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Old 05-22-2007, 09:49 AM   #1
Daniel Miller
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Default A few problems

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
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Old 05-22-2007, 05:09 PM   #2
Garrett Smith
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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?
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Old 05-23-2007, 08:51 AM   #3
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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
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Old 05-23-2007, 01:44 PM   #4
Robb Wolf
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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.
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Old 05-23-2007, 03:37 PM   #5
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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.
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Old 05-23-2007, 04:07 PM   #6
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Quote:
Originally Posted by Robb Wolf View Post

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.
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Old 05-23-2007, 04:55 PM   #7
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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!
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Old 05-23-2007, 05:35 PM   #8
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Quote:
Originally Posted by Robb Wolf View Post
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?
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Old 05-23-2007, 07:35 PM   #9
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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.
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Old 05-24-2007, 04:50 AM   #10
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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.
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