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Medical Hypotheses
Volume 185, April 2024

Summiting Mount Everest in deuterium depleting nutritional ketosis without supplemental oxygen

https://doi.org/10.1016/j.mehy.2024.111290

Highlights
•Body/nutrient interactions prepare humans to extreme challenges such as mountaineering in low atmospheric oxygen pressure.

•Climbing without supplemental oxygen is apt in natural ketosis to enhance proton delivery for cellular energy production.

•Deuterium depleted ketones spare ATPase nanomotors via efficient metabolic hydrogen peroxide, water and oxygen recycling.

•Deutenomics reveals how ketones aid peroxisomal-mitochondrial-cross-talk to control deuterium for endurance and health.


Abstract
During climbing seasons in the Himalaya only a few sportsmen attempt an ascent to and descent from the 8848 m top of the Earth without supplemental oxygen. This short report describes such successful summiting of the Mount Everest that rested with the nutritional, metabolic and exercise ketosis state, i.e., the burning of long chain saturated fat as the source of cellular energy after six failed attempts by the same athlete using carbohydrate-based nutrition. We herein describe the advantage of ketosis from the medical biochemistry angle by characterizing peroxisomal and mitochondrial cross talk as deuterium (heavy hydrogen) depleting principles in natural ketosis. We emphasize the importance of proton (hydrogen) and oxygen recycling via fatty acid deriving hydrogen peroxide produced in peroxisomes, followed by its conversion to metabolic water and O2 by catalase in mitochondria. Metabolic adaptation to natural ketosis maintains reduced NAD+ and ATP pools even in severely oxygen deprived environments. We hypothesize that severely decreased atmospheric oxygen pressure above 7000 m compromises alveolar gas exchange so much that biological oxidation becomes dependent on natural hydrocarbon (fat) based nutritional and consequent metabolic adaptation to natural ketosis. Such substrate level coupling of peroxisomal and mitochondrial metabolism via fatty acid breakdown aids oxygen recycling in muscles and tissues as a lifesaving option for the extreme climber.