Yes, Phinney’s terrific! I would take a look at the threads about here on his fasting comments - not to change your mind, but just to give his talk more context so that you can make an informed decision about how much to follow his warnings.
Phinney and Fung are not that far apart about fasting for more than 24 hours. I am beginning to wonder if people who listen to Dr. Fung and Ms. Ramos aren’t hearing what they want to hear, sometimes. (Or perhaps I am—that, too, is a possibility.)
@Gabe Gabe, you have to listen to the new Rhonda Patrick interview of Valter Longo! So much good info on fasting.
Overall his research pretty much fits with Fung’s clinical findings, and he does a lot of work on yeast and mice to figure out mechanisms, and then does trials with people (but with fasting mimicking diets) to see how it plays out in humans. If you want more research on fasting, it’s definitely worth a listen.
Some highlights that connect specifically to your concerns: with extended fasting (he seems to use 3-5 day stretches), people lose fat, water and lean mass. The lean mass is muscle loss and organ shrinking. But the organs and muscles bounce back after a re-feed, and though he hasn’t proven this yet, we have enough research on autophagy and apoptosis to make a reasonable hypothesis that the cells that are dying off are the weak/damaged ones and that they’re replaced with new cells. Good stuff
Longo’s actually not a fan of keto diets long term, although I think there’s a big gap in his reasoning and I hope we get into some discussions about it on the forum.
Another neat idea from the podcast: Longo hypothesizes that the body is used to periods of scarcity and uses those times to regenerate and rebuild. The problem for us is that with modern availability of food we just don’t have those periods (at least in most first world countries). This is a familiar thought to many of us, but he put it nicely - that the body needs sleep, so we get tired, have a strong pull toward sleep that at some point becomes overwhelming. However, we have never needed to evolve the same mechanism for fasting because it was just built into our lives for most of our evolution.
70% fat,25% protein ,5% cabs macro rations. is that in grams or calories?
Very good point!
I would love to see Phinney and Fung do a round-table kind of discussion kind of thing where they can flesh out their differences and perhaps build on their common ground. Like PaulL says, there might be quite a lot of common ground there.
I suppose if it results in death this could be true. Otherwise it sounds like unverifiable assertion and I can easily point to many counter examples including my own personal experience.
I see fasting as similar to exercise. It is a stress which can result in benefit or harm depending on the intensity and duration and the ability of one’s body to respond. That response is governed by ones general state of health due to factors such as sleep, chronic stress, nutritional status, sickness, toxin load, genetics, etc.
Now, that’s an intriguing thought, @brownfat. That really provides a whole new way of looking at fasting for me!
The “Biggest Loser” contestants were followed for several years, and the researchers found that their metabolic rates never returned to the level they were at before the show. Perhaps fasting does this too, if you eat the SAD. I wouldn’t be surprised to find that, if people like that went keto, it would reset their metabolisim. This is all pure speculation, of course, but I do wonder.
But part of the data that Dr. Fung usually uses when talking about the Biggest Loser study is how it contrasts with the BMR of post-op gastric surgery patients, who I assume are SAD eaters too. And it still works.
I think it all boils down to the question on whether the mechanism behind fasting of, say < 4 days works fundamentally different from calorie restriction. And based on my own findings, I think the answer is yes. Fung’s two-compartment theory has appeal in that it explains why calorie restriction slows down the metabolism:
In my case, I need 3,000 kcals per day. If I restrict this to 2,500 over a period of 1 week and then start eating 3k again, I gain weight, all factors being equal. The reason based on Fung’s idea is that, because I am still eating (as opposed to fasting), my body is receiving insulin stimuli and cannot access the body fat quickly enough to offset the 500kcal deficit. Now, the ketogenic diet helps a bit, because you generally do not eat highly insulin-spiking food. Yet, it’s enough that a prolonged calorie restriction (particularly if you eat frequently and bump up the insulin many times throughout the day) end with a slower metabolism.
I generally restrict my fasting to 48h max. Far more usual for me are 18-24h windows, though. In these cases, I don’t receive any insulin spike. Since insulin is low, the storage can be accessed and my body doesn’t need to slow down the metabolism and limit some less vital functions. One good indicator for me is freezing. If I freeze, I know it’s time to end the fast, as the storage cannot be accessed for whatever reason.
Which brings me to confounding factors for insulin levels! In my experience, these can be many things apart from eating. I might fast for 24 hours and still get the freezing sensation despite not having eaten and low insulin levels… but people sometimes tend to forget factors such as:
- basal insulin excretion
- environmental stimuli (particularly smelling and looking at food)
- psychological stimuli (thinking of food/food planning)
- MTOR-based stimuli (even coffee without cream can affect this in some people)
- stress and hormonal status
- general health status
- … probably tons more I didn’t think of
So in general, I think Fung and Phinney are both right: fasting is a tool which works great and if you listen to yourself and don’t overdo it out of ambition (trust me I learned this the hard way!), it will work tremendously well and, if anything_ boosts my metabolism if:
- I keep my fasting to 48h max
- I remain receptive to the physical messages my organism sends me
- I don’t perceive ending a fast as a “failure”.
My body needs to have the final say in this! If you force it, you abuse the tool and it will have detrimental effects (e.g. slowing down you BMR).
Jimmy Moore put on weight on keto after being a lot lower years ago, and has never managed to get rid of it again. I wonder if it’s chronic stress for him. Are you stressed? I was talking to a doc on Twitter and he talked about a patient he had that was losing their hair from job stress, but their blood cortisol was normal. When they got a new job their hair grew back yet their bloodwork remained the same. So unfortunately blood metrics can’t tell the whole story.
This is interesting and extremely alarming. My cortisol was tested as normal last year; I’m not markedly more stressed recently imho. I think the principle differences that may be behind the weight gain were that I had sudden hearing loss in December and was briefly put on steroids (about a week); they then had me on a diuretic for a couple of months. And then for several months, until about April or May, which is when most of the weight gain took place, I didn’t exercise at all – no cardio, no resistance. I suspect these are at least part of the reason behind the weight gain.
I got used to the plateau on LCHF; I never expected any weight gain. If the Carbohydrate Insulin hypothesis is right, I just shouldn’t be stacking on the weight right now. And now just to remain weight stable I have to fast 1-2x per week. That’s insane.
I have a followup appointment with an endocrinologist next week to discuss this.
As far as the weight goes, to be honest, I wouldn’t worry too much @gabe. I have weight fluctuations of 3-4 kg per day if I eat fiber and salt and don’t poop for a day or two. Your weight still seems very stable compared to my case.
Yet, I think something is off with your metabolism. IF you are struggling just to maintain, I agree something seems off. Could it be that your workouts prior to gaining weight have been too intense combined with caloric restriction? Another possibility is hormones, gut flora, auto immune diseases.
Also I would try the whole 30 reset program in your case. Perhaps there is some food intolerance?
Have you had your hormones tested? You know I’m having a similar issue (weight stall/gain except I’ve never actually lost any weight on LCHF) and just found out there’s a very good possibility it’s low testosterone.
Also - food intolerances are a real thing. You may look into AIP. I found out that I’m highly intolerant to avocados (among other things).
Thanks guys — yeah I mean I’ve definitely put on fat. Pants are very tight. Never thought this would happen on low carb.
Re hormones — I’m seeing an endocrinologist next week to discuss the blood tests he most recently ordered. A food intolerance test is a good idea too.
@Zimon — I also fluctuate 1-2kg. That’s why all my measurements are 7-day or 30-day averages. That most recent graph plots the 7-day average weight, so it’s definitely tracking a weight gain, and it’s for sure mostly fat.
For the record, I’m pretty sure there’s a hormonal issue that I may have to deal with. Sure, my activity has gone down a bit, and sure I still eat past satiety, but I always did. This is quite weird and unsettling.
I agree. I’m starting to think a lot of weight loss plateaus or mysterious gains people have are attributed to dietary reasons when in fact they are non-dietary.
So I was just reading the “New Atkins” book again today (the Phinney/Westman/Volek version) and they specifically say this:
There are many pharmaceuticals that can interfere with weight loss. They incluude … diuretics…
I was on a diuretic (for my sudden hearing loss) called acetazolamide, and that’s the only major variable that changed since December, though the weight gain did continue after I stopped taking the medication. There’s nothing online that suggests acetazolamide causes weight gain. So I can’t be sure that it’s the cause, but now it’s a suspect.
I have been stalled for almost 8 months. Like you I lost 20lbs quickly and easily, in the past few weeks I have gained back almost 7lbs and my waist is up 1.5". I am so upset. I never make it lower than I have been and then start going up again (set weight???). I am not calorie restricting and no hidden carbs. sigh!!!
Yeah, I’m convinced this is an issue that afflicts a substantial number of people. I’m not sure what to say here; would love it if the Dudes would address this. Mentioning @carl here for that reason!
I have listened to many podcast with interviews by many different people. I’ve heard numerous people mention that if you eat too much fat then your body doesn’t need to use its own fat as fuel. I’ve also heard keto nutritionists mention that once insulin is lowered and fat adaptation has occurred to continue to lose weight, we still eventually need to cut calories. Too much food is too much food, even if it’s keto food.
The most recent podcast I was listening to where this was mentioned was from the Biohackers Lab.
Unfortunately, I don’t remember where in the podcast that was discussed.