Back on the podcast today, we have researcher and athlete Brianna Stubbs, PhD. Brianna has been a world-champion rower and is now competing in cycling, running, and triathlon. She is also Research Lead for HVMN, advancing the science on human optimisation and creating content and products to improve physiology, metabolism, and cognition. As a world expert on ketone metabolism, Brianna is here with me to talk about the latest research on exogenous ketones. We discuss their effects on athletic performance, brain injury, and cognition, and she weighs in on the controversy regarding the effect of ketone esters on the inflammasome. We also look at the misunderstood role of lactate and how it’s now being used to improve athletic performance. Here’s the outline of this interview with Brianna Stubbs: [00:00:35] Our previous podcasts with Brianna: 1, 2, 3. [00:02:00] Podcast: Professor Tim Noakes: True Hydration and the Power of Low-Carb, High-Fat Diets. [00:02:19] Andrew Bosch at the University of Cape Town. [00:05:03] Training for full Ironman. [00:05:19] Podcast: Off Road Triathlon World Champion Lesley Paterson on FMT and Solving Mental Conundrums. [00:07:39] Using ketone esters to fuel for a race. [00:10:18] Who's using the ketone ester? [00:11:08] Effects of ketone esters on cognitive function; Study: Evans, Mark, and Brendan Egan. "Intermittent Running and Cognitive Performance after Ketone Ester Ingestion." Medicine and science in sports and exercise 50.11 (2018): 2330-2338. [00:12:21] Rescue of ATP in the brain of mice given exogenous ketones; Study: Prins, M. L., et al. "Increased cerebral uptake and oxidation of exogenous βHB improves ATP following traumatic brain injury in adult rats." Journal of neurochemistry 90.3 (2004): 666-672. [00:13:46] Unpublished research on ketone esters in hypoxia: Ketone Esters for Optimization of Cognitive Performance in Hypoxia. [00:15:33] One hour cycling record; Vittoria Bussi. [00:16:00] Bradley Wiggins; The Flying Scotsman Graeme Obree; Jens Voigt. [00:19:19] Professor Tim Noakes; Central governor model of fatigue: Noakes, Timothy D. "The central governor model of exercise regulation applied to the marathon." Sports medicine 37.4-5 (2007): 374-377. [00:19:32] Cyclists go slower from the first pedal stroke when you put them in a hot laboratory; Study: Tucker, Ross, et al. "The rate of heat storage mediates an anticipatory reduction in exercise intensity during cycling at a fixed rating of perceived exertion." The Journal of physiology 574.3 (2006): 905-915. [00:19:43] Cold water in mouth reduces perceived effort and improves performance. Study: Burdon, Catriona A., et al. "The effect of ice slushy ingestion and mouthwash on thermoregulation and endurance performance in the heat." International journal of sport nutrition and exercise metabolism 23.5 (2013): 458-469. [00:19:57] Cooling mouthwash improves performance; Study: Jeffries, Owen, Matthew Goldsmith, and Mark Waldron. "L-Menthol mouth rinse or ice slurry ingestion during the latter stages of exercise in the heat provide a novel stimulus to enhance performance despite elevation in mean body temperature." European journal of applied physiology 118.11 (2018): 2435-2442. [00:22:25] Podcast: Science and Application of High Intensity Interval Training with Paul Laursen, PhD. [00:22:56] Potential therapeutic applications of ketone esters. [00:23:43] Ketogenic diet may help with alcohol withdrawal. Study: Dencker, Ditte, et al. "Ketogenic Diet Suppresses Alcohol Withdrawal Syndrome in Rats." Alcoholism: Clinical and Experimental Research42.2 (2018): 270-277. [00:24:43] Dr. Stephen Cunnane; MCT study: Courchesne-Loyer, Alexandre, et al. "Emulsification increases the acute ketogenic effect and bioavailability of medium-chain triglycerides in humans: protein, carbohydrate, and fat metabolism." Current developments in nutrition 1.7 (2017): e000851. [00:28:13] Ketone esters as nootropics. [00:30:23] Mitigating traumatic brain injury (TBI);