[Transcript] – Everything You Need To Know About Ketones & Ketosis With Dr. Latt Mansor of H.V.M.N.

Affiliate Disclosure


From podcast: https://bengreenfieldlife.com/podcast/latt-mansor-hvmnpodcast/

[00:00:00] Introduction

[00:01:09] Podcast Sponsors

[00:07:35] Who is Dr. Latt Mansor?

[00:14:12] When did Latt first start messing around with ketosis or get into ketones

[00:25:20] Do you ever measure your ketones, and if so, how and what numbers do you look for?

[00:30:06] Ketone IQ as DNA protection

[00:31:48] Podcast Sponsors

[00:37:17] cont. Ketone IQ as DNA protection

[00:39:21] The difference between BHB, Ketone Ester, and 1,3-Butanediol

[00:45:59] DARPA grant…what was it actually for?

[01:01:17] Breath hold practice and ketones

[01:04:41] Ketones and exercise

[01:17:26] Lactate as alternative fuel to glucose

[01:24:11] Are ketones safe for kids?

[01:28:26] What goes well with ketones

[01:30:48] Closing the Podcast

[01:32:23] End of Podcast

Ben: My name is Ben Greenfield. And, on this episode of the Ben Greenfield Life podcast.

Latt: One thing about ketones that I love is that it is almost like an adaptive fuel. Because we have seen in studies with opposing effects. For example, we have seen an increase in leucine-mediated mTOR activation when you take it after exercise with carbohydrate and proteins.

Ben: Leucine-mediated mTOR activation. If you take ketones after exercise with carbo with protein, what you mean is it will have like an anabolic effect.

Latt: Anabolic recovery, yeah. 

Ben: Interesting.

Latt: And then, if you look at longevity studies that has calorie restriction and ketosis, they are looking at decreasing in mTOR activation, right?

Ben: Right. 

Latt: Same thing with —

Ben: With longevity, which drives me nuts because you got all these people wasting away muscle.

Latt: I know.

Ben: You want to be like hard to kill as you age. 

Latt: I know.

Ben: You don't necessarily just want to chase calorie restriction at all costs. 

Latt: Yeah.

Ben: Faith, family, fitness, health, performance, nutrition, longevity, ancestral living, biohacking, and a whole lot more. Welcome to the show. 

You're no doubt familiar with some of the concerns out there when it comes to EMF. Like, having your phone in your pocket and what science has shown that does to your sperm morphology. Having heated items producing EMF, particularly up near your precious skull or say near the crib or bed of your child. Having all these smart appliances just blasting you 24/7, we know that that causes a calcium influx into the cell. We know there can be some radiative DNA damage. Yeah, bodies aren't dropping dead right and left, but it is increasingly shown in research to be an issue. 

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Ben: All right, folks. Well, it's probably no secret that you've heard about my experiments with ketosis, which go all the way back. Gosh, I was talking with today's podcast guest last night at dinner over some fantastic salmon we were feasting on. About how I got into this idea when I was back racing Ironman Triathlon and had totally drank the Kool-Aid from the Gatorade Sports Science Institute. And, all the research and exercise science that — especially for endurance exercise, you eat like a 55 to 65%-ish carbohydrate-based diet. Leading up to race week, you'd typically carb load and increase your carbohydrate intake up to like 85 up to 90% carb intake all the way up to race day. And then, consume anywhere from like 300 to 400 calories of different carbohydrate mixes during the race. Like, fructose and maltodextrin to activate different glucose transporters in the gut to really enhance your carbohydrate uptake. And, that was like my jam. Up until around 2013 when I heard about this thing called ketosis. 

I actually ran into a researcher; his name was Dominic d'Agostino, at a conference. And, he had like a presentation poster that he was standing in front of. And, I think it was Dr. Peter Attia, who he had on a bicycle on the poster presentation drinking what Dominic described to me as like something that had the nasty ass taste of rocket fuel. But, that was like this little-known macronutrient that he'd been studying for brain injuries and, you know, TBIs and concussions and some diver-related injuries in the past, but he'd realized that it could be used for endurance exercise. And, there's like this preferential fuel for the liver, and diaphragm, and the heart.  

So, I thought that was interesting. And, even though ketones, as they are now, we're not really something you could just like go buy and drink. So, I started to eat a high-fat, low-carb diet. I started to use MCT oil in my bike bottle, and then my little running, what do you call them when you're a run, belt? My little run bottles during the race. And, noticed a profound shift in endurance. And, there was kind of like this side benefit of better focus during the work day. I got so enamored with the idea that I wound up being like strict nutritional ketosis for like 3 years, 85 to 90% fat. I did Dr. Jeff Volek's FASTER study, where he had us doing VO2 max test and 3-hour long runs on a treadmill to display what at that time was groundbreaking research. That by eating a high-fat diet and using ketosis for performance, you could shift your fat oxidation rates like higher than anything they'd ever seen in research or anything you could read in the textbooks to a massive amount of grams of fat per hour burnt during exercise. 

So, since then, I've on and off, just taken different plunges into the whole realm of ketones, ketosis research, high-fat diets, you know, MCT oils, and everything. And, part of that culminated in me connecting with this guy — who was kind of familiar with. His name was Geoff Woo. And so, I'd seen Geoff on Shark Tank before. He was selling some kind of like energy cube supplement on Shark Tank. And then, I later saw him on an airplane in the documentary about smart drugs. He was like a biohacker featured. And then, Geoff and I connected at a conference and he reached out to me about this ketone that he'd been working on developing. He sent me some. I tried it. And, it was like being able to drink your way into ketosis, which was kind of cool. Because all of a sudden, I did up like FASTER, you know, basically tape my mouth shut every time I walk past an Italian restaurant. I could actually drink my wind to ketosis. 

So, that was a few years ago. And, since then, you know, a lot of these ketone ester, and drinkable ketone companies have popped up. And, Geoff's company, which is called H.V.M.N., Health Via Modern Nutrition, wound up being a company that I started using for these drinkable ketone esters. Well, it turns out that Geoff wound up bringing a scientist on board for his company. And, the scientist is here sitting across from me. We've already done gym, and breathwork, and sauna, and cold, and gotten up to all sorts of stuff. I was pleased to see that he actually did also have a slice of my wife's homemade sourdough bread. So, he's not fully bread-phobic. 

But, his name is Dr. Latt Mansor. Latt has a Ph.D. in Physiology, anatomy, and genetics from the University of Oxford. He basically has over a decade of experience in academic research, health technology, pharmaceuticals. And now, oversees the scientific development and clinical application for H.V.M.N., which has this ketone ester. If you're watching the video version of this podcast, I've got one of these ketone shots in front of me. We have this big bottle of ketones. I've got — I don't know how many ketones I've already had this morning leading up to this show. So, it could be a really rough show or a great one, the best show ever. But, anyway, I'm definitely in nutritional ketosis right now. And, I believe that Latt is as well. So, Latt, welcome to the show. 

Latt: Thank you so much for the introduction. And, it was really interesting to hear how everyone else get to know ketosis, get to know about ketones, what are ketones to begin with, and all the way to where we are today, where we have multiple companies selling drinkable ketones. And, you know, some misinformation out there, of course, as many supplements would have. But, that's what we're here for today. We're going to talk about ketone science, ketone metabolism, and really dissect into what is the current literature that reflects the effect of ketones on brain, on heart, on performance, as well as general metabolic health. 

Ben: Yeah. Liver and diaphragm also, from what I understand. Like, most major organs. This is almost like a macro nutrient, like fourth macro nutrient. Addition to carbs, and fat, and protein that you just don't see in the textbooks right now, but that is now something that you can literally eat or drink as a fuel. And when I say “eat,” I mean I literally made cheesecake a couple weeks ago out of these Keto Bricks things, which are like coconut butter and, you know, ketone-supporting compounds in a brick. Not your guy's product, but it made good cheesecake. 

So, tell me about how you got into all this? 

Latt: Sure. So, I've got to start with where I'm from, right? I'm from Malaysia, born and bred. 

Ben: I was going to guess Kansas. 

Latt: I know. I was going to say New Jersey, but you know, I thought I would be a bit truthful. I'm from Malaysia. I was brought up in the family with very high prevalence of diabetes and cardiovascular disease. In fact, my late father passed away from stroke. And, before that, he had a heart attack and open heart surgery. So, growing up, I was also overweight as well. So, you know, for people who are listening or watching, like I know how that feels. I always thought to myself that growing up, that's who I'm going to be. Looking at my relatives, that's how I'm going to live my life. And, I'm just going to be heavy from young to old. Not until I was in undergrad, from University of Nottingham, that I started learning about biotechnology. I learned about physiology. I learned about metabolism. And then, I started exercising. For the first time, voluntarily. Because before that, I hated exercise. 

Ben: But, leading up to that point, like you enrolled in these science courses. Not because you had an interest in exercise science, you were just… 

Latt: I was just interested in science. I was just a nerd. And, I was a proud nerd then and now. And, I learned about — in fact, my final year project at the University of Nottingham was a mathematical model of adipose tissue metabolism. And, adipose tissue, as you know, is fat storage, main fat storage in our bodies. And then, I started losing weight. I lost about 45 pounds. Then, in one year, and people were asking me, was I using myself as a test subject for my thesis. And, I wasn't. But, I was just. I just got into exercise. I just learned more about physiology. And, knowing that there is something I can do to change my fate going forward. 

And then, that sort of continued when I did my master's from Columbia University in New York in biotechnology as well, where I really focused on drug development, pharmaceutical sciences, and learned how the world treat diseases. Especially, when it comes to chronic diseases, right? And then, right after my master's, I thought to myself, “Well, I'm not suited to be in research. I don't want to be in research. I don't want to look at test tubes every day for the rest of my life.”

Ben: Is that because you're like not introverted or you like –?

Latt: Yeah. It's because I want human interaction. One, I like, you know, meeting new people, learning new things, learning new languages, you know, meeting people from different cultures. But, most importantly, me being a scientist, I want to have an impact on people's lives, right? Whereas being scientists, yes, you will have an impact, eventually. But, most scientific discoveries or investigations won't get implemented in real life till years later. Because a lot of efforts — especially, with us in basic science research. Meaning, most of the time, we are looking at mechanism of actions. In animal science, for example, we are looking at really molecular changes of let's say for example, how ketones affect the brain. But, so what, right? We know the mechanism of action. Now, how does that translate to human, first and foremost? And then, secondly, what are the products that can be translated into humans? So, that's why I thought to myself, “Okay, I'm going to look for a job.” And, I ended up in a pharmaceutical company in New Jersey, called the Medicines Company.

Ben: It’s easy for you to find a good spot in the EU. My apologies to all the people who live in New Jersey. But, you didn’t exactly pick the —

Latt: But, I was still living in New York. I was still living in Manhattan.

Ben: Okay.

Latt: So, I did move out there. I worked there for half a year, and then they promoted me into full time and moved me to Munich, Germany. So, I worked there for a year. And, during that year, I was so inspired by the people who were there. They were so scientific. They were scientists. They all have PhDs. But, they're also very entrepreneurial and they're very good at translating science into first, the language that people can understand, and secondly, translate science into applicable behavioral change that people can then take away and improve their lives. 

So, during that time, that inspired me to apply for my PhD in Oxford. So, I thought to myself, “Well, it's a great university if I get in. If I don't, I do like this job. I can stay in this job.” And, I got into University of Oxford, specializing in cardiovascular disease and diabetes. So, my research was looking at the metabolism of type 2 diabetes in hypoxia, which is low oxygen environment. So, I looked at the differences between fat metabolism and glucose metabolism, especially in hypoxia. What happens if you put the diabetic heart in hypoxia to those substrate metabolism? 

Ben: How's that relevant? I guess are you referring to — because actually, I interviewed Gary Brecka. And, he's a biologist, lives down Miami, does a lot of biohacking and coaching for performance with some of these UFC fighters and the like. And, he says that most diseases are related to low oxygenation state, mitochondrial deficiencies, and subpar metabolism that's specifically causing a hypoxic metabolic state. Now, when you're looking at a diabetic and how they operate in a state of hypoxia, I assume that's what you — the reason that you were looking at that was to see how poor oxygenation levels are affected by blood sugar issues. 

Latt: So, remember why I was saying I was looking at cardiovascular disease and diabetes, right? So, I was looking at the link between them. I'm using hypoxia as a subset of ischemia. And, ischemia.

Ben: Oh, cardiovascular disease causes hypoxia?

Latt: Correct. 

Ben: Okay.

Latt: So, when you have clotted arteries, your heart is not essentially getting enough substrates going in. It's not getting oxygen going in, and it's not getting all the wastage going out. So, as a result, you get damage to the cardiomyocytes, the cardiac cells. So, my research at that time was to look at the ability of the heart to switch over to glucose, to utilize more glycolysis, which we know for a fact that doesn't use any oxygen to produce ATP. So, that's a sort of makeshift mechanism to protect the heart and make sure the heart still works. And, what we have found is that in diabetes, there is way less metabolic flexibility when it comes to ability to shift over from fat to glucose. So, that was my whole Ph.D.

Ben: Okay.

Latt: And then, because of my passion in chronic diseases, I was working in health tech and diabetes management program. Until around 2019, where I, H.V.M.N. and myself, we sort of got introduced to each other. And, we talked about it and they found my background very interesting, combining both the scientific background as well as the entrepreneurship in the startup world. 

Ben: Did that freak you out? Some company in California — because they're based on California, right? 

Latt: Yeah. 

Ben: It's randomly reached out to you?

Latt: No. So, I got to know them via their previous research lead, which was Dr. Brianna Stubbs, who's a friend. So, she and I graduated from the same lab in Oxford. So, we only graduated two years apart from each other. And, she was like, “H.V.M. N. is looking to hire. Would you be interested?” I was like, “Let's have a conversation.” Because at that point, I was still running my own company back in Malaysia. So, I was like I started building this up. I'm not going to just give up everything, right? But then, they flew me into San Francisco, really talked to me. I talked to the whole team and found that their vision and — I think what drew me most to H.V.M.N. was the honesty, transparency, and scientific integrity. They put everything behind the real data and real science, which is very rare these days. Especially, when it comes to marketing. Everyone will market their product as if it's the best thing that ever happened to human civilization, right? But, they are okay, and they are willing to say, “Okay. This product may not be the best product now. Let's reinvent this,” or “Let's innovate as H.V.M.N.” 

Ben: H.V.M.N. is [00:22:14]____.

Latt: Yeah, H.V.M.N. is willing to say that. “Let's innovate this with the current data we have and come up with something more useful and more efficient.” And, this kind of plays out to the history. And, I can tell you, you know the whole story of why we went from the first ever exogenous ketones in the market, called “ketone ester,” in 2017, to “Ketone-IQ” now, which is not the same as ketone ester.

Ben: Yeah. I definitely want to ask you about that, but I'm still curious like about your own personal experience with these things. Like, you told me before you hit the gym this morning that you took like 45, what, 45 milliliters of ketones. Like, when you went out there to H.V.M.N, man, were you already like, messing around with this stuff, or was this all new to you? 

Latt: So, that's an interesting question. Because when I was studying diabetes, all I knew about ketone — obviously, you know, we know about BHB, we know about ketones. But, that was more of a side product of metabolism. And, that was how I knew ketones. 

Ben: You knew about something the body made, not something you could like drink.

Latt: Correct. Something that your body makes and something that could be dangerous in a diabetic individual. Especially, when it comes to ketoacidosis. So then, when I joined H.V.M.N., I did try the keto diet. But, for me, it really caused more fatigue in the gym when I lift heavy. So, what I'm doing now, and as you said, I had a piece of sourdough bread because I am on a lower carb side. I'm not as liberal when it comes to carbs, but I'm also not strict keto where I have like 20 calories worth of glucose per day. So then I, you know, play around with exogenous ketones. 

And, I realized, like you said, I can get into ketosis, get all the benefits, get the ketones into my bloodstream, into my brain without having to conform to a strict diet, which means I can still lift heavy, I can still go about my day and be a little bit more flexible when it comes to my diet. But, yet, still having all the benefits of ketones. So, that was when I'm like fully dialed in. Not only I am giving presentations around the U.S. in conferences talking about exogenous ketones and the literature around it, but I'm also a true believer that I walk the walk, that I actually consume Ketone-IQ on a daily basis, especially before podcast and before workout. Generally, that's my use cases. Before podcast, before workout, and sometimes after workout for recovery.

Ben: What's ketoacidosis? 

Latt: So, ketoacidosis is when you have high level of ketones in the presence of high level of glucose, especially in diabetes. Because your body is not — because of the insulin resistance, you're not taking in the glucose in the bloodstream. But, at the same time, the rest of your body, like your liver, is also saying that, “Oh, you're starving.” Because, obviously, all these cells are doing respiration and metabolism, so I need to break down this fat and create more ketones. 

Ben: Yeah.

Latt: So, you are like starving but also have abundance of substrate at the same time. And, the increase, the sharp increase in ketones, lower your blood pH. That's why it's called “acidosis.” And, that is what causing, potentially, death. 

Ben: So, like the difference between ketoacidosis and like you having ketones this morning to work out, but then also having sourdough bread, which theoretically to raise your blood glucose, is you don't have diabetes, so your body's still to shove both the glucose and the ketones in the cells. Whereas, if someone has diabetes and they have elevated ketones and elevated glucose, it's all just going to be hanging around the bloodstream causing an acidic state.

Latt: Correct. Exactly that. 

Ben: So, should like if somebody has diabetes, should they not use ketone esters? Like, what do you think about that? 

Latt: So, a few studies came out of University of British Columbia, from Dr. Jonathan Little. They looked at diabetic individuals and obese individuals, and they were given exogenous ketones after food. So, postprandial. And, they saw a lowering effect of blood glucose after. So, I would say in terms of if your diabetes is very severe, because we know that diabetes is a spectrum, right? Either your early stage or all the way to late stage, where you are just unable to take in any glucose, and then your body also start creating ketones. So, in that sense, I would say definitely consult your doctor before you take, if you have diabetes. But, what we have seen so far for majority of these obese and diabetic patients, they actually managed to lower their blood glucose because there's a minor blood glucose-lowering effect when you have exogenous ketones. 

Ben: I was going to ask you why that happens. Because I have been using ketones and I drink them within moderation. But then, if I don't eat much food during the day and I exercise — and this happened to me a couple of months ago, and then I have a bunch of ketones. In this case, I had them before dinner and we were going out to a restaurant. It was actually, case in point, Italian restaurant in this case, so I knew I was about to have carbohydrates. But, I had a bunch of ketones and I felt like pale and clammy. And then, I tested — I wear this continuous blood glucose monitor, and I tested my blood ketones. I should test them right now, actually, because it'd be interesting because I just took a massive amount of ketones. And, my blood glucose was like in the 40s, so it dropped it a ton. How come ketones drop blood glucose?  

Latt: So, the exact mechanism of action, we still don't know for sure. But, the hypothesis around it is that ketone gives signal to your liver to stop or lower or reduce the production of glucose via gluconeogenesis. 

Ben: Okay.

Latt: Because even though we do eat glucose and we do have glucose intake in our diet on a continuous basis, our liver will create glucose via gluconeogenesis as well. What people don't understand about metabolism is not as simple as when you eat something, and then you break it down, and then you use it for energy. Yes, it does that. But, it also does the opposite at the same time. Metabolism consists of anabolism and catabolism. So, building up and breaking down, at the same time, is the flux. So, depending on what you do, depending on your activities, you either up-regulate the catabolism, which is you're breaking down and creating more raw materials for you to metabolize and create energy; or if you're at rest, you up-regulate anabolism, where it says you're recovering, you're sleeping, you up-regulate these hormones that are related to building blocks so that the next day you can have more energy for it.

Ben: Okay. So, basically, if you were fasting all day and then you took ketones, and you found that your blood glucose dropped too low, would the trick be then just to eat carbohydrates? 

Latt: Absolutely. If you start feeling unwell just because you know your glucose is way too low, then have some carbs. That's perfectly fine. What people have found is that they were very surprised that their glucose dropped about 50 points, but they don't feel unwell and they still have that energy level. 

Ben: The weird thing, most of the time, when I'm using ketones, it'll drop my blood glucose down to like the 60s. You know, when I'm still having a meal here and there. I'm not pushing myself super hard with exercise, and like fasting too much. And, compared to if I don't have high ketones or if I'm not drinking ketone esters, I feel great. Like, I don't have that blah low-energy feeling that I'd normally get if my blood glucose was too low. So, within reason, it seems to allow you to be in what some might define as like a hypoglycemic, or at least a lower blood glucose state, and still have high levels of energy. I assume just because your brain, your other organs, are using ketones instead of glucose as a fuel. 

Latt: Speaking of which, what's your glucose level right now? 

Ben: It's at 87 right now. 

Latt: Okay. 

Ben: But so, I just dosed. We started this podcast, I had those ketones like what, 20 minutes before the podcast and I'm drinking more ketones. It's probably more ketones. 

Latt: Maybe we should have a shot. 

Ben: I'll test again. Yeah, let's do another shot right now. And, I'll keep testing as the podcast goes on. So, what are we drinking right now? This is like a little bottle says “Ketone-IQ.”

Latt: Yup.

Ben: It says, “Has 10 grams of ketones.”

Latt: Yup.

Ben: And then, there's a big bottle here that's like, and I think it tastes different, too. Explain to me what's in these bottles. 

Latt: So, it's essentially the same thing. It's just that this big bottle —

Ben: Cheers.

Latt: Cheers. 

Ben: It actually tastes way better than back when I was first experimenting with ketones, I was blogging. So, as a blogger, people send all sorts of random products to your house. And, I was getting like these test tubes of nasty ass. Like, you just tasted, like drinking battery acid. And, this tastes a little bit better than that. I'd say a lot better than that. What is it? 

Latt: So, you asking what's this big bottle, small bottle. They're essentially the same thing. The big bottle contains 10 servings or 100 grams of (R)-1,3-Butanediol. And, the small bottle is 10 grams. So, more diluted version of a single dose of that. And, we can go into what is (R)-1,3-Butanediol if you want. 

Ben: So, the big bottle. So, if this little bottle has 2 ounces in it, and I were to drink this whole bottle, I would be getting 10 grams.

Latt: Ten grams. 

Ben: But, if I were to drink 2 ounces of this big bottle, I would be getting, well, like 20 grams or a lot more. 

Latt: See, I don't do ounces. That's the problem. I want milliliters. 

Ben: Okay. So, basically, the difference is that the big bottle is more concentrated. 

Latt: Yeah. So that's 35 milliliters for 10 grams. And, this is about 59 milliliters per 10. 

Ben: But, they're both called Ketone- IQ?

Latt: Yeah, both Ketone-IQ. 

Ben: Okay.

Latt: It's the same raw ingredient. It's the same active ingredient in there. It's just these ones are easier for people to travel around and it's TSA approved. So, people can bring it with them if they don't want to check the luggage. 

Ben: I take one on every plane flight. 

Latt: There you go. 

Let's talk magnesium. Not only does it really, really help with things like constipation and smooth poops, but it is amazing for relaxation at night. And, when you're pushing your brain at high levels, you go through a lot more magnesium. Like, if you're taking nootropic, smart drugs, coffee, stuff like that, magnesium deficiency sets in even faster. Now, the fact is, most people are depleted in magnesium. Why? Because we eat food from crabby soil. Soil is overworked. It's mineral depleted. It lacks organic matter. All of those things would normally help plants get minerals from the soil. But now, they don't get as much minerals from the soil. 

I don't know if this is true, but I read that if you had to eat like one orange now you would have to eat 10 to get the same amount of nutrients and minerals. I don't know about you, but I don't have time to unpeel and eat 10 oranges. And again, I don't know how much research there is behind that. But, I do know that soil is less rich in minerals, and I do know I feel amazing when I take magnesium. 

There's a whole bunch of different forms of magnesium, and magnesium can get confusing. Because there's like glycinate, and citrate, and malate, and oxalate, and blah blah blah, -ate. So, what this company did, BiOptimizers, is they took the seven most studied and effective forms of magnesium. They shoved them all into one bottle, one formula. So, you just like, get this shotgun formula of magnesium. I take five right now before I go to bed at night. I think the dosage is like four six, but it just solves all the magnesium problems all at once in one fell swoop. And, on a really cognitively demanding day, I'll take even more. Because magnesium, it just works so well and there's not really need. I mean, I could probably take the whole bottle and have side effects, but ultimately it's a pretty safe supplement, too. 

So, you get a discount. Not only do you get a discount if you go to magbreakthrough.com/ben, and use code: Ben10. That's Ben1-0. They're also going to give you a bunch of amazing promos and gifts if you use my code. So, magbreakthrough.com/ben, and then use code: Ben10. It's fun to shop at BiOptimizers, because if you one of my podcast listeners, you add stuff to your cart and all of a sudden, all sorts of other amazing goodies you didn't expect to wind up in there. You're welcome. So, magbreakthrough.com/ben, and use promo code: Ben10, to try this Magnesium Breakthrough. 

I'm often asked what is my go-to desert island supplement if I could take nothing else. Well, it's essential amino acids. I've been using them for almost a decade now, so you probably know that the human body is mostly water. What you probably don't know is that everything else in your body is 50% amino acids. They're the building blocks of life. Essential for health, fitness. They naturally boost energy, they build lean muscle, they enhance athletic recovery, they stave off the appetite. Even if you're eating a low-calorie diet or you're fasting. They're fantastic for pre-workout, for during the workout, for post-workout. And, the essential amino acids that I use are backed by over 20 years of clinical research. They're in perfect ratios. They essentially match what your body needs and what the muscle composition of amino acids actually is, which a lot of other amino acids do not do, especially branch chain amino acids, but many other essential amino acids as well. 

So, this is the stuff by Kion. Kion Aminos have the highest quality ingredients. No fillers, no junk, rigorous quality testing, and they taste amazing. With flavors like lime, berry, watermelon, probably my favorite, mango. They're amazing. You just put a little bit in water. You can add them to smoothies. They are one of the top supplements that my wife and I take each day. And again, it's been a staple of my diet for years and years. And, I swear by this stuff. I've had friends start to take these, and literally report that they feel like they're on some kind of a steroid. Now, there's no steroids in the Kion Aminos, of course, but it is amazing. How you feel when you step up your intake of essential amino acids. And, I'm shocked that more people don't know this secret. 

So, Kion Aminos. You can get 20% off monthly deliveries, 10% on one time purchases, and it's very simply. Go to getkion.com/ben. Get K-I-O-N. G-E-T-K-I-O-N.com/ben to get my fundamental supplement for fitness, recovery, appetite, and much, much more. Kion Aminos, check them out. You got to get on the essential amino acids bandwagon. You will be absolutely shocked at how you feel on these things. So getkion.com/ben. 

Alright, folks. It is coming up. June 17th through the 18th, in London. The big health optimization summit. One of the most fantastic biohacking events and expos I've ever been to in my life. You get to go experience a massive expo floor with the latest biohacking tech and gadgets. Red light therapy, PMF devices, supplements, brain-training wearables, you name it. You get to try it all out. And, you also get access to 35 different world-leading speakers, 100 different cutting-edge brands, massive swag bag entrance to this highly curated exhibitor village, which is amazing. There are breathwork workshops. There are movement workshops. You get complimentary recordings of the speaker talks afterwards. If you're professional, it is accredited towards your continuing education units. And, they've got everything from a VIP lounge, and VIP tickets, and VIP goodie bags, all the way down to just a normal entrance and anybody is welcome. It is a fantastic event. Here is how you can get in and get 10% off a regular or a VIP ticket. You go to BenGreenfieldLife.com/hos23T. Like, Health Optimization Summit 23. BenGreenfieldLife.com/hos23. Discount code: BenGreenfield. We'll give you 10% off and again, it's going to be June 17th and 18th in London. 

Ben: I've heard that ketones have a DNA protective effect. 

Latt: Yeah.

Ben: That was my reasoning, due to the radiative effects and some of the stress that occurs during airline travel, combined with my ability to be able to resist the appealing, yet ultimately crappy airplane food, that if I took the ketones, I'll begin double whammy effect. Wouldn't need the airplane food or get hungry. And, I'm walking to the airport and pay 20 bucks for a salad, and also have the DNA protective effects. Now, the appetite-satiating effects, I think we've already established why that works. It's replacing glucose as a bioavailable fuel. Is there something to the DNA repair idea? 

Latt: There are quite some preliminary data to look at mitochondrial protection, especially against radiation as well. In fact, I just reviewed a grant application that we're going to do. Review a draft of a grant application that we're going to apply to European Space Agency to get Ketone-IQ to astronauts. First of all, for cognitive and physical performance. But, second of all, protection against ionizing radiation. So, galactic cosmic protection. I know our CEO, Michael Brandt, last year at KetoCon in Austin, did talk briefly about this. He sort of closed this. It's like, this could be the future. So then, I think a few months ago, CEO of a space company, he was a space and defense officer of EU. And, he reached out to us. He was like, “I used your product for endurance exercise. I really loved it. I think this has potential to be used in ESA for astronauts.”

Ben: What's ESA?

Latt: European Space Agency.

Ben: Okay. 

Latt: So, let's look at applying for grants. So, that's what we're currently doing. Fingers crossed, we'll see in a couple of months or next year. Usually, this grant processes take a while, but that's one of our current grant application that we have in the pipeline. 

Ben: Cosmic galactic protection. You just sell that idea like of Elon Musk. 

Latt: I know. I know if Elon Musk is listening to this, you know, it's about time to send some Ketone-IQ out there.

Ben: Listens to every episode. He won't stop blowing up my phone with questions. Okay. So, the label on this stuff says 1,3-Butanediol.

Latt: Yes.

Ben: Now, my limited amount of experience in the past with ketones, when I would try them or they get sent to my house or whatever, you'd always see beta-hydroxybutyrate, like BHB.

Latt: Correct.

Ben: And then, sometimes, you'd have what I understand, you could probably explain it better than me. You'd have like a ketone ester, which is beta-hydroxybutyrate bonded via some kind of an ester bond to (R)-1,3-Butanediol.

Latt: That's correct. 

Ben: And then, yours just says — it doesn't say Beta-hydroxybutyrate at all. It just says (R)-1,3-Butanediol. So, how come this is different? 

Latt: So, let's take a step back and just explain what ketones are, right? So, as you were saying earlier, our bodies evolutionarily are designed to create and metabolize ketones. The three main form of ketone bodies that we produce are acetoacetate, acetone, and beta-hydroxybutyrate, BHB.

Ben: Okay.

Latt: BHB is the main form of ketones that we use to circulate within our body because it's in the stable form and it's also being metabolized for energy. So, there is something that called 3-BHB acid, which is a BHB powder that is a supplement that people can take directly. So, it's taking in BHB directly. The problem with that is that it is an acid form. So, it's like drinking acid, right? You're going to get acid reflux. You're going to get GI issues. So, people can't get too much of that. So, what happens is then, 20 years ago DARPA funded NIH to look at what is a potential super fuel that military can use to power their soldiers for long and demanding missions. You know, we know carbs, we know proteins, we know fats, but is there something else out there? That was when they were toying around with the idea of exogenous ketones. And, as a result, they came up with ketone ester. Because 3-BHB is too acidic. So, they bound a BHB to butanediol. 

What does butanediol do? Butanediol goes into your liver, gets converted directly into BHB. So, what happens when you drink ketone ester is that, when you drink it in the gut, the saturates cut the ester bond. So, the BHB goes directly to your blood. The BDO, butanediol, goes to your liver gets converted into BHB in a slow-releasing form. So, that was what H.V.M.N. brought into the market in 2017. That was the first ever ketone. 

Ben: [00:41:58]_____ was the ketone ester. The BHB-bound to the 1,3-Butanediol. That was like your first product. 

Latt: Yes. 

Ben: Okay. 

Latt: So, that was the first ever ketone ester that got to the market. And, that was the also the first product that manages to raise blood ketone levels up to 3 to 4 millimolar.

Ben: Which for people who might not understand 3 to 5 millimolar. From what I understand, usually, once you cross about 1 millimolar, you kind of sort of starting to get into ketosis. And then, once you get above 3 millimolar, you feel really good and super stable. And then, correct me if I'm wrong, once you get above like 7, that's where you start to risk like getting too much ketones, or almost like ketoacidosis.

Latt: That is correct. So, with the current data we have, we used to think 3 and above is good. We used to think that. So, ketosis, nutritional ketosis is defined by anything above 0.5. But, from a therapeutic point of view, a lot of these studies using ketones for either epilepsy, or Alzheimer's, or cardiovascular disease, or diabetes, anything above 1 millimolar is considered therapeutic zone.

Ben: So, the difference is nutritional versus therapeutic.

Latt: That's the loose term that people are using at the moment. And then, for performance, we are sort of looking at between 1.5 to 2.5. Anything more than 3, you are going into acidification of your blood and lowering of the pH already. Not so much in the ketoacidosis realm, but still you are getting your blood to be more acidic. One study actually came out stating that because of the acidification of the blood, they are up regulating all the cardio respiratory stress biomarkers, i.e., your heart rate, your breathing rate. Because they are trying to expel the carbon dioxide out to neutralize the blood pH. 

Ben: So, more isn't necessarily better?

Latt: Exactly. And, these people are also having higher RPE.

Ben: Rating of Perceived Exhaustion during exercise. 

Latt: Exactly. So they feel like they're working harder.

Ben: You feel like you're working harder. Now, I think it's going to vary from person to person, right? Because if you're, let's say, fat-adapted, you've been restricting carbohydrates moderately, or you've been using a lot of ketone esters, you might be able to better utilize ketones. And so, the amount of ketones, let's say drinkable ketones, that shifts you into like 3 plus millimolar, your fat-adapted marathon racing friend, that amount might only put them at like 1 and 1/2 millimole. 

Latt: Correct. 

Ben: So, based on that, it seems to me it would be pretty prudent if you're messing around with this stuff from the early time that you start experimenting with it, to perhaps measure your ketones and kind of see what amount would be shifting into what millimolar of that ketones. 

Latt: That is correct, yeah. 

Ben: What do you use to measure ketones? 

Latt: I use either Keto-Mojo, like meter the blood ketone. 

Ben: Keto-Mojo?

Latt: Keto-Mojo or the Abbott, Precision Xtra

Ben: Those are both blood?

Latt: I usually would go for blood, because blood measurement would measure your blood ketone levels, which is usually BHB. There are devices out there which measure breath. In which case you are measuring acetone. And then, urine, in which case you are measuring acetoacetate. 

Ben: Okay.

Latt: Those two are somewhat correlated with blood ketone levels; i.e., blood BHB, but not accurately. Because, sometimes, what happens is when you are on a ketogenic diet over a period of time and you're very keto-adapted, the amount of acetoacetate that you are going to be peeing out will be less because your body is more efficient at converting it back to BHB. 

Ben: So, it's not going to give you an accurate value.

Latt: Correct. So, I always go for blood. But then again, some people can't prick their own finger and they just can't send the blood, and what not. When we did our internal study because we obviously have to know this product like inside out, I had to put myself seven times in the span of six hours in order to look at my blood ketone levels going up and going down after a certain dose.

Ben: You poor baby. Finger must have been bleeding all over. 

Latt: I know. I ran out of fingers. 

Ben: Okay. So, back to your story. DARPA funds this trial and dumps millions of dollars into whether ketone ester would fuel their super soldiers or whatever for a long period of time. You guys, though, after launching this ketone ester based on, I assumed some of the research they'd done and that you'd done, didn't wind up continuing down the path. 

Latt: So, in 2017, we actually started a STTR Phase 1 trial with SOCOM, Special Command. And, we looked at the decline in cognition in hypoxia. And, that decline was mitigated with ketone ester. And, that was enough for SOCOM to say, “Here's $6 million as a contract from DoD and SOCOM. Why don't you guys do a Phase 2 study where we look at way more expansive tasks that looked at military and hypoxia and ketone ester,” which I'm the principal investigator of. So, I am currently overseeing the $6 million grant or contract that looked at ketone ester in cognitive and physical performance in hypoxia. 

Ben: Okay. So, why'd you start using the diol instead of the ester? 

Latt: Exactly. Because of pandemic, this study has been prolonged way longer than it's supposed to, right?

Ben: Because of COVID?

Latt: Because of COVID. Because of the recruitment. Because we can't recruit like people to — because it's clinical trial, right? So, everything was shut down and we had to have a no-cost extension. So, it's all prolonged. So, during that time, more and more studies and more data came out, right? Like I said earlier, the acidification of the blood, that paper came out. A lot of other conflicting studies came out that ketone ester that may not improve performance, but that just make you feel like you're working harder. Like, RPE, increased Rating of Perceived Exhaustion. We feel that on top of ketone ester being super expensive, that was about 25 grams for about 30, $40.

Ben: Twenty-five grams for 30, $40.

Latt: This is 25 grams for $10. 

Ben: Oh.

Latt: Okay. So, that's price point. 

Ben: Is this little — how much is it? 

Latt: That's 10 grams. 

Ben: So, 10 grams. This little bottle would be how much? 

Latt: That's for $5, I believe that's. We're available nationwide, in Sprouts as well. So, people can go there, and the first shot is on us. So, if you go there, get your first shot, you can scan the QR code, and we'll give you a refund. So that everyone can try this. Because we do believe in the product so much that we know that you will feel the subjective difference. 

Ben: That's cool. 

Latt: Yeah. 

Ben: Okay. So, you've got the diol, and what'd you find out once you started using a diol instead of ester? 

Latt: So, we found that the increase in blood BHB is very smooth and very slow and steady, instead of a spike. Because as I said earlier, for ketone ester, it enters your gut. The ester it into half. The BHB goes directly into your blood. So, you don't have a mechanism at which you can gate keep how much BHB you're getting. With butanediol, your liver is the gatekeeper. Because your liver is getting all the signals from the rest of your body, how much fuel you have in your body, so it is actually regulating how much BHB is releasing or converting from BDO. So, this is very apparent in our internal study where we use all the way up to 0.8 to 1 gram per kilogram of body weight. And, that translates to about 80 grams in 1 bolus. I've taken 80 grams of this, and my blood BHB will not go further higher than 2.5 millimolar.

Ben: How do you feel when you take 80 grams? 

Latt: Not good, to be honest. I do not recommend anyone to take 80 grams at one time, even when you're working out. That was just for a clinical study for safety and tolerability. I just feel sleepy, to be honest, and it's not something we recommend. So, what we normally recommend is 1 dose is 10 grams. Or, if you're working out, you could go up to 20 grams depending on your body weight. 

But, most importantly, what I wanted to point out is that the really slow increase in blood BHB gives people the larger amount of time where people are spending in ketosis. So, that's the third point as to why we switch to diol. First, it's the pharmacokinetics. The second is the price point, and third is the taste. So, the pharmacokinetics is what I just described. And then, the taste of ketone ester, as you've tasted it, it still tastes really horrible. 

One of the tasks that we had to do with the military $6 million contract was to improve the taste. And, we worked in conjunction with Monnel Research Center, and they're the experts in Sensory Research Center. Then they are very good at pinpointing what causes the bad taste and how to remedy that. Either they block the receptor, or they use a receptor antagonist, or they use a bitter blocker, whatever. They've done everything they could, and the results came out. Instead of any sweeteners, both natural and artificial, decreasing the bitterness of ketone ester. The ketone ester actually managed to decrease the sweetness of these superficial and natural sweeteners juice, which is horrible.

Ben: Cosmic galactic superpowers. I don't think it's that bad if you mix with like some sparkling water and some stevia. Like, I've messed around with the Esters. Like, if you dilute it, it's not half bad.

Latt: It's diluted. 

Ben: I like that you can drink these straight out of the bottle. Even this concentrated one with this big bottle, like it's a little bit more like syrupy ketone tasting. Not syrupy sweet, just like a thicker, almost like a slightly with a bitter taste. But again, it's not that bad. I actually do a shot now. I do a little bit more. I do like 45 to 60 at lunchtime. Because just like I don't have to eat again till dinner. That's my problem. I have a raging appetite. So, I've used this as a hack to just like keep me going from lunch to dinner, instead of hyper-productivity without actually having to grab some chocolate-covered almonds. 

Latt: I usually prefer the bigger bottle because it's easier for me to dose higher than 10 grams if I want to.

Ben: Right. Because I'd have to dump two of these bottles. 

Latt: Right. I'll have to open multiple bottles. 

Ben: Because, usually, at lunchtime, I pour in bone broth or sparkling water. So, related to the sleepiness thing, with the higher amount that you took like the 80 grams, this is something that's obviously getting talked about right now, is if it simulates the effects of alcohol, right? Because there's the companies that I'm sure you're aware of, like the Ketohol or KetoneAid. They have the drink that's supposed to simulate a Moscow Mule, or a gin and tonic, or whatever, with the idea. And, I think that's 1,3-Butanediol also that it would make you kind of sleepy, or give you like the socially lubricating effects of alcohol. Is that because it's like a super high dose? 

Latt: I think if you really go super high dose, I don't think it's like similar to alcohol because you don't get hangover from it. You don't. But again, it falls onto the dosing, right? If you look at science, anything at really high dose, you're going to feel ill. Even glucose. If you overdose on glucose, you will start puking. Because your body just rejects it, right? So, if you look at their product, their alcohol product has 12.5 grams of butanediol.

Ben: Right. And, if I drink like two of those, which I guess would be like 25 grams, I'll feel like a little bit like loosey-goosey. 

Latt: But, if they are just publishing that one, serving 12.5 gram is equivalent to alcohol, and they also have a ketone ester product, that is 30 grams of ketone ester, half of which is butanediol. Now, I might–

Ben: But, their ketone ester one, it says that's like 12 servings in a bottle. It's a very small bottle, but they say it's like 12 servings and you're supposed to take a tiny amount. 

Latt: Yeah. But before this, they would publish that 30 grams minimum for one serving. 

Ben: Oh, wow. 

Latt: Yeah. Because that's what the studies have been doing, right? All the studies that use 0.5 gram per kilogram of body weight, they use at least 30 grams or 25 to 30 grams of ketone ester. Half of which is butanediol. I may not have a Ph.D. in mathematics, but if you divide 30 by half, roughly, it's about 15 grams. 

Ben: If you're going that recommendation, drink the whole bottle.

Latt: Right. And, 15 grams is butanediol.  And these are the products that showed improvement in performance. Now, I'm going to argue how can you have something that contains butanediol, about 15 grams, increase performance; but then, something that's lower in butanediol 12.5 grams, you are simulating alcohol effect? To me, either they are spiking something into that 12.5 grams. In which, they should be transparent about it. It's like, that's not the butanediol that's causing the effect. It's whatever you're adding in there that's causing the effect, or you don't have scientific integrity, and actually lying and spreading this information.

Ben: Yeah. I think like 12.5 grams; I don't notice that — there's definitely an appetite satiation effect. But, if I get up closer to like that 30-gram range, like if I were to drink a couple bottles, I'll notice like a little bit of relaxing feeling. And, I'm wondering how much of that is due to potentially the hypoglycemic effect. Like, do you think that one of the reasons, like let's — because we know exercise just naturally raises blood glucose, right? Because you're out exercising and your liver is starting to break down glycogen and your muscles are trying to break down glycogen. So, it's pretty rare if you're out exercising that you're going to get hypoglycemic on ketones. But maybe, if you're just like sitting around in the evening drinking a bunch of ketones, I'm wondering if part of it might be the hypoglycemic effect that would cause you to feel like you've had some alcohol. 

Latt: It could be. But also, I think we do know that ketones do act upon the GABAergic Pathway where it does have anxiolytic properties. So, it does relax–

Ben: GABAergic meaning that GABA, Gamma Amino Butyric Acid. The inhibitory neurotransmitter. 

Latt: So, it does have that anxiolytic effect. 

Ben: It's so interesting. Because we were actually talking before the podcast, like the ultra-running community, right? They'll use THC before they go out and run. And, if I were to use THC and I'm sitting around with a bunch of friends at dinner or watching on TV or something, I actually get kind of sleepy. I've done this before. Like, I've taken 5 grams of THC and gone and exercised. I'm not necessarily endorsing using weed as a performance aid, even though it seems to work surprisingly well in the ultra-running community, along with LSD, which I recently learned actually increases beta-oxidation, which is one of the reasons why LSD plus THC is like the ultimate stack for ultra-running. And, again, proceed with caution folks. Like, be responsible. But, I'm wondering if part of it is the context, too. Like, you're out exercising, you have high ketones and you're in this performance state. And then, if you do the same thing and you're sitting around with your friends at night having food, maybe it has more of a relaxing effect. I don't know. 

Latt: One thing about ketones that I love is that it's almost like an adaptive feel. Because we have seen in studies with opposing effects. For example, we have seen an increase in leucine-mediated mTOR activation when you take it after exercise with carbohydrate and proteins. 

Ben: Leucine-mediated mTOR activation if you take ketones after exercise with carbon protein. What you mean is it have like an anabolic effect.

Latt: Anabolic recovery, yeah. 

Ben: Interesting. 

Latt: And then, if you look at longevity studies that has calorie restriction and ketosis, they are looking at decreasing in mTOR activation. 

Ben: Right.

Latt: Right. 

Ben: Same thing with the [00:57:36]_____ of longevity, which drives me nuts because you get all these people wasting away muscle.

Latt: I know. 

Ben: You want to be like hard to kill as you age. You don't necessarily just want to chase calorie restrictions at all costs. 

Latt: Yeah. And, we can talk about all about like increasing muscle mass for brain health and strength. We talked, I talked about this at length with Dr. Tommy Wood, who you are very familiar with as well. 

Ben: Yeah. He's cool.

Latt: And then, another example I'm going to give you is appetite suppression. So, we have seen ketone ester decreasing ghrelin. We know (R)1,3-butanediol, specifically.

Ben: Ghrelin is the hormone to make you hungry.

Latt: Yes, correct. And, (R)1,3-butanediol specifically has leptin sensitizing effect. So, leptin is the other hormone that makes you feel full. 

Ben: Yeah. 

Latt: But then, at the same time, you look at a study by c that looked at overreaching symptoms and recovery, they had ketones 30 minutes after workout, 30 minutes before bed. Three weeks later, they have an increase in 15% of output, power output. And, that is corresponding with an increased consumption of calories. So, if appetite suppression is supposed to be there, why are these people eating more and therefore producing more power? So, that's what's interesting to me. It's almost like you have ketones and it's doing whatever stimulus you provide your body. 

Ben: That's kind of cool. It shifts you into a better state. It sounds like horrific, like over-the-top marketing. But, what you've just described is my personal experience and it's been kind of confusing to me. It kind of helps me out the way that you explain it as like an adaptogen, like reishi mushroom. 

Latt: Right.

Ben: Like, it'll relax me if I'm ready for a nap and ready to settle down. And yet, if I need some energy, like using adaptogens for energy, seems to shift me the other way. The idea that adaptogens might increase cortisol if you need more energy, and decrease it if you need to rest. It seems that the ketone might work as an adaptogen. 

Latt: And, there are some questions from our customers as well. They're like, “Okay. You claim that this give you calm energy.” How can you claim that it gives you calm energy, but at the same time, you can claim that it gives you bigger performance or better performance? It's exactly because of that. It's, you can still have the energy but you're not jittery like a stimulant, like a caffeine would do to you. 

Another example also inflammation. We know for a fact that ketones reduce inflammation that has direct effect on NLRP3 Inflammasome, right? So, it decreases inflammation. But, get this, when they looked at in vitro, which is in the test tube, and they put bacterial toxin in it and they put ketones in it, inflammation went up. So, when there is an invasion, you want inflammation to go up. But, when ketones are present, inflammation is higher than without ketones. So, that's super interesting to me. 

Ben: Yeah. What about for sleep? Because again, it's like the performance thing. Like, because I've taken it before sleep. And, I've found — I'm curious about your thoughts on this. If I take like a moderate amount, like I guess what you might consider like a low to moderate amount of ketones before sleep, I get better sleep. And then, if I take a lot of ketones before sleep, it's kind of like if you drink a lot of alcohol before sleep. Like, you kind of fall asleep but you don't get great sleep. 

Latt: I see. So, we didn't look at sleep and HRV. So far, we did not see any significant difference between placebo and ketones. But, what I can say anecdotally, like you said, some people rave about the effect of ketone like you and sleep. They got better sleep performance. And, some people, they find that they have way more vivid dreams as well. So, I think with regards to sleep, there's still more research that needs to be done before we can claim anything on that. And, I think right now, people are just using it anecdotally and case by case basis. 

Ben: When I took my free diving course, I experimented with and without ketones before we did our breath hold practice and free diving. I think I was telling you this last night. I had over 40 extra seconds on breath hold on exhale after dosing with ketones. Is that because of the modulation of hypoxia, or how exactly is that working? 

Latt: This is super interesting. What you just said just reaffirmed what we have seen in our military project. Because we simulated 14,000 to 20,000 feet altitude of hypoxia in hypoxic chamber.

Ben: Not a hyperbaric chamber. Hypoxic chamber.

Latt: Hypoxic chamber. The oxygen saturation decreased from what 99, 100 to about 65%. 

Ben: It's pretty significant. 

Latt: But, if you have exogenous ketones, they only drop to 72%. So, there's a 7% increase in oxygen saturation, and that is reflected onto reaction time vigilance, cognitive benefits, all of that. And, we are in the middle of writing a manuscript to be published. So, I am so excited with this study because we've got seven tasks in total. So, we have at least three to four papers. That is, we're using a mask, we're using a hypoxic chamber, and also we followed the 10th special group into the mountains where they did their mountaineering course and have them on ketone to measure their biomarkers, and measure the performance, and ask them to do cognitive tests, and look at how they did after having ketones as well. 

Ben: Is that less glucose metabolism, therefore less lactic acid, therefore less need for oxygen buffering that that would occur? 

Latt: Mechanistically, we didn't measure because it's very difficult to measure mechanistically when you're already in the mountains and all that and draw blood. I would say, when you're in hypoxia for a fact that you are activating the HIF, which is Hypoxic Inducible Factor, which has direct effect onto your DNA so that you can start expressing all the enzymes and hormones that is related to hypoxia or hypoxic survivability. So, one of the things that get upregulated is glycolysis, which is glucose metabolism, right? But, with ketones, for some reason, it's increasing the amount of oxygen that you're able to carry. That may not directly be attributed to substrate metabolism per se, but it could be due to something around the mitochondrial efficiency. 

Ben: Interesting. 

Latt: So, that's I spoke briefly with another scientist who worked with Richard Veech, who was involved in the original DARPA research. 

Ben: He's kind of like the Godfather of Ketone research, right? 

Latt: Exactly. So, he said it's something to do with mitochondrial, and the different complexes, and superoxide conversion, and all of that. 

Ben: Interesting. Okay. By the way, my blood glucose right now is at 78. So, it's dropped 9 points since we started. So, I was at 87 when we started. And, before that, I peeked out on the walk this morning at like 100, and it's a steady decline since then. I've pretty much been dosing with ketones all morning. So, it's dropped. 

Latt: We have just been sipping ketones. 

Ben: It's dropped 23 points so far this morning and I'm not exercising, just sitting here. So, that's interesting. I'll keep measuring it as we go because I'm still drinking ketones. I'm thinking about just continuing the dose as we go as a kind of experiment here. 

So, to the exercise piece. Like I mentioned early on, in the Ironman days, I was experimenting with ketosis. And, all I had available to me was MCT oil, because a lot of these ketones were very expensive. And so, initially, I was mixing MCT oil with a small amount of carbohydrate. Like one-quarter of the amount of carbohydrate that I'd normally use. Initially, I was using this stuff called UCAN. The problem is, that's a very resistant starch, even though it results in a slow release of blood glucose into the fuel. Sipping that over 10 hours of an Ironman triathlon. The fermentation and bloating by the end of the race is horrific. It literally looks like I was pregnant by the end of the race. And, maybe it's because I just have trouble breaking down resistant starch, and it's still the case for me. Like, if I have a lot of those like green banana starches, or cooked and cooled rice, or anything like that, I get horrible gas. It might just be my GI system, but UCAN didn't work for me. 

So, I found that a longer chain starch. GlycoFuse was one that I was using, Vitargo is another. These are longer-chain potato-based starches, like way longer than maltodextrin. I found that by using about one-quarter of the recommended dose of that, so around 100 calories per hour. And, to contextualize that for people, a lot of recommendations for a guy my size would be 300 to 400 calories of carbohydrate per hour. So, I was doing one-quarter of that for getting a little bit of the slow bleed of glucose into the system. And then, I was combining that with electrolytes and with amino acids

Now, early on in my racing days, I had a lot of conversations with Dr. Peter Attia, and he highly recommended to me if I was going this ketosis route to use branch-chain amino acids as an alternative fuel. I later started to use essential amino acids, because I found those to be superior. And, that might sound like the fox guarding the hen house, because I have a company that sells essential amino acids. But, nonetheless, like they work for me. That's actually one of the reasons that I began selling them at my company, Kion, was because I was using them so much in my own racing and using them with all my clients, my athletes. So, basically, in my water bottle, and then in my little run bottles on the run belt for the marathon, I had, in the case of the run bottle, very thick mix, in the water bottle for the bike, a diluted mix of MCT oil, essential amino acids, a long chain starch, but in low amounts, and then electrolytes. 

Later, when I got my hands on ketones, I simply replaced the MCT oil with the ketones. And, that was just the most fantastic fuel ever for Ironman. Like, I could just go and go and go. And, the way that I raced is, when I got to the point in the race where I knew that I could go anaerobic. And, this was just based on testing. I knew that with about 10 to 13 miles left in the Ironman, at that point, I could pull the parachute chord and shift into glycolysis, turn up my intensity, and go up full steam to the finish line. At that point, I switched to just drinking Coca-Cola from the aid station, just pure sugar. So, I'm like, “Okay. Shift into pure glycolysis now.” I've spared glycogen this long in the race, so now I can shift to glucose and the stuff that's in Coke. Really, fructose, as a fuel. Plus, the caffeine and the coldness, and like the comfort food taste of the Coke. It just strings you through that last…

Latt: You know, with the carbonated… 

Ben: Yeah. Well, no. It's flat coke. It's flat coke at the at the aid stations. So, anyways, that was my jam for Ironman. It worked fantastically, by the way. And, I'm still surprised, at least to my knowledge, that no company has come out with like a powdered mix of like some kind of ketone or MCT with a high molecular weight starch, with electrolytes, with essential amino acids because that it's the most amazing endurance feel I've ever discovered. But, to my knowledge, like I was doing, you still have to kind of mix that all up yourself in the kitchen. I would literally have a blender, blend it all, and pour it into my water bottles. 

Latt: I think a lot comes with the body weight match data as well. Because if you have everything already blended, then — let's say if you have to increase the ketone dosage, then you have to take more. But then, you're also increasing the other stuff.

Ben: That's true based on what we talked about before in terms of ketone sensitivity, and you don't want to shove yourself over 3 millimolar. It's a good point. 

Latt: Right.

Ben: So, anyways. The thing that happened was later on, when I got out of endurance racing and got into a sport that's more anaerobic plus aerobic, namely obstacle course racing. In the Tough Mudder, I thought, “Well, gosh. Why don't I increase the levels of both substrates, simultaneously elevate my ketone values and my glucose values,” which I think, as you noted earlier, could be like an unnatural state for the body to be in, but an amazing performance hack, right? Elevated blood glucose and elevated ketones. Crushed the Tough Mudder, won the race by a country mile, and felt like I was on rocket fuel the whole time by mixing gels, like fructose melt index and gels with ketones. And then, I was like, “Oh, this could be used for like what might be considered anaerobic performance as well.” Not necessarily like a full-on like 30 second all-out sprint. But, carrying sandbags, climbing ropes, hauling over obstacles, and then running aerobically, and then going anaerobic again, and back and forth worked fantastically for that. 

Now, my question for you is that I saw before a podcast that there was some new research out on ketones related to anaerobic performance, when traditionally, they've only been associated with aerobic performance. So, explain to me, what's going on now with ketones and anaerobic performance?

Latt: Yeah. So, first and foremost, because ketones are so much more related to fats, because fats gets broken down into ketones, and then we metabolize it, right? So then, automatically, we are thinking that, “Okay. It must be good, better, for endurance.” Because for endurance, we want to tap into that fat like you said earlier, RER. You want the RER to go towards fat metabolism instead of glucose because glucose will always be king when it comes to anaerobic. Because glycolysis gives you that fast ATP without even having to use any oxygen. 

Ben: Right.

Latt: Right. So, that's why nobody has done anaerobic performance on ketones. But then, we decided, H.V.M.N. as usual, we do some crazy things. We do things that no one wants to do and let's see what the science says. And, we partnered with University of North Georgia, one of the best military college in the U.S., to look at effect on Ketone-IQ with carbs in anaerobic performance. So, what we have done is that we put participants, 18- to 24-year-olds, on a 5K run. Immediately after the 5K run, we put them on a stationary bike, odometer. And, they go, they went through the Anaerobic Wingate Test. 

Ben: You guys are cruel. 

Latt: I know. Explain the Wingate Test to people. Because I mean 5K is tough, but Wingate's really tough.

Latt: Yes. So, Wingate. So, these participants have to go through bouts of 10-second sprints on that bike at 7.5% body weight as a load, as a resistance.

Ben: 7.5% of your body weight. So, by me, I'd have 150 watts.

Latt: Something like that. 

Ben: Yeah. Wait, was that the wattage or was that the resistance? 

Latt: It's a resistance.

Ben: Oh, that was a resistance.

Latt: That was a resistance. Then, during that five bouts, they have 10 seconds sprint, 30 seconds rest, 10 seconds sprint, 30 seconds rest, five times, right? And, they got their ketones measured. So, they had ketones before the 5K run. And then, topped up after the 5K run. 

Ben: Okay. After the run, but before the Wingate. 

Latt: Yes. Correct. And so, we just submitted this paper. 

Ben: You hear that crinkling, by the way? I'm opening up another ketone shot. You want one?

Latt: Are you? Yeah, sure, why not. 

Ben: Here. Cheers. And then, keep going on this test. 

Latt: Yes. 

Ben: Let's do another one. So, I'm going to fear with my upper — this is going to be more ketones than A, I've ever had in my life in one sitting; and B, definitely more than I've ever had on a podcast. But, I'm doing this because I want to keep tracking. 

Latt: Let's see how…

Ben: I want to keep tracking the blood glucose too, as we're going here, and just see what happens. Alright, cheers. 

Latt: Let's see how smooth you are. And so, during this Wingate test, they were asked to go as fast, as hard as possible, right? And, we just submitted this manuscript to “Frontiers in Physiology,” and they're under review right now. And, we saw increase in average power, peak power, and velocity. So, not only these people are paddling harder, they're also paddling faster. And, on top of that, we also measure fatigue levels. Because as you go through that five bouts of exercise, you are inevitably going to be more and more fatigued. 

Ben: Yeah. 

Latt: People who are on Ketone-IQ and carbs, they experience less fatigue than those on placebo. 

Ben: I would hypothesize that part of this would be due to the glycogen-sparing effect that occurred during the 5K run. Meaning, you're burning less glucose during the 5K run. Is there anything else going on there? Like, had you ever thought about doing just the Wingate without the 5K run, for example? 

Latt: Great question, and I did ask that. So, the reason why we did the 5K run is because a lot of the studies, a lot of other studies, also did that 5K run and they saw no difference. And, we want to sort of replicate that to build on top of that. Because otherwise, other scientists would just scrutinize the paper and say, “You know, no one has done this. No, you can't compare to anyone.” So, that's the reason we did the 5K. 

So, the next step is definitely better to do just the anaerobic and see what's the difference. And, during the 5K run, you were right, we did measure the RER. People on Ketone-IQ and carbs have significantly lower RER. Meaning, they are burning more fat than glucose. So, in the placebo group or glucose-only group, we are looking at about 0.94 RER. Whereas, the Ketone-IQ and carb group, we are looking at 0.89.

Ben: Okay. RER by the way for those of those Respiratory Exchange Ratio. It's indicative of the amount of carbohydrates compared to fat that you're burning. Higher RER means more carbs, less fat; lower RER means more fat, less carbs that you're burning.

Latt: Yes. So, they're burning more carbs, and that is expected and as you said, it could be the glycogen-sparing effect. And also, because we measure the level of blood ketones before the 5K and after the 5K, and we saw a decrease in the ketone. So, together with the RER, plus the decrease in ketone levels, we can assume or we can insinuate that these people are burning the ketones are oxidizing the ketones as well. 

However, we are not sure if the ketones are being burned in skeletal muscles, in your heart, or just simply lost via acetone in the breath. So, that's you know, whoever was listening in terms of researchers, that's the next step we got to measure, right? Like, what are we measuring? What are we looking at muscle biopsy? You know, then we can look at really the glycogen-sparing effect. 

Ben: What about what about the brain? Like, is there anything going on in the brain? 

Latt: I was just about to say that. So, the next reason that we think that could be why these people are performing much better at anaerobic exercise, is not simply the glycogen sparing effect. Because this could have a potential analgesic effect on the brain. 

So, basically, it's a pain tolerance increase after taking Ketone-IQ and carbs during this. Because the whole Wingate test is meant to elicit a huge shift in pH; i.e., lowering the pH, increasing lactic acid buildup, and having excruciating pain, and possibly vomiting. And, pain in these sort of like target muscle groups. Having said that, if people are able to push through that, push harder and faster, and feeling fatigue less, then it could possibly be having a direct effect on the perception of pain itself. Now, if you compare this to ketone ester, it may not be a good combination. Because anaerobic itself, like I said, it's meant to elicit a huge shift of pH, and ketone ester on its own is able to already drop you so much.

Ben: Accelerate that pH shift.

Latt: Yeah. That people might just feel really awful. And, coupled with the bad taste, they might actually have GI issue, which could also lead to an overall decrease in performance in the study, which a lot of studies have showed. The drop in performance is because people started vomiting, started not feeling well in the general. 

Ben: Now, one of the reasons that you see, kind of like a shift in focus sometimes after you work out is, I think in some scenarios, probably due to an increase in blood ketones due to potentially glycogen exhaustion or increased fat utilization. But then, there's also this idea that in addition to ketones, being one of the preferential sources of fuel for the brain, lactate is another. And, you see lactate crossing the blood-brain barrier and being used as an alternative fuel to glucose for the brain. 

Now, based on that, is there something to be said for what might be occurring from a lactate standpoint here for the brain? Like is there any studies you guys have done on lactate as related to neural performance, or anything of the like.

Latt: I mean, we didn't measure the lactate. I don't think that lactate is that much different between the two grips, but we definitely see an increase in lactate during the anaerobic exercise, which we already expect. As to directly into the brain, we didn't measure that.  But it is an interesting point. Because I published a paper last year, a review paper on traumatic brain injury and exploring the roles of both ketones and lactate in helping both the recovery and the mitigation of damage of traumatic brain injury. 

Ben: Were you giving people lactate and ketones? 

Latt: It was a review paper. So, basically, looking at all the literature so far as to what we know, what happens in metabolism when you have a traumatic brain injury, and why we came to a conclusion that ketones and lactate may be able to help with that. 

Ben: Ketones are something that come to mind for TBI concussion. Because if you look at, for example, Dale Bredesen's book, “The End of Alzheimer's,” there's a whole multimodal approach to Alzheimer's or other dementia-like conditions, that include high amounts of DHA, hyperbaric oxygen, adequate hydration, the use of intranasal light or intracranial red light therapy for the brain. And, I believe either coconut oil or MCT oil or possibly ketones, I don't recall, we're one of the strategies used for TBIs, for concussions. And, I've also seen some indications for other neurodegenerative conditions. What's going on with ketones in the brain?

Latt: So, we are actually going to launch a pilot study on TBI together with the Naval Health Research Center to look at specifically Ketone-IQ, the effect of Ketone-IQ in recovery of TBI patients. There's a university, University of Western Australia in Perth, I spoke to the clinician as well a few days ago, and they are going to start a study on TBI using Ketone-IQ as well. So, stay tuned on that. But, as far as what we know, so far on TBI — what happens with TBI? When you have a concussion, when you have a traumatic brain injury, within the first 48 hours, what they have seen is the hypermetabolism of glucose. Your brain start taking in all the glucose, right? And, some people say because you need an increased energy because there's damage going on. But, there are some scientists who has shown that the glucose is being pushed towards the pentose phosphate pathway to create more NADPH, which could be helpful with the mitigation of the damage. 

Ben: Yeah. NADPH being able to have a protective effect on mitochondria.

Latt: Correct. Neuroprotective effect as well. And then, weeks to months after, in fact, seven days after, they saw a decrease in glucose metabolism. Because you can only ram something up so far before it goes back down because that's what the body does. You know, we always stay in homeostasis and really modulate the metabolism. So, when glucose goes back down in seven days, they saw a huge increase in lactate. Up to like 60 plus percent metabolism being relying on lactate. Showing that there is still an increase in energy, but somehow the brain capacity to up-regulate glucose metabolism is now not able to be maintained. 

And then, right after that, if you look at TBI patients years after, they also experienced somehow a hypo metabolism of glucose. Meaning, they're not as efficient in metabolizing glucose. And, this is very similar to neurodegenerative diseases, like Alzheimer's, why they call it type 3 diabetes. Because there is some form of insulin resistance, where the brain is not being able to uptake and utilize glucose as efficiently as a normal human being. 

So, that's where ketones come in, right? First and foremost, ketones are brain's super fuel. Like, it's a brain's preferred fuel. So, when it's present, the brain will take it up. So, because ketones are being shuttled in via MCT, which is Mono Carboxylates Transporter, it's different to glucose transporters, which are glutes, right? So, it's coming in from different shuttles, different channels, so it can bypass that whatever insulin resistance you have. Secondly, we're looking at the anti-inflammatory properties of ketones as well. The direct effect on of ketones on NLRP3 Inflammasome could also potentially help with both mitigation of the damage, as well as recovery down the road. So, first of all, is the energy deficiency gap that may be compensate it with ketones and lactate? And then, two, the anti-inflammatory properties of ketones.

Ben: Why does some people still say that glucose is the preferential fuel for the brain? 

Latt: I mean, under normal circumstances, the brain does use a lot of glucose, right? But then, how many people, like, how many studies are there that shows that you have high glucose and high ketones, and then the brain prefer ketones? Like, what we know is that ketones and brains and whatnot, when ketones are present, the brain and the heart will always take up ketones. What's more interesting is that, I know for sure in the heart, is that when the heart takes up ketones, it's proportional to the availability of ketones in the blood. However, this is independent of the uptake of other substrates. Meaning that when they measure the arterial blood and the venous bloods, of blood going in, blood going out; the uptake of glucose and fats remain the same, and ketones go up. And, this is especially important for a failing heart. Because you are essentially providing more energy because it's up taking more substrates and providing more energy to the failing heart. And, we know in heart failure, the heart actually up-regulates ketone metabolism. 

Ben: I didn't realize how applicable this was to heart disease. This is fascinating. Back to the brain. My sons just took their first dose ever of ketones. They're upstairs in their bedroom, I think right now in close proximity listening to us. And, I'm curious when it comes to things like school performance, cognitive performance, youth intake of ketones, A, are they safe for kids, if you can say that. And B, have you guys looked at academic performance or anything like that or is that on the radar or has that been studied? 

Latt: So, it hasn't been studied. So, first of all, let me answer for kids. We have had kids take it. In fact, recently a gentleman called James, his son had almost drowned when he was a baby. Now, he's 6, he's having brain injury and he had to be tubed and everything. And, I sent him some Ketones-IQ. And, reportedly, he noticed some changes. Like, his son became more alert. I mean Ketone-IQ is FDA GRAS, which is generally recognized as safe. So, we have a safe profile, like safety profile and tolerability, that is safe for everyone essentially. Let's put it this way, right.  Ketones are ketones are ketones. Babies spend most of their time in ketosis. 

Ben: Breastmilk has a lot of ketones in it as well, doesn't it? 

Latt: Just fats, and you are on low carb. So, most of the time, babies are on ketones. 

Ben: Yeah. 

Latt: So, having this, exogenous ketones, it's essentially normal for kids. Although, [01:25:36]_____ for old people.

Ben: I always thought about that. Like, how much more metabolically efficient humans would be if we shifted babies from breastmilk into rather than Cheerios and Sjögren's-fused Gerber to sardines, and avocados, and fatty fish and the like. Fortunately, even though as you've noted, and I'm sure noticed, we have cinnamon rolls and sourdough bread and all sorts of carbohydrates around the house. But my sons have certainly grown up on a diet that's also rich in avocados and fatty fish, and absent of a large amount of candy around the house, et cetera. So, I suspect, even though I haven't measured their RER and compared it to that of the average child, I would imagine their RER might be a little bit more stable in terms of metabolic efficiency. And, they currently use, I've had them do genetic testing and they have low glutathione production pathways. So, they supplement with glutathione in the mornings based on some research. 

Latt: Which is that's an antioxidant. 

Ben: Yeah. By some research, I've recently seen on DHA, particularly in adolescence, for assisting with neuroplasticity and brain support, they're now taking a decent dose of fish oil in the mornings. They are taking liver to support their methylation pathways. They're both heterozygous for methylation pathways, so they take a little bit of liver. I'm thinking about tossing some ketones in their little supplements cabinet in the refrigerator to take that as well and just see, if they see an even bigger improvement. 

Latt: So, as far as exams and studies go, we haven't had any studies or clinical trials that looked at that. But, I can tell you for sure one of my closest friend, he uses it every time before he goes into a quiz or a midterm. And, he claims that it does help him focus and concentrate. Same thing with another friend in Netherlands. His girlfriend had ADHD and had problems studying for her university courses. So, when she took Ketone-IQ, she's like, “Wow, I can actually study focus for longer than few hours at one time now.” Because she has always had trouble focusing. So, I think that says a lot. So, the way I describe to people what Ketone-IQ does is that any activity that uses brain power, be it just cognitive work, studies, podcasts, to performance. Because even if you're working your skeletal muscles, you're still using your brain a lot, right? This will provide the fuel that you need in order to maximize or optimize that sort of performance.

Ben: Yeah. Subjectively, and based on anecdotal reports from many of my friends, combining ketones with nootropics with smart drugs, such as like the modafinil. Or, combining them with microdoses of plant medicines seem to enhance the effect of any of these brain-supporting compounds that you might take. So, I think there is something there. 

Related to that and this idea of stacking. Like, you and I both tried some aminos today with the ketones. Based on that early experience I'd had with using aminos and ketones as endurance fuel, do you personally or anything you found, you've worked at H.V.M.N., found certain things to stack really well with ketones to enhance the effects or to play really well with ketones?

Latt: So, what I personally use, I usually use ketones like Ketone-IQ and green tea from pre-workout, because I don't drink coffee. Like, anything that has too high of caffeine level, I'll get headache. 

Ben: So, it's not the acidity, it's the caffeine.

Latt: It's the caffeine, yeah. Because coffee always gives me headache, like green tea doesn't. But, if I have more than two cups of green tea per day, then I'll have the same sort of headache. So, I would use green tea and Ketone-IQ for pre-workout. And then, after workout, I would have my general like protein shake, which has carbs and protein. And then, I have Ketone-IQ. 

Ben: Yeah.

Latt: Not mixed together though. I have a shot, and then I have my protein shake. 

Ben: Yeah. It wouldn't be that great mixed in, but that's actually the first I've heard about the anabolic mTOR stimulating effect of ketones with carbs and protein post-workout. 

Latt: Yeah. 

Ben: And, I'm trying to put on a little weight myself right now. So, I'm going to have to start trying that. 

Latt: Yeah. Because that's been what they've been asking around.

Ben: I'm going to roll over smoothie in the morning throwing in some ketones. 

Latt: I believe that study has been around since 2017 or 18. So, they measured in vitro, specifically in those muscle biopsy cells. And, they saw an upregulation of leucine-mediated mTOR activation. That's how they figure it out. And then, coupled that with the overreaching study by Haspel's group on the increase in power output after three weeks using it as post-exercise recovery strategy, that confirms that. 

Ben: Yeah. Man, so cool! By the way, I just tested my blood glucose. Again, I know we're getting towards the end of the podcast. I've stabilized. I've topped out about 78.

Latt: Okay.

Ben: So, which again, if I were just sitting here in a normal scenario without the ketones, I'd probably be at about 85, 90. And, I've had a total, so far today, I've probably had like 60 grams of ketones. Like, from the get-go and 40 grams. Let's see two of these. So, that's 20 grams, plus a pretty big shot of these. Another 20 grams. Yeah, I probably had 40 grams since the podcast started. Yeah, amazing. 

Well, this has been absolutely fascinating. And, I know for people listening in, you're going to want to be interested in some of the research that Latt and I have talked about. And so, I'm going to link to all that BenGreenfieldLife.com/hvmnpodcast, based on our partnership here with H.V.M.N. They've given us a 20% discount code on this stuff. So, if you go to BenGreenfieldLife.com/ketoneiq, you can use code: BENG. I'll put that in the shownotes as well. So, you can go to BenGreenfieldLife.com/ketoneiq to try it, and use code: BENG. And, like Latt mentioned, if you get at Sprouts and you buy a bottle and you send it, what do they do? They scan it?

Latt: So, they buy a bottle. They scan the QR code. Follow the instructions.

Ben: There's a QR code on the bottle? Oh, yeah. It's right there. 

Latt: Yeah. And then, follow the instructions and we'll reimburse you for the first shot. 

Ben: Sweet. I love it. And then, all the shownotes if you guys have questions or comments or feedback for Latt and I, I do my best to review all those. You can go to BenGreenfieldLife.com/hvmnpodcast for the shownotes. 

Latt, I'm super glad you came up. You're in for some Frisbee golf, some ketone-powdered Frisbee golf this afternoon?

Latt: Yeah. More ketone power. Oh, yeah! 

Ben: Yeah. 

Latt: And, if you guys are interested in you know metabolic health in general, in science in general. How we break down science for example. You know, Ben does it very well, breaking down complicated science concepts into terms that people can follow, but also take away for healthy lifestyles, do follow H.V.M.N. podcast as well. 

Ben: Yeah, I forgot you guys have a podcast. 

Latt: Yeah. Because I interview — and this episode will be on H.V.M.N. podcast as well. 

Ben: Sweet. Awesome. Alright. Thanks, Latt.

Latt: Thank you very much. 

Ben:  More than ever these days, people like you and me need a fresh entertaining, well-informed, and often outside-the-box approach to discovering the health, and happiness, and hope that we all crave. So, I hope I've been able to do that for you on this episode today. And, if you liked it or if you love what I'm up to, then please leave me a review on your preferred podcast listening channel wherever that might be and just find the Ben Greenfield Life episode. Say something nice. Thanks so much. It means a lot.



If you've looked into ketosis or ketone supplementation, then, you've probably heard of H.V.M.N., which stands for “Health Via Modern Nutrition.”
While forming the company Woo was an entrepreneur in residence in the Entrepreneur-in-Residence program of Foundation Capital, while Brandt worked as a Google employee, a freelance photographer, and an adjunct professor at the Academy of Art University.
Since that time, ketones and ketone research has exploded, and in 2018, HVMN products affiliated with United States Special Operations Command were tested as part of Operation Tech Warrior hosted at the National Center for Medical Readiness. In the 2019 Tour de France, multiple cycling teams including Team Jumbo–Visma and Lotto–Soudal confirmed use of ketone ester for performance and recovery.
This episode is all about what HVMN actually makes and how their products work, including how to time and dose ketones as a supplement.
My guest on this show is Dr. Latt Mansor, who holds a PhD in Physiology, Anatomy and Genetics from the University of Oxford. He also holds an MA (Columbia University) and BS (University of Nottingham) in Biotechnology. Latt brings over a decade of experience spanning academic research, health technology, and pharmaceuticals. As H.V.M.N.’s Research Lead, he oversees the scientific development and clinical applications for all H.V.M.N. products (use code BGL to save 20%).

During our discussion, you'll discover:

-How Ben, as a triathlete, got introduced to ketosis…07:36

-Dr. Latt Mansor, reasearch lead at HVMN…11:59

  • Dr. Latt Mansor 
    • PhD in physiology, anatomy and genetics from the University of Oxford
    • over a decade of experience in academic research, health technology, and pharmacology
    • oversees the scientific development and clinical application for HVMN
  • Ketone-IQ Shots (use code BGL to save 20%)
  • also the host of the HVMN podcast
  • Ben uses Keto Brick to make cheese cakes

-When did Latt first start messing around with ketosis or get into ketones?…14:12

  • Latt was born in Malaysia
  • Brought up in a family with diabetes and cardio-vascular diseases
  • As a child was overweight
  • As an undergrad from the University of Nottingham
    • started learning about biotechnology, physiology and metabolism
  • Started exercising
  • His final year project was a mathematical model of adipose tissue metabolism
    • adipose tissue is the main fat storage in the body
  • Started losing weight – lost 45 lbs. in 1 year
  • Research continued with his Masters in Biotechnology at the Columbia University, focused on
    • drug development
    • pharmaceutical sciences
  • Learned how the world treats diseases
  • As a scientist wanted to have impact on people’s lives
  • Found a job in a pharmaceutical company
    • worked for a year and was inspired by the scientists there
  • Applied for a PhD in Oxford
    • specialized in cardiovascular disease and diabetes
    • researched metabolism of Type 2 Diabetes in hypoxia
  • Differences between fat metabolism and glucose metabolism in hypoxia
  • Looking at the link between cardiovascular diseases and diabetes
    • using hypoxia as a subset of ischemia
    • cardiovascular disease causes hypoxia
  • Ben's podcast with Gary Brecka:
  • When you have clotted arteria your heart isn’t getting enough oxygen and wastage going out
  • Researched the ability of heart to switch to glucose
    • found out that in diabetes there is much less ability to shift from fat to glucose
  • Worked in health tech and diabetes management program until 2019
  • Got introduced to HVMN via Dr. Brianna Stubbs, former research lead at HVMN
    • honesty, transparency and scientific integrity
    • constantly improving products
  • First ever exogenous ketone in the market, Ketone Ester to Ketone IQ
  • While he was in research, he looked at ketones as just a side product
  • When he joined HVMN, started on a keto diet
  • At the moment, on a low carb diet
  • Wanted to have the benefits of ketones without conforming to a strict diet
  • Latt is also the host of the HVMN podcast

-What is ketoacidosis?…24:34

  • When you have high levels of ketones in the presence of high levels of glucose
  • It's like you are starving but at the same time have an abundance of substrate
  • The increase in ketones lowers blood ph, potentially causing death

-If somebody has diabetes, should they not be using ketones?…25:44

-How come ketones lowers blood glucose?…26:42

  • Ben experienced being pale and clammy after taking ketones before dinner
  • Had a low of blood glucose, in the 40's after he tested with a CGM
  • Exact mechanism of action is not known but the hypothesis is that ketones signal the liver to reduce production of  glucose via gluconeogenesis
  • Metabolism consists of anabolism and catabolism – building up and breaking down

-If you are fasting all day and you take ketones that result to a drop in blood glucose, can you just eat carbohydrates?…28:36

  • If you start feeling unwell because of very low blood glucose, eat carbohydrates
  • Ben's experience when using ketones

-Ketone IQ as DNA protection…29:46

  • Ketone IQ (use code BGL to save 20%)
    • Small bottle (Shots) – 10g of R-1,3-Butanediol (each 59ml serving contains 10g of ketones)
    • Big bottle – 100g or 10 servings of R-1,3-Butanediol (each 35ml serving contains 10g of ketones)
  • Ketones have DNA protective effect
  • Great mitochondrial protection especially against radiation
  • Just concluded review of a grant application to the European Space Agency
    • to get Ketone IQ to astronauts for protection against ionizing radiation
    • cosmic galactic radiation

-The difference between BHB, Ketone Ester, and R-1,3-Butanediol…39:23

  • Our bodies are designed to create and metabolize ketones
  • We produce 3 types of ketones
    1. Acetoacetate
    2. Acetone
    3. BHB (β-hydroxybutyrate) – is the main form of ketone in the body
  • There is a powder supplement called Free BHB Acid – causes GI issues
  • Twenty years ago, DARPA was looking for potential super fuel to power soldiers for demanding missions
    • Toyed around the idea of exogenous ketones
    • As a result, they came up with ketone ester
      • They bound BHB to butanediol
      • Butanediol goes to the liver and is converted directly to BHB
  • When you drink ketone ester
    • the esterase cuts the ester bond
    • BHB goes to the blood
    • butanediol goes to the liver, gets converted to BHB in slow releasing form
  • That’s the ketone ester HVMN brought to the market in 2017
  • Drinking ketone ester
    • raises blood ketone levels 3-5 millimolar
    • just above 1 millimolar – start to get into ketosis
    • above 3 millimolar – you get to feel really stable
    • above 7 millimolar – danger of going into ketoacidosis
  • It was earlier thought that 3.5 was good
  • Dosage and measuring ketones
    • Nutritional ketosis – above 0.5
    • Therapeutic ketosis uses (epilepsy, diabetes, cardiovascular diseases) – above 1 millimolar
    • Performance ketosis – 1.5 to 2.5
    • more than 3 – going to acidification of the blood and ph lowering
    • acidification of the blood upregulates all cardio-respiratory stress biomarkers to expel the CO2 to neutralize blood ph
      • heart rate
      • breathing rate
      • have higher RPE (Rating of Perceived Exertion) during exercise
  • To measure ketones
    • keto mojo
    • Precision Xtra
    • blood measurement measures BHB
    • breath measurement – measures acetone (not very accurate)
    • urine measurement- measures acetoacetate (not very accurate)

-What was the DARPA grant actually for?…46:00

  • In 2017, started STTR (Small Business Technology Transfer) Phase 1 trial with SOCOM (Special Operations Command)
    • looked at the decline in cognition in hypoxia
    • that decline was mitigated with Ketone Ester
  • Got funds for Phase 2 study
    • the study was prolonged, way longer, because of COVID
    • more conflicting studies and data came out during that time
  • Offered the product with refund so everybody can try
  • With Butanediol, the increase of BHB in blood is slow and steady – the liver is the gate keeper
  • In an internal study, Latt took 80g (not recommended) – his blood BHB did not go higher than 2.5 – just felt sleepy
    • the study was for safety and tolerability
  • Recommended is 1 dose – 10g Ketone IQ Shots (use code BGL to save 20%)
  • The slow increase in blood BHB gives people more time in ketosis
  • Why the switch to butanediol
    1. pharmacokinetics
    2. price point
    3. taste – ketone ester still tastes horrible
  • One of the tasks of the $6M grant was to improve the taste

-Is it because of Butanediol high dose that it simulates the effects of alcohol?…52:13

  • KetoneAid Ketohol simulates cocktails
  • It falls to the dosing – anything high dose makes you ill
  • It could be the hypoglycemic effect that is simulating the relaxing effect of alcohol
  • Ketones act upon the GABAergic pathway where it has an anxiolytic effect
  • The running community use THC for performance
  • Ketones is like an adaptive fuel
    • seen in studies that it has opposing effects
    • gives calm energy and yet gives better performance
  • Appetite suppression –
    • ketone ester decreases ghrelin
    • R-1,3-Butanediol has leptin sensitizing effect
  • Ben's experience with the adaptogenic effects of Reishi mushrooms
    • relaxes when ready for a nap or to settle down
    • gives energy when you want more energy
  • Ketones and inflammation
  • With regards to sleep, more research needed
    • Some people claim to get better sleep

-Breath hold practice and ketones…1:01:17

  • Ben had 40 extra seconds on breath hold after taking ketones
  • Similar to what was seen in military projects with hypoxic chamber
    • Oxygen saturation decreased from 99% to 65%
    • with ketones decreased to only to 72%
    • a 7% increase in Oxygen saturation
  • A paper is coming out soon about this study
    • study using masks and hypoxic chamber
  • The study also followed the 10th Special Group into the mountains during training
  • When in hypoxia, glycolysis is upregulated
  • With ketones, increase in the amount of Oxygen you are able to carry 
  • Ben's blood glucose is now at 78
    • 87 at the start of the podcast
    • peaked during the morning walk at a 100

-Ketones and exercise…1:04:42

-New research on ketones related to anaerobic performance…1:09:58

  • Ketones are more related to fats
  • Glucose is always the king when it comes to anaerobic
  • No one has done studies on ketones and anaerobic performance
  • HVMN partnered with University of North Georgia, a military college
  • Did an extreme test (5k run and anaerobic wingate test) and measured the ketones
    • had ketones before and after the 5k run
  • Anaerobic Wingate test:
    • 5 bouts of 10 sec sprints on the bike with 7.5% body weight as load
    • 10 sec sprints/ 30 sec rest 5 times
    • ketones measured after
  • Saw an increase in average power, peak power and velocity
    • paddling harder and faster
  • Also measured fatigue level
    • people on Ketone IQ and carbs experienced less fatigue than the placebo group
  • RER (Respiratory Exchange Ratio) results –
    • ketone IQ and carbs group had significantly lower RER – burning more fat than glucose
    • placebo group – 0.94
    • ketone IQ and carbs group – 0.89 –
    • ketone IQ and carbs group had a decrease in ketone levels
  • Another reason for better performance can also be increased pain tolerance
    • potential analgesic effect on the brain

-Lactate as alternative fuel to glucose…1:17:26

  • Lactate was not measured between the two groups
  • Lactate and ketones for traumatic brain damage recovery
  • The End of Alzheimer's by Dale Bredesen
  • A pilot study in partnership with the Naval Health Research Center on TBI and the use of Ketone IQ for recovery
  • The University of Western Australia is also going to start a study on TBI using Ketone IQ
  • In the case of traumatic brain injury, within the first 48 hours
    • Hypometabolism of glucose – the brain starts taking all the glucose
    • 7 days after – decrease of glucose metabolism
    • huge increase of lactate
    • years after, patients experience glucose metabolism – are not good in metabolizing glucose
    • very similar to Alzheimer's disease – also called type-3 diabetes
  • There is some form of insulin resistance, the brain can’t utilize glucose
  • That’s where ketones come in
    • ketones are the brain's super fuel, ketones can bypass insulin resistance
    • anti-inflammatory properties of ketones
  • Under normal circumstances, glucose is the brain's fuel
  • Important for a failing heart – the heart upregulates ketone metabolism

-Are ketones safe for kids?…1:24:10

  • Ben’s sons just took their first dose of ketones
  • Ketone IQ is safe for kids
  • Babies spend most of their time in ketosis
  • Ben's sons' regular diet and supplements:
  • Ben is thinking of adding ketones to his sons' diet
  • No studies or trials on cognitive performance
  • Benefits are reported by users of Ketone IQ
  • Every activity that requires brain power, Ketone IQ provides the fuel you need

-What goes well with ketones?…1:28:26

  • Combining ketones with nootropics like modafinil and microdoses of plant medicines
  • Stacking with aminos
  • Latt takes green tea and ketones for pre workout, protein shake after workout
  • Ben’s blood glucose – 78 (could have taken a total 60g for the day)
  • Ketone IQ (use code BGL to save 20%)

-And much more…

  • Scan the QR code on the bottle, follow the instructions, and you will be reimbursed for the first shot!

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Resources from this episode:

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