September 1, 2019

Weekly Emails

Can you maintain muscle during fasting?

But in the short-term (at least up to a week for most people), I believe you can maintain muscle mass while fasting, particularly if you’re resistance training.

Read Time 3 minutes

In last week’s email, I discussed a study, “Effects of testosterone supplementation on body composition and lower-body muscle function during severe exercise- and diet-induced energy deficit: A proof-of-concept, single centre, randomised, double-blind, controlled trial,” in which a severe energy deficit resulted in losses of fat mass (FM) alongside gains & maintenance of lean body mass (LBM) in the testosterone and placebo groups, respectively.

If you recall from last week, these young men were prescribed daily exercise to the tune of > 1,500 kcal expended, and were instructed to slightly restrict the number of kcal/d compared to how much they were eating at a weight-stable baseline. On average, participants were facing an estimated daily energy deficit of over 2,000 kcal/d.

So these guys were in an “energy deficit” and yet many of them maintained (or even gained) LBM. One of the questions I posed in my previous email and want to address in this one: what happens to LBM during a water-only fast? In particular, what happens to skeletal muscle mass? Can you maintain muscle while fasting?

We know that if skeletal muscle mass is maintained, muscle protein synthesis (MPS) and muscle protein breakdown (MPB) are balanced overall. So, what are the ways in which you can boost MPS and/or limit MPB?

Eating a meal that contains protein with high quantities of all of the essential amino acids, leucine in particular, is a great way to stimulate MPS (and reduce MPB). If you’re fasting, this important contributor of MPS, and attenuator of MPB, appears to be out of play.

Another way to stimulate MPS is by exercising (resistance training in particular, but also aerobic exercise, perhaps to a lesser degree). However, this also stimulates MPB. If that’s the case, how can we build muscle if exercise both stimulates the synthesis and breakdown of protein? It turns out that exercise also sensitizes skeletal muscle to the anabolic effects of a protein-containing meal, which can result in an overall increase in MPS and LBM. But if we’re fasting, apparently there’s no protein-containing meal to be had.

Anecdotally, during my week-long water-only fasts where I engage in daily resistance exercise and 1-2 zone-2 rides, I don’t seem to lose any muscle mass. (Granted, I’m basing this off pictures and bioelectrical impedance scales for the most part, so there may be some small margin of error.) Given the apparent constraints above, how is this possible?

For one thing, fasting increases the production of ketones, beta-hydroxybutyrate (BOHB) in particular, and this may spare the body’s protein from oxidation. Infusing BOHB is associated with the maintenance and even increases in circulating branched-chain amino acids (i.e., leucine, isoleucine, and valine). Steve Phinney and Jeff Volek have pointed out that the primary driver of MPS is the availability of essential amino acids (especially leucine) and that in the keto-adapted state, blood levels of leucine increase. In other words, the keto-adapted state spares protein and preserves lean tissue. Couple this with the effects of mechanical stress (and myokine signaling, perhaps) from resistance exercise on MPS, and it could be a powerful 1-2 punch for muscle maintenance during a fast. But how can you synthesize muscle protein if you’re fasting?

During fasting, insulin and glucose plummet while counter-regulatory hormones increase (e.g., growth hormone, adrenaline), setting up a milieu that favors fat-oxidation and enhanced autophagy. While protein breakdown exceeds protein synthesis during a week-long fast, this does not necessarily mean that MPB exceeds MPS. All cells contain proteins, so when proteins are catabolized, this may be preferentially coming from skin and intestinal cells, for example, compared to muscle cells. It stands to reason that during times of famine, muscle preservation is favored over other cells that turnover more rapidly. (Jason Fung, a previous guest on The Drive, has a great post explaining muscle preservation during starvation.)

Globally, mTOR—described as the cell’s general contractor by my friend David Sabatini—is turned down during fasting. But, the mechanical stress from resistance training can turn up mTOR (mTORC1, to be more specific) locally (i.e., in muscle cells), independent of growth factors and amino acids (which are the two other well-known ways to turn up this protein complex). This may help partition some of the amino acids in the body that are broken down toward muscle, thus preserving muscle mass. I don’t think it’s out of the realm of possibility that you can “eat” a meal of protein that contains all of the essential amino acids during a fast. This may be one of the benefits of autophagy, which literally translates to “self-eating.” Your muscle cells may be dining off your skin cells, so to speak.

Obviously, the longer you fast, the more you drain your internal sources of food, and the more likely MPB will exceed MPS over time. (This may also suggest that the fatter you are to begin with, the longer you can eat yourself, and presumably maintain muscle mass for longer.) If you want to ADD muscle mass to your frame, fasting is obviously not the best strategy. Getting leucine, and all of the essential amino acids for that matter, from outside sources is a must for long-term growth and maintenance of muscle mass. But in the short-term (at least up to a week for most people), I believe you can maintain muscle mass while fasting, particularly if you’re resistance training.

– Peter

Disclaimer: This blog is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this blog or materials linked from this blog is at the user's own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.
  1. “Anecdotally, during my week-long water-only fasts where I engage in daily resistance exercise and 1-2 zone-2 rides, I don’t seem to lose any muscle mass.”

    I really want to push back on this. I’m guessing you DID in fact lose muscle mass. Let’s be honest, you could have easily lost a few pounds of muscle and not noticed as you were losing fat otherwise. To assume you must have lost 0 LBM simply because you didn’t detect it with casual observation seems a bit presumptuous. We don’t have reason to believe you lost DRAMATIC amounts of muscle- but “not dramatic” doesn’t equal “I’m guessing zero”.

    Something that stands out to me is the fact that the subjects in your study “during severe exercise- and diet-induced energy deficit” were fairly chunky lads. Both groups were over 21% bodyfat to start. There’s relatively good data very obese people are far better at metabolizing fat, to the extent LBM loss is nearly nonexistent under high protein conditions, or gains can be seen with the addition of resistance exercise. It’s not unreasonable then overweight people would still show some enhanced LBM protection, to the extent a placebo group showed only nonsignificant reductions in LBM.

    The point that I’m driving at is this- I think that preservation of LBM in already lean people under caloric deficits shifts to being an increasingly harder uphill battle that hasn’t really been examined and could have serious implications in trying to extrapolate results to “normal” or athletic lean individuals.

    One case study on the extreme end would be a case study of a competitive bodybuilder, who lost about 75% lean mass during a deficit despite lifting and taking a huge cocktail of anabolic substances https://www.mdpi.com/2411-5142/2/4/37. The fact that he started at 4.5% bodyfat really might suggest that it becomes increasingly difficult to further reduce fat mass as one becomes leaner and leaner. Sure, it’s some junky case study with skinfold calipers, but let’s be honest- if it were possible to hit low bodyfat percentages with just lifting and fasting, bodybuilders (with the help of tons of anabolics) would lose almost no lean mass getting into contest shape.

    I think keeping in mind the STARTING body fat percentages in all studies can help to contextualize these results. Whether people are giga-obese, obese, overweight, “normal”, athletic, lean, or ultra-lean may dramatically impact their LBM-preservation prospects and the precautions that needs to be taken to further reduce body fat.

    I hope we see more experiments on sub 15%BF individuals, but I don’t think the research funding is really there.

  2. If one of your purposes of fasting is to inhibit mTOR to increase cellular autophagy and if resistance training turns up mTOR, wouldn’t that suggest that you shouldn’t do resistance training while fasting?

  3. I Am a female and recently competed in two bodybuilding shows and experimented with fasting 1 day a week 20 weeks out, then increased it to 2 days a week 10 weeks out and 3 times a week 8 weeks out. I still trained pretty intensely with not much cardio and always said I would stop if it affected my strength levels. I ended up dropping 5% in bodyfat and increased LMB by 6lbs as measured by dexascan between Jan and mid May. I don’t think that approach is appropriate for everyone but I did it as an experiment on myself and to prove to others that you do not lose muscle during fasting!

    • Should I drink BCAA during my workouts or is it fine just to stick with plain water? I box, lift, and run. I typically workout twice a day. 30 minutes on my lunch hour and 1 hour in the evenings. I take 1, sometimes 2 days off from working out every week.

Leave a Reply

Facebook icon Twitter icon Instagram icon Pinterest icon Google+ icon YouTube icon LinkedIn icon Contact icon