57: Exogenous Ketones with Dr. Ben Bikman

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In this episode of The Metabolic Classroom, Dr. Bikman explores the history, science, and benefits of ketones, focusing on exogenous ketones.

He begins by explaining the fundamental chemistry of ketones, emphasizing the difference between endogenous (produced within the body) and exogenous (introduced from outside the body) ketones. The three main ketones discussed are acetoacetate, which can convert to either acetone (excreted from the body) or beta-hydroxybutyrate (BHB), the primary ketone measured in metabolic assessments. Ketosis, the state of elevated ketone production, is typically inhibited by high insulin levels, which direct metabolic processes away from ketogenesis towards lipogenesis (fat creation).

Ben highlights the significant benefits of ketones for brain health. He disputes the common belief that glucose is the brain’s preferred fuel, citing research by Dr. George Cahill that indicates the brain relies heavily on ketones during fasting. Ketones have been shown to improve cognitive function, reduce oxidative stress, and alleviate symptoms of neurological disorders like Alzheimer’s and epilepsy. Beyond brain health, ketones enhance physical performance by increasing ATP production efficiency in muscle cells and boosting metabolic rates in fat tissues, thus promoting fat loss.

The classroom also addresses the evolution and advantages of exogenous ketones. Early forms of exogenous ketones, like ketone salts, had limitations such as mineral imbalance and poor taste. Advances led to the development of ketone esters and bioidentical BHB, which are more effective and palatable. Exogenous ketones can help control appetite, reduce inflammation, and improve exercise performance. Despite initial concerns about their potential to be converted back into fat, Professor Bikman clarifies that this is not a risk, as the liver cannot reverse ketone production into fat.

Overall, Dr. Bikman emphasizes that while ketones themselves offer numerous metabolic benefits, the primary advantage of a ketogenic state is maintaining low insulin levels, which supports fat burning and overall metabolic health. He encourages the use of exogenous ketones to enhance these benefits, particularly for managing cravings, improving physical performance, and supporting cognitive function.

00:01 - Introduction to Ketones
01:58 - Types of Ketones - Explanation of the three main types of ketones: acetoacetate, acetone, and beta-hydroxybutyrate.
02:58 - Ketones and Blood Acidity - Discussion on how ketones can affect blood acidity and the distinction between ketosis and ketoacidosis.
04:04 - Insulin's Role in Ketone Production - How insulin levels determine whether the body produces fat or ketones from acetyl-CoA.
07:23 - Benefits of Low Insulin Levels - Overview of the metabolic benefits of low insulin levels, including improved fat burning and metabolic health.
08:19 - Ketones and Brain Health - The positive effects of ketones on brain function and cognitive health, debunking the myth that glucose is the brain's preferred fuel.
13:33 - Ketones and Physical Performance - Evidence that ketones improve physical performance and energy efficiency in muscle cells.
17:31 - Anti-inflammatory Effects of Ketones - Ketones’ role in inhibiting inflammation and their benefits for inflammatory disorders.

#Ketones #Ketosis #ExogenousKetones #MetabolicHealth #InsulinResistance #BrainHealth #CognitiveFunction #WeightLoss #FatBurning #KetogenicDiet #LowCarb #Inflammation #Type2Diabetes #PhysicalPerformance #benbikman

Studies Referenced:

Alzheimer’s and Parkinson’s (Cunnane et al., 2016): https://alzres.biomedcentral.com/arti...

Ketones Elicit Distinct Alterations in Adipose Mitochondrial Bioenergetics: https://pubmed.ncbi.nlm.nih.gov/32872...

Ketogenic Diet Reduces Midlife Mortality and Improves Memory in Aging Mice: https://pubmed.ncbi.nlm.nih.gov/28877...

The Effects of Ketogenic Diet on Insulin Sensitivity and Weight Loss, Which Came First: The Chicken or the Egg?: https://pubmed.ncbi.nlm.nih.gov/37513...

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