Waist Reduction: Ketogenesis

70-75% percent of my diet comes from fat, and I lost more weight in the first month than on any other diet.

Here's a day I pretty much nailed my ratios.
Here’s a day I pretty much nailed my ratios.

The Mrs and I have been on a ketogenic diet since right after Thanksgiving. Our weights have been in a free fall for the whole month. Nothing I’ve ever done before has been this effective.

What is the Ketogenic Diet?

Here's the weight nose dive in my first month of Keto.
Here’s the weight nose dive in my first month of Keto.

The ketogenic diet is a high fat low carb diet. Typically you keep your carbs under 20-60g/day or <5% of your calories. You also want to moderate your protein and keep it at around 20% of your calories.

What’s going on inside your body is you are convincing your body to start burning fat for energy instead of sugar. Sugar in your body is glucose which comes from carbs. When your body wants to burn fat it makes ketones. Your cells can use either one for energy. As an aside, cancer cells can only use glucose for energy.

Yeah it seems crazy to eat that much fat, but the truth is you are probably eating more fat on your Standard American Diet (SAD), because you are eating more.

A Calorie Is A Calorie Isn’t The Whole Story

In case you thought I wasn't losing fat.
In case you thought I wasn’t losing fat.

I got inspired to try the keto diet because of a podcast where Tim Ferris interviewed metabolic cancer researcher Dr Dominic Dagostino about the ketogenic diet and its relationship to cancer. I followed this up by listening to a previous Ferris interview of Dr Pete Attia where they also talked about ketosis.

Dr Attia had an interesting distinction about calories, that I’m paraphrasing.

A calorie is a calorie. That’s absolutely true. But that statement isn’t very useful. It isn’t very interesting. It’s like saying “You know why Bill Gates is so rich? Because he spends less than he makes.” That’s true, but it isn’t the real story you want.

One question is Why? Why do people eat more calories than they burn? When you ask it that way you find out all calories aren’t equal.

There are lots of distinctions around this, but let me give you the big one for weight loss.

It Isn’t Just Chinese Food

I recently heard that ketones in your blood stream keep you from feeling hunger. In other words, if you are in ketosis you don’t feel hunger. My experience has born this out.

Most of what we call hunger is actually your brain being a whiney baby throwing a tantrum for sugar. Or maybe a better analogy would be your brain is an addict clamoring for its next fix. That isn’t hunger, but it is the most common feeling that motivates you to eat. It is the reason you feel hungry 20 minutes after eating that chow mein, or that piece of cake. A low blood sugar caused by a crash in your blood sugar.

One thing I’ve noticed is I generally feel tired before I feel hungry. Weirdly I’ll start dragging and I realize I haven’t eaten in hours. A high fat meal or snack and a few minutes later I’m awake again.

There is a big connection between the low carb, ketonic diet and fasting. Matter of fact the fastest way to get into ketosis is to fast. The two also share the pain of the first few days. That period of 2-5 days where you feel like crap because your body is out of glucose and hasn’t really figured out the ketone thing yet.

Also like fasting, after a few days you stop feeling hungry. Your body goes into ketosis and you don’t feel the hunger anymore. My friends who have fasted for 40 days tell me you don’t really feel hungry again until like 30 days in.

My Experience

The first few days weren’t bad for me, which was probably due to taking a supplement with ketones in it. There are few of these around and the one I found also had caffeine in it. Put those together and you can overcome some brain fog. Also those first few days I wasn’t tracking calories, so I ate a lot of food, just watching the carbs.

After about the first week, I started looking for a tool to track my food and carbs. In the end I went back to myfitnesspal. It has a good interface and the best database.

Once I started tracking calories I realized my biggest problem was eating enough. Having a calorie deficit is too easy when you don’t feel hungry and you get full very fast. You start looking for highly calorically dense foods. Which means fats. My cardiologist, if I had one which I don’t, would be shocked as some of the stuff I eat to get some calories in.

Is It Safe?

There is a lot of literature on this diet, and you can do the amount of research you feel is necessary to come to your own conclusion. I will tell you two things that make me think it is safe.

If you were trying to decide if a drug was safe, one thing that would carry a lot of weight is will they prescribe it to children. This isn’t a perfect test, but it does seem the bar for children is higher than that for adults.

Guess what? A doctor can and will “prescribe” a ketogenic diet to children with epilepsy who don’t respond to any anti-seizure medications. Kind of makes you wonder why they don’t just start with it.

The other fear is it will destroy your blood chemistry. Eating a bunch of fat must raise your cholesterol and triglycerides. Studies actually say the opposite, but for me it was just easier to test. I got my blood work done after 30+ days on this high fat diet and compared it to my blood work from February when I visited the doctor, the last ones I had in Evernote. The results were almost exactly the same.

Memorizing Makes Your Brain Bigger.

I’m reading Moonwalking with Einstein, a book about memory and how the author made it better. Facinating stuff so far, but this little tidbit deserves a blog post. I’ll never think about cabbies – at least London cabbies – the same way again.

“These studious cyclists are training to become cabdrivers. Before they can receive accreditation from London’s Public Carriage Office, cabbies-in-training must spend two to four years memorizing the locations and traffic patterns of all 25,000 streets in the vast and vastly confusing city, as well as the locations of 1,400 landmarks. Their training culminates in the infamously daunting exam called “the Knowledge,” in which they not only have to plot the shortest route between any two points in the metropolitan area, but also name important places of interest along the way. Only about three out of ten people who train for the Knowledge obtain certification.

That is a high bar to set for mere cabdrivers. Amazing.

The author then follows up with something my neuro-radiologist best friend and I were talking about the other day in Vegas. I’d asked if the often sited “we only use 10% of our brain” was true. He wasn’t sure exactly, but said it is more likely we only use 10% at a time. Then we talked a little about memory. I mentioned the 60 Minutes piece with the actor from Taxi who remembered every day of her life in detail, and how there were more people like her interviewed on the show.

Then we talked about the interesting thing they found out about those people. They did an MRI of their brains and found hypertrophy in the part of the brain associated with memory. But in the story they didn’t know which came first. Did they have extraordinary memories because they were born with the hypertrophy, or did remembering all that cause them to have the hypertrophy?

Well they did the same thing with London’s cabbies.

…she brought in 16 taxi drivers into her lab and examined their brains with an MRI…The right posterior hippocampus, a part of the brain know to be involved in spatial navigation, was 7% larger than normal in the cabbies – a small by very significant difference….The more years a cabbie had been on the road, the more pronounced the effect

So it looks like memorizing changes your brain. More to come as I keep reading.

4HB: Some Lab Work

If you are going to improve your health, then one thing you need to get is some lab work. So I got a number of blood tests done end of last year.

The Tests

In the Four Hour Body, Ferris suggests you get the Spetracell Vitamin Deficiency test. I went looking for someone near me that did the test and found Dr. Martin Basaldua, who is like 5 minutes drive from my work. He also does the kind of hormone replacement therapy that I’ve been going to Hotze Health and Wellness center for the last three years. I decided to change doctors since he is so much closer.

I went in and talked with Dr. Basaldua and gave him some older lab work Hotze had done. He wanted to get numbers on free testosterone and a PSA. Since I’ve got high cholesterol we also wanted to get that tested. Spectracell has a special cholesterol test that reports the size of the cholesterol lipids and I asked the doctor about it. He said he preferred the Berkley Heart Lab’s test, which breaks down your HDL and LDL levels into sub groups, some more important that others. I decided to do the Berkley.

I asked about testing Dihydrotestosterone as well, since Ferris recommended it and it is believed to the actual form of hormone that causes the benign enlargement of the prostate. The doctor wasn’t that interested in testing it because the OK range was so large as to be almost meaningless, and really you need to see is change, and since we don’t know what mine was, how can we know if there is a problem. I told him I wanted it anyway, because how would we know it changes if we don’t have a baseline.

Today I got back those results.

The Good

Spetracell came back showing I had no vitamin deficiencies. Dr Basaldua was impressed because he said since he’s been doing it only 5 people have come back with no deficiencies the first time. So I guess I’m doing something right.

I still want to do some research, especially into Vitamin D, because not being deficient doesn’t mean you have an optimal amount. Though it looks like the results are in percent of the control group, which might not be helpful.

The Bad

I know my cholesterol is high. Actually very high, with a low HDL. Low HDL is almost worse than a high LDL. About the only known treatment for low HDL is Niacin, and the doctor prescribed that even before the blood work was back.

It came back and even broken down, I’ve got issues. My HDL is just in the OK range according to Berkley and their test is actual level, where most test are calculated levels. Still the doc would like to see it higher. My HDL2b is an “intermediate” risk.

Total and LDL overall are high. Of the sub LDLs, most are OK, but the ApoB is very high. 141 where 120+ is bad and less than 60 is recommended. Homocystein, CRP, Fibriogen and Insulin are all green.

The most interesting finding was that my ApoE Genotype is 3/4. There are 3 kinds of genotypes that effect cholesterol, and for each of them some things work better than others. For instance in my type, exercise has only a moderate effect on raising HDL and lower LDL. Fish oil actually makes things worse, and the really effective treatment is a low fat diet.

I need to do some more research on this genotype stuff and I’ll be interested to see what 23andme says when I get my genetic profile back.


Doesn’t do any good to know your values if you aren’t going to do anything about it. So what action am I going to take?

1. Niacin. I’m taking the Niacin the doctor prescribed every night. At first it wasn’t pleasant, but I’m getting used to it.

2. Exercise. While exercise may not help my LDL/HDL, it is still good for me. I’m training for the Warrior Dash and will be running at least 3 days a week.

3. Diet. It’s time to admit to myself I can’t keep eating anything I want. Even if my weight/body shape are something I’m currently comfortable with. I’m going to have to go on a diet. I’d prefer low-carb, or slow-carb and a day off like Ferris suggest in the book. But I may have to look into a low-fat diet.

4. Keep measuring. Did you know Google has a health tracking site? Google Health. I’m putting all my labs in there. I’ve hooked it to my pharmacy so it automatically get any medicine I’m taking. Tracks my Wifings scale results. I put in BP when I get it taken.

Getting old sucks.

4HB: Improving Sleep

The chapter on improving sleep was the first one I read upon getting the book. It was finals week and I was strung out. I’ve been taking Adderall (Amphetamine Salt) for a couple of months now to help me focus and study. It works but has a couple of side effects – increased heart rate and messing with my sleep.

So I felt like I needed more or better sleep. But what is better sleep?

If I’m going to measure something and try and improve it I need to know what is better. There are two things I think we can start with.

How I feel when I get up.
How tired do I feel during the day.

Both of these things are subjective. Still I could measure them based on my subjective feeling. Just ask myself when I get up to grade my crappiness on a scale of 1 to 10 would do it.

Enter the Four Hour Body.

Tim tried a number of gadgets and settled on recommending the Zeo Sleep Coach. I put it on my Christmas list and got it.

The coolest thing about the coach is it lets you actually track you sleep. When I first started taking Adderall and noticing the sleep problems I started writing down when I went to sleep and when I got up. Also when I took my pills. These numbers were soft because I may have gotten into bed and laid there for an hour unable to go to sleep, but my number was when I got in bed. Also I might have woke up during the night 3 times for 15-30 minutes. Not in my log.

Adderall is a treatment for ADHD with a side effect of insomnia. But insomnia is also a symptom of ADHD. People with ADHD will lay in bed with their mind bouncing from one thing to another unable to sleep. The trick is to get your Adderall on the way down when you are ready to sleep, so it slows the thoughts down, but also allows you to sleep.

The Zeo changes all of this. It tracks when you get in bed, how long before you are asleep, how many times you wake up and for how long. It also tracks total sleep time and sleep phases – REM, Deep and Light sleep. It gives you an overall Z score and we will see how well that score helps me. When you put the headband back in the cradle it asks you to rate how well you slept on a scale of 1-5. Those numbers should be interesting.

The other pieces of data I need to collect are when I take my pills. I’m taking a number of different substances including thyroid, testosterone, Lisinopril, and supplements. I plan on measuring them as well.

Zeo gives you a number of “sleep stealers” to log and suggest changing. I will keep those too.

Will I sleep better. Hard to say. Just tracking my sleep for 4 days so far has been cool. I’ve found I sleep way longer than I thought. When I get up in the night – normally to pee – I’m not awake as long as I thought. Two things that haven’t happen are going to school and taking my Adderall in the afternoon.

Data and results to come.

The Four Hour Body And Me

Most years I give a book to my friends that I want to give a general gift to for Christmas. Books aren’t too expensive and yet thoughtful. (I’m big on thoughtful gifts, and I thought I’d written a blog post about it, but seems not. One for the future.) This is generally a book that is or has made an impact on me.

This year the book is The Four Hour Body by Tim Ferris.

This is appropriate because last year I gave a number of people the Four Hour Work Week by Ferris. That book lead to the creation of Photographer and Model and my involvement in entrepreneurship.

This time Tim has turned his thoughts to fitness and health.

He’s tried different things to change everything from how he sleeps to gaining muscle to losing fat to running faster and longer. The subtitle kind of sums it up, “An Uncommon Guide to Rapid Fat-Loss, Incredible Sex and Becoming Superhuman.”

Underlying Theme

The underlying theme is try stuff and measure to see if it works. Measure what matters. These are very important principles.

I wrote a post a long time ago, and just published, asking if I was a Metric’s Asshole and it was based on the principle that you don’t know something will or won’t work unless you try it and have a way to confirm it worked. People often tell me something will or won’t work and when asked how they know, they don’t have any real proof.

Medicine is going through a renaissance right now with something called “Evidence Based Medicine”. We studied it in Paramedic School and it is often mentioned in the literature. Basically this means we should test and measure the things we do in EMS and in medicine and see if they really make a difference. Where they’ve done this they’ve found major things taught as must do are really not needed or even harmful. For instance, the newest guidelines for CPR have lowered the importance of breathing in CPR. It used to be you started breathing for them as soon as possible. Now you should start and continue chest compressions before even trying to breath for them. It significantly improves outcomes for the patient.

To call Ferris’ book evidence based medicine might be a stretch, but he doesn’t recommend anything unless he’s tried it, measured the results, and found a positive outcome.

Measure What Matters

Measure what matters is a quote from Peter Drecker and one I’ve used a number of times. To me there are two meanings. One is measure the right thing, and the other is to measure what is important for the change you want to make.

Ferris’ has a story of a man who decided he wanted to lose 28 lbs in 6 months. So he created a spreadsheet that told him where his weight should be each day. Then he calculated a min and max for each, giving himself a range where he needed to be. Then he’d measure himself every day. And made no other changes. He made a conscious effort to not change diet nor exercise during the experiment. The only time he changed that was the couple of times he got too low, under his min. Then he gorged on doughnuts.

Six months later he was down 28 lbs, doing nothing but measuring.

Another meaning of measure what matters is the measure the correct things. Many people measure weight when they diet. This is a mistake. It can and will work, especially if you are really fat, but just making your mass go down, doesn’t tell you how much fat you’ve lost. You need to measure body fat, or lean mass. The easiest way to do this to measure your circumference. Use a tape measure and measure your belly, hips, chest, arms, thighs.

The second easiest, and the high tech one that I use, is a body fat scale. You step on it and it tells you your weight and percent body fat. These scales are very effected by hydration, but if you do it exactly the same every day, you get good trend data. (Discovered a few days ago, I’d been hitting the wrong preset button – you have to enter your height – for weeks. When it thought I was 6’1″ instead of 5’8″ like my wife, my %BF dropped dramatically.)

A Bunch of Specifics

The only problem with the book is there is so much you can do in it. Do you want to gain muscle? There’s chapters for that. Lose fat (notice not weight)? Chapters for that too. Better sleep? Better sex? Chapters there too. You could make lots of changes.

The back of the book says, “Which 150 pages will you read?” He suggests you pick out one or two things you want to change and just read those parts.

So that’s what I’m going to try and do. And for each thing I try I’ll write a blog post with my experiments and outcomes, hopefully with measurements and data.

Afterward: I’m not making these changes because it is the beginning of the year. I’m making them because the book just came out. So they aren’t new years goals or resolutions.

Have I’ve Become A Metrics Ass?

(Found this in my drafts folder it was written a year ago. In the middle of writing a post about The Four Hour Body, I thought it needed to be published.)

I don’t know when it happen, but I noticed the other day I’ve become a metrics asshole. And no I’m not saying I measure everything in liters and kilograms. Rather I doubt almost everything people tell me unless it can and has been measured.

A friend said he wanted to produce a certain kind of book because “everyone would like it.” Really? How do you know.

I guess I’m not really an ass yet because I didn’t actually say that out loud.

Another person told me I should change some copy on my website because it was too long and wordy. He based this on lots of experience with web design. My first thought was, have you tested that? I’m in the middle of split testing two complete sets of copy to see which is actually the best. I happen to like one and think it is the better, but I don’t know it is until Google Web Optimizer tells me so.

Lots of stuff is counter intuitive and you won’t know it until you test.

Reminds me an experiment in the great book Made To Stick. One author made his class give a 1 minute speech on violent crime vs white collar crime in America. Then right after the speech he had every student who had heard the speech rate which was best. So he had which ones everyone thought were best.

Then he showed them a clip from Monty Python and then told them to get out a piece of paper and write down what they remembered from each person’s speech. Very few of them could remember anything from the speeches. And the ones they could remember from were not the ones they voted the best speaker.

So everyone thought they knew which ones were best, but in reality they were wrong.

Now I think about that kind of thing all the time.

P90x End of Week 6

It is the last day of week 6 and I finally plugged all the weights and measurements into a spreadsheet I used for previous workouts and got some hard facts.

I’m a measurement nut, so I like as much data as possible. I weight myself everyday and my scale tells me weight and percent body fat. I know those scales aren’t perfect, but if you do it at consistently the same time every day they should give you accurate trend data. I do it first thing in the morning after I pee.

I also measure myself with a tape measure every Monday. Chest, belly (at the belly button), waist (narrowest part of my torso), hips (where my belt goes), thigh, and neck. This lets me calculate Waist to Hip, Waist to Chest Ratio, and a Body Fat measurement for men that the Navy uses with just measurements. I also added BMI.

Given all that data, here’s some results.

Total weight loss: 8.6 lbs so far.
Percent Body fat loss: 2%.

This means I’ve lost 6.37 lbs of fat and 2.23 lbs of lean body mass. I’d rather have not lost muscle, but I feel stronger, so I’m not sure what that means. Strength increases can be caused by muscle recruitment, which means you are using the muscle you have more efficiently. My muscles are also harder for what that is worth.

Lost an inch in my belly and chest and lost .65 inches in my waist and 1/2 an inch on the belt line.

My BMI has gone from 27.07 to 25.94. According to the linked website, you are overweight if your BMI is 25-29. So I’m right on the edge of “normal”.

My spreadsheet also projects using the average loss and number of weeks left in the challenge. It says at the end I’ll weight 188 and my percent BF will be 24.1.

So things are working, but I’m still thinking about changing my diet. I don’t feel like I’m getting enough to eat because I’ve started being hungry all the time. I’m thinking about going low carb – which P90x tells you to do from the beginning if you want to get lean. Of course I’ve become so accustom to entering my calories I might freak out if I started entering higher calorie things. I haven’t decided yet, but I want to be leaner in 3 weeks when I go to Vegas. I’m sure we’ll be at the pool and I’m not shirtless ready yet.

P90x Last New Workout Back & Bicep

This is week 5 which means you have two new strength workout. Monday was Chest, Shoulders & Triceps and today was Back & Bicep.

Tony is very creative. There are at least 12 different bicep exercises in this exercise of 18. Kicks your biceps like crazy and then the last set is a super set of 3 sets of 4 working from a heavy weight to a lighter one.

My friends and I have been using the phrase “Just push play” a lot. When you don’t want to do it, the key is just to get there and push play. You can do as much as you can and in general you’ll get through the workout once you get started.