Advice needed: Fasting with lean body mass?

#1

Hallo everyone,
my first time posting here. I apologize if my English isn’t perfect. But I was looking for some advice with the following:

I have ulcerative colitis. As it is an autoimmune disease it’s highly linked to inflammation, in particular of the gut. In my normal day-to-day life I am completely symptom free but when I get a flare up life can be a little more challenging. I have the diagnosis for six years now and I get a flare EVERY winter right on schedule.
Now my last flare in December was pretty bad and I made some changes in my diet and started to do daily intermittent fasting which helped immensely. I kept up the changed diet and usually do a fasting protocol of 18/6 or 20/4. Since the beginning of the year I lost over 53 lbs. I started out a little bit overweight, now I’m (at least BMI wise with 18,3) a little bit on the low side (but I am watching that “issue”).
Now that the colder season is approaching (yes, winter is coming) I want to do every thing to prevent the usual annual flare. As my disease is mostly a matter of inflammation and since fasting helped so much to get over the last flare I am thinking of doing a extended fast for at least five days. I am hoping to get rid of any systematic inflammation, heal and repair any issues with my gut.

I only weigh about 116 lbs and I estimate my body fat around 18%, possibly lower as I do strength training, which would be around 22 lbs of fat mass.
I read here and heard in an interview with Ted Naiman that every pound of body fat can only provide for around 30 kcal a day to fuel the body.
As I worked hard on the muscle I do have and I am sure that my muscle mass provides some help with the metabolic and endocrinological benefits against inflammation I do not want to lose much of it.
I am sure loosing some would be inevitable. But how much would I lose? How fast can I expect to regain it due to muscle memory?
As far as I know that number of 30 kcal was deducted from the Minnesota Starvation Experiment. To my knowledge the participants did a lot of cardio exercise but no resistance training (so even more catabolic?).
If I do keep up my usual resistance workouts (maybe with slightly less intensity) and give my body a clear signal that it needs the muscle can I expect less muscle loss? And if so, how much less?

In theory my BMR should be around 1200 kcal a day although I think after 8 months of consistently loosing weight my body probably adapted to a even lesser amount. I do not have a clue how much my maintenance calories are because I do not count my intake but I do not experience any of the “usual” adaptation signs like being cold or hungry etc.
So if my BMR is around 1200 kcal and with 22 lbs of fat that provide with daily 660 kcal of energy I would be short half of the daily minimum I would need. That does sound problematic if that deficit has to come from muscle.

Now, of course, I could go ahead and could up my calories before the fast to gain some fat mass. But I would have to go overboard to make a significant difference and also extremely overeating is definitely not a good idea for my gut.
That’s also a concern of mine: I fully plan on proper re-feeding after the fast because I do not need nor want to lose more weight. Can I expect to regain the lost weight without going to extremes? Is it easy for the body to balance back to where it started? Will adaptation from fasting (only if it’s for 5 days) make it easier to regain the weight? Or should I expect that my TDEE will be lower longterm?

Sorry for the long post but I am really unsure about a lot of things. A prolonged fast seems like a promising idea but I do have some doubts. Having UC can be very frustrating because sometimes it is so out of your control and fasting is something that I CAN do and that does help.
Sadly, my doctor is not much help with the minutia of fasting. She just said to keep it up if I think it helps but is not as informed and up to date with the literature as you guys are.

Thanks for reading. I am looking forward to your input on this.

(Bacon is a many-splendoured thing) #2

If you are new to the ketogenic diet, we suggest not fasting until you are fat-adapted and fully able to utilise your stored fat to feed yourself while fasting. Fat adaptation generally takes in the neighbourhood of six to eight weeks (in most people).

Once you are fat-adapted, you may find yourself fasting “accidentally,” because the lowered insulin that comes from restricting carbohydrate intake allows the hunger and satiation hormones to function properly again, and you are likely to find yourself going long periods between meals because you simply are not hungry. This is a good thing.

As far as lowering systemic inflammation is concerned, there are two things you can do for yourself. The first is to eliminate as much carbohydrate from your food intake as you can. We suggest an upper limit of 20 g/day. This will not only put you into ketosis, it will also significantly lower your serum insulin, which is one of the primary causes of the inflammation that has been plaguing you.

The other thing is to eliminate seed oils (“vegetable” oils) from your diet. They are extremely rich in polyunsaturated fatty acids (PUFA’s), many of which cause systemic inflammation. Instead of those oils, use solid fats, such as butter/ghee, bacon grease, lard, and tallow, which are rich in saturated and monounsaturated fats and low in PUFA’s. Our diet must contain small amounts of two types of PUFA’s (the ω-3 and ω-6 fatty acids), but we don’t need them in excess. The challenge, when eating the standard diet is not to get enough ω-6 fatty acids, but to avoid getting too much, since they are one of the primary drivers of inflammation.

You may find that eating a well-formulated ketogenic diet is enough to help your ulcerative colitis. But if you still need to fast, you can supplement your endogenous fat stores by eating some fat during the fast. Yes, that’s not fasting by the strict definition of the word, but you might find it helpful.

I don’t know whether fibre helps an ulcerative colon or damages it further. You may have to experiment with that. But many people on a ketogenic diet find that they are better off with very little fibre. The reason fibre is assumed to be beneficial is that the bacteria in the intestines can turn it into a chemical called butyrate, which is good for the lining of the colon. But a ketogenic diet generates lots of a related chemical, called β-hydroxybutyrate, which is even more beneficial to the colon. And since β-hydroxybutyrate is made from fatty acids, there is no need, therefore, to eat fibre in order to produce it.

(Joey) #3

@Nia Hallo … and welcome to the forum!

As noted above by @PaulL it takes time to become “fat-adapted” and reducing carbs can provide a number of essential benefits - especially for someone struggling with inflammatory health issues.

What is not entirely clear from your original post is whether you are already on a carb-reduced diet? I’m assuming so since you’ve noted that you’ve made “dietary changes” and have lost a significant amount of body fat… this suggests you’ve likely cut out most extraneous carbs for quite some time now. Also: you’re posting your message on a ketogenic forum :wink:

If so, it sure sounds like you’re doing fantastic in terms of taking good care of yourself. And would be fully fat-adapted by now, addressing @PaulL’s concern above.

Either way, can you share just a bit more about your typical eating habits?

(Bob M) #4

Is there anything you can eat beforehand to increase your calories for a while? I always eat more, even before 36 hour fasts, just before the fast. Whether you actually gain fat mass, though, that’s a different issue. I’ve seen many overeating studies where people gain a higher basal metabolic rate and gain little in the way of fat mass.

I don’t see why you can’t regain your body mass after the fast. I find mine comes up quite easily – to easily in fact – after a long fast. Though I’m also looking for other effects from longer fasts.

#5

Thank you so much for your time! I appreciate it a lot!

As for the matter of Carbs:
As of now I am not keto. I have a lot of protein in my diet because I focus on muscle building. I realized that I have under-eaten protein pretty much for my entire life (I am a vegetarian and have been for 20 years now and simply did not care before). So probably gluconeogenesis alone would put me out of ketosis (I guess).
Although in the last 10 months I think I must have been in ketosis a lot. Especially in the beginning of the year I ate very low carb and high fat. I do remember having that weird mouth taste and so on. As the months went by and the weight kept getting lower and lower I incorporated more carbs back into my diet and now I eat at least one banana and about 100 ml of oat milk every day. Also I eat some potato every other week or so… some raisins here and there. Definitively not keto but I do avoid highly processed carbs except for the very rare occasion.
I do think I am somewhat fat-adapted. Or at least I am much more insulin sensitive that I used to be. I do feel very very little hunger (if I would eat only when I am hungry I really think I would be in trouble) even after over 70 hours of fasting I am not really that hungry.

Concerning dietary fat:
I only use olive oil, ghee, coconut oil and grass fed butter. Any other fat comes mostly from cheese or eggs. I supplement Omega-3 because I think that I am too low on that front as a vegetarian.

Fibre is not a problem for my digestion as long as I do not have an active flare up. And it’s actually not some thing I am much concerned with. I do eat some vegetables as a vegetarian… guess there are also some carbs :wink:

My typical eating habits beyond what I just mentioned? Well overall I avoid processed food and tend to focus on nutrient rich food although I try not to be too dogmatic about it.
Macrowise (not sure if that is a word) I focus on protein (at least around 100 g/day) and fat. I can not tell you an exact ratio… because I really do not want to measure my food.
Most of my weight dropped while I did OMAD on most days. But for about 4 months now I eat some snacks before or sometimes even after my big meal.

Increasing my calories before the fast would be possible for me without risking gut issues. But I can only think of upping my carbs in that regard and least if it has to be to an substantial amount. I am not sure if that’s beneficial before a fast. But in general eating more before and after was the plan :wink:

Generally I really do think that I do a lot of things right with my diet. To be really honest I guess I tend to eat too little food on some days without realizing but other than that I think it could be well possible that I will not get a flare this winter even without an extended fast. I am not sure that I NEED to do it but I would really really up my chances!

Thank you very much for taking the time to answer. You guys are really helpful!

(Robin) #6

This has been an informative and intriguing thread for me! I have been vegetarian in the past. Solely from a place of honoring animals. Plus, veggies are my favorite food. I have restricted those veggies greatly now and am eating many dead animals! There, I said it.
I don’t plan on changing my carnivore ways, as this is the healthiest I have been in years. But I am very curious how a person can stay under 20 carbs a day, and meet their fat and protein goals without meat! Just curious.
Sign me, Guilty bacon lover.

#7

You’re over analyzing the hell out of this. Keep your protein high, workout the SAME. Keto by itself is VERY anti-inflammatory. You can back that up with supplementation with things like Turmeric, works way better than it gets credit for. Don’t bother with burst fasting because you don’t want to loose weight, the best thing is constantly done things that are sustainable. Keto and simply not having an inflammatory state will do what you need. The last thing you want is to start fasting combined with less intense workouts, you wouldn’t notice the loss in muscle mass doing it. I lost a TON and screwed my BMR huge.

#8

Hi Robin, I am a vegetarian for ethical reasons alone. It’s not that I think that vegetarianism is more healthy or because I do not like meat (although I have NO clue anymore how it actually tastes). But I do not have a “problem” with people eating meat. I do appreciate the fact that humans are omnivores. But I also think that they are highly adaptive and can function very well on diets consisting mostly of plants (and maybe some diary) or also mostly of meat. I do have a problem with the way most animals are raised and treated. But that is a very loaded topic.
But to illustrate my point: My husband for example eats a lot of meat (and I do mean a lot) but he makes informed decisions where his meat comes from and how the animal was raised and fed. And I am sure he has a lot of health benefits of not consuming meat derived from animals that were mostly fed with grains. But I realize that this is privilege to be able to choose to eat like that and I am not saying that everybody should do it. But I like that he does. What I mean is: There is NOTHING wrong with eating meat in my book!

For how one can eat under 20 carbs/day and meet macro requirement:
I am not sure if I really every did that to be honest. I always ate some vegetable that sure contained some carbs. But as far as I understand being in ketosis does not necessary mean to be under that exact number (but maybe I am wrong). It could of course be that I was never that much in ketosis. I never measured my ketons or anything. But I do think I was.

Concerning eating enough fat and protein: I do eat a lot of cheese and eggs… but I do supplement my protein intake with some whey on most days otherwise I would not manage a high enough intake. So yes, it’s not something that just happens by itself.

(Robin) #9

Thanks, I love hearing how other people manage to “make it work” with their food and conscience…

#10

I am pretty sure that you are right with that! :smile:
Well, that is sooo me.

Okay, so what I understand is that you advise me to not do a prolonged fast… and to be fully ketogenic (again.) I can do that. I am not really looking forward to it but if that is preventing a flare than that is worth it.
If I keep up the high protein how do I make sure that I am stay in ketosis. Sorry, that is probably a very newb question.

Do you supplement Turmeric in concentrated form or do you just eat a lot of it? I use a lot in my food but that’s probably not enough, I guess.

#11

Yeah, me too. It works for me but I am sure I’m not the best example.

(Michael - When reality fails to meet expectations, the problem is not reality.) #12

I don’t have much to add to what’s already been said other than as suggested if you’re not already in ketosis get there ASAP. If you’re already there, good, stay there as consistently as you can. Good things happen in ketosis that otherwise don’t.

What I really want to say, however, is that while vegetarian keto is certainly doable, and I think we have several forum members who do so, it is challenging to get sufficient protein while keeping carbs low enough to remain in ketosis. This simply because plant protein is intimately associated with plant carbs. This necessitates more attention to detail.

The other thing I want to mention is that the numbers we have regarding just how much body fat you can access on a daily basis are based on people eating standard SAD, not keto. The numbers for keto may be, and I suspect are, higher. I base that on my own experience when I started eating keto.

Knowing next to nothing, I unwittingly started out eating a 1000 calorie per day deficit and kept that up for 3 months. During those 3 months, however, I was never hungry and lost about 25 pounds. So my metabolism was taking more than 30 cals per day per pound of fat. As always YMMV.

Here’s some math. 25 pounds is about 90,000 calories. 3 months is about 90 days. So about 1000 calories per day.

#13

If you don’t want to eat 100% keto than don’t, I don’t anymore and I do fine. I still do LCHF, but not full keto anymore. It doesn’t take keto low carb to reduce inflammation. Most people eat WAY too much, don’t mean eating carbs as a whole is inflammatory. I eat 150-200g/day and my inflammatory issues stay at bay. Now if I were to eat “normal” and eat twice that, my scalp psoriasis, face, and back would start acting up within 24hrs. Plus, not all carbs are equally as evil.

There’s no need to fear protein, forget the nonsense of it all “becoming sugar”. That’s all it is. GNG is demand driven, not supply driven.

#14

Thanks again for your time, guys, it’s really helpful to converse with people who are so involved in this topic.

So I guess I will be lowering my carb intake then.
It’s late evening here where I live and I am done eating for today. I actually managed to track my macros for today to get a sense about it: I am at about 60 g of fat, 77 g of carbs and 107 g of protein. So I guess a little bit more fat and a little less carbs would be optimal. But I think that’s easy to manage (most of the carbs today came from tomatoes and banana)

You’re right with the plant protein. But most of my intake is actually animal protein (dairy and eggs). Sadly my gut can’t handle lentils or soy very well.

That’s good news to hear! Haven’t thought about where the people in this kind of studies started out from.

May I ask, when that happens to you do you see it in your blood work? I mean in this short time span?
One of the problems with my autoimmune issues is that I sometimes only realize that inflammation is up when I my gut is already extremely troubled. When I start to get symptoms and I check my blood CRP is very high and also keeps at a high level even when the symptoms are mostly gone. I did a lab last week and my CRP was at normal levels but I am never sure if that really means that I am “safe”. I just don’t know how fast it can rise and do not notice it when it actually does.

(Michael - When reality fails to meet expectations, the problem is not reality.) #15

OK, if you’re good for dairy and eggs you won’t have any problems. Although, I also eat meat, my main source of protein is dairy. Thank your gut for telling you lentils and soy are things to avoid! :heart_eyes:

#16

Well, I do miss Indian Daal soup :joy: Yeah, but you are right about that!

#17

I’ve never had my CRP checked while I’m experimenting with stuff, only on the times when I was at the doc while all this started. My barometer is my face, head and back. I’ll start having very mild back pain about a day or two before the face and then head flares up, it’s like clockwork. Always after I eat like crap for more than a day or so. I can take in a good amount of carbs like rice and starchy stuff, but if it’s sugary I can’t maintain it for long, if I do or even overdo the others all that will kick in and remind me it’s all there. Then I usually fist my anti-inflammatory, then steroid the face and head to fix it that way. If you’re not noticing the rise as far as symptoms I wouldn’t worry about it, CRP like everything is always moving around, it’s the point where it triggers everything you want to avoid.

#18

I am sorry that you have to deal with that. But it’s so great that you know your body that well and figured out what you can or cannot eat to avoid problems.
Wish I could say the same. But with my UC it was never very clear what causes flares. Except for certain medications or starting or stopping to smoke I could never correlate it to anything. I guess it’s because a heavy inflammation of my gut adds up over time. But I don’t want to whine about it too much. There a many people who struggle more than I do with the same disease.

(Butter Withaspoon) #19

Hi Nia
There are a number of things you say that make me think you should be cautious about doing a 5 day fast. I’m sure I’ve read somewhere that a BMI of 20 (or 19?) is the recommended cut off. Below that, a 24 hour fast is a safe maximum.
You said your weight is on the low side and you are watching that issue. I am imagining a very lean person who has to work out but also has to fix the health issue, and all as well as possible. There may be some other things you can do to support your health - improve sleep, relaxation, connection with nature - and limit the fast to something shorter.

I hope you don’t mind my comments. I wish you the best of health! And as another lean-ish person who exercises- I drop into ketosis quite easily and while still consuming more carbs than most people here. It depends on your history and metabolism. I get a fizzy tongue and and endless energy.

#20

Thanks for your input, Hellen :slight_smile: It’s all very valid what you’re saying.
And quality sleep is absolutely something that I need to work on. Bad sleeper over here!

After everyone advice I been rethinking things: I think I will try to get (back) into ketosis and watch what I notice. To be honest I don’t expect to feel much different. I did a over 70 hour fast last month because I was traveling and did not feel any different. So my thinking is that I am either hardly ever deep in ketosis or a lot of the time. But it’s probably helpful to KNOW.
So, once I gathered that information (as much as I can) I will reevaluate if a prolonged fast is a good idea or not.