Thursday, October 29, 2015

Almost there...




So this morning marks the beginning of Day Seven, although my last meal was between 10-12 pm on last Thursday so I will continue this fast until probably dinner tomorrow.  So around 36 hours to go... 

So far, I don't think I have reached that "no-hunger" state that people talk about. I'm definitely still hungry. I can control it obviously, but still, I will be glad to eat tomorrow.

I have put a lot of thought into what I will eat tomorrow night:  

Caesar salad with avocado, and Linda's Low Carb Lasagna.

Tuesday, October 27, 2015

Hunger



So for my "lunch" break today I thought I would update my journal.  I am back at work after a few days off, and am keeping busy and trying not to dwell on food too much although Starbucks does smell enticing.

Hunger is an interesting thing.  Today is day 5 of my fast, and even though I feel hungry, my stomach is growling, I have all the signs of hunger, I am just not very interested in the chicken broth I made, preferring instead at this moment to drink water or plain tea.  I had coffee this morning with coconut oil, butter and cream, and could only down half of it.  It just wasn't appealing.  Water and tea or even plain coffee sound better.  Megan told a story in the class the other day about a woman who loved and craved coffee daily, but during a fast ended up so tired of it that she had to give it up for a while...

I feel that way about cinnamon.  And chicken broth. And coconut oil.

I am also sort of cold.  Although I am not sure if that is because of the fasting, or because it is just cold in here.  I'm not the only one who feels cold today...

I'd like to just go home and take a nap which could be due to waking up at 2:30 am and not being able to really get back to sleep, or it could be due to a breakdown in my fuel pathways.  If I do this again, I may just take the whole week off--I think it would be easier.  I am hoping that any minute now my body will figure out that I have ample fat stores that it could easily use for fuel.  It is definitely struggling right now.

Dr. Fung has a great description of the process that we go through when fasting to be able to create ketones and alternate fuel for the body.  It is pretty amazing.

Mentally, I am sort of vacillating between tired/hungry and euphoric/satisfied.  Since today is day 5 of my fast, I should be well on my way to using large amounts of ketones in my brain.  People say that it is at this point (or near this point) that the un-hungry phase begins.  May people report that after 4-5 days that they completely lose their appetite and are comfortable and happy not eating. Currently, my stomach is still growling, so I am not quite there yet.  I hope to be there soon...

Monday, October 26, 2015

What Does Fasting Feel Like?


One of the big questions I had as I approached my 7 day fast was, "I wonder what it will feel like?"  I have done many short 24-46 hour fasts, so I had some idea of what the first day or two would be like...

I am lucky in that I get a sort "buzz" from fasting.  A feeling of well-being.  If you have ever taken Phentermine, you might be familiar with this feeling.  It is almost like euphoria.  I don't think everyone experiences this, or at least not at first. The first few days of a fast can be difficult.  During that time, your body is using up its glucose stores.  It knows that you aren't putting more food in, and so it sends you hunger signals. The feeling of well-being I get is the result of chemicals that the brain releases to deal with the stress that I am putting my body under.  There is a good short post on one of my favorite science blogs that talks about what happens to our brains when we fast.

If you have not been following a low carbohydrate diet--fasting can be pretty miserable those first few days.  Since I follow a low carb Paleo diet (Primal really, since I do consume dairy), it really hasn't been that hard for me.  Yes there are moments of hunger.  But hunger really isn't a constant growling pain in my stomach.  It comes and goes.  I start my day off with Keto coffee, and I drink lots of water and tea the rest of the day.  When I feel the stirrings of hunger, I sip on a cup of bone broth.  If I feel ravenous, I know it will stop in a few moments.  In a few days, maybe today or tomorrow, I will get to the place where my body starts burning primarily fat for fuel, and the hunger pangs will stop, because my body will realize that I have ample stores of fat, and it can use that fuel instead.

I took a few days off from work, because in the past when I have fasted for more than one day, I have felt a little nauseated from time to time.  I don't like the idea of dealing with that while at work--just because it could be totally solved by sleeping through it.  I find that it is really easy to nap through a couple of days if I can manage that, and if I am feeling "icky". Part of the nausea might be lack of salt, so I made sure to put a heaping tablespoon of it in my bone broth.  It is also important to drink enough water, and other liquids which I have great access to at home.  At work, I am subjected to cravings far more than at home because there is the smell of food and the smell of coffee from the Starbucks on site, so I decided that this time I would just skip all that...

So far, other than occasional expected moments of hunger, I feel great!  I have had a hard time falling asleep at night, but fortunately with not having to worry about work, I can sleep when I am actually tired so that is  working out well.  Even if I was going to work, I seem to be very awake and alert in the morning anyway.  I got up at 3:15 to get lunch together for my husband, and could have gotten up then if I had wanted to--I was certainly alert, and didn't feel sleep deprived even though I didn't go to sleep until around midnight the night before...

I have had a slight headache off and on for the past couple of days, but so far today I feel pretty good. Up until now, my longest fast has been 68 hours.  As of today I have fasted 76 hours so far, I plan to fast until dinner on Friday, just because it will be easier--no packing of food, etc.  That means I have 100 (ish) hours to go.  By tomorrow at this time, I will be more than halfway to my 176 hour goal!

Sunday, October 25, 2015

An N=1 Fasting Project

So here are the details of my fasting project:

My goal, as I mentioned before is to lose weight, (although fasting on its own has been used for centuries for a multitude of ailments.)  

I would say I'm a pretty average American woman.  I'm substantially overweight, 48 years old, and have a sedentary job.  Most people I talk to think fasting is pretty extreme.  I have dabbled in intermittent fasting for a long time, and am totally comfortable with the idea of going without food for a day. It's not that extreme, but there is a fear that has been ingrained in us that fasting is somehow dangerous. This idea that if you don't eat six times a day, you will suppress your metabolism, and put your body into "starvation mode."  For more information on why intermittent fasting is different, read this.

Fat equals energy.  The reason I am overweight is because my body does not use the stored fat that it has available.  Humans, like other mammals evolved to be able to store fat and to use that stored fat as a resource when necessary.  Because I am insulin resistant, I cannot access those fat stores.  I joined Dr. Jason Fung's Long Distance Intensive Dietary Management program with the support and approval of my current doctor.  I sent them my medical records, and will meet with them via GoToMeeting every month or so for support and advice, while my doctor monitors my blood tests, and supports my health on this end.  

I had a five hour class Friday as part of the IDM program. Despite the fact that I had to get up early for it (because they are located in Ontario, and I am on the west coast), it was a great class!  I did learn a couple of new things.  This is great because I do A LOT of reading on the topic of fasting and the ketogenic therapeutic approach to diet, and I wanted to learn more and was afraid this class would not give me the kind of information I wanted.  Megan, who I am going to call my project adviser was fun to listen to and a very good teacher--she used a lot of stories and easy-to-absorb examples.  This program is obviously designed for people who don't know much about a ketogenic diet, and who have not fasted or read about fasting as much as I have.  I admit, I have been obsessed with it for some time, but even so, I felt the class was well worth my time, and it was a quick five hours.

Insulin resistance causes fat gain.  Insulin resistance is the result of chronic high levels of insulin in the blood. This can be caused by multiple factors.  One of the most common factors is too many refined carbohydrates in the diet.  Another thing that can cause high insulin levels is long term psychological stress.  Dr. Fung describes how this works in this post:

"In modern times, chronic, non-physical stressors increase cortisol. For example, marital issues, problems at work, arguments with children, and sleep deprivation are all serious stressors, but do not result in vigorous physical exertion afterwards to lower blood glucose. Under conditions of chronic stress, glucose levels remain high. There is no vigorous physical exertion to burn off the glucose, and there is no resolution to the stressor. The blood glucose can remain elevated for months.   This chronic elevation in glucose can trigger the release of insulin. Chronically elevated cortisol leads to increased insulin. This has been demonstrated in several studies."

Much of the class was an overview of how fasting can bring down insulin levels.  And the last hour or so was an overview of the recommended diet that you follow when not fasting.  I started off my program with a 7 day fast. I started my fast Friday, October 23, and will eat again next Friday, October 30.  The purpose of this fast is to lower my insulin levels.  This will allow my body to enter a state of ketosis.  When I am in ketosis, it unlocks the fat from my cells and allows my body to use them as fuel in the form of ketones. There is an excellent (and easy to understand) description of how this works on Dr. Fung's blog. 

During the fast I am to drink 2 liters of water.  I am allowed still and sparkling water.  I can also have any kind of tea and herbal tea, coffee and bone broth.  I can make Keto coffee if I want to. Recipe:  2 T. Organic coconut oil (or MCT oil), 2 T. grass-fed butter, 2 T. grass-fed (pastured, not pasteurized) cream.  Adding cinnamon to coffee will help to lower insulin, so my recipe includes 1/4 tsp. of cinnamon as well.  MCT oil is tricky, I end up with digestive distress if I take more than 1 T. of it at a time, although I understand that your toleration of it improves with time.
I am also advised to take 1 T. of apple cider vinegar 3 X per day before meals in water. 

Obviously on fast days I won't be eating, so I will take the Apple cider vinegar before my keto coffee and before bone broth.  I am starting off with 1 tsp instead, because 1 T. is a little too vinegary for me at the moment.  I am going to add lemon next time I try it to see if it helps with the flavor.  Apparently vinegar serves as a good appetite suppressant, and has other healthy attributes--I use Bragg's Organic, raw, unfiltered apple cider vinegar.  


Once I am done with my 7 day fast, I will switch to a regular fasting schedule.  


There are many different intermittent fasting schedules.  


If fasting is very difficult, a good way to ease into it is to try three 24 hour fasts per week which entails eating only one meal on those three days, say M, W, F, like this:


           Breakfast        Lunch         Dinner

T           Eat              Eat               Eat
W          Fast            Fast              Eat
T           Eat              Eat               Eat
F           Fast            Fast              Eat
S           Eat              Eat               Eat
S           Eat              Eat               Eat 

The next step up would be three 36 hour fasts where you would choose three days to skip meals and eat the next day.  This 36 hour fast schedule would look something like this:



           Breakfast        Lunch         Dinner

M          Fast             Fast             Fast
T           Eat              Eat               Eat
W          Fast            Fast              Fast
T           Eat              Eat               Eat
F           Fast            Fast              Fast
S           Eat              Eat               Eat
S           Eat              Eat               Eat

The fasting schedule I will be starting with, however is a 42 hour fast:
           Breakfast        Lunch         Dinner

M          Fast             Fast             Fast
T           Fast             Eat              Eat
W          Fast             Fast             Fast
T           Fast             Eat              Eat
F           Fast             Fast             Fast
S           Fast             Eat              Eat
S           Eat               Eat              Eat

It may turn out that I will be able to do a 42 hour fast on Monday and Wednesday, but not on Friday in which case I may be have to be happy with that--we have a lot of events on Fridays and weekends, so it may work out best for me to do two 42 hour schedules and one 24 hour schedule at least some of the time.  We will see what kind of success I have. 


One thing Megan did mention is that it is not a good idea to do 24 hour fasting every day and just eat dinner.  We want to keep the body guessing!  In the past I have made this mistake just eating one meal a day and the result was that I managed to lose weight initially, but then after a couple of months I plateaued...


For the meals I eat, I will be following a strict low carb high fat diet.  (LCHF).  


The rules are pretty simple:  Avoid all processed food.  Limit meat to about 60 grams per day (for women).  Eat only organic, grass-fed, pastured and wild protein sources.  Limit carbs to 30 grams.  For me, (doing this for weight loss) that means eating non-starchy vegetables (veggies that grow above ground) pretty much exclusively for my carbs.  I can also eat berries and fruits with skin, but those have to be within my 30 gram limit per day. The rest of my diet will be made up of fat.  I don't have to limit fat, but I should only eat until I am satisfied. Fat, like the proteins I am eating, needs to be made up of healthy choices.  Grass-fed butter, coconut oil, the fats that come naturally with the meat you eat.  Eat your chicken skin!


If I am having a meal out, or it is a special occasion, I can have an occasional starchier treat like legumes, or sweet potato, but those need to be 10-20% of my diet and only on special occasions.  


If special occasions become every day or even every week--it could derail me so I have to be careful.  I know myself, and I can justify pretty much anything to myself, so it is important that I control my special occasions.  


I can have one glass of dry red wine or so with meals on my eating days--for my part I  think I will restrict that to Fridays and weekends, and have flavored (no sugar) seltzer water instead during the week.  Alcohol can lower my resistance to the foods I shouldn't be eating...


Megan had a great rule for us that I think will be helpful.  The rule of three.


In order to increase variety and add control don't do anything more than three times a week:  For example:  I can have chicken up to three times per week, eat Brussels sprouts up to three times per week, drink wine up to three times per week, eat raspberries up to three times per week, etc...


So today is day three.  I am experiencing hunger off and on, but it comes in waves and is pretty easy to ignore.  When I get hungry I have a cup of coffee or tea or broth, and it subsides.  The only issue I have had so far is a difficult time sleeping.  This could be because I drink coffee too late in the day, or it could be the fasting...In a few days I will be over this introductory period, and am told that I won't feel hungry, and I will be able to sleep better.

I am looking forward to the future!  :)





Saturday, October 24, 2015

Fasting for Weight Loss: A woman's perspective

A few years ago, Stephanie Ruper wrote an article "Shattering The Myth Of Fasting For Women: A Review Of Female-Specific Responses To Fasting In The Literature."

As a result of the article, I started to second-guess myself.  I am one of those women who loves intermittent fasting.  I feel very good in a fasted state.  I can consistently lose weight.  My skin improves, everything improves.  My menstrual cycle becomes much more normal. But, I read the article, and doubt started to creep in.  What if all the studies she mentions in the post could be applied to me?  What if I was burning out my adrenals, and ruining my metabolism?  What if I was doing serious damage to my hormonal regulation?

This fear was reinforced by the fact that my doctor at the time was very much against fasting.  She wanted me to try a straight ketogenic approach to diet, exercise some, (not too much), and take Phentermine, an appetite suppressant.  Unfortunately, I listened to them, I worked really hard to limit my calories, worked with my doctor to come up with good ketogenic macros, and consistently ate three meals a day.  I lost about 20 pounds over about 2 years.  I didn't feel very good much of the time.  I was encouraged to increase my Phentermine from 1/2 tablet to 1 whole tablet, because I wasn't losing weight consistently.  I would lose 5 pounds and then plateau for 3 months, then I would experiment with my macros and add more fat into my diet and lose a couple more pounds, then plateau again.  After a while I became very discouraged.  

I started asking myself questions.  Why was I taking an appetite suppressant when eating too much was obviously not my problem?  If a ketogenic diet was supposed to suppress appetite, why did I need an additional drug that did the same thing?  In the middle of all this questioning, I went on vacation to Wales for two weeks.  On the trip over, I was faced with absolutely no healthy food choices in the airports or on the plane.  I decided to fast instead of eating badly, and stuck as closely as possible to my ketogenic diet while over there.  I also tried to fast each day so that my eating window was more easy to control.  I wasn't perfect, after all, I was on vacation, but when I got back I began the diet and drug plan with renewed enthusiasm.  But the questions remained, and now I had a new one:  Why was it that when I did fast, I felt less hungry and had a great sense of personal well being?  As opposed to feeling lethargic and weird most of the time?  

I started to wonder if maybe Stephanie Ruper and Diane Schwartzbein were right and that women really shouldn't be following a low-carbohydrate diet?  So, I did some reading and decided to try a Whole30 without worrying about the carbs.  My previous doctor had just retired, and my new doctor was Paleo-friendly, so in the four weeks before I met with him for the first time, I decided to try out the Whole30 and just eat ad libitum as they suggest.  It was delicious.  I gained 12 pounds.  

When I met with my new doctor, he suggested two things:  that I lower my carb intake, and that I read Jason Fung's blog.  He thought I might be interested in what Dr. Fung was doing, and I was.  Jason Fung is a Canadian nephrologist who is using a fasting protocol to help his diabetic patients lose weight and get off their medication.  He has a program called Intensive Dietary Management, which utilizes fasting as a tool for weight loss in combination with a Low Carb High Fat diet (LCHF).  Basically, the fasting forces your body into ketosis, and the diet keeps you there.  Weekly periods of fasting help with this, so that even for people who have cheat days, overall the protocol works wonderfully.  

After several weeks of Intermittent Fasting on my own schedule, (Mondays and Wednesdays) and experimenting with daily fasting I met with my doctor the week before last and asked him to give me the information I need to join Dr. Fung's Long Distance IDM program.  I have a 5 hour class that I will take October 23rd, and I will be starting off with a 7 day fast.  The most I have ever managed is a 3 day fast, so I find it slightly frightening, but also exciting and challenging.  M doesn't think I can do it, but I am sure I can.  I am going to be home for the first four days. They say that the first three days are the hardest, but then ketosis will kick in and your appetite will be much more manageable.  I did a three day fast a few weeks ago, and after about 56 hours, I felt good, like I could have kept going...but ended my fast with a family dinner thing.  

So this is my new n=1 experiment.  Will fasting help me get into ketosis and help me burn fat?  I think it will.