June 18, 2013

Nutritional Biochemistry

My Quantified Self, Part I

My 2013 presentation at the Institute for Human and Machine Cognition (IHMC): An Advantaged Metabolic State: Human Performance, Resilience & Health.

Read Time 2 minutes

In 2013 I gave a presentation at the Institute for Human and Machine Cognition (IHMC) in Pensacola, Florida. Ken Ford, the CEO and Founder of IHMC, is a remarkable person and I could not wait to meet his team and see their research.  IHMC does cutting edge work, primarily for the Department of Defense (DoD). I had an exhilarating day which culminated with a presentation I gave to the team and also the public.

Want more content like this? Check out our interviews with Kristin Neff on the power of self-compassion and Esther Perel on the effects of trauma.

The talk I gave was a first timer.  (Usually the first two or three times I give a talk it’s not very good, as I need to work out some kinks.)  However, since the talk was recorded I’ll set my perfectionist tendencies aside and share it, below.   The talk is about an hour, and the Q&A session was also recorded.

A month or so before the talk, I asked Ken what he wanted me to talk about and he suggested I speak about human performance and resilience – both topics of importance for the DoD.  I don’t consider myself an expert in either of these topics, but I certainly appreciate the need to maximize, or least optimize, both.  Rather than give a highly technical talk, I chose to give a slightly technical talk that focused more on my own journey in this space and some of the experiments I’ve done on myself, specifically those around energy utilization.  This talk does not present all of the data on my self-experiments, of course, but hopefully it gives you a sense of what kind of data can be gathered for studying energy utilization.  In subsequent posts I’ll likely delve further into the data that support these findings and expand on a few of the tangents not fully explored here.  For “regular” readers of this blog, the first half of this presentation is pretty basic, but the second half should offer novel info.  For new readers, hopefully the entire talk will be informative.

For those reading via email, here is the presentation:

https://www.youtube.com/watch?v=NqwvcrA7oe8

Photo by Siyan Ren on Unsplash

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303 Comments

  1. My reponse to the TED talk that just went public (06/25/13).

    A baby step in the right direction, I guess, but he’s still speaking of fatness as an abnormality. I don’t hear anyone calling thin people abnormal because some of them get osteoperosis and because their cancer mortaility is higher than anyone else’s. Why always this focus on getting rid of the heaviest third of humanity? 80% of fat people do not now and will never have Type II diabetes. 25% of Type II diabetics are thin people. You can’t talk about fatness and diabetes as if they’re somehow interchangeable or inevitably related. I can’t give him a complete F, but this is certainly no higher than a D. The first step toward less deadly medical “care” is to first get rid of the presumption that a third of humanity shouldn’t exist. Weight falls on a bell curve like anything else. I’ve never seen any evidence anywhere that the heaviest third should be wiped from the face of the earth.

    And the questions on the TED blog about “food addiction” and “HFCS,” etc. are absolutely ridiculous. Again, the underlying assumptions need to be examined FIRST. No one anywhere has even proven that fat people eat more or differently than thinner people. The same food intake, same calories counts, result in DIFFERENT BODY WEIGHTS IN DIFFERENT PEOPLE. Before you do anything else, stop assuming fat people eat more than thinner people. Stop assuming fatness is abnormal. No one, anywhere, has proven that either of these assumptions is based on anything other than bigotry.

    • You make some excellent points, Kell, and I’d be interested to read informed opinions about them from the likes of Peter Attia and Gary Taubes. There is no doubt that the number of overweight & obese people has drastically increased over the last 40 years, which sort of “skews” the bell curve, so I honestly believe there IS an “abnormal” health response occurring in that phenomenon. But, historically, heavier people have always existed, many of whom live long and healthy lives. Why should we lump all overweight folks into the “unhealthy” category? Seriously obese people have issues of mobility and joint problems (aside from whatever problems they may or may not have related to metabolic syndrome, heart disease, etc), but to look at every individual who is 25+ pounds overweight and conclude that s/he is unhealthy is simply reductive. There is a huge amount of bigotry involved, no doubt. I have a bachelor’s degree in nutrition from the 1980s (although I never became a registered dietician), but the first time I heard anyone suggest that body weight in and of itself isn’t a predictor of health was in a meeting with an R.D. I went to see her with my husband, who is a very healthy type-1 diabetic, diagnosed at age 4. This was just a routine visit suggested by his doctor for fine-tuning diet and insulin dosage. Hubby has a naturally compact, solid build (built like a power-lifter or a wrestler), so his BMI is borderline “overweight.” I mentioned that fact to the RD, and she said, “Oh, body weight by itself isn’t a good indicator of someone’s overall health.” (She was very thin, for what it’s worth.) That surprised me, so I did some research, and lo and behold was surprised. What seems to be much more important than weight is WHAT people eat (ie, the quality of their diet) and whether or not they get any exercise. Not talking about the so-called morbidly obese here, but rather the “overweight.” This was over ten years ago, and I haven’t continued that line of research. I’d LOVE to see NuSI address the topic!

  2. Very interesting talk. Galileo must have had some of the same thoughts about the dogma surrounding science in his day. Maybe, these are always the first steps needed for change to take place. I like the way you are doing it. Much more effective than Jack Kruse, who always talks in code Two questions:
    1. Have you experimented with d-ribose and if so does it effect ketosis?
    2. Do you believe in the mesomorph, ectomorph, endomorph categories. Seems I read years ago that we cannot change from these body types we are born into, however, ketosis seems to say it is possible. Maybe hormones are more at play with all this, and ketosis helps rectify our hormones.

    The Best

  3. Hi Peter,

    Having read your site and ‘Why we get fat’ (Taubes) – I just have one question.

    If a person is cutting carbohydrates to <25g per day, is in ketosis and losing fat, and also intermittent fasting (I'm having great success with a 16/8 or 18/6 window most days and 23/1 once or twice a week) – what happens in their body if they drink an artificially sweetened zero calorie soft drink during the fasting period?

    I have read that the sweetened drink can spike an insulin reaction despite there being no carbohydrates in the drink. If insulin is floating around but there is no blood sugar for it to play with, is it going to kick us out of ketosis or slow down progress significantly or cause harm to our bodies (similar to a diabetic injecting too much insulin)?

    Keep up the great work!
    Amanda

    • I have read that the sweetened drink can spike an insulin reaction despite there being no carbohydrates in the drink. If insulin is floating around but there is no blood sugar for it to play with, is it going to kick us out of ketosis or slow down progress significantly or cause harm to our bodies (similar to a diabetic injecting too much insulin)

      Since 2011 I have been attempting to follow a ketogenic diet. Having lost 55 pounds I can attest to the success of the diet. My problem has been that I could never, even with a 3 day fast, register more than a .5 on my Precision Ketone meter. About 5 days ago I stopped all consumption of any kind of artificial sweetener. The main one being splenda and last night I registered .6.

      I find that remarkable and hope this information helps others. I have committed to a month of no artificial sweetener to see what happens. After that time period I may reintroduce stevia.

  4. I watched your talk on ted.com and it brought me to tears. As a person who has struggled with insulin resistance for years, thank-you for putting in to words things I have known but not known how to fix. I have tried drinking shakes, juice fasts, eating vegan, counting points, eating paleo etc., etc. My doctor is always quick to point out that my weight is the problem and I just need to try harder. I have put a ton of effort and research in to finding something that will work to get the weight off and reverse the insulin resistance, to hopefully add both quantity and quality to my life. Your take on this is refreshing and I know in my heart you are correct. I found your blog and watch the above talk. I found it so informative. I love that you geek out with the numbers. I am very hesitant to put my body in ketosis. I have a daughter with type one diabetes and I am sure you are well aware that the number one cause of death in type one diabetic is ketoacidosis. I know ketones are a different story in a type one diabetic who makes little to no insulin. Ketones in our family are not a welcome thing so it will take a huge effort on my part to welcome them in my own body. If in your practice you are ever looking for test subjects, I would be game. It would be much more reassuring for me to be in ketosis under the close supervision of a doctor such as yourself. I am going to spend the next few days pouring over your blog and will discuss this with my doctor before I begin this process. Thank-you for your work in this area, I hope it will make a difference in my life!

    • Heidi, I’m sorry to hear about your struggles and I’m moved by your comments. Remember, nutritional ketosis (which is to fireplace fires what DKA is to house fires) is not “the answer” … it’s just one place on a nutritional spectrum.

  5. Great Talk! I sent the video to some of my family members who ask me about my diet, but won’t read the literature I send them. Much more likely to watch a video.

  6. I AM A TYPE 2 DIABETIES PERSON ONLY HAVE BEEN DIAGNOSED AND I BELIEVE YOU HAVE STUCK GOLD
    AS A YOUNG ADULT I WAS SO FIT PLAYED RUGBY AND GRIDIRON AT A 5’11” 90KG MAN AND WORKED AS A PHYSICAL MOTOR MECHANIC UP TO AROUND 32 YEARS OLD THEN MOVE FROM PHYSICAL WORK TO OFFICE WORK ALTHOUGH I HAVE STOPPED PLAYING SPORT ALTHOUGH PLAY WITH MY KIDS NOW, I HAD A APPENICITIS ATTACK AND IT WAS REMOVED — SHORTLY AFTER I STARTED HAVING PAINS IN MY KIDNEYS — SO ALL TYPES OF TESTS WHERE PERFORMED — FINALLY A BLOOD GLUCOSE TEST WAS DONE AND THE RESULT WAS THAT MY INSULIN LEVEL HAD DROPPED — NOW MY FAMILY DOCTOR TOLD ME I HAVE TYPE 2 DIABETIES — SO FOR THE NEXT STEP OF COURSE WE HAVE TALKED ABOUT DIETS AND EXERCISE AND SOME MEDICATIONS TO TAKE — BUT I FEEL WE HAVE MISSED SOMETHING — WHAT COULD IT BE — THEN I HAVE LISTENED TO YOUR TEDMED TALK — I CERTAINLY DO NOT WANT TO GET TO THE STAGE WHERE MY DOCTOR SAYS I NEED TO LOSE A LIMP EITHER. — JUST WANTED TO SAY I BELIEVE IN YOU — THERE IS ALWAYS TWO SIDES TO EVERY STORY — GO FOR IT

  7. Hi Peter,
    I am currently studying to be a whole health education with the National Institute of Whole Health based in Boston. They teach only evidence based wellness information from a holistic perspective – physical, emotional, nutritional, environmental (internal and external) and spiritual (Candace Pert’s work). They stress that the effects of food on the body depend on each individual’s organ function, metabolic function, on top of the influence of the 5 elements mentioned above. Just wanted this dream team of researchers of yours to be cognizant of that when coming up with recommendations. Also – Our class on Metabolic syndrome was by an endocrinologist, Dr. Diana Schwarzbein who came to your conclusion in your TED talk many years ago – she has successfully treated 1000s of patients in california looking at all factors influencing metabolism including stress, etc. – will definitely be worth your while to check her out. We need more docs like you to admit the failures of the past and move towards honest answers!!
    Best regards – Ann

  8. Peter, thanks so much for posting this. You’re saying in your talk that one does not need to eat fat during exercise as one might as well tap their own fat reserves and it would not make a difference. Is there really no difference in tapping the fat reserves than using the fat from food? A short while ago I went for a long bikeride and took three large pieces of cheese with me. Subjectively, they helped me more than if I had not eaten anything (and it was cheese with only traces of carbs). Also you said you like to take nuts on long rides. Don’t you think the fat also helps you besides the carbs in the nuts?

    But maybe you’ll answer that question in the fat flux post?

    Thanks

    • It might, at least from the process of satiation and maybe gut transit time. But I suspect the hunger we experience during prolonged exercise is more due to hypoglycemia than ATP shortage.

  9. Thank you for posting this. I have shared it with many friends who have been asking me “But what do you eat before a [mountain bike] race if you’re in ketosis?”

    I went out of ketosis for the last 2 months and I have been very tired all the time, needing afternoon naps, and I got terrible leg cramps after my last speed run. I also have been bonking. I am so sick of carbs, I don’t know why I was eating them. Back to LC in prep for a 24 hr mtb race at the end of July, I hope I am ketoadapted in time!

    Do you have citations for papers on cancer and ketosis? Are there any? Thanks!

  10. Andreas Eenfeldt posted your TEDMED talk – AMAZING!! GO PETER, GO!! Bless you, your family, and your team as you endeavor to help obese and all insulin resistant people. I was crying at the end too.

  11. Peter, your presentations are amazing and have become my #1 go to for low carb nutrition information. I have been doing a ketogenic diet for 3 months now, and I can honestly say, I haven’t felt this good since my high school years. Thank you for your hard work, keep it up!

    • Absolutely agree. Between Dr. Phinney, Dr. Attia, and Taubes, we have an amazing team that is willing to do what scientists are supposed to do – question everything!

  12. Hello Dr. Attia:

    enjoyed that! You speak as well as you write. Many gifts.
    Waiting for the TEDMED video. Let us know when it is out there.

    On a personal note:

    NK for 5 mos completed.
    – Age ~60.
    – Weight 125 before, 123 now. BMI ~18.
    – Fat(15% before, 9.2%now); happy with progress. I do not crave Carbs or Sugar. Salt often.
    – muscle to weight ratio up ~6%. Hoping this would up my chances for a credible attempt at BQ.
    – A1C clinging to 5.3 . Not much progress there. Jimmy Moore had superior results with his A1C.

    Anyway, NK is definitely working for me. The mind seems to be better focussed more often. Practicing musical scales again, after hiatus of ~20 years!

    Best.

  13. Peter, great post again as usual and the TEDMED talk was awesome. I feel somewhat rejuvenated every time you make a post because obviously, as you have identified, this is a journey and more and more things become clear when we have good science happening and excellent/open minds tackling it. It literally get’s exhausting to A) hear the daily constant bombardment of conventional recommendations and B) to try and explain my dietary habits (after finding your site a year ago) to people who really could care less to take the time to look at real available information but think how I eat is crazy. So again thank you for everything you do.

    A couple questions I’ve thought about:
    Can you talk a little bit about the role of timing/dosing of the foods you eat? What would you expect to happen if you could some how perfectly isolate all your grams of fat at (let’s say) and ate that at breakfast, all your protein at lunch, and then 20-30g of carbs at dinner? Would it still be possible to be in ketosis? You may have touched on this in a response to a post comment somewhere but I could not remember.
    Finally, rather then ask what you would recommend for timing/dosing, what do you do personally as a guideline/range for how much of each you prefer to eat with each meal? Does that make the question less awkward to answer :)? If you answer and say it deserves a separate post I will be upset lol, jk. Thanks Peter

  14. Peter,
    Great talk. Great site. It was only when you mentioned that you are sedentary except for your massive exercise load, that it occurred to me that you might be a low NEAT person and if you’re not familiar with NEAT and Levine you should be.

    NEAT is the acronym for NonExercise Activity Thermogenisis.

    James Levine from the Mayo Clinic originated the idea of the treadmill-desk after doing research in which 20 volunteers were calorie controlled while free-living.

    In the book ‘Move a Little, Lose a lot’ by James A Levine MD PhD (Crown, 2009)
    and in Ch 2 “Thin or Fat? The NEAT difference” Levine explains analyzing the data from the research:

    “… a pattern began to appear. It got stronger and stronger until we could barely contain our excitement. It was as though we’d just uncovered the Rosetta Stone to deciphering the confounding obesity code.

    The difference between the obese men and women and their lean peers came down to one thing and one thing alone: NEAT. Specifically, the obese volunteers sat planted like ferns for a full two and a half hours per day longer than the lean volunteers …”

  15. When you were intermittent fasting was it stopping you from being keto-adapted (as described by Volek and Phinney)? Thanks.

  16. I think the TED talk is excellent. A better metaphor (in lieu of bruise and coffee table) might be seeing a red light on the dashboard of your car and then covering the light. We all know that the light is a signal or symptom, covering it doesn’t make the problem go away.

  17. Peter,
    Thank you for all the great info here. Do you know if coffee with heavy cream throws people out of ketosis? I am 41 years old, 5’4″ and weigh ~125. Each day I eat around 10 carbs, 55- 60 g of protein, and lots of added fat mostly from heavy cream in my coffee, coconut oil, and bacon grease. Do you think 4- 6oz cups of coffee with cream each day could keep me from being in ketosis? I still have more fat around my waist than I would like but I am too big of a wimp to prick my finger daily.

    • Typically does not, but that may not explain what you’re experiencing. Hopefully my post on fat flux (hope to write before end of summer) will shed some light on this.

  18. Hi Peter, I am advising several close family members about reducing their carbs (and also increasing their exercise) to reverse or halt diabetes and obesity symptoms. However, reading about such keto-diets makes me concerned on two counts and wondered if you have any thoughts: is there a problem short-term with regular bowel movements and the gut flora balance generally? Secondly, longer-term does the lack of insoluble fibre and high proportion of meat and fat increase the risk of bowel cancer? There isn’t much I can find in the literature on this issue tho’ some studies touch on it for example: The Effects of Low-Carbohydrate versus Conventional Weight Loss Diets in Severely Obese Adults: One-Year Follow-up of a Randomized Trial Linda Stern, MD et al Ann Intern Med. 2004;140(10):769-777.
    There is no doubt that keto-diets are effective in reversal of many diabetes and obesity markers including reduction of hypertension: A Randomized Trial of a Low-Carbohydrate Diet vs Orlistat Plus a Low-Fat Diet for Weight Loss, William S. Yancy, MD et al Arch Intern Med. 2010;170(2):136-145.
    I have found your Eating Academy fascinating reading and your new venture of NuSI is a valuable contribution to raising awareness for the benefit of evidence-based health eating. Thank you.

    • Carly, believe it or not, the largest prospective trial looking at the role of fiber in the prevention of colorectal cancer found none. It’s quite likely that Dr. Burkitt’s original observation about the correlation between fiber intake and low rates of cancer was confounded by all the other things the people in that section of Africa were not eating. (See my post on red meat for more on this idea.)

    • Thank you Peter.
      Although not labelled as ketogenic diets per se this is the sort of research about the effects of (long-term) adherence to high fat / high meat / low fibre diets which prompted my question:
      * Curr Issues Intest Microbiol. 2000 Sep;1(2):51-8. Protein degradation in the large intestine: relevance to colorectal cancer. Hughes R, Magee EA, Bingham S.
      * IARC Sci Publ. 2001;154:101-11. Biomarkers in colorectal cancer. Owen RW.
      However, for individuals who are ‘merely’ restricting their carbs but not looking to attain a ketogenic state then eating enough insoluble fibre would not be an issue I guess.
      I would be interested in the details of the prospective study you mention as it would be the proverbial cat amongst the pigeons, given the received wisdom currently.
      Meanwhile, eating plenty of garlic (with your steak!) is considered protective. Wishing you well. Carly.

  19. I find the perspective on insulin resistance that the body may be actually attempting to “protect” itself against a chronic, and/or acute, toxicity of a commonly found physiological compound (in this case blood sugar) very interesting. Is there anything in the literature, or research, current or past, that you are aware of that considers this same perspective in many (or any) of the cell surface receptor mediated pathologies in other conditions such as physical dependencies on opiates, etc? From this perspective it would seem like the resistance, and/or subsequent reduction in cell surface receptors or attenuation of the receptor mediated response could be some form of “vestigial” adaptation that we may have developed in response to something from our ancestral past or perhaps the body is trying to find a solution to a problem it has never before experienced? Would love to see the results from some genomic and epigenetic analysis done in this area. Love all the stuff I am learning here! Thanks so much, and keep up all the great work!

    Dan

    • I know this will sound strange, but it’s not exactly clear exactly what happens at the cellular level in IR. The latest thinking is that something goes awry post the process of insulin binding the insulin receptor inside the cell via second messengers, etc.

  20. Any thoughts on compounds that pass through the cell wall and act as independent GLUT Translocation mediators such as Vanadyl or the newer preparations of non-racemic formulations of Alpha Lipoic Acid? There are probably others, but those are the only 2 I have any knowledge of.

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