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 October....so 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...

Sunday, November 13, 2016

The Ketogenic Diet and Intermittent Fasting

I recently learned about two approaches to nutrition that are moderately mind-blowing...not at first gander, but once you delve into the details and understand the research that's been done, as well as the myriad health benefits this research suggests.  

While not new, in some ways both of these nutritional patterns are new to me...at least in how potentially game-changing they may be.

They are kind of related...and kind of not.  It was kind of a coincidence (and kind of not) that I learned about both in rapid succession.

I'm talking about The Ketogenic Diet and Intermittent Fasting.   Below I'll summarize each and provide links to sources (mainly podcasts and videos) that explain them better, for anyone who wants to delve into those delectable details.  

While some of the sources can be more easily understood with a background in nutrition, biochemistry, or medicine, I think they are also accessible enough for a motivated layperson to glean the key principles. 

The Ketogenic Diet

My recent binge-learning started with this video from Peter Attia, who is both a renowned physician and also an ultra-endurance athlete.  He reviews some nutritional biochemistry basics, and then explains his own journey with the ketogenic diet.

The ketogenic diet is kind of similar to other low-carb diets that we've all heard of, like Atkins.  But it differs in an important way:  Instead of just limiting carbohydrates,it also keeps protein at a moderate to low level.  The bulk of calories come from healthy fats.  

What does this accomplish?  It causes the body to convert to using ketones as the primary energy source.  Ketones are the energy molecules that our bodies make by breaking down fat, and they can replace glucose as an energy source for many of our organs, most notably the brain.  

When our bodies' "engines" run primarily on ketones instead of glucose, the body learns to burn fat much more aggressively, since that's where all the ketones come from.  It also gives the pancreas a break from pumping out loads of insulin all the time, so you're a lot less likely to get diabetes.  

As you can imagine, this type of diet spurs weight loss.  But it has a host of other documented health benefits, thanks at least in large part to avoidance of high blood sugar (glucose) and insulin spikes.  

What are some of these other benefits?  To name a few:
  • Improved insulin sensitivity 
  • More consistent energy levels  
  • Decreased need for sleep (anecdotally)
  • More consistent mental clarity 
  • Anti-cancer effects 
    • Tumors seem to mainly use glucose for energy, so having a consistently low blood glucose level can effectively "starve" many pre-cancers, and potentially shrink existing tumors.  
There are various other documented biochemical benefits, and for further details I'll refer you to the the podcast episodes below, featuring Peter Attia (whom I mentioned above) as well as Dom D'Agostino, who is a professor of physiology and pharmacology and an avid ketosis researcher.
I haven't tried out the ketogenic diet yet (though I absolutely will), mainly because I decided to try out this other thing first...

Intermittent Fasting

Intermittent fasting is what is sounds like...having regular periods of time when you don't eat as much or don't eat at all.  It's classically done by severely restricting calories two days per week, or every other day, OR by having a shorter window of time (6-8 hours) for eating every day.

It doesn't sound like that big of an adjustment at first, until you realize that almost everyone in our modern society (who isn't living on the street) is basically stuffing food in their face during all waking hours.  We rarely go more than a few hours without eating something except when we sleep. 

Part of the theory behind intermittent fasting is that in most of human history people haven't had such ready access to food, so as a species we're not really adapted to that constant caloric intake we now typically practice.  While I take any evolutionary theory with a grain or two of salt, the preceding would be true even over the past few hundred years.  Food was never so consistently abundant before grocery stores came around.  

But more important than the theory...what benefits of intermittent fasting have been observed?

Intermittent Fasting Benefits Suggested by Research
  • Promotes a degree of ketogenesis (see above), if only temporarily.  
  • Appears to positively affect-
    • Insulin sensitivity
    • Neurogenesis (making more brain cells)
    • Neuron repair (fixing brain cells)
    • Mitochondrial repair (for energy production in cells)
    • Cognitive function
  • Lower chance of Alzheimer’s disease and Parkinson’s
  • Reduced cancer risk and tumor burden (size)
  • Improved longevity
  • Promotes weight loss (though that's not necessarily the primary goal)
That's kind of a "wow" list...but it's not fabricated (or even exaggerated) either.  A lot of credible research has been done on this topic, and for more info about that I refer you to the following from Mark Mattson (not to be confused with Mark Madsen), perhaps the foremost researcher on Intermittent Fasting, as a starting point to learn more:

What am I doing with this information?

I was intermittently fasting two days per week (restricting calories to about 600/day) for about two months from late August through late October of this year, and I noticed a variety of interesting effects.  Most notably, I was less food-obsessed on the days I fasted and had improved mental clarity those days as well.

I stopped for a few reasons...mainly because I was starting to feel increasingly binge-prone on the non-fasting days (after about 6 weeks).  So there are certainly some potential challenges with this type of eating pattern, but I think it's absolutely beneficial if you can pull it off.  

What's next?  I'm gearing up for a prolonged trial (3-6 months) with the ketogenic diet.  I wanna see how it affects me.  But even if I don't notice any benefits (which is unlikely)....it will probably purge some of those pre-cancers floating around inside of me, which I tend to view as a plus.  

Monday, July 27, 2015

Traipsing through Taiwan

Taipei 101
 In June of this year I traveled to Taiwan.  I know a girl who lives in Taipei (the capital and biggest city), so it seemed an ideal opportunity to go while I had someone I could stay with who was willing to show me around.  Stella and I originally met online, and had been talking for a while when I decided to plan a trip.  She offered a place to stay and to show me around.

This trip was many firsts for me - my first trip to Asia, first time in the Eastern Hemisphere, first time crossing the International Dateline, first time going to a country where the primary language is not English or Spanish, and my first flights longer than six hours.  And some other firsts too….like my first time eating pig intestines.  :).  It was a great trip, and a really cool experience.  

The trip started off with a...Bang?  As I was hastily packing, only two hours before departure and shortly before my ride to the airport would have come, I got an email informing that my first flight was cancelled, bumping me to the next flight (three hours later), which would cause me to miss my connection in San Francisco, and in effect extend my layover there from one hour to 18 hours.  My first thought was “Holy Crap”.  The email said if this change was not acceptable, I should call customer service, which I did, and ended up on hold for over an hour before I gave up.  In the meantime, I posted on Facebook and managed to find an old friend in San Francisco I could stay with, so I opted for the 18-hour layover rather than trying to change the flights.  And I tried to focus on the positive--even though I would get to Taiwan a day later than planned, I now had a chance to briefly explore a city I’d never seen before.  Similarly, though I had to cancel my ride to the airport, I later found a new and convenient method for parking at a transit station and riding a bus to the airport that will come in handy in the future.  

San Francisco was pretty cool--I took the metro straight from the airport to a part of downtown and walked down to the shore.  I stumbled upon the Golden Gate Bridge and got to take some pictures.  I was in downtown when the Golden State Warriors clinched the NBA title, heard some celebratory honks and yells, and got to mingle with celebrators milling about and on the subsequent subway rides to my friend Rebekah’s house.  I slept on the couch in Rebekah’s apartment after watching a replay of game 6 of the Finals (the final game).  The next day, I took the metro again and stopped off in another part of downtown to explore before heading back to the airport.  I spotted the “famous trolley” and police on horseback, and bought a big pizza at a place with great reviews on Yelp (Z-Pizza).  I took the leftovers with me, and was then the target of hungry homeless people (I gave away two pieces on the street), and later everyone in the airport seemed to be eyeing my pizza box, especially while going through security.  I had three large pieces left for the 13-hour flight.  

Silly in San Francisco
The flight was long.  At 13 hours, more than double my previous longest airplane ride.  It was nice to have the pizza, but they actually served a lot of food and drink, so much so that there seemed to be almost continual commotion from the attendants and concession carts.  I managed a few hours’ sleep and watched one in-flight movie (American Sniper) I hadn’t seen.  I also got up to walk around and stretch several times, and wore compression stockings, both in efforts to ward of DVT’s.  

At Chiang Kai-shek Memorial Hall Square
Stella was an amazing hostess.  First off, she met me at the airport and helped me find a bus across the city towards her home--everybody was speaking Chinese from the moment I left the airport, and I would have been lost without her (she also texted me written instructions in Chinese for a taxi driver in case she didn’t have time to come).  She took me to dinner at a Japanese style restaurant the first night, and took me to many other yummy, interesting, and fun restaurants and shops throughout my stay.  And on nearly every occasion, I was the lone English-speaking person in the establishment.  Stella translated or ordered on my behalf basically everywhere we went (I did go out on my own for a few hours one day, and felt very limited.  I managed to buy dinner and some donuts using a few basic words and gestures,, and was very proud of myself).  We visited several places I wouldn’t have known of as a regular tourist.  She planned various fun activities and improvised each day depending on weather and other factors.  She also took 3 days off work while I was there (she worked one day, and we had the weekend and one day of holiday for the “Dragon Festival”).  I never would have thought to go to Taiwan were in not for her, and she made the six-day stay very pleasant and memorable.  Even her roommate chipped in and took us out to eat, and later bought additional local foods for me to sample.  

Possibly the most remarkable thing about the visit was that I never exchanged any money nor used an ATM (nor paid for anything with dollars).  I used my credit card to pay for some things (a few meals, movie tickets [for Jurassic World in 4D, no less]…), and Stella paid for all the little things as we were traipsing around.  I gave her some cash before I left to help even it out, but the total cost of the trip besides airfare was incredibly only about $200!

Taipei by night
I did very little research before the trip, basically winging it.  I did make a list of places, however, because I had a patient in the ER about a month prior who was a returned-missionary from Taiwan (and was in the ER because he broke his ankle there on a return visit), and I asked him what I should do and made a list.   I also got a list of foods to try and one destination from my old roommate David McCombs, who likewise served his mission in Taiwan.  I left the rest to Stella, basically.  

Japanese style hot pot
I didn’t study any Chinese before the trip (I finally learned how to say “thank you”--xiexie-- while in San Francisco the day before) because I decided it would be too hard to make any substantial progress.  But after I’d been there a couple days, I decided to learn the basics, and found it made the whole experience more mentally engaging.  And just a few words and numbers go a long way for basic communication with the locals.  

Overall it was a unique cultural experience, and I loved trying so many different foods while I was there.  I showed Stella a list from some website of a bunch of different foods to try in Taiwan, and from that point she seemingly made it her quest to check off the whole list.  Some memorable treats:  Japanese hot pot, Taiwanese hot pot, sushi & sashimi, Thai buffet, stinky tofu soup with duck blood and pig intestines, mango “ice monster”, squid in various forms, mango smoothie, “Danbing” (kind of a like a fried skinny burrito for breakfast), and some good fruit (mango, papaya…).  My chopstick skills have also markedly improved, since that was usually the only option.  

soup w/ stinky tofu, duck blood, pig intestines
After six days, I sadly departed.  I had a three-hour layover in Tokyo on the return trip, so I can check off one more country, and that felt like its own mini cultural experience--the people and language seemed to have a different “rhythm” than in Taiwan, and everything seemed very efficient.  Plus they had a special toilet for squatting...  On the flight from Tokyo to LA, for some reason I got to sit in what my seatmate told me is called “premium economy” (not quite first class), which had more elbow and leg room than I’d ever had before on a plane--I was even able to prop my legs up part of the time to improve blood flow.

What a great and unique trip.  It was different from any other I’ve taken.  Asia, Chinese, the Eastern Hemisphere, crazy foods, and having someone so helpful that made my trip so much easier and cooler (and cheaper) was, on the whole, almost surreal.  And now, I’m very jetlagged.  But it was worth it.  

Additional photos from the trip can be seen here.  

Monday, September 29, 2014

Down to the DF – A Mexican Excursion

Random and Bizarre. 

And awesome. 

Those are all words that characterize my recent six-day trip to Mexico City. 

What led to this trip?

After my 3-month training program in the ER ended, I made a goal to go on one trip per month.  Why?  Because I can.  That’s the beauty of working in the ER.  While there is no paid time off, there is substantial schedule flexibility.  I can take a week off no problem, as long as I plan ahead two months or more. 

So along with my other recent trips (Atlanta, Carson City, Denver) and an upcoming one to Knoxville, I planned one to Mexico City.  Why Mexico City?  Because I love traveling in Latin America and speaking Spanish, because I’ve only been to Mexico once before (a non-touristy part in the Northwest), because Mexico isn’t that far away, because I like Mexican food, and because the airfare is relatively cheap (compared to other countries and compared to other parts of Mexico).  Also because a random Irish guy I sat next to on my last flight to Guatemala said it’s a really nice place to visit.  Additionally, why not? 

Eating tacos with Sandra (left) and Ninely
I prefer to travel places where I know someone, for the many obvious advantages (or have work pay for the trip, as was the case with Carson City).  The problem was, I didn’t really know anyone in Mexico City.  But I kinda sorta did.  A little tiny bit.  You see, there were a couple people whom I had randomly connected with on Facebook a few months earlier, but never met in person.  One of those was Ninely Contreras, with whom I had exchanged a few messages beginning in March.  I told her of my upcoming trip, and she said I could stay at her house if I didn’t mind sleeping on the couch.  I called her a couple days before the trip to touch base and go over the details (and to feel out if she seemed like a murderous criminal or not :) ), during which conversation she suggested a friend of hers might be better suited to host me as she lives closer to downtown, and has more free time because she’s not currently working. 

That friend, Sandra, who had never met me or ever talked to me before, not only hosted me at her apartment, but took time out of her schedule to meet me at the airport so she could accompany me on the Subway back to her home.  And from that moment on she acted like we were longtime friends, and was extremely helpful with anything I needed during my stay. 

I stayed at Sandra’s apartment every night except one (on the weekend when I stayed at Ninely’s house
because she was accompanying me to visit some of the more peripheral locations).  Sandra and Ninely were both exceptionally generous, kind, and helpful, and I had a great time hanging out with them and learning from them.  Really, that was the most remarkable thing about the trip—how far out of their way two strangers went to make sure my experience in Mexico City went smoothly.  Well, as smoothly as you can expect anything to go in Mexico City.
:)  Ninely said she’s traveled around Mexico a lot and been helped by other strangers, so she likes to pay it forward.  Sandra just said “I’m awesome, so I do stuff like that.”  She didn’t really say that, but it would be true if she did. :)

Other observations and experiences from the trip, in no particular order:

  • My favorite place in Mexico City was Plaza Garibaldi, a big park where a bunch of Mariachi bands (and some not-quite-as-Mariachi bands) congregate every evening to play songs for visitors.  I went there three times because I loved it!  The only song I requested (and paid for) was “Bésame Mucho”, just because it’s hilarious.  The singer was ridiculously off-key….but most of the groups sounded better than that.    
  • Somehow, some way, I didn’t get sick on this trip, despite trying all sorts of different foods.  That makes four consecutive foreign trips with no sickness.  I hope I’m not jinxing myself.  My secret?  I always carry hand sanitizer and a bottle of clean water.  But mostly I’ve just been lucky.  
  • I love speaking Spanish, and this was a great opportunity to practice and learn (or relearn) new words.  It was also a reminder that as good as one may be speaking a second language, discussing complex topics or communicating subtleties is an ongoing challenge, but also part of the fun.  It was likewise instructive about how much practice and repetition is required to master any language, something we likely take for granted in our native tongues.  
  • I learned how to find my way around alone on the Mexican subway, which was satisfying.  
  • Traveling on that same subway during rush hour can be intense.  One of the nights I was packed hilariously tightly with all the other people heading home from work.  I wasn’t holding onto anything but there was no way I could have fallen down.  And at each stop more people would cram in, packing more and more tightly.  I chuckled intermittently at the hilarity of the scene, and got some funny looks from the Mexican passengers.    
  • Thanks to busses, subways, and guidance from friends, I didn’t use a single taxi during the whole trip!
  • My three primary goals for the trip were to 1) Don't get killed, 2) Don't get kidnapped, and 3) Don't get mugged.  Success!
  • As an adult, I’ve developed allergies that plague me in certain places, which unfortunately include Central America, and now Mexico.  Ugh.  
  • The electric company randomly came and disconnected Sandra’s power my last night in Mexico, so we got to bust out lots of candles, and I couldn’t charge my phone or check email.  Last I checked she is still without power.  Something to do with an illegal connection that was placed by
    Panuchos - yum!
    a former landlord.
  • The food was great!  I didn’t see a single burrito or nacho while I was there (apparently those are more common in Northern Mexico), but plenty of tacos, quesadillas, and some new (to me) stuff like panuchos, sopes, and huaraches.  Which are all sort of similar but it still presented a learning curve.  And we ate lots of cacti (napales)…
  • There are a lot of museums in Mexico City!  In case you were wondering.  
  • Yogurtland in downtown was a great place to study food vocab, cuz all the 50 or so toppings were labeled with placards.  
  • The correct way to refer to Mexico City in Spanish is “el DF”, which is short for the Federal District (much like DC).

Some of the places I visited:

Heart and Soul in the rain
  • Teotihuacan – the apparently-not-Aztec pyramids 30km Northeast of the city.  Great views, lots of stairs!
  • Xochimilco – in the Southern part of the city there are several canals, and colorful boats you can ride on in said canals.  
  • El Zócalo – The central plaza of the city which is surrounded by government buildings and the main Cathedral, and connected to a touristy walkable street that is much like Calle Conde in Santo Domingo, DR, or the Fremont Street Experience in Las Vegas.    
  • Chapultepec – an urban park and “forest” intermingled with various museums and at least one body of water.  Also where I found a random outdoor piano which I played for about two hours (in two sittings) to the delight (or horror?) of passers-by, got one offer to join a band, and taught two people how to play heart and soul.  

And others.  Don’t those places have awesome names that are easy to memorize?  :)

What a great trip.  And it didn’t even cost that much (less than $1,000 total for everything).  The best thing about it was the people I met (especially Sandra and Ninely, but also a lot of friendly strangers on the streets or elsewhere), followed closely by the music, food, language, and incredible sights.  It left me with great memories and good feelings, and I hope to go back soon!  

Palacio de Bellas Artes


 More pictures from the trip can be seen here