Darcy, that does make sense - that if the body feels it has to get energy from somewhere, and if lean body mass is all that’s available, then it’s going to get used. I looked at the Aria scale - seems pretty good and accurate, more than I would have first thought. Did you feel any differently while the scale was indicating you were losing the LBM?
Insulin resistance - ugh. I am so thankful to have found out how it works; I was on a bad road.
The Every Other Day Diet book prescribes a program of alternating days of fasting (500 calories) and feasting. It’s written by Dr. Varaday, a researcher at the University of Illinois. She states that folks following her protocol who exercise lose twice as much weight as those who don’t.
I don’t know if the “use it or lost it” axiom is true, but maybe resistance training can guard against muscle loss while fasting. I’ve incorporated it into my plan (along with cardio), and it seems to be working. I lost 30 lbs of fat and 2 lbs of LBM according to DEXA scans.
I know that today fasting feels a lot better than it did then. Instead of taking 4 or 5 days to get the high energy levels, I am on my 2nd day and the energy is great. I will check ketones later today and see if there is a big improvement. Now I did lose 3 lbs between yesterday and today and the Aria says I am up 0.2 body fat percentage. Seems too small to worry about. I am pretty sure the Aria is reasonably reliable to show a trend, though it is a couple full points lower than the body composition scale my doctor uses.
Darcy, I’d say that 0.2% is almost surely well within the margin of error of the scale’s fat-determining capabilty, though I have read impressive reviews of the Aria. You are right about focusing on the longer-term trend.
Within “lean body mass” there is a lot more than just the muscles we all depend on - there is skin (1/6 of our body weight, a fact that always amazes me) and cells that are damaged or diseased; as I understand it the body is pretty good at using up the stuff that needs to go (or is even harmful) long before it starts consuming the stuff we should really worry about.
Perhaps that sounds overly optimistic, and it may be - I don’t know for sure.
is the key. While people on medication should definitely have help in reducing medications as needed, I wonder if there are monetary and ego incentives at work too. After all, people have been doing extended fasting for health benefits since at least the Ancient Greeks.
In any case, Dr. Phinney “rants” as well:
http://blog.virtahealth.com/science-of-intermittent-fasting/
Dr Phinney believes that fasting causes irretrievable loss of muscle. But Dr. Fung posits that our bodies would not weaken us to the point where we couldn’t hunt for food.
We really need new modern RCTs to explore this issue.
Whoa. Guns blazing. Can’t read it all now. It might be the first thing Phinney has written that I don’t like.
Seems to me there are three areas of “lean body mass” on the table:
Skin (losing excess skin during weight loss), damaged or diseased cellular components, etc. - stuff that’s demonstrably good for the body to get rid of. Stuff where if it builds up too much, it leads to neurodegenerative disease.
Skeletal muscles. On another thread, Todd Allen says,
Organ tissue - as with the heart, liver and kidneys, as Drs. Phinney and Volek mention. This is where I really disagree. The other thread:
Translation: His weight loss clinic doesn’t incorporate fasting.
So why not “put down” alternative weight loss methods ? Especially ones that are gaining popularity and that you don’t plan on using in your clinic.
The “not everybody should and so nobody should” fallacy is everywhere. I’m quite weary of it. Of course anorexics shouldn’t fast.
That won’t help because there is too much individual variation. There have been anodotal studies. Dr Fung quotes a few in his book.
I can say definitively (DEXA) that I’ve lost 45 lbs and almost no LBM via fasting.
I’m pretty disappointed in Phinney.
Low quality fear-mongering blog post.
I was willing to consider much of what he TRIED to say (but didnt do so well), until he fear mongered about Intermittent Fasting.
I tuned out from there.
Thought-provoking comments! I find that there are many forms of ‘eating’ disorders, so many, in fact, that I have come to describe them as disordered relationships with food. I have always found food fascinating - likely that is what led me through cooking, reading, and, ultimately restaurants and culinary school, and then working in the industry for several years. So I pay a lot of attention to ingredients, foods, and what people do with it. I guess that, plus the frenzied behavior - both in kitchens and in the dining room - in reaction to the latest trend has made me aware that I needed to bring some form of critical thinking and common sense to the subject, be it my own plate, or those that I prepared for others or taught students how to make. I hear and read a lot from folks who take up the latest thing, and then immediately take it up - without thinking it through, without other opinions, and without educating themselves along the way. I honestly do not know whether and/or how to suggest to those folks that there are things they should consider, like a 12/12 IF is a relatively doable, good place to begin. Then, maybe 16/8, 18/6, etc., and that it takes acclimatization and practice to go for 2 - 4, or so days with a full-out fast. Beyond that, as Dr. Fung himself has said, requires medical supervision. And certainly if one has battled anorexia prior to adopting a ketogenic diet, any type of fast could be risky. Ultimately, though, by listening to the people in the forefront of this field - and I mean those going at it with a background in science, research, etc., - a person has the opportunity to hear from each and all of them that this is not a path to take a sprint on, and that self-monitoring and education about it is essential. I am beginning to realize the importance of the concept of n=1 - you are obliged to monitor and measure yourself, and to do that in conjunction with solid support. I’ve yet to hear Fung, or any of the others suggest or encourage tasting as some medal-seeking act of bravado. But you and I know that there are showboaters out there who cannot resist doing just that.
If those of us in the world of Keto have learned anything, it’s to question anyone that would say “don’t do something our ancestors have done for tens of thousands of years because it’s bad for you”, without science to back it up.
Extended fasting isn’t for everyone, and Dr Fung is pretty clear about that. I have a friend that does intermittent fasting and maxes out at about 4 days, but he’s less than 10% body fat, so 4 days in and he’s tapped his reserves.
I, on the other hand, have enough stored fat in reserve that I could make an attempt to beat the current fasting record if I chose to try it. Although I haven’t worked up the mental fortitude to go beyond 5 days…yet.
Dr Fung also makes it pretty clear that you need to listen to your body, and if you’re not feeling well, EAT. I find it difficult to believe that with all the hardwired survival mechanisms our body has in place that someone would be able to starve themself to death through fasting without… discomfort.
Hello,
First time poster, been lazy keto for a year or so. IF’ing and a few extended fasts (3-5 days). I feel like I have put on muscle since I have been extended fasting, and intermittent fasting.
So, if memory serves me, Dr. Phinney seems to reference older studies from like the 60s and 70s. Dr. Fung’s referenced studies are somewhat new and current. It would be cool to have them together and have them look at the same studies and see how close their conclusions are.
I was at Low Carb Breckenridge and heard Dr. Phinney speak against fasting. Guns blazing is an accurate description of how I feel. Is he waging a campaign b/c Dr. Fung is a competitor to Virta? How can he be so dead set against something that reverses diabetes & improves health? I thought his talk laid out a poor argument. You said that was the first thing you disagreed with. ( I know this is off topic, but) How about this:
Dr. Phinney also recommends canola oil on the Virta website. This should blow the mind of anyone who has read the Big Fat Surprise.
With these 2 idecological differences, Dr. Phinney has dropped very low on my list of low carb heros.
I was also bewildered, especially coming from a founding icon of the Keto movement.
Something @richard so wisely mentioned on a recent podcast is to keep in mind that he is working with a different patient base than Dr Fung. Phinney is usually working with athletes who are generally in lean enough shape, that extended fasting probably isn’t needed, or even possibly advisable.
Dr Fung and Megan Ramos are generally working with people like myself, and many on the forum, that are overweight and/or trying to reverse diabetes and insulin resistance.
True but…
There is an unnecessary and pathological aspect to this. Phinney could easily say that fasting isn’t his gig or should only be for the obese or whatever but he continuously wages a pointless war against it based on his own paranoia from the setbacks of his early days. It would almost be worse if he was doing it for personal financial/commercial benefit - Virta vs. IDM. Isn’t keto big enough for both (or maybe their 2025 goal is so ambitious they can’t afford the competition?).
The fact that his case is so scientifically weak and obviously flies in the face of the evidence (the basis of Keto vs. the nutritional orthodoxy) is really a little embarrassing.
He just can’t seem to let it lie… and it continues to devalue his current work and taint his legacy IMHO.
Hmm
I’m listening to him and he says don’t extended fast because of losing electrolytes.
If he wasn’t obviously biased, he’d be saying that it’s OK to extended fast but be sure to replace your electrolytes.
I’m at 46 hours of fasting and have been drinking my own version of Snake Juice. Basically Potassium Orthintate, Magnesium Orthintate, Calcium orthintate and Cayenne Extract. Tonight I’ll add Sodium Chloride to the mix.
I’m over 100lbs overweight, I don’t feel like I’m in any danger.
You’re in all kinda danger. 
But you’re on your way to fixing it, so all good!
I’m 220, so have 70 to go to 150. Started at 300 so am looking to halve my body mass!!