Body Recomposition – Part 2

Goals

Proposing to do a test on myself with the following goals:

  1. Improve HbA1C number (HbA1C is a lab test which shows the Blood Sugar over the previous three months)
    July 2017: 5.8 (Low end of Pre-Diabetic level)
    Goal: < 5.6 (Below bottom of Pre-Diabetic levels)
  2. Lose weight to reach 15% Body Fat (Visualize Body Fat percentages)
  3. Barring any injury, be able to do exercise throughout entire test (CrossFit)
    Submaximally is OK (<85% of max level)
  4. Conserve current LBM (Lose Weight but not muscle)
    Possibly add LBM?
  5. Maintain current metabolic levels.
    The same thing as saying not to eat at a net calorie deficit.

Methodology

The means to this end is a form of the Protein Sparing Modified Fast:

A protein-sparing modified fast (PSMF) is a very low calorie diet with some protein, fluids, and vitamin and mineral supplementation.

I don’t plan on doing this using very-low-calories but with an adequate level of calories to not lower my metabolism. The source of calories will come from both body fat and from macro-nutrients consumed.

See also Very-low-carbohydrate diets and preservation of muscle mass.

The Math

Some math is required. Some of this is constants (values which don’t change) and some of it is variables (numbers which you can play with). Part of the variables relate to weights and measurements. Some of the variables change day to day.

Constants and Variables

  • Current Weight (CW) = what the scale told you that you weigh this morning (using lbs for this discussion). My Current Body Weight at the start of this exercise is 205 lbs. This number should decrease over the course of this test or something is really wrong.
  • Lean Body Mass (LBM) = The amount of non-fat in your body. This includes muscle, connective tissues, and everything that is not fat in your body. Without any other value, the US Navy Calculator gives a good estimation of your current LBM. Better values can be found by BodPod or DEXA scans. My LBM is 156 lbs.
  • Pounds of fat is your current weight minus your LBM.  For me, I have 49 lbs of fat left. I can’t lose all of that, but that’s what I have left.
  • Basal Metabolic Rate – The number of calories you burn (per hour) doing nothing. Here’s one on-line calculator for your basal metabolic rate. I am using 11 calories/lb/day for my exercise rest days and 12 calories/lb/day for my exercise days. Better values of your Resting Metabolic Rate can be found by BodPod or DEXA scans.
  • Percent Body Fat – A goal. Use Visualize Body Fat percentages to select your goal number. My own goal is 15% body fat. No point in going any lower.
  • Fat oxidation rate – 31 cal/lb/day (SS, Alpert.A limit on the energy transfer rate from the human fat store in hypophagia. J Theor Biol. 233 (1): 1–13). You can only lose 31 calories worth of fat per lb of your body fat weigh in one day. Since I currently have 49 lbs of fat, I can lose 49 times 31 calories of fat per day or 1519 calories from body fat the first day. This number decreases as you lose weight. (Checking the numbers/units, the article states 290 kJ/kg-day, which is 69.26 kCal/kg-day. With 1 lb = 2.2 kg, that’s 31.5 kCal/lb per day).
  • Calories per pound of fat is 3500 calories/lb.

MacroNutrients to Achieve Goals

There are only three macronutrients in this world (other than alcohol). They are fat, protein, and carbohydrates. Selecting the right mix and amount of each of these three macronutrients is what any diet is about.

Low Carbohydrates

Of the three macronutrients, carbohydrates have the most effect on blood sugar and are the lest important macronutrient for function. It is necessary to stay at a low carbohydrate level to maintain a low blood sugar level.

I plan on sticking with the 20 grams of carbs per day limit. This number will not change over the course of this experiment. The source will continue to be green vegetables.

Protein for LBM preservation and Gainz

The Protein Sparing Modified Fast provides enough protein to maintain LBM and a little extra protein to cover muscle building. Dr Fung has a lower value for this number than most of the other sources (0.61 g/kg/day). KetoGains has a number of 0.8 g/lb/day of LBM.

For my LBM of 156 lbs, that’s 124.8 grams of protein per day. This number will not change over the course of this experiment since I want to maintain my LBM. I don’t want this number to be higher because it will lead to GNG or lower because it will lead to LBM loss.

Fat Level

When I have done long fasts, the lack of fat during the fast put me at a metabolic deficit. I could see this was true from my body temperature which was cold. I had enough energy to walk and function but was quickly tired by any exercise.

What gets left over after carbs and fat are determined is the amount of fat. Rather than High Fat or Moderate Fat of the typical LCHF/Keto diet, dietary fat is only used to make up the difference between the fat oxidation rate and the number of calories needed to not drop the base metabolic rate.

On day 1, that is only 17 grams of fat – about 1/2T of butter a day. That is quite a bit lower than I am currently doing but that’s probably why I am not losing weight. If I go over this number it will decrease my daily deficit and I will lose weight slower.

Intermittent Fasting

In the short term, I plan to do this experiment by continuing to feed one time per day. This is convenient and helps me keep my Insulin levels as long as possible. I may experiment with the timing of this one meal or may split it into a pre and post workout meal.

Testing the Results

Any good experiment requires some evaluation criteria against the goals. For this experiment I will:

Proposing to do a test on myself with the following goals:

Goal: Improve HbA1C number

Measurement: Get test done of HbA1C on Jan 1 for  < 5.6. Surrogate will be 90-day average blood sugar of 110 or less.

Goal: Reach 15% Body Fat

Measurement:  Use Visualize Body Fat percentages to check body fat percentage. Get third party to check from the pictures. Alternately use BodPod or DEXA scan test.

Goal: Be able to do exercise throughout transition

Measurement: Stick with current CrossFit with minimum average attendance record of 3 days per week. Stretch goal of 4 days per week (only open 5 days per week). Submaximal performance is OK although I would like to be able to complete at least 50% of timed WODs in the allowed times.

Goal: Maintain current LBM

Measurement: Same as Body Fat % Goal.

Goal: Maintain current metabolic levels.

Will know if this works if end weight is maintainable.

Best thing is this all could be done by Christmas!

Chia Seeds

I referred to Chia Seeds in another BLOG post as part of my refeeding strategy for ending extended fasts.

Chia Seeds are one of those SuperFoods which should be a part of our diet. They provide a lot of fiber and very few calories. One ounce (about 2 tablespoons) contains 139 calories, 4 grams of protein, 9 grams fat, 12 grams carbohydrates and 11 grams of fiber, plus vitamins and minerals.

For Low Carb folks the 12 grams of carbohydrates are before subtracting fiber so the net carbs are 1-2.

To use them I soak the seeds in water (1/4 cup seeds to 1 cup liquid) until they take on a chewy texture reminiscent of tapioca pudding, about 20 minutes. Soaked chia seeds can be refrigerated for up to 5 days, so you can make a big batch at the start of the week.

I eat them one day before ending a longer (more than 7 day) fast. I also eat them three hours before refeeding. I usually eat them with a dill pickle which acts as a Sodium bomb.

 

Electrolytes are not Optional During a Fast (KetoGains)

One things I have struggled with on extended fasts is getting the formula right for electrolytes. There’s a variety of advice on what to do about electrolytes during a long fast varying from next to nothing (the “tough it out” mentality) to very specific minimums.

KetoGains has the following recommendations for electrolytes:

That is probably the best listing I have found in one place of what to take and how much to take.

Franky I think I failed to go past 25 days in my last extended fast due to not keeping control of my electrolytes so I’ve got a particular interest in getting this right. I really haven’t paid much attention to electrolytes in the past. All I have done has been to add Morton Lite Salt to my coffee (a couple of shakes). Mortons Lite Salt is half Sodium Chloride and half Potassium Chloride.

The Nutrition Facts Label for Morton Lite Salt shows:

The problem with Morton Lite Salt is that it is intended to be used to replace regular table salt and the manufacturer adds Iodine. Each 1/4 tsp has 40% of the RDA for Iodine. Too much Iodine can be a bad thing. 3/4 tsp would exceed the daily RDA for Iodine and only provide 36% of the Sodium and 30% of the Potassium.  My conclusion is that the Morton Lite Salt is a good thing to add as a shake or two into coffee since it gets both Sodium and Potassium over a few hours or a day, but is insufficient for daily needs during extended fasting. So what to do for electrolytes during fasting?

Sodium

For Sodium, this can easily be solved by using either Sea Salt or Pink Himalayan Salt. These salts do not contain Iodine. Morton Fine Sea Salt costs $2.24 for a 17.6 oz (500g) container.

Here is the nutrition label for the Morton Sea Salt.

To meet the 5000 mg minimum listed on the Ketogains electrolyte slide would be 10 servings of 1/4 tsp. The cost per day is ($2.24 for 36 servings or 6c per day).

Sodium: Use 2-1/2 tsp of Morton Sea Salt

Potassium

Where should Potassium come from? The KetoGains Electrolyte slide shows Potassium from either Nu-Salt® or NoSalt.

Nu-Salt® contains 0.530 grams or 530 milligrams of Potassium per 1/6 tsp. (1 g) serving. So a tsp of Nu-Salt® would have 3180 mg of Potassium. A half tsp of Nu-Salt® would have 1590 mg of Potassium.

NoSalt is a similar product. It is available at WalMart for $5 for 11 ozs.

Here is the nutrition facts for NoSalt.

Presumably the .25 Serving size is 1/4 tsp? One tsp would be 2560 mg of potassium which is in the Ketogains range. That means that the container has about 60 days worth of NoSalt ($5.00/60 days is less than 10c per day).

Potassium: Use 1 tsp of NoSalt or NuSalt

Warning for Taking Dietary Postassium

Note some medications, such as ACE inhibitors for blood pressure interfere with Potassium. Read this warning. Consult your physician for specific information.

Magnesium

This is probably best done with a supplement.The Ketogains suggestion is to avoid Magnesium Oxide and use Magnesium Citrate instead. The Magnesium Citrate is available in smaller doses of 70 or 100 mg so more tablets are needed).

These are available from Walmart for $6 for a bottle of 100. Three capsules would get to the minimum 300 mg of the Ketogains numbers. That would be 18c per day.

Magnesium: Take 3 of 100 mg Magnesium Citrate tablets

Conclusions

  • Sodium: Use 2-1/2 tsp of Morton Sea Salt
  • Potassium: Use 1 tsp of NoSalt or NuSalt
  • Magnesium: Take 3 of 100 mg Magnesium Citrate tablets

These are numbers for fasting only. Less are required when eating since some of these come from food.

 

Biochemical Stages of Short and Long Fasts

Here’s a great paper on what happens during a short and a long fast.

The paper covers the daily feast/fast cycle of the regular American diet. It also covers what happens over a longer fast. One of the interesting charts relates to a longer fast:

The chart on the left is the Glucose level over a longer fast and the chart on the right is the Ketone Bodies chart. Per the charts the Blood Glucose falls faster than the Ketone Bodies can kick in. That could the reason that the third day of an extended fast is considered to be the toughest. This also explains why it is much easier to enter a fast being already in Ketosis because your Ketone levels are higher.

 

Blood Sugar Levels During an Extended Fast

Here are some observations based on data of my Blood Sugar levels during a 25-day Extended Fast.

  • Blood Sugars go up significantly during the first few days of a fast.
  • The Blood Sugar “high” level is still nowhere near a dangerous level.
  • Blood Sugar peaks at 3-4 days into the fast and then drops rapidly.

  • Blood Sugars drop into the range considered low by the meter and stay that way through the rest of the fast.

  • The two high values are related to HIIT (High Intensity Interval Training Exercise). See my Cori Cycle BLOG post for more details.
  • After the fast my blood sugars are better than they were before the fast but I have added an exercise component to my routine.

 

The Cori Cycle – Not a new kind of bicycle

I had an interesting response to intense exercise the other day. I was many days fasted and went to an introductory CrossFit class. I measured my blood sugar after I got home from the class and my blood sugar was around 80 points higher. Did some digging to try and find out why.

My first assumption was that the liver was dumping glycogen and that’s partly true. Turns out that the muscles store around 80% of our glycogen stores and the liver contains the rest. The muscles use the glycogen locally and they don’t dump glucose into the blood stream. All of the glucose does come from the liver which takes it out of stored glycogen. That would account for some of the rise. I usually see a ten point pop with some exercise like bike riding but not like that time. The CrossFit exercise was very hard compared to normal exercise.

Here’s where the the Cori Cycle comes into play. I was fasted during the exercise for more than 20 days. From the Wikipedia article:

The Cori cycle is a much more important source of substrate for gluconeogenesis than food. The contribution of Cori cycle lactate to overall glucose production increases with fasting duration. Specifically, after 12, 20, and 40 hours of fasting by human volunteers, the contribution of Cori cycle lactate to gluconeogenesis is 41%, 71%, and 92%, respectively.

This was a piece of data which I didn’t have before. This makes sense of the experience that I had with intense exercise. The muscles released a lot of lactate which at the end of the exercise gets converted in the liver through gluconeogenesis into glucose. Hence, the large pop in blood sugars.

Here is a great discussion of exercise and the Type 2 Diabetic with Dr Finney.