Dr Boz Calculates levels of autophagy using blood sugar/blood ketones ratio

[Ricardo_Wheelock]

Guys, I am bit worried, I need some help/advice:
I started what I expected to be a 7 day fast. But my sugar level where too low from the start, So at 60 hours I felt some pain in my kidneys and dec

ided too look what normal sugar levels should look like, I got so worried about Hypoglycemia that I decided to stop immediately, I just had some watermelon, very little, and I am sharing my numbers expecting someone to chime in. As you can see I got into what is known as deep autophagy level quite fast but those sugar numbers got me really worried. I have never been diabetic or had any diabetes problems.

[Keto6468]

I’m certainly not a doctor but it seems like maybe you should do shorter fasts

[Karim_Wassef]

I can function just fine at 35G and 5K… the low glucose at low ketones are the concern: 42G and 0.7K…

If ketones are high enough, the need for glucose drops to the basic essentials - red blood cells and some nervous system/brain function.

With low ketones, that looks off… I would get a second meter (or borrow from a friend) to confirm that yours is accurate.

I would stop a fast if you feel pain. Kidney pain may be the result of dehydration so make sure you’re taking enough salt and water (actually I take a range of minerals when I do extended fasts). My longest fast was 19 days and I usually get to that deep autophagy after the first week.

That’s just my n=1… I’m not a medical doctor, just a personal experimenter.

[Ricardo_Wheelock]

thank you Karim, really useful stuff!

[Karim_Wassef]

Glad to help. I’m a dataphile myself so I track almost everything I can to make sense of things…

Karim's Extended Fast Tracker - come along for the ride

Day 10 final - PSK [image] Weight loss still progressing but it has a larger component from muscle mass too… and that’s while consuming a lot of protein. My GKI has been steadily increasing and is in the 3-4 range now… so low level ketosis with Glucose in the high 80s and ketones in the low 1.0s… I’m getting sun, sauna and deadlifting outside every day now.

[gstlynx]

Most serious research Doctors qualify every statement about autophagy in humans with something like, “We don’t know, but in animals…” Having said that I think Dr. Boz’s metric is useful, when viewed in a state of protein restriction/denial.
Others have already noted this but I think it bears repeating:
The 2 sensor pathways that we know how to manipulate for autophagy are AMPK and mTOR. Ketosis activates AMPK. Limit the amino acid pool, specifically leucine and 2 others that activate mTOR. So if one is restricting/denying protein intake that should limit mTOR activation.
Those 2 together SHOULD stimulate autophagy in humans, I believe it does watching my age spots fade, scars diminish, also loose skin and wrinkles from being fat disappear.
Having said all that, I am so lean now that I will only do fat fasting in the future. On day 5/7 of a well hydrated adequate electrolyte fast I was absolutely drained, drank some MCT and got on with it knowing I didn’t really mess with the autophagy promoting pathways too much.
I believe/hope that the animal data will be proven to extend to humans.

[Janie]

I have seen my age spots flake off after fasting so I am a believer

[Karim_Wassef]

My conclusion is a little different. I’m 47 and my concern isn’t just with losing fat or recycling bad lean tissue with autophagy. I am also very much interested in building up a base of new lean muscle mass.

I think mTOR is much maligned but it’s just as important as AMPK for longevity. The difference is whether it’s chronically high or intermittently high.

My goal is to maximize both by being in autophagy most of the time but spiking AMPK with protein and heavy weightlifting to increase muscle hypertrophy locally… then get back into autophagy. If I can do this in a state of higher ketones, then I also get the lean mass preservation mechanisms…

It’s tricky, so I try extended multi-week fasts, protein sparing keto/fast, keto, cyclic fasting, etc…

Karim's Extended Fast Tracker - come along for the ride

Keto - Day 2 [image] interestingly, my ketones went up once I stopped PSK and went to keto. I think this is mostly dietary fat converted to ketones, not body fat ketones. I did lose weight on PSK. I used 19 days for the average of the EF but still corrected for the first three days that came back after the fast… here are the results: [image] so PSK was half the fat loss of EF (54%) and almost three quarters the lean mass loss of EF (72%). Based on my results, EF is still a superior lean m…

[gstlynx]

I don’t know if you were responding to me but I see no discrepancy, and I train with heavy lifts while fasting because I don’t care so much about muscle autophagy, I want organ autophagy–liver, kidneys,brain, gut etc.

[TotallyKO]

Hi Karim - I am obsessed with this graph. I love the way you are thinking about looking at GKI and body fat percentage. I’ve been fasting for 2+ years, but I’ve just started tracking my GKI (and doing keto) in the last few weeks. May I ask, how did you create this graph? I’d love to try and recreate this with my data! Thank you! Katherine

[Karim_Wassef]

Hi Katherine and welcome. I use excel and plot the GKI and BF% on two axes (primary and secondary). I can’t post the excel on the forum so I’m not sure the easiest way to share it, but someone else on the forum may know?

[TotallyKO]

Hi Karim! Oh Excel, ok very cool, I can do that. I’m so curious, have you seen evidence that GKI and weight or BF% are consistently correlated? It would make a lot of sense if they were, but I’ve never seen anyone else write/make that connection so directly before. Probably the closest I’ve seen is Dr. Boz saying anything <80 = weight loss and this “Data Driven Fasting” concept that suggests you can use your glucose readings as a barometer for when you should eat. I’m super curious about this topic, because I’ve never really found a sustainable way to get my weight (and really BF%) down to where I want it. This gives me hope!

[Karim_Wassef]

I’m a scientist by trade so the first thing I tried to do was to correlate the GKI to BF%. I can see the trend visually but the noise in the data made it difficult to mathematically correlate.

The GKI is generally polluted by elevated glucose due to occasional stress, but the algorithm doesn’t know that. The ketones can likewise be polluted by exogenous fatty foods … and then the BF% is a strong function of accumulated food and water retention - so eating a salad can increase BF% by retaining more fluid around the fiber… I knew it wasn’t true when I gained BF% on an extended fast…

The only reasonable correlation was the overall effect I measured on a multi-week fast where GKI < 1

If I had more data points and more variables, I may have been more successful.

Personally though, it’s still a directionally useful indicator. If my GKI < 3, I’m losing fat.

[TotallyKO]

I love it. Maybe there is a way to factor in cortisol levels to account for the stress fluctuations in glucose? Though, I suppose that’s not an easy at-home test.

I’m always skeptical about those BF% on at-home scales. I didn’t know it was specifically water/food retention, but that makes a lot of sense. That’s wild that you “gained” BF% on an extended fast!

When you say “If my GKI is <3, I’m losing fat” - Do you mean body fat? Or can it also be burning just dietary fat?

That’s one big question I have… how do I know when I’m burning body fat and will maintain it (vs. immediately restock those fat cells it when I go back to eating, even keto food)?

And, another big unanswered question I have is how does this all work with your body’s “weight (or BF) set-point”? If you maintained a GKI of <3 for an extended period of time would your body keep losing weight or will it start to “fight back” at some point to try and preserve a certain amount of fat?

I don’t know if you have any inisght on those, but I’m imagining you’re probably exploring the same questions.

May I ask, what kind of scientist are you? I was a physics major undergrad (though have been in business ever since) and my fiance is a bio-chemist, so I regularly ask him my fasting/keto questions and then am forced to realize how little I understand about how the human body actually functions!

[Karim_Wassef]

While there’s no way to tell if the ketones in the GKI are dietary or not, in my experience it’s unlikely to get that low of a glucose and high of a ketone (GKI<3) eating whole natural foods without losing body fat… eating only fats would break this rule but I’ve never done that and fats alone wouldn’t be whole foods anyway.

I’m a physicist who’s in business now too.

Here’s my experience on maintaining fat loss:

Keto is the gentlest and most sustainable loss mechanism because there’s an abundance of nutrient rich fat soluble vitamins and minerals as well as anti inflammatory fats with minimal insulin excursions. This avoids the body’s starvation panic stress where cortisol takes over and pumps in glucose by breaking down muscle. That leads to an insulin response and you stop losing fat… you lose muscle.

At some point, the body will reach a historic set point … or rather a series of set points. Think of your stable weight plateaus since puberty. The body has a memory of those set points and will work backwards through them. Each time you get to a historic set point, it will reduce your metabolism so you’re unable to continue your weight loss journey.

I’ve found a couple of tricks for breaking through this…

the first is a refeed. I think if my weight as being caught on a fishing hook, the more I struggle, the worse it gets. The remedy is to back out slowly and then redirect it again but as gentle as I can be. This means that I have to accept that the super fast loss I experienced for weeks will be partially reversed (temporarily) and then will go half as fast for some time until I break through.

The second is fasting. This sounds like the exact antithesis but it’s not. Water fasting with minerals puts the body in a state of necessary change. It’s more aggressive but ketones and hormones kick in to help. A couple of weeks usually do the trick.

My current battle isn’t weight loss. I’m trying to build up muscle and keep the fat off. Unfortunately, that’s more difficult at 47 than it would have been at 27. Having said that, I’m in better shape than I’ve ever been…even going back to my teenage years.

Hope that helped

[collaroygal]

Take a screen shot of the data in Excel, save as jpg. Post as usual.

[Karim_Wassef]

That’s what I’ve done. I think she was looking for the sheet to update her own data on the same format.

[TotallyKO]

Hi Karim -

That helped a lot. Thank you!!

I cannot believe you’re a physicist turned business person too! We’re a rare and unique breed. No wonder I like the way you think.

I got into all of this a bit backwards. I started with fasting actually. About three years ago I started dabbling in it. First with a potato fast, then intermittent fasting, then 24 to 3-day’ers. Starting in January I got serious about it, doing ADF and 4:3 fasting for four months straight, but continuing to eat what I wanted when I was not fasting. Slowly I cut out sugar and for the last month I’ve been Keto.

Going Keto has made a huge difference for me. I’m down 6+ pounds and my clothes fit way better. I’ve just started re-introducing the fasting. I’m doing two 40-hr fasts this week.

That’s so interesting to learn about how you hit your previous set points. I think that is totally what happened w/my March/April plateau. And, the switch to Keto broke me out of that. Really good to know what to do if it happens again, though!

And, that makes a lot of sense (what you’re saying about GKI<3), for me. I only hit that if I’m fasting or working out. Keto alone doesn’t get me there typically.

It is exciting that you don’t need to have weight loss as the big goal any more. Don’t you wish you knew all this back when you were 27? It would have made things so much easier. But, hey, building muscle now is going to be way easier than at 67. I’m sure you’ll get there! It sounds like you’re very disciplined and well-researched.

Thanks for all the help. I really appreciate it!

[Mkinder]

Thank you, for introducing me to dr boz. I have read her book and her 81 resources to back up the keto lifestyle. Dr. Boz has given me the tools to help deal with people who scold me on the keto life style.

[Paden]

This is such a wonderful thread. Hope everyone is still doing well after these years.

I stared Paleo in 2013 and was in the best health of my life from 2014 to 2019. Losing 70 pounds and in better shape than in my 20s.

Since covid, I have lost my way. Up 30 pounds while still eating clean. However, I stopped my fasting routine.

Decided to break out my keto mojo and get more info about what is happening. Doc visit recently showed A1C at 6.1 even though I am eating paleo/clean. (Except the wine aspect).

Currently on a 3 day fast, half way through.

Cheers to all who are sill out here and doing their thing.