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#312 - A masterclass in lactate: Its critical role as metabolic fuel, implications for diseases, and therapeutic potential from cancer to brain health and beyond | George A. Brooks, Ph.D.

The Peter Attia Drive

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Balance of Brain Fuels: A Split Supply

The brain utilizes a combination of fuels, specifically glucose and beta-hydroxybutyrate (BHB), even during states of prolonged fasting. In studies from the 1960s and 1970s, subjects on extended water-only fasts demonstrated elevated BHB levels, which at times surpassed glucose concentrations. This indicates that while glucose contributes approximately 50% to the brain's energy demand, BHB can fulfill the remaining portion. The presence of both substrates influences fuel usage, suggesting that the brain is capable of competitive substrate utilization, varying its energy sources based on availability. Additionally, both lactate and BHB are transported via the same mechanism, indicating a preference for lactate when similar concentrations are present, illuminating the complexities of metabolic substrate competition in the brain.

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