For today’s edition of Dear Mark, I’m answering three questions taken from last week’s post on the power of pairing low-carb with fasting. First, do I have any advice for a woman who’s struggling to see results eating one meal a day? Second, how does low-carb interact with the different types of glucose tests you can take? And third, what are my thoughts on carb limits when fasting? Is lower always better? Is there a carb threshold after which fasting stops working so well?

Let’s go:

I have been dappling in low carb for nearly year and in the last 2-3 months I have been playing around with OMAD. My question is, I eat ’till I’m full ,which is about 12-18 grams of carbs, never over 100g protein and around 100g fat, sitting at 1000-1400 calories—but I’m not losing weight. Over 3 months I’ve lost about 6kg and I have about 30kg to lose. Do I keep going? I’m enjoying it but I get frustrated about the lack of weight loss (I’ve lost a dress size).

The majority of women don’t do well on one meal a day. Consider the average office worker struggling to lose weight. They do coffee for breakfast and maybe have a salad with no meat (and few calories) for lunch, struggle mightily not to eat five stale donuts at 3p.m. in the break room, only to cave at night and eat a sack of potato chips and take out while streaming some show.

My point is not that these people would do better if only they ate a solid meal for dinner rather than chips and snacks and Netflix. Nor is it that this problem only afflicts women and never men. Plenty of men do it, too, and have bad results. But it shows more quickly in women, who by nature of their reproductive physiology are simply more vulnerable to nutritional insults than men—on average. I explain the reasons this happens in this post on fasting for women. Long story short, because reproduction is far more costly and demanding on a woman’s body than a man’s (conception, pregnancy, nursing); woman are more finely attuned to caloric restriction and fasting. My point is that fasting for most of the day, every day, doesn’t work well for most women—it becomes a constant stressor, driving unhealthy cravings to which you eventually succumb.

It sounds like OMAD might not be working for you. Just one dress size (which is a better barometer than weight) in 3 months? Yeah, it might be time to try something else.

Was low carb with more frequent meals working?

I’ve seen a lot of men burn out on OMAD, too. Throw in some sleep disturbances, a heavy training schedule, work-related stress, cooking for the family, bills, and whatever other stressors modern life throws our way, and OMAD can be counterproductive.

For one thing, your calorie intake is way too low. One thousand calories is way too low; 1400 calories is really pushing it. Perpetually starving yourself for 22 hours a day and then trying to cram a big meal in that doesn’t even provide enough calories or nutrients just doesn’t work for most people. I can imagine your leptin is low, your caloric expenditure dampened, your thyroid function inhibited.

Here’s what you might try.

Do OMAD with 1000-1400 calories once a week. Twice max. Eat normal—two to three meals—the rest of the days. This way you pulse your fasting and OMAD’ing. You eat normal amounts of calories for five days a week and then drop them down low twice a week, giving your body a message of relative abundance punctuated with short bouts of scarcity.

I think that’ll work better for you. Write back with your results.

If you are low carb and need to do a glucose blood test and an A1C test: What is the best fasting times then? Just the night before or for 24 hours?

If you fast longer, shouldn’t the glucose reading be lower?

It really depends on what kind of test you take.

If you’re doing a fasting blood glucose test, fasting will probably lower it.

If you’re doing a postprandial blood glucose test, fasting will probably raise it. You’re asking your body to suddenly go from burning fat to processing 75 grams of pure glucose. The fat-based metabolism triggers transient insulin resistance, which inhibits your ability to process the glucose efficiently. Your postprandial reading will thus be higher than is “real.”

If you’re doing an HbA1c test, fasting won’t affect it. HbA1c is the “average” blood sugar over three months or so; a single meal will have no impact.

I totally agree with the science of this relationship. Mark, at what intake level of carbs are you considering this relationship no longer synergistic? Anything over 100 grams or should the carb intake be kept lower to have the greatest fat-burning / weight-loss effect?

The bulk of the synergy lies in the ease with which you can maintain the fast. Low-carb/fat-based metabolisms simply make it easier to slip into and remain in the fat-based metabolism of the fasting state. If you can easily fast, easily slip back into ketosis and maintain the fast while eating an otherwise moderate or high-carb diet, have at it. That isn’t as common as the opposite, drawing on my experience talking to hundreds of people about this.

However, some people get the best weight-loss effect by combining intermittent fasting, heavy weight training, and periodic/timed carb feeds. The trick is to time your carbs around your workouts, and eat no more than you’ve actually expended through glycogen depletion. That means you’re still in a fat-based metabolism because the carbs you do eat are going toward glycogen repletion rather than being burned for energy, so they never actually inhibit the burning of body fat.

If you’re doing CrossFit WODs that hit every muscle and leave you panting on the ground (or the equivalent), you could probably get away with 100-200 grams right after without any issues. It really depends, of course. More muscle, larger glycogen sinks. Some people just slip right back into ketosis more easily. Others have a life history that may inhibit this. But that 100-ish carbs after a “hard” training session that you feel should be a good target for most people.

You should keep fat low and protein high in these carb-heavy meals. What you want is to refill that glycogen and hit the protein hard.

That’s it for today, folks. Take care. Be sure to ask any followups or additional questions down below. Thanks for reading!

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The post Dear Mark: OMAD for Women, Low-Carb Glucose Testing, and Carb Limit When Fasting appeared first on Mark’s Daily Apple.

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keto pills inlineThere are a dizzying number of keto pills on the market now. They promise easy weight loss, increased energy, and the benefits of ketosis without the pesky following-a-strict-diet part.

As savvy MDA readers, you know that optimal health never comes in a bottle. You also know that I’m a proponent of wise supplementation to support a Primal diet and lifestyle when appropriate. I’ve said before that I think exogenous ketones can be useful in specific circumstances, though they’re never necessary for success.

The question at hand is whether keto pills are likely to offer any benefit or if they’re a waste of money. I focused on pills that seem to be popular on Google searches and Amazon—ones with names like Ultra Fast Keto Boost, Super Fast Keto Boost, Keto Burn Xtreme, Instant Keto, and Keto Slim Rx. (My Amazon search history is shot now. This is the sacrifice I make for my readers.)

First Impressions: Are Keto Pills a Scam?

My first impressions weren’t positive—let’s just say that. 

These products are being sold as diet or weight management pills. Their descriptions strongly imply, or sometimes state outright, that the pills will help you lose weight and “enjoy a slim and fit physique.” Most of the claims center on the general promise that being in ketosis causes you to burn fat and, by extension, lose weight (it doesn’t necessarily), and that their products will help keep you in ketosis (a claim I’ll investigate below).

The biggest red flag was when I noticed how many Amazon customers were trying to find the keto pill featured on the TV show Shark Tank. This was news to me, so I did some digging. Apparently there was a popular scam a while back wherein sellers claimed that their keto pills appeared on Shark Tank, and the sharks went wild for them. You didn’t miss anything. This never happened.

Only one product that I looked at—Keto Burn Xtreme sold by Advanced Life Science—still had that on their Amazon page as of December, 2019. It seems like some of the other products might have been falsely advertising this in the past based on older reviews and questions, though.

So it wasn’t looking good off the bat, but I’m an open-minded guy. Bad marketing doesn’t necessarily mean an ineffective product. Sure, the Amazon reviews for these pills are pretty negative overall, but maybe people just aren’t giving them a fair chance? Some folks like them, after all. Let’s try to be objective here.

Do These Keto Pills Contain Ketone Bodies?

Assuming you can trust the labels: Yes. 

Exogenous ketones come in two forms: ketone salts and ketone esters. Ketone salts in commercial products are the ketone body beta-hydroxybutyrate (BHB) bound to a salt. Ketone esters are ketone bodies bound to alcohol.

All the keto pills contain ketone salts because they are easier and less expensive to manufacture than esters. On the label they’ll list BHB bound to minerals, such as “calcium beta-hydroxybutyrate” and “magnesium beta-hydroxybutyrate.”

Do the Pills Contain Enough BHB to Be Effective?

Short answer: No, not likely. 

A keto pill might “work” because it successfully raises blood ketone levels or because it brings about a desired outcome such as weight loss or improved athletic performance. In any case, keto pills are unlikely to hit the mark, but I’ll get to that.

Both ketone salts and esters raise blood ketone levels, but esters are considerably more effective. In laboratory studies, even large doses of ketone salts usually yield blood ketone levels to between 0.5 and 1.0 mmol/L. That’s enough to qualify as being in ketosis, but it’s not a knock-your-socks-off result by any means. It’s what you’d expected from following a standard keto diet. Still, plenty of people notice that they have more energy and decreased appetite in this range.

It’s probably not enough to profoundly affect certain health markers or athletic performance. For example, a panel of respected exogenous ketone researchers agreed that blood ketone concentrations in excess of 2.0 mmol/L are needed to boost athletic performance. Ketone esters can get you there, which is why most studies demonstrating the efficacy of exogenous ketones use esters. Studies using ketone salts yield decidedly more mixed results.

How Much BHB Salt Is Needed to Be Effective?

There is no agreed upon minimally effective dose for BHB salt. However, let’s use some laboratory studies as a reference point:

  • In this paper, Study 1, participants received about 24 grams of BHB, and their average blood ketone levels peaked at 1.0 mmol/L.
  • In this study, researchers gave participants 11.7 grams of BHB prior to exercise and then a second dose 45 minutes later during exercise. Blood ketones averaged 0.6 ± 0.3 mmol/L.
  • These researchers gave participants two doses of 18.5 grams BHB, which they noted was 60% more than the standard dose recommended by the manufacturer, prior to exercise. Blood ketones measured 0.33 ± 0.16 mmol/L prior to exercise and 0.44 ± 0.15 mmol/L at the end of exercise about an hour later.
  • Finally, these participants ingested 0.3g/kg of BHB, which would be about 24 grams for a 175-pound individual. Blood ketone levels peaked below 1.0 mmol/L.

How Do Keto Pills Measure Up?

Answer: Badly

Of the keto pills I looked at, the highest dose of BHB I saw per serving was 1000 mg, or 1 gram, in Ultra Fast Keto Boost Pro.

It turns out that many of the products contain the same BHB product, goBHB®. For example, Ultra Fast Keto Boost, Insta Keto, Keto Burn Xtreme, and Keto Slim Rx* sold on Amazon by nutra4health LLC are all the same goBHB blend at different price points ($19.95 – $39.95 for 30 servings). Super Fast Keto Boost and Ultra Fast Keto Boost—same thing. Per serving, goBHB contains 800 mg of BHB.

(*This is not to be confused with the other Keto Slim Rx product on Amazon that doesn’t disclose its ingredients but does promise you can “achieve your dream body” and “skyrocket your ketosis!!”)

Many pills contain even less than that. Pure Keto Boost and Instant Pure Keto list 800 mg of another blend that includes BHB salts plus other ingredients, so less total BHB. Others I checked out contained 700 mg or less.

I’m extremely dubious that 800 or even 1000 mg would meaningfully boost blood ketone levels. This is a mere fraction of the dose used in research. If the researchers could give 1 gram of BHB instead of 12 grams or more and still get a measurable effect, they would. Plus, reputable brands of exogenous ketones such as Perfect Keto and KetoCaNa offer 11.4 and 11.7 grams of BHB per serving, respectively.

Finally, it’s worth mentioning that none of the Amazon reviews I read for any of these products mentioned that the reviewer had tested their blood ketones and saw a rise after taking the pills. (And I read a lot of reviews. Too many.)

Can Ketone Pills Make You Lose Weight?

Answer: No.

These pills claim that they’ll put you in ketosis, which will melt away body fat. Unfortunately, being in ketosis does not guarantee that you’ll burn body fat. You lose weight on a keto diet they same way you do on any other diet: by expending more energy than you ingest.

That said, it’s fair to say that ketosis is an advantaged state for weight loss. Ketones both suppress appetite and increase energy, meaning it’s easier to eat less and move more when in ketosis. Ketones are also anti-inflammatory and they improve blood glucose regulation. These both contribute to having a healthier metabolism so you trend toward your ideal body weight with less resistance.

If these pills actually support ketosis, which I doubt, their main benefit would probably be appetite suppression, not increased fat burning per se, as they imply. Anyway, the sellers frequently state that these should be used in conjunction with a low-carb or keto lifestyle to be beneficial. Thus, even if someone loses weight while taking them, it would be impossible to attribute it to the pills directly.

The Verdict

It’s obvious what I think: Save your money.

If you want to be in ketosis, drop your carbs, play around with intermittent fasting, or just go do a hard workout and wait to eat until W.H.E.N. (when hunger ensues naturally).

 

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The post Keto Pills: Why I’m Highly Skeptical appeared first on Mark’s Daily Apple.

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Say you set a goal this year to get healthy — for all the right reasons. You are determined to do it for you, out of nothing but self-love. Because you know all about diet culture. And restriction. And the all-or-nothing trap. Yes! This time it’s going to be different! And, we — as advocates of an anti-diet life — are proud of you. SO, so, proud. We are cheering you on, like whoa. However, we gotta give you the heads up that this isn’t always a clear path — it can be messy and complicated. And, it can be…

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Did you decide to go all in and ditch the dieting, restriction, and overall diet culture mindset this year? Hey, us, too. via GIPHY And to keep you well read (and fed!) on your journey, here are our favorite anti-diet posts to help you get your unconditional self-love on. via GIPHY 1. What You Need to  Know About Diet Culture 2. Why Diet Culture Is Full of You-Know-What 3. How to Stop Moralizing Food 4. 13 Signs You’re Dieting Without Even Realizing It 5. 25 Pieces of Weight-Loss Advice You’ve Never Heard Before (It’s not what you think …) 6.…

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