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Daniel Miller
05-22-2007, 09:49 AM
I've been experimenting with IF, primarily with a focus of health/longevity.

In addition I've been sticking to paleo foods and have been limiting my Cho intake to 2-3x per week sweet potato + fruit (100g Cho) PWO. During my feeding times, which have ran 4-9hours usually 6-8, 1-2 meals will contain some low GI fruit (for totals of around 80-100g of Cho per day before subtracting fiber), but most of my food is fibrous veggies, some protein, and copious fat. Total kcals are down slightly, but so far it isn't a problem due to the nutrient partitioning.

Problems:
1. I've had a few bloody noses since I began this. I wasn't light headed or having any other symptoms, just spontaneous nose bleeds (I think 3).

2. I'm finding myself low on energy. 2 days per week I feel great but 3-4 days per week I feel really sluggish and tired. Yesterday, I had a Cho PWO meal at around 11:30 am, and then ate until 5pm. At 6:30-8pm I was incredibly tired. I went to bed at 8:30 and woke up at 6am feeling still incredibly tired.

I didn't eat until around 11am today and actually felt pretty well after an initial 1-hour period of having a hard time waking up, which is something I rarely experience, being a morning person.

3. As I eluded to in problem 2, I have not yet felt a huge increase in energy during fasting times. Only 2x in the last two weeks did I feel great while fasting. Other times, Iíve felt weak, unfocused, and cold.

Lastly, I've been using urinalysis strips and find I can be in ketosis (trace amounts) if I eat 80-90g fibrous Cho for only 1 day. After 2 days, I have small amounts of ketones washing out.

Part of me thinks that this is a good transition period and I should try and stay in ketosis. Another part of me, and the part which at the moment seems more prudent, is for me to add a little more fruit to my feeding times and speak with my clinician(s) and some other relevant people about the dangers/benefits of me being in ketosis.

Any thoughts about my problems would be appreciated.
-Dan

Garrett Smith
05-22-2007, 05:09 PM
Have some fruit, no big deal.

It may help your transition a little bit, as well as possibly give you a bit more vitamin C and bioflavonoids (for the nosebleeds).

Which IF plan are you generally following?

Daniel Miller
05-23-2007, 08:51 AM
Hi Dr G,

Thanks for the reply.

I'm following an intermittent plan that Scotty Hagnas described. Generally there is a 15-16 hour fast (last meal 5-6pm don't eat until 11am-noon). Then 1-2 days per week I'll go 6pm to 6 pm the following day.

The last two days have really gone quite well. Today was the first time I got a short metcon-ish workout in...with suprisingly good strength. I'm also waiting an hour to eat PWO, which seems to be going OK.

The days that I suffer have been days when I commute on my single speed bike to work. The ride is only about 3-4 miles but 20 minutes or so after I get to work until noon I feel ravenous. Strange because the ride is not all that hard in terms of heart rate or respiration rate. If I drive to work or take the bus, I'm fine. Perhaps I'll try it again next week, which will be week 3 and see how it goes with a little more adaptation.

-Dan

Robb Wolf
05-23-2007, 01:44 PM
Daniel-
You can get decreased platlet agregation similar to n-3 suppledmentation with intermittnet fasting or just lower insulin levels. That may be part of the issue.

I'm pretty convinced there are significant health benefits from periods of ketosis. Most of the medical community does not currently share this opinion...but most of these people can not distinguish between ketosis and ketoacidosis.

A few things:
From Stryer Biochemistry, 4th edition, pg 777- After adaptation ketones bodies become preferred fuel sources for both the hart and brain.

pg613- "Acetoacetate and b-hydroxybutyrate are normal fuels of respiration and are quantitatively inportant sources of energy. Indeed, heart, muscle and the renal cortex use acetoacetate in preference to glucose..."

That was from my medschool biochem text. My undergrad biochem text was much more thorough on that topic but I remember being struck at the time (1997) that it was very odd that ketone bodies might form a preferential fuel...yet no one was the least bit interested in this phenomena.

Fast forward to the work in metabolic control analysis, intermittent fasting, epigenics, caloric restriction with adequate nutrition...hormesis (had to sneak that in). Very compelling stuff IMO.

If you are torched after the bike ride I'd just eat! It's not necessary to do IF every day to garner benefits.

Daniel Miller
05-23-2007, 03:37 PM
man I wish I could remember that Kierkregaard quote about the 'leap of faith'.

No doubt, I'm with you on how compelling Hormesis, MCA, IF, CR, etc are. In fact, it all might be changing my course of study slightly or at least my eventual choice of specialty/residency.

Once concern I have had concerns my lymphatics and how they are handling the loads of fat I'm eating given the health condition I spoke of in the email (lymph mets). Somewhere inside my black box are things I don't want to piss off. I have no idea if this is a legit concern, but it is something I think about.

Stuart Mather
05-23-2007, 04:07 PM
I'm pretty convinced there are significant health benefits from periods of ketosis. Most of the medical community does not currently share this opinion...but most of these people can not distinguish between ketosis and ketoacidosis.



Robb, but do you think there are similar benefits to constant ketosis. I mean, if you are in ketosis while fasting, and eating a VLC/mod protein/ high fat diet when eating, so in ketosis then too, wheres the downside?

I haven't noticed any (downside) in five years of VLC nor since adding 24/24 IF for the last seven months, but I'm curious where you stand on this?

Stuart.

Robb Wolf
05-23-2007, 04:55 PM
Daniel-
Hmmm....the lymphatics issue was certainly not on my radar. I'm just thinking out loud here...if your inflammatory markers are "good"/improving, if you are not seeing increased levels of oxidized LDL/VLDL, if liver enzymes are not on the up-tick, if glycated hemoglobin is improved(ing)...I really do not see an issue.

Keep in mind that under paleo/zone conditions one will sequester the TAG's consumed into muscle, adipose and the liver, typically in that order. If intake is HEYUGE we may have a problem for anyone but I honestly think the intake you are experiencing is higher than what you were previously doing but not ubber-high in an absolute sense.

Stuart-
I'm not sure but I'm inclined to think there are some significant benefits for at least occasional/seasonal forays into ketosis. Intermittent fastign alone appears to foster this state so any movement towards a moderate protein, low carb high-ish fat diet will goose things along this path. here are a few thoughts:
1-Health among the Inuit who followed the traditional diet (which was ketogenic) was "very good". Virtually no cancer, diabetes heart disease etc. Not ANY type of proof but certainly interesting:
http://discovermagazine.com/2004/oct/inuit-paradox

2-Ketogenic research for epilepsy. Not much long term follow-up which is disappointing. I've found precious little on folks following an anti-epileptic diet long term and their health but that appears to be due, at least in part, to folks not necessitating the diet forever. Whatever problem the brain is experiencing appears to be "fixed" with the ketogenic diet.

So...I really don't know other than it looks like some time spent in ketosis/fasting is good for a wide variety of things. I know on one level I just feel much better at a lower carb level (generally less than 100g carbs). Beyond that it's loads of speculation!

Chris Forbis
05-23-2007, 05:35 PM
2-Ketogenic research for epilepsy. Not much long term follow-up which is disappointing. I've found precious little on folks following an anti-epileptic diet long term and their health but that appears to be due, at least in part, to folks not necessitating the diet forever. Whatever problem the brain is experiencing appears to be "fixed" with the ketogenic diet.

Wait... so people with epilepsy have their seizures go away by eating ketogenic. Then they stop the diet and the seizures don't come back?

Daniel Miller
05-23-2007, 07:35 PM
Robb,

right now my thought is to continue with some IF and eat Paleo and to include some attention to a hormesis in and out of ketosis. Part of my plan in paleo is to eat seasonally...so I'll keep you posted next fall/winteron the month+ ketosis.

Ok, thanks for the relies.

Stuart Mather
05-24-2007, 04:50 AM
Thanks Robb, but I think you may have misunderstood my question. I was wondering if you thought there was any health reason to choose to go out of ketosis, ever? I mean do you think there is a downside to perpetual ketosis? Why would you want to take 'breaks' from being in ketosis?

Stuart.

Robb Wolf
05-24-2007, 07:46 AM
Chris-
Yea...interesting, no? I found a few communications in the medical literature about migraines, depression...a number of conditions resolving as a consequence of some time spent in ketosis.

Stuart-
That is an interesting question. I'd be inclined to think that change in metabolic state is good...for plasticity of gene expression and the episodic stressor this change introduces. An up-tick in glycolysis is a stressor but occasionally that may be a really good thing.
Really interesting question however.

Joyce Behrendt
05-24-2007, 10:38 PM
Have you heard of Dr. Richard K. Bernstein? He's a Type I diabetic who has lived on < 30g carbs per day and prescribes that in his book The Diabetes Solution. He's in his 70's and pretty healthy for a Type I. He feels that diabetics are entitled to normal blood sugar and will achieve that using a formula of 6-12-12 grams carbs for breakfast, lunch and dinner and are able to maintain A1Cs of < 5. He recommends modest amounts of protein and no worries about fats. One person on the forum takes care of her mom. She noticed that if she added some butter to her mom's low carb meal, it helped the ratio and prevented post prandial blood sugar spikes. Here is a formula she posted (I confess I don't understand it).

(.9 fat + .46 protein) is the ketogenic side
(.1 fat + .54 protein + 1 carb) is the glucogenic side.
Divide the ketogenic side by the glucogenic side to get the the ratio. Any number 1.5 and above denotes a ketogenic diet, a diet that will inhibit PP sugar rises.

http://www.diabetes-book.com/

We discussed the depression question and most of us feel happier, healthier and less depressed eating this way. My guess is that the study that linked depression and low carb diets may not have extended beyond the adaptation period or that the subjects had problems with depression regardless of diet.

Robb Wolf
05-26-2007, 08:53 AM
Joyce-
Art Devany has talked about Dr. Bernsteins book quite favorably. thanks for the reminder!

Bo Bolund
06-13-2007, 03:56 AM
I've been experimenting with IF, primarily with a focus of health/longevity.

In addition I've been sticking to paleo foods and have been limiting my Cho intake to 2-3x per week sweet potato + fruit (100g Cho) PWO. During my feeding times, which have ran 4-9hours usually 6-8, 1-2 meals will contain some low GI fruit (for totals of around 80-100g of Cho per day before subtracting fiber), but most of my food is fibrous veggies, some protein, and copious fat. Total kcals are down slightly, but so far it isn't a problem due to the nutrient partitioning.

Problems:
1. I've had a few bloody noses since I began this. I wasn't light headed or having any other symptoms, just spontaneous nose bleeds (I think 3).

2. I'm finding myself low on energy. 2 days per week I feel great but 3-4 days per week I feel really sluggish and tired. Yesterday, I had a Cho PWO meal at around 11:30 am, and then ate until 5pm. At 6:30-8pm I was incredibly tired. I went to bed at 8:30 and woke up at 6am feeling still incredibly tired.

I didn't eat until around 11am today and actually felt pretty well after an initial 1-hour period of having a hard time waking up, which is something I rarely experience, being a morning person.

3. As I eluded to in problem 2, I have not yet felt a huge increase in energy during fasting times. Only 2x in the last two weeks did I feel great while fasting. Other times, Iíve felt weak, unfocused, and cold.

Lastly, I've been using urinalysis strips and find I can be in ketosis (trace amounts) if I eat 80-90g fibrous Cho for only 1 day. After 2 days, I have small amounts of ketones washing out.

Part of me thinks that this is a good transition period and I should try and stay in ketosis. Another part of me, and the part which at the moment seems more prudent, is for me to add a little more fruit to my feeding times and speak with my clinician(s) and some other relevant people about the dangers/benefits of me being in ketosis.

Any thoughts about my problems would be appreciated.
-Dan

I think you need to increase your carbs. I had problems with muscle weakness/fatigue on low carb diet and never had any energy to exercise.
Right now I'm on a regular diet with a warrior schedule fasting 22-23 hours every day. Since I've increased my carbs I have no problem exercising during my fast.

Robb Wolf
06-13-2007, 06:26 AM
I think you need to increase your carbs. I had problems with muscle weakness/fatigue on low carb diet and never had any energy to exercise.
Right now I'm on a regular diet with a warrior schedule fasting 22-23 hours every day. Since I've increased my carbs I have no problem exercising during my fast.

Certainly something to tinker with. Scotty Hagnas has been intermittent fasting for over 2 years now and finds even met-cons to be doable on low carb and IF. This may reflect a very long adaptation period however.

Bo Bolund
06-13-2007, 06:36 AM
Certainly something to tinker with. Scotty Hagnas has been intermittent fasting for over 2 years now and finds even met-cons to be doable on low carb and IF. This may reflect a very long adaptation period however.

It seems like some people work very well in ketosis and extreme low carb.
I tried it for almost 5 months and never felt I had energy for exercise.

Ron Nelson
06-14-2007, 11:24 AM
I haven't suffered any of the depression or headaches until just recently. Hopefully this means a shift into some sort of ketosis. The "depression" really is general grumpiness more than anything else, but the headaches are real.
I had one yesterday even after I ate (I was good yesterday, strictly meat and salad), and I rarely get headaches.

Also, I haven't noticed any appreciable drop in energy or willingness to exercise. In fact, I can't wait to get to the gym. . .even on metcon days like today.