The FastDay Forum

I'm a big fan of Dr Attia and his self experimentation with low carb diet and exercise. This lecture covers many subjects that have been discussed on this forum (eg ketosis, fat burning, low sugar intake, igf1 and cancer in the post lecture questions etc) and although not really about fasting it's v informative and his presentation style is good. If you watch it I hope you find it as interesting as I did.

http://eatingacademy.com/personal/my-qu ... elf-part-i

This was really good although some of the info went way over my head. I'd love to know how he got sugar down to 5g as everything I see on packs etc. would make much more than that. I suppose it comes down to a few berries or something. I have ordered the 'Fat Chance' book so perhaps that may be enlightening.

[carorees]

Thanks for this link @skippyscuffleton! I've only just managed to finish watching the lecture. Fascinating and wonderful.

Key messages I learned/had confirmed

• Metabolic inflexibility occurs when we eat a lot of carbs especially sugar
• Metabolic inflexibility means we burn glucose/glycogen not fat
• Metabolic flexibility means we burn fat and save glucose/glycogen for emergencies
• Burning fat results in a higher metabolic rate
• You don't have to be in ketosis to benefit from getting more calories from fat and fewer from carbs in your diet
• Carbs are best eaten when glycogen stores are low (i.e., at breakfast/after exercise)
• Nuts are a good source of slow release carbs and also of fat
• Too much protein can knock you out of ketosis

Some links I made from listening to the lecture and my current knowledge from reading the scientific literature and observations from this forum:

• Most people eating a standard diet are metabolically inflexible (judging from the symptoms they experience on their first fasts)
• Fasting appears to improve metabolic flexibility (judging from the improvement in symptoms with repeated fasting)

I'm now checking out his blog, and found this interesting article about how some cultures eat a lot of carbs but don't have an obesity problem:
http://eatingacademy.com/nutrition/how- ... bohydrates

Thanks skippy, very interesting. I hope Dr. Attia is successful in his low carb quest, but in the US the AMA is and has been the strongest proponent of high carb eating since the early 1970s. It is going to be politically hard for them to change from 'eat less fat/protein and exercise' to 'eat a high fat/protein diet'.

I'm actually hoping that the 'compromise' will be IF. The good doctors could start pushing IF without having to admit they were wrong about high carb, and everyone would benefit.

Speaking from experience, low carb eating on an ongoing basis is very hard for most people. Just look at the tons lost, but regained, by Atkins followers. But I am getting the same results much more easily from IF. Once this is documented in some way or another, and the populace reeducated, I think the 'obesity epidemic' will go away.

Thanks skippy and carorees

Glad to see that some of you also found it an interesting talk.

I think for me the main message that I was left with was, that diet/WOE is ideally where I should be. I've been mulling over giving it a go for most of this year but havent got the cahonas to lock in to it and give it a good a go.

The talk broadened my understanding of ketosis which was a good thing. The metabolic inflexibility didn't really shine thru for me but the apparent energy benefits of a high fat diet really did stand out. I also got the impression that exercising on a fast day really helps to push you to greater ketosis, something I always try to do. Am now also interested in furthering my understanding of the state of my glycogen stores and fat metabolism. Would love to have devices that could show my real time liver glycogen level and RQ. His last point in the post lecture qus re taking lab produced ketones (not raspberry ones) also caught my attention, especially his very interested reaction to the whole subject. I wonder what physiological effects will potentially ensue from injecting/ingesting ketones? Will be doing some further digging in this area in due course.

Caroline - you're link to Attia's posting on why some carb eating country folks don't get fat is also worth reading. As ever the main reason appears to come back to sugar / carb consumption. Living in Japan I am particularly interested in this subject and am constantly making mental notes on how the Brits differ from the Japanese regarding diet and the whole subject of food.

simcoeluv - Interesting comments. I'm not sure the obesity epidemic as such will ever go away in first world societies where we have constant easy cheap access to sweet carbs. I hope I'm wrong.

Very interesting. Thanks everyone much food for thought on many issues. Still more encouragement that 5:2 IF still gives us a regular opportunity to change our bodies and reduce disease process especially if we get re-educate ourselves about a much healthier ongoing WOE

[carorees]

I think that metabolic flexibility is key. If the body can change to prefer to use fat rather than glucose then whenever we don't have carbs entering we will burn ketones/fat rather than use glycogen stores. I think that frequent fasting does this especially if combined with reducing the carb intake.

I think that metabolic flexibility is key. If the body can change to prefer to use fat rather than glucose then whenever we don't have carbs entering we will burn ketones/fat rather than use glycogen stores. I think that frequent fasting does this especially if combined with reducing the carb intake.

I agree that metabolic flexibility is important but I suspect there is maybe only a small minority of folks on here who are truly metabolically inflexible. Most of us probably have no trouble increasing fat oxidation when glycogen is running low and those who regularly exercise I suspect have lower average daily RQ indicating a better fat to carb burning ratio. Personally, I'm not convinced that the discomfort people feel (if that's what you allude to on your first post above) on their first few fasts is true metabolic inflexibility. My memories of it lead me to suspect it's just discomfort that maybe my blood glucose took a small drop when I wasn't used to it. Under the bonnet so to speak I'm sure my energy requirement were being met through glycogen oxidation and increased fat oxidation, otherwise I suspect I would have been comatose on the floor.

His last point in the post lecture qus re taking lab produced ketones (not raspberry ones) also caught my attention, especially his very interested reaction to the whole subject. I wonder what physiological effects will potentially ensue from injecting/ingesting ketones?

There's an academic in Oxford doing work on this - ketone esters - even made it to the Daily Mail

Thanks skippy, very interesting. I hope Dr. Attia is successful in his low carb quest, but in the US the AMA is and has been the strongest proponent of high carb eating since the early 1970s. It is going to be politically hard for them to change from 'eat less fat/protein and exercise' to 'eat a high fat/protein diet'.

I'm actually hoping that the 'compromise' will be IF. The good doctors could start pushing IF without having to admit they were wrong about high carb, and everyone would benefit.

I agree with your assumption that it is going to be hard politically to achieve progress in this area, simcoeluv. However, I am not sure a fruitful strategy will be to hope for the bureaucrats to reach a sensible compromise.

One of my favorite quotes is that the definition of insanity is to do the same thing over and over, and expect a different outcome. We need to lay the idea that the government is good at prescribing what you should do, think and eat to rest.

My personal experience with low carb, ketosis, ketogenic diet etc is that when I low carbed the first time I went through a horrible 5 days. It was like a horrible case of the flu. It is not unusual if you have eaten a standard Western diet for 30+ years and then make such a drastic change. Now when I have been in ketosis for long periods of time I can switch between using ketones and glycogen for energy without noticing it at all.

I think it is also important to stress the point that it is not a matter of eating 350 grams of carbs a day or 5 grams of carbs a day. I have been able to remain in ketosis on 40-50 grams of carbs per day and there are great benefits in decreasing carbs to 100 or 150 grams as well, even if that will not keep you in ketosis for extended periods of times.

On a fasting note, the added benefit I find with IF is that it will makes low carbing so much easier. You can be more liberal with carbs and you need to make less sacrifices for the same result. For instance, I make killer baby back ribs, but while low carbing I always missed the BBQ sauce. Now I can slab on some sauce at the same time I improve my health and lose weight. I do not see this as a competition between fasting and low carbing. Low carb eating has great benefits, just like IF has.

[carorees]

I think that metabolic flexibility is key. If the body can change to prefer to use fat rather than glucose then whenever we don't have carbs entering we will burn ketones/fat rather than use glycogen stores. I think that frequent fasting does this especially if combined with reducing the carb intake.

I agree that metabolic flexibility is important but I suspect there is maybe only a small minority of folks on here who are truly metabolically inflexible. Most of us probably have no trouble increasing fat oxidation when glycogen is running low and those who regularly exercise I suspect have lower average daily RQ indicating a better fat to carb burning ratio. Personally, I'm not convinced that the discomfort people feel (if that's what you allude to on your first post above) on their first few fasts is true metabolic inflexibility. My memories of it lead me to suspect it's just discomfort that maybe my blood glucose took a small drop when I wasn't used to it. Under the bonnet so to speak I'm sure my energy requirement were being met through glycogen oxidation and increased fat oxidation, otherwise I suspect I would have been comatose on the floor.

I have to say that I disagree about only a minority being metabolically inflexible. There is plenty of scientific evidence to show that obesity and sedentariness is associated with metabolic inflexibility. Most people who are overweight, especially if they have abdominal adiposity, will be insulin resistant and have high levels of insulin, which means that fat cannot be mobilized from stores as insulin prevents this (though there is evidence that the insulin-mediated suppression of lipolysis is blunted in obesity), therefore they have to rely more on glycogen. The reliance on glycogen when fasting could contribute to the observed symptoms without causing a sufficiently low blood sugar to result in coma. The use of glycogen results in release of a lot of water (glycogen being composed of 1 part glucose to 4 parts water), which will result in sodium depletion and hence symptoms of headache etc. A small drop in blood sugar is also likely as you say. (However, some symptoms may come from other causes, such as caffeine withdrawal, tension/stress of venturing into the unknown, not drinking enough). Those who exercise regularly may still be metabolically inflexible as Peter Attia describes...if you exercise at a moderate intensity most of the energy comes from glycogen anyway. His self-experimentation showed that, before he adopted a ketogenic diet, glycogen was his main fuel, even though he was extremely fit.

This fascinating article gives some interesting theories about metabolic flexibility, insulin resistance, hormesis etc. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2678135/

Here is another paper about metabolic inflexibility in obesity: http://www.ncbi.nlm.nih.gov/pubmed/21692967

This study (albeit in mice) shows a link between a high GI diet and metabolic inflexibility: http://www.ncbi.nlm.nih.gov/pubmed/19934403

This review and associated study describes how obese individuals tend to burn less fat for fuel than lean people: http://www.ncbi.nlm.nih.gov/pubmed/19133411 and http://www.ncbi.nlm.nih.gov/pubmed/18175746

More mice - this time on ingested ketones http://www.coconutketones.com/pdfs/Kash ... g_2012.pdf

Really fascinating reading, and many thanks. Now how do I get my brain and out-reaching hand to stop picking up that sandwich/cake/sweet/chocolate bar/fruit juice / bag of chips hmmm?

You just have to have emptied your glycogen stores sufficiently - then you seem to be able, in fact required, to refill with carbs. Low carbing looks to make sound sense up to the point where exercise becomes fairly strenuous but even Peter Attia takes in carbs to replace glycogen used in exercise (and repair muscle damage). I suspect true low carbing requires a sedentary lifestyle...