HoldsUp

Andrew Koutnik

Andrew Koutnik is a researcher in the fields of nutrition, exercise physiology, and metabolism. His published research focuses on the effects of carbohydrate intake, exogenous ketone supplementation, and ketogenic diets on exercise performance, metabolism, and cognitive function. Additionally, his work investigates the physiological and cardiovascular impacts of nutritional interventions in individuals with type 1 diabetes.

42 claims checked on air: 5 context 1 contradicted 2 overstated 25 supported 9 unverified

What they said on air - citing their own research

4 citing their own research

0:25:30needs contextmoderatetheir own paperThe Fuel Myth: Rethinking Carbs, Brain Health, and Human Per

Administration of exogenous ketones without dietary changes improves cognitive retention during acute hypoxic exposure at altitudes between 15,000 and 20,000 feet.

"we've studied just the mere application of ketones independent of diet change and see profound effects in various conditions, including in extreme environments like high altitude hypoxic exposure for special operations command grant looking at the ability to improve resilience against hypoxia exposure. Anywhere between 15 to 20,000 foot altitude immediate exposure and it increased the ability to have retained cognition in these extreme environments." (said at 0:25:30)

Exogenous ketone supplementation (such as ketone monoesters) taken acutely without dietary changes has been shown in controlled laboratory studies to partially attenuate declines in specific cognitive and psychomotor functions—such as reaction time on vigilance tests and code substitution performance—during severe acute hypoxic exposure simulating altitudes of 15,000 to 20,000 feet (4,500 to 6,100 m). However, the evidence is domain-specific and mixed: several randomized trials have found that while exogenous ketones improve blood oxygen saturation or neural signaling under hypoxia, they do not consistently improve broader cognitive test batteries, complex task performance, or real-world field performance during high-altitude operations.

0:43:00supportedmoderatetheir own paperThe Fuel Myth: Rethinking Carbs, Brain Health, and Human Per

1,3-butanediol-based exogenous ketones elevate blood hydrogen ions, increase blood oxygen saturation (SpO2), and improve cognitive function in acute hypoxia.

"One of the effects of 1,3-butanediol based products... is that you have a slight change in the hydrogen ion levels within the blood. And that subtle elevation hydrogen ions in the blood seems to change the ability to uptake oxygen levels within through ventilation... and even in those extreme settings, we were seeing that you we increase SPO2, increase resilience against cognitive decline, and actually improve cognitive function against uh uh a placebo-controlled arm." (said at 0:43:00)

The speaker's description matches findings from randomized, placebo-controlled crossover trials evaluating (R)-3-hydroxybutyl (R)-3-hydroxybutyrate (a 1,3-butanediol-based ketone monoester) under acute hypoxic conditions. In a randomized crossover trial of 16 military personnel exposed to acute severe hypoxia (simulating 6,096 m / 9.7% O2) at rest, ingestion of the ketone monoester attenuated the decline in blood oxygen saturation (SpO2 was 76.8% vs. 70.4% in placebo, P = 0.049) and attenuated cognitive performance decline during the Defense Automated Neurobehavioral Assessment code substitution task (+6.8 correct responses/min compared to placebo, P = 0.018). While a companion study during exercise in hypoxia found that ketone monoesters attenuated SpO2 desaturation without a statistically significant cognitive benefit, the specific resting severe hypoxia trial demonstrates the SpO2 and cognitive improvements described.

1:01:30supportedmoderatetheir own paperThe Fuel Myth: Rethinking Carbs, Brain Health, and Human Per

Ironman competitors on a 6-week ketogenic diet sustained 70% VO2 max cycling performance without deterioration compared to a high-carb diet despite experiencing higher rates of hypoglycemia.

"what we wanted them to do was sustain 70% of their VO2 max on a cycle bike for as long as they could before they fatigued below the 70% threshold... What we were finding is that when we compared the same athlete for 6 weeks on both of these diets... we found that yet again, athletes on the ketogenic diet did not see a deterioration in performance. But what was absolutely critical to this, David, is that the athletes on the ketogenic diet actually had a higher incidence of hypoglycemia. Yet, they maintained the equivalent level of physical performance." (said at 1:01:30)

A randomized crossover study in trained triathletes compared 6 weeks of a very-low-carbohydrate/ketogenic diet (40 g/day) versus a high-carbohydrate diet (380 g/day) during strenuous cycling time-to-exhaustion tests at 70% VO2 max. The trial found that time-to-exhaustion performance was maintained without deterioration on the ketogenic diet compared to the high-carbohydrate diet, while the low-carbohydrate condition resulted in lower glucose levels / exercise-induced hypoglycemia unless minimal carbohydrate supplementation was provided.

1:06:11supportedmoderatetheir own paperThe Fuel Myth: Rethinking Carbs, Brain Health, and Human Per

Administering 10 grams of carbohydrates per hour during prolonged strenuous exercise improved endurance performance by 22% in both high-carbohydrate and ketogenic athletes.

"Well, when we gave 10 g per hour on both the high-carb diet and the low-carbohydrate ketogenic diet, both diets improved performance 22%." (said at 1:06:11)

A randomized crossover study in trained triathletes adapted to either a 6-week high-carbohydrate (380 g/day) or a very-low-carbohydrate/ketogenic (40 g/day) diet tested endurance capacity during a cycling time-to-exhaustion test at 70% VO2max. Administering a low dose of carbohydrates (10 g/h) during exercise prevented exercise-induced hypoglycemia and increased time to exhaustion by exactly 22% across both the high-carbohydrate and ketogenic diet conditions.

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