Dr. Latt Mansor | Mitochondria & Ketones: Boost Your Energy Smarter

In this episode of the Smarter Not Harder Podcast, Dr. Latt Mansor gives us one-cent solutions to life’s $64,000 questions that include:

• How do ketones act as both an energy source and a signaling molecule in the human body?

• Can exogenous ketones like Ketone-IQ improve cognitive performance and brain resilience?

• What role do ketones play in heart health and recovery after cardiac injury?

• How does metabolic flexibility influence longevity, mental health, and disease resistance?

• Are ketones the next frontier in treating psychiatric and metabolic disorders?

Who is Dr. Latt Mansor?

Dr. Latt Mansor holds a PhD in Physiology, Anatomy, and Genetics from the University of Oxford. He also holds an MA (Columbia University) and a BS (University of Nottingham) in Biotechnology. Latt brings over a decade of experience spanning academic research, health technology, and pharmaceuticals.

As Ketone-IQ’s Research Lead, he oversees the scientific development and clinical applications for all Ketone-IQ products.

What did Dr. Latt and Jodi discuss?

00:00 Introduction — Why Ketones Are the Future of Energy and Longevity

01:00 Meet Dr. Latt Mansor: From Oxford Research to HVMN and Ketone IQ

05:00 What Are Ketones and How Do They Work?

07:26 Inside the Diabetic Heart: What Dr. Mansor’s Research Reveals About Energy Flexibility

10:30 Endogenous vs. Exogenous Ketones Explained

12:25 Ketones 101 — What They Are, How They Work, and Why the Brain Needs Them

15:00 Ketones and Brain Health — Focus, Cognition, and Alzheimer’s Research

21:00 Mitochondrial Function and the Science of Energy Metabolism

27:00 Ketones in Heart Health and Recovery After Heart Attack

33:30 Metabolic Flexibility — The Key to Longevity and Performance

38:00 The Rise of Metabolic Psychiatry: Ketones for Mental Health

45:00 Muscle Preservation, Exercise, and Ketones as Signaling Molecules

52:00 Personalized Ketone Supplementation and Dosing Tips

01:06:00 Final Insights — Optimizing Energy, Optimizing Everything

Full Transcript:

Dr. Latt Mansor (00:00.064)
Your liver can act as a gatekeeper monitoring all of the inputs, all of the feedback that your body is giving it and making sure that we don't get too high of a ketone level. Because remember this, even though something is good for you, too much of it, it's still not good for you. Vitamin C is good for you. You shouldn't take too much of it either. You know, same thing with ketones. It is very good for you.

but you want to keep it within the optimal zone. And a lot of these studies, we found that the optimal zone is between one to 2.5 millimolar.

you

Jodi Duval (00:48.206)
Welcome back to the Smarter Not Harder podcast, your home for one cent solutions to $64,000 questions. I'm your host, Jodie DeValle. So today we're joined by Dr. Lat Mansa, our global leader in human performance and metabolic health with a PhD in physiology from Oxford and years of industry and academic research. Lat is currently the research lead at HVMM where he's helping redefine how we fuel the brain and the body.

And so in this wide and rich episode, we explore LAT's personal professional journey from childhood metabolic challenges to academic research on the diabetic heart and energy metabolism, the basics of ketone physiology, how they're produced, when they're needed, and why they're more than just a backup fuel. The role of exogenous ketones like

ketone IQ, enhancing cognition, preserving muscle, improving heart function, and even supporting mental health. Cutting edge research into Alzheimer's, psychopenia, cardiovascular disease, and psychiatric conditions, and how ketones act as both fuel and signaling molecules. Why mitochondrial function and metabolic flexibility are foundational to health span, resilience, and recovery.

how ketone supplementation can actually be personalized for peak performance, focus and long-term wellbeing. So if you're a clinician, an athlete, a health optimizer, this conversation offers actionable insights into energy metabolism and emerging therapies and the future of metabolic medicine. So if you enjoy this episode, please don't forget to take a moment to review, like, share with your community. And now let's welcome

Dr. Lat Mansour to the show. All right. Welcome to the show. It's a pleasure to have you, Dr. Lat Mansour. Thank you so much for coming on. So here we are on the Smarter Not Harder podcast and we're going to learn how to live smarter, not harder with you today. And we are going to be talking about everything ketones. But before I get started, I always like to, in my episodes, ask your why.

Dr. Latt Mansor (02:45.742)
Thank you so much for having me.

Jodi Duval (03:04.724)
And so I see you have a beautiful history of research. I can't believe you've actually also created a mathematical model of adipose tissue. So I need to know about that one actually. But your motivations, you know, why coming into this sort of metabolic field? And I see you have, you know, family reasons and also personal reasons. So

Yeah, I think everyone loves to hear the story behind all the incredible information that you put out.

Yeah, of course. I think why, what got me really interested in, biology was, actually initially I wanted to be an astronomer. So I was really interested in astronomy science and I was like memorizing all these planet names and all of that. And I was 16 then back in Malaysia where I was born and brought up. And I thought, you know, I, I'm going to be a researcher in the area, but

then I realized in during that time, the career opportunities weren't really there for, and also there aren't a lot of scholarships that would sponsor me to go study in those areas. So the next best thing that sort of caught my attention then was genetics. And that was how I got into biotechnology. And then the more I learned about biotechnology, especially in my second year, where I really learned about physiology.

And as you said, in my final year, my thesis was actually a mathematical model of adipose tissue metabolism, which is fat tissue metabolism. Right. And then I realized actually learning all of these metabolic pathways and knowledge about physiology is actually helpful for me. Is personally, I always grew up overweight. I've always grown up overweight since, you know,

Dr. Latt Mansor (05:03.936)
I was as far as I can remember until I was 22. And that was my second year. My mom's side has high prevalence of diabetes and obesity. My late dad died of stroke and before that he had a heart attack. And my half brother also passed away in his forties because of a heart attack. So together is not the best recipe in terms of genetics disposition. However, learning all about the genetics and physiology and metabolism

made me realize that I am not my genetics. My genetics may be part of the makeup of who I am, but you know, I love the saying when people say genetics load the gun, but epigenetics pull the trigger. So then I realized there are so many things regarding chronic diseases that are preventable, that are avoidable and modifiable.

with lifestyle changes, nutrition, exercise, and a lot of areas that in your life that you are in control of. What you are born with, i.e. genetics, you are not in control of that, right? You are what you're given. But what you can change and what you can actually put effort in is how to shape the expression of those genes, hence epigenetics. So that was what got me really interested in this area and really

know, bring home the whole idea of, you know, going into physiology in my undergrad and then going to drug development and biotechnology focus on drug delivery, regulatory affairs in biotechnology as well in my master's in Columbia University. And then that led me to getting a job as a clinical trial coordinator at this pharma company called the Medicines Company.

At that point, they were very focused in cardiovascular disease and critical care pathway in the hospital. So after working with them for a year, I was inspired by the people in the company who are very scientifically driven, very evidence driven, but they are also very entrepreneurial. And I thought, you know what? I want to be like them. I want to be able to eloquently and coherently spread the knowledge that I've learned in the lab.

Dr. Latt Mansor (07:26.966)
so that people who do not have the privilege to learn about this knowledge or people who do not have the know-how to understand the knowledge to then get this knowledge and apply in their daily lives so that they can improve their lives so that people like my late father could do something about where his health trajectory was going and hopefully prevent the tragic end that he had. Right. So

then that was what drove me to apply for my PhD or DFL from the university of Oxford, specializing in physiology, anatomy and genetics. And my fight and my PhD pro my PhD thesis was the metabolism of the type two diabetic heart in hypoxia, which is low oxygen environment where I learned about the switching around the metabolic flexibility of the direct diabetic heart.

of how capable it is to switch from fatty acids to glucose metabolism and vice versa under different types of stresses. So, and then I finished my DFL more than about 10 years ago now. It's funny because I just recently saw my DFL supervisor in Nara, Japan, because we were together at a conference at the International Society of Heart Research World Congress. And she gave a presentation where she

you know, cited some of my first papers, because I was her first default student. So it really brings back memories. And after, you know, I finished my default, I worked in a startup for a couple of years, started my own company. And then in 2019, I joined HVMN or Keto and IQ and moved here in the States to San Francisco and run the science division. Essentially, I oversee all of our scientific collaborations with clinicians, universities.

research institutions and really help push forward the understanding of ketone science, the understanding of metabolic health, and how can our product be impactful in people's lives, be it in performance or longevity or metabolic health or, you know, simple things like appetite suppression.

Jodi Duval (09:44.75)
And I was I was having this thought on the way to work this morning and it's everything you said around the information that we need to have from research and the bridge into making it useful in either clinical practice or with public. And that I think is the most important part about doing the research and obviously for what you have at the moment in terms of

position with HVMN. It's something that is so important and right out there in the world that you can actually be touch base with all of the universities and the current research, including we found out that Perth as well right here in, you know, far away Perth. There's some research going on.

long? How many hours is that from West Coast America?

Yeah. So normally when I when I travel every year, it will be a sort of four five hour flight to Sydney and then it will be a 14 to 16 hour flight to LA and then anywhere else we add on to that. So it's about 20, 22 hours normally in in layovers as well. So it's far, it's far. It's time difference as well. And we flick that time difference. That's the biggest part. An impact on the body as well. So.

Yeah. So is that, is that bridge. it's really important. And I, and I completely, really honor the fact that that's something really close to your heart and actually educating like we are today. everyone about, you know, what you can be doing. And that's the important part and how you can be making change in your life and your family's life and in your clients or patients lives. so absolutely incredible. And HVMN, must say is the, you know, on the, taste.

Jodi Duval (11:30.474)
on also the aesthetics. It's a beautiful brand, but really gets to the point because ketones we must admit like they're not the greatest tasting things in the world.

People don't drink it for the taste. And we we had all these different like amazing flavors right now that we have. We used to tell people it tastes like it works and people get it. You sort of get it when you say that.

No, no.

Jodi Duval (11:56.878)
Absolutely. Yeah. My herbal medicine, when I mix that up for people and I don't like it, it's like, it's just, it's working well. So now onto, onto, onto the what, you know, so ketones. So explain to people, yeah, I'm sure we do have a big clinician focused audience here.

It's meant to be tasting like that.

Jodi Duval (12:24.998)
am on the podcast, but many people already know what ketones are, but maybe some basics 101s just to get us started into the conversation. Then we can head straight into some of the current research and exciting information.

That's great. Like ketone 101 always, always my go-to starter. So ketones are essentially fuel, fuel molecules that our bodies are genetically programmed to produce and also metabolize. It is not a new molecule like, you know, GLP-1 agon, a small molecule that may affect a certain pathway in your physiology. It is literally a natural molecule that your body will produce.

from fat molecules when you are low on sugar. it will physiologically be produced only when your blood sugar is low and your glycogen stores are low. So the only way to achieve that in modern times is via either keto diet where you restrict your carbohydrate intake or you intermittent fast where you do not eat for a long time. Now why

does the body create ketones? That's the question. Because if you're not using glucose, obviously fats are still available for metabolism. And in fact, actually create, or metabolizing fat create more ATP than glucose anyway. So why can't the body just use fat? The answer is due to the blood brain barrier. The blood brain barrier stops fat, which is a bigger molecule from going through, going past

blood brain barrier and enters the brain. So when you're low on sugar and the brain primarily uses sugar as a fuel for metabolism. So when you're low on sugar, the brain needs something else. And this something else is ketones. The answer is ketones. So the liver breaks down the fat into smaller molecules, i.e. ketones, and then will send it up to your brain to be metabolized and to be used for energy. So a lot of people might see it as an emergency fuel.

Dr. Latt Mansor (14:36.78)
But through all these studies that we have conducted, as well as we have observed, know, independent studies that we're not part of, we then realized that even when you are on a normal diet and you have high glucose level, which does not allow you to naturally produce ketones in your body, you can still increase your blood ketone levels by drinking exogenous ketones, which is an external source of ketones. So whatever I described earlier,

we would call it endogenous ketones, is internal, of internally produced ketones. When you drink exogenous ketones, you can increase your blood ketone levels regardless of your current physiological state. And in these studies, we realized that with the presence of ketones, a lot of good things happen. Your brain, your heart takes up ketones preferentially.

People with heart attacks, with heart failures are improving their symptoms when ketones are present. People that go through functional MRI saw that there is an increase in brain network stability when ketones are present. So meaning to say, it's not necessarily an emergency fuel. It is produced when you are low on glucose, but it's not necessarily a...

inefficient last resort sort of thing. I think we need to let people know and so that people can think out of that little box that it gives ketones. And it is an augmentation right now, the way I see it as an augmentation fuel that is given on top of whatever we already have in i.e. glucose or fat, and it enhances performance or it improves symptoms in therapeutic areas.

And it's just so much to be done. I feel still as you can agree in terms of research for this, cause it's still such an exciting field, but, it's, and it's been, it's been years now that we've been, but you know, in some, in some cases where you find something out and you go, wow, this is incredible. This has got a lot of clinical application and then you're like, Oh yeah, not exactly what we thought it was going to be, but ketones just keeps on giving.

Dr. Latt Mansor (16:55.138)
Now, I mean, let's look at it even timeline wise. Yes, ketone, like the keto diet has been around for more than a hundred years now because people have been using keto diet to treat epilepsy, but that is a natural way of producing endogenous ketones. It is probably not until, you know, maybe a decade ago that we have invented exogenous ketones where we allow our bodies to have access to ketones

even though we are not on a keto diet. So allowing us to see the effect of ketones on its own when our body is not in the natural ketosis level. So, so because of that, the research is still in its infancy level. And that's why a lot more work needs to be done to in both the basic science area as well as the clinical area as well, because

one is understanding the mechanism of action, but then two also really observing what are the clinical outcomes that comes from them.

Yeah, yeah, absolutely. So my interest in ketones initially sparked cognitive health. So from coming from that sort of neuroprotective, we also have hyperbaric. So Dr. Scott Scherz, hyperbaric here, good colleague, your friend, obviously co-host of the podcast as well. So I've been in the field of TBIs and cognitive health and neuroprotection, especially with athletes and

You know, I've got UFC fighters and basketball players coming in for emergency support and help. And we also have a lot of brain tumor cancer patients coming through the clinic as well. So initially that's where I got into a lot more of the research and looking at that and even for myself, again, like I think you love to experiment on myself and actually feel the benefits and know what that feels like in, you know, daily practice. So

Jodi Duval (18:58.114)
I think let's dive into cognitive health and neuroprotection and some of the key components and research that we're seeing or some maybe clinical uses applications on this. yeah, it's, guess that there is so much to be said about that. There is a lot of new studies showing that it's the executive function, there's the metabolic syndrome and also with Alzheimer's as well. So

I will let you lead the way with this because I know you know the research much better than I do. But it was just really interesting reading some of the different research components and more of the latest research around Alzheimer's and possible interventions that we can be using there as well.

Yeah. I think, as I said earlier, the brain has shown to preferentially taking up ketones, even when the other substrates are available. And then via functional MRI, we are seeing just one dose of exogenous ketones is similar to a week of keto diet where they saw an improvement in brain network stability.

which is defined by the interaction between the brain regions. So the cross talk between brain regions increases as you have ketones in the body. But I think recent papers also have published, I think it was like in January where they looked at specifically Alzheimer's where the role of ketones may also be responsible for the clearance of misfolded proteins by increasing the insolubility

of these misfolded proteins. And it's so interesting because as I said earlier, I just came back from a conference in Japan, the International Society of Heart Research World Congress. And while they were talking about cardiovascular disease, the role of misfolded protein also came up quite a few times because the accumulation, so, you know, it's normal for our proteins to be misfolded, right? It's just an error.

Dr. Latt Mansor (21:02.574)
You know, as we always keep, think of it as a factory, you know, there will be errors as we are producing all these proteins, but usually they will have a clearing house to make sure that these proteins are broken down and get recycled. The problem arises when these mechanisms are being blocked or being dysfunctional. And then therefore you get an accumulation of misfolded proteins that increases stress and oxidative damage.

So it's the same when it comes to the brain as well. And people do think that part of these accumulation of misfolded proteins are also contributing to the progression of Alzheimer's and that the presence of ketones may help clearing up these proteins by increasing the insolubility as well as making it targeted for autophagy.

Yeah, incredible. And I think, again, it's like there's such a big talk around the increase of dementia Alzheimer's and what we're seeing. And I say, you know, again, in clinic, it sort of like replicates what we're seeing outside. And I think many clinicians would agree is that the incidence of so many of these, you know, metabolic diseases, inflammatory diseases are really on the rise. And it's something that we need to be doing something about fast to help. Yeah, I know.

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Jodi Duval (23:22.082)
The home home nonprofit that sort of is behind this podcast, we do a lot of metabolic testing that sort of like that clinical metabolomics is our primary module to help support and teach doctors practitioners. And so we focus a lot on the mitochondria. So this is a really exciting part for all of us. So how are we seeing that sort of ketone shift any of this NAD plus NADH?

or even that integrity of the mitochondria. What are sort of the comments and some of the research that's come out recently?

Well, before I go into that, I love the fact that you're focusing on mitochondria because I think there is a lot to do with mitochondrial dysfunction when it comes to chronic diseases and, you know, cognitive or even metabolic syndrome, they do not stray far away from some form of some sort of mitochondrial dysfunction.

because mitochondria is so important in generating ATP. mean, that is the powerhouse of the cell. So that is the main organelle that essentially uses all these fuels and then go down a very complex pathway and create energy for whatever function of the cell is, whether it's creating energy for muscle cells to contract and relax.

for heart cells or creating energy for, you know, red blood cells to be able to carry enough oxygen throughout your body and so much more. And what we are seeing now is that the current diet and lifestyle of the modern human beings are being so perturbed from the natural, well,

Dr. Latt Mansor (25:15.374)
then people would say, what is the natural way of eating or living? But what I can say is that our current way of living and eating, the majority of us, it's not working well, especially in America, when we have more than 90 % metabolically unhealthy people, we are obviously not living how our bodies should be living. And how our bodies are reacting to it is overloading the mitochondria with a lot of stress.

with a lot of, with abundance of glucose. And hence the body is trying to counteract that by increasing insulin resistance. And then insulin resistance increases inflammation. Inflammation does create a lot more problems from that. So the question, whether or not BHB increases or have an effect on NAD and ADH sort of pool, it definitely does. I think, I mean, some, some diseases way back, they use

the measurement of BHB as a proxy to measure the NAD and NADH pool. So having said that, you know, the direct correlation of the total BHB concentration to NAD and NAD plus NADH pool. But I think it's definitely more complicated than that as well, because BHB will only go into, this is going into biochemistry now.

BHB goes into S.coa and goes to the Krebs cycle. That is not the only input into the whole system, right? And yes, that creates FADH and NADH and all of that. But ultimately, there are also the roles of intermediates that are being upregulated or downregulated that may affect the NAD and NADH pool. So we can't really say, BHB may help with increasing NAD

and therefore be good for energy. That is a very simplified, oversimplified way of seeing it. We got to really address what is the overarching problem here. Is the decrease in NAD caused by longevity? Is it caused by increased abundance of glucose, hence insulin resistance? Or is it some form of genetic dysfunction that is causing certain intermediates to block certain pathways?

Dr. Latt Mansor (27:40.364)
that can produce NAD, right? Because then you can try and identify the problem and also the solution rather than have one size fits all, BHP increases NAD. Do know what mean?

Yeah, absolutely. And I think it's important to note that the intermediaries or the intermediates that we talk about are these co-factors, know, exposomic, some of these toxins that are in our current environment, we are not living how we should be, you know, so when...

when I look at in my clinic, and obviously with home hope, we look at this clinical metabolomics and there's all these co factors and functions of, you know, what's, what's high, what's low, what's needing to be corrected, and then to push in that citric acid cycle into its effective motion. so exactly stop and start and push.

Exactly. Just glycolysis in and of itself. You haven't even entered the mitochondria. Glycolysis happens in the cytoplasm and that in and of its own has 10 steps and it has all these intermediates that may already affect what's going on in the mitochondria. Right? So then if you add in the intermediates of the Krebs cycle, it becomes more and more complicated after that.

It is yeah. And for brains like yourself and somewhat myself, we find the excitement in that because it's really nitty gritty and really interesting to actually push and pull different levers for clients as well and to see how that can make big impacts in their life and their mitochondrial health. And so with the mitochondria as well, you know, a lot of that is cardiac tissue, you know, when we're talking about big dense areas of mitochondria and where we're looking at in terms of, you know,

Jodi Duval (29:28.182)
reproductive organs, heart, brain, even eyes, you know, so they're their most highest density components or percentages of mitochondria. So you think about the fact that, you know, when we impact or have this inflammatory cascade or, you know, ill living measures, then they're the areas, they're the organs, they're the components that are going to be most affected and you're going to see much faster.

And I see in clinic, you know, people's eyesight starts to decline, their heart health starts to decline, their reproductive organs and their reproductive health is declining. And sometimes when we look at that, it's just that shift in mitochondrial health and really knowing how to push and support that. And then, wow, we have a big impact across multiple systems. So I know cardiac health is a big part of your research.

So, you know, what have we seen potentially, you know, looking at now in the research?

Yeah. So we've got quite a few papers now, both coming out from the Denmark Arhats University, as well as I believe Duke University and Penn, UPenn here in the U.S. We have seen multiple studies using exogenous ketones, essentially improving outcomes in heart failure patients. And what they have seen is that it really improves the cardiac output.

improves the ejection fraction, even with just one dose of ketones. So right now we have the biggest clinical trial on exogenous ketones, which I believe, because we have 250 heart failure patients going on ketone IQ for 30 days in Aarhus University in Denmark. So these are heart failure patients and they are essentially going to be improving their symptoms hopefully. And we'll see the results in two years time.

Dr. Latt Mansor (31:26.158)
Um, and actually this week I just wrote a, uh, a support letter from, uh, for the same group of researchers, one of the, uh, the researcher who is a interventional cardiologist. So he deals with a lot of, um, patients with a heart attack. not necessarily heart failure, but, but heart attack. And he'll go in there with the stent and try and, and re perfuse those hearts. And he is writing a grant.

that is an open call by Novo Nordis looking at myocardial infarction and specifically using ketone IQ to prevent the cardiac remodeling after myocardial infarction. So people don't understand if you have a heart attack, some of your tissues or some of your myocardial myocytes, cardiomyocytes, some of the cells in your heart will die off. Some of it will be damaged.

Right? You have oxidative damage because there is lack of blood going in because what is heart attack is essentially ischemia is the lack of blood flow. So when you have a lack of blood flow, you have lack of substrates going in, you have lack of oxygen going in and you have lack of waste coming out. So there's accumulation of waste as well. So that sort of oxidative damage can kill off some of yourselves. As soon as you re-perfuse a lot of the damage happens.

upon reperfusion. A lot of people think that the damage is when you have that blockage. know, when you reperfuse, they call it reperfusion injury. So that is when a lot of damage happens as well. after myocardial infarction, there is some form of cardiac remodeling to really, it's a compensatory mechanism so that your heart can cope to survive that, that, that sort of insult.

And sometimes you get a cardio hypertrophy. You get the heart enlargement of the heart. Sometimes you get arrhythmia, which is a regular heart rate and a lot of sort of dysfunction that comes with the remodeling. So this researcher, this cardiologist, he is convinced that ketone IQ may be able to mitigate, if not prevent that sort of remodeling.

Dr. Latt Mansor (33:37.602)
by mitigating the damage in the beginning to begin with. And it will be very interesting to see if we can get this grant. And we'll find out in a couple of months.

Yeah. And, and what incredible work because of the, again, you know, we talk about mitochondrial and issues and, you heart, it's, it's the biggest conversation that most of us had. And most people are so aware of the fact of monitoring their cardiac health and to have impacts like this, because the rates again, they're going up. Yeah. It's absolutely incredible. I can't wait to see the research come out then.

Yeah. And one more point I want to add is that if you notice whenever we would talk about the brain and the heart and a lot of these other areas is what is the overarching theme here? It is the deficiency in energy. for example, in the brain, if you are having, so they call it, know, type three diabetes, there's some form of glucose deficiency or glucose metabolism deficiency that is

reducing the energy being produced in the brain and therefore creating the damage. Same thing in a heart attack where you have lack of blood flow, lack of substrates going in and therefore really hampering the production of ATP in the heart. And mind you, like you said, why are organs like heart and brain have the densest mitochondria is because they have to keep working even when we're not, even when we're sleeping, it has to keep working since you're born until the day you die.

So therefore it has to make sure that it is omnivorous. It can take in any fuel. It can switch over. That's why metabolic flexibility is very important so that you can switch over to fats and glucose in whichever situation that calls for one or another. And to be able to really run on, you know, whatever fuel that is most efficient. And a lot of these studies showed

Dr. Latt Mansor (35:37.314)
that ketones are the most efficient fuel because they are being taken out because when they measure the arterial blood and the venous blood, so blood going in, blood going out, they saw the increase in uptake in ketones directly correlating to the availability of ketones in the blood. And this is independent of the presence of the other substrates as well. So it's not reducing glucose or fat intake. It is on top of what they're taking.

they're also taking in ketones, which is super interesting because now you are having a lot of substrate to create more energy, knowing that in the failing heart, you do need a lot more energy than normal.

Hmm. Yeah. Just all 100 % love all of that that you just said. It's, and I think it's a really good segue into, I'd love to talk a bit more about metabolic flexibility as well, but I also want to talk about sort of mental health because there is again, a rise in mental health issues. but you know, again, with this metabolic flexibility, that's the most, that's the most interesting component I see in observation in clinic is when I start to get clients to actually,

increase their metabolic flexibility switching. So mostly I'll get clients here really high insulin levels, really poor glucose metabolism. And then when we shift that and start to change that slowly, their resiliency to everything improves. And I find it so fascinating that most people that I see in the outside world of this sort of health field don't have

any metabolic flexibility. And it's really detrimental, shaky, can't regulate meals without, you know, time without meals. So it's some of the most powerful things we can actually give our clients, patients is this increase in support into metabolic flexibility. I'm totally on board with all of that. I love it. So segue into how

Jodi Duval (37:42.51)
keto or ketones and ketogenic diets can and have been shown to improve even the psychiatric symptoms. So bipolar was something that I was reading about schizophrenia. And again, I know it comes back to what we've already spoken about. So it's sort of like reiterating some some key messages here. But how how do we see ketone esters or they be making the biggest effect here in the mental health field?

Yeah. And one thing also to clarify. So whenever we talk about ketones, I'm referring to BHB, like you said, because that is the main form of ketones that our body produce and also transport around because it is the most stable. But there are also two other ketones that our bodies produce, which are acetoacetate, which is usually released via breath and sorry, acetoacetate released via urine and then acetone released via breath.

whereas ketone ester is a form of exogenous ketones that has BHB bound to RN3-butanediol. And our product, ketone IQ, is a pure R1-3-butanediol, which is an iteration of what ketone ester was. Because we were the first people who brought ketone ester to the market in 2017. And then now we're just sticking with the R1-3-butanediol as our main product.

Yeah, that's a good clarification. was going to say that we'd touch base on that at least by the end. Yeah. Yeah.

Yeah. So, so I think the area of metabolic psychiatry or even the term, that coin, you know, the term metabolic psychiatry is fairly new. you know, people like Dr. Chris Palmer from Harvard really came out and took it and gave all the evidence that we needed to associate mental illness, psychiatric disorders with metabolic dysfunction.

Dr. Latt Mansor (39:35.198)
you know, he really thinks that it is not a brain problem. is a metabolism problem. And when he started to treat his, his psychiatric patients with a keto diet in the beginning to, to, to really solve the metabolic side of things, because they are overweight and they're increasing the risk of cardiovascular disease and all of that. It wasn't meant to treat psychiatric disorders. And then he noticed there was an.

improvement in symptoms in the psychiatric disorders. That was when a light bulbs of lit up and and he started using the keto diet and the the the the change of lifestyle to really treat these psychiatric disorders. In fact, right now we are in collaboration. We're talking with a researcher called Dr. Mary Phillips. She's a leading psychiatrist in the world. She has a six million dollar grant.

to look at treating bipolar disorder using keto diet by the Bazooka group. And we are currently drafting an application to apply to SBIR and NIH to look at the at-risk group using ketone IQ as well. So it is a very new area because in the past people with psychiatric disorders are being treated

based on the symptoms and then they're given the drugs and then they're to, you know, even with the exact same symptoms, exact same drugs, the outcomes can be different. So that's what they've observed. So they don't know why. And they sort of chalked it to, you know, the brain is different between people. There's inter individual variability. But now with all of these studies and all of this funding going to really look into the role of keto diet, looking on ketones,

we are going to find out more about the link between mental illness and metabolic dysfunction.

Jodi Duval (41:34.616)
Yeah. And even having a quick read over some of this research in preparation for today, you know, looking at how also that impact of the neurotransmitters. And then when we're looking at some of these impacts of what we know of also our interaction with our environment, you know, we can't forget that epigenetics, exposomics impact.

constantly, but it's something now we have actually as an alternative with less side effects and supporting people to actually control or support and get better outcomes in mood disorders. And again, it's on the rise and it's really, it's a very disheartening place to be when you're a clinician watching people really suffer and it's not given enough validity, I feel, with the current GPs and the primary care physicians.

In some cases, they're not taking it as seriously as we need to. And so again, this information is so important so people actually have an understanding of like, this is an option. We can actually be using this and this is a research and this is what it shows. Absolutely incredible. I really, really love this. So this episode is also brought to you by Troscriptions, creators of Blue Canotine, a precision diced buckle trochee designed to boost mental focus, clarity and verbal fluency.

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Now back to Dr. La and how energy metabolism affects cognition, psychiatric resilience and recovery. I want to segue into emerging therapies and some innovations. And I know this is a big part of what you and your history of research has involved and sort of this building into muscle retention as we sort of age. There is a huge

Jodi Duval (43:49.646)
piece around GLPs at the moment as well and causing, you know, early psychopenia and things like that, that are more new in terms of the research. But what most fascinated me was this perspective of this lake molecule. And so I'm not sure if you could, it's this exercise, mimic impact of using the lactate and ketones. That's something that fascinated me the most when I was reading through this.

So, just to clarify, is that lactate and ketonesta?

Lactate? Yeah. So it was the ketones. So it was was used in the met some of the metabolic health interventions. So it was mimicking the exercise. Yeah.

Right. So what we have seen, this was published by McCarthy et al, is that ketone ester, specifically ketone ester, when given, it raises blood ketone levels at a very high level to a very high level very quickly. So that's the pro of it. But the cons of raising it so high so quickly is that you drop your blood pH. So your blood becomes more acidic.

And as a result in that study, they show an increase in cardiorespiratory stress biomarkers. So these people who are exercising on ketone ester, they have higher heart rate, they have higher breathing rate and they have higher rate of perceived exertion. So they feel like they're working out harder, but without the performance enhancement. I personally, based on the literature that we have,

Dr. Latt Mansor (45:25.868)
wouldn't recommend using lactate and ketone ester for exercise because lactate is also another form of acid, right? So you are essentially piling onto the acidification of your blood. So you're increasing that cardiorespiratory stress biomarkers because your heart is now working double time to expel the carbon dioxide to really neutralize the blood.

That's why we switch over to R1-3-butyendial or ketone IQ because we have not seen that acidification of blood when people take it for exercise. One of reasons is because ketone ester, half of the molecule is BHP and it goes straight to your blood and that is what probably causing the pH to drop.

Whereas the butyendial enters your liver and gets converted to BHP. So your liver can act as a gatekeeper, monitoring all of the inputs, all of the feedback that your body is giving it and making sure that we don't get too high of a ketone level. Because remember this, even though something is good for you, too much of it, it's still not good for you. Vitamin C is good for you. You shouldn't take too much of it either. You know, same thing with ketone.

Yeah, same thing with ketones. It is very good for you, but you want to keep it within the optimal zone. In a lot of these studies, we found that the optimal zone is between 1 to 2.5 millimole.

Yeah. Okay. Perfect. And I definitely want to get into personalizing some of this supplementation, but, I think a good, good thing to sort of say there is that there is an, we, we always are searching for this magic pill, you know, to actually come away from the real thing of doing exercise or eating healthy, but it really is just down to the fact that we actually just need to be doing the eating healthy exercise and the basics and the sunshine. but yet the acidity, you know, again, it's all of these, you know, ongoing or,

Jodi Duval (47:28.79)
outside of impacts that would be even bone density issues. So really understanding that before applying these things, like you say, and too much of a good thing is not a good thing. And so always remembering that. So back to sarcopenia. And so it is again, a big issue in aging populations, but we are seeing it earlier now. so what's your most valued or

impactful information that you want people to know about this and also their link with ketones.

For Oskopinia specifically.

Yeah, so preservation, preservation of muscle. Yeah.

Yeah.

Dr. Latt Mansor (48:11.726)
It's really funny because we talked about it earlier. My undergraduate thesis was on adipose tissue metabolism and the mathematical model of it. But my master's thesis was actually on psychopenia, whereas I'm using exercise as an intervention against psychopenia. So I looked at both aerobic

endurance exercise as well as strength exercise. obviously strength exercise is very, very important in preventing sarcopenia. And we have seen impact of strength training in even like 80 year olds and 90 year olds. And they're still able to, produce muscles and, and really build muscle when given the right, routine and nutrition. Now, as far as ketones are, are concerned, we have definitely seen.

are ketones preserving muscles in our tachyxia animal models. So when you have muscle wastage in sort of cancer models, we saw that ketones preserve the muscles and in humans in exercise physiology specifically, we have seen that when people exercise and then post exercise having ketones, proteins and glucose, they saw an, they saw amtol activation. So that is increasing protein synthesis.

and essentially helping you recover and really repair those muscles as you used use them and, you know, damage them. And we have also seen an increase in glycogen resynthesis in the muscles, which again will help you recover better and perform better over time. And recently we just finished a study with KU Leuven in Belgium looking specifically in EPO, erythropoietin.

which is a signal that gets sent to your bone marrow to increase red blood cells production and therefore increasing oxygen delivery and adaptation to hypoxia. But we also saw increase in markers related to antigenesis, which is new blood vessels formation. So all of that really goes into how are you training and how can ketones help with the adaptation of your training?

Dr. Latt Mansor (50:28.578)
you're damaging your muscles or you're needing more oxygen because you're training in high altitude. How is ketone essentially acting not just as a fuel, but also as a signaling molecule that is jumpstarting all these different pathways that helps you physiologically and anatomically build the different parts of your body to then adapt to that workload.

Incredible. So fascinating. I love that you're saying that it's a signaling molecule. I think it's a really interesting way to view ketones. I absolutely love that.

And for the fact that we can use it as also, and this is a segue into my next question for you to make it practically applicable in real life and within clinics is that we can use it in combination with other things too. And like you're saying, it's sort of like you use it as an aid and supporter for some of the activities or the therapies and things that you're trying to achieve. So personalizing the ketone supplementation.

A big question because again, we have to measure it correctly. We have to know what is going on. It can be not an easy thing to get right. Obviously there is the, you know, what we are aware of, you know, fasting will cause ketosis. But where can we apply ketones, especially the ones that you're, you know, HVMM are creating ketone IQ to

impact certain areas of either clinicians life and we have to keep it sort of quite broad I guess because it is hard to touch on all of these but where have you seen it to be most applicable?

Dr. Latt Mansor (52:17.108)
If we go back to the theme of our conversation, a lot of these dysfunction or diseases that we talked about is due to deficiency in energy, right? So then let's reverse engineer that and think about where do we need energy? If you need energy in the beginning of the day, where you're going to start your day, either you go to meetings, have, you have presentation and whatnot, have it in the morning. And then that will sustain you throughout.

you know, at least six to eight hours. So you can take that for a cognitive productivity point of view. Right. But then if you're talking about, okay, at the end of the day, I need to go to like for myself, I work out, I go to the gym after work. So it is already at the end of the day, my energy might be a bit lower. So I have it as a pre-workout. then I'll have it half an hour before I go. And then I'll have that energy to get through.

my workout and really help with my recovery as well. So it really, I already want people to think about where do you need energy most? That is the best time to take ketone IQ. And usually you'll be able to feel the difference, subjective difference between, within 15 to 20 minutes. You can feel that clarity once you take it. And I think that is

one of the main reason why we are still doing so well, despite the taste, right? Because naturally it doesn't taste good, as we said, but people don't take it for the taste. People literally can feel that they can focus better and they can perform better when they are doing exercises, whether they are doing endurance exercise or anaerobic exercise, because we have now shown in both endurance and anaerobic exercise, ketones has its place in really enhancing power as well as

duration

Jodi Duval (54:14.446)
Yeah, no, absolutely. And I second that, you you feel the clarity is like you say, 10 to 15, 20 minutes later, you can, you know, get going in the cognitively in the space and then muscles, they are all working much more efficiently.

And you also asked, you also asked in terms of like dosing, right? Do note that a lot of these studies are body weight matched dose. So meaning that depending on how heavy that person is, we are matching that body weight to dose them rather than having all 10 grams, 20 grams, 30 grams. We are usually finding that 0.3 grams per kilogram of body weight to be an ideal dose. And one great way to

to see how much you need is by measuring your blood ketone levels, like we said earlier. So, you know, find a ketone meter either like Abbott or Keto-Mojo or whatever, your finger, look at your blood ketone levels. You want to be in between, you know, one to 2.5 for performance, especially for physical performance. If it's for cognitive, usually anything above 0.5, you should be good to go.

I think then you can adjust up and down depending on where you want to be. And also like really, you know, keep the record for yourself and then try and associate how you feel subjectively to your ketone levels, because that will tell you how much you actually need. But in the studies it's 0.3 gram per kilogram of body weight.

That looks fascinating.

Dr. Latt Mansor (55:58.574)
Great question. So I would measure like half an hour after or half an hour between half an hour to an hour you're good to go.

Jodi Duval (56:17.728)
Absolutely. It's so exciting. And again, it's back to that basics where you said is that energy, you know, where are we needing more energy and why is the body not efficiently making or putting it in those areas itself? And so it's very, it's very simplified as well, but we can go really complex like we have. So, yeah, I thank you so much for, giving us all of that information. I wish I could talk to you for hours and I'll probably have to have you back on to talk about more because there's so much.

Not taking more than 30 grams a day. That would be our advice. would recommend it goes as like, know, 30 grams a day. But although some of our athletes, they do take more than 30 grams, but they are using it for long endurance runs. So as they are running, they are measuring their ketones as well. They know where they are and your body is constantly using it up. So yeah.

Research coming. So we have to keep up to date there.

Exactly. And if you do a video set, obviously your body will start to feel, you know, you feel GI distress and all of that. So you, you won't feel well.

Dr. Latt Mansor (57:04.566)
I mean, even glucose, if you take too much of glucose, you start puking.

Dr. Latt Mansor (57:19.054)
I mean, even if you're on your keto diet, MCT is great for you, but try taking a lot of MCT and see what happens.

Dr. Latt Mansor (57:29.812)
Yeah, you can feel it. You can feel your bowels.

So yeah, and are we good to have that that research there to have guidelines around that? But anecdotally, I see that and you would have again, it's like this is why you're doing the research is that it's a natural side effect, a positive side effect to have the appetite suppression for most cases with ketone supplementation. really, so where can we find you? Where can we find more about all of this? We'll put all the links, obviously, in the podcast as well. But

Is there anything specifically you to point people in the direction of so they can find more?

Yeah, sure. I think there are a lot of ketones now, know, ketone companies.

Yeah, exactly. All of this popping up on Amazon and all of that. So it's important for people to really go to the ingredients section and see what exactly is the form of ketone that they're selling. So one very common and cheap form of ketones are ketone salts. So you see BHB bound with any salt, potassium, sodium, magnesium. So BHB, sodium, BHB, magnesium, those are ketone salts.

Jodi Duval (58:15.854)
Perfect. All right. Dr. Lattman, so it's been an honor and I don't want to stop but I have to. So thank you so much again for your time. It's very valuable and I really thank you for being here with us today.

Thank you for joining us for another episode of Smarter Not Harder. A huge thank you to Dr. Lart Mansell. It was such a fun episode. He shared his expertise on ketones, mitochondria, metabolic health, and his ability to bridge deep science with real world application is really inspiring and such a nice person. So here are some key takeaways from today's conversation. Ketones are

And ketone salts taste much better and it's much cheaper. However, it doesn't usually get you to that zone to one millimolar and above, because if you start piling up a lot of ketone salt, if you drink a lot of it, it is dose dependent to a certain point, but you are also increasing your salt load and you're increasing risk of diarrhea as well and GI distress. So that's ketone salts. And then you have ketone esters.

not just emergency fuel, they're efficient, clean burning energy sources with roles in signaling recovery and cognition. Metabolic flexibility is essential for longevity and resilience and it's trainable. Exogenous ketones like ketone IQ may support everything from mental clarity and muscle preservation to mood and heart health. And ketones show promise in areas like psychiatric care, Alzheimer's and cardiac remodeling post heart attack.

which are BHB bound with RN3 butane diol. Those are the most premium, the most expensive one. And those are the one that really shoots up your blood ketone levels to a really high level. And when we sort of marketed it to the world in 2017, we thought good things, ketones are good things. So you want it as high as possible, as fast as possible. Turns out we're wrong, right? And that's what science is all about, right? Really finding out.

Jodi Duval (59:24.94)
The future of medicine will likely include precision energy support, targeting metabolism at the mitochondrial level. So if this episode sparked your curiosity, make sure to subscribe, leave us a review and share it with your network so you don't miss out. And don't forget to check out the YouTube channel for upcoming episodes and visual content. And remember when we optimize energy, we optimize everything.

Okay. Admitting that that is not the best solution because you're increasing acidity in the blood because you're raising your blood ketones too fast. So what else after that? Right. So that's where we arrived at R1-3 butane dial as something that has a much more subtle increase in blood ketone levels, but it stays up longer than ketone ester because ketone ester goes up very fast and then it drops, it crashes down.

So until next time, stay curious, keep learning, and we'll be back soon with another one cent solution to a $64,000 question.

Butane dial, goes up, it stays up for as long as six hours if you are not working out. If you're working out, will go down faster, obviously, because your body is using it. So, and then some people also claim that, butane dial is alcohol, you get drunk on it. I'm like, we have Olympians using ketone IQ. Do you think that Olympians would risk their career if it's an alcohol, if it has an intoxication effect? If you overdose anything, it will be

you know, it will be bad, like we said. So I think people are trying to sell the overdosing of it, and, not actually following the science. And we also NSF certified as well. have to go through a very rigorous process to ensure the safety and efficacy of the product. And therefore, like, I, I love whenever people ask me, is it alcohol? And I love for those people claim it.

Dr. Latt Mansor (01:00:56.77)
have a live debate with me, bring all the literature, bring all the science and let's talk science, right? Because we have people who are being saved, you know, all over around the world in like mental health, in heart failure, all of these areas that I'm very, very passionate about and very proud of. And for them to like just put out all these claims for marketing purposes is just not very high integrity.

Dr. Latt Mansor (01:02:00.206)
And the company who sells it as alcohol as well, I believe the product is 12.5 grams and they call it alcohol. But then they also sell their ketone esters, which is 25 grams, half of which is also butane diol. But then that is not alcohol. That's for performance. I'm like, can't have the two opposing claims. And that's where the scientific integrity comes in. That's where you know what...

company actually knows the product well and knows the science well.

Dr. Latt Mansor (01:03:19.65)
No, thank you very much for your kind words. Unfortunately, I am not making as much content as I used to because I'm focusing a lot on research collaborations and grant applications. And these are the things that I'm very excited about. And to answer your question, one of our grants is very close, very, very close. We've got a final review of the council looking at sleep apnea. So we are collaborating with Johns Hopkins for that study. So fingers crossed, we'll find out in July.

whether or not we'll get it. And obviously this big study of heart failure, the 250 patients on ketone IQ for 30 days. It's also very important in both efficacy and safety to tell us that, you know, ketone IQ does not have any negative effects, but in fact, is saving people with heart failure. And in September, on the September deadline, we have a bunch of grant applications that will be going out covering different areas of like fatty liver disease.

bipolar disorder, cognition in, in like shift workers, spreading depolarization in migraine patients. Yeah. And I believe there's one more, but yeah, a lot of these different areas and, I am very, very blessed to be in this position working for this company and this product, because I don't think that

there is another product, another food product out there, there is as widely applicable in all these so different therapeutic areas as ketone would be. Because when was the last time I hear a food product, cardiovascular disease and mental illness and appetite suppression?

Dr. Latt Mansor (01:05:36.91)
That be an awesome.

Dr. Latt Mansor (01:05:41.666)
Yeah, I mean, one of our research is finishing in July. It's with University of British Columbia in Canada looking at appetite suppression. So we are looking at Laptin, ghrelin, peptide YY and GLP-1, which will be super interesting if it does have some form of significant effect because given how popular GLP-1 is, but then you also get a lot of the side effects and all of that. Although nowadays they do talk about micro-dosing GLP-1.

So we'll see, you know, we'll be able to use it as a supplement for people who are trying to lose weight, who are going on keto diet and all of that.

Dr. Latt Mansor (01:06:51.756)
Yeah, sure. You can find me at Latmansoor, L-A-T-T-M-A-N-S-O-R on all social media and at ketone for ketone IQ as well as the website www.ketone.com.

Dr. Latt Mansor (01:07:20.43)
Thank you for having me.

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