Tools of Titans

About

Download it here - [1]. It's a collection of life nuggets that Tim Ferriss learned from the 200+ people on his podcast.

Notes

• Ferris took copious notes of every workout, and most topics in his life. So he could repeat and regain his experience.

Text

RHONDA PERCIAVALLE PATRICKRhonda Perciavalle Patrick, PhD (TW/FB/IG: @FOUNDMYFITNESS, FOUNDMYFITNESS.COM ) has worked alongside notables including Dr. Bruce Ames, the inventor of the Ames mutagenicity test and the 23rd most-cited scientist across *all* fields between 1973 and 1984. Dr. Patrick also conducts clinical trials, performed aging research at the Salk Institute for Biological Studies, and did graduate research at St. Jude Children’s Research Hospital, where she focused on cancer, mitochondrial metabolism, and apoptosis. More recently, Dr. Patrick has published papers on amechanism by which vitamin D is able to regulate the production of serotonin in the brain and the various implications this may have for early-life deficiency and relevance for neuropsychiatric disorders. THE TOOTH FAIRY MIGHT SAVE YOUR LIFE (OR YOUR KIDS’ LIVES) Dr. Patrick introduced me to using teeth for stem-cell banking. If you are having your wisdom teeth removed, or if your kids are losing their baby teeth (which have a particularly high concentration of dental pulp stem cells), consider using acompany like StemSave or National Dental Pulp Laboratory to preserve them for later use. These companies will send your oral surgeon a kit, and then freeze the biological matter using liquid nitrogen. Costs vary, but are roughly $625 for setup and then $125 per year for storage and maintenance. Mesenchymal stem cells can later be harvested from the dental pulp of teeth for useful (e.g., bone, cartilage, muscle, blood vessels, etc.), life-changing (e.g., motor neurons for repairing damaged spinal cord), or potentially life-saving (e.g., traumatic brain injury) treatments using your own biological raw materials.HEAT IS THE NEW BLACK “Hyperthermic conditioning” (calculated heat exposure) can help you to increase growth hormone (GH) levels and substantially improve endurance. I now take ~20-minute sauna sessions post- workout or post-stretching at least four times per week, typically at roughly 160 to 170°F. If nothing else, it seems to dramatically decrease DOMS (delayed- onset muscle soreness). Focusing on endurance and growth hormone, here are some observations from Dr. Patrick: “One study has demonstrated that a 30-minute sauna session twice a week for 3 weeks post-workout increased the time it took for study participants to run until exhaustion by 32% compared to baseline. The 32% increase in running endurance found in this particular study was accompanied by a 7.1% increase in plasma volume and 3.5% increase in red blood cell count.” “Two 20-minute sauna sessions at 80°C (176°F)separated by a 30-minute cooling period elevated growth hormone levels two-fold over baseline. Whereas, two 15-minute dry-heat sessions at 100°C (212°F) separated by a 30-minute cooling period resulted in a five- fold increase in growth hormone. . . . The growth hormone effects generally persist for a couple of hours post-sauna.” TF: Hot baths can also significantly increase GH over baseline, and both sauna and hot baths have been shown tocause a massive release in prolactin, which plays a role in wound healing. I usually stay in a hot bath or sauna for about 20 minutes, which is long enough to significantly elevate my heart rate. I push a few minutes past dynorphin release, which usually makes one feel dysphoric and want to get out (but *not* to dizziness or lightheadedness). Generally, I’ll listen to an audiobook like The Graveyard Book by Neil Gaiman during the heat, then cool off for 5 to 10 minutes using an ice bath (I put 40 pounds of ice in a large bath to get it to roughly 45°F; more details on page 43) and/or by drinking ice water. I’ll repeat this cycle 2 to 4 times.✸ Three people Dr. Patrick has learned from or followed closely in the last year Dr. Bruce Ames, Dr. Satchin Panda (professor at the Salk Institute in San Diego, California), Dr. Jennifer Doudna (professor of biochemistry and molecular biology at UC Berkeley).“If the best in the world are stretching their assesoff in order to get strong, why aren’t you? ” Spirit animal: FalconCHRISTOPHER SOMMER Christopher Sommer (IG/FB: @GYMNASTICBODIES, GYMNASTICBODIES.COM ) is a former U.S. National Team gymnastics coach and founder of GymnasticBodies, a training system that I’ve tested for the last 8 months (no affiliation). As a world- renowned coach, Sommer is known for building his students into some of the strongest, most powerful athletes in the world. During hisextensive 40-year coaching career, Coach Sommer took meticulous notes on his training techniques— his wins and failures—so that he could translate the best elements into a superior exercise system for both high-level and beginner athletes. His four decades of careful observation led to the birth of Gymnastics Strength Training (GST). BACK STORY The combination of GST and AcroYoga (page 52) has completely remodeled my body in the last year. I’m more flexible and mobile at age 39 than I was at age 20. I’m going to skip explaining a lot(e.g., Maltese, Stalder press handstand) that is best seen in video or pictures, though I’ll describe the most critical (starting on page 53). Google is your friend. ON WORKING ON YOUR WEAKNESSES “If you want to be a stud later, you have to be a pud now.” Coach first told me this when I was complaining about slow progress with shoulder extension (imagine claspingyour hands together behind your back, arms straight, then raising your arms without bending at the waist). When in doubt, work on the deficiencies you’re most embarrassed by. My biggest weaknesses are shoulder extension and bridging using the thoracic spine (versus lower-back arch). After improving them 10% over 3 to 4 weeks—going from “making coach vomit” to merely “making coach laugh”—a host of physical issues that plagued me for years completely disappeared. To assess your biggest weaknesses, start by finding a Functional Movement Screen (FMS) near you. Related from Sommer: “You’re not responsible for the hand of cards you were dealt. You’reresponsible for maxing out what you were given.” “FLEXIBILITY” VERSUS “MOBILITY” Sommer’s distinction between “flexibility” and “mobility” is the most concrete and clear I’ve heard. “Flexibility” can be passive, whereas “mobility” requires that you can demonstrate strength throughout the entire range of motion, including the end ranges. See the J-curl and pike pulse exercises on pages 15 and 18 for two examples of mobility, which can be also be thought of as “active flexibility.” The pike pulse is a particularly cleardemonstration, as it tests “compression strength” in a range that most people never experience. CONSISTENCY OVER INTENSITY “Slow down. Where’s the fire?” This is Coach’s constant reminder that certain adaptations take weeks or months of consistent stimuli (see page 160). If you rush, the reward is injuries. In GST, there are surprising stair steps after long periods of zero progress. Roughly six months into doing his “hamstring series” with minor gains, I seemingly doubled my max ranges overnight. This was completely unsurprising to Sommer.“I used to tell my athletes there are stupid gymnasts, and there are old gymnasts, but there are no old, stupid gymnasts because they’re all dead.”“DIET AND EXERCISE” → “EAT AND TRAIN” Coach Sommer dislikes the fitness fixation on “diet and exercise.” He finds it much more productive to focus on “eat and train.” One is aesthetic, and the other is functional. The former may not have a clear goal, the latter always does. THEY FAILED WARMUP! Coach describing his first-ever seminar for non-gymnast adults, in roughly 2007: “We’ve got all of these beasts there [advanced lifters], and they’re strong. I tried to do my entry-level plyometric group work and some floor work with them. The stronger the athlete, the fasterthey went down: knees, lower back, ankles . . . from baby stuff. We’re not talking anything hard. We’re talking about standing in place, and, with knees straight, being able to bounce down the floor using just your calves. “No way. Their tissues couldn’t take it. They hadn’t done anything like it. [To show you] how bad mobility was, we had 15 minutes on the schedule to stretch. Nothing intricate, nothing intense —just an easy, basic stretch. Get them loosened up for the day. That stretch took an hour and a half to complete. There were bodies lying everywhere. It was like I was in Vietnam or filming a war movie. I turned to my staff, and I’m like, ‘What the fuck am I supposed to donow? They failed warmup. They failed warmup.’” WHY THOSE OLYMPIC BOYS HAVE GIGANTIC BICEPS Male Olympic gymnasts don’t have biceps the size of their waists from curls. It comes largely from straight-arm work, especially Maltese work on rings. But how on earth can you practice a Maltese as a novice? I use a 50/50 pulley system to cut my body-weight resistance in half, which is similar to the Ring Thing (Power Monkey Fitness) or generic “dream machine” that Jason Nemer (page 46) loves using. I combinethis with “power levers,” strap-on metal gauntlets that allow me to attach the ring ropes to my forearms anywhere between the elbow and the fist. This allows me to use progressive resistance, starting near the elbow and moving out to the hand. The best versions are currently only available in Europe, but there are vaguely similar “iron cross trainers” available in the U.S. 3 MOVEMENTS EVERYONE SHOULD PRACTICE J-Curl (page 15)Shoulder Extension: Lift a dowel behind your back (standing), or sit on the floor and walk your hands backward behind your hips. Thoracic Bridge: Elevate your feet enough to feel the bulk of the stretch in the upper back and shoulders, not the lower back. The feet might be 3+ feet off the ground. Ensure you can concentrate on straightening your arms (and legs, if possible),holding the position, and breathing. GOOD GOALS FOR ADULT NON-GYMNASTS The following goals incorporate many different aspects of strength and mobility into single movements: Beginner: J-Curl Intermediate: Straddle Press Handstand [ TF: I’m working on this] Advanced: Stalder Press Handstand SOMETIMES, YOU JUST NEED A VIBRATORCoach Sommer introduced me to a Russian medical massage specialist who recommended I use the plug-in (not cordless) model of the Hitachi Magic Wand on its high setting. I’ve never experienced such heights of ecstasy. Thanks, Vladmir! Just kidding. In this case, it’s for relaxing hypertonic muscles (i.e., muscles that are tense even though they shouldn’t be). Just place the wand on your muscle belly (not insertion points) for 20 to 30 seconds, which is often all it takes at the proper hertz. Tension headaches or a stiff neck? It’s great for relaxing the occipitals at the base of the skull. Warning: Having Hitachi Magic Wands lying out around your house cango terribly wrong—or terribly right. Good luck explaining your “hypertonic muscles.” As one friend said to me, “I think my wife has that same problem. . . .”GYMNAST STRONG Unusual and Effective Bodyweight Exercises In less than eight weeks of following Coach Sommer’s protocols, I saw unbelievable improvement in areas I’d largely given up on. Try a few of my favorite exercises, and you’ll quickly realize that gymnastsuse muscles you didn’t even know you had. QL Walk—An Unusual Warmup Coach Sommer borrowed this exercise from power lifter Donnie Thompson, who calls it the “butt walk.” Donnie “Super D” Thompson is the first person to hit a power lifting total of more than 3,000 pounds (bench press + deadlift + squat). The QL walk is intended to get your glutes and quadratus lumborum (QL) firing, the latter of which Donnie calls “an angry troll in your back”:1. Sit down on a mat (or gravel, if you want to turn your ass into hamburger meat). Legs are extended in front of you, ankles can be touching or slightly apart, and your back should be straight. I keep legs together. This is “pike” position, which I’ll refer to quite a bit in this book. 2. Lift a kettlebell or dumbbell to your collarbones (think front squat). I weigh 170pounds and use 30 to 60 pounds. I hold the kettlebell “horns,” but Donnie prefers to support it from underneath. 3. Keeping your legs straight (no bend at the knee), walk your butt cheeks—left, right, left, right—across the floor. I typically go 10 to 15 feet. 4. Reverse direction and go backward 10 to 15 feet. That’s it.Jefferson Curl (J-Curl) Think of this as a controlled, slowly rounded, stiff-legged deadlift. From Sommer: “Progress slowly andpatiently. Do not rush. For this type of loaded mobility work, never allow yourself to strain, grind out reps, or force range of motion. Smooth, controlled movement is the order of the day.” The ultimate goal is body weight on a bar, but start with 15 pounds. I currently use only 50 to 60 pounds. This can perform miracles for thoracic, or mid-back, mobility, all while helping the hamstrings in the pike position. When I asked Coach Sommer how often I should do these, he said, “We do these like breathing.” In other words, at a minimum, J-Curls are done at the beginning of every primary workout. 1. Begin by standing upstraight, legs locked, holding a bar waist- high with your arms shoulder width apart. (fig. A) Think dead-lift top position. 2. Tuck your chin tightly against your chest (keep it tucked for the entire movement) and slowly bend over, one vertebra at a time, from the neck down. (fig. B) Keep your arms straight and the bar close to your legs. Lower until you can’t stretch any farther.As you become more flexible, stand on a box (I use a Rogue plyo box), with the goal of passing your wrists below your toes. Keep your legs as perpendicular to the ground as possible, and try to not push your hips back until your head is below your waist. 3. Slowly stand back up, rolling one vertebra at a time. Your chin should be the last thing to come up. (fig. C) That’s 1rep. Repeat for a total of 5 to 10 reps. Dips with RTO (Ring Turn Out) So you can do 10 to 20 regular dips? Fantastic. I challenge you to do 5 slow dips on rings with proper turnout at the top (“support position”). Imagine the lines of the knuckles pointing to 10 and 2 o’clock at the apex. Perform this without piking (bending at the hips) or leaning your torso forward. This requires the brachialis to work like a mofo at the top, and it requires goodshoulder extension at the bottom—my nemesis. Curse me, then thank me in 8 weeks. If you can’t do 15 regular dips, consider starting with push-ups with RTO, which Kelly Starrett (page 122) first showed me. For the push-ups, ensure that you use the hollow and protracted position from cast wall walks on page 19. Hinge Rows This is an excellent low-risk option for smashing your mid-traps and external rotator cuff muscles, which are used for handstands and just about everything in gymnastics. Visualize popping up likeDracula in a coffin, then hitting a double bicep pose. The catch: Your hands are holding rings the entire time. Once you can do 20 reps of hinge rows, Google “lat flys” and progress to those. 1. Set up a pair of rings to hang about a foot above your head when you’resitting on the floor. 2. While sitting on the floor, grab the rings. Keeping your heels on the floor, lie back, and —arms straight—lift your hips off the ground. Focus on making your body (head to heel) ramrod straight. (fig. A) 3. Sit up (pike) until your head is between the rings and hit that double-bicep pose. The bends at your waist andelbows should be about 90 degrees. (fig. B) 4. Slowly lower yourself back down. Repeat 5 to 15 times. Ag Walks with Rear SupportThese are hugely productive and a major wakeup call for most people. 99% of you will realize you have no shoulder flexibility or strength in this critical position. 1. Get some furniture sliders ($5 to $15). These look like drink coasters and are used to move furniture around without scratching the floor. 2. Sit down in pike position and put your heels on the furniture sliders (which I nowalways pack for travel workouts). 3. Put your hands on the floor by your hips and —arms straight—lift your hips off the ground. Try to make your body perfectly straight from shoulder to heel, just as in the hinge rows. 4. Easy? Now walk forward with your hands, pushing your feet along the floor. This can be done forwardand backward. Aim for 5 minutes of constant movement, but feel free to start with 60 seconds (you’ll see). Pro tip: This is a great way to freak people out when done at 2 a.m. in hotel hallways. Pike Pulses When one of my meathead friends is laughing at my GST exercises, I have them attempt this. It usually ends with a head shake and a puzzled “Holy fuck.”1. Sit in pike position in the middle of the floor. Point your toes and keep your knees locked. 2. Walk your hands out on the floor, as far toward (or past) your feet as you can. 3. Now, try to lift your heels 1 to 4 inches, which is 1 repetition or “pulse.” For 99% of you, this will be completely impossibleand you’ll feel like an ice statue. Ratchet back and put your hands midway between hip and knee. See how you do and then move your hands forward enough to allow only 15 to 20 pulses. If you did really well, now try it with your lower back against a wall. What happened?! Sorry, killer, you weren’t actually pulsing, you were rocking back and forth like a cradle. Do it against the wall to keep yourself honest. Cast Wall WalkIf you have no gymnastics background, this one will be fun/terrible. I use cast wall walks as a workout finisher and recommend you do the same, as you’ll be worthless afterward. First, let’s define the position you need to maintain. Torso “Hollow”: Sit on a chair, back straight, with your hands on your knees. Now, try to bring your sternum (chest bone) to your belly button; “shorten” your torso by 3 to 4 inches by contracting and pulling in your abs. You’ll maintain this position throughout the entire exercise. No lower-back arch or sag permitted. Shoulders “Protracted”: Keep your torso “hollow” per the above. Now, pretend you’re hugging a telephone pole.Your shoulders should be well in front of your chest, sternum pulled back strongly. Straighten your arms but maintain this position. Next, without losing any of the aforementioned, lift your arms overhead as high as you can. There you go. Now we can begin. 1. Get into a handstand position against a wall, nose facing toward the wall. (fig. A) 2. Keeping your body in one line, slowly walk your hands out and your feet down the wall simultaneously. (fig. B)Keep your knees straight and walk with your ankles. The steps should be small. 3. Reach the bottom with your feet on the floor in a push-up position. (fig. C) Correct your form to be maximally hollow and protracted. 4. Reverse and go back up the wall, returning to handstand position. That is 1 rep, my friend.Target is 10 reps, but stop this one at least a few reps before muscular failure. Otherwise, woe unto your face when gravity opens a can of whoop-ass on your flattened head.Spirit animal: Beaver DOMINIC D’AGOSTINO Dr. Dominic “Dom” D’Agostino (TW: @DOMINICDAGOSTI2, KETONUTRITION.ORG ), PhD, is anassociate professor in the Department of Molecular Pharmacology and Physiology at the University of South Florida Morsani College of Medicine, and a senior research scientist at the Institute for Human and Machine Cognition (IHMC). He has also deadlifted 500 pounds for 10 reps after a 7-day fast. He’s a beast and—no big surprise—he’s a good buddy of Dr. Peter Attia, my MD friend (page 59) who consumed “jet fuel” in search of optimal athletic performance. The primary focus of Dom’s laboratory is developing and testing metabolic therapies,including ketogenic diets, ketone esters, and ketone supplements to induce nutritional/therapeutic ketosis, and low-toxicity metabolic-based drugs. Much of his work is related to metabolic therapies and nutritional strategies for peak performance and resilience in extreme environments. His research is supported by the Office of Naval Research, Department of Defense, private organizations, and foundations. LITTLE-KNOWN FACTS Back around 1995, Dom gifted Tony Robbins’s(page 210) Personal Power audio set to all of his undergrad lifting buddies. Two contacted him years later to thank him for changing their lives. After my first podcast with Dom, Whole Foods Markets around the country sold out of Wild Planet canned sardines. PREFACE This profile is one of several that might save your life, and it has certainlychanged mine. As such, it deviates from the usual format to act as more of a mini- primer on all things ketosis. There is a lot of diet talk, but the supplements and fasting can be treated as separate tools —no bacon or heavy cream required. For ease of reading, some of the concepts are slightly simplified for a lay audience. My current personal regimen is included. FIRST, SOME BASICS The ketogenic diet, often nicknamed “keto,” is a high-fat diet that mimics fasting physiology. Your brain and body begin touse ketones (derived from stored or ingested fat) for energy instead of blood sugar (glucose)—a state called ketosis. The diet was originally developed to treat epileptic children, but there are many variations, including the Atkins diet. You can achieve ketosis through fasting, diet, exogenous ketones, or a combination. How do you know when you’re in ketosis? Themost reliable way is to use a device called the Precision Xtra by Abbott. This can measure both glucose and blood levels of beta-hydroxybutyrate (BHB). Once you reach 0.5 mmol—millimolars, a concentration—you can consider yourself lightly “in ketosis.” I tend to feel increased mental clarity at 1 mmol or higher. The primary resource, as you’ll come back to this: Dom’s top go-to resource for the ketogenic diet,including FAQs, meal plans, and more is ketogenic-diet- resource.com. “I like to promote mild to moderate ketosis for health and longevity, which is between 1 to 3 mmol.” TF: These levels help protect DNA from damage, among other benefits.WHY CONSIDER KETOSIS OR SUPPLEMENTAL KETONES? Fat loss and body recomposition Potent anti-cancer effects Better use of oxygen: Dom can hold his breath for two times his normal duration when in deep ketosis (2 minutes → 4 minutes). I observed the same. Essentially, youcan derive more energy per oxygen molecule with ketone metabolism. This oxygen utilization advantage is why some elite cyclists are experimenting with keto. This also helps performance at high altitudes, if you’re going from sea level to mountains, for instance. Maintain or increase strength: In a study with 12 subjects, Dom demonstrated that even advanced weight lifterscould maintain or increase strength, performance, and hypertrophy after 2 weeks of keto-adaptation, consuming 75 to 80% of calories from fat (supplemented with MCT and coconut oils) and restricting carbohydrates to 22 to 25 g per day. Ketones have an anti- catabolic protein-sparing and anti-inflammatory effect. Lyme disease: (Caveat: This is a personalexperience, not a double- blind study.) Reaching deep ketosis (for me, 3 to 6 mmol) through fasting, then continuing with calorie-restricted keto for a week, completely eradicated symptoms of Lyme disease when all else failed. It was the only thing that helped after my first course of antibiotics. It produced a night-and-day difference: a 10-time improvement in my mental performance and clarity. I suspect this relates to mitochondrial“rehab” and the anti- inflammatory effects of ketones. More than a year has passed and the symptoms have not returned, despite following the non- ketogenic Slow-Carb Diet (see page 81) 90% of the time. WHY CONSIDER FASTING? Dom has discussed the idea of a therapeutic “purge fast” with his colleague Dr. Thomas Seyfried of Boston College. Per Dom: “If you don’thave cancer and you do a therapeutic fast 1 to 3 times per year, you could purge any precancerous cells that may be living in your body.” If you’re over the age of 40, cancer is one of the four types of diseases (see Dr. Peter Attia on page 59) that will kill you with 80% certainty, so this seems like smart insurance. There is also evidence to suggest— skipping the scientific detail—that fasts of 3 days or longer can effectively “reboot” your immune system via stem cell–based regeneration. Dom suggests a 5-day fast 2 to 3 times per year. Dom has done 7-day fasts before, while lecturing at the University of South Florida. On day 7, he went into classwith his glucose between 35 and 45 mg/dL, and his ketones around 5 mmol. Then, before breaking the fast, he went to the gym and deadlifted 500 pounds for 10 reps, followed by 1 rep of 585 pounds. Dom was inspired to do his first 7-day fast by George Cahill, a researcher at Harvard Medical School, who’d conducted a fascinating study published in 1970* wherein he fasted people for 40 days. Fasting doesn’t need to make you miserable and weak. In fact, it can have quite the opposite effect. But let’s start with how not to do it. . . . SOME PERSONAL BACKGROUNDI did my first extended fast as a last resort. Lyme disease had decimated me and put me at 10% capacity for nearly 9 months. My joints hurt so much that it took 5 to 10 minutes to get out of bed, and my short-term memory worsened to the point that I began to forget good friends’ names. Adding inputs (e.g., drugs, IV treatments, etc.) didn’t seem to help, so I decided to try removing all inputs, including food. I did my homework, found the best-reviewed fasting clinics in the U.S., and headed off. My first 7-day fast was excruciating. It was medically supervised at a clinic, where we also had room and board. Patients were permitted to consumenothing but distilled water. Tap water, toothpaste, and even bathing were advised against. No exercise or leaving the facility were permitted for liability reasons. From days 3 to 4, my lower back pain was so extreme that I remained on my bed in the fetal position. The doctors told me this was “toxins” being released, which I didn’t accept. I insisted on blood testing instead, and the explanation for the lower-back pain was simple: My kidneys were getting hammered by sky-high uric acid levels. I wasn’t allowed to exercise (not even brisk walking), so it was taking forever to get into ketosis. My body was breaking down muscle tissue so the liver could convert it into glucose, and uricacid was a by-product. On top of this, since patients were limited to distilled water, nearly all the fasters (about 40 in total) couldn’t sleep due to electrolyte depletion and subsequent cholinergic responses (e.g., rapid heart rate when trying to sleep). Nonetheless, I noticed benefits: Long-standing skin issues disappeared after a few days, as did chronic joint pain. On the morning of day 7, I woke up to blood spilling out of my mouthguard. I had been dreaming of strawberry shortcake (seriously) and chewed the fucker so hard that my gums split open. Basta. I broke my fast with stewed pork— against doctor’s orders—and decidedtwo things: Fasting was very interesting, but this wasn’t how I would do it. WAIT . . . SO WHAT’S THE FASTING YOU PRACTICE? In the last 2 years, I’ve done a lot of fasting experiments, focusing on real science instead of old wives’ tales (e.g., you must break your fast with shredded cabbage and beets). I now aim for a 3- day fast once per month and a 5- to 7- day fast once per quarter. I would like to do one 14- to 30-day fast per year, but the logistics have proven too inconvenient.The longest fast I’ve done to date was 10 days. During that fast, I added vitamin C IVs and hyperbaric oxygen (2.4 ATA x 60 minutes) 3 times per week. I did DEXA body scans every 2 to 3 days for tracking and also consumed roughly 1.5 g of BCAAs upon waking and roughly 3 g of BCAAs intra- workout. After a 10-day fast, I had lost zero muscle mass. In contrast, I lost nearly 12 pounds of muscle in that first 7-day fast. How and why the difference? First, I allowed trace amounts of BCAAs and 300 to 500 calories of pure fat per day on my “fast.” Second, I got into ketosis as quickly as possible to skip muscle wasting. I cannow do this in under 24 hours instead of 3 to 4 days. The more often you enter keto, the faster the transition takes place. There appears to be a biological “muscle memory” related to monocarboxylate transporters and other things beyond my pay grade. Fasting is key, which is why the keto protocol used at Johns Hopkins for children with drug- resistant seizures begins with fasting. Here’s my protocol for my usual monthly 3-day fast from Thursday dinner to Sunday dinner: On Wednesday and Thursday, plan phone calls for Friday. Determine how you canbe productive via cell phone for 4 hours. This will make sense shortly. Have a low-carb dinner around 6 p.m. on Thursday. On Friday, Saturday, and Sunday mornings, sleep as late as possible. The point is to let sleep do some of the work for you. Consume exogenous ketones or MCT oil upon waking and 2 more times throughout the day at 3- to 4-hour intervals. Iprimarily use KetoCaNa and caprylic acid (C8), like Brain Octane. The exogenous ketones help “fill the gap” for the 1 to 3 days that you might suffer carb withdrawal. Once you’re in deep ketosis and using body fat, they can be omitted. On Friday (and Saturday if needed), drink some caffeine and prepare to WALK. Be out the door no later than 30 minutes after waking. I grab a cold liter of water orSmartwater out of my fridge, add a dash of pure, unsweetened lemon juice to attenuate boredom, add a few pinches of salt to prevent misery/headaches/cramping, and head out. I sip this as I walk and make phone calls. Podcasts also work. Once you finish your water, fill it up or buy another. Add a little salt, keep walking, and keep drinking. It’s brisk walking—NOT intense exercise—and constant hydration that are key. Ihave friends who’ve tried running or high- intensity weight training instead, and it does not work for reasons I won’t bore you with. I told them, “Try brisk walking and tons of water for 3 to 4 hours. I bet you’ll be at 0.7 mmol the next morning.” One of them texted me the next morning: “Holy shit. 0.7 mmol.” Each day of fasting, feel free to consume exogenous ketones or fat(e.g., coconut oil in tea or coffee) as you like, up to 4 tablespoons. I will often reward myself at the end of each fasting afternoon with an iced coffee with a bit of coconut cream in it. Truth be told, I will sometimes allow myself a SeaSnax packet of nori sheets. Oooh, the decadence. Break your fast on Sunday night. Enjoy it. For a 14-day or longer fast, you need to think about refeeding carefully.But for a 3-day fast, I don’t think what you eat matters much. I’ve done steak, I’ve done salads, I’ve done greasy burritos. Evolutionarily, it makes no sense that a starving hominid would need to find shredded cabbage or some such nonsense to save himself from death. Eat what you find to eat. ONCE YOU’RE IN KETO, HOW CAN YOU KEEP ITGOING WITHOUT FASTING? The short answer is: Eat a boatload of fat (~1.5 to 2.5 g per kilogram of body weight), next-to-no carbs, and moderate protein (1 to 1.5 g per kilogram of body weight) each day. We’ll look at Dom’s typical meals and day in a minute, but a few critical notes first: High protein and low fat doesn’t work. Your liver will convert excess amino acids into glucose and shut down ketogenesis. Fat as 70 to 85% of calories is required.This doesn’t mean you always have to eat rib eye steaks. A chicken breast by itself will kick you out of ketosis, but a chicken breast cut up into a green leafy salad with a lot of olive oil, feta cheese, and some Bulletproof Coffee (for example) can keep you in ketosis. One of the challenges of keto is the amount of fat one needs to consume to maintain it. Roughly 70 to 80% of your total calories need to come from fat. Ratherthan trying to incorporate fat bombs into all meals (one does get tired of fatty steak, eggs, and cheese over and over again), Dom will both drink fat between meals (e.g., coconut milk—not water—in coffee) and add in supplemental “ice cream,” detailed on page 29. Dom noticed that dairy can cause lipid profile issues (e.g., can spike LDL) and has started to minimize things likecream and cheese. I experienced the same. It’s easy to eat a disgusting amount of cheese to stay in keto. Consider coconut milk (Aroy-D Pure Coconut Milk) instead. Dom doesn’t worry about elevated LDL as long as other blood markers aren’t out of whack (high CRP, low HDL, etc.). From Dom: “The thing that I focus on most is triglycerides. If your triglycerides are elevated, that means yourbody is just not adapting to the ketogenic diet. Some people’s triglycerides are elevated even when their calories are restricted. That’s a sign that the ketogenic diet is not for you. . . . It’s not a one-size-fits-all diet.” All that preamble out of way, here’s what Big Dom eats. Keep in mind that he weighs roughly 100 kg (220 lbs), so scale as needed: Breakfast4 eggs (cooked in a combo of butter and coconut oil) 1 can of sardines packed in olive oil (such as Wild Planet brand) 1⁄2 can oysters (Crown Prince brand. Note: Carbs on the label are from non-glycemic phytoplankton) Some asparagus or other vegetable TF: Both Dom and I travel with boxes of sardines, oysters, and bulk macadamia nuts. “Lunch” Instead of lunch, Dom will consume a lot of MCT throughout the day via Quest Nutrition MCT Oil Power. He will also make a Thermos of coffee with a halfstick of butter and 1 to 2 scoops of MCT powder, which he sips throughout the day, totaling about 3 cups of coffee. Dinner “One trick I’ve learned is that before dinner, which is my main meal of the day, I’ll have a bowl of soup, usually broccoli cream soup or cream of mushroom soup. I use concentrated coconut milk in place of the dairy cream. I thin it out [with a bit of water] so it’s not super dense in calories. After eating that, the amount of food that I want to consume is cut in half.” Dom’s dinner is always some kind of large salad, typically made up of:Mixed greens and spinach together Extra-virgin olive oil Artichokes Avocado MCT oil A little bit of Parmesan or feta cheese A moderate amount—about 50 g— of chicken, beef, or fish. He uses the fattiest versions he can get and increases the protein in the salad to 70 to 80 g if he had a workout that day. In addition to the salad, Dom will make some other vegetable like Brussels sprouts, asparagus, collard greens, etc., cooked in butter and coconut oil. Heviews vegetables as “fat delivery systems.” Dom’s Recipe for Keto Ice Cream Dom’s “ice cream” recipe contains roughly 100 g of fat, or 900 kcal of keto goodness. It can save the day if your dinner is lacking fat (remember to hit 70 to 85% of total calories from fat!): 2 cups sour cream (I like Straus Creamery brand) or unsweetened coconut cream (not coconut water) 1 tablespoon dark chocolate baking cocoa1–2 pinches of sea salt (my favorite is flaky Maldon) 1–2 pinches of cinnamon A small dash of stevia (Dom buys NOW Foods organic stevia in bulk) Optional: 1/3–1/2 cup blueberries, if Dom hasn’t had carbs all day, or if he has worked out Stir that all into a thick mousse and stick it in the freezer until it takes on an ice cream–like consistency. Once you’ve removed it and are ready to dig in, you can eat it straight or add toppings: Make whipped cream using heavy cream (nearly 100% fat) and abit of stevia. Drizzle on 1 tablespoon of heated coconut oil (especially if the “bomb” has the blueberries in it) and mix it all in, which produces the mouthfeel of crunchy chocolate chips. The keto diet calls for around 300 g of fat per day at Dom’s body weight of 100 kg (220 lbs). This dessert helps up the ante dramatically. It’s also delicious. Dom’s wife does not follow a ketogenic diet, but even she loves this dessert. Dom’s Tip for Vegetarians“MRM Veggie Elite Performance Protein—the chocolate mocha is very good. If you take roughly one scoop and mix it with coconut milk, throw in a half an avocado, pour in some MCT oil—the C8 oil—the [shake] that I made up has 70% of the calories from fat and 20% of the calories from protein, 10% of the calories from carbohydrates.” DOM’S GO-TO SUPPLEMENTS Quest Nutrition MCT Oil Powder and Quest Nutrition Coconut Oil PowderKettle & Fire Bone Broth —2 to 3 times per week Idebenone “is another product that I take [400 mg] when I fly or before hard exercise. I think of idebenone as a version of coenzyme Q10. It’s more absorbable and gets to the mitochondria easier. It’s like a mitochondrial antioxidant.” Magnesium daily. “Magnesium citrate, magnesium chloride, and magnesium glycinate . . .When I started the ketogenic diet, I started getting cramps. Now that I’m supplementing, I don’t get any cramps. . . . If I had one go-to magnesium, it would be this magnesium citrate powder called Natural Calm.” Scivation XTEND Perform branched-chain amino acids (BCAAs): leucine, isoleucine, and valine in a 2 to 1 to 1 combination, leucine being the predominantbranch chain amino acid in the formula. “Leucine is a powerful activator of mTOR, which is a good thing; activating mTOR in skeletal muscle is really important in a short workout. I use the product pre-workout and intra-workout.” KetoCaNa and KetoForce Prüvit KETO//OS— Creamy exogenous ketones, tastes great Kegenix—More of atangy Kool-Aid flavor Both Prüvit and Kegenix are based on a BHB + MCT patent Dom’s lab developed, which is owned by his university. MORE ON FASTING AND CANCER TREATMENT “Fasting before chemotherapy is definitely something that should be implemented in our oncology wards,” says Dom. He adds, “Fasting essentially slows (sometimes stops) rapidly dividing cells and triggers an ‘energetic crisis’ that makes cancer cells selectively vulnerable to chemo andradiation.” There are good studies to support this.** One of my friends is in full remission from advanced testicular cancer. Others in his chemo cohort were laid out for 2 to 3 days in bed after chemo sessions, but he fasted for 3 days before sessions and was running 10 miles the next morning. Fasting sensitizes cancer cells to chemo, as mentioned, but it also helps normal cells resist the toxicity. This isn’t appropriate for all patients, especially those with extreme cachexia (muscle wasting), but it is applicable to many. In cases of cachexia, some selective androgen receptor modulators (SARMs), which are designed to have the anabolic tissue-building potency of testosterone(and other anabolic steroids) without the androgenic (i.e., secondary hormonal) effects, could be helpful. Dom is also researching the use of BCAAs. He has had ~50% increase in survival in cancerous rats by adding the branched- chain amino acids to a ketogenic diet. Just as promising, the animals maintained their body weight. In one study, treating mice with aggressive metastatic brain cancer using keto and hyperbaric oxygen treatment (HBOT), Dom, Dr. Seyfried, and other scientists were able to increase the average survival time from 31.2 days (standard diet) to 55.5 days. For the HBOT protocol, Dom used 2.5 Atmospheres (2.5 ATA) for 60 minuteson Monday, Wednesday, and Friday. Including pressurization and depressurization, each session lasted about 90 minutes. Even in a worst-case scenario—if a patient is intubated and on their last legs —one could potentially add exogenous ketones to an IV alongside (or in place of) glucose, as exogenous ketones have been demonstrated to have a significant tumor-suppressing or -shrinking effect, even in the presence of dietary carbohydrates. To me, the last italicized part is the most remarkable. If you think the ketogenic diet is for lunatics, exogenous ketones only require mixing a scoop in water and swigging it down.5 THINGS IN CASE OF LATE-STAGE EMERGENCY Here are the 5 things Dom would do if he were diagnosed with one of the worst-case scenarios—late-stage glioblastoma (GBM), an aggressive brain cancer. Some of Dom’s colleagues are opposed to the “standard of care” protocols, like chemotherapy. Based on the literature, Dom feels these are warranted in situations involving testicular cancer, leukemia, lymphoma, and stage 1 and 2 breast cancer. Outside of those examples, “it makes little senseto treat cancer with something we know is a powerful carcinogen (chemotherapy).” Dom’s 5 picks all appear to work through overlapping mechanisms. This means that there is a synergy in using them together. The whole is greater than the sum of its parts. 1