My N=1 Experiment Part 6 - Reset Week

So this was a different week. Part good, part not so much. The good part was a weekend trip last weekend to Toronto. The bad part was being diagnosed with gout in my big toe.

So the good part first. My wife and I went to Toronto last week and had a very good time. I really enjoyed the city and could definitely see her and I moving there one day.

The bad part started a couple weeks before we left When I started having pain in my big toe at the middle joint. Now, I couldn't remember injuring myself but I assumed I must have done something to it. However, the pain just stayed. Walking around Toronto was somewhat painful, especially if something bumped my toe. My wife wondered if it was gout but I didn't think so, mostly because I was embarrassed that it might be.

Anyway, on Wednesday I went to the doctor and he thought it probably was gout so I got the pills to help it out and the sheet with the diet recommending I avoid meat and eat white bread (seriously, it recommends white bread with whole wheat as a 'be careful' food). The pills have sort of started to work but my toe still hurts and I'm trying to avoid the worst offenders in the meat department (beef and seafood). I'm also going to try to avoid meats for breakfast and lunch for a while until things calm down and stop drinking anything alcoholic.

My take on what probably happened is:

1. The fasting was probably the trigger. I have been following a low carb diet and eating lots of meat for almost a year now without a problem but within a week of when I started intermittent fasting the gout set in.
2.  I also don't really watch my alcohol intake. Not that I drink alot but there are evenings I'll have 2-3 glasses of wine or a glass of wine with a couple ounces of scotch. I don't think this was a major factor but it could be.
3. Some of the sprinting I've done hasn't helped. Uric acid excretion by the kidney can be slowed down by lactic acid which could be aggravating things.
4. I've been trying to go pretty low carb (well less than 50 g a day most of the time less than 40) which means that ketones are most likely present in my body and ketones inhibit uric acid excretion. 
5. I may have been overindulging somewhat in more processed meats like bacon and sausages. I do eat beef a fair bit but that is a moderate purine food compared to bacon.
6. Seeing as it's winter, I suspect my Vitamin D levels are low because I'm not getting much sun exposure.

Now in looking at some research, the affect of seafood in the diet is the greatest but really looks like it only adds about 1.5 mg/dl to the number (meat adds about 1.3 mg/dl). This is somewhat significant. The normal levels are between 2.4 and 6 mg/dl so a 1.5 mg/dl could push one over the edge. However, if one supplements with 500 g of vitamin C (see here in the last paragraph), that affect can be erased.

So what's my low carb strategy to deal with this (you didn't think I was going to run out and eat bread did you?). Well it's this:

1. Wait for the pain and swelling to clear up before getting back to an exercise routine.
2. Eat far less of the worst meats (bacon and processed meats) in the long term and lessen the quantity of moderately purine rich meats in the near term until things clear up.
3. No more intermittent fasting.
4. Supplement with 500 mg of Vitamin C per day.
5. Supplement with Vitamin D (currently trying 4000 iu dosages but I need to research this further).
6. Add berries into my diet to get my carb count in the 50-100 g a day range to cut down on the ketones in my system. I may try to take it to the higher end of that range and see how things go.
7. No alcohol until things clear up and then limit to 1-2 glasses of wine a week and 1 scotch a week after that.

So that's the plan. Now for the results of last week...

Because of the trip to Toronto, I decided to do a bit of a reset this week. I didn't keep track of my food intake and had a couple small cheats in Toronto. I did however take my weight with interesting results. My weight went up a pound but my body fat percentage dropped quite a bit. My 2 day average weight was 212.9 and my body fat was 23.9. When I run the numbers, that means a reduction in my fat mass from last week of about 1.2 pounds and an increase in my lean mass of 3 pounds. I suspect the lean mass increase was water. Anyway, interesting results. 

Until next week...

Let's make Grok Fat

So a while ago, my buddy D2 Primal posed to me a challenge. If exercise does not make you lose weight, how do you explain to someone looking at the before after pictures at our gym (we go to a gym that is a part of a large chain I'll call Silver's to hide the real identity) that it was not the exercise that made them lose weight (and specifically fat).

So I got to thinking about this and decided to write a series of posts to explain, first how we get fat, then how conventional wisdom fails us in the advice it gives us on how we get rid of the fat, and finally how the low carb/primal lifestyle can help us to get rid of the fat and get back to being healthy.

I will say now that I will not be as eloquent as Gary Taubes or as technical as Hyperlipid. These guys are very deep thinkers who have a lot of knowledge and experience behind what they say. This will be more of my attempt to organize what I believe is happening within our bodies.

I have decided to use Mark Sisson's character Grok to illustrate the process of getting fat and getting back to health. For those of you who don't know about Grok, I'll give a small introduction but I highly recommend Mr. Sisson's excellent book Primal Blueprint as a more complete picture.

Grok is the personification of what humans evolved into during the majority of our existence on Earth up to about 10,000 years ago when agriculture was introduced into the equation. He eats what we evolved to eat, which is largely animal products with some fruits and vegetables. He does not avoid grains and sugars because, they didn't exist. He didn't go to the gym for the same reason. The exercise he did get was from walking a lot, doing intense work for brief periods of time to bring down prey or escape becoming prey (not the equivalent of an hour of cardio but more like wind sprints or tabatas), and from play. His species (and therefore us) evolved through natural selection to thrive off of this type of lifestyle.

Now, I'm a computer guy so I tend to like numbers and equations. So let's say that Grok eats about 2000 calories a day (I don't know if that is realistic but it's round) and expends about 2000 calories a day. We know he expends this much because he is weight stable and therefore is burning and excreting what he brings in.

So how do we make Grok fat? Well, let's transport him from his life 10,000 years ago to the present day. This will give him access to grains, sugars and foods he never imagined eating. So Grok starts eating sugar and refined carbs (rice, white bread, etc). He replaces some of the animal products he used to eat (bison liver, etc) with this new tasty food. What happens in his body? Well, as a result of the sugar, two things happen since sugar is made up of two things: fructose and glucose. The fructose goes to his liver and is turned into fatty acids, the glucose goes into the blood stream and raises blood sugar levels. The pancreas responds to the higher levels of blood sugars by producing insulin. The insulin does a few things, first it chokes off the supply of fatty acids into the blood stream from the fat cells. It does this to get the body to burn off the blood sugar since high levels of blood sugar can be toxic. It also causes cells in the liver, muscles and fat tissue to take up the sugar in the blood to lower the blood sugar levels.

Now if the fructose dose Grok gets is high enough, the fructose puts such a load on the liver that it causes the liver to become insulin resistant which means the pancreas will have to produce even more insulin to get the blood sugars out of the system. As insulin levels consistently go up in reaction to the intake of sugar and refined carbohydrate , eventually muscle cells become insulin resistant. This leaves fat cells to take in the blood sugar. Fat cells can become insulin resistant too but they are usually the last ones that do. Eventually Grok's body has consistently high levels of insulin in his system which means the calories that he does takes in (plus the carbs that he takes in) gets partitioned more to fat storage than to burning. Why is this? Because the insulin enhances the process of fat storage and simultaneously chokes off the release of fatty acids from fat storage to be used as energy.

So what does this do to Grok at a macro level? Well, he is eating 2000 calories a day and his body still wants to burn 2000 calories a day but let's say, the result of the elevated insulin levels is that 500 calories of his intake is put into fat storage and blocked from being released (imagine putting a kink in a garden hose and slowing down the release of the fatty acids). So his body has only 1500 calories to burn. Two things can happen at this stage. His body can react by slowing down his metabolism (keeping him tired and listless, cooling his body temperature, etc) to match the 500 calorie deficit, or (and maybe as a result) his body will make him hungry to eat more. So Grok eats another 500 calories. And 100 calories go into storage and 400 more calories are available to burn. Still a deficit of 100 calories between what his body wants to burn and what he has available.

Keep in mind, at this stage Grok is not aware of his body changing, he is just reacting to hormonal signals that are telling him to eat or slow down his activity.

Let's say it now takes 2600 calories a day to allow Grok to keep his lifestyle going. 2000 calories must be available to burn, but because what he is eating is forcing more fat into storage and (maybe more correctly) slowing down or blocking the release of the fatty acids from storage, he is storing 600 calories a day. This would result (if nutritionists are to be believed) in about a pound of weight gain a week. Let's say that continues for a year and he gains 52 pounds. Eventually, the fat cells are going to get so full, insulin cannot choke off the supply completely and some fatty acids will overcome the effect and get into the blood stream to be used for energy. I'm sure this is overly simplistic, but what I'm getting to is that the body will eventually reach an equilibrium where the energy coming in equals the energy being expended and excreted and weight will become stable. This maybe at 52 pounds of extra weight, it could be at 200 or 300. It all depends on genetics, environment and other factors.

So this is how Grok got fat. Now one thing to notice here, it's not because he was eating that well marbled rib steak. It was because he ate that steak with a white potato and followed it up with that piece of cake. Yes, fat played a factor but only because it was accompanied by food that caused insulin resistance and blood sugar spikes and both resulted in elevated levels of insulin which signaled to Grok's fat stores that fatty acids should not be released because the body needed to get rid of blood sugar. Even after the blood sugar dropped down to a reasonable level, the level of insulin in Grok's system remained high (due to the insulin resistance) and since the fat stores would not release their fat, Grok felt hungry and tired. He, as a result, slowed down his activity and probably had a snack.

This is very simplistic and ignores a whole lot of other interactions that go on, but as far as I can tell, this is the primary reason we get fat. If I have made any errors, PLEASE comment with a correction. If you have a reference that will help my understanding, I'd like that too!

The next part will be what happens when Grok looks in a mirror and starts wondering how he let himself go.

My Primal Blueprint Experiment - Week 0

So I started reading the Primal Blueprint by Mark Sisson.. So far, it is a very easy read and makes some logical arguments for eating and living the way that homo sapiens evolved to eat and live (at least as much as possible in the modern context). Now I do take issue with logical arguments being anything other than the start of a argument for how one should eat or live. The reason for this is is that just because it seems logical, those theories should be tested before we have any level of certainty that that logic holds up to reality. After all, when it seemed logical that 'fat makes you fat', the entire world went nuts for this and we ended up where we are, fatter than ever, unhealthier then ever and even more confused about what is the 'right' thing to do to get healthy.

Where I think the Paleo movement (which the Primal Blueprint seems to be a part of) has some merit is the fact that it agrees in large part with the low carb movement. The low carb movement has had years of experiementation that seems to back up it's philosophy of weight loss (especially for those obese and insulin-resistant people). Where Paleo and Low Carb seem not to agree is largely in the area of fruit. This is a bit of a questionmark for me as well. I don't know how much fruit one should eat while losing weight and I would assume that it would be dependent on how insulin resistant and carbohydrate sensitive one is.

They also emphasize trying to get the freshest, most naturally grown and harvested food available. So organic and local when possible. I haven't read any studies that say organic is significantly healthier than conventional food, but I don't believe it can be less healthy, right?

The thing I do like about the Paleo movement is it adds some lifestyle advice along with the dietary advice. Sleep and sunlight are discussed as being very important to health and from what I've read they have a strong point on this. Their ideas about exercise is very different from the 'exercise until you puke' mentality that seems to be out there right now. So far I've just read the summary of the advice but in general it is, exercise at a very low intensity frequently (walking, playing, etc), occasionally lift heavy weights (still have to read what occasionally means but I'm told it's at most 2 or 3 days a week), and once in a while sprint. When they say sprint it seems to be a very short all out sprint (5-10 seconds) rather than the HIIT sprints of up to a minute.

So here's my plan for my Primal Blueprint Experiment:
1. I plan to slowly introduce low carb high fibre fruits into my diet. Mostly berries. I'll still avoid the more sugary stuff, like bananas.

2. I plan on trying to get my food from organic sources where practical. It's inconvenient as the organic grocery store near my place doesn't sell meat and the one that does is a ways away but I'll try.

3. Once I've read the advice on exercise to see some specifics on the resistance training, I plan on doing that as well. Since it's so freaking cold here, I'll do the low intensity at the gym for now on the treadmill but once it's possible to walk outside, I'll go outside for a walk (my wife will enjoy that as I tend to beg off walking outside).  I'm hoping that since I'll be doing less intense exercise, it'll be easier to make it more consistent.

4. I'll try to get a bit more sunshine, when there is a sun out there. I don't know exactly how I'll do that. Possibly go for a walk around the block for a break at work when the sun is out. I'll see if there is another way to do that.

What do I hope to accomplish? Well, I'm hoping that a bit more weight will come off but that is secondary and I'm relatively happy where I'm at now. I'm also hoping my energy level will increase, my body composition will improve and that I will feel healthier. Not that I'm not feeling relatively healthy now but I'd like to have more energy.
It really isn't that much different from the lifestyle I'm currently leading except for the fruit and the consistent exercise. I started this morning by adding a small amount of blueberries (1/3 cup non-organic frozen ones heated in the microwave so not terribly paleo) to my almond flour/coconut milk pancake. It tasted good but I was surprised at how little sweetness there was in the berries. Probably because of them not being organic. It's about 2 hours afterwards and I do not have any cravings so that's a plus.

I weighed in at 212.2 and 25% BF. I'll weigh in again on Thursday and Friday next week and see what happens. I weigh in two days in a row each week because the daily fluctuations can change by a pound so I think doing it two days in a row gives a better picture of where I am.

I'll try to check in on my blog for a while, more for my own benefit but who knows someone might find it worth reading.