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April 15, 2017

©STRETCH THERAPY™

Do you want to diet? Don’t! Detailed analysis of why diets fail, and what to do instead.

In this article, I consider alterations to one’s ordinary eating routine as a means of getting the muscle weight to fat weight ratio that you want (not “How to lose weight!”) and, in particular, I compare various approaches to eating as a means to this end.

Excess fat vs “overweight” distinction

We are all tired of hearing that a huge and growing fraction of the Australian and American public are classified as “obese”. You can’t open a newspaper or magazine without reading about this ‘crisis’, and I am sure everyone had a laugh about the very recently-published research that (amazingly!) claimed to have shown a link between hours spent in front of the television, and propensity to being overweight. “Overweight”, of course, properly means that one is carrying excess body fat, and that needs to be said clearly at the outset. I will have more to say on this below, but one’s body weight is an entirely different matter. If you assess your overall condition by the bathroom scales alone, you need to know that if you lose 10 kilograms the chances are half of that weight will be muscle – which you can ill afford to lose – and about half is fat. In this article, I want to consider alterations to one’s ordinary eating routine as a means of getting the muscle weight to fat weight ratio that you want (not “How to lose weight!”) and, in particular, I want to compare various approaches to eating as a means to this end. What you will not find here is any explicit form of calorie counting, or the word “diet” – except insofar as it applies to the concept “combinations of food”.

Net energy balance, and eating AND exercise patterns

Two basic propositions to begin with: in order to lose weight – muscle and/or fat – you will need to have a net negative energy balance; in other words, the calorific value of your food needs to be less than your total expenditure. How this might be done is part of what this article addresses. The second is to note that, long term, changing your eating or exercise patterns alone are not as likely to be successful in changing your body composition as doing both together.

Lifestyle and diet changes in recent times

Are you a sugar burner or a fat burner?

Diets don’t work: everyone who has dieted knows this; and ever more research is showing what everyone knows to be true. What is the real problem – by this I mean: why is our population getting fatter? There are two broad categories of answers: lifestyle and diet. The major increases to the rate of these changes, I argue, have happened in the last 30 or 40 years, and this the time over which both more research into obesity has occurred and over which increases in obesity has been observed. And this is the era of every kind of diet – from high carbohydrate to low, from high fat to low, and from high protein to low. These ‘eating plans’ can be arrayed on various conceptual axes. However, to make sense of the many apparently-contradictory recommendations, I will suggest that one place to start is to determine whether you burn sugar or fat as your energy source. The reason is that your choice of main fuel has important effects on your internal hormone environment and, consequently, how the nutrients in your food are likely to be used.

How did our ancestors eat?

If we go back in time (or look to the surviving traditional peoples left on the planet) you can envisage the hunter-gatherer. This mode of survival characterised the vast majority of our specie’s time on the planet, and the forebears of our species, too. The point is that our body and its hormones evolved together under this dietary regime. It is characterised by “feast and famine” supplies of nutrients: when the group hunted successfully, everyone ate – fat and protein, mainly, and as quickly as possible. Our hormones support this style of eating: when the body is fed an excess of certain calories (proteins or carbohydrates) the pancreas secretes insulin.

Important hormone #1: insulin

Creating new fat: lipogenesis

Insulin is the body’s most anabolic hormone and it is described in these terms because it is the body’s number one storage hormone. When insulin levels are high, glucose (from carbohydrates) is stored first in the liver (to replenish its supplies, about 150g) and then in the muscles – assuming you have been active enough to use the glycogen ordinarily stored there. After this, excess glucose is turned to new fat, in a process called lipogenesis. At the same time as the glucose storage is happening, whatever fat is in the bloodstream at the time is stored in your fat cells, as well. So, the crucial point here is that when insulin is high, insulin stores glucose and fat. Most people are not aware of this fat storage aspect of insulin’s role. The body is storing fuel for the famine that experience has shown it is just around the corner – except that in out environment of constantly-available food, this storage mechanism has become somewhat of a liability for many people. This is only half the story, though.

Important hormone #2: glucagon, insulin’s twin

Lipolytic, or ‘fat accessing’; insulin/glucagon axis

Insulin has a twin, the hormone called glucagon. Like many twin hormones and other substances in the body, glucagon’s actions are the opposite: it is lipolytic, or fat accessing. Glucagon allows various enzymes to be released so that one’s stored fat can be used as a high-grade fuel for most activities. It is how we evolved to be able to use stored energy when there was no food available – and understanding how this all works helps us to understand one of the main reasons people get fat today. Glucagon cannot do its job if either blood sugar or insulin is high. This relationship is sometimes called the insulin/glucagon axis, or ratio. The rule is that blood sugar rises after eating, insulin follows a short time after this, and storage of any fuel that cannot be used immediately begins. So, in short and put simply, because of a combination of frequent feeding and the composition of the food we eat, we are favouring the action of insulin over the action of glucagon. Before we look at things more closely, let us consider the main macronutrients.

Macro-nutrients

Protein

The macronutrients are water, protein, fat and carbohydrates (micronutrients are vitamins and minerals). About 70% of the body is water, so I assume that its importance is already obvious. I will add a few remarks re. recommended daily volumes and just where you source this crucial macronutrient below. Protein (from the Greek meaning “of first importance”) is composed of amino acids; nine are essential (meaning that all nine are needed by the body, and in certain proportions to each other for all to be able to be used; babies require 11). Your body turns over a large “pool” of these every day (from breaking down and recycling parts of yourself) – the protein you eat each day “tops up” this pool. This pool contains about 150g in an adult male, and proportionately less in a female (depends on lean muscle mass, mainly (Akerfeldt, 2000, p. 105)).

Fatty acids

There are two essential fatty acids – so-called omega-3 and omega-6 (these names refer to their structures and the number of carbon atoms they contain). Most Western people do not get enough of the former, and too much of the latter, the reason that supplementing one’s diet with flaxseed oil and similar foods is often recommended. If the body has these two fatty acids in the right proportion (roughly one to three), it can make all the other fatty acids it needs (Erasmus, 1997, p. 45).

Carbohydrates

The final macronutrient is carbohydrates – and it is worth bearing in mind that there are no essential carbohydrates. This is despite the claims of the necessity of glucose mentioned above. The fact is that we almost certainly evolved without carbohydrates in any great quantity: our present bodily needs reflect their relative scarcity in the hunter-gather environment. This changed radically with the advent of agriculture, reckoned to be somewhere around 7,000 to 10,000 years ago—a very short time ago, evolutionarily-speaking.

Calorie density vs nutrient density

The modification of native grasses that resulted in the grains that most people eat today (wheat, rice, barley, etc.) had many far-reaching effects: a significant change in the fat/protein/carbohydrate ratios, very heavily favouring the carbohydrate content (think about what wild rice looks like compared to white rice, for example) and a shift from nutrient-dense and calorie-sparse carbohydrate sources (like vegetables and pre-agriculture fruit) to calorie-dense nutrient-sparse food (think of pasta, for example). As an aside, sourcing one’s carbohydrates from vegetables means that you are getting more nutrients per calorie than if you source from pasta – and every mouthful of pasta has many more calories than a mouthful of vegetables, too.

US Government findings, 1977

For another vital part of the story, we need only to go back to 1977. The U S Senate Select Committee on Nutrition and Human Needs commissioned research to find out why Americans were getting fatter and were suffering increased cardiovascular disease. The main findings led to the recommendations to cut saturated fat intake (as a fraction of total calories, from 40% to 30%) and to increase the consumption of complex carbohydrates and naturally occurring sugars (from the then-current 28% to about 50%; Grills & Bosscher, 1981, p. 444ff.). The U S Department of Health and Human Services, together with the U S Department of Agriculture, jointly published a booklet “Nutrition and your Health” (1980), recommending how to do this (Grills & Bosscher, 1981, p. 446).

Cholesterol

Casualties in these recommendations (aimed in part in cutting blood cholesterol levels) were the dairy and egg industries: this was the beginning of the “cholesterol is the enemy” era (and we see this still today in the “no cholesterol” labels on foods like olive oil and avocados). As most people know these days, however, one’s consumption of this vital substance is only poorly correlated with the levels found in the bloodstream. More on this later.

So these pronouncements heralded the shift that we have seen in macronutrient proportions – changes that have had the opposite to the intended effect: as the consumption of saturated fat has decreased, most significant research indicates that cardiovascular disease has increased (this may be due in part to us living longer) AND people have become fatter. What’s going wrong?

Shift in dietary proportions of the macro-nutrients

In simple terms, the shift in calorie source has pushed the glucose-insulin axis mentioned above towards fat storage and away from fat use – the very reason for its storage. Specifically, the change in eating from roughly one-third protein, one-third fat, and one-third carbohydrates to 20%, 30% and 50% respectively has had this significant effect. Add to this the often-made claim that “eating fat makes you fat”, and the aggressive promotion of the very high carbohydrate diets (70% of total calories and over) that many athletes eat helps us to further understand the problem. (This dietary recommendation is standard in most popular magazine article one finds, too.) This sort of diet may be suitable for an athlete training hours a day – but simply is not suitable for the average largely sedentary person.

You are what you eat?

Before I make my suggestions about how to eat (and for what purpose), let me make a few remarks on dieting in general. Your past and current choice of food and your past and current activity levels is precisely what has made the you body you live in today – nothing else. We need to amend the old axiom “you are what you eat” to “you are what you eat and do”.

Why cutting calories does not work

If you need 2,000 calories to maintain your present body weight, then eating only 1,800 calories will cause you to start metabolising your own body – your muscles as well as your fat, unfortunately (about 50/50, as mentioned), if not exercising; more on this below. There are three problems with this approach: you lose muscle which you cannot afford to lose and your body detects what’s going on and (within two weeks or so), down-regulates your metabolism … to around 1,800 calories a day. You stop losing weight. You cut a further 200 calories from your diet, and you start to lose weight again – until the body again down-regulates your metabolism. And this is not the worst of it: when you either have a blowout day, or give up the diet, your body does the opposite: it puts in chain a series of hormonal events that result in your body storing the extra calories as fast as it can – as a hedge against the “famine” it has just weathered. This is the third problem; often called “rebound effect” – sound familiar? This is most dieter’s worst nightmare.

Muscle-sparing effect of exercise

What if we exercise and diet (leaving aside what we mean by “diet”, here)? The good news is that (under a suitable regime) 200 calories’ worth of exercise (I will expand on type of exercise further, below) will burn 200 calories and (more good news) a further proportion of muscle is spared in this cannibalising process (this is a precise use of the term: you are consuming yourself to lose ‘weight’ – ideally, fat). The old idea is that there is a “fat-burning zone” – true, but not the whole story. It is true that low-level intensity aerobic exercise burns mostly fat (more on using this fuel below), but the amount is very small, and confined to the exercise duration.

Increasing your metabolic rate to burn more fuel – while at rest!

Other higher-intensity exercise burns glucose and fat – but raises the metabolism in the process. If you train with weights, for example, you can elevate the rate significantly – and use the 200 calories and more after the exercise – while you are at the office, for example. This rate elevation can range from six to 24 hours in duration. High-intensity exercise is weight training or intervals on a bike (or running); any activity that gets you in to the anaerobic zone (so, you need to get out of breath!). Aerobic and anaerobic exercise can be mixed for this purpose; some people can do high intensity interval training (HIIT) following weight training and others will feel better doing it on non-weight-training days. Another advantage of weight training is that a further muscle-sparing action occurs (this makes sense, if you think about it – you are signalling to the body that this tissue is important to you). More precise recommendations follow.

Fat burner vs sugar burner

I mentioned above the important distinction between being a “fat burner” and a “glucose burner”. Very likely you are the latter – because you have been taking current dietary (and possibly current “fat-loss” exercise advice, too). There are a number of ways to become a fat burner. In the process you will teach your body to use fat instead of glucose for most of its energy needs and maximise your lean muscle mass. This advice is suitable for both men and women, and assumes ordinary health. This is NOT the right advice for someone with kidney problems – so check with your doctor if you are not sure. As well, this is not a ‘diet-for-life’ recommendation – it is a set of strategies to get your body composition to where you want. After that, other dietary strategies will be better (see more on this below).

And if there are no carbs?

I mentioned that there are no essential carbohydrates. What does the body do if there aren’t any to be had? A number of interrelated events occur (I will describe these over a timeframe of a few days, then a longer one of three weeks or so). Eating plans follow.

How the body adapts; ketogenic diet mechanism

If you reduce carbohydrates to less than 100g/day to begin (the amount to keep the process going tapers over time), or less, then your blood sugar steadily decreases (this assumes that you are burning glucose for fuel). The rate can be calculated fairly precisely but that is unnecessary for our present purposes. As blood sugar decreases, glucagon is secreted (by the same organ that secretes insulin, the pancreas). This signals the liver to start releasing its stores of glycogen (the form glucose is stored) to maintain your blood sugar at their normal levels; this process lasts for about 12-16 hours (McDonald, 1998, p.43), during which glucagon continues to rise and insulin falls. At some point, when the liver has run out of glycogen, lipolytic enzymes are released and your body starts to access, then burn, its fat supplies for fuel. This is the essential mechanism of all “ketogenic” or low-carbohydrate diets.

Does the brain really need glucose?

We are told by the vast majority of nutritionists that ‘glucose is the best fuel for the body’ or that ‘the brain can only function on glucose’. Neither of these statements is entirely true; in fact both are true and false – depending on the internal environment of the person in question. No doubt you will have heard also that the brain needs glucose for its operation (or, the brain can only use glucose for its energy); this is true, if you are a sugar burner. If you are not, then it still does – but a small amount only and what it does need is supplied from sources other than carbohydrate. This is how it works: the brain needs about 100g of glucose a day. Deprived of carbohydrate, the body empties its liver glycogen stores, as mentioned, to satisfy this need. This is accomplished by the end of the first day. For the next couple of days, the body converts protein – either your muscles or what you eat—to glucose, via a process called gluconeogenesis. X grams of protein produces Xg of glucose. As the brain is used to using glucose, this means that about 100g of protein is converted per day in the first few days. For this reason, if you are going to try a ketogenic diet you need to have extra protein in the first few weeks of causing the body to adapt.

What is normal blood sugar level?

And how does the body adapt while ‘going keto’?

Also during the first few days, blood levels of glucose drop from ‘normal’ (that is to say, normal if you are a sugar burner) of 80-120 mg/dl to about 65-75 mg/dl – and there they stay (these will rise slightly to 80-85 following a protein meal). [In Australia, we use a different measure: blood sugar is said to be normal if it falls in the range 4-8 mmol/L; Diabetes Australia.] The body maintains that level via a number of pathways, discussed below. Insulin, too, drops from 40-50 micro Units to 7-10 micro Units (McDonald, 1998, p.39). After the third day, 90% of the body’s energy requirements are being met by Free Fatty Acids (FFA) and ketones. Ketone production is up to its maximum by the third day, but blood levels do not plateau until the third week (McDonald, 1998, p.40), as they are being used partly for feeding muscles in the early stages of adaptation.

What does fat break down into?

The changing role of ketones during adaptation

Fat, or triglyceride (TA) is broken down into FFAs (90%) and glycerol (10%); glycerol is further converted to glucose in the liver. This means that an average sized person (70kg) may catabolise up to 160-180 g of fat and produce about 16-18 g glucose a day (McDonald, 1998, p. 44). Muscles derive up to 50% of their energy from ketones during the first few days of adaptation, but this, too, shifts: by the third week, only 4-6% is being met by ketones, the rest coming from FFAs (McDonald, 1998, p. 46). The TA conversion operates on dietary and stored fat alike. And over the three weeks of adaptation, the brain changes over from using glucose for all its energy requirements to deriving up to 75% from ketones. By the end of the second week, the protein-sparing aspects of the ketogenic diet are manifesting themselves: by the body getting all its energy requirements from FFAs and by supplying the brain with ketones for its energy requirements, the protein needed for glucose production drops from 100g/day to about 20g/day, which remains relatively constant from that point on.

Cortisol

Downside of long-term ketosis

During this process, a large array of other hormonal changes are occurring, too, but the one of concern at this scale is cortisol, one of the “fight-or-flight” hormones. Cortisol is one of the catabolic hormones (that is, involved in the breakdown of substances in the body) and is necessary in both the use of protein to make glucose, and fat breakdown. Cortisol is released from the adrenal glands in response to both calorie deprivation and exercise, and thought to be necessary in the building of new muscle, too (McDonald, 1998, p. 212). Too much cortisol in the bloodstream for too long is not good, though: it is characteristic of the highly-fatigued state and long-term elevation of cortisol may even be involved in auto-immune disorders. Elevation of cortisol levels is one reason to avoid long-term ketosis if exercising, even though fat lost will be maximised under this regime, because we want to maintain as much muscle mass as we can. Cortisol levels can be reduced by having some carbohydrates from time to time, a point to which I will return below. Let us look now at the various low-carbohydrate eating regimes that have been popular in recent times, and attempt a comparison.

The Atkins diet

The concept of ‘self-limiting calorie intake’

The best-known of the ‘lo-carb’ diets is probably the Atkins diet. Dr Atkins, a cardiologist, has been promoting various lo-carb diets since the publication of Diet Revolution, 1972, and with various modifications since, the latest being the New Diet Revolution. Simply stated, he recommends a very low carb. diet (40g/day or less) and he attracted some criticism when he first published when he claimed that “you can eat all the meat and fat you want” – which some detractors saw as defying the basic laws of thermodynamics. It turns out, though, that when one confines one’s diets to these foods, there is a self-limiting phenomenon at work – you tend to limit your total calories in a day to 2,200-2,400 naturally and without conscious choice. This is probably a combination of satiety (mostly a function of total fat consumption) and a kind of ‘boredom’ through lack of variety. The point is that if you are in a calorie deficit (eating less calories than you are burning) then you will lose weight, and if you are in ketosis, then more of that weight is likely to be fat, rather than muscle.

LDLs and HDLs explained

Dr Atkins claims that his diet has helped a great many cardiac patients, and through a number of mechanisms: improvements in the Low Density Lipids (LDL) to High Density Lipids (HDL) ratios (the highs increase and the lows decrease); these are regarded as far more reliable markers of likelihood of heart problems than the popular measure of cholesterol. As well, due to ketosis, unwanted body fat is shed. My reservations about the Atkins diet is that there is insufficient carbohydrate in the diet to facilitate weight training or any other high-intensity exercise. There is no doubt, though, that this dietary regimen will help you lose unwanted fat. You will also lose muscle, which I regard as a substantial negative.

The Zone diet

Zone macronutrient proportions; concept of nutrient density

What about the Zone Diets (in their multiple manifestations)? Dr Sears, a biochemist, recommends a diet that attacks what he calls “the four pillars of aging” (Sears, 1999, p. 50): excess insulin, excess blood sugar, excess cortisol, and excess ‘free radicals’ (substances produced by oxidative reactions, like those produced by overheating cooking oils). He recommends a diet that carefully combines “blocks” of protein, fat and carbohydrates in a precise ratio: 30%:20%:50% (percentages, by nutrient amount). His reasoning is based on his understanding of the hormones we have discussed above, but his overall approach is explicitly calorie restricting (from “The Anti-Aging Zone” book onwards, at least; this hidden aspect was one of the grounds for criticism in his earlier books), but “without hunger or food deprivation” (Sears, 1999, p. 55ff.). As well, because he recommends getting the day’s carbohydrates from low density sources – this means vegetable and fruit – his plan is relatively nutrient dense (these are the best sources of phytonutrients, those vitamin-like substances found only in plants – over 10,000 in all).

How hard is it to follow the Zone diet?

If you are comfortable with his approach (which despite his critics is easy to implement), I can recommend it, with the following reservations. If you are a weight trainer or another sort of athlete whose calorie requirements (and protein requirements) are substantially higher than sedentary folk, you will need to ‘upwardly adjust’ the meal sizes. This can be done easily. The downside of doing this is, for those who are more insulin resistant (meaning that the key cells’ response to insulin’s effects are reduced, leaving sugar in the blood for longer and keeping insulin levels elevated for longer, too) may be consuming an undesirably high total amount of carbohydrates (recall that carbs elicit a greater insulin response than other macronutrients). People who are likely to be insulin resistant are the overweight, and the older members of the population, especially if you have been overweight for a considerable time.

Zone diet and ketogenesis

The standard Zone diet is not ketogenic, per se; it achieves its fat reduction by calories restriction and by normalising the insulin/glucagon ratio. It is possible to do intense training on this diet, in my experience, with the provisos mentioned above. It is essential, however, to follow the recommended number of meals and small between-meal ‘snacks’ to avoid a blood sugar ‘crash’.

Cyclic ketogenic diets

Having your cake and eating it, too

Are there any other approaches to ketogenic diets that avoid the problems with the Atkin’s diet? Yes, and I will discuss these under the heading “Cyclic Ketogenic Diets”. These will include the recent and (IMO) deservedly best-known populariser of the keto diet, Lyle McDonald (author of “The Ketogenic Diet”, 1999, and still the benchmark), a relative newcomer, Rob Faigin (author of “Natural Hormone Enhancement”, 2001) and an explicitly bodybuilding approach by Torbjorn Akerfeldt (“The ABCDE Diet”, 2000). The key concept here is “cyclic”: this means that carbohydrates are eaten from time to time over particular cycles. The advantages of these approaches are that you can eat all your favourite ‘naughty’ foods – just at certain times, rather than all the time! By so doing, you can replenish your glycogen stores (to facilitate intense training), you avoid food boredom, you can lose body fat, you can create the optimal hormone environment to push both anabolism (the storage I mentioned above, essential if you want to increase lean muscle) and catabolism (the using of the body’s fat for most of the fuel you need). This approach is really the best of possible worlds, in my view, and these approaches readily lend themselves to ‘tweaking’ in subtle ways, to favour particular desired hormone responses. By this I mean that you can favour muscle building over fat loss, or vice versa quite easily. As well, no calorie counting!

Lyle McDonald’s book, The Ketogenic Diet

In The Ketogenic Diet, Lyle explains the biochemistry of ketosis in great detail; it is a fascinating read. As he is minutely concerned with the biochemistry, I have relied on his book for most of the numbers I have cited here; all are drawn from a fair and representative sample of the scientific literature on the subject. I will not expand on this further here; get his book if you are interested. The essence of his approach can be stated simply: his Standard Ketogenic Diet (SKD) is more-or-less identical with Atkin’s original book (1972) in its approach: cut carbohydrates to 50g a day, obtain the rest of your food from protein and fat sources, assess the presence of ketones in the urine using Keto Diastix (available from chemist stores; diabetics use these for measuring ketones and glucose; you will use them to make sure that you don’t go too deeply into ketosis). Now watch the fat disappear. Note that for anyone doing intense exercise, this is not the recommended approach, for the reason given above. To enable weight training (by replenishing muscle glycogen) but mainly staying in ketosis to maximise fat use, Lyle offers the Targeted Ketogenic Diet (TKD), the CKD (the Cyclic version) and the Advanced CKD. It is important to note here that Lyle explicitly mentions that neither the TKD or the CKD are optimal for increasing muscle weight, so if that is your top priority, you might consider a mixed, non-ketogenic diet, below.

Targeted Ketogenic Diet (TKD); pre- and post-workout feeding

The TKD is simplicity itself: within a context of a SKD, and once ketosis is established (three weeks on his account; four to five for complete stabilisation in my experience; I will elaborate on this below), you have some carbs and protein before a workout (he recommends 50g glucose and 30g protein powder as a starting point) and some after, as well. He feels that the insulin spike from the pre-workout carbs maximises the uptake of the post-workout carbs, also taken with protein. The amount will depend on both your Lean Body Mass (LBM) and just how much work you will do in the gym. In this way, you target the muscles with glucose, and the blood sugar spike will elicit enough insulin to push the glucose into the muscles you have just worked. You can assess your energy levels in the workout (assuming that you are an experienced trainer) and increase carbs if low, or decrease to maximise fat loss over the period in question.

Cyclic Ketogenic Diet (CKD)

The CKD involves a SKD all week (and a weight training routine designed to deplete muscle glycogen to a prescribed amount), then eating high-carb relatively low fat and protein meals (he recommends high Glycaemic Index (GI) carbs for this) and, if your body fat levels are low enough, a second carb-up day, where lower GI carbs are favoured.

The Advanced CKD

The Advanced CKD mixes the TKD and the CKD: carbs and protein pre- and post-workouts; and a carb-up day (or two – if you are lean enough!) on the weekend. Advantages of this approach are that one’s eating fits most people’s social lives better, one really can eat one’s favourite foods, once or twice a week, and fat gain is minimised (or can even continue, depending on the total amount of carbs and one’s mix of cardio and weights). Note that there is little fat gain in the carb-ups – an interesting ‘partitioning’ phenomenon occurs: assuming ketosis, incoming glucose is not used to replenish liver glycogen stores; instead it goes to the muscles that have been worked. Much more detail on these approaches can be found in his book.

Rob Faigin’s book Natural Hormone Enhancement (NHE)

Rob Faigin’s approach relies on a similar understanding of hormone interaction as we have discussed, but he emphasises the role of Growth Hormone (GH) and Insulin-Like Growth Factor 1 (IGF-1). His critics suggest that he has over-emphasised this aspect. I do not intend to recapitulate his arguments here, but will say that, in sum, his book is a fascinating read too, and gives a wide and deep historical perspective for his recommendations. Rob’s book is more emotional in tone than Lyle’s, but this observation should not be construed as a criticism – it is both lively and informative and I consider it, with Lyle’s book, to be essential reading by anyone interested in ‘going against the mainstream’, diet-wise!

NHE method; starchy vs. surgary carbs distinction

Rob recommends a very low regime of low carbs to prime the system (20g/day for seven days). He does not discuss the use of the stix. The main difference in Rob’s dietary recommendations is that, contrary to Lyle, he recommends against pre-and post-workout carbs (and especially against using glucose in this way); instead he favours a three-day lo-carb cycle (50g/day, after the seven-day starting cycle) followed by an evening high-carb low-protein, low-fat meal (where starchy carbs are favoured over sugary ones (70%:30%). The next four days are lo-carb too; and followed by the second hi-carb meal of the week. This recommendation is for relatively sedentary people; his bodybuilding version suggests lower carbs on the lo-carb cycles, and more carbs in the carb-up meals, which may be split over two meals (so hi-carb late lunch followed by hi-carb dinner). The reason for the difference in the recommendations for bodybuilders is to increase the intensity of the ‘rebound’ effect, and to consume more carbs in total, to increase muscle resupply of glycogen. Rob recommends starchy carbs on the basis that these are less likely to be used to replenish liver glycogen (in contrast to sugary carbs that may, especially if sucrose: this disaccharide contains both fructose and glucose – the former being favoured for liver replenishment). It must be mentioned here that this distinction is somewhat simplistic, as all carbs enter the bloodstream as either glucose or fructose – this includes the ‘complex’ (or starchy) carbohydrates, too. Adding an understanding of Glycaemic Index (GI) to the equation may help here: high GI foods will generally replenish muscle glycogen preferentially.

For bodybuilders: Torbjorn Akerfeldt’s ABCDE diet

Deliberately under- and over-eating

Finally in this note, I want to canvas an interesting bodybuilding-specific approach, developed in Sweden by a biochemist-bodybuilder named Torbjorn Akerfeldt. He is the originator of the Anabolic Burst Cycling of Diet and Exercise (ABCDE) method and it, too, relies on manipulating the insulin/glucagon axis to favour using fat for fuel and using raised insulin to store glycogen, triglyceride and amino acids in the muscles. The basic approach is two weeks of underfeeding and two weeks of calorie excess – the underfeeding cycle is to lose body fat and to prime the metabolic system for storage, and this is capitalised upon during the following two weeks. ABCDE requires that you work out your Lean Body Mass (LBM), and thus your basal metabolic requirements (that is, how many calories you need to maintain your present body weight). Once you know this figure, you calculate the number of calories you eat during the ‘under-feeding’ two weeks (usually around 800 calories less than maintenance) and the ‘overfeeding’ (usually about 1,600 calories above maintenance). The results are said to be very significant: about 1-2.5kg bodyweight increase in the two week’s calorie excess (about 30% fat; 70% muscle, on his account), and the majority of that new fat is lost during the next low calorie phase. As one’s LBM increases, one’s calorie requirements do too, so these figures will need to be revised. Be aware that Torbjorn’s claims (re. amount of muscle gained in the overfeeding phase) have been questioned – the change in body weight may be mostly water.

Concept of protein cycling

An interesting aspect of Torbjorn’s recommendations is that it is good for a bodybuilder to cycle protein too: he claims that a few days of low protein (75-100g, LBM dependent) during the low-calorie period ‘resets’ the protein pool ‘turnover’ point to an optimal low, so that when you do increase protein intake once again in the following weeks, the body will use it to build muscle. His point is that if you are always eating a high protein diet (his example is 400g/day, not unusual in the bodybuilding world) the body gets used to this and continuing to eat these high levels no longer has the stimulating effect these amounts would otherwise have. As far as I can tell, this claim has not been tested by the research community. I can direct readers to a very technical discussion if interested.

How hard is it to go ABCDE?

Disadvantages of the ABCDE approach are maintaining the low calorie two-week period (low blood sugar levels, feelings of weakness in the gym, and so on) and (perhaps surprisingly) the difficulty of eating enough during the high calorie phase. Some people will not find this difficult, but I did – and the low calorie weeks affected my concentration levels at the computer, too. You may care to consider the ABCDE diet though – it may be effective if you can live with the side effects I mention.

Making sense of it all

Kick-starting ketogenesis; the importance of enough water; blood sugar swings

So – how to make all this work for you? I will intersperse my own experiences with these diets from here on. To recap, the real advantages of going keto (and doing weight training, or some sort of relatively high intensity exercise) is that you should be able to maintain more of your LBM than eating other ways. You will still need to be in calorie deficit for this to work, but in my experience it is truly effortless to do this on a ketogenic diet. If you are going to experiment in the ketogenic world, you will need to make a real commitment for the first week of low carb—and if you are addicted to them (as many people are) this will not be the easiest week. Don’t do it if you are really stressed at work, or embarking on a new project! Personally, I had no problem with this, but I ‘kick started’ the approach by fasting for 24 hours. I rested, drank plenty of water (extremely important on any diet, I will argue; I filter my own and drink 2-3 litres/day). Get some Keto Diastix and use them; this is an unambiguous way to know if you are in keto. Perhaps atypically, I found the fourth week to be harder, in the sense of having my mood adversely affected and I cannot trace this to any deficiency in following the plan (why I mentioned four to five week’s acclimatisation above). Once past that point, I have found mental function to be clearer, food craving entirely absent, no discernible blood sugar swings (and as those that know me can attest, this has not always been the case in the past!). As well, my body does not anticipate food as it used to and delayed meals have no effect either. This suggests that the new normal blood sugar (65-75 mg/dl, as mentioned) is more stable in its low phases and less elevated in its high phases – and that this stability suits me personally. It may suit you, too.

Can I have the odd drink?

Re. alcohol: be aware that alcohol consumption stops ketosis stone cold (the chemistry is complex; I can recommend an article if you are interested). Experimenting with the stix tells me that the worst kind of alcohol is Carlberg’s wonderful Elephant beer: Two of these small bottle, very high alcohol (9%!) beers stopped my brother’s ketosis from 8:00p.m. to 12:00 pm – the next day. Do not underestimate beer’s effects in this regard (possibly due to the fructose and maltose content on top of the alcohol). Conversely, one glass of red wine seems to stop ketosis for only an hour to an hour-and-a-half. This amount (and type) of alcohol is all that can be recommended, if fat loss is your goal. I suggest drinking even this minor amount only once or twice per week, if you are serious.

The crucial importance of enough dietary fibre

Protein shake composition; flaxseed oil

I suggest having two protein and water ‘shakes’ at morning and afternoon tea times – buy a good quality whey protein powder; it will mix with water immediately without a blender. Recall the body’s additional need for protein during the first three days, especially. Always add psyllium husks to all shakes – some people will suffer irregularities in bowel movement due to reduced food volumes and reduced fibre, otherwise. The psyllium husks take care of that perfectly. Do not use too much of these (start with half a teaspoon – experiment to determine your tolerance; some people cannot handle them well). I have kept the shakes going as a matter of course; for various reasons, males need 150g protein per day if weight training IMO (assuming 75kg bodyweight); you may need more or less. Getting 60-80g of this in two quick shakes seems like a good way to go. The protein and water mix can be augmented with a tablespoon or two of fresh cream once in ketosis proper (although technically three days, probably safe to either allow a bit longer, or use the stix to be sure) – remember that fat is not the enemy to someone in keto! The fact is, I have found it difficult to eat enough calories on a keto diet – I have found that adding the right oils/fats to the shakes is the easiest way for me to have enough. As well, the shakes can be a good opportunity to make sure that you are getting the essential fatty acids: put a tablespoon of flaxseed oil in the mix, too: delicious.

Personal experiences on CKDs

I should mention at this point that over a period of four months, my body fat has gone from about 15% to 10% (both estimates by competition bodybuilders at my gym) and I have maintained the majority of my body weight in the same period (down about 2kg from 79.9 to 77.5). This means that I have put on (in muscle weight) most of what I have lost in fat, which I regard as a fantastic outcome, and it exceeded my expectations. Realistically, it means that I have put on a kilogram or possibly two during a training phase where I lost a considerable amount of fat. I have not been able to do this on other eating approaches.

Java, Arrabica, or just coffee!

Re. coffee: coffee is your friend, especially to a first-thing-in-the-morning-weight-trainer. Caffeine releases the catecholamines: adrenaline and noradrenaline. Both help fat mobilisation, in addition to waking you up! If you do your training first thing in the morning, here’s another time to have a protein shake: a shake 30 minutes before you hit the gym, and breakfast afterwards seems to work well for me.

What should I eat when I do the ‘carb-up’?

Re. carb-up composition: Rob’s reasoning re. starchy vs sugary carbs seems right to me (if you factor in the GIs of the foods), but that may be a prejudice I have against sweet things. Lyle is strongly for glucose in pre- and post-workout carbs, but I found that seemed to give me a lightheadedness that I attributed to rapid increase in blood sugar, followed hard by insulin. I also know that his method works just fine for many people (like my bodybuilding friends at the gym) – so you will have to try it yourself and see what works for you. I have found the two carb meals (à la Faigin) a week are working very well – but I can also eat a reasonable amount of vegetable carbs daily without going out of keto – providing I don’t drink alcohol. Again, for me, the carb up day (following Lyle) didn’t suit my tastes or my body, but if you are a big eater (and plenty of weight trainers are!), then this aspect will suit you down to the ground. Please experiment.

And when I have remade myself, what then?

Re. what to do once your composition and weight are to your liking? I am going to write a separate article on this, but interested people may care to download a chapter from may last book, available from my web site in .pdf format so you may download it. It is called “Sensible eating” and is largely what I would recommend for maintenance. This was written in 2001, and on re-reading, there is very little I would change now. It recommends a roughly “isocaloric” diet (Dan Duchaine’s great term); so roughly equal amounts of fat, protein and carbs, the latter derived from vegetables mostly, with some fruit, to maximise phytonutrients. The URL will be found below.

Keto diets and longevity, and a couple of other questions …

A couple of concluding remarks: I was asked to answer a question or two on keto diets from one of my more insistent students, and I will answer here. Can ketogenic diets contribute to a longer life? Yes, possibly, with qualifications, I believe. The main advantage of going keto is to maintain your body fat at optimal levels – and all the hormonal advantages that entails. Longevity is more a function of one’s genes than any other factors, but exercising and maintaining optimal LBM is definitely advantageous (and enhances one’s functionality as well; no point in living long if you can’t function well!).

Kidney disorder caution

Keto diets and metabolic rate

She also wanted to know the effects on one’s kidneys; I will not dwell on this aspect except to note (following Lyle) that ketogenic diets are the treatment protocol of choice for children with epilepsy – and they stay on strict keto for years with no apparent ill effects. Of course, as mentioned above, no one with pre-existing kidney disorders should go keto; seek medical advice is the best advice here. Her last two questions are interrelated: do keto diets raise basal metabolic rate (BMR) and is doing so good from the perspective of longevity? As far as I know, BMR is related to total calories, more than other factors – the central reason Sears recommends an explicitly calorie restrictive diet. Briefly, his argument is that the only animal research re. dietary protocols that correlate with increasing life span is calorie restriction – and the mechanism is a slowing of the BMR (down-regulation of many metabolic processes). So, a ketogenic diet, if you are losing fat, suggests that (other influences like change in exercise routine aside) calories are lower than maintenance – hence I would assume that BMR would be down on your normal BMR too; this is conjecture, however. I will leave that to the experts.

The second part of her question can be clearly answered, though: if only longevity was the goal, then reducing BMR may help – but if optimising function is added to the list of desired goals, then exercise of various sorts is indicated – and BMR will be raised thereby.

Resources

There are a number of resources that you should use, rather than relying on this précis. First the references (I am trying to stock both Lyle’s and Rob’s books on my web site; I will advise via the home page when successful); the others are freely available:

Akerfeldt, T., 2000. Get ready to grow. Article in four parts, Muscle Media 2000. Interview of TA by Bill Phillips, available from the net on:

www.musclemedia.com/training/abcde/v58_abc1.asp (this gets you to part one; links there to remainder).

Erasmus, U., 1986. Fats that heal; fats that kill. Alive books, Burnaby, BC, Canada.

Faigin, R., 2001. Natural Hormone Enhancement. Extique Publishing, P.O. Box 694, Cedar Mountain, NC, USA

Grills and Bosscher, 1981. Manual of Nutrition and Diet Therapy. Macmillan Publishing, NY, USA

McDonald, L., 1998. The Ketogenic Diet. Morris Publishing, Kearney, NE, USA. A .pdf version of this is available from Lyle’s site:

www.theketogenicdiet.com/

Sears, B., 1999. The Anti-aging Zone. Regan books, NY, USA

Acknowledgements

My sincere thanks to Elzi Volk, a biochemist colleague in the US with a special interest in diets – her comments headed off some of the more egregious errors. All of the other ones are my fault entirely! As well, the article benefited greatly from being read a number of times by Dr Gregory Laughlin (he of the Elephant beer story fame); he is looking a lot leaner after following the advice contained in the article. My friend and colleague Bill Giles read the article and we had a number of lively discussions – it seems he and I have converged on similar recommendations (diet-wise) from completely different starting points. Thank you.

Kit Laughlin, June 7, 2003


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