Sunday, April 23, 2017

Type 2 Diabetes, a Dietary Disease #377: My 10-week, 30-lb Challenge: Final Report

Executive Summary: Primary End Point: Achieved, lost 31 pounds in 10 weeks. Discussion: All day fasting (300kcal/day) – either alternate day or 3-consecutive-day fasting – is an effective way to break a weight loss plateau if you are keto-adapted to start. It is easy because you will not be hungry, and it is effective because you lose weight while your metabolism continues to run in “high gear” as you burn your own body fat. During fasting your fasting blood glucose will fall dramatically (while continuing a Metformin regimen), but not below 60mg/dl. There was no hypoglycemia. Gluconeogenesis from fatty acids and amino acids provided glucose. My FBG average dropped from 119mg/dl before to 81 (10-week average). A1c went from 5.8% to 5.3%. Lipid Panel: Total Cholesterol: 201mg/dl; HDL: 74mg/dl; LDL: 114mg/dl; Triglycerides: 67mg/dl.
Week 6: Lost 0 lbs. Annoying. I thought I might be in trouble when after my first day of fasting this week I had lost only 1 lb and my FGB was 83. The week before my FBG was 61. I also ate out on Friday (3/17), and while lunch was VLC, my supper was 3 Ultras and ad lib peanuts. So, Saturday’s FBG was 107 and my weekly average bumped up to 79 (4.3mmol/L). Still, not bad.
Week 7: Due to the less-than-desired results in Week 6, I decided to try a 3-consecutive-day fast this week (Tue-Wed-Thu). I’m never hungry on fast days, so I thought it would be easy…and it was. No hunger, even on Friday morning. I could have kept it up for longer, easily. I had lots of energy and low but consistent fasting blood sugars (60s & 70s), average 71 mg/dl, and I lost 2 pounds. It was successful so I decided to repeat the 3-day fast the next week.
Week 8: Once again, the 3-day fast was easy. No hunger. Very little thinking about food. When I wasn’t busy with projects, or needed to rest from pushing hard all day, I sat down and read for half an hour. This week I ended the fast with a seminar in NYC that included a talk by Gary Taubes and lunch. I had the salad (with candied walnuts!), a piece of chicken and a spinach side. For supper, I had a petite filet, broccoli rabe side, and a drink. FBG this morning was 87! That raised my weekly average to 74mg/dl. I also lost 5 pounds, bringing my 8-week loss to 25.
Week 9: All good things, as they say…slow down. My weight loss continued, but just 1lb, to 26. My FBG average jumped 15 points, to 89mg/dl (range 74 to 101). Explanation (excuse): I spent most of the week in Florida and on the road. It’s hard to stay on track with so many diversions. I cheated. “No dessert,” I said at the Charleston Grill, but then without thinking ate the offered petit fours. Etc. So, with only 8 days remaining in my 10-week, 30-pound challenge, I will need to employ “the nuclear option” again this week: a 3-consecutive-day fast; still 4 pounds to go.
Week 10: It worked, for the 3rd time. I lost 5 pounds, bringing my 10-week weight loss to 31. And my FBG average was 80mg/dl (4.4mmol/L) – higher than expected, due no doubt to the adjustment period the body needs to down regulate from the previous week’s excesses. The 3-day consecutive fast, I discovered, is just as easy as, and more effective than, the Tuesday-Thursday alternate day fast. You just need to be keto-adapted to avoid hunger altogether.
Conclusion: If you eat VLC (just 15-30 grams of carbs/day), and you are thus keto-adapted, and you reach a weight loss plateau, you can effectively employ full-day fasting (alternate day or consecutive day) to restart weight loss in a healthy way. I did and I lost 31 pounds in 10 weeks.

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