Wednesday, August 15, 2012

the ketogenic elemental diet day two: why ketogenic?

Devil's Pool, Wisshickon Valley Park this am
Tuesday August 7

veggies fermenting
Today was not nearly as bad as I thought it would be, all except for the "meals."  I felt weak in the am, so I decided not to workout, as Tuesdays are normally my CaTV indoor interval workout days on the trainer and I just could not imagine getting on the bike.  I did however, get up at 4:30 as usual and did a bunch of chores, including making kombucha and yogurt, and dehydrating the tomatos and shiitake mushrooms that would spoil during my Foodless Fortnight.  I straightened up the place and took the dogs on a long hike in the Wissahickon.  When one makes and comsumes cultured foods like kombucha,  kefir, yogurt and fermented vegetables, you really can't just blow them off for a couple of weeks while you attempt your latest wacko diet.  They are live organisms and need to be tended and fed.  But then I'm used to taking care of all manner of organisms, from my kombucha SCOBY to garden spiders to birds to the canine-shaped variety.

one of my gigantic Kombucha SCOBYs
So a major reason why so many try a low-carb diet and then quit is because they are unable to get through the keto-adaption phase, which takes anywhere from a couple of days to two weeks to a month.  In fact your body is always producing ketones, water-soluable compounds that are the byproduct of fatty acid breakdown in the liver, even when you are not on a low-carb diet, for instance during periods of intermittent fasting or strenuous exercise, both examples of events which require the brain to get a percentage of its fuel from this alternate fuel source, ketones, as blood levels of glucose drop.  However, according to Stephen Phinney in The Art and Science of Low Carbohydrate Living, blood ketones produced while eating a normal diet rarely exceed 0.1 millimolar.  Once you have restricted dietary carbohydrate to the point where your levels of blood ketones rise above 0.5 millimolar you are actually at the beginning of keto-adaptation, when you can perform more strenous exercise utilizing fatty acids as fuel.  And he should know, he has done studies on competitive cyclists showing no change in performance on a ketogenic diet, although these cyclists were tested during the ketogenic phase at a mere 60-65% of VO2 max, and let's face it, I go way over that for long periods on my weekend rides on the road and mountain bike and even in my short interval workouts.  Phinney makes the point that most of the studies used to support the supremacy of carbohydrate as an endurance fuel compare the much improved endurance shown by eating a carbohydrate rich-diet with the poor performance of subjects on a low-carbohydrate regimen derive at these results because the subjects are tested before they have been properly keto-adapted.

from pg 91 of The Art and Science of Low Carbohydrate Performance
Remember those charts on the treadmill at the gym?  Even when eating a normal diet, the mitochondria in your working muscle cells will derive most of their energy from fat when exercise intensity is less than 65% of VO2 Max.  Above that intensity level, the muscles draw on the glycogen stored in the muscles themselves as well as the liver, which in the average person is about 1300-2000 calories stored as carbohydrate.  This translates into a mere 2-3 hours riding at moderate intensity.  Of course those charts are oversimplified, because at any given point of time in a workout you are burning a portion of both fat and carbohydrate, and the point of Bob Seebohar's work with his athletes and now in his book is how beneficial it is to raise your metabolic efficiency point so you are able to burn fat at much higher intensities.  This has broad performance implications for athletes, because if you can tap into this unlimited fuel tank (your stored fat) even at race pace then you will not suffer from all of the issues that accompany the constant refueling of that small glucose tank, such as inconvenience and GI distress from the blood shunting effect.  He does not believe you need to follow a ketogenic diet to do this either; he shows you how with diet and training modifications in his book.  Phinney and Volek take this a step farther in their research, as they have done many studies showing the benefits of a low-carb diet on exercise performance as well as on human health in general.

At any rate, when I was restricting all carbohydrates, (and fats and proteins for that matter), during my water fast I'm not sure how long it took me to enter ketosis but it seemed way longer than the 72 hour average for women that Joel Fuhrman mentions in Fasting and Eating for Health. And I was tired for 8 of the 9 days, I mean I felt terribly weak and listless.  So I'm not expecting too much, but this time I'm not flying blind, as I purchased a blood glucose and ketone test meter so I can test every day and see exactly where I am and how that corresponds to my symptoms.

The most incredible thing is I'm not hungry at all (maybe not so incredible when you see the choice I have for a meal)  I could barely choke down the second shake today, so I never bothered with the third one, which was probably OK since I did not workout.  I realized though, that tomorrow I'm going to have to go with Plan B, because I don't think I can stomach another one of those amino acid drinks.  Plan B is the Semi-Elemental diet, in which I replace the horrid amino acids with a scoop of casein, or milk protein.

So tomorrow, I'm going Semi-Elemental, which does not have the same medical studies to back up its efficacy in curing SIBO but I can't even look at that amino acid powder now without getting nauseous.  So onward to Day Three....

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