Friday, February 25, 2022

36 Hour Fasting Protocol ala "The Fasting Method"


From the book "The Complete Guide to Fasting" by Jason Fung.  The Fasting Method is here.

Breakfast, Lunch, Dinner


Breakfast, Lunch, Dinner


Breakfast, Lunch, Dinner


Breakfast, Lunch, Dinner

Early stages of a fast or low-carb diet. Easing into it.

This exchange illuminates what is going on when you see that dramatic weight loss at the onset of fasting, or a low carb diet, the need for electrolytes..etc.  Here I think Megan was largely talking about very sick, potentially elderly people, people on blood sugar meds. It may be possible for healthy people to more fluidly switch between fasted and not fasted - even if they aren't on a low-carb diet.  Caveat-emptor, that's my lay interpretation of the context around what she was saying.  I recommend listening to the whole podcast.

From Diet Doctor Podcast #7 with Meagan Ramos

Megan: But if anything, they were sick, I mean these people had their arms amputated, such bad arthritis-

So you tried to use low-carb as the transition point? Try and get them on low carb first and then into some form of fasting? 

Megan: This is what I do. I realize that it's just tough and I do need to get them into a bit of a state of ketosis. When they're going from high carb to fasting, that's dangerous, because their insulin levels are going to drop rapidly and their kidneys are going to release all kinds of sodium, they are going to lose a bunch of water and a bunch of electrolytes at once, and they're going to fill horrendous, they're going to get nauseous, fasting is not going to be a good experience for them, nor a safe experience for some of these patients. 

So the idea of getting them to follow what a lot of them consider the fancy low-carb diets was not possible. So I got them to do something we joke around and we call a fat fast for four days leading up to an actual fast. And for those four days they're only permitted to eat bacon, eggs, olives, and avocados. 

And if they don't eat bacon for whatever reason then they have eggs, olives and avocados, I don't care, but just those four foods. And to be honest most of them enjoy it. Most people love at least two or three of those four foods, if not all of them. They're all simple to make. Olives require zero preparation, avocado zero preparation, eggs can be unbelievably simple and bacon, you can throw it in the oven or in the microwave, you don't have to sit there at the stove. So it's all very simple, all very easy and things that you can get for reasonable prices within the Toronto area. So they liked it, they like the challenge, it became a game to them. 

So they would do it, they would always do it. And so they would lose water weight safely while replenishing their electrolytes and then they would be able to transition into fasting quite effortlessly. And once they got into a fasting state, they felt like eating less on their eating days, they wanted to eat that bacon and those eggs a little bit more often and then because they were fasting intermittently or fasting for a couple chunks of time throughout the week, like maybe two 48 hour fast a week, they were able to actually save money.

Thursday, February 24, 2022

Pickle Juice and Fasting

From Diet Doctor Podcast #7 with Meagan Ramos

 "A lot of patients are very fascinated in autophagy, so the cellular recycling process... after it won the Nobel Prize in medicine in 2016, people are very interested. Cancer rates are now through the roof and people are looking to do whatever they can. So people want to jump in on day one and start water fasting and we say no, no. Try drinking the [bone] broth first. 

Alternatively some people really dislike the [bone] broth, so we encourage them to have a quarter to half a cup of pickle juice on the day and people actually like that in the summer. The humidity in Toronto in the summer is disgusting, so no one wants to be drinking warm chicken broth in the summertime. So pickle juice is an alternative at that time of year that will encourage patients to have. Of course with no sugar in it and we teach them different ways that they can make it at home themselves to supplement."

The right level of fasting, and fasting as therapy

From Diet Doctor Podcast #7 with Meagan Ramos

How do you break down what's the right level of fasting for the right individual? 

Megan: So we usually assess someone in consultation and then see how they respond emotionally towards the fast. But we really believe that sort of to be insulin resistant, 24 to 36 hours of fasting is very effective doing that intermittently. That's all you really need and it creates a nice balance. The idea is to throw the body off to now let the body adapt. We always tell our patients that human beings are a dumb species.

We are not a very bright species, but we're a highly adaptable species. So if we stay in any one physiological state long enough our body is going to adapt to it and so we just want to confuse the body. And I found that we've been doing this now for seven years, intermittent fasting 36 hours three times a week in people, treating that like a therapy, not as a diet.

We really encourage our patients to treat it like a therapy. I made such progress of my own health for six months, because I treated fasting like it was my attendance to chemotherapy. And I wouldn't skip a treatment of chemotherapy if my friends wanted to go for lunch. And there would be days where I wouldn't feel good, but I'll be okay because eventually it would lead to my inevitable great health. 

A dietician reports what a 3 day fast is like

Where exactly does that 95% failure rate number for non-surgical weight loss come from?

From the New York Times:

95% Regain Lost Weight. Or Do They?

By Jane Fritsch

May 25, 1999

It is a depressing article of faith among the overweight and those who treat them that 95 percent of people who lose weight regain it -- and sometimes more -- within a few months or years.

That statistic has been quoted widely over the last four decades, in Congressional hearings, diet books, research papers and seminars. And it is the reason so many people approach dieting with a sense of hopelessness.

But in fact, obesity researchers say, no one has any idea how many people can lose weight and keep it off. Now, as researchers try to determine how many people have succeeded, they are also studying the success stories for lessons that might inspire others to try.

''That 95 percent figure has become clinical lore,'' said Dr. Thomas Wadden, a professor of psychiatry at the University of Pennsylvania. There is no basis for it, he said, ''but it's part of the mythology of obesity.''

Dr. Kelly D. Brownell, the director of the Yale Center for Eating and Weight Disorders, said the number was first suggested in a 1959 clinical study of only 100 people. The finding was repeated so often that it came to be regarded as fact, he said.

Since then, nearly all studies of weight-loss recidivism have followed patients in formal hospital or university programs, because they are the easiest to identify and keep track of. But people who turn to such programs may also be the most difficult cases, and may therefore have especially poor success rates.

To get a more accurate picture, two researchers are studying long-term dieters for a project called the National Weight Control Registry, and have found it surprisingly easy to collect success stories. About half the people who maintained a substantial weight loss for more than a year had done it on their own, they found. This suggests that many people have found ways to lose weight and keep it off, but have never been counted in formal studies.

''There is something very optimistic about this whole data set,'' said Dr. Rena Wing, a professor of psychiatry at the University of Pittsburgh and the Brown University School of Medicine. ''Without much effort, we have identified 2,500 people who have succeeded.''

Dr. Wing and Dr. James O. Hill of the University of Colorado are collaborating on the registry project, which they began five years ago with financing from drug companies and other sources. They are compiling detailed histories of successful long-term dieters -- people who had maintained a weight loss of at least 30 pounds for at least one year. Most of the volunteers were solicited through articles in newspapers and magazines. ''It was really to convince ourselves and convince the world that there are people who are successful, and then to learn from them,'' Dr. Wing said.

To their surprise, Dr. Wing and Dr. Hill found that on average the respondents had maintained a 67-pound weight loss for five years. Between 12 and 14 percent had maintained a loss of more than 100 pounds.

The success stories might not have been so surprising had it been clear that the 95 percent failure rate was so poorly founded. The figure comes not from any kind of random sampling, but from a study of 100 patients treated for obesity at a nutrition clinic at New York Hospital in the 1950's. In 1959, its authors, Dr. Albert Stunkard and Mavis McLaren-Hume, published a paper in which they concluded, ''Most obese persons will not stay in treatment, most will not lose weight, and of those who do lose weight, most will regain it.''

That conclusion, Dr. Brownell of Yale said, has since become the most frequently quoted statement in obesity literature.

Dr. Stunkard, who is now a professor of psychiatry at the University of Pennsylvania, said the study was ''perfectly respectable'' for that period. ''The paper made a big impact because everybody thought obesity was pretty easy to treat,'' he said. ''This showed that, for whatever reason, it wasn't.''

But the study has little relevance to the current understanding of how to control weight, said Dr. Stunkard, who specializes in the treatment of obesity and eating disorders. The 100 patients in the study were ''just given a diet and sent on their way,'' he said.

''That was state of the art in 1959,'' he added. ''I've been sort of surprised that people keep citing it; I know we do better these days.''

The intervening years have brought significant changes to the treatment of obesity, the most important of which, Dr. Stunkard said, has been the introduction of behavior modification techniques.

Since the 1959 study, though, the statistic has been reinforced by most other clinical studies, which also showed people with discouraging results.

''Unless we can prove they're typical, the data cannot be generalized,'' Dr. Brownell said. ''The people we see in clinics tend to be more overweight and have more psychological problems. They are more likely by a factor of two to have binge- eating problems.''

The true failure rate could be much better, or much worse, he said. ''The fact is that we just don't know.''

The new research on successful dieters will disappoint those hoping for a magic-bullet solution; most had simply eaten less, and healthier, food, and exercised regularly. But judging by their accounts, it is entirely possible for people without the resources to hire personal trainers and chefs to accomplish permanent weight loss.

For inspiration, it would be difficult to surpass the story one of the participants in the Weight Control Registry, Tammy Munson, a 32-year-old receptionist and ambulance dispatcher from Jamestown, N.Y., who lost 147 pounds and has kept it off for eight years.

At 5 feet 4 inches tall and 185 pounds, she was overweight throughout high school, but ballooned to 253 after she graduated and got married. She knew little about nutrition, she recalled, and ''didn't even realize that liquid had calories.''

''I'd get up in the morning and have ice cream and cookies,'' Ms. Munson said. Dinner might be three or four fast-food hamburgers and candy bars. Her husband, Jeffrey, who has lost 100 pounds, was also seriously overweight. ''Our wedding pictures are really funny,'' she said. ''We broke the bed when we were first married.''

Ms. Munson began to face her weight problem, she said, when her blood pressure began to rise. At first she did some crash dieting, eating only about 650 calories a day.

''I read every book in the library about how to keep the weight off,'' she said, and eventually settled on a more balanced approach that included salads, fish, vegetable burgers, fruit and always a little dessert. And exercise. She exercises to a tape every day, jumps rope, and has begun running.

In part, Ms. Munson attributes her success at least in part to the fact that she did not know success was supposedly impossible.

''You've got to find it for yourself,'' she said. ''And don't spend money on it. You can get it for free. You can get if from reading. It's just the food pyramid, but people don't want to hear it. Slimfast, Optifast, you can't live like that forever.

''You eat a lot of good stuff and a little bad stuff, and you'll be fine, but you've got to have the little bad stuff, too.''

The experience of Russell M. Lomando, 47, of Brooklyn, was less dramatic, but probably more typical of the people in the study. ''I was 39 years old and I was walking up the train stairs in Brooklyn huffing and puffing,'' he said. ''I could see myself going into the grave when I was 40.'' He used to eat, he said, ''pounds of junk -- donuts and cookies and cakes, and I'm talking boxes at a time.''

One day, climbing the subway stairs, Mr. Lomando made up his mind to cut out the junk, but gradually.

At first, he was able to do it only four days a week; he worked up to seven over a period of months. He took up karate for exercise, and over two years lost 50 pounds, getting his weight down to 160.

''You just have to change your life style,'' he said. ''You just have to have the will power to do it.'' But that is not necessarily easy, he conceded. ''You just have to weigh the choices. Do you want to become healthier?''

Small little reminders of just how overweight I am

Standing helping my dad on his computer.  After a few minutes back and knees start aching.  Don't pregnant women talk about stuff like this?

Obesity, Treadmill Walking, Speed, Incline, and Injury

Energetics and biomechanics of inclined treadmill walking in obese adults (Click for abstract)


Brisk walking is a recommended form of exercise for obese individuals. However, lower-extremity joint loads and the associated risk of musculoskeletal injury or pathological disease increase with walking speed. Walking uphill at a slower speed is an alternative form of moderate intensity exercise that may reduce joint loading.

Purpose: The purpose of this study was to quantify the energetics and biomechanics of level and uphill walking in obese adults. We hypothesized that compared to brisk level walking, walking slower up a moderate incline would reduce lower-extremity net muscle moments while providing appropriate cardiovascular stimulus.

Methods: Twelve obese adult volunteers, with mass of 100.5±15.7 kg and body mass index of 33.4±2.6 kg·m (mean±SD), participated in this study. We measured oxygen consumption, ground reaction forces, and three-dimensional lower-extremity kinematics while subjects walked on a dual-belt force-measuring treadmill at several speed (0.50-1.75 m·s) and grade (0°-9°) combinations. We calculated metabolic rate, loading rates, and net muscle moments at the hip, knee, and ankle for each condition.

Results: Metabolic rates were similar across trials and were of moderate intensity (48.5%-59.8% of VO2max). Walking slower uphill significantly reduced loading rates and lower-extremity net muscle moments compared with faster level walking. Peak knee extension and adduction moments were reduced by ∼19% and 26%, respectively, when subjects walked up a 6° incline at 0.75 m·s versus level walking at 1.50 m·s.

Conclusions: These results suggest that walking at a relatively slow speed up a moderate incline is a potential exercise strategy that may reduce the risk of musculoskeletal injury/pathological disease while providing proper cardiovascular stimulus in obese adults.

Ehlen, Kellie A., Raoul F. Reiser, and Raymond C. Browning. "Energetics and biomechanics of inclined treadmill walking in obese adults." Med Sci Sports Exerc 43.7 (2011): 1251-1259.

Wednesday, February 23, 2022

Is natural sugar from fruit just as ‘bad’ as added sugar


My takeaway was don't eat sugar, but eat all the berries, grapefruits, and kiwis that you want.

Green Zone Training

My takeaway was that the bulk of training should be done in the green heart rate zone, which is 70-80% of max heart rate.

How to sneak up on a regular workout routine that doesn't brutalize my body...

 I hammered it in January on the treadmill, and lost a bunch of range of motion in my hips.

Going forward, focus on cycling rather than treadmill.  Train up towards an hour, but start at something much more manageable like 15 or 20 minutes.

Go for less workouts per week than my personal inclination. This might mean 3 or 4, not 7.

If I'm doing a 36 hour fasting protocol, it might just make sense to make fed days workout days.

Friday, February 11, 2022

It's funny how a lie takes over (Exogenous Testosterone and HGH)


If Joe Rogan were a full-time advocate for hormone therapy, I'd be OK with that.  However, I feel like he needs to issue a disclaimer every time he talks about "fat lazy people who can't stop eating".  His physique is not 100% (or 90%, or 80%) willpower, diet and training.  He's shooting steroids and growth hormone.

It's just not honest.


 Decided to try out eating meat again.  First meal with meat was last night.  I feel a little washed out today, supplementing salt, and taking it easy.  Predictably, have the runs.

I'm not going to go much into why I made this change.  I was vegan for a year, veg for many years, and also spent years pescatarian.  No lack of commitment.  Also -- I want to leave open the possibility of going back, or interleaving different eating patterns.

Saturday, February 5, 2022

Current concerns

Treadmill Sports Specificity, Overweight, and Biomechanics

 The biggest concern is the degree to which I'm leaning on the treadmill for the bulk of workouts.  I need to find a way to get good enough on the exercise bike to start enjoying it.

I think here I also have to recognize that a given beats per minute of heart rate on the bike might not be 100% equivalent to the same on the treadmill.  This might be for a variety of reasons, but a big one is sports specificity.  I have been essentially training myself to be a good treadmill walker over the past months.

What's the concern with the treadmill?  It stems from a kind of lay understanding of biomechanics:  I'm carrying an extra 100 pounds, and the weight-bearing, repetitive motion of a treadmill isn't 100% benign.

The power of the minimum workout

I live on an island that is 18 miles long, and less than a mile wide at points.  Needless to say, if you are going to go for a walk a lot of it is straight out, and straight back.

One technique that helps me stay motivated is to mark out what is the shortest walk to still be worth doing.  For me it's about a mile, but that is a personal thing.  

The power here is that on days where I don't feel motivated, I can usually just drag myself onto the short minimum workout.  Often then the individual workout turns into more once I warm up.  

This minimum workout has the effect of turning a series of unmotivated days into a building sequence, starting small, and moving up.  This is the way it should be rather than having large swaths of blank days on the calendar with no workouts.

Wednesday, February 2, 2022

Natural v.s. Steroids (Pick natural!)


This video is a little weird, with the guy standing there talking with his shirt off, but it is useful for modulating expectations around muscle gain.  The presenter clearly goes through a number of transformation photos, and calls out what is possible without steroids, and what is not.

International standards of fitness 2 | National Security


International standards of fitness

Facing up to the fact that the US culture is more video game than national trail can be hard.

Tuesday, February 1, 2022

January Workout Stats

I'm pretty happy with how this month went.  I am noticing that I need to interleave both lower intensity workouts, as well as different sports in order to avoid RSI.  Started dipping my toe into the fasting water and seeing some initial weight loss (probably water).

It's not necessary to work out in the highest heart rate zones every workout.  There is going to be real benefit from interleaving lower intensity pieces.

Playing around with intermittent fasting.

Tracking data, working out regularly, having fun, paying attention to satiety, overtraining, and other bodily signals.