Dominic D’Agostino: Ketosis, Insulin, and Human Physiology Beyond Simple Calorie Counting

Dominic D’Agostino: Ketosis, Insulin, and Human Physiology Beyond Simple Calorie Counting

by Laurent Glatz – for Athletic Carnivore

Modern nutritional debates often get stuck on a simplistic question: how many calories go in and how many calories go out? Dominic D’Agostino compels us to shift our perspective. The central question isn’t just the amount of energy consumed, but the metabolic state in which the body is maintained. An organism under high insulin, dependent on glucose, inflamed, and mitochondrial fragile does not function like one capable of switching to fats, producing ketones, and accessing its reserves without panic.

D’Agostino, a researcher in metabolic physiology and neuroscience, approaches ketones not as a dietary fad but as a biological tool. His work on ketosis, neuroprotection, mitochondria, epilepsy, performance under extreme conditions, and metabolic therapies raises a crucial question: what happens when the body regains deep access to fats and ketones?

Insulin is the main gatekeeper. It is necessary, but when chronically elevated, it directs the body toward storage. Lipolysis decreases, access to fats becomes more difficult, ketone production remains low, and metabolic flexibility diminishes. The body can then hold enormous fat reserves while behaving as if it lacks energy between carbohydrate intakes. This is one of the central paradoxes of obesity and type 2 diabetes.

Reducing carbohydrates changes this landscape. When insulin drops, fatty acids can be mobilized more easily. The liver can produce ketone bodies. The brain then receives a stable alternative fuel capable of supporting a significant portion of its energy needs. This reality contradicts the simplistic idea that the brain is a prisoner of glucose. It requires a minimum of glucose but can very well use ketones in an adaptive context.

Ketones are not just fuel. They also act as signaling molecules. They can influence gene expression, inflammation, oxidative stress, mitochondrial function, and certain neurotransmitters. This makes the subject far deeper than a mere weight loss story. Ketosis changes the cellular environment.

Autophagy also fits into this logic. The body has internal recycling systems capable of eliminating damaged structures, cleaning dysfunctional cellular components, and maintaining better biological quality. Fasting is often presented as the primary activation pathway, but hypoinsulinemia, carbohydrate restriction, and fat adaptation also contribute to this state change. Again, the central point is hormonal, not just caloric.

Within a carnivore approach, this logic becomes clearer. By eliminating major sources of dietary glucose, processed products, irritating fibers for some profiles, unstable oils, and sweet flavors, the body receives a simpler signal. Animal proteins, natural fats, salt, water: the metabolic message becomes more readable. This is not magic but a reduction of noise.

However, one must avoid a mistake: confusing ketosis with perfection. A person can be in ketosis and lack protein. They can produce ketones and sleep poorly. They can eat carnivore and not salt enough. They can reduce carbohydrates but maintain high cortisol due to excess coffee, fasting, or training. Ketosis is a powerful tool, not a physiological exemption.

Mitochondria are at the center of this discussion. They don’t just produce energy; they partly determine the quality of that energy. A metabolism that can oxidize fats and use ketones often produces more stable energy, with fewer glycemic rollercoasters. For the brain, this can change alertness, clarity, hunger, and resistance to fatigue. For athletes, it can alter effort management, especially in endurance or recovery.

Modern medicine often discusses chronic diseases as if they were separate entities. D’Agostino brings part of the debate back to a common foundation: cellular energy, insulin, mitochondria, inflammation, metabolic flexibility. This perspective doesn’t replace all medicine but reminds us that many modern pathologies develop in an unfavorable metabolic environment.

The real question is not whether ketosis is a trend. The real question is: why has such an ancient metabolic state, so deeply embedded in our physiology, become so rare in modern life? If humans rarely experience phases of low insulin, fat mobilization, and ketone production, what do they lose in repair, stability, and access to their own reserves?

And what if the modern problem isn’t just overeating but living permanently in a hormonal state that prevents the body from repairing, accessing its energy, and regaining flexibility?

#DominicDAgostino #Ketosis #Carnivore #Insulin #Mitochondria #Autophagy #MetabolicHealth #LowCarb #AthleticCarnivore