Cutting Calories = Cold Hands

Since I’ve cut calories significantly on several days out of the last week my hands and feet have become cold, suggesting thyroid/metabolism slow down.  I’m not going to go down that road.  So instead, I’ve decided to turn to the macro percentages identified using this Keto Calculator.  Given my height, weight, and activity level (“lightly active”) my energy expenditure appears to be 1885 calories per day.

Holy crap…it says I have about 90 pounds of fat on me (including 14 lbs that are essential).

If I choose to eat 20g of carbohydrate per day and around 70g of protein per day, then 128g of fat per day would mean a 20% calorie deficit of 1512 calories per day.  Maybe I’ll try this for a week and tweak based on how it goes.

I’m going to focus more on exercise to get the insulin down.  That might mean eating more than the numbers above, depending on how I feel.

High Fat/Low Cal – An Experiment

I got discouraged by high hunger and inability to reduce protein or calories, which was resulting in very slow weight loss.  So a few days ago I tried something new.  I ate fat all day long. And guess what – I can’t say the hunger disappeared completely, but it dropped so low I was able to keep overall calorie intake very low:

3-2-16 diet.png

I know peanut butter is not an ideal food – I make it a little better by pouring off the peanut oil and mixing in melted coconut oil.   But the point is I’ve struggled for years with reducing calories because of hunger.  Hence, my fatness.  Once I reduce the insulin-generating foods significantly (protein and carbohydrates) I’m able to eat much less. I did this 2 days in a row and lost 4 pounds (down a total of 6 now).  Here was day 2:

3-4.png

The last 2 days I’ve increased calories to over 2000 and haven’t lost any more, but haven’t gained anything back either.  I’m considering alternating 2 days of very high fat/low calorie with 2 higher-calorie days for a while.  Today is another high fat/low cal day.  All the while I’ll be continuing LCHF.

Now that I’m pretty sure it’s protein that’s been keeping me hungry I’ll be adding vegetables back into my diet.  Hey here’s a fun keto tip…Did you know that sauteed radishes taste a lot like fried red potatoes?

2016-02-29 14.32.58.jpg

I make them with a lot of butter or bacon grease (ideally from grass-fed beef bacon, if I have it), salt and garlic.  Fry them until they’re soft and some of them are browning (about 10 minutes).  I would probably cook them a little longer than the ones in the picture.

A 16-oz bag of radishes is dirt cheap ($1-2), has 72.6 calories, 3.1g protein, 15.4g of carbohydrates (7.3 of which are fiber), and 0.5g fat, and has the following micronutrients:

radishes

Obviously the macro/calorie load shifts when you add a bunch of fat to the pan.  And that’s what makes them so delicious.   Best of all I can eat a whole bag of radishes cooked up like this without noticeable endotoxin problems (e.g., depression) and without any impact on my blood sugar.  I can’t say that for potatoes.

Hey one last thing on the topic of eating straight oil and calling it a meal.  I have been feeling great on the days I do this – focused, high energy, great mood.  I’m not sure if it’s the MCT oil itself or the reduced brain fog from having lower insulin.  I’ve been smiling for no good reason.  When you catch yourself doing that it’s a wonderful thing.

 

Don’t put ghee in your BPC

For whatever reason, ghee is not a good substitute for butter when making Bulletproof Coffee.  It doesn’t blend well, and is like drinking an oil slick.  I regretfully had to dump the whole thing.

Macros for yesterday:

today

I stayed as low as I could on protein, and still 91 grams.  Fucking hunger.

I’m annoyed.

Keto – Week 6

You know how sometimes you hear the same thing over and over and then one day it clicks and you just get it?  And you wonder why it didn’t click the first 10 times you heard it or even considered it?  I’m having that experience right now.  Today I read this transcription of a talk given by Ron Rosedale in 2006 for the American Society of Bariatric Physicians (ASBP), entitled “The good, the bad, and the ugly of protein.”  Although much of this information is new to me (and a lot of it I’d have to spend more time with to really understand – leptin, MTOR, IGF-1, for example), the theme that too much protein can cause problems is one that has been recurring for me.  This passage jumped out at me today:

A high protein intake has endocrine effects such as it increases insulin, increases IGF, and we know these hormones increase the rate of aging. Furthermore the metabolic effect of high urea and many amino acids may exceed the kidney and hepatic system’s ability to metabolize and excrete the excess nitrogen.

In other words, when you use protein as a fuel, you take off the excess nitrogen, and then you have to do something with it. Because, it’s a poison. If you take too much, It causes acidosis in the blood and that causes redistribution of calcium and magnesium, and all sorts of things, and what the consequence are for that is manifold.

So what’s high.  Certainly above 1 gram per kilogram of lean mass is probably high.  Most people, I’ll put on .7 or .75 grams per kilogram of lean body mass.  But if I’ve got a diabetic, and I really want to reverse their aging, which means reverse their diabetes, because diabetes is a model of aging, I’ll put them down to .5 or .6 grams per kilogram of lean body mass per day.

A year ago when I was attempting to eat a ketogenic diet (but failing, cuz too much protein, but I didn’t realize it because I wasn’t bothering to test for ketones) my labs were disappointing.  High uric acid, high (bad) lipids, poor BUN/Creatinine ratio, struggling thyroid, high calculated anion gap (which can indicate acidosis).  After 4-5 months I was tired and irritable all the time and quit.  The above passage explains that maybe some of this was because of my high protein intake, which led to sustained high insulin levels and high nitrogen.  Too much protein = high insulin and difficulty eliminating excess nitrogen = metabolic acidosis and feeling shitty.

Rosedale goes on to recommend limiting protein and increasing fat consumption. Starting today I’m using his recommended 0.5 to 0.6 grams of protein per kg of lean body mass.  For me that is somewhere in the neighborhood of 60-70g of protein per day.  I’ve been eating twice that amount.  What do I have to show for it?  Overall good energy and sleep, but very slow fat loss and still relatively high hunger.  I’ll be using Cronometer to track my intake for a while to make sure I’m staying within that range.

Since my last update I’ve gained back a pound or so.  6 weeks of keto and I’ve lost about 4 pounds and a couple inches from my waist.  I’m not complaining….well actually, yes I am complaining.  It’s not easy eating a diet this restrictive and exercising 3x a week with so little to show for it.  I think the amount of protein I’ve been eating is a critical factor.  A possible confounder is that I’ve been eating butter in an otherwise dairy-free diet.  I’ll be eliminating that too for now.  I can always add it back in later to test for problems.

Keto – 1 Month Review

About a week and a half ago – 3 weeks into eating a LCHF diet – I added high intensity interval training (HIIT), as often as time permits, which isn’t much – I think I’ve had 4 sessions since I started.  I do 30 seconds of running uphill (5.5 mph, 6% incline), and then 4 minutes of slow walking (2 mph, 0 incline).  Repeat 4 more times.  So really I’m doing only about 5 minutes of hard work per week.  Since I started this I’ve lost 5 pounds and my fasting blood sugar has dropped from around 114, where it’s been stuck for 3 weeks, to about 102.  Post-prandial blood sugar (at 2 hours) is usually in the 80s.

I’m sleeping better, I have more energy, my mood is better than when I was eating carbs every day.

My usual diet:

  • Breakfast: eggs (1 whole egg plus 2 egg yolks cooked in coconut oil) and 1/2 of an avocado.  Sometimes a couple ounces of meat if I’m particularly hungry, but I notice ketones drop quickly if I eat too much protein.
  • Snack (because I can’t make it the 6 hours till lunch without one): bulletproof coffee (16 oz coffee with 2 Tbs unsalted grassfed butter and 2 Tbs MCT oil.  Yes, I’m using the actual, authentic mycotoxin-free upgraded coffee from Mr. Bulletproof himself).
  • Lunch: 1/2 avocado, 1-2 Tbs. homemade mayo, about 4 oz of chicken/fish/steak, a bunch of kalamata olives.
  • Snack – whatever coffee is still in my thermos, maybe some macadamia nuts
  • Dinner – a small-medium portion of whatever my family eats – last night it was cod cooked in butter.  I have been avoiding the veggies to see if it makes a difference one way or the other.

I’m hungriest in the morning, and have been eating till I’m not hungry anymore.  I might experiment with getting rid of that last egg white, and see if that reduces hunger by reducing impact on insulin levels.

Current supplements:

Medications:

  • Hydrochlorothiazide – 25mg/day (for hypertension)
  • Methyldopa – 250mg 3x/day (for hypertension)

I quit taking the Metformin.  It made my breasts stupid big and really sore and after 3 weeks it just wasn’t going away.  I figured I could manage without it eating Keto anyway.  So it’s gone.  Now, a couple weeks later, my bras still don’t quite fit.  Hot flashes are starting to come back as hormone levels return to baseline.

Marriage update:  Things are on cruise control.  It’s a real pain in the ass to split up.  For now, we’re just getting through the day to day, no movements in that direction.  He doesn’t want to split up and I’m not sure my life would be better if we did.  We get along well so it’s not painful.  Not the marriage I thought I had, but many things in my life are wonderful, so this is fine for now.

A request was made for my extremely easy homemade mayo recipe.  I have to admit it’s not MINE, exactly, because I got it from here.  I did tweak it a little so I’ll share the recipe as I make it:

Coconut Oil Mayonnaise

Equipment:

  • 1 glass jar with a mouth wide enough to accommodate a stick blender. I’ve used Vlasic dill pickle jars and 16-oz wide mouth Mason jars.  Both are great.
  • A stick blender (I use this one).

Ingredients:

  • 1 egg
  • 1 cup of fractionated coconut oil (the kind that is liquid).  I use Carrington Farms, which is available at Walmart.
  • 1 Tbs lemon juice (more if you like it a little more sour)
  • 1/4 tsp salt

Instructions:

  • Put everything in the jar.
  • Get the stick blender and put it in the jar, resting it on the bottom of the jar.
  • Hold on to the jar.  (<– Once I didn’t do this and the jar spun right off the counter onto the floor.  A serious waste of good ingredients).
  • Turn on the blender for 20-30 seconds, moving it up and down a little to incorporate all of the liquid into the emulsified mayo.
  • Done!  Refrigerate for up to 2 weeks.

Some info about fractionated coconut oil is here.  Apparently it is liquid at room temperature because the long-chain fatty acids are removed, along with some of the health benefits of coconut oil.  I made the mistake of trying this recipe with regular (melted) coconut oil once and found myself with an unacceptably solid final product.  The fractionated oil works well for this recipe, and still has the health benefits associated with MCT oil, without the PUFAs found in other liquid oils.

I’ve tried this recipe with other oils.  Olive oil (“extra light”) tasted good but even good olive oil is 12% PUFA.  The same is true for avocado oil, though I never tried that one.  I tried it once with regular olive oil (not the “extra light”), and it tasted way too strong.  I tried making it in a bowl once, rather than in a glass jar…it didn’t emulsify.  It needs to be in the narrower container to come together.  I already mentioned my foibles with using regular coconut oil and letting the jar spin out of control….Ok, I guess that’s it. The recipe and instructions above has never let me down.

Oh and speaking of PUFA…check this out.  Michael Eades, a long-time leader in the low-carb community seems to be turning his attention away from blaming sugar and towards the evils of PUFA.  Very interesting.  And score one for Ray Peat.

Keto – Day 25

About 3.5 weeks into a ketogenic diet and I’ve lost 0 pounds or inches.  I know what’s going on though, thanks to my handy Kentonix meter, which I got about a week ago.  Indeed my problem with low carb in the past (and the present) has been eating too much meat (protein), not enough fat.  It’s been extremely hard for me to eat 70%+ of calories from fat because it leaves me hungry.  Why is that?  Because my insulin is perpetually too high.  Becoming fat adapted – burning fat for fuel instead of glucose – is not something that happens overnight. About a week ago I dropped dairy again, since that seemed to work some magic last time around.  Since then my hunger has dropped off a little but I’m still nowhere near being able to fast more than 12 hours or so.

A few days ago I got a fasting insulin level to see exactly what it looks like after 3 weeks of no starch or sugar.  It was 20.7 (range 2.6-24.9).  That’s after 3 weeks of very low carb living.  So I added exercise this week – HIIT, specifically – based on the this study and others that indicate quick bursts of intense exercise can help lower insulin.  I think by eating 200-300 grams of carbohydrate a day for 4 months from September through December of last year I managed to raise my base insulin level so high that now it’s going to take time and intention to bring it down.  I wish I would have tested before starting low carb, but I didn’t.

In any case, I’m sticking with this because I feel so much better throughout the day now and my sleep is so much better.  When I eat too much meat the Ketonix lets me know I’m no longer producing ketones…so my diet is a lot of avocados, homemade mayo, spinach and kale for calcium and other nutrients, eggs, coconut oil, and some meat.  My hunger is dropping gradually.  This will be a slow and steady process.

Keto – 2 weeks in

I started eating a LCHF diet 2 weeks ago.  I’m down only a couple pounds, which doesn’t surprise me really.  I’ve learned that for me it takes a little while for my insulin to drop enough to utilize body fat for fuel…at least, that’s what I suspect is going on.  Last time I kicked the carbs out of my life it took about 2 weeks to see anything measurable on the scale.  The scale is so passe anyway…all the cool kids are doing circumference measurements anyway.

Other than weight, I feel so much better now that I’m not eating stuff that feeds my endotoxin-prone gut.  Mood is better, energy is better, everything is better.  It’s easy to accidentally trigger that though – a raw salad or other gut-irritating foods and I’m right back there again, irritable and tired.   (Tried that yesterday so it’s fresh in my mind).   Generally things are going well.

I mentioned the metformin I started taking a few weeks ago is causing hormonal changes, as evidenced by the disappearance of my hot flashes a few days after starting it.  I guess that’s why it’s prescribed to treat PCOS.  I can’t tell what hormone changes exactly, but it’s making my breasts sore and bigger.  They didn’t need any help in that area, and I wish they would stop it.  I’m considering stopping the Metformin if this doesn’t go away.  I googled it and I’m not the only one with this symptom.  Apparently it’s not an increase in estrogen, or I would expect there to be a correlation with breast cancer in the literature…and there doesn’t seem to be.  The opposite, actually…Metformin may have an ant-cancer effect.  So maybe it increases progesterone or behaves like progesterone in the body?

Dunno.  Research for another day.

Insulin

Well, I fucked up.

Last year when I was eating low carb, I was doing it all wrong.  I think I was scared of all macronutrients except protein, and instead of following a diet plan that was ketogenic – allowing for the production of ketones to provide fuel to the body – I was following some random Atkins-esque plan.  I was losing weight (at first) so it seemed like the right thing to do, but when my weight loss stopped and my labs looked terrible and I started feeling tired and bored with my meat-and-vegetable diet I gave up.  I now realize that my focus was misguided.  I was targeting carbohydrates (keeping them low) when I should have been targeting insulin.

Thanks to my brilliant commenters I now realize that diet was actually fairly insulinogenic, and with all that insulin it’s impossible to use body fat for fuel.  I lost 15-20 pounds eating that way, which probably represented a reduction in my previous Peat-inspired insulin level of 27.9 two years ago.  I wonder if this is why people stall on low-carb diets…they manage to reduce their insulin level enough with their meat-and-veggies-only diet, but because the meat is actually insulinogenic the weight stops at the point that the insulin stops dropping.  So Atkins had it right up to a point…and for some people that’s enough.  Their insulin isn’t so chronically high, or their body isn’t so quick to toss insulin all over the place, and just cutting the carbs is enough to drop insulin low enough that their body can release stored fat for fuel.  I’m not one of those people.

For years I’ve had to be very careful of what I eat because everything seems to make me desperately hungry.  Coffee, rice, gigantic salads containing many ounces of skinless chicken – always with the ravenous hunger 1-2 hours later. 10 years ago I could eat a “low carb diet” of meat, eggs, and veggies and never feel hungry.  Now my blood sugar is much less stable than that, probably because insulin resistance has advanced and therefore insulin output has increased. When I was eating meat/eggs/veggies for 6-8 months last year I would have what seemed like a giant breakfast of steak and eggs – seriously, like 800-1000 calories, and I would be hungry 2 hours later.  I figured I was just broken and kept eating more and more to make the hunger go away.

When I originally started with Nourish Balance Thrive I met with their diet specialist, Julie, and she recommended a paleo diet that was 60-65% fat.  I think for most people that would probably work well.  I eliminated all starch and sugar from my diet and figured I was probably in the ballpark as long as I was eating fatty meats.  I really should have Cronometered it, because looking back I was probably getting only about 50% of my calories from fat…and that was not enough.  So I was putting myself in a state where I had no carbohydrates for quick energy and no ketones due to high insulin.  It’s really no wonder I stayed hungry, weight loss stopped, and I got tired. It seems the goal shouldn’t be low blood sugar – it should be low insulin, as discussed by Dr. Fung in Christopher Kelly’s podcast and Woo all over her blog (though, ironically the latter considers the former to be a menace who must be stopped).

So I’ve been learning over the last couple of days about insulin – how to lower it, how to keep it low, and how to fuel the body while doing that.  My goals, of course, are to lose body fat and improve metabolic markers (reduce blood sugar, cholesterol, triglycerides, blood pressure) while not starving and being irritable all the time.  I came across the Optimising Nutrition blog discussing an “insulin index” – much more useful to me than a “glycemic index” since my goal is shifting from low blood sugar to low insulin.  Contrary to my previous belief, carbohydrate density and insulin demand are not perfectly correlated.

The author states:

“The chart below [see it here] shows the relationship between the glycemic load and insulin index from the testing undertaken in healthy people.  Reducing the glycemic load does not guarantee a low insulin response, particularly when it comes to high protein foods.”

This graph, which is based on the data in this thesis: Clinical Application of the Food Insulin Index to Diabetes Mellitus (Kirstine Bell, September 2014 indicates that raisins create about as much insulin as cheddar cheese.

I know, right?

Click here and scroll down for a chart of Least Insulinogenic Foods along with their Food Insulin Index.  Suddenly my seemingly-random and incredibly-annoying hunger makes so much sense.   I was eating too much meat, and my insulin was too high.

So for the last 3-4 days I’ve been following these charts and eating things that are much less insulinogenic.  The steps I’ve taken:

  • Eliminated all dense forms of carbohydrate again (rice, sugar in all forms, etc) limiting carbohydrate intake to just vegetables
  • Drastically reduced meat intake to probably 4 ounces per day
  • Eliminated egg whites
  • Added high fat dairy including cream cheese, sour cream and mozzarella cheese (no milk), as well as olives, homemade low-PUFA mayonnaise, and raw macadamia nuts

The results so far: hunger has dropped about 80% and when it’s there it’s not the gnawing painful type. Irritability and fatigue are gone, unless I accidentally eat too much protein.  I learned today that egg yolks (not just the whites) contain a certain amount of protein and 3 of them – even without the whites – is really too much.  I’m still working out the details, but Cronometer tells me that even a seemingly high ratio of fat to protein+carb is not high enough to avoid the irritability and hunger that suggest too much insulin was generated.  For example, this morning breakfast was 3 egg yolks cooked in coconut oil with half of an avocado.  Here’s the macronutrient breakdown of this meal:

fat

So this meal had a ratio of about 2.6/1 fat to carb+protein.  About 90 minutes later I had that familiar hunger/irritability.  So I’ll be looking for more of a 3/1 or 4/1 ratio which translates to about 75-80% of calories from fat.  I ate a couple ounces of macadamia nuts and felt much better.

Further experiments to follow.

I feel really happy.  My mood has improved 100% since giving up the carbs again, and it happened on day 1.  This is probably related to discontinuing the eating of foods that cause endotoxin.  I hope I’m on the right track now.

A side note – taking the Metformin is going well.  My hot flashes went away a few days after I started taking it.  Things are looking up.

What Now?

I don’t know.

I started taking Metformin a week ago, and this time around I don’t feel terrible.  I do feel like there’s been some change in sodium balance or something – I feel like I’m retaining water or something and the scale is up a couple of pounds.  I’ve regained almost all of the weight I lost a year ago.  Again my clothes don’t fit and I feel fat.

Exercise has been a bust.  I haven’t been able to commit to using my lunch hour for working out.  It required giving up the only down time I have some days, and it was making me hungrier (if that’s possible).  I’m sure there’s a way to incorporate exercise but right now I just feel overwhelmed.  I started meditating and stopped that too.  I also started a gratitude journal…and stopped it.  I am having trouble feeling rested and my energy is really inconsistent.  Some days I can do it.  Other days – like, all of last week – I feel like I can’t. Last week I was experimenting with eating low carb during the day and then eating rice or sweet potatoes with dinner.  I guess not a good plan.  All of the hunger of a carb-rich diet and none of the energy.

Suggestions have been made to do a ketogenic diet for a week and then do intermittent fasting after that.  Yeah, maybe.  When I was doing low carb last year I was eating too much meat….so maybe it wasn’t ketogenic.  Maybe I should try a fat-tastic diet.  I did this once before without success but I might be up for trying it again.  Peat friends, I already know what you’re going to say.  I really do.  My answer to you is this: My labs suck either way, and my perpetual hunger has got to be stopped.  So it’s a maybe.

Edited to add – Hey, I just had a profound insight about my marriage.  When you really love someone you don’t abandon them.  All the negotiation, confusion, upset…it’s all just drama.  He’s just not that into me.  I never thought I’d have to say that about my husband, but there it is.  If he was, he’d do what it takes to stick around.  Ok then.