## Slower But Fitter?

An interesting study put a group of endurance athletes on a Ketogenic diet and measured their performance as well as body composition changes (Zinn C, Wood M, Williden M, Chatterton S, Maunder E. Ketogenic diet benefits body composition and well-being but not performance in a pilot case study of New Zealand endurance athletes. J Int Soc Sports Nutr. 2017 Jul 12;14:22.). The study concluded:

All athletes increased their ability to utilise fat as a fuel source, including at higher exercise intensities.

Mean body weight was reduced by 4 kg ± SD 3.1 (p = 0.046; effect size (ES):0.62), and sum of 8 skinfolds by 25.9 mm ± SD 6.9; ES: 1.27; p = 0.001).

But how was their performance?

Mean time to exhaustion dropped by ~2 min (±SD 0.7; p = 0.004; ES: 0.53). Other performance outcomes showed mean reductions, with some increases or unchanged results in two individuals (VO2 Max: -1.69 ml.kg.min ± SD 3.4 (p = 0.63); peak power: -18 W ± SD 16.4 (p = 0.07), and VT2: -6 W ± SD 44.5 (p = 0.77).

Athletes reported experiencing reduced energy levels initially, followed by a return of high levels thereafter, especially during exercise, but an inability to easily undertake high intense bouts. Each athlete reported experiencing enhanced well-being, included improved recovery, improvements in skin conditions and reduced inflammation.

In the end the athletes likes the health benefits even with the performance losses.

## How much fat was I burning?

It took some maths for me to figure out my own fat oxidation rate from my VO2max testing. Here’s the math (REE from VO2max).

At one point I got over 1.2 g/min of fat oxidation. Not bad considering that high numbers are often 1.6 g/min sort of numbers. Here’s the classical curve – an inverted parabola – of heart rate (x-axis) vs fat oxidation in g/min (y-axis).

The R^2 is 0.87 which is a pretty decent fit.

My sweet spot for maximum fat burning is about 120 bpm. My MAF range is 112-122 which nicely straddles this sweet spot of fat burning found during VO2max testing.

If you do the same maths on VO2max data you can find your sweet spot. But it won’t work well for fat burning if you are not fat adapted already. Or just use the MAF 180 formula.

## Exogenous Ketone Experiment Results

I finished off the jar of exogenous ketones that I bought and recorded my own experiences.

## Effects on Weight

Here’s my weight on the day taken in the morning before and the morning of the day after I took the PerfectKeto Exogenous Ketones.

 Date Wt before Wt after Wt Change Calories 5/10/2018 167.95 169.35 1.4 2219 5/11/2018 169.35 170.5 1.15 2243 5/16/2018 165.69 166.1 0.41 2221 5/17/2018 166.1 167.05 0.95 2153 5/21/2018 162.59 164.71 2.12 2504 5/22/2018 164.71 166.51 1.8 2317 Average 1.31 2276 Std Dev. 0.6 112.7

Why Weight Gain?

In my n=1, there was a consistent weight gain (1.3 +/- 0.6 lbs) the day after I took the exogenous ketone supplement. So if you are already on a ketogenic diet and are expecting exogenous ketones to help you lose weight you could be really surprised and disappointed. I wasn’t disappointed – I did this experiment since my body weight is fairly stable and I am not concerned about gaining a lb or two.

The question is especially pertinent since higher ketone levels are usually indicative of fat burning and weight loss. There’s some belief that exogenous ketones cause your own body to reduce its generation of ketones. I can’t say whether or not I would have lost weight on those days but I can say that there was a strong correlation to weight gain on the days I supplemented with the product.

It wasn’t extra calories consumed on those that caused the weight gain. My average calorie count is right in line with my maintenance calories. At the very least there was nothing in the food consumed that day that would come anywhere near a 1.3 lb weight gain.

Also, there’s only 15 calories in each product serving so there weren’t enough calories in the supplement itself to cause such a consistent and significant day-to-day weight gain.

The ingredients list might be a clue. Magnesium, Potassium, Cocoa, Stevia leaf, Vitamin C.

They don’t list Sodium as an ingredient although some exogenous ketones include Sodium. If there was Sodium then that could be the reason for the temporary weight gain. But the binding salt could be the Magnesium or Potassium. There’s no reason to think that Potassium alone should cause temporary weight gain. I wonder if there is Sodium? That could provide the most plausible explanation for the temporary weight increase. The Perfect Keto site states:

Ketone salts are formed when the ketones are bound to a salt, typically sodium or calcium, potassium, or magnesium, to improve absorption rate.

This site (BHB Salts) states:

The “BHB salt” is simply a compound that consists of sodium (Na+), potassium (K+), and the ketone body β-hydroxybutyrate.

The weight gains were temporary and quickly reversed in the days after I discontinued the product.

Rat studies showed rats gained less weight than controls when were fed ketone supplements (Shannon L. Kesl, Angela M. Poff, Nathan P. Ward, Tina N. Fiorelli, Csilla Ari, Ashley J. Van Putten, Jacob W. Sherwood, Patrick Arnold, and Dominic P. D’Agostino. Effects of exogenous ketone supplementation on blood ketone, glucose, triglyceride, and lipoprotein levels in Sprague–Dawley rats. Nutr Metab (Lond). 2016; 13: 9.).

## Cost

The Keto Base Chocolate Sea Salt product costs \$59 for 15 servings. That’s pretty expensive. That’s about \$4 a serving which seems like a lot compared to my other supplement costs.

## Mood Changes?

I think I saw a very small mood improvement but I really can’t quantify this. It may have had more to do with having more water from salt?

I did notice I developed a tiny bit of an addiction to the product. Perhaps it was just the chocolate salt mix taste that I was looking forward to. It wasn’t hard to stop so the addiction wasn’t that strong and the \$4 a serving made it easier (that’s about the amount of money I spend each day on food anyway).

## Performance Increases?

I didn’t perform any particular exercise benchmarks to determine if I had any performance increases. I also took the supplement early in the morning in my first coffee so I wasn’t exercising around the time. I also don’t know if it would have any time effect with respect to exercise.

I can imagine a potential use of exogenous ketones in people who are just transitioning into the ketogenic diet. It could allow them to make the transition easier and may ease the keto flu. It would be interesting to see if it has any better effects than electrolyte supplementation – which is a lot cheaper.

However, this is an application that I can imagine few taking due to the cost. People “try” diets and starting this diet with a \$60 product might be too much for most people to swallow (pun intended).

## Body Recomposition Series

My Body Recomposition series is on my Low Carb Studies BLOG.

In the series I set a number of goals for my body composition and means to achieve the goals. Looking back I did really well at hitting what were very aggressive goals.

1. Improve HbA1C number (HbA1C is a lab test which shows the Blood Sugar over the previous three months)
Goal: < 5.6 (Below bottom of Pre-Diabetic levels)
I achieved 5.2 which is non-diabetic.
2. Lose weight to reach 15% Body Fat (Visualize Body Fat percentages)
I ended up at 7.5% body fat per Bod Pod.
3. Barring any injury, be able to do exercise throughout entire test (CrossFit)
Submaximally is OK (<85% of max level)
I did this goal through June 2018 but was not able to exercise at a low enough level due to the competitive nature of Crossfit.
4. Conserve current LBM (Lose Weight but not muscle)
Bod Pod shows I did gain LBM over that period.
5. Maintain current metabolic levels.
The same thing as saying not to eat at a net calorie deficit.
I think the goal was correct (my TDEE is equal to my pre-diet TDEE due to higher exercise energy expenditure). But I had to have been at a significant caloric deficit because I lost quite a bit more weight.

## Thoughts on Exercise from Aug 2017

I’ve edited the following since I’ve learned a lot about exercise since I originally wrote the post (August 2017).

# My Original Goal

At the start of this experience my goal was to Hack My Type Two Diabetes. Per my MD, I am no longer a diabetic and am just at the bottom end of the Pre-Diabetes range. So mission accomplished???

[2018-06-29 update – My last HbA1C was 5.2 which is no longer even pre-diabetic but right in the middle of the “normal blood sugar range.]

# Are We There Yet?

My initial theory was that Diabetes is just a symptom of the underlying condition which is Insulin Resistance. Eating Low Carb. Moderate Protein and High Healthy Fats reduces the need for the body to produce Insulin but does it cure Insulin Resistance itself?

[2018-06-29 update -There is a need to differentiate between insulin resistance due to diabetes and peripheral insulin resistance due to a low carb diet. An Oral Glucose Tolerance Test (OGTT) may or may not be able to distinguish the two. Some people say it takes a time of reintroducing carbs before taking an OGTT.]

## What is Insulin Resistance?

Insulin Resistance is the inability of the body’s cells to take in glucose in the presence of Insulin. From Skeletal Muscle Insulin Resistance Is the Primary Defect in Type 2 Diabetes.

Under euglycemic hyperinsulinemic conditions, ∼80% of glucose uptake occurs in skeletal muscle

If your muscles are not able to efficiently take up glucose then you have Insulin Resistance. It may be that exercise is the only way to improve glucose uptake in the muscles.

[2018-06-29 update -I believe that still to be the case but with the added thought that a low carbohydrate diet causes peripheral insulin resistance. Your muscles resist the action of glucose in a state where Insulin is low so that the glucose can be conserved (some say spared) for the essential parts of the body (brain, etc) that require glucose).]

# Types of Exercise

When it comes to improving Insulin Resistance, I think there may be a difference between the sorts of exercise, ie, aerobic and anaerobic exercise. Repeatedly dumping all of the glucose out of the cells is part of what is needed to increase insulin sensitivity. That seems like where High Intensity exercise comes into play. Things like rapid reps of high weights vs walking on a treadmill.
[2018-06-29 update -Change this from “may be a difference” to “is a difference”. A year of CrossFit showed me the difference. I will write a post on it – or a hundred posts on it.]

## My Experience with Exercise

This would bear out with my own experience of the quick dump of glucose that I experienced in the high intensity workout. My glucose went up at least 80 points which I now think is due to Insulin Resistance.

[2018-06-29 update -It was almost certainly peripheral insulin resistance plus workouts at high intensities mobilize a whole lot of carbohdyrates – perhaps as much as 60g/hr. That’s a whole lot of sugar dumped into the blood stream. And my body doesn’t do all that well with that much sugar. Although I will say it got better with time. Until I quite Crossfit that is.]

Not only is the liver dumping in that case but the muscles are dumping too. And that’s a good thing.

[2018-06-29 update -Turned out that the muscles don’t dump into the bloodstream. Only the liver does that. Learning more every day about this.]

So perhaps if I got this right it’s more about the type of exercise when attempting to improve the underlying Insulin Resistance than it is about the exercise itself. Is it true to say the reason my blood sugar rises so high with high intensity exercise is that my muscle cells are still Insulin Resistant and that with more exercise they will get better at responding to the Insulin they are given and then I will not see high blood sugar spikes during and immediately after exercise?

If I have this right I should easy be able to measure and observe progress by checking my blood sugars after exercise to exhaustion and the levels should drop.

I wish I had done those measurements more often and recorded the data.

Here’s a pretty good 2014 article on the subject. [2018-06-29 update – The article did not deal with the blood sugar of diabetics. I wish I had bothered to think more about this but was happy enough with my HbA1C numbers that I didn’t care.]

## So why LCHF and Fasting?

Using LCHF + Fasting has helped me get to a weight where my pulse rate is lower, the stress on my joints is lower, my BP is lower and I am now at the point where I can safely exercise. Surely my Insulin Resistance is somewhat better but the only real way to attack it that is left is with high intensity exercise.
[2018-06-29 update – That’s when I took up Crossfit which I did for almost a year.]

## Diet Plus Exercise Equals Diet

The common mantra is “get more exercise”. My question is whether or not exercise helps in weight loss and if so, how much?

Turns out exercise doesn’t help all that much in weight loss.  This study looked at just how much exercise helped in weight loss (Christiansen T1, Paulsen SK, Bruun JM, Pedersen SB, Richelsen B. Exercise training versus diet-induced weight-loss on metabolic risk factors and inflammatory markers in obese subjects: a 12-week randomized intervention study. Am J Physiol Endocrinol Metab. 2010 Apr;298(4).)

The study was 12 weeks long and looked at the effects of diet alone, exercise and diet, and exercise alone. Seventy-nine obese subjects were recruited for the study. They were fed a very low calorie diet and the exercise cohorts were given aerobic exercise three times a week for 60-90 minutes.

Weight loss was virtually identical in the diet only and the diet plus exercise groups. The exercise only group lost significantly less weight.

The key item to note is that both diet and exercise and diet alone both reduced the metabolic syndrome (Insulin Resistance) significantly.

After the intervention, a significant decrease in the number of subjects with the metabolic syndrome was observed in both the DIO group and the DEX group (both P < 0.05; Table 2).

In fact, the Glucose level and Insulin Resistance was more improved in the diet only (DIO) group than in the diet plus exercise (DEX) group.

So you might want to consider the advantages of Diet Only although it looks as if Diet plus Exercise won’t hurt your numbers too badly.

To be fair the exercise groups did have a positive benefit to their health:

Subjects in the EXO and DEX groups increased their VO2max
with 18 and 14%.

A good article (Julia Belluz and Javier Zarracina. Why you shouldn’t exercise to lose weight, explained with 60+ studies. Vox, Updated Oct 31, 2017.).