Diet & Weight Magazine

Diet Doctor Podcast #20 — Dr. Ryan Lowery

By Dietdoctor @DietDoctor1

Ryan is an expert in human performance and in ketogenic diet, but also bridges this gap between science, academia and implementation for the everyday person, for health and performance not just from an athletic stand point but from just an overall life performance. He has over 100 published articles in peer reviewed journals, book chapters, and then he has also published his own book "The Ketogenic bible".

Ryan is a wealth of information and can talk on a lot of different topics from authority, and I really appreciate about that, I really appreciate that about him, so I hope you enjoy this conversation. We touch on a lot of different topics and go a lot of different directions, but there's a bunch of nuggets in here that you can walk away with, to really help you in your daily life.

So if you want to learn more and see the full transcripts go to, otherwise sit back, relax and enjoy this interview with Dr. Ryan Lowery.

Ryan Lowery, thanks so much for joining me on the Diet Doctor podcast today.

And then as I went throughout college I started diving more and more into the actual literature, actual research and soon after traveling to all these different conferences, I started realizing there is so much great information, but the challenge is scientists speak at this high, high level, it really just goes over people's heads.

And I'm like, how do you take that information, that such high quality information and not, I don't like to use the term dumb it down, but how do you make it relatable, how do you take that information and translate it, and be able to put it into practical, meaningful use. And ultimately, that's what we do at ASPI, the Applied Science and Performance Institute, we said, you know what, how do we take this cutting edge research, look at everything from the full spectrum of performance, high level athletes to people with neurological conditions... how do we take that research and then be able to get that message out to the world?

And a lot of the time, people think performance and they think- and they immediately go to athletes, and like you said, we work with the most elite athletes in the world and for them a millisecond can mean the difference between gold and not even placing, so, it's very intense, but also, at the same token, performance also is a grandfather being able to get up and play around with his grandchildren, like, that's performance as well.

So how do we work both ends of the spectrum and use the science and the technology to be able to apply it to both? And that's what we are trying do today at ASPI.

The thought is we need more protein to build muscle and one of the things I've ever heard you say is we need less protein on a ketogenic diet. So tell us a little bit about what you learned about building muscle on a keto diet, and how protein plays into that.

So we were really one of the first ones to look at this and we say, what if we take two groups, and we took a Western diet group, and like we took people who were eating a healthy Western diet and a ketogenic dieting group, we matched them for protein intake.

So, both groups had about 20% of their calories from protein, and then we trained them for eight weeks, and at the end of that period, we looked at muscle mass and we did a dexa body composition, and we looked at their lean body mass and there were no differences between the people who were eating carbohydrates and the people that were eating a well formulated ketogenic diet.

And their protein was matched and so it was kind of like this eye opening thing, and people were like, "There's no way... How's that possible?" So, we took a deeper dive and started doing more animal studies looking at things like muscle protein synthesis, muscle protein breakdown, we know that ketones themselves prevent the breakdown of like leucine, which is a very important amino acid for maintaining muscle.

We also found out that- and this is pretty new, is that ketones themselves can stimulate muscle protein synthesis. So, kind of to your second point is... Do we need more protein? Do we need less protein? I think that two reasons; one because of the elevation in ketones themselves being anabolic in nature you likely probably need less protein than a normal individual.

And two, just from general research we know that the more insulin sensitive you are, the more likely you are going to response to a lower dose of protein to trigger muscle protein synthesis. It's one of the reasons why, if you take a 20-year-old, who is highly insulin sensitive and take a 70 year old, who might be more insulin resistant, in order to turn on the switch, or trigger muscle protein synthesis, the 20 year old might only need 20g of protein, the 70 year old year might need double that, 40g of protein.

So what if you were to have that 70 year old be at the same degree of insulin sensitivity as the 20 year old, maybe that's the difference, in- the more insulin sensitive you are, likely the lower the amount of protein that you need to initiate that response.

You need a place to have that storage, you want to prevent sarcopenia, because we all know that the minute that you fall down and break a hip, it's like things start spiraling downhill from there. So how do you maintain? And if you're trying to improve it, minimum keep the amount of muscle mass that you have, I think those are two very important things, when it comes to how do I keep muscle mass and utilize a well-formulated ketogenic diet to do that.

Glycogen is stored inside muscles and when you first start a ketogenic diet, sometimes that can be attributed to the water that's coming from the fat mass, lean body mass, whatever that may be, that can contribute over time, as you adapt you start to replenish and upregulate pathways to increase glycogen, so it's like about the same as it was prior to doing it, but I think if you're on a well-formulated ketogenic diet, and you're having an adequate amount of protein, people won't see muscle mass loss.

Because when people switch to a ketogenic diet and then they're eating that way, a lot of times people feel less hungry all the time, so they might only eat one or two meals a day and they're not used to getting in enough protein, and so sometimes I see people eating one meal per day, they might be getting in 20g of protein in that meal and people are like, "Why's my hair falling out? Why am I getting keto rash?

I'm like, those are clear signs of protein deficiency. So, I encourage people to get enough, I'm like make sure you're getting enough, but just don't go overboard with it, there's no reason to go body builder, 300g per day.

It's not like they're taking that in and they're doing a cheat day, sitting on their butt and watching TV, it's like they're actually going in and utilizing that fuel source and utilizing the carbohydrates for what they're meant to be, which is this tool or a potential ergogenic aid not as a necessity that I'm just having because.

If you're fully adapted, I don't know that yet, because I think that ketones can provide some quick energy, but certainly in the aerobic sports, I think being a ketogenic fat adapted in some capacity is way better than running into the wall or hitting the wall and running out of glucose, having all those gels and goo's and everything and it messes up your stomach and I think for aerobic it's very clear. In between is what people- like I think that Brazilian Jujitsu, we work with a lot of Brazilian Jujitsu, MMA is starting to get a lot of attraction for it.

It's very big in sports, that where the weight to power ratio becomes very important, wrestling, things like that, because your goal is how do I fight or compete at the lowest weight possible, yet maintain or maximize my power and output in strength, how do you do that? I think that being on a well-formulated ketogenic diet ultimately allows that, because when you cut down and you're not on a ketogenic diet, you're at risk for muscle mass loss, you're losing strength, you're losing power, what if you can preserve that?

And like we were talking about, maybe due to the elevation of ketones, maybe even preserve that muscle mass when you're dieting down to a different weight class and still be able to perform.

How do you gauge whether someone is adapted and how do you know when they reach that point? Is it their respiratory quotient on a cardio metabolic test or is it some other testing you can do? Because this seems very vague at this point.

We know that the keto adaptation, there are ways to accelerate it, doing things like intermittent fasting, making sure you're supplementing with the proper electrolytes.

Doing high intensity interval training, depleting muscle glycogen levels as fast as possible, it's one of the things I tell our athletes all of the time, is like if you're going to do this, like fight through it, like try and do it as quick as possible, like I know you're not going to- you're like hey I want to have my best work out, but fight through it, deplete that muscle glycogen, because what's on the other side is a lot better, so the quicker you can get through it, the quicker you can adapt, the more you're likely to sustain this and be able to make it a lifestyle.

Just go on a walk, get moving, try and deplete muscle glycogen levels, maybe incorporate in some intermittent fasting, make sure you're supplementing with electrolytes and having thins like bone broth, make sure you're incorporating those things in, because the quicker you can adapt, the less likely you are to be like, you know what, I'm just having a headache and this isn't worth it.

Now I heard you're doing a whole certification process now with your company, to certify these. So, tell us a little bit about your concerns of what's in these keto package products and how your certification process is going to help with that.

So I go to the movie theatre and I have like four pieces of this sugar-free Reeses going in and I was like, oh gosh, my stomach was- it was killing me, I was like, "There's no way I'll do that again", but people don't know that.

And I think it's sad to see products like that, that have so much sorbitol and maltitol, so that's my biggest concern, is not only are there sugar alcohols that can cause a spike, there's also various different sweeteners, but there's also like fibers, it's not like fibers are all created equal, and I think we're starting to see some regulations starting to change. It's just not fast enough yet.

So I hope it's not malicious on the company's part, I hope it's just a lack of understanding on the RND. Yeah, it's easier to make something with sorbitol and maltitol, yeah, it's easier to use a fiber known as isomaltose oligosaccharide.

It's all about the intent and the research and development behind the product, to make sure it's done the right way and so we want to be kind of a voice, a reason to help further that and say, we'll not only test these out and look at all the ingredients, but we're actually going to test this out and do blood testing to make sure these things are tested properly.

But erythritol is probably one of the better ones, stevia, monk fruit, things like that. I'm starting to see a new trend, which I'm excited about, because we're starting to do research on this, it's actually a rare sugar and people freak out because they hear the word sugar, but it's called allulose, and we're starting to see it pop up more and more, but it tastes just like sugar.

But we've actually done research where 92% to 97% of it is completely excreted out of the body and it causes no glucose response, no insulin response. We're actually collaborating with someone overseas that is working with type 1 diabetics and just giving them allulose and their glucose is dropping and no increases in insulin.

And that's partly why I recommend whole foods only and I understand that people are still going to crave that sweet tooth, but I love it when someone comes back to me and says, "Carrots taste so sweet now", whereas before they could just pop carrot after carrot and not even blink, but now even a carrot tastes sweet, I'm like yes, you've trained your taste buds, you're doing it right, so I think that's so interesting.

So, we talked about athletes and athletic performance and one of the other things you've talked about is longevity and that's a huge topic right now, not just longevity but also health span, living healthy as long as we can. And so there's some thoughts that a ketogenic diet and ketones have a positive benefit for longevity, obviously we don't have 20, 30, 40 years studies on it, but tell us your thoughts on where the science is for that, and where the hypotheses are for that and what you're most excited about for ketosis for longevity.

So that's one thing, if you'd just be careful with what information you're taking in, that's why the Diet Doctor does an amazing job, you do an amazing job, putting out this information that's legitimate information, not something that's just, "Hey here's a study. Let me misinterpret it from media and press and pump it out there."

We looked at everything, we looked at every marker you can think of- we're still looking at markers inside of tissue, everything you can imagine and what we found was that animals that were on a ketogenic diet, their half-life, meaning that the amount of time it took for half of the animals in that group to die was almost double the amount from the Western dieting group.

Which was very, very interesting and these animals lived significantly longer, and we just carried them out, let them live throughout entire lives and fed them a ketogenic diet versus like a traditional Western diet and even though protein was matched, they still lived longer.

And both ketones themselves can help with that via through a ketogenic diet or even ketones themselves, partly because if you look at studies on ketones, it downs, it shuts off the NLRP3 inflammasome, it blocks the NLRP3 inflammasome, which is the main marker of inflammation, so it's tough to titrate it out, but it seems to be, just being in a state of ketosis seems to be driving that response.

It's very individualized when you're talking about like low-carb versus ketogenic, but like 40% or 30%, which is what some of those studies are doing, like mortality studies, I wouldn't even consider that low-carb. To me is still a really high carb.

There's treating different diseases, like traumatic brain injury, Alzheimer's or Parkinson's, there's athletic performance, and then there's general health, how exogenous ketones fit into those three categories, because they're very different. So, tell us a little bit about how you see and how you use exogenous ketones.

And I think it's been refined since of understanding like, it's not a magic supplement, it's not going to magically melt body fat off of your body. If you're talking about general health to your point of like inhibiting HDAC and somebody's longevity, there's a possibility that ketones themselves, there are studies, like in the C. elegans, they were utilizing just exogenous ketones.

They weren't putting them on a certain diet, they were utilizing exogenous ketones. We've done studies in animals, utilizing both a combination of a ketogenic diet and exogenous ketones and saw a slightly better result for like things like increasing brown fat, decreasing food deficiency, which is the amount of weight you gain over the amount of food you consume. So, for general health that's really the application.

The other application where the weight loss can come from consuming exogenous ketones it's when people consume exogenous ketones they seem to feel more satiated, so the thought process is like, if you're consuming exogenous ketones and you're extending that fasting window, if that's something, it's the same reason why if you have a little bit of MCT oil inside of your coffee it can extend your fasting windows, so you're eating less within that window, that ultimately long term will help with body composition and weight loss.

So, I think a lot more people are starting to report seeing that and utilizing it for that benefit, versus hey just drink this and then I'm going to go and eat a ton of carbs on top of it, but to the other aspects we're starting to see more and more research on performance, there's some early studies with the ketone ester on performance, we're starting to see some now with ketone salts, looking at athletic performance, so there is potentially an application there, and then to your point I think starting to utilize some of these interventions for things like neurological conditions, where there's an energy gap, right.

We're starting to call Alzheimer's type 3 diabetes, and the problem is the receptors in the brain are insulin resistant, they're not able to properly take up and utilize glucose as effectively as they used to, prior to having that diagnosis. So, how do you provide a fuel source to the brain that allows individuals to get something to there? Doctor Marian Newport, has a great, great TED talk, she wrote a book on this, talking about how with her husband- He wouldn't go on a ketogenic diet and it's tough when you're dealing with family members.

He wouldn't eat it, but what she would do, is she would give him spoonfuls of coconut oil at the time and then the ketone supplements started becoming more and more readily available and she started giving those, but her, she was just like, "How do I get some type of elevation of a substrate that his brain can actually utilize?"

And she saw amazing improvements, even with just coconut oil, utilizing that to try and get that fuel source to the brain. So, to your point, I think there are different applications and it's just using it in context as a tool, not a crutch.

We're starting to replicate that and see it more and more, where again I think it's an energy gap, and so if you're providing these individuals with a fuel source, that they can utilize, one of the reasons I think exogenous ketones can play a role is, say you're taking a professional athlete, we work with NFL athletes, if they're not on a ketogenic diet during the season, what can you give them... boom, they take a huge hit, they have a concussion, something immediately after, yeah you can fast them but we just talked about, it takes time to adapt, but they have to play again the following Sunday.

How do I give them something that will give their brain a fuel source immediately, versus delaying that process, all of a sudden, the brain starts starving and we start building towel plaques, we start developing CT? How do you provide a fuel source immediately after that trauma? I'm interested in seeing that, I think one day we'll see on the side lines of some of these contact sports, like rather than drinking a huge sugary drink, we'll start seeing some incorporation of like exogenous ketones to be able to provide a fuel source to the brain that it can take up and utilize.

Now when it comes for exercise and fasting, it can have different effects on the body depending on what our goals are, so how do you think about fasted exercise versus fueled exercise and who's it right for?

I think one of the most incredible studies that I don't think is out there yet, that would be done, and I have a theory on this, but like I when I intermittent fast, most people do this, they tend to skip breakfast, they might eat sometime in the afternoon and then they'll have something for dinner, just because it's convenient, it's the convenience.

Based on non-ketogenic studies, if you look at studies that have given a larger breakfast meal and a smaller dinner meal, there seems to be more benefits. Eating a larger amount earlier on the day, versus later on in the day, in non-fasting, non-ketogenic conditions, seems to be more ideal. I think if it were more feasible for most people, eating in the morning and then eating at lunch and then probably not having anything at night would probably yield better results than not eating in the morning, eating at lunch and eating at night.

It's just my theory based on the fact that you're more active throughout the day. You're going to be utilizing those calories and then a lot of those times people will eat a big meal at dinner and then two hours later be laying in bed or sitting on the couch, watching Netflix or something.

But a lot of these things seem to go along with that, but logistically and socially, it's just hard when the big meal, you know, is the social meal with the family and the kids and you're going to skip it, it makes it hard.

I think there are other aspects to mTOR, because mTOR is a very complex pathway that multiple things can stimulate it. But I used to be of the thought process, like when I was literally trying to put on muscle mass, I used to set an alarm in the middle of the night at like three in the morning and get up and drink a weight gainer shake and a bunch of protein, because I was like, I need to hit this threshold as much as possible.

And it was like this crazy mindset like I'm trying to hit this as many times as possible throughout the entire day. And I was eating probably six meals a day with branch chain amino acids in between like each meal. And I was trying to keep it elevated. Now doing intermittent fasting, being on a ketogenic diet, I think I'm probably stimulating it, maybe two three times per day, but I think from my goals and what I'm trying to accomplish now, that's plenty. I mean, I think it's giving my body a break from all of the digest and giving it some time to rest as well.

Then I go and get a workout in, I like getting my workout in early, just because by the end of the day I'm tired and I want to go home and have dinner or something, so I get my workout in and go into the office and either have a bunch of meetings or just crank out some more work, and I usually finish around five or six o'clock at night and then I get home and I usually have my meal, which is like a moderate meal.

My lunch is typically, it's fairly small- it's big in volume and I think it's one of the biggest challenges that people forget about on a ketogenic diet it's one of the reasons why people incorporate in salads or vegetables, is to get more volume.

So, like my lunch hack for people that are listening is, I usually, if I'm on the go, if I'm in meetings, I like just having MCT powder with protein, some creatine, sometimes unsweetened almond milk and if I were to put that inside a blender or like a shaker bottle, or just blend it up, it might be a small amount of volume. But if you take that same amount, add some ice into it and throw it into a blender, you're adding air into the equation.

So that little amount now becomes this huge amount of volume that I pour into this huge styrofoam cup, and it takes me like 20 to 30 minutes just to drink it, because it's so much volume, but it's keeping me satiated all the way until the end of the day.

I think there's different ways or different hacks to increase volume that I think, it's sometimes when people struggle with overeating, I was one of those people where I came from eating six to seven meals a day and then all of a sudden cutting that back to two, is like wow, I need to figure out ways to increase the volume of my foods on a ketogenic diet, using a blender, and increasing that can help significantly.

And you don't have the muscle loss that sometimes can be attributed to like long, long, long duration cardio. So, I usually just do resistance training and high intensity interval training.

Always go back to your why and I think that's one of the biggest things to anchor people into this, you've got to think long term. A lot of times people look at temporary and then they're just like- or they want immediate results, I'm just like play the long game.

Understand that this is something that you want to ultimately help you 5, 15, 20, 40 years from now, you want it to be able to help and the decisions you're making today are ultimately going to contribute to that. So, yeah, I think on social media, you can follow me on Instagram, it's @ryanplowery. Sometimes people say "plowery" but my middle name is Patrick, ryanplowery and then on Facebook, doctor Ryan Lowery, we've just started to do some YouTube stuff on Doctor Ryan Lowery on YouTube as well.

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