IF and LCHF and T2D
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Dr. Fung is in the last video there. His website is Intensivedietarymanagement.com. His books are The Obesity Code and The Complete Guide to Intermittent Fasting.
I second Dr. Fung as an excellent resources on insulin resistance treatment with fasting. I'm into my 2nd month this week, of 16:8 IF, basically I don't really eat until noon or after, and my last meal is done before 7 p.m. I am very pleased with the results.
However, insulin was making me fat and not doing much to keep my BG numbers under control (following the ridiculously high carb/low fat and approved by my doctor diet similar to what the American Diabetes association puts out--who's BFFs with garbage food manufacturers, btw). Although I did drop a bit of weight when I was first put on Lantus back in 2009 (along with 1000mg/day of Metformin, which I had already been taking for 2 years), I soon stopped benefiting from it and only found myself having to increase my dosage. I was up to 116 units per day of Lantus plus 1.2 units per day of Victoza. Two kinds of insulin and eating "clean/whole food" diet and still fat AF and high blood sugar LOL. Took a few months on keto to bring down my numbers but it DID happen and now I have normal blood sugar readings, no more hypertension, and weight still coming off slowly but surely.
I'm sure if you keep it up, you will succeed!8 -
I've just started making bone broth and kale smoothies if anyone has any good recipes. I'm trying to get use to the flavor of drinking grass. Lol
I always say, why eat anything you don't like? We have a myriad list of foods we can enjoy, contrary to popular belief...it seems nearly limitless!
If you want to eat veggies but don't much like the taste of them raw, we are lucky souls who can get away with cooking them in butter and covering them with cheese! And bacon! And heavy cream sauce!
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Sunny_Bunny_ wrote: »cstehansen wrote: »Sunny_Bunny_ wrote: »cstehansen wrote: »Autophagy is not just for those with disease. It is a necessary process for everyone. Art De Vany and others have done some pretty interesting analysis of existing data showing the benefits of fasting for everyone. For some IF is enough. For some, longer fasts are needed.
The 130g commonly sited is based on the brain needing about 500 calories a day, so if ALL of it comes from glucose, that is about 130g. However, only about 1/4 of that MUST be glucose. 3/4 of that energy need can be fueled by ketones. When you knock that number down to 30-35, the amount from glycerol that is in every triglyceride that breaks down will make up a larger percentage than when you try to come up with 130.
Also, given that amino acids (protein) are continuously being broken down and recycled, and some of them are damaged and unable to be recycled, you will be losing that protein anyway. Why not use it instead of getting it from diet? This is actually one of the reasons fasting is associated with healthier mitochondria, slower aging and improved health is it helps the body get rid of these damaged materials.
I will say, I work out much harder than most people a decade or two younger than me and I did not reduce intensity or duration of workouts during either of these fasts. I did not feel any negative effects. In fact, the first workout after the first fast, I noticed I had to increase the weights being used to generate the same level of effort.
Tearing down of muscle for energy, from the medical research I can find, is more associated with eating in a hypocaloric manner (under eating) than it is with true fasting. If you have research showing otherwise, please share. I am never afraid of being wrong. I want to have the correct information.
I had avoided fasting (outside of IF just because I wasn't hungry) because being at healthy weight, without fatty liver and a relatively low body fat %, I could find no studies showing BG benefit for someone like me. All the studies centered on those who were obese or had fatty liver. It was only through frustration that I could not get my BG lower was I willing to give it a shot. Turns out I was wrong and fasting does seem to be helping me with my BG control.
I realize autophagy is for more than just disease treatment.
I just think it's misguided to suggest that muscle won't be sacrificed. In some cases it makes perfect sense to do it but in others, like for weight loss in relatively normal weight person, it's probably taking two steps back to take one step forward.
I say this based on a few people I'm aware of achieving a near underweight BMI but still having higher bodyfat. One woman kept fasting because she believed it would tighten up her abdominal skin through autophagy. Now she has very low muscle and is still overfat at 5'6" and 115 pounds.
There is no one size fits all. Based on what I am seeing in myself, I am convinced I hold too much glycogen and these 2 day fasts have helped reduce those reserves. Given most people have 500-600 g of glucose stored this way, gluconeogenesis would not be needed on intermediate length fasts of 1-3 days.
Given even at near zero carb intake I was unable to get BG below 100, but with a couple of 2 day fasts, I am getting readings 20-30 points lower, I have to think the needed glucose came from glycogen and not breakdown of muscle.
The improvement in the gym I have seen leads me to the same conclusion. Obviously this as n=1 and as I mentioned right at the beginning, there is no one size fits all. However, this may be something worth trying for others who have been unable to improve as much as they need to.
You might use stored liver glycogen during fasting but do you think the stores stay at that now reduced level until you break the fast or do you think glycogen use and replenishment through GNG are in constant flux to maintain a minimum level? So you'll be refilling stores through GNG.
I'm not saying don't fast. But GNG is happening. It has to. Its not going to wait until the fast is over to refill glycogen. It's definitely going to come from junk proteins and such but how much? I know of enough examples of people becoming skinny fat through extended fasting to think muscle wasting is a real threat. Now, I can say that the people I've spoken to through different groups that have had that problem didn't do any resistance training at all. On one hand I feel like that could be helpful but on the other I'm thinking it could be worse. I can't speak to that at all. I don't know anyone that's done extended fasting with exercise.
I guess keep us posted.
Again, I will preface that I have yet to see any research on any topic showing 100% of subjects have identical responses.
That said, here is what I have been able to find. The rate of protein being used for energy is far lower than many predict. Fasting shows less loss of lean mass than does calorie restriction for instance. So someone fasting a couple days a week taking in the same number of calories for the week as someone who is just cutting calories every day, but both are taking in the same number of calories for the week will result in the person fasting losing more total weight and less lean mass. This variation tends to be more significant the more obese the person is.
It is important to understand lean mass does not equal muscle. Muscle is lean mass, but so are blood vessels, ligaments, tendons, skin, etc. This is important because if you notice someone who has fasted (or starved in the case of a P.O.W.), even if they were obese to start, they don't have the same issues with loose skin after large amounts of weight loss as those from severe calorie restriction (i.e. gastric bypass, the biggest loser, etc.). Therefore, it would seem the lean mass lost through fasting would be lean mass one would want to lose.
Additionally, there tends to be a spike in growth hormone both during the fast and after re-feeding which leads to muscle re-build. This is something Art De Vany for one points to as to why he finds this beneficial for maintaining peak fitness. Given he is pushing 80 and still in really good shape and lifts weights, I have to say it is at least working for him.
Unfortunately for me, I am not finding much in regard to BG control outside of those who are overweight/obese. For that reason, I will just have to continue my self experimentation. So far, results have been mostly favorable with some neutral.
The consistent positive is strength is clearly increased following fasting. This seems to be consistent with what Art De Vany says about fasting clearing out the damaged amino acids from the muscles that are broken down during exercise and the growth hormone stimulating a healthier rebuild.
As good as that is, my primary purpose is BG control. In that regard, I had a clear and unmistakable improvement after the first fast. After the second, it has been weird. I saw another stair step improvement initially, but then it has been more erratic than normal. Overall, it is lower than it was before the first fast, but it just seems to fluctuate more than normal and not in a way that makes sense. For instance, it is more likely for my post meal reading to be lower than my pre-meal right now.
Two fasts of two days two weeks apart is not enough for me to really draw conclusions. I am planning my third one next week. I will continue to measure BG and track how it is going at the gym and hopefully get a clearer picture of how this is working FOR ME.3 -
cstehansen wrote: »Sunny_Bunny_ wrote: »cstehansen wrote: »Sunny_Bunny_ wrote: »cstehansen wrote: »Autophagy is not just for those with disease. It is a necessary process for everyone. Art De Vany and others have done some pretty interesting analysis of existing data showing the benefits of fasting for everyone. For some IF is enough. For some, longer fasts are needed.
The 130g commonly sited is based on the brain needing about 500 calories a day, so if ALL of it comes from glucose, that is about 130g. However, only about 1/4 of that MUST be glucose. 3/4 of that energy need can be fueled by ketones. When you knock that number down to 30-35, the amount from glycerol that is in every triglyceride that breaks down will make up a larger percentage than when you try to come up with 130.
Also, given that amino acids (protein) are continuously being broken down and recycled, and some of them are damaged and unable to be recycled, you will be losing that protein anyway. Why not use it instead of getting it from diet? This is actually one of the reasons fasting is associated with healthier mitochondria, slower aging and improved health is it helps the body get rid of these damaged materials.
I will say, I work out much harder than most people a decade or two younger than me and I did not reduce intensity or duration of workouts during either of these fasts. I did not feel any negative effects. In fact, the first workout after the first fast, I noticed I had to increase the weights being used to generate the same level of effort.
Tearing down of muscle for energy, from the medical research I can find, is more associated with eating in a hypocaloric manner (under eating) than it is with true fasting. If you have research showing otherwise, please share. I am never afraid of being wrong. I want to have the correct information.
I had avoided fasting (outside of IF just because I wasn't hungry) because being at healthy weight, without fatty liver and a relatively low body fat %, I could find no studies showing BG benefit for someone like me. All the studies centered on those who were obese or had fatty liver. It was only through frustration that I could not get my BG lower was I willing to give it a shot. Turns out I was wrong and fasting does seem to be helping me with my BG control.
I realize autophagy is for more than just disease treatment.
I just think it's misguided to suggest that muscle won't be sacrificed. In some cases it makes perfect sense to do it but in others, like for weight loss in relatively normal weight person, it's probably taking two steps back to take one step forward.
I say this based on a few people I'm aware of achieving a near underweight BMI but still having higher bodyfat. One woman kept fasting because she believed it would tighten up her abdominal skin through autophagy. Now she has very low muscle and is still overfat at 5'6" and 115 pounds.
There is no one size fits all. Based on what I am seeing in myself, I am convinced I hold too much glycogen and these 2 day fasts have helped reduce those reserves. Given most people have 500-600 g of glucose stored this way, gluconeogenesis would not be needed on intermediate length fasts of 1-3 days.
Given even at near zero carb intake I was unable to get BG below 100, but with a couple of 2 day fasts, I am getting readings 20-30 points lower, I have to think the needed glucose came from glycogen and not breakdown of muscle.
The improvement in the gym I have seen leads me to the same conclusion. Obviously this as n=1 and as I mentioned right at the beginning, there is no one size fits all. However, this may be something worth trying for others who have been unable to improve as much as they need to.
You might use stored liver glycogen during fasting but do you think the stores stay at that now reduced level until you break the fast or do you think glycogen use and replenishment through GNG are in constant flux to maintain a minimum level? So you'll be refilling stores through GNG.
I'm not saying don't fast. But GNG is happening. It has to. Its not going to wait until the fast is over to refill glycogen. It's definitely going to come from junk proteins and such but how much? I know of enough examples of people becoming skinny fat through extended fasting to think muscle wasting is a real threat. Now, I can say that the people I've spoken to through different groups that have had that problem didn't do any resistance training at all. On one hand I feel like that could be helpful but on the other I'm thinking it could be worse. I can't speak to that at all. I don't know anyone that's done extended fasting with exercise.
I guess keep us posted.
Again, I will preface that I have yet to see any research on any topic showing 100% of subjects have identical responses.
That said, here is what I have been able to find. The rate of protein being used for energy is far lower than many predict. Fasting shows less loss of lean mass than does calorie restriction for instance. So someone fasting a couple days a week taking in the same number of calories for the week as someone who is just cutting calories every day, but both are taking in the same number of calories for the week will result in the person fasting losing more total weight and less lean mass. This variation tends to be more significant the more obese the person is.
It is important to understand lean mass does not equal muscle. Muscle is lean mass, but so are blood vessels, ligaments, tendons, skin, etc. This is important because if you notice someone who has fasted (or starved in the case of a P.O.W.), even if they were obese to start, they don't have the same issues with loose skin after large amounts of weight loss as those from severe calorie restriction (i.e. gastric bypass, the biggest loser, etc.). Therefore, it would seem the lean mass lost through fasting would be lean mass one would want to lose.
Additionally, there tends to be a spike in growth hormone both during the fast and after re-feeding which leads to muscle re-build. This is something Art De Vany for one points to as to why he finds this beneficial for maintaining peak fitness. Given he is pushing 80 and still in really good shape and lifts weights, I have to say it is at least working for him.
Unfortunately for me, I am not finding much in regard to BG control outside of those who are overweight/obese. For that reason, I will just have to continue my self experimentation. So far, results have been mostly favorable with some neutral.
The consistent positive is strength is clearly increased following fasting. This seems to be consistent with what Art De Vany says about fasting clearing out the damaged amino acids from the muscles that are broken down during exercise and the growth hormone stimulating a healthier rebuild.
As good as that is, my primary purpose is BG control. In that regard, I had a clear and unmistakable improvement after the first fast. After the second, it has been weird. I saw another stair step improvement initially, but then it has been more erratic than normal. Overall, it is lower than it was before the first fast, but it just seems to fluctuate more than normal and not in a way that makes sense. For instance, it is more likely for my post meal reading to be lower than my pre-meal right now.
Two fasts of two days two weeks apart is not enough for me to really draw conclusions. I am planning my third one next week. I will continue to measure BG and track how it is going at the gym and hopefully get a clearer picture of how this is working FOR ME.
@cstehansen, great post. Thx for sharing your insights.1 -
"The rate of protein being used for energy is far lower than many predict. Fasting shows less loss of lean mass than does calorie restriction for instance. So someone fasting a couple days a week taking in the same number of calories for the week as someone who is just cutting calories every day, but both are taking in the same number of calories for the week will result in the person fasting losing more total weight and less lean mass. This variation tends to be more significant the more obese the person is."
I would expect that to be true when going from a SAD, sugar burning diet to fasting, but is there evidence that it holds true for a fat adapted person?
I think the reason fasting shows reduced lean mass loss compared to calorie restriction is because the person becomes ketotic, and the need for glucose reduces as compared to the calorie restriction. I can't imagine what mechanism would occur that would make that scenario true for a fat adapted person.0 -
Sunny_Bunny_ wrote: »"The rate of protein being used for energy is far lower than many predict. Fasting shows less loss of lean mass than does calorie restriction for instance. So someone fasting a couple days a week taking in the same number of calories for the week as someone who is just cutting calories every day, but both are taking in the same number of calories for the week will result in the person fasting losing more total weight and less lean mass. This variation tends to be more significant the more obese the person is."
I would expect that to be true when going from a SAD, sugar burning diet to fasting, but is there evidence that it holds true for a fat adapted person?
I think the reason fasting shows reduced lean mass loss compared to calorie restriction is because the person becomes ketotic, and the need for glucose reduces as compared to the calorie restriction. I can't imagine what mechanism would occur that would make that scenario true for a fat adapted person.
I will agree that keto will change aspects of these studies. However, I would recommend you look at table 4 of this study as I think it shows the effect best:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5042570/
What this shows is two groups where one did alternate day fasting for 8 weeks and the other did reduced calorie. They did an additional follow up after 24 more weeks (32 weeks after the start). Of course, the fat loss for fasting was better than calorie reduction. Also, both groups had some regain of weight at that last follow up because basically most probably just went back to eating they way they did before the study.
Here is the key part though. For the fasting group, after 32 weeks, their weight was down, but their LBM was higher by 2 kg even though their overall weight was down by 3.2 kg. This means their fat mass was down by 5.2 kg.
This would be attributable to the growth hormone response I was talking about. That increased HGH actually builds lean mass in those who fasted.
Other studies I have found implied this and talked about it, but I thought this one made it the clearest by putting it in this table.
That said, my hypothesis would be that being keto would make these LBM improvements even better. I certainly wouldn't hypothesize that being keto would make fasting less advantageous than it is for someone on a SAD diet.4 -
I know they're not perfect, but since I've started using a mix of Alternate Daily Fasting with some extended fasts mixed and intend to continue that for the duration of my weight loss, the chatter here has me curious. I'm going to see if I can get in for a DEXA scan in the next week or so and get a few of them over the next year.1
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I know they're not perfect, but since I've started using a mix of Alternate Daily Fasting with some extended fasts mixed and intend to continue that for the duration of my weight loss, the chatter here has me curious. I'm going to see if I can get in for a DEXA scan in the next week or so and get a few of them over the next year.
Please report back on results.1 -
cstehansen wrote: »Please report back on results.
There's a sports medicine center locally where I can get one for $75, so I've got that on the books for early next week, and as long as I keep up the fasting regimen and continue to lose weight I figure I'll go back at some regular interval to see how things go.
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If the alternate day fasting people weren't fat adapted that study is completely irrelevant as that alone explains the protein sparing effect.0
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Sunny_Bunny_ wrote: »If the alternate day fasting people weren't fat adapted that study is completely irrelevant as that alone explains the protein sparing effect.
That sounds like the same kind of broad hypothesis stated as fact the the main stream nutrition people would use. Perhaps getting some actual data would be appropriate before making such a statement. After all, many of Dr. Fung's patients are also keto in addition to fasting and have positive results. That is clinical and not trial, but it is the only available evidence.
All I am saying is we are all fed up with the main stream nutritionists being dogmatic when stating hypotheses as fact so we shouldn't do it either.
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cstehansen wrote: »Sunny_Bunny_ wrote: »If the alternate day fasting people weren't fat adapted that study is completely irrelevant as that alone explains the protein sparing effect.
That sounds like the same kind of broad hypothesis stated as fact the the main stream nutrition people would use. Perhaps getting some actual data would be appropriate before making such a statement. After all, many of Dr. Fung's patients are also keto in addition to fasting and have positive results. That is clinical and not trial, but it is the only available evidence.
All I am saying is we are all fed up with the main stream nutritionists being dogmatic when stating hypotheses as fact so we shouldn't do it either.
You're making just as broad statements as I am.
I'm really just saying you can't apply a study to support the idea that isn't done on fat adapted people anyway. Im not really making any firm claims. I'm just stating my thoughts based on what people I've spoken to have told me and again, that studies done on non fat adapted cant really be used to support the claim you're making.
As far as I'm aware, there are no specific studies on Fungs patients and also no before and after photos to support his idea that the skin just goes away because of autophagy.
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The skin doesn't 'just go away'. The photos in this article prove it. And there is a video on here somewhere about a fitness Guru's talk on this WoE, and his 'Hero'; a young man who lost all his excess weight on LCHF, who they then introduce to the audience, but also show pictures where clearly, he has had an abdominal op to remove...'excess baggage'...1
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Sunny_Bunny_ wrote: »As far as I'm aware, there are no specific studies on Fungs patients and also no before and after photos to support his idea that the skin just goes away because of autophagy.
That's my understanding as well. He's stated that he's never needed to refer a patient for loose skin surgery after weight loss, even patients who lost 100+ pounds, and hypothesizes about autophagy, but there's nothing concrete there.
For me, so far, ADF combined with keto seems like a great match and I'll just keep my fingers crossed about the loose skin.
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AlexandraCarlyle wrote: »The skin doesn't 'just go away'. The photos in this article prove it.
Nothing in that article references the guy fasting though.0 -
Oh yes, @radiii, I see your point; but I was referring more to the skin 'going away'... if it doesn't go away on an altered diet, and focusing on LCHF/P, I don't see how fasting into the bargain, would miraculously change that. That was all....
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Yes, this thread seems done, but I still want to add.
As far as protein consumption/sparing when fasting, 2keto dudes have a few blogs. The first talks about and has a calculator for how much protein you might lose.
http://blog.2keto.com/protein-loss/
This next blog talks about why fasting is more difficult for us thin people and has a calculator for determining fat supplementation while fasting to maintain autophagy while sparing muscle.
http://blog.2keto.com/why-fasting-is-easier-for-some-people/
I had been low carb for years when I found out I was T2D. Now I do stricter Keto and fast. My fasts average to about 36 hr, 1-2 per week. That keeps my CBG <110 and usually 70-90. I can’t Do longer because my body fat is about 20% and I start getting a bit crazy/grumpy when I am in the 40 hr range, but without the fasting my CBG won’t stay within the range of a non-diabetic person which is my goal. I could probably supplement with fat, but don’t want to.1 -
I always want someone (read: anyone with education and science to do it right and explain it to us lay-folks) to do a post about fasting without a gallbladder aka WITH A CONSTANT TRICKLE OF BILE THAT TURNS TO ... backside lava after about the 6-8 hour point without food intake. *cries* I enjoyed fasting, but I could have bought stock in diaper cream...1
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I’m not doing IF. I was diagnosed as prediabetic without officially having it on my chart. I’m allergic to metformin and they tried no other drugs on me. I ignored the prediabetic diagnosis since I wasn’t exactly told. I didn’t know that much about glucose levels besides what’s healthy for a diabetic due to my adoptive family having different diabetics in it. T2 and T1. A year or so later my glucose was high enough when I finally bought a testing kit to be considered diabetic but still in the early phase. So I decided to do keto dieting. I lost my glucose meter for a bit. I put it in a coat pocket of one I only wear on rainy days. Since I found it I’m totally in the normal range being on the LCHF dieting whether truly in ketosis or not. Now my PCP don’t actually know I was ever diagnosed. Until the last visit which insurance won’t pay they wanted test my sugar and everything you can think of all at once. I don’t have $511 for what insurance won’t pay and it’s truly cheaper to do it elsewhere for only $233 without using any insurance for every test he wants with blood sugar level being the only exception. I can just bring my own meter in and show him. But I’m glad I don’t have it at the moment even if I am on a diet and haven’t broken off it lately. I want to stick to it for at least 2 years before I get off it. In cases like mine it has been reversed doing LCHF for 2 years only. And it’s wonderful someone had an experience like that I read here. I didn’t read everything.1
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The 2 years is interesting...when I was doing keto for migraines no one had really studied it long term (it was just starting to be used as a migraine treatment)...but I did discover that in epileptic children treated with keto the effects were permanent after 2 years and the kids were switched to low-carb after that time with most of them having no return of symptoms, which has worked well for my migraines.
It's interesting that it seems to work for T2D, I hadn't heard that before, but it seems to fit the overall trend.0
