Exercise Performance on a Ketogenic Diet

UPDATE 3/17/2013:

As I go back through the blog I wanted to provide "results" of my various musings/self-experiments. This one I think was a failure. I've read accounts of people doing meat-only high-intensity endurance exercise with success, but for me at least it didn't work out that way.

I was able to go on long hikes up very large mountains (Algonquin) without any more trouble than I would have had eating my previous diet, but hiking is almost by definition low-intensity. I was able to play 24 hour paintball games, but paintball is mostly walking around with brief, short sprints or intense action. No problems there. Anything that was mostly aerobic probably isn't going to be an issue.

Biking up a huge steep mountain? Probably wasn't going to happen. Now, when I did Wintergreen on my previous normal diet, I was probably going ~3MPH for the final 7 miles. It was incredibly painful and difficult, and come to think of it I was probably thoroughly bonked at that point and operating mostly in the aerobic zone. But I doubt I could have gotten through the previous 100+ miles on meat alone, at least not at the pace my carb-loaded father was setting.

So, experimenters, don't get fooled by the hype. Everything comes with a tradeoff.

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One of the most difficult transitions I’ve had to make has been mental. I’ve been thoroughly indoctrinated in the carb-loading exercise dogma and it is not an easy thing to escape. There is a huge body of studies showing that dietary carbohydrate is necessary for physical performance, which would give anyone looking to perform athletically pause.

As I’m finding very common in health science, however, there have not been very many studies done on competing hypotheses. Now, that’s mostly because no one can even conceive of there being a competing hypothesis; nothing has been swept under the rug, so to speak. But there is a body of evidence that suggest that carb-loading is not the whole story.

I’ve only been able to find one well constructed study on ketogenic diets and exercise. You can find the full text here. Phinney attempted to gather data explaining the apparent paradox presented by primitive hunting societies which ate close to zero carbohydrates. If carb-loading is necessary for physical performance, the survival of the Inuit and Plains Indians is difficult to explain. Historical accounts of white explorers living on an all-meat diet also become difficult to explain, especially their reported endurance.

Two studies are reviewed. In the first, overweight individuals are placed on a very low calories ketogenic diet for several weeks. They did no physical training during the study except for two treadmill tests. Over the course of the study they lost a lot of weight, and of course performed much better on their second treadmill test, even wearing a backpack weighted according to the amount of weight they had lost.

The second study was of competitive bicycle racers. They spent four weeks on a ketogenic diet while continuing their normal training rides. They reported a decline in energy levels during their first week, which they subsequently recovered. Their sprint ability declined and did not recover over the course of the study while their aerobic performance remained essentially unchanged over the course of the study.

Phinney concludes that aerobic performance up to 65% of VO2 max is not impaired and might be improved by a ketogenic diet, but any significantly anaerobic activity will be impaired. Thus, the diet is not optimal for high activity athletes.

His conclusion does not appear to resolve the paradoxes he sets out to address. How is it that Plains Indians, living on a diet consisting predominately of buffalo meat, created a culture of running and physical endurance if they would be unable to perform on a diet lacking carbohydrates? I’ve tracked a few stories down on the internet (they all come from a book called “Indian Running”, which I’ll have to buy to see where the stories are really sourced from) such as the following:

“In 1876 Big Hawk Chief ran from the Pawnee Agency to the Wichitas, a distance of 120 miles, inside 24 hours. His claim to have run such a distance was not believed. The Wichita chief arranged to ride back with him, sending a relay horse to the 60-mile point so that he could change horses there. Before the 60-mile point, the Wichita chief’s horse was forced to stop and rest, but Big Hawk went on. The Wichita chief eventually reached the Pawnee village before sunrise, less than 24 hours after their start, and found Big Hawk asleep. He had come in around midnight, covering the 120 miles across mountains, hills, and streams in about 20 hours.”

It seems similarly unbelievable that the Inuit exist at all if carbohydrates are required for maximal performance. Subsistence hunting requires punishing physical exertion. Did the Inuit paddle their kayaks at 65% VO2Max? They hunted whales. Whale + 65% VO2Max does not add up.

I think the major confounding factor here is adaptation time and training time. The longest modern study lasted a mere six weeks. Most were only run for a week, which as any Atkins dieter can tell you, is quite clearly insufficient time to adapt to the new diet. Perhaps, with a longer adaptation time and more time spent training under the new dietary regimen, some of the reported ultra-endurance reported by various historical sources could be achieved.

Thus I propose a thoroughly unscientific, n=1, study of exercise performance in very low carb, high fat diet conditions. I will spend the winter lifting weights, with a secondary emphasis on running and hiking when possible. When the weather gets warm, I will begin bicycle training. In August 2010, one year after beginning a ketogenic diet, I will attempt to ride a full century without ingesting any carbohydrates. Given how much pain I was in riding centuries while downing carbohydrate gel and Clif bars, I expect this to be quite a challenge. But it will also be a test of the hypothesis that with sufficient adaptation time, endurance performance should not be hugely inhibited on this diet. Or, it will test my ability to kill myself. We’ll see!

September Weights and Measures

Second monthly roundup of measured data and analysis.

Data

Since blogger is annoying in how it handles images, I’m going to upload an Excel (2003) spreadsheet. Here’s a link:

http://www.forefrontpb.com/phildiet/Diet%20Records.xls

The "Weekly Graphs" worksheet shows the weekly average of weight and the weekly average combined BM score and quantity.

The "Weight Chart Daily Graph" worksheet shows the daily morning weight.

The "BM Score Daily Graph" worksheet shows the daily combined BM score and quantity.

I'm keeping a food log and notes in a written notebook, which for the sake of putting off an annoying task, I will scan and upload when I'm done rather than every month.

Analysis

My second month has been interesting. I gained about 5 pounds, give or take, and my energy levels have shown steady improvement. My bowel movements have settled into a pattern: I go once or twice a day for a few days, then I eat or do something that unsettles me and I get a spike, which settles down after a day or two. It looks like sausage is my new nemesis.

I played in a two day paintball game in mid-September, on punishing terrain, and performed about as well as I always do. I didn’t notice any special fatigue or any inability to perform. My meals were much easier, since I basically ate hamburger and pemmican the entire time.

I had an interesting experience in the later half of the month. I was trying to work a piece of meat out of my front tooth and ended up prying off what looked like a piece of tooth enamel. This was disconcerting to say the least, so I went to a dentist, who said it wasn’t a big deal. Given the volume of material that I removed, his lack of concern was surprising. I figured he’d be rushing to do $5k worth of restorative work. Incidentally, my blood pressure was 112/68.

I’ve been doing pushups and squats every other day for the past month. I do three sets of 30 pushups, and then 3 sets of 10 squats. I added pullups for the last few workouts and usually end up with something like 5 then 4 then 3. My squat cage arrived along with a new bar and I got Dad’s old weights, so October 5^th will be the day I start lifting real weight.

On September 31, I had to get my brakes fixed. So I left the car in the Byram STS and ran to work (with some walking in the beginning to warm up). That was about 3.2 miles, at what turned out to be a 5.6 mph pace. At lunch, I ran back to get the car. Again, 3.2 miles, this time at a 7.1 mph pace. Not bad for someone who hasn’t run a mile in years. Of course, my guts reminded me of why I don’t run anymore, but I’m going to try to work up to a sane running level so I can be in better paintball shape.

Using my August reference point for energy and overall sense of wellbeing, September is definitely a positive 1 or 2 on a scale of 1 to 10. I still have occasional bouts of tiredness, and work can still sometimes cause weird fatigue, but that appears to be slowly going away.

My cow is on order from a different farm in Wykertown, NJ. We’ll see how that goes.

Two months down, ten to go!

August Weights and Measures

First monthly roundup of measured data and analysis.

Data

Since blogger is annoying in how it handles images, I’m going to upload an Excel (2003) spreadsheet. Here’s a link:

http://www.forefrontpb.com/phildiet/Diet%20Records.xls

The "Weekly Graphs" worksheet shows the weekly average of weight and the weekly average combined BM score and quantity.

The "Weight Chart 9-06-09" worksheet shows the daily morning weight for the past month and change.

The "BM Score Quantity 9-5-09" worksheet shows the daily combined BM score and quantity for the past month and change.

I'm keeping a food log and notes in a written notebook, which for the sake of putting off an annoying task, I will scan and upload when I'm done rather than every month.

Analysis

Since this is the first month of data, it is probably going to be the most interesting and volatile. As you can see from the weight chart, my weight has fluctuated between 151 and 155 pounds. As you can see from the BM chart, there have been some rather tumultuous days and some rather boring ones.

If I had done this properly, I would have begun tracking things back when I started low carbing. The weight chart would have shown a sharp decline down to this range back in July. I'm not actually sure what the BM chart would have shown, because I wasn't paying as much attention to that back then. Without that starting frame and baseline, we are left with mid-stream data. Unfortunately, this means that I will have to use this first month as my baseline, which will probably lead to misleading results. Chalk it up to not thinking of this experimentally at first - live and learn.

Anyway, from a subjective standpoint, I think these past few months have traced a bit of a "U". I started out feeling very, very odd. My body temperature was noticeably elevated, I felt as if I had the beginnings of a sore throat and a head cold all at once, except I was not congested. In retrospect, my crash descent to very low carb probably engendered a stress or even immune response from my body, which was counter-productive. If I had to do it all over again, I'd taper into it, just like tapering off of a steroid or powerful medication.

This lead to a long month or so of what I've come to think of the "exhausted energy jitters". I'll be sitting at work and my legs, quadriceps particularly, will feel dead tired, as if I had just run a marathon. But at the same time, I’ll have a jittery sense like I have to move. Then when I actually go and do something physical, like hiking in the Adirondacks, not only do my legs not feel tired, they feel exceptionally un-tired. When we finished hiking Algonquin, which is the second highest peak in the Adirondacks, my legs felt like they could have kept going for another round, which they absolutely should not have been able to do.

This sensation has abated somewhat but not significantly. The longer I am sedentary, the worse it becomes. By 3pm or so at work, I often find myself running around the pond and then going to the gym for twenty minutes just to “wake up” my body. Interestingly, I do not feel this at all when I first wake up. I feel refreshed, ready to go and happy when I step out of bed. Then as the day goes by I get progressively more “blergh” until I eventually hit that point of needing to do something but feeling as though I have zero energy to do it.

Mentally, I don’t feel this fatigue. I’m as sharp as I’ve ever been (which may not be saying much) and in general I feel a sense of contentment and well-being. The highs and lows of alertness I used to experience are gone, replaced with a sort of constant awakeness.

I suspect that I am not doing myself any favors with my sleep schedule. I probably should be getting an extra hour or two as I go through this, but I find that when it comes time to go to sleep, the jitters don’t let me. My body will want to sleep but at the same time it’s telling me that it’s not tired. I’ve added wake up and sleep times to my log to sort of remind myself that I need to go to bed earlier. The cat takes care of waking up early.

I hope to start an exercise regimen this week. I will start with a few weeks of bodyweight exercises intended to get my body ready for an actual lifting program starting in October. I hope this helps burn off whatever the jittery part of this feeling is so that I crash at night.

My August level of wellbeing, alertness and energy is now my zero point. Every month I’ll judge how I feel against this zero and see how it goes. This is obviously a very subjective and not at all trustworthy metric, but since I’m actually living at the same time I’m doing this experiment, it is noteworthy to see how I “feel” during it.

On a food note, I’m currently pricing out buying a whole steer from a farm in Stillman, NJ. This should be an interesting experience and I’m looking forward to seeing just how much beef you get from a whole steer!

One month down, eleven to go!

Fiber

Unfortunately, there’s a lack of good science when it comes to fiber. One is forced to rely on experience, anecdote and extrapolation, which is of course not quite as forceful as a measurement or controlled observation.

Still, I can come up with a testable hypothesis (one which I am in the process of testing, and which you can too; more on that later). So I will start there.

A common theme of questions about my diet surrounds bowel function. “Aren’t you constipated?” “Doesn’t meat take a week to digest?” “Doesn’t meat putrefy in your bowels?” The answers, respectively, are no, no and no, but since this is a blog I will put a little more effort into my response than that.

The first question is very easy to answer and indisputable: I am not constipated. I can measure this daily. In fact, for the past four days (reading from my log-log here), I have gone to the bathroom zero to two times per day. All bowel movements have been small, solid and have required no strain to pass. I feel like I have to go, I sit down, and within a couple minutes of wondering if that’s really it, I am on my way back out the door marveling at my excretive prowess.

The results speak for themselves. Constipation is a non-issue on this diet. Now, for the more curious, the question of why I’m not stuck in there straining away inevitably comes up. This is actually difficult for me to answer with any scientific data, which is why I referenced my own results above. I genuinely don’t know what causes constipation in most people, and so can’t really explain in specific terms why it is that I don’t have any problems with it. In lieu of anything, er, solid, I’ll just speculate.

Googling around has revealed that constipation is actually not well defined and thus is difficult to diagnose and measure, let alone treat. Theories abound, most surrounding a lack of fiber or roughage to stimulate the bowel to move things along. This sounds reasonable, and since most people don’t devote a lot of time towards wondering about constipation, it’s not surprising that it has become so ingrained. But let’s think about that critically for a moment.

Fiber is, by definition, indigestible material. It enters your small bowel more or less intact, which triggers a complex response. Peristalsis, or the contractions of your bowel to move things along, is elevated when fiber is present. This leads to the logical conclusion that fiber helps move things along, and thus must be a good thing.

However, that hypothesis seems to rest on shaky ground: why is it that you need to move things along, exactly? Why would one assume that this is healthy, and not your bowel attempting to rid itself of an unwanted substance? It can’t be digested, after all. It stands to reason that your bowel would want to clear itself of something it can’t do anything with, and it further stands to reason that such a response is counter-productive. The purpose of your small bowel and colon is to absorb nutrients and water. Speeding things up doesn’t make any sense. This alternative explanation for fiber’s effects does not appear to have been considered.

Worse, fiber adds bulk to stools. This is considered a good thing, for reasons I cannot fathom but which probably would be readily acceptable to any male between the ages of 0 and 80. Pride in crap size and integrity is not uncommon. The damage and strain caused by a bulky stool, however, is left unconsidered. Your bowel must stretch and strain to push a huge mass down and out, which is difficult. Over a lifetime, this stretching of the bowel can prevent it from functioning properly, which is a boon for the producers of Metamucil and fiber supplements but really sucks for the poor person who has to take them.

“But don’t you have to move things along to keep your bowel clean?” This is a corollary to the meat putrefaction question I referenced earlier. Let’s first dispel a myth implied by this statement: your bowel is not, and never will be, “clean”. It contains huge amounts of bacteria and food in various states of digestion. If you are eating a standard fiber filled diet, mucous is being secreted to protect your delicate intestinal lining. Poop comes out of it. It’s not and never will be clean, at least not until they flush you out with formaldehyde before your funeral.

That aside, the idea that food just sits around in your bowels putrefying is somewhat absurd. Your body is designed to take in organic matter, break it down and absorb it. Your intestines have developed incredibly robust mechanisms to handle this task. Food never “sits” anywhere. It is first assaulted by hydrochloric acid and broken down, then bile salts to emulsify the fats, then a whole host of digestive enzymes which further break it down into components your body can absorb. In the absence of fiber or an overload of any given nutrient, your body then does exactly what it’s supposed to do and absorbs everything it can. Provided you aren’t eating a ton of fiber, you end up with a relatively tiny mass of undigested material to send down the pipe.

The problem, I believe, is that when people eat “healthy”, ie, avoiding fat and eating lots of carbohydrates, they inadvertently (or intentionally) consume a huge quantity of starch and fiber. The fiber bulks up and any undigested starch enters the colon to the joy of billions of anaerobic bacteria. They multiply vociferously and then die, adding their bulk to the stool. If you aren’t drinking enough water, or there’s some other disruption, you now have a huge mass of indigestible material stretching your bowel and defeating its ability to push things along. You are now constipated, in lay terms.

Notice how protein and fat don’t enter into the equation there. Protein and fats are almost completely absorbed. If they aren’t, the result is far from constipation. Fat doubles as a lubricant, which is quite effective at speeding things along and results in quite effective bowel movements. Worse still, if you are unable to absorb all your fat and protein, it’s likely that you are also failing to absorb excess enzymes and bile, which leads to a wonderful condition known as bile-salt diarrhea.

I assure you personally and with great conviction that neither experience qualifies as constipation.

The final claim I’d like to address is the myth that “meat takes a week to digest” or otherwise persists in your bowels longer than other foods. I don’t know how the hell whoever came up with this came up with it, and I don’t understand why people believe it. Again, let’s examine our friend meat. Meat consists almost entirely of protein and fat. In your stomach, these two macronutrients are broken down into smaller bits by hydrochloric acid. Pepsin attacks the proteins here as well. Bile salts are added in the duodenum, which emulsifies the fat and allow the enzyme lipase to attach to it. Various processes and other enzymes (proteases primarily) break the proteins down into amino acids. This slurry, called chyme, then slushes through your small intestine, being absorbed. The tiny amount of muscle glycogen you ate is quickly handled by amylase.

A very small part of any given piece of meat will be indigestible or fail to be digested. It will effortlessly pass into the colon and then out again sometime later. The stool will be very small, and since you don’t have a ton of food to push along, you might go a day or two in between bowel movements before you have enough in there to trigger a movement. Regularity is relative – you only need to crap often if you have a lot to crap out, which you don’t if you don’t eat indigestible materials. For the past week or so, I’ve gone to the bathroom far less per day than at any period in my memory. This is a gift, not a curse.

Most importantly, there’s nowhere for meat to “sit”. Your bowel is not a train station. It’s a slippery tube that, unless you’ve damaged yourself from years of eating too much fiber and carbohydrate and have something like diverticulitis or a fistula, does not have places for food to stick. I’ve got some great pictures of a bleeding inflammatory polyp if you want to see what a large intestine looks like.

Anyway, to summarize:

1) I have no constipation issues. On the contrary, I have no strain and go once every day or two.

2) Meat is almost completely absorbed in your small intestine and does not generate any significant indigestible mass for you to worry about.

3) Your intestine has evolved over several hundred million years to handle the problem of absorbing organic matter. Thankfully, our ancestors did not evolve anything as stupid as a place for food to sit for a week rotting. Let the cows do that, and then eat the cow.

4) If you want to constipate yourself, eat something that expands in your colon and which cannot be broken down by your body, along with some food that feeds your gut bacteria. Then go take several ox-bile supplements along with a big heaping pile of animal fat and experience the wonders of fatty bile-salt diarrhea. You’ll never forget.

Taste

One of, if not the, key aspect of food for most people is taste. The sensation of a good taste is a prized experience, something which we devote a substantial part of our attention when it comes to food. For some meals, it might be the only consideration. To define my terms here, when I refer to “taste”, I am referring to the physical sensation you experience when holding food in your mouth as well as the larger sensation of wellbeing that you experience when eating what your body wants you to eat at that moment.

My completely unsupported theory is that when it comes to food, there are three fundamental factors in play. In order of survival priority:

1) Calories. You need to have enough energy to survive.

2) Nutrients. You need to attain enough vitamins and minerals to maintain your body.

3) Poison. Don’t eat something that will kill you obviously, but also avoid things that are merely detrimental without being instantly fatal.

Taste is one tool that has evolved in order to assist us in handling these three fundamental food factors. It rewards us for eating something when we are hungry and attain calories. It gives us hints as to what we should eat to attain the necessary nutrients. It warns us when we put something in our mouths that will cause harm.

Ideally, taste would serve only to help us accomplish healthy living, but this is an ultimate goal. Proximately, we are driven only to eat what tastes good, and taste is something that easily loses its calibration. Therein lies the problem.

Taste can be trained by experience, as evidenced by the phrase, “an acquired taste”. We train ourselves to like the way something tastes over time, which overrides taste’s natural function. Rather than serve as a tool to assist our survival, it becomes corrupted by the socialization process and begins to drive us to eat things we have trained ourselves to want to eat. When this happens, we find ourselves with a very powerful physiological and even emotional attachment to the foods we have been trained to eat over time.

This process begins when we are children. We are weaned from milk and begin eating solid food, very likely some sort of baby formula. These formulas are inevitably carbohydrate based, and while they provide adequate nutrition for survival, they do not provide optimal nutrition for health. One can see evidence of this in every child that requires braces, every child that requires glasses, every child that suffers from any chronic illness not caused by some environmental factor. We did not evolve to have poor eyesight, bad teeth, narrow noses and allergies, and when you examine populations eating their traditional, primitive diets, you discover that these ailments occur at vanishingly small frequencies in chidlren. (1)

But railing about childhood nutrition isn’t the point of this post. The purpose of illustrating the failure of early nutrition is to point out that this must inevitably train our sensation of taste to accept a certain class of foods. Our taste is thus trained to fail at its second most important function – indicating nutrient rich foods – almost from birth. It’s important to point out that adequate calories are almost always provided by these diets. Our taste is being successfully trained in its primary goal – to drive us to seek food which provides energy. It simply is not being taught how to recognize the second, and arguably failing to detect the third.

It’s also important to recognize that we likely have an evolutionary urge to eat carbohydrate rich foods such as fruits. Fruits, being mostly seasonal and far less sugary in evolutionary times than at present, would likely never have served as a staple food in our diet. However, they would be available seasonally, and would be a rich source of energy. We would gorge on fruit for a time, which would likely coincide with the end of a time of bounty. We’d fatten up due to the insulin spike and fructose, and thereby be prepared with adequate fat for the lean season that would follow. By feeding that urge early, we train ourselves to give in to it constantly, well beyond the ability of our bodies to handle the carbohydrate intake.

This is reinforced as we grow older through various social conventions. Celebrations inevitably involve food, and the most prized food for any child weaned on sugar-rich formula is almost always sugar-rich. We crave birthday cake, cookies, ice cream, candy – our taste, trained to seek out sugar, drives us blindly towards foods which fail utterly to provide even a semblance of nutrition. As we go through our lives, foods will come and go as the object of our obsession, but our bodies never forget the lesson they learned early on – seek calories and seek sugar.

That taste is addictive should not really be disputed by anyone. If you believe that food is not addictive, I challenge you to quit cold turkey. More seriously, if you believe that sugar is not addicting, I challenge you to quit cold turkey. If you believe that your way of eating is not addicting, I challenge you to change it radically overnight. You will find it both physiologically and emotionally difficult, having been trained over a lifetime to seek a certain spread of foods.

This brings me to the social aspect of taste. It is common to hear loud exclamations of satisfaction when one sits down to a large dinner. This is, after all, polite. You are complimenting the cook and the family on their excellent food, and sharing in the experience of that excellent food with people you are close to.

What remains unexamined is the way this social experience drives us to value foods. We are seeking taste sensations that we perceive as valuable because those around us are indicating that they are valuable. An American would find drinking the arterial blood of cattle revolting, perhaps even physically upsetting, whereas a Masai herdsman and his friends would pat their bellies and exclaim their satisfaction (or whatever the equivalent Masai way of showing contentment is). The blood is actually very nutritious, as it turns out, but we are incapable of appreciating that without proper training. As we sit around the table telling each other we are eating something good, we are participating in a social taste training ritual which tells us that what we are eating is good. What is lost here is that eating is not, fundamentally, about socializing. It’s about acquiring adequate calories and the optimal nutrient balance for health.

The modern American has completely lost that sense of food. We assume that we will get adequate calories and adequate nutrition, and so feel comfortable completely ignoring these aspects of food in favor of the social aspects or simply feeding our poorly calibrated taste buds. The results are not pretty. We get fat. We get sick. We get chronic illnesses. We have no energy so we eat five times a day in order to keep the sugar rush going until we finally overload our body's ability to handle insulin and get diabetes. By the end of our lives our intestines are scarred to the point where we often need supplementation just to get adequate nutrients. But we ignore all this, failing to make the connection, either willfully or because when everyone is doing something, it’s very difficult to think that there’s anything wrong with it, and thus we just don’t think about it.

Oh, sure, we count calories for a few months or read a headline about fat being bad and buy lean chicken breasts, or have a glass of red wine with dinner for the anti-oxidants. The truly dedicated exercise religiously and follow some health guru or another towards their random idea of optimal health. But we rarely give up that early training. We almost never escape the socialization of taste. In the end, we remain slaves to a sensation that is not providing us good guidance.

One of the most common things people ask me is how I don’t get tired of meat. It’s quite simple: meat is able to supply my caloric needs, is nutritionally complete, and is not a poison. Your body will not ever tire of something that is meeting its needs, once your taste sensation is re-calibrated to adequately sense those things. After only a month of eating an all meat diet, I can honestly say that I sit down to each meal with my mouth watering at the thought of what I’m about to eat. I can’t wait to eat another steak.

A further question I receive is something along the lines of, “well, why deprive yourself of things that taste good?” This question has two answers. The first is contained within the introduction post to this blog. The second is better served with a short illustration:

Imagine that you are walking through the park one day with your two-year old, when a man walks up to you. The following conversation takes place:

Man: So, have you given your kid heroin yet?

You: My god, no! Why would I do that?

Man: Because it’s such a great trip! Why would you deprive your kid of that?

Clearly, giving children heroin is a bad idea. It’s addictive and physically destructive, and a habit that you really don’t want to form in your two-year old. This more or less outlines my reasoning on food experiences. I know that chocolate double fudge cake is a good trip. A very good trip. But it’s also an addictive, physically destructive trip that fails utterly to provide me with any substantial nutrition.

I recognize that this is not a view shared by many, and is not the way people want to live their lives. It is, however, the way I’ve come to view food. The social aspect of food is dead to me, and I’m weaning myself away from my trained cravings as time goes by. Taste follows nutrition, rather than obstructing it – I’m training myself to enjoy the taste of that which is healthy. For me, good food is that which provides calories, nutrients and isn’t a poison. A blood rare unseasoned ribeye steak does all of these things – and damn does it taste good!

Phil

1 – Nutrition and Physical Degeneration, Weston Price, the entire book

Books to read

Good Calories, Bad Calories - Gary Taubes.

(Diet Delusion in the UK)

Taubes has made his career writing about bad science for newspapers and the journal Science. He discovered his next target in the late 90s: public health. After spending years reviewing journals, studies and the history of public health, Taubes essentially concluded that the standard wisdom rested on a very faulty foundation, and that the slate needs to be wiped clean so that real science can be done. This book is fairly long and dense, but very engaging if you are interested in the science he is discussing.

The Fat of the Land - Vilhjalmur Stefansson

Stefansson spent years in the arctic eating an all-meat diet. On his return, he subjected himself to a supervised medical experiment in which he ate nothing but meat for a full year. He wrote several books about his experiences. He draws on those books in The Fat of the Land, in which he argues that healthiest diet is one that is predominately based on animal meat. This book contains Stefansson’s take on the experiment he engaged in, as well as an overview of the use of meat in arctic exploration.

Nutrition and Physical Degeneration – Weston Price

Weston Price was a dentist who, in the 1930s, decided to take a survey of the primitive people’s of the world to see what their teeth looked like. He quickly discovered that so long as a population was eating its traditional diet, their teeth were nearly flawless and had very low incidence of tooth decay. Moreover, he found that they were typically in good health and did not appear to suffer from diseases of civilization. Price took pictures of the teeth and facial structure of the people he surveyed and those pictures are fairly remarkable to view. Price’s prose is a product of his time, so one must be careful to sift through the claims about “racial stock” and “racial purity” to reach Price’s ultimate conclusion: that nutrition, not race or racial purity, was the cause of society’s physical degeneration.

Life without Bread – Wulfgang Lutz

Basically, this is a low-carb diet plan that focuses on total health instead of weight. Lutz spent decades treating Crohn’s patients with his diet, with a claimed 80% success rate. He published his book in 1967 in German, but it was not translated to English until the early 2000s. It was eclipsed by the Atkins diet, and is critical of Atkins in the sections about implementing a low-carb diet.

Introduction and explanation

The purpose of this blog is to serve as a way for me to explain what the heck it is I'm doing to myself for the next year. The number of shocked, confused or otherwise disturbed looks I've received over the past month have convinced me that it's time to put something like this together. It's obviously difficult to answer all questions someone might have in a single conversation without forgetting an important detail or mangling the delivery, so I hope that this site will serve to do a better job than I do in person!

For this blog to work, you have to do one thing for me. You have to assume that I’m not a moron, that I’m not deluded, and that I have put and am putting fairly significant effort into validating the safety and validity of this experiment. Please grant me the courtesy of an open mind and a fair hearing – if I’m wrong, I’d love to hear how and why, so long as the rebuttal is formed logically and on sound evidence.

With that out of the way, I'll start at the beginning.

I was diagnosed with Crohn's Disease in 2003 at age 19. I was in ROTC at the time and weighed in at 137 for my final PT test - and I'm 6'3". I was placed on prednisone and asacol, cortico-steroid and anti-inflammatory drugs respectively, and eventually gained weight up into the 155-165 range depending on what time of day I stepped on the scale.

For obvious reasons, this sparked an interest in diet and health. After about a year of very strict eating (according to a random plan which was based on a poorly researched jumble of knowledge), it became clear that the medication was doing its job with or without my dietary restrictions. Since I was able to live my life without thinking much about it, I gradually relaxed most of my restrictions. I still limited the dairy to hard cheese or yogurt, rarely drank (after my sophomore year in college, that is) and typically tried to eat what I believed, without much justification, to be healthy.

In 2007, I received the first indication that perhaps this strategy might not be ideal. A colonoscopy revealed a large inflammatory polyp in my intestine. Inflammatory polyps rarely develop into colon cancer and are associated with inflammatory bowel diseases, but there it was. The doctor took a biopsy and it came back negative for cancer. At the time, I shrugged it off and went on living.

In June of 2009, there was a discussion at the lunch table at work about diet and health. For some reason, I recalled something I had read about a medical study done on two men who ate nothing but meat for an entire year. There was suitable skepticism of that claim, and I couldn't remember important details, so I went back to my desk to see if what I remembered was true.

As it turns out, there actually was such an experiment. Vilhamur Stefansson and Karsten Anderson ate nothing but meat under the supervision of the Bellevue Medical hospital in New York for one full year (1). It's important to recognize that "meat" for them did not mean "lean chicken breast". Over the course of the experiment, both men averaged 60-80% of their daily calories from fat, the remainder from protein. What trace carbohydrate they received came only from the muscle glycogen of the meat they consumed or seasonings.

This experiment was preceded by a fair amount of controversy. The diet experts of the day proclaimed that both men would be stricken with scurvy within weeks or months and the experiment would have to be terminated in order to save them from certain death. When the year was completed and both men remained in good health, there was an even greater stir. The lead doctor in the study wrote that the most remarkable thing about the results was the totally unremarkable nature of the results - both men were hale, healthy and content.

I was somewhat startled to read all this. It took a few days of confirmatory googling before I was willing to believe that this was true, but when I discovered the text of the study on one of the medical journal publication sites, it was impossible to deny the veracity of the report. (See 1)

It was also impossible to square with what I believed to be "healthy". Fat is bad, right? Red meat causes cancer and rots in your guts, right? How didn't they get constipated without adequate fiber? They avoided deficiency diseases somehow, but how? The entire framework of what I believed to be healthy had been challenged, and it was a challenge I couldn't back away from.

I dove into Stefansson's background and discovered that he had spent about a decade, in aggregate, exploring the Arctic. As a Harvard anthropologist, he spent years living with and studying Alaskan Eskimo who had not yet been westernized. The families that Stefansson stayed with disdained plant life as unfit for consumption except in times of extreme need. They ate caribou, seal, whales and fish, often lightly boiling the meat over a tallow-fed flame to produce broth and stock (2). Most remarkably, Stefansson claimed that they had no incidence of any of the diseases of civilization, and wrote a book about his unsuccessful attempt to find a case of cancer amidst Eskimo populations living traditionally. (3)

THAT caught my attention.

Now, I can understand if one is skeptical of the claim that primitive populations had vanishingly small incidences of one the number one killers in modern society. I was for a while as well. However, the more I looked into it, the more independent sources I found claiming exactly that. Missionaries or pioneer doctors would go to an unsettled frontier and begin treating the native peoples. (4). So long as those natives were living according to their traditional lifestyle, eating their traditional diet, they rarely showed signs of any heart disease, cancer, metabolic disorder or tooth decay. As the frontier moved through and those cultures began to westernize, that rapidly changed. The change was so rapid that individual doctors who worked the same areas were able to record the shift over the course of a single generation.

Weston Price, a dentist in the 1930s, traveled around the world attempting to catalogue the health of primitive populations. He would compare populations of the same “racial stock”, or basically groups of people that were from the same geographical area or tribe, who were eating either a traditional diet or were eating a westernized diet. In all cases, those eating the traditional diet were in better health than those eating the westernized diet, and rarely showed any signs of the diseases of civilization. (5)

This isn't to say that pre-industrial societies were free of all ills. They still got infectious diseases, still broke bones, suffered through famine and drought and a generally harsh existence. They just didn't get cancer or have heart attacks. A standard response to this I get a lot is "oh they just died at twenty so they didn't have time to get heart disease." This is not supported by the data. The meme about cavemen only living to twenty is one of those things that one repeats without thinking or confirming it - and when you try to confirm it, you quickly realize that it's a mangling of reality. If you discount child mortality, most primitive cultures had life spans rivaling those of industrial societies. Their ages at death were close as well. (6)

As I discovered all this, I started to realize that it wasn't something I could just ignore. It was a fundamental challenge to the way I was living my life, made all the more relevant by the fact that I suffered from one of those previously non-existent diseases. I continued to read and research, but within the course of a week I was very well convinced that I needed to make a lifestyle change, if only as an experiment. So in late June, I began low-carbing.

Keto-adaption is not fun. The standard American diet is carbohydrate based - depending on what you eat on a given day, you might get upwards of 60% or more of your calories from carbohydrate. A low-carb diet is fat based. Adapting your metabolism from one to the other is not a trivial undertaking for your body. It takes a week or two before the initial period is over, more for some people, less for others. Full adaptation in trained cyclists took about 7 weeks in one study of a ketogenic diet, and that might only represent something like 90% adaptation (7). Full keto-adaption is probably an ongoing thing, much like adapting to whatever diet you happen to be eating. Worse, my Crohn's is active in the last section of my small intestine, which is where a fat and the byproducts of fat metabolism are absorbed by the body. A predominately fat based diet is not easy for my intestines to extract energy from.

At the time of this writing, I am about two months into this process. More like a month and a half. My energy levels are slowly returning. My digestive processes went through some turbulence but seem to have normalized into a pattern. I dropped about seven pounds - prior to the start of the experiment, I would weigh in at 160 or so when I woke up. Now I weigh in at 153 pretty consistently.

Sometime towards the end of July, I began reading about fiber. Fiber has become one of those things that everyone knows is good for you and which you have to have in your diet. Ask why and you will receive some logical sounding answers such as that it adds bulk to your stool, thereby facilitating elimination and preventing constipation. Sometimes people will cite studies claiming health benefits to fiber, or claim that by moving things along very quickly it prevents toxic waste from building up.

As far as I can tell from reviewing the literature, none of this is proven. There appears to be little benefit for most people in adding fiber to the diet. It has no effect on cancer rates (8). Simple and obvious questions reveal the logic behind its effects on constipation to be incorrect – ie, how is it possible that Inuit who ate vanishingly small amounts of fiber didn’t all die of constipation? No properly constructed study has shown any effect in preventing constipation (9), and indeed virtually every fiber supplement carries with it a warning that it might cause constipation!

Worse, fiber, being indigestible, always reaches the large intestine intact, where it is fermented by various bacteria. The resulting chemical action and bacterial overgrowth is speculated to play a role in Crohn’s, though the focus is usually on simple sugars. The theory is that the immune response starts by attacking a bacterial infection in the colon, but gets derailed and begins attacking all intestinal tissue.

As someone with an irritated gut lining, it seems totally counter-productive for me to eat a bowel irritant which fuels unnecessary bacterial overgrowth. Unfortunately, if one is going to eat a low-carb AND low-fiber diet, one is left with almost no dietary option except meat and animal products. It took me the month of July to really reach this conclusion, but at the end I realized that there was no point in doing this by half measures. So on July 20th, I ate my last vegetable (some spinach).

My plan for the next year is fairly simple. I will eat nothing but meat and animal products, and drink nothing but water. I will avoid all food additives including artificial sweeteners (topic for another post!). I will measure the results of this diet by keeping a food diary, logging the frequency and severity of my bowel movements (a standard metric for Crohn's), logging my weight, and soon logging my energy levels by starting and logging a workout routine.

My last colonoscopy was August 1, 2009. The doctor discovered another inflammatory polyp and noted the usual inflammation associated with Crohn's. A further test of the results of this diet will be to see what my colonoscopy next year shows. I'll probably get a physical as well.

Some people have asked what would cause me to stop this diet. Well, if my energy levels do not recover to the point where I can do the things I like to do, I would consider terminating the experiment in September. If my weight drops into the low 140s, I would stop as well. If I begin to notice anything really 'weird', I'll assume that I'm starting to have a vitamin deficiency and start taking a multi-vitamin. If that doesn't clear things up in a week or two, then I will stop the diet. At six months, I will do a “gut check” to see if I want to continue. For now I'm testing the result obtained by Stefansson and others that showed that no added supplementation was required.

It’s important to note other individuals who claim to have eaten nothing but meat for long periods without issue. Owsley Stanley, of LSD and Grateful Dead soundman fame, is a dedicated adherent of the all-meat diet. Since he’s managed to survive for decades, I’m confident I can last a year. Random googling has turned up a “zero carb” forum, which is a community of people who eat nothing but meat, usually to lose weight, various blogs of people who have turned “carnivorous”, and other contemporary examples of humans surviving for at least one year on a carnivorous diet (10) (11). We will see if I have the same result.

So that's the introduction to what I'm doing. If you're still with me, I appreciate you taking the time to read this and hopefully it covers the basics. I will be writing additional posts in the coming days focusing on some of the claims I've made above, as well as trying to address the questions that seem to come up the most frequently. Above all, I want to assure everyone that I have not gone insane, that I haven't developed an eating disorder or otherwise cracked. I'm not going to start preaching, either, although if at the end of this year I'm in better health than I was at the beginning I hope that you don't ignore the implications for yourself. I consider this my choice and I have no desire to push my choices on other people. Above all, this is an experiment. I have no idea what the outcome will be, but I have no doubt that it will be interesting!

Phil

1 - Prolonged meat diets with a study of kidney function and ketosis: http://www.jbc.org/cgi/reprint/87/3/651

2 – Not By Bread Alone, Stefansson, pg. 15 – 39

3 – Cancer: A Disease of Civilization? Vilhjalmur Stefansson

4 - Good Calories, Bad Calories, Gary Taubes, pg. 89, (whole chapter entitled Diseases of Civilization)

5 – Nutrition and Physical Degeneration, Weston A. Price, the whole book.

6 – Longevity Among Hunter-Gatherers: A Cross-Cultural Examination, Michael Gurven, Hillard Kaplan: http://www.anth.ucsb.edu/faculty/gurven/papers/GurvenKaplan2007pdr.pdf

7 - Ketogenic diets and physical performance, Stephen D Phinney:

http://www.nutritionandmetabolism.com/content/1/1/2

8 - Dietary fiber intake and risk of colorectal cancer: a pooled analysis of prospective cohort studies: http://www.ncbi.nlm.nih.gov/pubmed/16352792?dopt=Citation

9 - An Evidence-Based Approach to the Management of Chronic Constipation in North America, American College of Gastroenterology Chronic Constipation Task Force:

http://www.nature.com/ajg/journal/v100/n1s/full/ajg2005519a.html

10 - http://www.carnivorehealth.com/main/2009/6/13/things-ive-learned-after-a-year-on-the-all-carnivorous-diet.html

11 - http://zeroinginonhealth.com/