Dom D'Agostino on Disease Prevention, Cancer, and Living Longer (#188)

dominic d'agostino

“The pursuit of size and strength really contradicts what we want to go after for longevity.” – Dominic D’Agostino

Dr. Dominic “Dom” D’Agostino (@DominicDAgosti2) is one of my most popular guests, and I’m happy to have him rejoin the show for the third time. (You can listen to Dom’s first appearance here, and his second appearance here).

Dom is an assistant 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) — which is mentioned in the current issue of Outside Magazine (on which there’s a clown who looks a lot like me).

Much of Dom’s work is related to metabolic therapies and nutritional strategies for peak performance and resilience in extreme environments. Dom’s research is supported by the Office of Naval Research (ONR), Department of Defense (DoD), and other private organizations and foundations.

In this episode, Dom focuses on disease prevention, cancer, and more mastery of the ketogenic diet. Please enjoy this tutorial and masterclass with Dominic D’Agostino.

You can find the transcript of this episode here. Transcripts of all episodes can be found here.

#188: Dom D'Agostino on Disease Prevention, Cancer, and Living Longer

Want to hear my first interview with Dom D’Agostino? — Listen to our in-depth conversation here. In this episode, we discuss fasting, heavy deadlifts, and the end of cancer (stream below or right-click here to download):

#117: Dom D'Agostino on Fasting, Ketosis, and The End of Cancer

This podcast is brought to you by Vimeo Business. Vimeo Business has all of the prior benefits of Vimeo Pro, including VIP support. Whether you make videos for a living, run your own company, or simply want to amp up your video marketing, Vimeo Business is here to help. It has more than 280 million creators and viewers worldwide and makes it easier to share your videos with a global audience and connect with professional video makers to bring your stories to life.

Vimeo Business allows you to upload up to five terabytes and store your videos in one secure place, add up to 10 team members to your account for easy collaboration, and gather feedback with seamless review tools. You can even add clickable calls to action and capture email addresses directly in the player, which can help you generate leads and drive conversion for whatever you’re trying to optimize — such as a newsletter or a sales page.  Check out to save 10 percent on Vimeo Business.

This podcast is also brought to you by Wealthfront. Wealthfront is a massively disruptive (in a good way) set-it-and-forget-it investing service led by technologists from places like Apple. It has exploded in popularity in the last two years and now has more than $2.5B under management. Why? Because you can get services previously limited to the ultra-wealthy and only pay pennies on the dollar for them, and it’s all through smarter software instead of retail locations and bloated sales teams.

Check out, take their risk assessment quiz, which only takes 2-5 minutes, and they’ll show you — for free — exactly the portfolio they’d put you in. If you want to just take their advice and do it yourself, you can. Well worth a few minutes to explore:

QUESTION(S) OF THE DAY: What was your favorite quote or lesson from this episode? Please let me know in the comments.

Scroll below for links and show notes…

Selected Links from the Episode

  • Connect with Dom D’Agostino: | Facebook | TwitterUniversity of South Florida

Show Notes

  • Does the ketogenic diet “beat” chemotherapy for cancer? [06:45]
  • Dom elaborates on the detoxifying effects of ketosis on precancerous cells in healthy individuals. [15:07]
  • How does one jump start a daily ketogenic cycle without supplements? [16:25]
  • How can lean muscle mass be maintained when fasting? [17:56]
  • What types of cancers are most affected by ketosis? [21:34]
  • What process is most effective for targeting cancer? [23:25]
  • The ketogenic diet as a do no harm therapy. [26:14]
  • Nutritional ketosis and hyperbaric oxygen therapy: how, why, and when? [27:51]
  • How long would an amateur endurance athlete need to be in ketosis to get the full benefit of being fat adapted for a marathon, and what supplement stack would Dom recommend? [33:47]
  • Should an APOE4 (Apolipoprotein E) carrier — someone at genetic risk for Alzheimer’s disease — be careful with a ketogenic diet? [36:35]
  • Are there any downsides to shifting out of ketosis for an occasional cheat meal? [41:06]
  • What does Dom have to say about the study that found ketogenic diets have no metabolic advantage? [46:19]
  • If your body doesn’t do well with dairy or nuts, what would be good fat source alternatives on a modified ketogenic diet? [48:58]
  • Dom talks about Metformin, methylene blue, and other non-food substances meant to increase longevity. [50:24]
  • Can the ketogenic diet be used while glycolytic training? [58:06]
  • What is it like for Dom to be an academic who makes serious weight training a big part of his life, and how do these two pursuits complement (or complicate) each other? [1:01:06]
  • Dom’s thoughts on John Kiefer’s carb backloading. [1:07:26]
  • Are ketone salt products on the market safe — specifically the DL beta-Hydroxybutyric salts? [1:12:27]

People Mentioned

The Tim Ferriss Show is one of the most popular podcasts in the world with more than 900 million downloads. It has been selected for "Best of Apple Podcasts" three times, it is often the #1 interview podcast across all of Apple Podcasts, and it's been ranked #1 out of 400,000+ podcasts on many occasions. To listen to any of the past episodes for free, check out this page.

Leave a Reply

Comment Rules: Remember what Fonzie was like? Cool. That’s how we’re gonna be — cool. Critical is fine, but if you’re rude, we’ll delete your stuff. Please do not put your URL in the comment text and please use your PERSONAL name or initials and not your business name, as the latter comes off like spam. Have fun and thanks for adding to the conversation! (Thanks to Brian Oberkirch for the inspiration.)

34 Replies to “Dom D'Agostino on Disease Prevention, Cancer, and Living Longer (#188)”

  1. Thank you Dominic for another fascinating episode!

    I think you might be the ideal man to answer this question for me. Dr. Nun Amen Ra claims to eat an average of 1250kcal per day in a single vegan meal, he fasts the remaining 23 hours per day. Do you think this is plausible?

    Whether he uses anabolic steroids with his deadlifting world records or not, does not concern me so much. Rather, could he eat so few calories per day is enough to maintain weight and muscle mass? Autophagy, increased GH production, ketosis/lipolysis should all play a role, however I am a BIT skeptical skill.

  2. Regarding BCAAs and how it affects to uptake of tryptophan (a precursor for serotonin production), should someone who suffers from major depression and is currently taking SSRI anti-depressants stay away from supplementing with BCAAs?

  3. Great having Dom on as always – very informative! Dom covered Kiefer’s Carb Backloading protocol, but didn’t get to the Carb Night (CN) protocol. Given that CN is essentially a type of cyclic ketogenic diet, I’d love to hear Dom’s thoughts on it. Kiefer is adamant that a weekly carb re-feed and the associated insulin response is critical so that Thyroid hormones don’t get down-regulated while on a long term ketogenic protocol.



    1. I have Hashimoto’s and have been on keto for about 8 months and I have a feeling that it’s been adversely affecting my thyroid disorder. I’ve read that an insulin response is required for T4 to T3 conversion. I’m now considering integrating a carb re-feed every few days but still would like to keep staying on keto since I want to keep the benefits of that. Would also love to know Dom’s thoughts on this.

  4. Thanks for one more Don episode!!!

    What I’m still wishing is to see a list of blood exams to do prior and after ketosis transitioning and fasting (I’m initially going for a 4 day fast).

    I’m willing to donate $100 through PayPal to the best scientifically based answer.


    1. I have to ask what your goals are, for optimum health i personally think thru years of my own research is the wahls foundation diet,if your goals are for a leaner body then i suggest following dr axe,on youtube he recommends eating at noon 3 and 6pm, so your bascially intermittent fasting daily, both of theses individuals are MD’s and have common sense at their core,ok pay me bud that was sooooo worth 100

  5. I listened to the first two podcasts and started connecting some dots. I started on the ketogenic diet 15 days ago. I feel like I’m fasting, but I am eating. My overall wellbeing has increased exponentially. I also love butter and heavy whipping cream in my coffee now. Thanks for the podcasts Tim and Dom.

  6. Always interesting. Thank you.


    Could someone please explain to me how you are doing a fast if you are consuming BCAAs?

    BCAAs are food.

  7. Altho Dom says that slow growing prostate cancer is not affected by a keto diet, there are aggressive prostate cancers. Are the aggressive forms of prostate cancer influenced by a keto diet?

  8. Hey Tim,

    Great show as always. So glad you could get Dr. Dom on the show again. I have a possible guest for you: Andrew Skurka. You will love this guy, he is does crazy extreme hiking, and we all know you love crazy and extreme. (Hiked the Pacific Crest Trail, Continental Divide Trail and the Appalachian Trail all in one year!!) Totally up your alley!

  9. I would be interested if Dom has an opinion on IP-6 as a cancer preventative supplement and if he thinks it’s worth consideration as part of a treatment plan for cancer patients.

  10. Tim, Dom

    There’s this professor in Germany who’s been dedicating her life in order to fight cancer with the ketogenic diet. Her name is Prof. Dr. Ulrike Kämmerer. She’s fighting a difficult battle, and is kind of fighting against windmills, but she continues to fight. She’s also written a book (I believe it’s being translated into English), my own translation into English would be:”Cancer cells need sugar, patients need fat”. She works at the university hospital in Würzburg, Germany. It would mean the world to me (and surely to her as well as to many others in the German speaking countries) if you could somehow touch base with her, i.e. for an interview or a general exchange of thoughts or for collaboration etc. I am sure you can find her on the Web in case interested.

    Thank you


  11. Hi Tim.

    I have your book, The 4-Hour Body, and I am about to take on the diet routine… This looks like a diet I can relate to and carry out without major difficulties. But I have a couple of questions:

    1: Are other oils than olive oil acceptable? I use sesame oil on thinly sliced hipsi cabage.

    2: Is it acceptable to sprinkle salads with sesame and nigella seeds?

  12. Would love if someone can help.

    Is there any study that shows the ketogenic diet can help with ulcerative colitis?

    I have searched, but it is foums and blog posts. It would be great to read some data.


  13. These masterclasses are wonderful. I am continually impressed by your ability to balance enthusiasm and conviction with rigor and humility.

    I’ve heard you mention specifics of weight training here and there (Arnold’s book here, weighted stretching on IHMC, admiration for Layne Norton’s work, etc.). I’ve also heard you talk in a few places about how you would do things very differently if you were starting out knowing what you know now, but the details are mostly related to nutritional ketosis. I’m interested in your perspectives on the practice of and best resources for weight lifting, particularly for novice and intermediate trainees (i.e. folks who aren’t athletes).

    Of course specifics for training depend on a person’s goals (general health vs. powerlifting vs. bodybuilding, etc.), so you can feel free to speak to one of these general goals or maybe, to make it more specific, talk about what you would change in your own practices at, say, 20 or 25 years old if you could travel back in time.

    Thank you for your work. Inspiring stuff.

  14. I just found out that I have the GG genotype APOA2. This isnt mentioned in this podcast, only Apoe4. Is Keto ideal for me? I know this is merely one snp, and needs to be looked at beyond just this one. But in general, for people wanting to keto. APOA2?

  15. Tim – would adding a bit of fat consumption (say coconut oil in coffee) every morning on your monthly 3-day fast accomplish basically everything? To me it seems it would give a bit of energy to the brain in the morning yet starve cancerous/pre-cancerous cells of glycogen. Or is there more you are trying to accomplish during this monthly food abstinence?

  16. Thank you Dominic for another great episode. I was wondering if fasting or Ketosis has any benefit for for gynecomastia reversal, specifically reducing the gland size and not fat deposits in the the breast tissue. Are the effects of autophagy as induced by a fast effective to reduce this type of tissue?

    Thanks you,

    Vasily S

  17. Thanks to both of you for sharing all this info. I used 5-htp but had to stop because it causes cramps. I started waking up with severe leg cramp in the middle of the night, made a research and found out that it is the side-effect of 5-htp. Since I am still dealing with some nerve problem on my shoulder, cramps caused by a casual drug is the last thing I want. Perhaps I wouldn’t mind it so much if I wasn’t already having severe shoulder and neck pain.

    I want to try keto diet. The hardest part for me is to give up fruit. Once my shoulder is better I want to get on with it. I know I can do it if I put my mind to it, but I need to fix my other parts first. Because say I am in a restaurant and pain comes suddenly, I might eat the sweetest thing ever. It is like mental compensation. I don’t care about anything when the pain comes.

    A friend who studies medicine in Germany said “when I have kids they won’t even know the taste of sugar. It is the worst thing ever.” I think even if we can’t completely manage keto diet, consuming as little sweets as possible is still an improvement. I need to come back to this episode and listen to it properly when I’m ready to do it. Best x

  18. Tim,

    Very curious about the ketogenic diet and longevity vs all the blue zone groups who are obviously long lived and to my knowledge do not put themselves in ketosis. Any thoughts?

  19. I have Hashimoto’s and have been on keto for about 8 months and I have a feeling that it’s been adversely affecting my thyroid disorder. I’ve read that an insulin response is required for T4 to T3 conversion.

  20. Tim & Dr. D’Agostino, I’ve had three brain surgeries (In 2000 – at 14, I underwent craniotomy with language mapping and resection of dysembryoplastic neuroepithelial tumor [DNET] situated in the mid to posterior temporal lobe). Due to science – the surgeons were able to remove 92% of my tumor. Had to give up contact sports, luckily took up tennis…

    Through my life – which I am very greatful for, I continued to have complex partial/petit-mal seizures 1-3x per month. At age 26 I went back to NewYork-Presbyterian and had two more surgeries, with deep worry about speech loss and potential loss of memory. My neurosurgeons were able to remove the remaining 8% of the tumor, although shortly after (<4 months) complex partial seizures reoccured, except post op they changed to cluster seizures. I've tried all but 1 FDA approved epilepsy medications, the one I haven't tried is Vigabatrin (which has potential to permanently damage peripheral vision).

    I don't have anything new to try, but thank's to Tim – I found my myself here.

    Jan. 1st, I will begin the keto diet. Any other people, ideas, no matter the location – would be awesome, my neurologist's haven't helped much in the last 12 months. I've been through everything – put my life in the hands of the surgeons at NewYork-Presbyterian 3x now.

    "When you are going through hell, keep going" – Winston Churchill


    Jackson Peddy

  21. Thanks Dominic.

    Wanted to asked you about eye sight loss or improve in the ketogenic diet.

    I have astigmatism and when I fasted for 7 days I noticed that my eyes felt much better

    And also, my grandma used to wear glasses but then she was diagnosed diabetes and started consuming high doses of metformin and after some months she didn’t need the glasses anymore

    I’d like to known if you’ve studied something like that

    Thanks!!! Awesome podcast

  22. Tim,

    I hope this finds you well…I was wondering if you or Dr. D’Agostino are planning on having any conversations, blogs, podcasts etc. on the topic of a ketogenic diet and fertility…My wife has an auto immune disease (we have had four miscarriages…something that prompted me to listen to your keto podcasts)…this diet is something that was recommended by our amazing Dr. Rob Kiltz, but I figured I would ask you this question too…since I am probably not the only person that has listened to your podcasts with Dr. D’Agostino and said…I wish they continued this topic on on Keto, Infertility and Auto Immune Diseases.



  23. Hi Tim,

    I’m an avid listener/reader and fan of yours. I have transitioned from a slow-carb regiment to a ketogenic diet as I tend to learn about life off the beaten path through your work (outsourcing). Having lost my mom to pancreatic cancer two years ago, and now my dad having recurring thyroid cancer, I’ve taken a great interest in the potential cancer-fighting properties of ketogenesis. However, in my research I have come across conflicting opinions. As a clinical psychologist I take very seriously the information that is proposed to others, especially in vulnerable states such as receiving terminal diagnoses. I want to offer for your review the following recap of some very interesting work that explores the scientific, experimentally (human) data on why ketogenesis is not helpful for cancer. I’d love to hear you present the other side of the discussion for balance and scientific authenticity.



  24. Hey Dom and Tim,

    I tried out Now Sports’ pure MCT oil with my coffee but it just gives me explosive pants later in the day. Is Quest Nutrition’s MCT powder oil any different than pure MCT oil?

    1. It takes to get use to the MCT oil, I was the same way, start with a small amount then work your way up, and be consistent with taking it. I no longer explode lol