Sunday, April 8, 2018

10 Days Without Food: On Salt, Fasting, and Euphoria

Ever since I started eating again two days ago, I haven't felt like writing about it.  That's because the exquisite mental clarity that accompanied me for the last week-or-so of the fast is no more.  Now I am fooded, and the contrast is stark.  

However, despite my relatively sluggish and clouded mind (when compared to fasting), I will summarize some details while they remain fresh.  

If your time or attention is short, the pithiest points follow the heading "Summary and Key Points", below.  

Earlier Experiences with Fasting

Some of what I've been "eating"
I first learned about the health benefits of fasting and lowering insulin just over a year and a half ago.  Those were compelling enough that I immediately started a version of "intermittent fasting", and continued for a few months.  I originally thought a ketogenic diet (which is very low in carbohydrates) would be too great a lifestyle change to try right away, but just a few months later I was ready.  I did that for about four months, to great success.  

In the second month of my ketogenic diet (Jan 2017), I tried fasting for five days.  A few months later I went for seven days.  Five months after that I fasted for 8.5 days.  And during the past two week I fasted for over 10 days, a personal record.  

Over the months, I've applied varying degrees of strictness (nearly always consuming < 200 cal / day, sometimes much closer to zero calories), consumed assorted supplements, and my experience with and understanding of prolonged fasting has evolved and progressed.  

In the past year, I've also done many shorter fasts ranging from about 24 to 84 hours, as well as daily "time-restricted eating" more days than not since about September 2017.   

Overall, I've lost approximately 30 pounds in the past 1.5 years, all while increasing my strength somewhat, and I believe I've dramatically improved my short- and long-term health projections.  During this most recent fast I reached the lowest weight of my adult life.  (I also have absolutely no fear of "rebounding" or regaining the weight, in the so-called "yo-yo diet" that nearly all traditional dieters experience.  That's because fasting doesn't lower your metabolic rate the way popular diets involving calorie restriction do.) 

Having previously summarized my experiences with prolonged fasts, what then makes this fast worth rambling on about?

Well, I felt great.  

I felt really good (almost) the whole time.  

There are a just a couple (easily avoidable) caveats that I'll mention, but otherwise this fast was remarkable for both the mental calm, clarity, and focus, as well as the physical energy and well-being.  

How I Felt This Time

Physical State

I didn't plan to go to the gym at all, but I had enough pent-up energy that I went swimming twice, on days five and eight (and spent considerable time in the jacuzzi and sauna), and lifted weights on day nine.  Not to mention going for walks around the neighborhood at least once daily.  I even felt physically well enough to donate blood on day 10 (more details below), and up until doing so had scant physical concerns during the fast.  My energy was not significantly lower than in times of eating, in contrast to prior experiences.  

Mental State

You know those times when your worries seem to sort of recede to the background and you feel calm, energetic, and ready to tackle any challenge?  That's what I was feeling almost continuously for a week.  While on the one hand I kind of missed food and looked forward to the pleasure of eating again, I felt an equal or perhaps greater desire to continue feeling the way I did on the fast.  But most good things must end...  

Why I Felt this Way

Why do I believe I felt so great during this fast?  Why didn't I feel a lower mental or physical energy level as I had at times on previous fasts?  Why didn't I experience sleep disruption as many people do, and I had once before?

Well, ignoring for a moment that my body is much more "fat-adapted" (accustomed to using fat for energy, including both body fat and dietary fat) than the average person thanks to over a year of fasting and intermittent low-carb eating, I think what sets this fast apart mainly boils down to one thing:  

Sodium (commonly known as salt).

This time, I made a concerted effort to increase my sodium intake every day.  Last time, I drank enough bouillon to get about 1 gram of sodium per day.  This time, using a combination of bouillon, broth, stock, dill pickles, and straight salt I consumed anywhere from about 3-10 grams of sodium per day.

I also supplemented magnesium and potassium for insurance (and to prevent potential muscle cramping or palpitations), but I don't think those made nearly the difference that salt did.  

Why does salt matter so much?

Long story made short, when the body's insulin level is low (such as when not eating sugar / carbs, or eating nothing) more sodium is excreted in the urine.  On top of that, when fasting you may consume little or no sodium.  And if more sodium is going out, and less is coming in....well you do the math.  

Furthermore, if sodium in the blood goes low, blood pressure also drops (because water follows sodium).  And low blood pressure results in symptoms like feeling lightheaded, confused, or weak.  A lot of people complain of those types of symptoms when fasting, especially people who've never tried it before.  

So by increasing my salt/sodium intake, I was able to largely mitigate any symptoms related to low blood pressure.  And by using the other electrolytes (magnesium, potassium), my kidneys had plenty of fodder to play with when balancing everything out.  

Another consequence of keeping the blood pressure up naturally (thanks to the salt) is less need for assistance from hormones like cortisol, norepinephrine (aka noradrenaline), and epinephrine (aka adrenaline).  All of these hormones are elevated to some degree while fasting anyway, partly because they keep your blood sugar from going too low (low is good, but there are limits).  But these hormones will be produced even more if your blood pressure is dropping due to low sodium.  And not suprisingly, higher levels of those "stress" or "activation" hormones tend to also interfere with sleep, so they are probably the main reason some people experience insomnia while fasting.     

So putting it all together, by increasing my sodium intake dramatically I was able to deter symptoms of feeling lightheaded, sluggish, or weak, and even make it easier to sleep.  

And as a result...I felt fantastic!  With the caveats below. 


Exercise and Heat Exposure

As mentioned above, I didn't really experience decreased energy levels during this fast, and actually felt rather energetic, especially after the first hour of the day.  As a result, I decided to go to the gym a few times.  Twice I went swimming, and once I did weight training.  

I also spent a lot of time in the jacuzzi, especially on day eight, when I ran into a friend and kind of lost track of time while we chatted. 

I think between the overheating on the eighth night and resistance training on the ninth day, it was a little much all within 24 hours, and contributed to feeling a bit worse in general the last couple days of my fast.  Not to mention...

Giving Blood

I had just become eligible to donate blood again around the time I started fasting and was receiving more-frequent-than-usual notifications from the blood center about it.  Initially I determined it would be too risky to give blood during a prolonged fast, (as it could worsen various potential symptoms), and if I did it in the early stages it could derail my plans.  

But a few days later, feeling as well as I was in general, I gradually warmed up to the idea.  I made an appointment for the 10th and final day of my fast.  At the center, on a whim I switched from a regular donation to a "double RBC", or double donation (which I've never done before, fasting or otherwise). 

I tolerated the donation well enough, just feeling cold but never lightheaded.  But from that point on I did feel fatigued, and my heart rate became more easily elevated with activity.  Those are totally normal symptoms after such a donation, but with 10 days of fasting on top of that....

So, all-in-all, blood donations are not really recommended during a long fast, especially not double donations.  Shocker, I know.  I don't really regret doing it, but I would do a normal donation, rather than double, if I had it to do over again.  

Jet Lag

I came off the night shift about a week before starting this fast, so my circadian rhythm was still adjusting.  It wasn't the smoothest sleep transition, so I still felt kinda groggy for about the first two-three days of this fast.  After that I was fine.  

Summary and Key Points

Let me explain.  No, there is too much.  Let me sum up.  

Fasting was normal for humans to do for thousands (if you don't believe humans developed through evolution) or even millions (if you do) of years.  Only in the past 50-100 years have we had things like grocery stores and refrigerators that made food readily and constantly available.  Our ancestors for many generations were accustomed to fasting out of necessity for varying lengths of time, and if their bodies knew how to do it, so do ours.  

Fasting is normal.  And not only is is normal, it appears to be the only way to access certain healing and regeneration mechanisms, such as autophagy, and regeneration of the immune system (which can heal or at least improve many autoimmune conditions) and other organ systems.  It's also likely the best available weapon again obesity, diabetes, and even cancer, not to mention heart disease.  Many people have eliminated signs and symptoms of diabetes through fasting, as described in this new book, and studies have shown that cancer cells become easier to kill when fasting, resulting in more effective treatment with chemotherapy or radiation (as well as fewer side-effects).  That's to say nothing of fasting helping to prevent cancer in the first place.   

I could go on.  And on.  

If you're interested in the evidence in favor of fasting's health benefits, there is plenty to go around, and it's a lot more compelling than any counterarguments I've heard (which are typically steeped in the flawed nutritional dogma of the past few decades while ignoring most of the actual evidence and millennia of human history).  

However, though fasting was the norm till just a couple generations ago, many people have never gone more than a few hours without food in their lives and can scarcely imagine doing so.  That is our culture, that's how we grew up, and it doesn't help that misguided dieticians (among others) continue to recommend "small frequent meals" even to the people who would benefit the most from eating less frequently (such as the obese or diabetic). 

So, here we are with an incredibly powerful beneficial practice known to humans for millennia and practiced both intentionally and out of necessity for countless generations prior to ours.  Now that same practice, fasting, has been largely abandoned due to a few decades of misguided dietary advice and a culture of constant food.  And by no small coincidence, now everybody is getting fat and sick (though refined sugar wants to claim its credit for that too). 

Fasting isn't easy at first if you've never done it before.  Just like running a 5K would be hard if you've literally been sedentary your whole life and don't prepare in any way.  It's basically the same.  Start doing something different with your body out of the blue and you'll likely struggle.  

So start slow and give your body time to adapt, as mine has over the past year-and-a-half.  I wrote here (under "Conclusions") about how to ease into it:  basically start with time-restricted eating and/or eliminating refined sugar and other refined carbs for a time.  That's like the warmups and short training runs you might do leading up to your first-ever 5K.  After that, try some water fasts of 24 hours at a time, and then later for 36 hours.  After a while the sky's the limit.

And as I've learned gradually--dramatically of late--getting enough of the right electrolytes, especially sodium, can make a prolonged fast much more comfortable than it might be otherwise.  Not only comfortable, even euphoric. 

Let the fasting begin.  Now you'll excuse me while I go eat lunch...

Photos:  Breaking the Fast

My first meal

A more substantial meal about an hour later (I had seconds, and thirds)

Lunch on the same day (I didn't eat dinner)

BONUS SECTIONS:  Results, Food List, Resources

Specific Results of my 258-hour (10.5 day) Fast

I've already talked about how I felt during this most recent fast, but here are some specific stats (and below are images with my detailed daily notes):
  • Weight lost:  officially 10 pounds, but more if you consider the additional 4-5 pounds I dropped on the scale during the preceding 2.5 "transition" days mention in the notes (during which my "eating window" was less than an hour each day). 
  • Blood sugar/glucose levels:  Trending down fairly steadily from the 80's to the 50's and even 40's (though there is obviously daily fluctuation with many variables). 
  • Ketones:  Medium - high on urine measurements after a few days and then pretty steady.  Urine testing is subject to error, however, and the breathalyzer I got near the end of the 10 days had me at the maximum measurable amount continuously until I broke the fast.  
  • Energy intake:  About 100 cal / day with a little variation.  
  • Salt Intake:  about 3 - 10 grams / day. 

"Food" List 

A few people at different times have asked what I consume while fasting.  The list below many not be exhaustive, but gives a pretty good idea about what I've tried.  

Of note, on my first prolonged fast I intentionally ate about 200 cal / day with a high protein content.  Since then I've decided that's counterproductive, and I tried to keep my calories as low as reasonably possible during the next two extended fasts.  On the most recent fast, however, my calories were a little higher than before, for two main reasons:
  1. The food-stuffs I was eating were essentially vehicles for sodium/salt -- it's hard to just drink a bunch of salt water or eat it by the spoonful, and the other products made the salt more palatable.  
  2. After my last long fast my stomach felt a bit contracted, as though I'd had a bariatric surgery.  This gradually wore off, but in an attempt to avoid the same sensation I included more solids this time (such as dill pickles--things that were still very low-calorie and high in sodium) and tried to really expand my stomach at least once a day.  This time, after two days of eating so far, I don't feel quite as much like someone who just got their stomach stapled.  
With that context given, here's a list of things I've consumed while fasting:
  • Water 
  • Tea, often with a splash of lemon juice (zero cal)
  • Potassium supplements (tablets, and later powder)
  • Magnesium supplements (capsules, and also Epsom Salt baths)
  • Salt (on the tongue, in water, or added to any of the items below)
  • Bouillon (about 5-10 cal / serving depending on the type, ~800mg sodium)
  • Veggie Broth (5 cal / serving, ~800mg sodium)
  • Chicken Stock (~10 cal / serving, ~800mg sodium)
  • Sugarless gum (artificial sweeteners are generally to be avoided, but I've made exceptions)
  • Vitamin pills and similar supplements (not all the time, only took one or two multivitamins during most recent fast)
  • Dill pickles (5 cal / serving, 290mg sodium)
  • Sliced jalapeƱos (from a jar, 5 cal / serving)
  • Banana peppers (from a jar, 10 cal / serving)
  • Green chiles (from a can, 5 cal / serving)
  • Chia seeds (kind of a "cheat"; 60 cal / tablespoon)
By mixing and matching items on this list, or similar things, you can get quite a high sodium intake with easily under 100 cal.  

As noted, I ate some other proteinacious things on my first five-day fast that I haven't used since, so I saw no reason to include them here.   

Resources to Learn More

Without going too crazy (hit me up if you want more), here are a few simple resources I'd recommend for beginners:

More on YouTube

Tuesday, October 24, 2017

Fasting for 8 Days: Why? And Now what?

In mid-September I set out to fast for at least one week, drinking water but essentially no food.  I broke the fast in the afternoon of the ninth day after over losing more than 13 pounds. 

Part of me wanted to keep going because I felt exceptionally focused and calm on the 7th and 8th day.  However, I was also looking forward to finally eating again, and I had a kind of silly reason not to continue:  I had signed up for some "diet bets" that were ending a few days later, and I was worried they might flag me for losing too much weight if I didn't squeeze in a few solid days of re-feeding before the weigh-in.  

So I stopped, and I actually tried really hard to eat as much (healthy food) as I could for the next 4-5 days, mainly for the diet bets, but also for the rebuilding process that happens in the body after any fast.  It turned out eating was challenging, however, because I felt like I assume people feel after bariatric surgery:  I could only eat about half as much food as usual before feeling incredibly full.  That sensation wore off gradually over the next week-or-so as my stomach re-expanded, and I didn't have any problems with the weigh-ins.  In fact, they were the easiest "diet bets" I'd ever done... 

Why did I do something so crazy? 

First, there is growing evidence that fasting may be the best thing you do for your health.  Research and other preliminary data in both animals and humans have shown evidence for:
And the list could go on.  The most dramatic benefits come when you do more than 3 days in a row, but any duration is beneficial. 

Keep in mind I've been aggressively steeping myself in nutrition- and health-related research for the past year or so, but as I think on it now I'm convinced the only reason more people aren't fasting is because they just don't know how beneficial it can be.  And of course the fact that it goes again decades of traditional advice that was based on basically nothing...

Second, I'm convinced that fasting (intermittent, extended, or some combination) is the best way to lose weight and keep it off.  

Basically, if you cut your calories down every day (i.e. traditional advice you hear everywhere), you lose some weight until your metabolism adjusts accordingly, and then you plateau.  After that you regain the weight (and then some) when you inevitably fall off the wagon because your strategy isn't working and you're frustrated.  

When you fast, on the other hand, you don't lower your metabolism in the long run, and you keep your body guessing by switching things up regularly.  You also lower your insulin for long stretches of time, and insulin is basically the signal to your body to store fat in response to energy intake. 

For those basic reasons, I think weight loss is much easier once you have this additional tool in your belt.  

What else happened while I was fasting?

Here are the notes I took during the fast:

In case you can't read my chicken scratch or it's too busy for you, some key stats:

  • Weight loss:  over 13 pounds, or just under two per day on average.  (The two numbers listed for each day are two different scales.) 
  • Urine ketone levelsVery high all the time after day one.
  • Blood Sugar:  83 on day one, then never over 60 again; typically in the 40's.  
  • "Food" Intake:  Some sugarless gum here and there, salt, potassium, magnesium, vegetable bullion to increase sodium (about 9 cal/day starting on day 3), and some tea (no calories).  That's about it. 
  • Energy Levels:  About 20% lower than usual on average, actually felt the best on day seven and day eight out of the whole 8.5 days.  


It's been about month now since I finished the fast, and my current weight hovers around 170 lbs (10 lbs below starting weight).  That's quite remarkable really, considering you would typically expect to regain about 2/3 of the weight you lose during a prolonged fast (because of the transient components of the weight loss, in the form of water, sodium, glycogen, recycling old proteins, and shrinking down certain cell populations, such as white blood cells and various organs).  It's also remarkable because I've been regularly lifting weights in the past several weeks, so I expect I have a few more pounds of muscle now than when I started the fast.  

I think the sustained nature of my weight loss is a testament to what I've done since then:  Additional fasting, and avoiding refined sugar and refined flour at all times.  I've been in nearly-continuous ketosis since the week before the fast, and that's despite eating a lot of berries, and sometimes even oatmeal, legumes and other fruits, including bananas and oranges.  The sustained weight loss is also further evidence of how well fasting works as a tool for weight loss.  

If after reading this you're thinking of trying some type of fasting, you are wise individual indeed. :)  However, to approach it smartly, here's what I'd suggest: 

  • First, start by cutting out refined sugar and other refined grains for a period of time, perhaps 1-3 months, and ideally doing a full-fledged ketogenic diet during that time.  It will be a lot easier to fast if you're already in ketosis, and after your body has some time to get used to using ketones for energy.  Interestingly, ketones both curb hunger and inhibit muscle breakdown.  Chew on that. :)
  • Second, Start with time-restricted eating (12, 10, 8, or 6 hours in a day).  The clock starts when you eat your first caloric substance, and stops when you eat your last, and you try to keep it below whatever time you set.  The simplest way to do this is to skip breakfast or dinner.  This is a form of intermittent fasting, and basically gives your body an extra 6-8 hours with low insulin levels, and at least a slight bump in ketone levels. 

Either or both of those methods will help you to ease into it, and after that there are myriad options of how to approach it. 

Personally I plan to continue regular fasting of some sort in perpetuity, both until I get to my ideal weight as well as thereafter for "maintenance" and additional health benefits. 

Thursday, August 31, 2017

Thailand in a Nutshell (and a touch of South Korea)

Temple of the Emerald Buddha
There's a lot I could say about Thailand.  But instead of rambling on and on, I'll merely ramble a moderate amount.  And I'll boil it down to the burning questions that I can only assume are keeping you up at night. :)  Let us begin.

(Note:  I included just a few pictures in this post, you can find many more in this album.)  

When did you go to Thailand?
August 6-27.

Wow, that's a long trip.  So you were in Thailand for three weeks?
Not quite.  The cumulative flights lasted about 35 hours, and I had a 13-hour layover in Seoul, South Korea each way.

What did you do with all that time in South Korea?  
On the first layover, I took advantage of some free tours that are offered from the airport (perhaps as a response too the long layovers that appear to be common with Korean Airlines).  The tours took me to a small temple, a big temple, a Korean restaurant, and a popular shopping street in the Seoul area.  Between the tours, customs, and security, it took up most of the 13 hours.  And now I can reasonably say I've "been to" Korea. :)

On the way home, I opted instead to explore the airport itself, partly because it's routinely ranked best airport in the world and has some remarkable amenities, but mainly because I wanted to sleep.  After eating, I used one of the nap rooms and managed to sleep for over 7 hours!  Then I took a shower in one of the shower rooms that are complimentary for transfer passengers. 

What did you do with 35 hours of flight time?
Some sleeping, reading, writing, and eating, and I watched five movies.  I also got up to walk around and stretch quite often because A) I don't want a blood clot, and B) It hurts the behind to sit so long.

Why did you choose Thailand over other potential destinations?  
It was basically a coin flip between South America, Europe, and Southeast Asia.  Various friends and family had recommended Thailand to me, and I'd only been to Asia once before, on a much shorter trip.

Did you go to Thailand by yourself?  
Absolutely.  While naturally there are pros and cons to traveling alone, I think overall I prefer it, in a very Vagabonding sort of way.

While it's obviously fun to travel with friends, there are also advantages to traveling alone:  You can interact a lot more with the locals (and other travelers), go where your whims take you, be on your own schedule, and have a chance to practice the language.  In my opinion that last point is too often overlooked, as traveling with friends from home usually means speaking English 99% of the time, with little or no real language practice. 

Speaking of language, did you learn how to speak Thai?
I tried!  I decided 2.5 weeks was enough time to give it a whirl, especially since I was going alone, and I thought it would be a fun and interesting challenge to learn an Asian language (with tones and characters) for the first time.

beaches on Ko Lan
I wrote about my experience learning the Thai language in much more detail here, but in summary I tried to learn the most common and useful words, practiced them with everyone I met, and though I was still extremely limited in my vocabulary and understanding, people were nearly always very impressed.  So much so that they had a hard time believing I'd only been learning for 1-3 weeks (depending on when I met them).   

Why do you have a website about medical Spanish?
It's part of a project I'm working on, the culmination of which will be a course to teach medical providers how to speak Spanish with their Latino patients.  

Anyway, back on topic.  Where did you go in Thailand?  
I spent most of my time in Bangkok, took a day-trip to Ayutthaya (one hour North of Bangkok by bus / van) to see the ruins, and later spent a few days in the Pattaya area (two hours Southeast from Bangkok by bus) where I was able to go to the beach and take a boat out to a nearby island.  I hung out on the island for most of a day and rented a scooter to get around, since the island is rather large.   

I considered taking a long (possibly overnight) train or bus ride to a more distant area, partly because everyone (and their dog) recommended going to Phuket (in the South) and Chiang Mai (in the North).  But ultimately my priority wasn't to see the whole country, and I didn't want to spend a lot of time or money simply traveling.  I was already in Thailand, and I didn't need to go very far to experience some of the culture, see some historical and aesthetic sites, meet Thai people, eat Thai food, and practice the language.  There's a lot to see and do in Bangkok alone, and the other two destinations were a nice addition without too much travel time or expense.  I'll save the rest of a country for a subsequent visit.

Oh really...when are you going back?
Well...I have no idea. :)  But it would be nice.

Where did you stay all this time?
I found a couple rooms on Airbnb, the first of which (in Bangkok) cost me $14/night; the second (in Pattaya) was $12/night.  And the amenities weren't bad. 

Was everything in Thailand that cheap?
If you're careful, yes.  Basically you could eat for about $5/day if you play your cards right, have a decent place to stay for under $15/day as I mentioned above, and use public transportation for a few more dollars each day to get wherever you want to go (within reason).  It may be expensive to get to Thailand in the first place, and like anywhere there are upscale businesses that appeal to the rich and famous, but overall it was a very cost-effective trip considering I went halfway around the world.

What are some of the specific attractions you visited?
At the risk of boring you with unfamiliar details (feel free to refer back to this part right before or after your next trip to Thailand), here goes...

In Bangkok:  I visited the Grand Palace, Temple of the Emerald Buddha, a few other very ornate temples (Wat Pho, Wat Arun...), and a secondary palace (right next to the zoo).  I rode in a tuktuk and took some taxi rides, but mainly used the subway system, which I became quite comfortable with.  I took a few boat rides on the Chao Phraya River that cuts through the center of the city, went to the two biggest shopping malls and various others (including one my sister-in-law recommended), and visited some very large local markets (day and night varieties), such as Chatuchak (aka Jatujak, in Thai) and Rot Fi Rachada.  I checked out the famous Khaosan Road and surrounding streets, attended some free Muay Thai matches at a local TV station (though I had to buy a black shirt to get in, since I was wearing red and the country is in a period of mourning), visited Chinatown a few times, and wandered through some of the nightlife areas to see what it was all about.  I rode on a big Ferris Wheel at an outdoor mall, and ate more street food than you can shake a stick at. 

In Ayutthaya:  I rented a bicycle and saw the ruins of an ancient capital that was destroyed by the Burmese in the 1700's, rode an elephant, and fed the elephants (which is really cool, because they grab the vegetables right out of your hand with the tip of their trunk).

In Pattaya:  I walked the famous "Walking Street" (saw some amazing break dancers there), and repeatedly rode on the "Songtaews" (the main public transport there, two benches welded onto the back of a pickup truck).  I took a ferry to the island called Ko Lan where I rented a scooter and visited five beaches in one day.  I happened upon a night market in the neighboring city of Jomtien, and also visited the largest weekend market in the area, on Thepprasit Road. 

There are many more things, but that's a reasonable summary of the notable destinations. 

Did you make any friends in Thailand?
Quite a few actually.  I guess that happens naturally when you constantly talk to everyone you meet or see to practice the language.

Some of the people I met were valuable resources later when I had questions about how to get somewhere or how to say something in Thai. 

Of note, I spent a full day, and part of another, hanging out out with my sister-in-law's sister-in-law's brother, and his wife and son.  Yes, you read that correctly. :)  They showed me around some additional areas in Bangkok, and assisted me to sample many varieties of local cuisine. 

Eating lunch with Tony.  He's having rice.
In a more random example, I ran into a young Chinese tourist named Tony who asked if he could tag along when I went to the island, so we spent the whole day riding around together.  I taught him how to say "Do you have any rice?", since that's what he always wanted to eat.

Did you see a lot of Chinese tourists there?

So did you do everything you set out to do on the trip?
Yes.  My stated goals were to ride an elephant, see some temples, go the beach, and eat lots of Thai food, and I did all of those things.  I also made substantial progress with the language, a goal that I didn't adopt until one week before the trip.

Riding an elephant in Ayutthaya
Is there controversy surrounding the riding of elephants?  
Indeed there is.  I didn't learn this until after I went on a ride (convenient, I know), but apparently the
elephants tend to be mistreated when they are raised to give rides, particularly in the way they are poked behind the ear with a sharp metal instrument to keep them on the desired path.  I suppose you could make similar arguments about any beasts of burden, but suffice it to say there are those who disagree with the practice of riding elephants. 

Was it really crowded in the places you went?  Other than the hordes of Chinese tourists, I mean.
There was an odd juxtaposition of very crowded areas in certain streets, markets, and businesses with a lot of restaurants that appeared completely empty.  Apparently it was the low season because it's also the rainy season.  Most days it rained for about an hour, maybe two, usually in the evening.  I generally carried an umbrella, but I was also pretty lucky about being indoors or under some shelter when it rained.  And some days it didn't rain at all.  They say the busy season is October through January, or thereabouts, because the weather is nicer (cooler, and less rain), but I think I'd prefer the rain and heat over crowdedness.

Was it hot?  Did you sweat like a pig?  
Yes and yes.  Which is fitting because I also ate like a pig at times, especially at the markets. The temperature wasn't actually that extreme, with highs in the upper 80's most days, but it's also very humid, and I was outside walking a lot.  I was always sweaty and gross by the end of the day, and invariably took a shower before bed.  At least the rooms I stayed in had AC.

Wouldn't you say at this point that you have rambled on, and on, and perhaps on?  
Wait till I get going!  Just kidding (which by the way in Thai is "Law len naw"), the end is near.  

With all this talk of food, how much weight did you gain on the trip?  
Surprisingly, none.  In retrospect, this can likely be attributed to eating a ton of fruit (perhaps literally), as it was readily available on the street and appeared a healthier alternative to the other street food (thought I certainly sampled that as well, and often).  Additionally, I had a natural tendency towards some time-restricted feeding (closely related to intermittent fasting) as a result of typical daily logistics.  Oh, and I fasted for 22 hours on my last day because I was in a hurry to get around before packing up and rushing off to the airport, so I didn't eat anything until after I was on the plane, around midnight. 

What did you like the most about Thailand?
Meeting the locals, speaking just enough of their language to do so, learning said language, eating the food, and seeing a variety of cool things along the way.  I loved the markets, mainly for the food, and the street food was great in other places as well.  I enjoyed driving the scooter all over the island, and found the Muay Thai matches very entertaining as well.  I could go on...

Anything else on your mind?
The jet lag from a trip like this is remarkable.  I've now reached modest lucidity, but will still likely crash before 9pm for a few more days. 

In other news, due to paperwork delays I won't be starting my new full-time job at least until I may go another trip somewhere.  But probably a much shorter trip, and within a few time zones of home, to avoid a second round of circadian rhythm mayhem.

Sunday, March 26, 2017

Ketogenic Update, and Fasting for Five Days

uncured bacon, avocado, and eggs
At the end of November, 2016, I set out to follow the ketogenic diet for three months.

And guess what?  I did.

I took a couple breaks as planned (though fewer cheat days than I was allowed), but otherwise stuck to it.

At the end of 3 months, I had lost 15 pounds (roughly going from 193 pounds to 178, though I've weighed in as low as about 174) and my clothes were fitting noticeably more loosely.  Multiple people commented on the thinner appearance of my face and body.

While on the diet, I ate a lot of:  Avocados, coconut oil, olive oil, non-starchy vegetables, nuts, nut butter, eggs, cheese, and fatty meats (salami, pepperoni, bacon, sausage).  I supplemented my fat intake at times with plain cream cheese, sour cream, and whipping cream, as well as MCT oil.

I also ate in moderation:  chicken, beef, salmon, sardines, and berries.

This is not a comprehensive list of what I ate, but it probably hits all the staples.  

I've included photos of some representative meals, mainly at the bottom of the post.

While on the diet, I didn't eat any:  Bread, pasta, rice, tortillas, potatoes, cereal, processed sugar, or any other blatantly significant source of carbohydrates.

I checked my ketone levels multiple times every day using urine ketone strips.

I took a one-week break from the diet at Christmas, and took one additional cheat day on Superbowl Sunday.

When my three months were over at the end of February....I didn't feel like stopping the diet so I kept it up for about three more weeks.  I continued in steady ketosis until late March, and finally took another cheat day on March 24th while visiting Ohio for a medical course.  That was only the 2nd day in 2017 on which I'd eaten any sweets or grains (other than tiny quantities in foods prepared by other people).

As I write this, I'm back on the diet, and plan to continue for at least eight more days (until a certification test I'm taking on April 3rd, as ketosis makes mental focus more predictable).

I suppose my desire to extend the diet past the original 3-month commitment stems from a few things:

  • The obvious benefits:  It's a simpler menu and shopping list, I'm less binge-prone, there's still plenty of enjoyable food to eat, and my energy levels don't fluctuate as much.  I can go without food for extended periods of time without much difficulty, and mental focus is generally improved.
  • It's easier to stay in ketosis than to get back into it (takes 3-5 days on average to get into solid ketosis), which makes cheat days or other breaks undesirable.  
  • I've adhered to this "diet plan" more easily than any other I've tried over the past few years, which makes me want to stick with it even more.  
I certainly don't plan to eat this way forever.  But I'll probably use the ketogenic diet intermittently (perhaps a few months at a time) for the rest of my life.  

Speaking of going without food more easily...

Fasting for five days

At the end of January, I decided to "fast" for five days.  I put quotation marks because it wasn't a complete fast, I was still drinking water and I ingested about 200 calories per day.

As was the case with my ketogenic experiment, my main goal wasn't to lose weight.   I did it moreso for the myriad other proposed or documented health benefits, including but not limited to the body recycling many old, worn out proteins and undergoing a general "renewal" as a result.

Another prominent benefit that is supported by existing literature (and also intuitively logical) is a reduction in cancer risk by purging damaged cells or "pre-cancers".  One proposed mechanism is that cancerous cells typically rely on glucose for energy, and depriving them of sugar weakens the cancer cells, which allows the body's own immune system to eliminate them more effectively.  

I lost about seven pounds while fasting for five days, and about half of that stayed off when I started eating again (my Superbowl binge was only a few days later, but it all evened out within a few more days).

Muscle wasting, a common concern in the context of prolonged fasting, didn't seem to be an issue (though I didn't do any DEXA scans to confirm or anything).  I did consume protein every day, including a BCAA supplement which has very few calories but tends to promote muscle building, and this likely helped mitigate any atrophy.  On the other hand, if I did lose some muscle mass, that may be a good thing in the context of the "autophagy" effect discussed at the link above, and certainly some (or all) of that can be regained upon refeeding.

For fun, I measured my blood sugar frequently while fasting, and after the first day or two it was consistently in the 50's and 60's (70-100 is "normal" upon waking when not on a prolonged fast) without causing any adverse effects.  My ketones were also quite high throughout the fast, which probably explains why I could function just fine with "abnormally" low blood sugar.

My overall energy level felt about 20% lower while fasting, but otherwise I didn't notice any adverse effects.  I also went to the gym every day but one.

If you've considered fasting or simply want to learn more about it, check out this podcast to hear about people who've fasted 3-4 weeks at a time and dramatically improved their health.  The Complete Guide to Fasting is from the same authors who run the podcast, and though I haven't read the book I would still recommend it based on my familiarity with their other work, and the reviews on Amazon.  

My "takeaways" from the ketogenic diet

veggies and eggs cooked in coconut oil and amply seasoned
In general, the ketogenic diet is remarkable for smoothing out energy fluctuations and promoting steady weight loss in people who are overweight.  The weight loss doesn't happen magically, but it's certainly easier to modulate energy intake, thanks at least in part to the appetite suppressing effect of ketones.

The diet also helps with mental focus, presumably due to the more consistent (low) blood sugar levels as well secondary effects of ketones on the brain.  (By way of indirect illustration, elevated ketones reduce the likelihood of seizures, and generally reduce anxiety, both of which are central nervous system effects.  It follows logically that ketones have other beneficial effects on brain function as well, and this has been anecdotally observed by myself and others).

The diet is also both inconvenient (harder to eat out or eat at other people's homes) and convenient (I can easily skip a meal or two and function just fine, and my shopping list is about the same every week).

And beyond those observable effects, it has many probable benefits that are less easily measured:  reduced risk of cancer, diabetes, Alzheimer's, and so on.  See my prior blog post for several links that delve into the known and proposed health benefits.


As public consciousness drifts away from the vilification of fat in our diets with tortoise-like velocity, the ketogenic diet is a remarkable tool that is becoming gradually more accepted and understood, and can have a dramatic impact on the health of many people, obese or not.

While fasting (intermittent or otherwise) is still vilified and largely misunderstood, the "three meals a day" routine that we are all familiar with appears to be more of a product of modern culture and economic revolutions (agricultural, industrial...) than of any actual benefit to frequent meals or consistent eating patterns.

If you're obese, overweight, or trending towards diabetes, give the ketogenic diet a try for 1-3 months, and consider a trial of fasting.  It may just change (or save) your life.  And even if you're not overweight or suffering from insulin resistance, you'll likely benefit as well, whether the benefits are immediately obvious or not (e.g. reducing cancer risk).

Note:  This blog post is a merely a brief summary of my experience with the ketogenic diet and fasting over the past four months.  If you want to learn more, visit the resources I've linked to, and feel free to contact me with any questions.  

More Ketogenic Meals

chicken and veggies, both cooked in coconut or olive oil and amply seasoned

Keto pizza!  I only made this once, it was pretty good.  

Plenty of salads

A random keto meal from the doctor's lounge

An experimental meal when I first started the diet - notice the salami, and sour cream added to the salad.
Eggs & veggies cooked in oil and amply seasoned, avocado, and broccoli with cheese

And just for fun...the pizza I ate on my cheat day in March


Monday, November 28, 2016

Kicking Off the Ketogenic Diet

I'm starting the ketogenic diet today, 11/28/2016.

I will do this diet for the next 3 months, till the end of February 2017.

I'm allowed:
  • A one week break at Christmas (Dec 22nd - Dec 28th), with some caveats
    • No candy
    • Only homemade desserts (none from store)
  • 2 cheat days per month, which are optional
    • No cheat days in December other than the one-week mentioned above
I wrote more about the ketogenic diet here, as well as another approach to nutrition called intermittent fasting, which somewhat explains why I want to try it out.

Exactly what I eat every day will be a work in progress, but my initial shopping list was strongly influenced by this blog post from Peter Attia.  

My primary goal is not weight loss, but I do expect to lose weight.  
My starting weight on 11/28/2016 is 193 pounds.  

I will return and report at a later date.  

And here's a random picture of me with two nephews and a niece, sharing some of our thoughts about life in general...