Sunday, June 21, 2020

Retrospective #491: Ketogenic Intermittent Fasting

My wife tells me I should tell “newbies” how I started out on my VERY Low Carb journey, not how I manage to maintain a 180-pound weight loss. I tell her I did that in Type 2 Nutrition #419, Reversing Type 2 Diabetes: My Secrets,” I describe the many ways that my Way of Eating has evolved since I began to eat Very Low Carb in 2002
In this post, however, I’m writing about my current paradigm, the “Ketogenic Intermittent Fast,” as described by Dominic D’Agostino. D’Agostino, a PhD, is probably the leading researcher in ketogenic metabolism in the USA today. He initiated the 2016 Nutritional Ketosis and Metabolic Therapeutics Conference in Tampa, FL, that I attended. By the 3rd year, 2019, it had morphed into The Metabolic Health Summit in Long Beach, CA, which I also attended. It sold out, and they announced the next year’s Metabolic Health Summit, would also be held in Long Beach in January. And it was, without me.

D’Agostino appears to be a healthy, very fit, non-diabetic scientist. He says he follows a Ketogenic Intermittent Fasting diet 95% of the time. Jeff Volek, a PhD physiologist, now at Ohio State, is also a world-renowned expert in low carbohydrate research who presented both in Tampa and Long Beach. Together with Stephen Phinney, MD, Volek authored, “The Art and Science of Low Carbohydrate Living,” one of my favorite nutrition books. Phinney is co-founder of  Virta Health, “a clinically proven treatment plan to reverse Type 2 diabetes without medications or surgery.”

At the Tampa meeting Volek spoke to an overflow crowd in a break-out session attended mostly by endurance athletes and bodybuilders. I did not attend. LOL. In Long Beach Volek had a plenary session, which I did attend. But I gleaned from some Tampa attendees that many of the ultra-lean and ultra-muscular attendees take a therapeutic dose of Metformin, off label, to help get and stay lean. Metformin works by 1) suppressing unwanted gluconeogenesis especially in those with any degree of Insulin Resistance, and 2) by increasing insulin sensitivity. In this way users keep their blood glucose levels low and thereby their blood insulin levels low…and thus, being in ketosis, burn body fat (instead of the “unwanted” glucose) for energy TO GET AND STAY LEAN.

This would explain the pied piper interest in Volek and Nutritional Ketosis from athletes and bodybuilders. It stands to reason. To burn body fat, they want to be in nutritional ketosis most of the time. To do that they eat low carb, moderate/high protein, and high fat. They keep blood glucose and blood insulin low, eat protein and exercise to build muscle, and burn body and dietary fat for energy. To get and stay lean, that is their modus operendi.

So, for “healthy” people who want to stay lean, that is the “ketogenic” part. What does that have to do with fasting? When you fast, your blood glucose lowers, you blood insulin lowers, and you burn body fat for energy. If you were a Low Carber before – low enough to be in “Nutritional Ketosis” – your body easily shifts from “fed” to “fasting,” without hunger, and you use body fat for energy and without slowing down your metabolism
In addition, according to D’Agostino, fasting has 1) anti-inflammatory effects and 2) epigenetic effects, by the mechanisms of apoptosis and autophagy. Check out the hyperlinks. These effects are why ketogenic nutrition and fasting are such hot research topics today. Researchers are exploring the use of ketogenic nutrition and fasting for the whole panoply of metabolic disorders. All that, however, is OT (off topic) for today’s post.

My focus these days is how to maintain my 180-pound weight loss, keep my Type 2 diabetes in remission (with A1c’s in the low 5s), and stay in tip-top physical and mental health. In other words, how I’m going to continue to thrive. I’ve concluded that Ketogenic Intermittent Fasting is the best way for me to do that.

As the National Institutes of Health Richard L. Veech (d. 1/30/20) told Gary Taubes, “Doctors are scared of ketosis. They’re always worried about diabetic ketoacidosis. But ketosis is a normal physiologic state. I would argue that is the normal state of man.” And, as Dr. D’Agostino says, “It keeps the brain happy,” and “I feel better.” D’Agostino also says he “likes the food,” and he’s “lost his sweet tooth.” I like it too.

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