Friday, February 28, 2020

Retrospective #377: My 10-week, 30-lb Challenge: Final Report

Note: This “Final Report” was originally written in early 2017 and reports of my first experience with full day fasting (300kcal/d) to break a weight-loss stall. It is important to note that I was already keto-adapted or “fat-adapted,” meaning I was already eating and continued to eat (on most “feast days”), 15-30 grams of carbs a day. The original goal was to lose 20 pounds in 2 months. Due to early success, the goal was modified to 10 weeks and 30 pounds.
Summary: Primary End Point: Achieved. I lost 31 pounds in 10 weeks. Method: Full-day “fasting” (300kcal/day) – either alternate day or 3-consecutive-day fasting – as an effective way to break a weight-loss plateau if you are keto-adapted at the 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. When full-day fasting, your fasting blood glucose will fall dramatically (while continuing on Metformin), but not below 60mg/dl, and without hypoglycemia. Essential glucose was provided by glycerol backbone when triglycerides from body fat break down to free fatty acids and from gluconeogenesis when dietary protein breaks down to amino acids. FBG average dropped from 119mg/dl to 81mg/dl (10-week aver). A1c dropped from 5.8% to 5.3%. Total Cholesterol: 201mg/dl; HDL: 74; LDL: 114; TG: 67.
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, 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 cocktail. FBG this morning was 87! That raised my weekly average to 74mg/dl. I also lost 5 pounds, making my 8-week loss 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.
Discussion: As the reader can see, this was a far-from-perfect experiment. It was “real world,” yet the result fully achieved the primary and secondary goals (weight loss and blood sugar control).
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 while achieving greatly improved blood glucose control.

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