Episode 153: Dominic D’Agostino discusses new advances in the study of nutritional ketosis

06/08/23 • 68 min

Today we have our good friend and colleague Dr. Dominic D’Agostino returning for his third appearance on STEM-Talk. Dom, as most of our longtime listeners know, is well-known for his research into the ketogenic diet and the physiological benefits of nutritional ketosis. Since our last conversation with Dom in 2019, a tremendous body of research has been added to the literature about the therapeutic potential of ketosis. The high-fat, low-carb ketogenic diet has been linked to advances in the treatment of Alzheimer’s, cancer, migraines, type-2 diabetes, psoriasis, sleep apnea, psychiatric disorders, traumatic brain injuries as well as a host of other diseases and disorders, which we cover in today’s interview.

In episode 14 of STEM-Talk, we talked to Dom about his development and testing of metabolic therapies involving the ketogenic diet for a wide range of diseases and conditions. In episode 87, Dom returned to reflect on his 10 years of research focused on the high-fat/low-carbohydrate diet.

In today’s interview, we talk to Dom about this latest work as well as his extensive research on hyperbaric oxygen. Dom is a tenured Associate Professor in the Department of Molecular Pharmacology and Physiology at the University of South Florida Morsani. He specializes in neuroscience, molecular pharmacology, nutrition, and physiology. Dom also is our colleague and a research scientist here at the IHMC.

Show notes

[00:02:50] Dawn opens the interview mentioning Dom’s recent IHMC Evening Lecture, in which he mentions the film “First Do No Harm” starring Meryl Streep. The film is based on the true story of a four-year-old boy diagnosed with severe epilepsy, whose extreme seizures continued despite extensive medical treatments. The boy’s mother reached to Dr. John Freeman, a physician who had successfully treated patients with a ketogenic diet. Dawn asks Dom to give some context about this fictional film based on a true story.

[00:05:05] Dawn asks Dom to discuss the many evidence-based applications of the ketogenic diet that he highlighted in his IHMC evening lecture.

[00:07:11] Ken asks Dom about another story involving Russell Winwood, a man with severe chronic obstructive pulmonary disease, also known as COPD. Russell reached out to Dom with respect to treating his COPD with a ketogenic diet.

[00:11:21] Ken asks if Russell only engaged in the ketogenic diet or if also used exogenous ketones.

[00:12:10] Ken mentions that the ketogenic diet has the broad potential to be an anti-inflammatory diet. Ken goes on to mention that COPD is an inflammatory disease. As Dom’s case report suggested, Ken wonders if the ketogenic diet has the potential to have strong therapeutic effects for other inflammatory conditions as well. Ken asks what other conditions Dom thinks might benefit from therapeutic ketosis.

[00:14:02] Dawn mentions that Dom has been busy since his last appearance on STEM-Talk, having authored or collaborated on more than 40 papers, one of which garnered a lot of attention and was published in Frontiers in Neuroscience. This paper investigated whether therapeutic ketosis via ketone esters could represent a viable way to treat epilepsy and other seizure disorders. Dawn asks Dom to elaborate on this paper’s findings and their significance.

[00:16:26] Ken mentions that those listeners who are unfamiliar with ketone esters may want to check out our interview with Dr. Brianna Stubbs. Ken asks Dom to give a quick primer on ketone esters and why so many researchers in the field are excited about their potential.

[00:19:20] Ken mentions that in addition to ketone salts and ketone esters, there are other product formulations out now, like the one from a company called Kenetik. Ken asks Dom what he thinks about this formulation.

[00:23:33] Dawn mentions that Dom has had a number of animal studies published since 2019 looking at ketone induced neuroprotection and asks Dom to give an overview of some of this work.

[00:25:57] Dawn asks Dom about his research on Angelman Syndrome, which is a rare genetic and neurological disorder that causes seizures, developmental delay, loss of body movements, and lack of speech. Dawn mentions that Dom was a part of a mouse study that explored whether ketone supplementation could mimic the ketogenic diet as an anticonvulsant, as well as the effects of ketone esters on behavioral and metabolic outcomes. The results of this study were promising, and Dawn asks Dom to talk about some o...

Show notes

[00:05:05] Dawn asks Dom to discuss the many evidence-based applications of the ketogenic diet that he highlighted in his IHMC evening lecture.

[00:11:21] Ken asks if Russell only engaged in the ketogenic diet or if also used exogenous ketones.

[00:23:33] Dawn mentions that Dom has had a number of animal studies published since 2019 looking at ketone induced neuroprotection and asks Dom to give an overview of some of this work.

Previous Episode

Episode 152: Mark Shelhamer talks about the effects of spaceflight on humans and NASA’s Planned Mars Mission

Today we have the former chief scientist of NASA’s Human Research Program, Dr. Mark Shelhamer. Mark specializes in neurovestibular adaptation to spaceflight.

He is an otolaryngology professor at Johns Hopkins School of Medicine and the director of the school’s Human Spaceflight Lab. He also the director and founder of the Bioastronautics at Hopkins initiative.

In addition to his work with NASA, Mark is an advisor to the commercial and consumer spaceflight industry. In today’s interview, we talk to Mark about some of this work, as well as the research he conducted on the first all-civilian crew that successfully orbited the Earth for three days in a SpaceX capsule.

We mostly talk to Mark, however, about how the harsh conditions of space imperil humans. We have a fascinating discussion about Mark’s role in NASA’s planned human mission to Mars and how he is investigating ways to maintain the health and performance of astronauts on such a long-duration spaceflight. We also discuss how the lessons Mark is learning about how the lessons of human spaceflight can be applied to healthcare on Earth.

Show notes:

[00:02:42] Dawn starts the interview mentioning that Mark grew up in Philadelphia in the ‘70s. She asks Mark what he was like as a kid.

[00:03:32] Dawn asks if it is true that Mark played drums in a band in school.

[00:03:54] Ken asks Mark to talk about an uncle who was key in fostering Mark’s interest in math and science.

[00:05:31] Ken mentions that Mark was only 10 years old when he took up an interest in electronics and asks what sparked that and what electronics he specifically found interesting.

[00:08:14] Dawn mentions that Mark attended Drexel University and initially wanted to become an electrical engineer but changed his mind somewhere along the way. Dawn asks what caused this shift.

[00:10:20] Ken asks Mark why he selected to attend MIT after Drexel.

[00:13:52] Ken asks Mark how he ended up at Johns Hopkins after finishing his studies at MIT.

[00:15:52] Dawn mentions that when Mark arrived at Johns Hopkins as a postdoc fellow in 1990, he continued the research he had been doing at MIT on sensory motor physiology and modeling, including astronaut adaptation to space flight. Dawn asks Mark to give an overview of this research as well as how he tracked back into studying astronauts.

[00:17:15] Ken mentions Mark’s 2007 book “Nonlinear Dynamics in Physiology: A State-Space Approach,” which provides mathematical-computational tools for analyzing experimental data. Ken asks Mark to talk about the book and its goals.

[00:20:43] Ken mentions that Mark has done quite a bit of research into motion sickness and vestibular issues, and asks about his more recent work on Space Motion Sickness.

[00:24:53] Dawn explains that on Mark’s Wikipedia page, there’s a reference to his pioneering work on a multidisciplinary approach to human space flight research. She asks Mark to give an overview of this work.

[00:29:17] Dawn explains that spaceflight has widespread effects on many different body systems at the same time, and that Mark has been an advocate for developing approaches to examining all these interactions in a rigorous way. Dawn asks if Mark feels that we should be taking this rigorous multidisciplinary approach and applying it to terrestrial medicine as well.

[00:34:08] Ken asks Mark to talk about some of the progress he has made in convincing certain groups that they need to embrace a multidisciplinary approach to their research.

[00:38:37] Dawn mentions that getting people, especially groups, to change their approach to research can be a daunting task. She goes on to mention that Mark has been quoted as saying “If there’s one thing I’m known for, it’s banging my head against the wall trying to convince people to do integrative research.” Dawn asks Mark how many scars he has on his forehead from these efforts.

[00:43:00] Dawn asks Mark to talk about his informal expertise on the history of NASA’s early stages of human spaceflight.

[00:48:54] Dawn explains that we may be on the cusp of another exciting time with NASA’s Artemis program and plans to return to the moon. Dawn also mentions that two years ago, the first all-civilian crew was sent on a 3-day mission orbiting Earth by SpaceX in a Falcon rocket. Dawn explains that there were several research projects related to Inspiration4 and that Mark was the principal investigator for one of them. Dawn asks Mark to talk about this project, which is part of a NASA-supported experiment to test and study astronauts through the year 2033.

[00:57:16] Ken points out the success of Apollo 17’s scientific inquiries thanks to Jack Schmitt being a scientist who had the chance to fly the mission as an astronaut. Ke...

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Episode 154: Orthopedic surgeon Brian Cole discusses advances in the treatment of knee, elbow and shoulder injuries

Today we have Dr. Brian Cole, an orthopedic surgeon who specializes in cartilage restoration, orthobiologics, and advanced surgical techniques for the treatment of knee, elbow, and shoulder injuries. He is the team physician for the NBA’s Chicago Bulls and the co-team physician for the Chicago White Sox. He also is the host of the Sports Medicine Weekly Podcast.

Brian practices orthopedic sports medicine at Midwest Orthopaedics. He also is a professor of Orthopaedics, Anatomy and Cell Biology at Rush University Medical Center in Chicago. He is Managing Partner of Midwest Orthopaedics and is the department’s Associate Chairman and the Section Head of the Cartilage Research and Restoration Center. In addition to this work, he also serves as the Chairman of Surgery at Rush Oak Park Hospital.

In today’s interview, we talk to Brian about his cutting-edge research into ways to treat knee, shoulder, and elbow injuries. Brian shares his novel approach to dealing with ACL tears, one of the most common sports injuries, and his investigations of methods to enhance the healing and recovery time following ACL reconstructions. He also talks about new advances in minimally invasive surgical techniques for many common injuries. We have a particularly interesting conversation with Brian about exciting developments in the use of stem-cell treatments as well as the use of bone marrow aspirate to treat injuries.

Show notes:

[00:03:53] Marcas opens the interview mentioning that Brian was in the eighth grade when he fell in love with a popular sit-com from the 1970s, “The Bob Newhart Show.” Marcas asks Brain what he loved about the show and what impact it had on him.

[00:05:07] Brian enrolled in the University of Illinois after graduating from high school. Marcas asks Brian if knew he wanted to major in biology and psychology when he arrived on campus.

[00:05:58] Ken mentions that after Brian’s undergrad, he travelled upstate to the University of Chicago, where he earned an MD and an MBA. Ken asks what led Brian to pursue both an MD and MBA.

[00:09:52] Ken explains that after the University of Chicago, Brian moved to New York City for an orthopaedic research fellowship in metabolic bone disease at the Hospital for Special Surgery. Brian also decided to do his residency there as well. Ken asks how that came about.

[00:11:31] Marcas mentions that after Brian finished his fellowship and residency, he went to the University of Pittsburgh for a sports medicine fellowship. Marcas asks what led Brian there and what drove his interest in sports medicine.

[00:13:10] Marcas asks Brian about a fortuitous phone call he received when he was a fourth-year resident.

[00:14:34] Ken explains that Midwest Orthopaedics is one of the nation’s most respected private orthopaedic practices. Ken notes that through a partnership with Rush University Medical Center, Midwest has developed a national reputation as a leader in sports medicine; hip, knee, spine, and cartilage restoration; as well as shoulder care and pain management. Rush also is an academic medical center that includes a 671-bed hospital and is a center for basic and clinical research. Ken asks Brian to describe the scope of the work that goes on at Midwest and Rush.

[00:17:20] Marcas comments that Brian is also the head team physician for the Chicago Bulls and the co-team physician for the Chicago White Sox, and asks Brian to describe some of the work that he does in that capacity.

[00:20:09] Marcas explains that Brian treats a wide range of patients with injuries and pain, from athletes to non-athletes, and from children to senior citizens, and that he has performed more than 20,000 surgeries over the course of his career. Marcas asks Brian to give a sense of the patients he sees and what his average day at the office is like.

[00:24:00] Ken points out that Brian is known for focusing on treating the patient and not the x-ray or MRI. Ken goes on to say that x-rays and MRIs often bog down both the practitioner and patient with too much information. Brian often refers to this overload as BARF and VOMIT. Ken asks Brian to explain what he means by BARF and VOMIT.

[00:31:56] Marcas reflects that a few decades ago, the only way to help someone with the loss of cartilage in the knee was to surgically go into the knee and clean up the debris. Bone on bone pain makes it difficult to walk, get up and down in a chair, and climb stairs. Marcas asks Brian to explain the range of options available to patients today in this regard.

[00:35:31] Ken mentions that in the past couple of decades, there have been numerous advancements in how to treat patients with shoulder, elbow, and knee injuries via non-surgical means, ranging from biochemical to pharmacological to diet and rehabilitation. Ken asks Brian to give an overview of these nonsurgical methods and the status of evidence supporti...