really a personification of ethic discipline, some of the cultural values that we choose to honor. So I think that's a good analogy. It's a good personification of some of these soft qualities, which is also... I mean, going back to the point around the pneumatic feel of, okay, you sound like the energy in the room, I guess, matched the leaders who had this confidence, this swagger, this inevitability. And that permeated across the entire organization.

Tim N.

In that episode, Winning the World Cup, there was a moment where South Africa could've got knocked out in one of the earlier games. The score was suddenly 20-20. It had been 20-null, and it was suddenly 20-20. The captain realized that the team had lost it, and he called them together. He said, "We didn't come here to lose to this team." He spoke to them because he picked up immediately, and the team just went away and quickly scored the points needed to win the game. They were totally dominant at the finish. Again, the just understanding his colleagues and understanding what was wrong and making the correct diagnosis and initiating the right intervention.

Geoff

Yeah. If there is one takeaway that I can draw from this anecdote, it's that there's some intuition here. Spot the flagging confidence, and when there's that fear, have courage and lift everyone up. Let's push this a little bit more, which I think we all should think about when we have that flagging of courage. Can we have the discipline or willpower to, "Yes, that is happening, but no. We're going to power through this"?

Tim N.

Be brave. And, in fact, that's what the coach told them. Before the final, he said, "Be brave. Just be brave."

Geoff

That is inspiring. I think we discussed quite a bit about how you essentially almost created, or were at least a seminal player in creating, sports science. Going to a second big area that you've contributed towards and are now very vocal about and, I would say, a thought leader in the space of is this notion of low-carb diet for metabolic health, metabolic syndrome. As we all clearly know, and I know our audience is very aware of this, that diabetes rates skyrocketing. Obesity rates skyrocketing. These are unsustainable chronic diseases that essentially, if we do not leave checked, will make society unlivable. If all of us are obese with diabetes with neurological conditions like Alzheimer's, etc., etc., etc., it's just not going to be sustainable. How did you transition or expand your interest from the physiology world into broader health conditions? Was there some trigger point there? Was it just a realization over your career as a doctor, physiologist, realizing... and perhaps your personal journey seeing that a lot of the things that we're working on in exercise physiology can apply to everyone's just daily living, daily health.

Tim N.

I think there are two factors. Firstly, my father died of Type 2 diabetes. I watched him die over 10 years, being treated conventionally. He got all the complications of diabetes, and there I was as a trained medical doctor, not helping him. I couldn't help him. That was very frustrating because I'd been taught that Type 2 diabetes is a reversible condition. It took him 10 years to die from diagnosis to death, and it was just too terrible. I won't even go into his condition when he died. It was appalling. So I watched this process, and ultimately, then, I developed Type 2 diabetes myself and realized I had 10 years to sort the problem out because that was what had taken my father 10 years to die. I realized there were 10 years to sort this thing out, and fortunately, I had a low-carb diet and sorted my problem out relatively quickly and put my Type 2 diabetes in remission.

I've probably had the condition for 12, 13 years now. And, cross fingers, I don't have any complications as yet. I'm hoping I'm going to avoid them. So when I learned that insulin resistance is the most prevalent condition in the world but we don't even teach it in medical school, then I asked the question, why not? What I realized is that 85% of chronic disease is linked to insulin resistance, and the treatment is nutrition. What we do and what we're taught as doctors is we put each of the components of insulin resistance into a separate silo: heart disease, dementia, obesity, hypertension, cancer. We treat them in these different silos, whereas if I was head of a hospital or a medical school, I'd say, "No, no, no. They're all in the same silo. They're all the same disease."

Geoff

Right. The same primal cause.

Tim N.

Exactly. And it's not pharmaceutical interventions. They don't work. They don't help. We've got to sort out the cause. When I was in medical school, we were taught to look for the cause. That doesn't happen anymore. It's now, what's the diagnosis? And here's the road to treatment. And if it doesn't say, "This is how you treat it," you don't treat it that way because then you're in trouble. That's what's motivated me because, as you indicated, we face a tsunami, a disaster heading our way. The obesity/diabetes epidemic is going to destroy medicine, and people don't see it. And we just delay, delay, delay. We have to do something. The answers are relatively simple. It's not rocket science what we have to do.

Geoff

I think everyone, I would say, has good intentions, assuming good faith. I think we would both agree that doctors or researchers that are more of the standard-of-care methodology are not trying to harm people. Academics aren't trying to mislead people when they're publishing about carbohydrates in the exercise physiology world. I think that's something that I think more and more people are starting to realize, is that what are the institutional blocks here where there are actually quite aggressive in blocking novel thought? I mean, this happened in your academic career when you're publishing papers. You were mentioning that if you didn't have this kind of characteristic in publishing for VO2 maximal performance, they would reject the paper or ask you to reanalyze your data.

We're looking at insulin resistance as a root cause, and obviously, I would say in recent years that has more wider acceptance. But standard of care is very, very far from that. Perhaps, just starting at the very, very philosophical or high level there, why is this happening? I think the goals are the same, right? I would think that the doctor on the other side who is arguing for standard of care is saying, "I want to help people, too. This is a tsunami. We should do something about it."

Geoff

What do they have wrong, or what do we have wrong? Someone is wrong. I think good faith... Everyone wants to work on this problem. What's going on here?

Tim N.

I don't want to promote conspiracy theories, but I've looked at it for a long time, and what happened to me was clearly coordinated because I was asking questions that people didn't want to answer. I just happen to think that the pharmaceutical industry and the food industry is so powerful that they control what's being taught at the medical schools. They control what the public are reading. They control the television networks. They control everything. That's the reality. So there's only one message that people are going to get, and that's the one that promotes the industrial diet and the use of pharmaceutical agents. To get past that, it's impossible. You can't do it. The only way we can do it is to train each individual human to question and to experiment with different diets and find out what works for them. Then we slowly work through the doctors because if we can convert doctors, eventually they will realize that this is the way to go.

I think social media has been very important in this because now, today, people will see what works and what doesn't work. I tell my medical students that in 10 years' time, if you're prescribing things that don't work, you won't have any patients because they will have gone onto the internet, and they'll see that doing X, Y, and Z is what works. And there are millions of people reporting that it worked for them. They will try it, and if it works, they won't go back to medicine. So I think with the social media is the only force we have to reverse what's been happening.

Geoff

Would you say you're optimistic? I think the social media, just given what we've seen in our community and the growth and interest in the internet world around ketogenic diets, low-carb diets... Would you say you're optimistic? You have built quite a following on Twitter. We've seen an uptake in interest and discussion. Should we be optimistic? I think conversations like these, where we're nuanced, we're thoughtful, we're unpacking some of the mechanisms of action here, is going to help accelerate this change. I think we see it already where our listenership has been growing quite quickly over the last couple of years. Do you sense a tidal shift?

Tim N.

Absolutely. Just go back five years. No one knew about the banting diet. No one knew about the low-carbohydrate diet. For a period it was the topic of discussion among South Africans. I can't go anywhere without being embraced and thanked every day for saving people's lives. They start crying, and, well, I didn't do anything. I just wrote a book on something. They did it for themselves. And those people... The examples are remarkable. There's a Facebook page, The Banting Seven-Day Meal Plan Facebook Page in Cape Town. 1.5 million people. Three years ago, had no followers. It's got 1.5 million. And it's from every possibly groups of South Africans. Any race, any ethnicity, any age, any gender, they're all there. This start was thought to be for the elite, and it's gone right across the country.

Geoff

Yeah. It's very encouraging.

Tim N.

We're currently working with a domestic servant. So she's quite low on the social scale. She's written her own book on the low-carb diet, a banting book. Isn't that astonishing?

Geoff

It's a movement. Yeah.

Tim N.

She cured her diabetes on the diet. She now helps people like herself.

Geoff

I want to play devil's advocate here for a little bit. So banting, the banting diet, this was a very old diet. Banting, I believe, was the '20s. I don't remember the exact decade, but this is-

Tim N.

1860.

Geoff

'60. Okay. Yeah. Okay. 1860?

Tim N.

Yeah.

Geoff

Okay. Yeah. So this has been around for 150+ years. We had the resurgence of the Atkins diets, I would say... What, '80s? 1980s, 1990s? That was popular for a while. So there's been a couple, I would say, false starts. What's different today versus the initial banting introduction in 1860s, the introduction of Atkins in 1980s? Was it a difference in the specific nuances of how to apply this low-carbohydrate diet, or is there just a much better understanding of how to measure the physiological health markers? What's different today versus the previous false starts?

Tim N.

I think one false start was that the Atkins diet was taking off in the early 2000s, and then he died, sadly. Then that killed it for... People said, "Oh, he died because of X, Y, Z," which wasn't true. His diet didn't kill him. I think what's changed now is that the internet and social media has helped, but I think the science is coming through. And you can tell the science is coming through because the backlash is huge. Industry's backlash and getting published rubbish data, which is absolutely appalling because there's been this onslaught of nonsensical science, which has been published by beta journals in Britain and the United States.

It just shows how scared they are because they're allowing this rubbish to be published. So I think that's what's happening, and let's not forget the company that lives very close to you, Virta Health, which has now shown that we can reverse Type 2 diabetes. That is a massive, massive event. If it hadn't been for Virta Health, we would still be 10 years away from showing that you can reverse Type 2 diabetes. They accelerated the acceptance of it. And the impact of Virta Health... You have to understand the American Diabetes Association has finally, this year, accepted the low-carbohydrate diet can be used in the treatment of diabetes because they couldn't ignore the Virta Health data. So that is a major change because for the last 50 years, they've been promoting high-carbohydrate diets as healthy for diabetics. And how they've got to say, "Actually, a low-carbohydrate diet is acceptable treatment."

Geoff

Right. For folks that might not have seen that paper, this was a two-year study, a one-year study?

Tim N.

Two years. Yeah.

Geoff

Yeah. It's a two-year study of a low-carbohydrate diet, and I think Virta Health has a app to help people go through and coach them through some of these applications. But it's essentially a ketogenic diet. And people essentially got off insulin. People's fasted glucose, fasted insulin would drop. Those are impressive results. Perhaps dive into some of the steel-manning of the other side of the argument. Some might describe that this is... You didn't cure the root cause of carbohydrate intolerance. You just have managed the condition. Did you actually manage Type 2 diabetes, or did you actually cure Type 2 diabetes? For some of the more nuanced discussions, I think it's unquestionable that you are managing this, right? People don't need insulin as much. They can reduce insulin load. But when people reintroduce carbohydrate back into their life, my understanding is that you don't reverse carbohydrate intolerance, necessarily. What are your thoughts there?

Tim N.

Oh, absolutely. It's semantics, but you see, the carbohydrates is the problem. It's like if you're using poison. For us with diabetes, carbohydrates are poison. We can never start eating the poison again. It's going to activate the illness again. So that's the reality. You can't reverse insulin resistance because insulin resistance probably is beneficial in people eating high-fat diets. But it's not beneficial if you're eating a high-carbohydrate diet. Why would insulin resistance be so prevalent as a genetic component of so many populations in the world? Like the Australian aborigines, profoundly insulin resistant. Also the people living in the Pacific Islands, very, very insulin resistant. Why would that be? It has to have some biological reason, some survival value. So I wouldn't want to get rid of my insulin resistance. I just don't want to activate it with a high-carbohydrate diet.

Geoff

Interesting. So maybe this is a protective mechanism. It's sort of the analogy that this is the ambulance on the scene and not necessarily a causal factor, which is interesting. Obviously, I think you're right. Over the last three, five years, this banting diet, this low-carb diet notion has really taken off. And I would say within the last year, carnivore, this notion of only eating meat, has taken off. We've spoken to a number of folks who are advocating that. I've seen you post and discuss that a little bit. Curious to hear your thoughts on carnivore. I've actually experimented with carnivore myself, doing a couple four-week blocks of carnivore. Curious to hear your thoughts on this new, somewhat fringe, perhaps fringe, perhaps interesting diet.

Tim N.

Well, when I first started writing about the high-fat diet, I got letters from people who said they've reversed their Type 2 diabetes. And I said, "It's impossible. I don't believe you." Now, we now accept that, that this diet can reverse Type 2 diabetes. The messages we're getting now is people reversing their autoimmune disease on the carnivore, plant-free diet, plant-based diet that there's no plants in it. I have to say I think that's the next generation of effects, that if I was a scientist today and I was treating people with autoimmune disease, I would like to see what happens if you put them on a diet that was completely free of plants foods and only carnivorous. We're going to have some spectacular results. I don't suggest that it's for everyone, but there will be some spectacular results. Then you can start understanding what's causing autoimmune disease, and there there's a Nobel Prize waiting out there. If I was at the University of California, San Francisco, that's what I'd be doing. If I was a gastroenterologist or leading with other autoimmune diseases, I'd be studying that.

Geoff

I know we have PhD students out there listening, so a Nobel Prize tip here.

Tim N.

Quickest way to the Nobel Prize.

Geoff

What would you say was the hypothesize mechanism of action here? People talked about plants being... Some of the polyphenols are actually triggering immune reaction. What would you hypothesize is in plant material that is not in animal material that is triggering this? What would you specify? What would you hypothesize?

Tim N.

I think that it's the leaky gut syndrome, that there's something in plants, like lectins or other agents that cause the leaky gut to develop. They cause the interest sites to move apart and then allows the bacterial protein to get in. And you cross-react with a protein that comes in which looks like one of your tissues. So you produce an antibody as a response, a cell-based response to that. So you get autoimmune disease. It is so simple, and it's so obviously probably wrong, but it's such an obvious hypothesis to test that that's what I would be doing. I would be looking for leaky gut, reversing the leaky gut and autoimmune disease healing itself.

Geoff

Interesting. Yeah. I think the case studies or the N=1 anecdotes suggest there is some signal here. I think that, to me, is the foundation of science. You see some observation, like here's quite a number of folks who are claiming some autoimmune disease attenuation or some sort of fix with a carnivore diet. There's clearly some signal there. I think that it's premature for folks or professional doctors or researchers to say that is completely wrong. I think the curious mind would say, "Why is that happening? There seems to be some signal here. Can we investigate?" If people do the research and it is wrong, then we will know. But now I think if we just completely ignore it, I think that's unscientific. A fascinating conversation. I'm sure we could go on for a few hours here, but I always want to wrap up with one final question here. And that is, if you had infinite resources, infinite subjects, you could do whatever you want with them, what would be the one trial, the one study that you would want to run? And how would you set that up? You can put people in the metabolic wards. You can put people in the... Whatever you want. What is the Tim Noakes experiment?

Tim N.

One of them would be carnivore diet and its role in autoimmune disease. I think, to me, that would be one of the most spectacular interventions. I think the reversal of dementias with interventions like ketone bodies, that would be really interesting. But I think that the damage has been done to some extent, and I'm not sure how we could go forward there. The other one is cancer. I would love to study cancer on this low-carb diet plus a whole bunch of other supplements. I get feedback from people who use supplementary treatment for cancer, and five years ago, I said they were quacks. It's nonsense. It can't work. But I would like to consider that. In other words, it's not just the ketogenic diet. It's the addition of ketones, and it's the addition of other supplements. I think that that would be really, really interesting. So I would focus on autoimmune disease, and I would focus on cancer because if we can show that we can reverse those two or put those two conditions into remission, that would completely revolutionize medicine.

Geoff

Via a low-carb-diet intervention.

Tim N.

Yeah, off the top of my head. I think that we solved the diabetes issue. Although we continue to research it, I think we've got it. And, finally, because obviously I know your interest, I think the use of ketones in medical conditions needs to be addressed. And, just to finish up, when I was last with you and I was given some of your product, my ketone bodies shot up and my glucose shot down. It was astonishing. I couldn't believe it. So there's a treatment for high glucose. The effect was greater than the drugs I take for controlling my blood glucose.

Geoff

Yeah. Work to be done there. That's a very interesting signal. Absolutely. We're looking into it.

Tim N.

The role of ketones in health is a huge area. But there we go.

Geoff

Professor Tim Noakes, thank you so much for your time. Really a pleasure to have this conversation, and hope to speak to you soon.

Tim N.

Thank you for all the wonderful questions and the chat. I really, really appreciate it. Good luck to you and great success for your company.

Geoff

All right. Cheers. Thank you so much.

Carb Cycling Guide for Athletes

0,080–that’s how many minutes are in a week. Maintaining a diet through all those minutes, for weeks or months, requires supreme, almost unwavering willpower.

Even The Rock doesn’t do it; his Sunday night cheat meals are stuff of legend, consisting of thousands of calories of his favorite food.

The social side of dieting is tough. It takes dedication to remain unmoved on a diet; happy hour invites, dinners out, work-sponsored lunches–saying “no” to all these are small wins on the battlefield of dieting. For a diet like the ketogenic diet, avoiding carbohydrates can feel like tip-toeing through a minefield of Western, carb-centric eating.

Water Fasting: All You Need to Know

Often, we’re told happiness and self-improvement can come only through addition—it’s the consumer culture we live in.

There is nothing inherently wrong about this. Eating healthy food, supplementing, and taking some time to better yourself through exercise or meditation are all additive actions that (hopefully) add something to our lives and help us achieve our best.

But, there may also be another side to human enhancement, one that involves restriction, rather than addition.

What are Exogenous Ketones?

Originally posted on HVMN and authored by Brady Holmer on July 27th, 2019

The ketogenic diet is more lifestyle than diet. It’s gaining popularity among those who wish to improve their metabolic health, lose weight, or boost their productivity. The many purported benefits of the diet are due, in part, to the properties of ketones, which are produced by the liver in someone on the low-carb diet, or someone in a fasted state.

Table of Contents

Endogenous vs. Exogenous Ketosis

General Health Benefits of Ketosis

Exogenous Ketones: Another Avenue to Ketosis

Benefits of Exogenous Ketones

Ketone Salts

The Science on Ketone Salts for Health

The Science on Ketone Salts for Performance

Advantages and Disadvantages of Ketone Salts

Ketone Esters: Acetoacetate Diester

The Science on AcAc Diester for Health

The Science on AcAc Diester for Performance

Advantages and Disadvantages of AcAc Diester

Ketone Esters: BHB Monoester (HVMN Ketone)

The Science on BHB Monoester

Advantages and Disadvantages of BHB Monoester

Ketone Oils and Powders

The Science on MCTs

Advantages and Disadvantages of MCTs

How do MCTs Differ from Exogenous Ketones?

When and How to Use Exogenous Ketones

Final Thoughts on Exogenous Ketones

But, keto isn’t for everyone. Some may find it restrictive, and others, like athletes, may find that this way of eating does not lend itself to optimal performance (depending on their specific needs). Fortunately, there is another way to benefit from ketones without going on a keto diet or fasting. 

Exogenous ketone supplements are another way to get into ketosis.

Endogenous vs. Exogenous Ketosis

Being in a state of ketosis means that you have elevated levels of ketones in your blood, usually measured at > 0.5mM. That’s simply the line you must cross to enter ketosis; but there are two distinct ways of arriving there. 

Traditionally, this happens as a result of eating a very low carbohydrate-ketogenic diet (called nutritional ketosis) or practicing caloric restriction or intermittent, prolonged fasting. In these situations, carbohydrate depletion and a reduction in insulin causes free fatty acids (FFAs) to be released from fat stores in the body through a process called lipolysis. Then, these FFAs are transported to the liver, where they’re used to produce ketone bodies. This is known as endogenous ketosis—meaning ketones are being produced by the body. 

Someone who is producing their own ketones is in a ketogenic state.

There are three ketones: beta-hydroxybutyrate (BHB), acetoacetate(AcAc), and acetone. However, we don’t produce an equal amount of each.  

Normally, the ratio of circulating BHB to Acetoacetate is about 1:1. However, in ketosis (whether due to fasting or a ketogenic diet), this ratio can rise up to 6:1. In ketosis, you’ll have higher levels of circulating BHB compared to AcAc.1 Acetoacetate is the first ketone produced and from this. BHB and then acetone are also produced. While BHB is highly active and stable, acetone can essentially be thought of as a waste product of metabolism—most of it gets excreted in the breath, although a small amount may be metabolized.

The other avenue by which we can enter ketosis is known as exogenous ketosis. Exogenous means that ketones are coming from an outside source—either directly through exogenous ketone supplementation or indirectly through another supplement that can serve as a ketogenic precursor (like an MCT oil). We will discuss these later on.

General Health Benefits of Ketosis

What’s the big deal about being in ketosis? In order to enter ketosis, the BHB ketone body must be present in your blood at >0.5mM—this is true regardless of whether ketosis is achieved endogenously or exogenously (through supplements). 

Ketosis achieved through dietary or fasting-related routes has a variety of health benefits. Some of these are distinct to endogenous ketosis, and some benefits are provided by ketones regardless of the source.

For one, using ketones as an energy source, as opposed to carbohydrates, actually produces more ATP molecules per unit of oxygen consumed.2 The ketogenic diet is one way to create a body that burns a “cleaner” fuel that results in less oxidative stress. When looking specifically at the benefits of the ketogenic diet, appetite suppression and satiety,3 enhanced memory,4 lower levels of inflammation,5 weight loss, increased fat burning, and protection from cardiovascular diseases and diabetes6 are all cited. 

Similar metabolic benefits have been shown to occur with intermittent/prolonged fasting—which is another way to achieve ketosis.

Exogenous Ketones: Another Avenue to Ketosis

As you already know, instead of becoming ketogenic (producing our own ketones from body fat stores), we can consume ketones and ketogenic precursors exogenously. If your blood ketones are above 0.5mM, you’re in ketosis—regardless of how you got there. 

For the most part, exogenous ketones come in the form of BHB or acetoacetate. The ketogenic precursors include types of fats known as medium-chain triglycerides (MCTs) which are also present in food sources like coconut oil, another exogenous “ketone supplement.” We have “ketone supplement” in quotes because these products don’t actually contain ketones—they’re simply the fats that are readily converted into ketones in someone following a low-carb high-fat diet.

Exogenous ketones provide a way to achieve ketosis even in the absence of a ketogenic diet, carbohydrate restriction, or fasting. While the route to ketosis differs, the signaling effects of exogenous vs. endogenous ketones are virtually the same—BHB and AcAc from the liver are no different structurally than BHB or AcAc taken as a supplement. It’s just simple biochemistry!

Since exogenous ketones don’t require modified dietary practices, they can be used by anyone who wants to get the benefits of ketosis without the time it takes to get there through diet alone (sometimes it can take weeks). Athletes and mathletes alike can use ketone supplements to get themselves into a ketotic state. These supplements rapidly elevate blood ketones and with consistent supplementation, can keep blood ketone levels elevated for a prolonged period of time. For example, H.V.M.N. Ketone Ester drink keeps blood ketones elevated between 4 - 6 hours. 

It is important to differentiate ketosis from ketogenesis here. Those who elevate blood ketones through supplements aren’t ketogenic, but they are in ketosis.

For those who are eating a ketogenic diet or practicing fasting, exogenous ketones can be used to deepen ketosis, helping to achieve higher levels of blood ketones than might be possible through dietary restriction. Essentially, you’d be superimposing exogenous ketones onto the endogenous ketones you’re already producing.

Benefits of Exogenous Ketones

Using supplements vs. a ketogenic diet or fasting does have some benefits. While the metabolic health boost might not be the same (for instance, exogenous ketones aren’t ideal for weight loss), exogenous ketones have several other assets, depending on your personal needs. 

Quicker ketosis is one of them. 

Many ketone supplements, like H.V.M.N. Ketone Ester, can elevate blood ketone levels within 30 minutes of ingestion.7,8 For this reason, they can be used like many other performance aids (i.e. caffeine) in a short period of time. They don’t require a change in diet or prolonged fasting. This could be ideal for those who might not find either of these lifestyle practices ideal or enticing. Intermittent fasting is a hot topic, sure, but it’s not for everyone.

Exogenous ketones are also a great way to aid the transition into a ketogenic diet. 

For example, if you’re practicing a carbohydrate periodization or carb cycling routine, exogenous ketones can quickly get you back into ketosis. New to the keto diet? Exogenous ketones could help prevent the keto flu—the period when the brain has no glucose for energy, but the liver hasn’t yet fully started to produce a steady supply of ketones.9

For already-keto folks, exogenous ketones can be one way to deepen ketosis. Using these supplements while on a fast can also raise ketone levels above what your body is naturally producing. 

Finally, while they don’t directly aid in weight or fat loss, exogenous ketones have an appetite suppressant effect.

This property just might help you adhere to a dietary regimen or prevent the munchies that could derail your strict eating habits. H.V.M.N. Ketone Ester reduces ghrelin (the hunger hormone).10

With the benefits explained, it’s time to delve into the various types of exogenous ketone supplements. The most common—ketone salts and ketone esters—directly elevate blood ketones. In addition, MCTs and other sources of fat (coconut oil) can be consumed as supplements to provide a source of fat through which ketone production can be stimulated or maintained.

Ketone Salts

Ketone salts won’t be found in your table-side salt grinder. 

These supplements usually are found in a powder form which can be mixed with a liquid and consumed. Ketone salts are composed of a ketone body (usually BHB) bound to one of several minerals that might include sodium, potassium, calcium, or magnesium

Some salts also include an amino acid like lysine or arginine. The fact that ketones come bound to another mineral or amino acid makes ketone salts one way to consume ketones plus some necessary nutrients. But they aren’t without certain considerations of side effects.

The Science on Ketone Salts for Health

The use of ketone salts for health conditions isn’t exactly a new concept. Two of the earliest studies on these supplements investigated their potential therapeutic use for children with metabolic disorders (fatty acid oxidation defects). In these studies, ketone salts were found to improve heart function and cognitive performance, which resulted in a better walking ability and disappearance of many neurological symptoms.11 

In rats, exogenous supplementation with BHB salts has been shown to improve blood lipid profiles (higher HDL, lower LDL/HDL ratio), reduce blood glucose, and reduce the amount of visceral fat and the size of fat cells.12,13

More studies (again, in rats) show that ketone salts can reduce anxiety-like behavior. This suggests that ketosis achieved through supplementation may be one strategy to reduce anxiety in people, but more studies need to be done in this area, especially in humans.14

The Science on Ketone Salts for Performance

If you’re an evidence-based athlete, the published literature suggests you might want to steer away from ketone salts, or at least be aware of the potential performance-negating side effects that have been reported. But hey, you are your own experiment.

To date, there have been three studies on ketone salts and athletes. 

One study was done on cyclists. They were put through a maximal exercise protocol (essentially, a VO2 max test) after ingesting a BHB ketone salt. While ketosis was achieved, the BHB salt showed no advantage compared to a placebo beverage when comparing lactateappearance, perceived effort, or muscular efficiency. In fact, 13 out of the 19 participants complained that the ketone salt led to severe gastrointestinal issues that limited their athletic performance.15

In a second study, ketone salt ingestion prior to exercise (again, cycling) led to a 7% decrease in average power output throughout a time trial simulation (though the participants' fat oxidation was increased during exercise). Again, it’s important to note that the performance impairment likely occurred due to GI issues reported by many participants—and not to direct effects of ketosis itself.16 

A third study investigated how ingestion of a BHB salt would influence high-intensity cycling performance and cognitive measures during and after exercise. While the ketone salt induced ketosis (0.53mM), no improvement was seen in cycling or cognitive performance. In fact, a “fatigue index” measured in the study was higher in the participants consuming BHB compared to the control group not receiving a ketone supplement.17 

While the efficacy for ketone salts inducing ketosis is strong, the impact on performance is inconclusive, if not mostly negative.

Advantages and Disadvantages of Ketone Salts

Compared to other ketone supplements, ketone salts only mildly raise blood BHB (up to around 1mM). This is still well above the ketotic threshold (0.5mM) but below levels achieved with ketone esters.

Ketone salts are also cheaper to produce (and purchase) than currently available BHB ketone esters (discussed later).

Salts are also one way to deliver other nutrients (minerals, amino acids) along with BHB, which could have certain health benefits.

On the other hand, pairing BHB with a mineral comes with a cost. To get 50g of BHB in a formulation with a ketone salt would require consuming about 5,800mg of magnesium, 9,600mg of calcium, 11,0000mg of sodium, or 18,800mg of potassium—amounts way above any FDA recommended intake for these minerals.

Another obvious disadvantage is the possible side effects, often taking the form of gastrointestinal issues. This may be a result of the acid load and/or mineral load that is obtained when consuming BHB salts at high doses.

Finally, most BHB salts contain a mixture of BHB isoforms—essentially a different structural configuration of BHB. The D-form of BHB is the one we produce. The L-form, which is basically a “mirror image” of the D-form, is only obtained exogenously, and might not be as rapidly metabolized as the D-form, and thus may not have the same benefits; although studies are needed to confirm this. 

Ketone Esters: Acetoacetate Diester

The acetoacetate diester (1,3-butanediol acetoacetate diester) is one of two common supplements collectively known as ketone esters. It’s comprised of the ketone body acetoacetate and butanediol (BDO), connected by an ester bond (hence the name “ketone ester”). 

While fewer studies on this ester have been done compared to the more popular BHB ester (discussed later), there is still some science to support using this ketone supplement.

The Science on AcAc Diester for Health

Most studies to date on this ketone ester have been done in mice; application to humans should come with the necessary caveats. Nevertheless, the AcAc diester has shown promising results in regards to neurological health. 

Ketosis achieved through AcAc diester ingestion effectively delayed the onset of seizures due to central nervous system oxygen toxicity18—a danger encountered by undersea divers and patients on oxygen therapy. This same protective mechanism has also been shown to occur as a result of fasting, perhaps by altering brain energy metabolism.18 

In a mouse model of neurological disease, AcAc diester ingestion improved several aspects of brain health including motor coordination, learning, memory, and synaptic plasticity.19 This could have relevance for several human diseases of the brain, like cognitive decline, epilepsy, and other learning disorders. More research needs to be done here, however. 

The Science on AcAc Diester for Performance

There has been only one performance-related study to date conducted on AcAc; results were generally negative. When ingested prior to a 31-kilometer cycling time trial, AcAc ingestion led to a greater reduction in performance compared to consuming just carbohydrates and caffeine.20 These results should be interpreted with caution, however. A probable cause of the performance decline, similar to the ketone salts, was the severe and frequent GI symptoms experienced by the study participants who ingested the ketone.20 

Instead of ketosis, it seems like tummy trouble was a big reason for the bonk in performance.

Advantages and Disadvantages of AcAc Diester

The AcAc diester produces a milder elevation in blood BHB (~1mM) compared to other ketone supplements. 

As with some of the ketone salts, AcAc diester has been described as “unpalatable” and routinely produces GI symptoms in research study participants who consume it. This, or potentially some other reason, leads to performance declines. 

As such, this ketone supplement might not be recommended for athletes prior to competition or training, especially if it’s your first time experimenting with it.

Ketone Esters: BHB Monoester (HVMN Ketone)

The BHB Monoester (R-1,3-butanediol-R-3-hydroxybutyrate) is the ketone ester found in H.V.M.N. Ketone

In contrast to the BHB salts, this ketone ester, when broken down, releases D-BHB into the blood along with a molecule of butanediol (BDO), which is eventually metabolized to D-BHB in the liver. This results in two molecules of D-BHB in the blood, one reason why this particular ketone supplement is the most efficacious for elevating blood ketones.

The Science on BHB Monoester

There have been few studies regarding the BHB monoester in regards to general human health, but one study suggests that this ketone ester may have the ability to treat human conditions associated with metabolic abnormalities. 

When rats were given a diet containing the BHB monoester, they experienced an improvement in heart function, increase in endurance capacity, cognitive performance enhancement, and were more efficient at using energy from ATP breakdown.21

The data on human performance is much more promising for the BHB monoester than for the other exogenous ketone supplements.

Ketosis achieved through BHB ester ingestion has been shown to improve physical endurance in cyclists by switching the body’s fuel preference to favor ketone metabolism vs. glucose/glycogen oxidation even in the presence of high muscle glycogen.22 

The BHB ester has also been investigated as a recovery aid. When consumed along with a post-exercise carbohydrate or protein source, the BHB monoester increases activation of mTORC123 (which plays a role in protein synthesis) and also enhances the resynthesis of muscle glycogen.24 

A recent study provides compelling evidence that chronic BHB monoester (which is the key ingredient in H.V.M.N. Ketone Ester) ingestion during periods of strenuous endurance training can prevent symptoms of overreaching and improve endurance performance in fit individuals.25 

“The real magic isn’t what ketones do for you during exercise; it’s what they do afterwards.” - Alex Hutchinson, Outside Magazine

While the precise metabolic signals responsible for the benefits are not completely known, the evidence for using BHB ketone ester in the setting of athletic performance is strong.

Advantages and Disadvantages of BHB Monoester

The BHB monoester results in the most rapid and highest elevation of blood BHB of all the ketone ester supplements (3 - 6 mM within 30 minutes).8 One study demonstrated that blood BHB can be elevated to about 2.8mM following BHB ketone ester ingestion, while the same amount of BHB provided from a ketone salt will elevate blood ketones to around 1mM.7

Furthermore, this ketone ester delivers only the D-isoform of BHB (this is the isoform we naturally produce when ketogenic). Ketone salts also provide a greater amount (but usually a mix) of the L-isoform of BHB along with some of the D-isoform.

H.V.M.N. Ketone Ester is FDA generally recognized as safe (GRAS) for use as a food, and is approved by the world anti-doping association (WADA). No doping violations here, if you’re a serious athlete who has these types of considerations for your supplements. 

The side effects of BHB monoester appear to be generally mild, if not non-existent, at low doses. 

Most studies report no side effects of ketone ester ingestion.8,7 BHB ketone esters do have a distinct, bitter taste, which some may find unenjoyable. The tolerability of this aspect is highly individual, however. We like to say “it tastes like it works.”

Ketone Oils and Powders 

What are ketone oils and powders? This name may be a bit misleading, since technically these supplements are actually types of fats known as medium-chain triglycerides (MCTs) and not actually ketones. 

However, they can be considered as part of the family of exogenous ketone supplements because once they’re ingested, they can serve as substrates for ketogenesis. 

Popular among the keto crowd is a supplement known as MCT oil or powder. MCTs are fat molecules made up of a glycerol bound to medium-length fatty acids that are 6 - 12 carbons in length. Coconut oilis a rich source of MCTs. 

These fats are the most efficient type for producing ketone bodies. 

The medium-chain fats go right into the liver once ingested, where they are then broken down faster in comparison to short- and long-chain fatty acids. There are several MCTs: caproic acid (C6), caprylic acid (C8), capric acid (C10), and lauric acid (C12). Caprylic acid (C8) is the most “ketogenic” of the MCTs;26 if you’re looking for an MCT supplement, this should be the one you look for. Coconut oil is high in lauric acid (C12), which makes up about 50% of the stuff. 

Due to it’s ketogenic nature, we selected pure C8 a part of the base (along with prebiotic acacia fiber) of H.V.M.N.’s MCT Oil Powder. It’s 100% natural, real food, harvested sustainably and carefully purified into pure C8. No additives, no artificial ingredients, zero net-carbs. It’s a great source of MCT without all the other junk you might find in other MCT products.

The Science on MCTs

The benefits of MCTs for a ketogenic or low-carbohydrate diet might come in the form of appetite-suppression. 

This might be great for those having a hard time adhering to a dietary regimen and may indirectly aid in weight loss. Intake of MCT oil has been shown to lead to a reduction in food consumption, while also reducing the rise in blood glucose and triglycerides after eating.27 This satiating effect was observed with MCT, but not coconut oil.28Interestingly, the subjects also reported that the MCT oil was more palatable than the coconut oil. 

There is also interesting research on the ability of MCTs to assist in weight loss directly. Supplementation with MCTs led to weight loss in overweight men. 29 This might have been due to the effects that MCTs had on increasing energy expenditure, fat oxidation, metabolism, and body heat production (thermogenesis). 

MCTs have also been shown to lower cardiovascular risk factors like LDL cholesterol and increase lipoprotein particle size.30 

Advantages and Disadvantages of MCTs

Like any supplement out there, consuming a large amount of MCTs has been reported to induce GI issues as a side-effect.31,32 

Unfortunately, consuming enough MCTs or coconut oil to get blood ketones as high as you could with a ketone supplement (like H.V.M.N. Ketone Ester) might require a dose likely to upset your stomach. Expect an elevation of blood ketones to around 0.5 - 1mM following a reasonable dose of MCTs. This will depend highly on diet and other lifestyle factors, however. 

Another downside to MCT/coconut oil consumption might be the caloric load. When using these supplements in large quantities, it’s easy to overdo it. 

Even though MCTs result in a lower level of ketosis compared to ketone salts and esters, MCT oils are a cost-effective and approachable option for people new to the keto diet.

MCTs might be advantageous especially for people looking to lose weight. Through their thermogenic and appetite suppressing effects, MCTs might help you feel fuller longer and more satisfied when added to a meal, shake, or coffee.28,29 And, similar to ketones, MCTs have been shown to have a variety of protective effects for the cardiovascular system and other health markers.30 

How do MCTs Differ from Exogenous Ketones?

MCTs have their benefits, which include being a bit more tasty (especially if you’re mixing them in coffee or baked goods), less expensive, and versatile—you can use MCTs in everything from cooking veggies and meats to preparing smoothies and shakes. 

But MCTs aren’t direct ketone supplements, and therefore aren’t as effective at raising blood ketones when compared to salts or esters. The shorter length MCTs must first be broken down in the liver and then used to produce ketones, it’s not a “direct path” to ketosis. 

Nevertheless, feeding MCT oil has been shown to elevate blood ketones 18-fold (in rats) after just one hour, suggesting this fuel source is readily and rapidly oxidized.33 Furthermore, it was shown that MCT administration led to lower blood sugar and depressed lipogenesis, which appeared to potentiate ketosis, but not initiate it. Although these findings are interesting and may apply to humans, more studies are needed to confirm this. 

This suggests that MCTs might be more beneficial in terms of sustaining or maintaining ketosis rather than directly plunging you into it.

When and How to Use Exogenous Ketones

There are many different scenarios where exogenous ketones could make a big difference in your performance or help you reach your goals, whatever they may be. 

One situation to use ketone supplement is on top of your ketogenic diet. In this sense, exogenous ketones would be used to deepen your level of ketosis by raising blood ketones even further. They might also come in handy if you’re trying to re-enter ketosis after a cheat day or a carb-cycling routine.

You might give ketone supplements a try while you’re on a prolonged fast—say something like a 24 - 48-hour water-only fast. While ketones do contain calories, they’re negligible, and might help you last a bit longer in your fast, or help with mental clarity and focus, if those are your fasting goals. 

If you’re someone who likes to workout while fasting, exogenous ketones might be the perfect supplement to fuel your workout instead of some quick-burning carbohydrates.

But you don’t have to be on a keto diet or regularly fast to use exogenous ketones. 

Anyone wishing to raise blood ketones can use these supplements. Athletes might try them out before a workout or big race, or perhaps even consume exogenous ketone supplements regularly throughout a tough training stint to prevent overtraining.

Exogenous ketones are also great for recovery—take them after a workout with a meal high in protein and some carbohydrates to refuel.

What does dosing look like? This depends on how high you want your blood ketones to be. For acute benefits, supplements like the BHBketone ester should be taken about 30 minutes before activity and perhaps another serving during. For workout recovery, take one serving of a ketone supplement like H.V.M.N. Ketone Ester with your normal post-workout nutrition. 

For more information on dosing H.V.M.N. Ketone Ester, visit this page for instructions.

If you’re transitioning to ketosis, using ketone supplements for about 3 - 5 days is recommended to “jump start” ketosis and prevent some of the symptoms (from keto flu) that might occur before your body is naturally producing ketones

Final Thoughts on Exogenous Ketones

Whatever your goal, exogenous ketones and other ketone supplements have the potential to help you meet them. 

The advancing science is allowing new and more practical formulations of ketone supplements to be produced and consumed. The benefits of ketosis are now available to almost everyone.

Scientific Citations

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2.Manninen AH. Metabolic Effects of the Very-Low-Carbohydrate Diets: Misunderstood “Villains” of Human Metabolism. Journal of the International Society of Sports Nutrition. 2004;1(2):7-11. doi:10.1186/1550-2783-1-2-7.

3.Sumithran, P., Prendergast, L. A., Delbridge, E., Purcell, K., Shulkes, A., Kriketos, A., & Proietto, J. (2013). Ketosis and appetite-mediating nutrients and hormones after weight loss. Eur J Clin Nutr, 67(7), 759-764.

4.Krikorian, R., Shidler, M.D., Dangelo, K., Couch, S.C., Benoit, S.C., and Clegg, D.J. (2012). Dietary ketosis enhances memory in mild cognitive impairment. Neurobiol. Aging 33, 425 e419-427.

5.Dupuis N, Curatolo N, Benoist JF, Auvin S. Ketogenic diet exhibits anti-inflammatory properties. Epilepsia. 2015;56(7):e95-8.

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7.Stubbs, B.Cox, P.; Evans, R.; Santer, P.; Miller, J.; Faull, O.; Magor-Elliott, S.; Hiyama, S.; Stirling, M.; Clarke, K. (2017). On the metabolism of exogenous ketones in humans. Front. Physiol.

8.Clarke, K., Tchabanenko, K., Pawlosky, R., Carter, E., Todd King, M., Musa-Veloso, K., Ho, M., Roberts, A., Robertson, J., Vanitallie, T.B., et al. (2012). Kinetics, safety and tolerability of (R)-3-hydroxybutyl (R)-3-hydroxybutyrate in healthy adult subjects. Regul. Toxicol. Pharmacol. 63, 401-408

.9.D c harvey CJ, Schofield GM, Williden M, Mcquillan JA. The Effect of Medium Chain Triglycerides on Time to Nutritional Ketosis and Symptoms of Keto-Induction in Healthy Adults: A Randomised Controlled Clinical Trial. J Nutr Metab. 2018;2018:2630565.

10.Stubbs BJ, Cox PJ, Evans RD, Cyranka M, Clarke K, De wet H. A Ketone Ester Drink Lowers Human Ghrelin and Appetite. Obesity (Silver Spring). 2018;26(2):269-273.

11.Van Hove, J.L.K., Grunewald, S., Jaeken, J., Demaerel, P., Declercq, P.E., Bourdoux, P., Niezen-Koning, K., Deanfeld, J.E., and Leonard, J.V. (2003). D,L-3-hydroxybutyrate treatment of multiple acyl-CoA dehydrogenase deficiency (MADD). Lancet 361, 1433-1435.

12.Caminhotto, R.d.O., Komino, A.C.M., de Fatima Silva, F., Andreotti, S., Sertié, R.A.L., Boltes Reis, G., and Lima, F.B. (2017). Oral β-hydroxybutyrate increases ketonemia, decreases visceral adipocyte volume and improves serum lipid profile in Wistar rats. Nutr. Metab. 14, 31.

13.Kesl, S.L., Poff, A.M., Ward, N.P., Fiorelli, T.N., Ari, C., Van Putten, A.J., Sherwood, J.W., Arnold, P., and D’Agostino, D.P. (2016). Effects of exogenous ketone supplementation on blood ketone, glucose, triglyceride, and lipoprotein levels in Sprague–Dawley rats. Nutr. Metab. 13, 9.

14.Ari, C., Kovács, Z., Juhasz, G., Murdun, C., Goldhagen, C.R., Koutnik, A.P., Poff, A.M., Kesl, S.L., and D’Agostino, D.P. (2016). Exogenous Ketone Supplements Reduce Anxiety-Related Behavior in Sprague-Dawley and Wistar Albino Glaxo/Rijswijk Rats. Front. Mol. Neurosci. 9, 137.

15.Evans M, Patchett E, Nally R, Kearns R, Larney M, Egan B. Effect of acute ingestion of β-hydroxybutyrate salts on the response to graded exercise in trained cyclists. Eur J Sport Sci. 2018:1-11.

16.O’Malley, T., Myette-Cote, E., Durrer, C., and Little, J.P. (2017). Nutritional ketone salts increase fat oxidation but impair high-intensity exercise performance in healthy adult males. Applied Physiology, Nutrition, and Metabolism, 1-5.

17.Waldman HS, Basham SA, Price FG, et al. Exogenous ketone salts do not improve cognitive responses after a high-intensity exercise protocol in healthy college-aged males. LID - 10.1139/apnm-2017-0724 [doi]. (1715-5320 (Electronic)).

18.D'Agostino, D.P., Pilla, R., Held, H.E., Landon, C.S., Puchowicz, M., Brunengraber, H., Ari, C., Arnold, P., and Dean, J.B. (2013). Therapeutic ketosis with ketone ester delays central nervous system oxygen toxicity seizures in rats. Am. J. Physiol. Regul. Integr. Comp. Physiol. 304, R829-836.

19.Ciarlone SL, Grieco JC, D'agostino DP, Weeber EJ. Ketone ester supplementation attenuates seizure activity, and improves behavior and hippocampal synaptic plasticity in an Angelman syndrome mouse model. Neurobiol Dis. 2016;96:38-46.

20.Leckey, J.J., Ross, M.L., Quod, M., Hawley, J.A., and Burke, L.M. (2017). Ketone Diester Ingestion Impairs Time-Trial Performance in Professional Cyclists. Front. Physiol. 8, 806.

21.Murray, A.J., Knight, N.S., Cole, M.A., Cochlin, L.E., Carter, E., Tchabanenko, K., Pichulik, T., Gulston, M.K., Atherton, H.J., Schroeder, M.A., et al. (2016). Novel ketone diet enhances physical and cognitive performance. FASEB J.

22.Cox, P.J., Kirk, T., Ashmore, T., Willerton, K., Evans, R., Smith, A., Murray, Andrew J., Stubbs, B., West, J., McLure, Stewart W., et al. (2016). Nutritional Ketosis Alters Fuel Preference and Thereby Endurance Performance in Athletes. Cell Metabolism 24, 1-13.

23.Vandoorne, T., De Smet, S., Ramaekers, M., Van Thienen, R., De Bock, K., Clarke, K., and Hespel, P. (2017). Intake of a Ketone Ester Drink during Recovery from Exercise Promotes mTORC1 Signaling but Not Glycogen Resynthesis in Human Muscle. Front. Physiol. 8, 310.

24.Holdsworth, D.A., Cox, P.J., Kirk, T., Stradling, H., Impey, S.G., and Clarke, K. (2017). A Ketone Ester Drink Increases Postexercise Muscle Glycogen Synthesis in Humans. Med Sci Sports Exerc.

25.Poffé C, Ramaekers M, Van thienen R, Hespel P. Ketone ester supplementation blunts overreaching symptoms during endurance training overload. J Physiol (Lond). 2019;597(12):3009-3027.

26.St-pierre V, Vandenberghe C, Lowry CM, et al. Plasma Ketone and Medium Chain Fatty Acid Response in Humans Consuming Different Medium Chain Triglycerides During a Metabolic Study Day. Front Nutr. 2019;6:46.

27.St-onge MP, Mayrsohn B, O'keeffe M, Kissileff HR, Choudhury AR, Laferrère B. Impact of medium and long chain triglycerides consumption on appetite and food intake in overweight men. Eur J Clin Nutr. 2014;68(10):1134-40.

28.Kinsella R, Maher T, Clegg ME. Coconut oil has less satiating properties than medium chain triglyceride oil. Physiol Behav. 2017;179:422-426.

29.St-onge MP, Jones PJ. Greater rise in fat oxidation with medium-chain triglyceride consumption relative to long-chain triglyceride is associated with lower initial body weight and greater loss of subcutaneous adipose tissue. Int J Obes Relat Metab Disord. 2003;27(12):1565-71.

30.Baba N, Bracco EF, Hashim SA. Enhanced thermogenesis and diminished deposition of fat in response to overfeeding with diet containing medium chain triglyceride. Am J Clin Nutr. 1982;35(4):678-82.

31.Henderson, S.T., Vogel, J.L., Barr, L.J., Garvin, F., Jones, J.J., and Costantini, L.C. (2009). Study of the ketogenic agent AC-1202 in mild to moderate Alzheimer's disease: a randomized, double-blind, placebo-controlled, multicenter trial. Nutr Metab (Lond) 6, 31.

32.Ivy JL, Costill DL, Fink WJ, Maglischo E. Contribution of Medium and Long Chain Triglyceride Intake to Energy Metabolism During Prolonged Exercise. Int J Sports Med. 1980;01(01):15-20.

33.Yeh YY, Zee P. Relation of ketosis to metabolic changes induced by acute medium-chain triglyceride feeding in rats. J Nutr. 1976;106(1):58-67.

L-Theanine: Tea’s Amino Acid for Overall Wellness (from HVMN.org)

Tea: coffee’s coy competitor in the cutthroat—yet throat-soothing—world of hot beverages. Both provide daily stimulant boosts, both are great to share with a loved one, and both are steeped in rich and complex histories.


But popular teas (like green tea, black tea, and even tea extract and tea constituents) have something coffee doesn’t—an amino acid celebrated for its cognitive performance and wider health benefits: L-theanine (L-THEE-uh-neen).


If you have a cup of green tea or black tea in front of you, take a sip. Savor those tocopherols and flavonoids lending the cup its signature color and flavor. The tea leaves’ distinct bitterness is supplied by natural antioxidants knowns as catechins.1


But there’s another flavor you should be experiencing. A pleasant mouth-filling sensation that creates a rounded and savory taste. Umami, often called the fifth taste after bitter, sour, sweet, and salty. Tea’s umami flavor is all thanks to the non-protein amino acid, L-theanine.1

In this article, we won’t just stick to why tea is so tasty. We’ll talk about the positive effects L-theanine can have on your stress levels, cognitive performance, and cardiovascular and immune health.