Author: Lee Aase

Our 10 Weeks of Alternate Daily Fasting

As I mentioned in this post, when I heard Art De Vany say he eats “two meals a day, sometimes one, sometimes none” I thought that was unfathomable.

But after reading The Obesity Code and The Complete Guide to Fasting, in which Dr. Jason Fung described his experience with his Intensive Dietary Management clinic and how he would get many patients with type 2 diabetes off insulin and diabetes medications within just a few weeks through extended fasting, Lisa and I were ready to give it a try.

Neither of us had even been diagnosed as prediabetic, but Lisa’s fasting blood sugar had been 102 in October 2016, which is what got us started on this dietary and lifestyle journey.

In The Obesity Code, Dr. Fung cited a study of 70 days of alternate daily fasting in which body weight was decreased by an average of 6%, while fat mass decreased by 11.4%, with no loss of lean mass. He also said

Studies of eating a single meal per day found significantly more fat loss, compared to eating three meals per day, despite the same caloric intake. Significantly, no evidence of muscle loss was found.

The Obesity Code, p. 243, Jason Fung, M.D.

It’s important to note that with alternate daily fasting, you’re still eating every day. Typically you eat dinner every evening, and skip breakfast and lunch every other day.

So on Sunday you would eat all three meals, but then on Monday skip breakfast and lunch, limiting yourself to water, black coffee or tea. Then repeat the cycle.

Two Three important additional points:

  1. If you are taking insulin or medications for diabetes, you absolutely need to have medical supervision while fasting to prevent dangerous low blood sugar episodes.
  2. If you’re eating lots of carbohydrates, you will be miserable on an all-day fast. It’s best to get at least somewhat converted to fat metabolism before starting fasting. Eggs, meat, avocados, nuts and other foods relatively high in fats and with moderate protein, combined with limiting carbs to 25-40g per day, will help convert your body to burning fat.
  3. I’m not a doctor. I’m not giving medical advice. Check this out for yourself and make your own decision in consultation with medical professionals you trust.

One more tip: a good way to start is with time-restricted feeding, just skipping breakfast every day and eating lunch and dinner during a 6-8 hour window. This still gives you an extended period of lowered insulin levels, and isn’t quite as extreme as going 24 hours without food.

With all of those caveats, here are my weekly bluetooth scale readings from our 10 weeks of alternate daily fasting. I weighed every day, but for simplicity am just sharing the Wednesday morning readings.

With the caveat that the body fat and muscle percentages seem to be calculated by some voodoo electrical signals running through the soles of my feet, at least all of those readings were coming from the same scale.

So the bottom line is that I lost about a pound of fat per week while essentially preserving muscle mass. (The other 4 lbs. lost, according to the scale, were water weight .)

Note also that when we started the 10-week experiment I was already down 37 lbs. from Peak Lee, as demonstrated in my “before” pictures. So presumably I had already lost the “easy” weight.

And in keeping with the study cited by Dr. Fung, my body weight was reduced by 6.2%, while my body fat was reduced by 18.1%, during the 10-week period.

Have you tried intermittent fasting or time-restricted feeding?

If so, how did it work for you?

If not, what questions do you have?

See the whole series about my health journey. Follow along on Facebook, Twitter and LinkedIn.

An Unfortunately Named Book

The Obesity Code by Dr. Jason Fung came up among my recommended titles on Audible in May of 2018. (Note: commissions earned through any Amazon purchases are donated to support partial HELPcare Clinic memberships.)

The name didn’t put me off, because the subtitle was compelling: “Unlocking the secrets of weight loss.”

And while by that time I had lost about 25 lbs. through the Trim Healthy Mama Plan and the Slow-Carb Diet, I figured this highly rated and recommended book would add to my knowledge.

Little did I know it would be among the most important books in my health journey.

Dr. Jason Fung is a nephrologist who became increasingly dissatisfied with his practice because he felt helpless to deal with the progressive kidney damage his patients were experiencing.

Many if not most of them had diabetes resulting from obesity, which led them to need increasing amounts of insulin, which led them to gain more weight, and the cycle would continue. Eventually, they would end up on dialysis or would have foot ulcers that required amputation.

In listening to this book, I felt an increasing sense of the despair he must have felt in his practice, because in the first several chapters he laid out the scope of the problem, describing both the epidemic of obesity and why so many diets fail.

Essentially our weight control mechanisms behave like a ratchet, at least in our current food environment. Once we gain weight and our bodies adapt to a new normal, they in effect establish a new “set point.”

If we then follow the “eat less, move more” advice as exemplified by The Biggest Loser, we may achieve some short-term success, but at a long-term price. With chronic caloric reduction, our metabolisms slow because our bodies sense starvation and the need to conserve energy.

Instead of a basal metabolic rate of, for example, 2,000 calories per day it may be reduced to 1,500.

Our body temperature is reduced, as is the stroke volume of our hearts. We end up cold, tired and hungry.

Then when we resume normal eating, we gain it all back (and more) because we still have the lowered metabolism.

Fung describes obesity as primarily a hormonal issue, and highlights those hormones that play the largest roles: leptin, grellin, cortisol and, above all, insulin.

He describes how the Atkins diet showed some success, but that it too tends to have problems with long-term compliance.

This dreary story continues for 18 chapters, until he summarizes as follows:

There are two primary findings from all of the dietary studies done over the years. First: All diets work. Second: All diets fail.

Dr. Fung then gives some helpful advice on the importance of eating whole foods and avoiding sugar and refined carbohydrates. But it isn’t until the final chapter, after nine hours of describing the futility of other approaches, that he provides the solution.

As I said, the title of this book is really unfortunate. I would love to have all of my friends read it, but the title makes it kind of awkward to recommend.

Five days after I downloaded The Obesity Code, I bought a book coauthored by Dr. Fung called The Complete Guide to Fasting, which helped me to understand and implement the solution advocated in Chapter 20 of the first book.

I unreservedly recommend both, but if you want an introduction to Dr. Fung’s message, this address from last year will be helpful.

Next time I’ll tell you what happened when Lisa and I implemented a fasting regimen for 10 weeks starting in mid-May 2018.

See the whole series about my health journey. Follow along on Facebook, Twitter and LinkedIn.

Longevity Lessons from Art De Vany

Tim Ferris introduced me to several interesting thinkers through his podcast, “The Tim Ferriss Show.” I’ve learned a lot from them, and they in turn have introduced me to others who have affected my approach to diet, exercise and wellness.

Dr. Arthur De Vany was among the first, through this episode on “How to Reverse Aging.”

Art De Vany is one of the pioneers of the Paleo movement. He’s an economist, not a physician. And as Tim said, “he’s nearly 80 years old and ripped.”

Now he’s 82, and one of the things I appreciate about him is that he’s approaching the study of aging as a layman. “I only started studying it a few years ago. I figured I’m an expert because I’m experienced… When you’re coming up on 80, you start thinking about – when you approach middle age, you start thinking about these things.”

Beyond his characterization of 80 as approaching middle age, here are a few more snippets from Art in that conversation that caused me to stop and think.

  • I never have three meals a day. I sometimes have one. Sometimes none. Most times two. But you don’t have to cut calories. It’s just the timing. 
  • I eat only twice a day. So I want long intervals between meals. I want low insulin signaling so that I bring on the defensive and repair pathways. I want to be conscious of maintaining my stem cells.
  • The leanest are the ones who engage in the most intense bursts. Little children don’t steady state exercise.
  • I work out almost every day. Maybe 10, 15 minutes. 
  • Yeah, you can jog if you want to. If you want to kill some of your stem cells. 

Having been one of those guys who jog, thinking it was good for my health and longevity, that last point was jarring. But given that Art has something like 8% body fat, and that he says his blood test results are at levels typical of men 30-40 years younger, I thought it was worth exploring further.

Somewhere else I recall him comparing the overall physical appearance of sprinters vs. marathoners and asking: “Which looks better to you?” The sprinters are bright-eyed, muscular and vigorous, while the marathoners look like they’re about to die.

Point taken.

So this interview was part of my journey toward high-intensity interval training (HIIT) as well as more weightlifting.

Having been on a regular three (or more) meals per day cadence, the first bullet point above about eating two meals most days, sometimes one, and sometimes none was unfathomable to me. It seemed crazy.

But on further reflection, it increasingly made sense. Our ancestors didn’t have constant access to food. When they succeeded in a hunt, they ate, and with no refrigeration available it meant they loaded up while they had access to food. And then they were hungry for a while.

While I didn’t realize it at the time, this was my introduction to the concept of intermittent fasting or time-restricted feeding.

This podcast episode is well worth your time. Art discusses some fascinating concepts from his work as an economics professor, and the importance of major events in our personal lives and in economics as opposed to incremental developments. By far the most impact – for good or bad – comes from a handful of events, and he says it’s essential to recognize and remain poised in those situations.

If you want to read more from Art, check out The De Vany Diet, as well as his updated version, The New Evolution Diet.

Next time I’ll review a serendipitous Audible book recommendation that revolutionized my understanding, that when you eat is almost as important as what you eat.

See the whole series about my health journey. Follow along on Facebook, Twitter and LinkedIn.

Renewing a Connection, and a Call to Comment

My post yesterday on why A Calorie is NOT a Calorie — and why “eat less, move more” is a simplistic and harmful slogan masquerading as scientific weight-loss advice — led to a delightful reconnection with someone I first met more than a decade ago.

My good friend Dave deBronkart’s comment on my LinkedIn post drew Dr. Ted Eytan into the discussion, and it was a great pleasure to renew our acquaintance.

I first met Dr. Eytan in 2009 when we were on a panel together at a conference in Baltimore (which was also the day I met Ed Bennett for the first time after having interacted for several months on Twitter).

I was delighted to learn that he’s taken on a role as Associate Director with The Nutrition Coalition, and that he’s engaged in the effort to have U.S. Dietary Guidelines reflect sound science.

I had heard Nina Teicholz on a podcast talking about the Dietary Guidelines Advisory Commission and her work with The Nutrition Coalition, so it was cool to find out that Dr. Eytan is working so closely with her. As described earlier in this series, her book — The Big Fat Surprise — started me on this journey of dietary discovery.

The Nutrition Coalition is urging public comment as the U.S. Dietary Guidelines Advisory Commission is developing its 2020 Guidelines. This process happens every five years, and it has a huge impact. It affects everything from hospital meals to school lunches to what physicians and dietitians recommend to patients.

I submitted my comments last night. I hope you’ll check out all of the great information from The Nutrition Coalition and do likewise.

Tomorrow I’ll continue the series about my health journey. Follow along on Facebook, Twitter and LinkedIn.

A Calorie is NOT a Calorie

Just as not all studies are created equal, neither are all calories.

This isn’t new news in the scientific literature. In fact, a study from the 1950s showed that carbohydrates, protein and fat in the diet have significantly different impacts on metabolism.

And yet today we still hear the refrain: “A calorie is a calorie is a calorie. Weight is simply a matter of calories in vs. calories out. If you want to lose weight, the solution is simple: Eat less. Move more.”

A paper published in The Lancet in 1956 by Kekwick and Pawan (embedded at the bottom of this post so you can read for yourself) tells a much different story.

The paper reported on three diet studies involving obese patients.

In the first, when the proportion of protein (20%), fat (33%) and carbohydrate (47%) calories were held constant (20%), lower daily calorie intake led to greater weight loss.

No surprise there.

But the results of two other series of diets seriously undermined the theory that “a calorie is a calorie is a calorie.”

In the second series, 14 subjects were put on three different semi-starvation diets, each of which fed them 1,000 calories per day with 90% of calories coming from either carbohydrates, protein or fat. On the 90% protein and 90% fat diets, the subjects lost 0.6-0.9 lbs. per day, while on the 90% carbohydrate diet they actually gained weight.

Let that sink in: obese subjects gained weight on 1,000 calories per day.

On a semi-starvation diet.

When the calories came from carbohydrates.

In the third diet series, patients were put on a balanced diet of carbs, protein and fat at 2,000 calories per day, which caused them to maintain or gain weight.

When they were placed on a 2,600 calorie diet that was mostly fat and protein, four out of five lost weight.

With 600 more calories each day, as long as they came from fat and protein, the patients lost weight.

This study involved a small group of subjects, and the authors noted that “many of these patients had inadequate personalities. At worst they would cheat and lie, obtaining food from visitors, from trolleys touring the wards, and from neighbouring patients…. At best they cooperated fully but a few found the diet so trying that they could not eat the whole of their meals.”

That last point is important: if patients were on a 2,600-calorie protein/fat diet and found they couldn’t eat their whole meals, that’s kind of the goal, isn’t it?

It’s reverse cheating. They can eat as much as they want…but they just don’t want.

As the authors noted, high-carb diets tend to promote water retention, while protein/fat diets lead to loss of water weight. And even though those water weight losses aren’t permanent, it still demonstrates the underlying point: your body is not a bomb calorimeter. It doesn’t “burn” calories.

While the laws of thermodynamics are true, they aren’t the major driver of body weight issues.

Different types of calories are metabolized differently.

A calorie is NOT a calorie.

This was shown more than 60 years ago. And yet well into this century the U.S. government was officially recommending 6-11 servings per day of bread, cereal, rice and pasta.

I first learned about the Kekwick-Pawan paper in The 4-Hour Body by Tim Ferriss, which led to me adopting the Slow-Carb Diet and eating eggs for breakfast every day.

Tim’s podcast also introduced me to some interesting researchers, thinkers, authors and podcasters, whose programs and publications led to others from whom I’ve learned.

I’ll introduce you to the first of these next time.

See the whole series about my health journey. Follow along on Facebook, Twitter and LinkedIn.