Intermittent Fasting great results

[aiken]

Nowhere. Lots of people including the experts drink caffeine and coffee on a ketogenic diet.

I suspect the comments are regarding intermittent fasting and morning coffee.

Yes, the Dr. in the video said the consensus was caffeinated black coffee was a negative for the time constricted eating concept.

 

[audreyh1]

For Harley and Haha and CoCheesehead:

My understanding is that someone on a ketogenic or low carb diet a long time, may have higher fasting blood sugar in the morning due to the body doing gluconeogenesis to get you ready for the activity of a new day.

Slightly elevated fasting blood glucose for a low-carber is pretty normal and doesn't necessarily mean you are eating too high carb. Higher blood glucose could be an issue.

I think this is behind a paywall, but you can perhaps sign up for one month free? There is a lot of information in this article:
https://www.dietdoctor.com/low-carb/fasting-blood-glucose-higher

1. Relax, it is normal — call it “adaptive glucose sparing”
“We definitely see that in people who are doing low carb long term, the majority will find that their fasting blood glucose becomes their highest value of the day,” says Dr. Sarah Hallberg. “They are not actually having issues with blood sugar. They are doing really well. But if you are looking at a log of 24 hours of blood glucose you will see a high first thing in the morning and then a steady decline throughout the day, with no big excursions [in glucose levels] even after meals.”

The scientific name is “physiologic insulin resistance” and it’s a good thing — unlike “pathologic insulin resistance.”

As regular visitors will know from Dr. Jason Fung, Dr. Ted Naiman, and Ivor Cummins, the “pathologic” kind of insulin resistance is caused by higher and higher levels of insulin — hyperinsulinemia — trying to force glucose into over-stuffed cells. That insulin resistance is a prominent feature of type 2 diabetes, polycystic ovarian syndrome (PCOS) and other chronic conditions.

So let’s call physiologic insulin resistance instead “adaptive glucose sparing,” a name that has been proposed by many to reduce the confusion. Dr. Ted Naiman describes it as muscles that are in “glucose refusal mode.”

Prior to converting to the ketogenic diet, your muscles were the major sites to soak up and use glucose in the blood for energy. On the long-term keto diet, however, they now prefer fat as fuel. So the muscles are resisting the action of insulin to bring sugar into cells for energy, saying, in essence: “We don’t want or need your sugar anymore, so move it along.” Hence, the slightly elevated, but generally stable, glucose circulating in the blood.1

Where is that glucose coming from when you consume no sugar and only leafy veggie carbs in your diet? Your liver, through gluconeogenesis — the creation of glucose from non-carbohydrate sources such as lactate, glycerol, and glucogenic amino acids from proteins. It is a natural protective process that got homo sapiens through hundreds of thousands of years of feasts and famines.

“There is no essential requirement for dietary carbohydrate because humans possess a robust capacity to adapt to low-carbohydrate availability,” says Dr. Jeff Volek. In the liver of a keto-adapted person, he notes: “ketone production increases dramatically to displace glucose as the brain’s primary energy source, while fatty acids supply the majority of energy for skeletal muscle. Glucose production from non-carbohydrate sources via gluconeogenesis supplies carbons for the few cells dependent on glycolysis [using sugar for energy.]”

Why are blood sugars highest in the morning? It’s the dawn phenomenon, when cortisol, growth hormones, adrenaline and the enzyme glucagon pulse to the liver to get you up and moving for the day — spurring gluconeogenesis for the cells that need glucose.

“It’s your body making you breakfast,” notes one post that discusses the common phenomenon — except that when your muscles are fat-adapted, they don’t want it.

Or perhaps you can find more information on the Dr. Sarah Hallberg site aka Virta Health.

The article goes onto say what matters is whether insulin is low. Fasting blood glucose and fasting insulin should be taken together.

As Dr. Naiman recently posted, only testing fasting blood glucose without testing fasting insulin tells you very little. That’s because two people could have exactly that same fasting blood glucose levels and have very different circulating insulin levels.

But much higher blood glucose could be a sign of latent autoimmune diabetes. So that should be tested.

5. A word about LADA – Latent Autoimmune Diabetes in Adults
If all of the information in this post does not help you understand your rising blood glucose on the low-carb diet, and your blood glucose continues to rise higher and higher, not only in the morning but at other times of day, there may be a potential issue of latent autoimmune diabetes in adults (LADA), also sometimes called type 1.5 diabetes.

Both Dr. Hallberg and Dr. Fung say they see LADA regularly among their patients who may have been misdiagnosed with type 2 diabetes and have LADA instead.

LADA is like type 1 diabetes in that antibodies are attacking the insulin-producing cells of the pancreas, but it arises in adulthood, not childhood or adolescence. Diabetes researchers note that LADA also has features of type 2 diabetes, but the patients usually are thinner and progress to needing insulin faster because their insulin producing beta cells have been attacked by antibodies. The highest rates of LADA are found in Northern Europe, with up to 14% of type 2 diabetics actually having it.

“I test serum C-peptide and insulin in everybody in my Intensive Dietary Management program,” notes Dr. Fung.” I re-check them over time and it often takes 6 months to 1 year to clinch the diagnosis. I would suspect about 5-10% of my type 2s are actually LADA.” Dr. Naiman has similar experiences and routines.

Maybe the above can give you enough information to research the issue further. Since I'm not a doctor - that's the extent of what I know.

 

[COcheesehead]

For Harley and Haha and CoCheesehead:

My understanding is that someone on a ketogenic or low carb diet a long time, may have higher fasting blood sugar in the morning due to the body doing gluconeogenesis to get your ready for the activity of a new day.

Slightly elevated fasting blood glucose for a low-carber is pretty normal and doesn't necessarily mean you are eating too high carb. Higher blood glucose could be an issue.

I think this is behind a paywall, but you can perhaps sign up for one month free? There is a lot of information in this article:
https://www.dietdoctor.com/low-carb/fasting-blood-glucose-higher

Or perhaps you can find more information on the Dr. Sarah Hallberg site.

The article goes onto say what matters is whether insulin is low. Fasting blood glucose and fasting insulin should be taken together.


But much higher blood glucose could be a sign of latent autoimmune diabetes. So that should be tested.



Maybe the above can give you enough information to research the issue further. Since I'm not a doctor - that's the extent of what I know.

Thank you!

 

[yakers]

AFAIK the A1C test is more important than the FBS, the FBS is often the last measure to come down when switching to a carb controlled diet. Also there is the Dawn Phonomena which for a large number of people makes their blood sugar higher in the AM, the liver releases glucose to get us ready for the day. If my A1c is good and my FBS not crazy high (>120/125) I would just not worry about it. MY recent a1c was 5.5 but the last several months FBS have averaged 111/104/109/106 and periodic tests during the days are never <100 so maybe I go a bit lower at night but in any case the A1c is gold for my Dr and for me. Foe me I control blood sugar with LCHF diet and reasonable exercise, no meds.

 

[harley]

Audrey, thanks. I've read the info from Dr.s Fung, Naiman, Hallberg, etc. I am concerned about the LADA issue, but as it says in the article it's going to take time to determine.

Actually, since I posted my FBS has been jumping around weirdly, high, low (for me, still high for most), back and forth. I'm sort of hoping I'm dumping decades of Ben and Jerry's and Taco Bell, and it will settle down over time. I've been diabetic a long time, and it's not going to reverse itself in a matter of months.

No matter what, I'm loving this life of slightly overweightedness, especially with such a relatively easy way of eating. Just compared to last year I can do things easily that had me short of breath before. I may even fit in an airplane seat now.

I've tried pretty much everything over the years, and this is the first "diet" that can actually be a lifestyle change for me as opposed to an effort of willpower. Of which I have very little.

 

[audreyh1]

Anybody who is very active fasting? I workout 90 min to 2 hours a day. Not sure I can get to the 16 hour autophagy point without eating. Any experiences?

If you have adapted well to fat burning (ketosis) you can pull on huge body reserves of fat regardless of when you have eaten.

It can even drive you into autophagy faster (exercise induced ketosis).

I certainly have noticed major increased stamina/endurance after the first few weeks in ketosis.

You might want to read about endurance sports athletes and Keto?

 

[COcheesehead]

If you have adapted well to fat burning (ketosis) you can pull on huge body reserves of fat regardless of when you have eaten.

It can even drive you into autophagy faster (exercise induced ketosis).

I certainly have noticed major increased stamina/endurance after the first few weeks in ketosis.

You might want to read about endurance sports athletes and Keto?

I will look into that. Thank you.

 

[audreyh1]

Audrey, thanks. I've read the info from Dr.s Fung, Naiman, Hallberg, etc. I am concerned about the LADA issue, but as it says in the article it's going to take time to determine.

Actually, since I posted my FBS has been jumping around weirdly, high, low (for me, still high for most), back and forth. I'm sort of hoping I'm dumping decades of Ben and Jerry's and Taco Bell, and it will settle down over time. I've been diabetic a long time, and it's not going to reverse itself in a matter of months.

No matter what, I'm loving this life of slightly overweightedness, especially with such a relatively easy way of eating. Just compared to last year I can do things easily that had me short of breath before. I may even fit in an airplane seat now.

I've tried pretty much everything over the years, and this is the first "diet" that can actually be a lifestyle change for me as opposed to an effort of willpower. Of which I have very little.

Well, you said it’s been 8 months, and you’ve been diabetic for 15 years. Seems like it would take a while longer for the body to adjust to such a huge change.

Is your FSB the highest reading for the day?

 

[Drewskers]

I started LCHF/IF last February at the suggestion of my doctor, due to remarkably bad lab tests at my yearly wellness checkup, and under threat of having statins prescribed.

It took me a month to get on a consistent 20/4 fasting regimen (two meals a day), and then I further reduced carbs to get into ketogenesis. For exercise I walk 2-3 miles a day along with 3-4 bike rides a week, as weather permits.

By July I lost 40 lbs and achieved my healthy target weight of 182. Since February my overall cholesterol is down13%, LDL down 18%, VLDl down 33%, HDL up 10%, and triglycerides down 36%. Blood glucose was 122 in February and is now 87. My doc had not been testing A1C but now it is 5.3. Liver enzymes ALT and AST are now well within normal range for the first time in a decade. My doctor says my non-alcoholic fatty liver is basically cured. My BP is now 120/80 or lower despite cutting my BP med in half. My resting pulse rate has dropped from high 80's to around 60.

On top of all that I no longer have obstructive sleep apnea and often sleep undisturbed through the night!

As my doctor said "strong work and strong results". I am continuing with the 20/4 two-meal a day ketogenic regimen with my doctor's approval, hoping for further cholesterol reduction as my LDL is still higher than the doctor would like to see -- although LCHF/IF doctors say elevated LDL is normal and not a cause for concern. I plan some further research to put that issue to rest in my own mind.

I did have a few bumps in the road with all this. At first some digestive issues since I was not used to all the vegetables. Later, after I lost most of the weight, I started having problems with muscle cramps in the calves and feet, due to electrolytes deficiency (magnesium/potassium). These are normal side-effects with easy corrections. I relied heavily on Dr. Eric Berg's YouTube videos for information on dealing with these issues, also what supplements to take to assist my particular health issues (fatty liver in particular).

Yesterday I bought a 20lb bag of birdseed and pedaled it a couple of miles home on my bicycle. Stunning what a difference that 20 lbs made, and equally stunning to realize just a few months ago I was schlepping the equivalent weight of TWO of those bags everyplace I went!

 

[street]

^ beautiful!
In the 5 to 6 weeks I have been doing the IF it is hard to beleive my results so far.

 

[RAE]

AFAIK the A1C test is more important than the FBS, the FBS is often the last measure to come down when switching to a carb controlled diet. Also there is the Dawn Phonomena which for a large number of people makes their blood sugar higher in the AM, the liver releases glucose to get us ready for the day. If my A1c is good and my FBS not crazy high (>120/125) I would just not worry about it. MY recent a1c was 5.5 but the last several months FBS have averaged 111/104/109/106 and periodic tests during the days are never <100 so maybe I go a bit lower at night but in any case the A1c is gold for my Dr and for me. Foe me I control blood sugar with LCHF diet and reasonable exercise, no meds.

+1, the "dawn phenomenom" (sometimes called the "dawn effect") is a real thing, and it is not that uncommon (I, for one, experience it). As you say, the liver releases glucose shortly before you awake, to get you ready for the day. I know that my FBG is always around 105-107, but my A1C is at 5.0, so I'm not worried about the FBG number. In fact, I have tested my FBG after eating breakfast (30 minutes after, and again at 60 minutes after), and my FBG actually drops a bit after eating. You always hear doctors and others say that having a FBG above 100 is not a good thing, but for me, that is just not achievable, regardless what I eat. I do want to get my fasting insulin tested this year to confirm that it's okay, but I suspect that it is.

Here is more information on the "dawn effect":

https://blog.virtahealth.com/dawn-phenomenon/

 

[audreyh1]

It took me a month to get on a consistent 20/4 fasting regimen (two meals a day), and then I further reduced carbs to get into ketogenesis. For exercise I walk 2-3 miles a day along with 3-4 bike rides a week, as weather permits.

By July I lost 40 lbs and achieved my healthy target weight of 182. Since February my overall cholesterol is down13%, LDL down 18%, VLDl down 33%, HDL up 10%, and triglycerides down 36%. Blood glucose was 122 in February and is now 87. My doc had not been testing A1C but now it is 5.3. Liver enzymes ALT and AST are now well within normal range for the first time in a decade. My doctor says my non-alcoholic fatty liver is basically cured. My BP is now 120/80 or lower despite cutting my BP med in half. My resting pulse rate has dropped from high 80's to around 60.

Wow! Fantastic results. Yay - fatty liver cured! That’s huge!

I’m skeptical of low targets for LDL too. Seems like ratios are better indicators. Plus there are different types of LDL. I have been researching this area quite a bit, and there is a lot more to it.

 

[EastWest Gal]

I’ve only been on LCHF for about two months. Since mid-June doing time-restricted eating-26/8 or a more restricted window. My lipids are the worst ever but I hadn’t checked them in two years and was in a toxic work environment.

BP was 130s/85. Now 120/70. Stepping up the exercise now. I hadn’t been swimming in a year, but last week did nearly a mile twice with no issues. Lost 17 lbs, many more to go. With retirement and getting eating under control, I feel much better, and the future looks bright.

I also found a new PCP, concierge medicine, and I’m really pleased. He’s a supporter of LCHF, very into high performance himself.

Last, it’s amazing how much more time you have to do other things when eating only 2 meals a day.

 

[haha]

For Harley and Haha and CoCheesehead:

My understanding is that someone on a ketogenic or low carb diet a long time, may have higher fasting blood sugar in the morning due to the body doing gluconeogenesis to get you ready for the activity of a new day.

Slightly elevated fasting blood glucose for a low-carber is pretty normal and doesn't necessarily mean you are eating too high carb. Higher blood glucose could be an issue.

I think this is behind a paywall, but you can perhaps sign up for one month free? There is a lot of information in this article:
https://www.dietdoctor.com/low-carb/fasting-blood-glucose-higher

Or perhaps you can find more information on the Dr. Sarah Hallberg site aka Virta Health.

The article goes onto say what matters is whether insulin is low. Fasting blood glucose and fasting insulin should be taken together.


But much higher blood glucose could be a sign of latent autoimmune diabetes. So that should be tested.



Maybe the above can give you enough information to research the issue further. Since I'm not a doctor - that's the extent of what I know.

Thanks Audrey. This seems quite helpful. I’ll look along this path for more over next week.

Ha

 

[harley]

Just an update on my previous posts, since I just got my blood work done and received the results. I'm sort of blown away.

Basically my issue was that with IF and LCHF I have lost ~45 lbs in 9 months. That's wonderful. I stopped taking insulin, and decreased my Metformin to once a day since I'm eating fewer meals. My Fasting Blood Sugar, which has always been high, was running around 150 or so, which was fine by me. Then, after 5 or 6 months it leapt into the high 200s/low 300s. That's with no changes in my eating or exercise habits. It freaked me out, as I was worried I was doing damage to my organs. But I didn't want to start insulin back up, as it works against the concept of IF. Then, after a couple of months of insanely high FBS levels, it dropped back down to the 130/140 range. Again, with no changes in routine. Weird. That was about 3 weeks ago.

I was concerned that my A1c would be high after all those weeks of ridiculously high FBS levels, and I'd have to deal with a doctor that wouldn't understand/support what I was doing. And I'd have to decide whether to take medications that I believe are absolutely the wrong way of dealing with the situation, vs. maybe doing myself damage. But I got my results back yesterday, and my A1c is 5.2. Hard to believe, but what a relief! All my other numbers are fine to good, with a couple of minor exceptions. Before I started all this, my A1c (taking insulin and twice as much Metformin) tended toward 5.7-6.0.

I'm just about to drop back below 200 lbs (at 6') for the first time in many decades. I've been as heavy as 263, and recently was 245. So I'm pretty happy. And the best part about all of this is that I find IF and LCHF to be really easy to do. At least once I got past that carb cold turkey period. It took me 2-3 weeks before the cravings went away. Now when I splurge and have a little ice cream or pizza or whatever, it's like "what's the big deal?" It doesn't taste as good as I remember, so I'm not all that tempted. Which is really great, since I've never been known for my willpower.

I can't wait to talk to the doctor tomorrow, and hear what she has to say.

 

[audreyh1]

Fantastic! 5.2 is a great normal number. And getting down to 200lbs - wonderful!

That is so bizarre that you suddenly had high blood sugars for a couple of months, and then you had even lower blood sugars.

But those were your fasting blood sugars. You don’t know what your blood sugars were doing the rest of the day? The A1C hints that they might have been dropping? It’s supposed to be a 3 month measure.

 

[footenote]

DH's morning FBS has been higher for the past few months, despite exercise and diet being rock-solid.

We learned that adhering to LCHF can cause the liver to dump glucose in the morning, which has nowhere to go because you're fat-adapted. His A1c (like yours) has been fine (5.1 at last check). Weird to adjust to, but FBS can stop being a meaningful metric because BS will drop over the day.

 

[Tekward]

Anybody who is very active fasting? I workout 90 min to 2 hours a day. Not sure I can get to the 16 hour autophagy point without eating. Any experiences?

Yes. I have been IF'ing for over a year and my regular gym/yoga workout of about 2 hours is started after 16 hours fasting and I have no problems. I enjoy the thought that my energy use is burning fat.

I have not been fasting when playing Pickleball because I push myself so hard and I don't want to hit the wall in a game.

M/ 61YO/ RHR <50 BPM, TG/HDL ~0.8 IF has been good for me.

 

[audreyh1]

DH's morning FBS has been higher for the past few months, despite exercise and diet being rock-solid.

We learned that adhering to LCHF can cause the liver to dump glucose in the morning, which has nowhere to go because you're fat-adapted. His A1c (like yours) has been fine (5.1 at last check). Weird to adjust to, but FBS can stop being a meaningful metric because BS will drop over the day.

Yes, this dawn phenomenon seems to be relatively common in low-carb individuals, and was discussed earlier in this thread.

I haven’t experienced it yet myself, as my recent fasting blood glucose was 69 after 3 months ketogenic diet. Lowest ever for me I think. It will be interesting to see if that changes as my body continues to adapt.

 

[Tailgate]

IF 16/8 since March.. not too strict, but avoid carbs and work on portion control. A1C dropped to 5.1, dropped 4 BP meds, lost 45 lbs. I attribute a lot of my successes so far to DDPYOGA along with the lifestyle change.

 

[harley]

Fantastic! 5.2 is a great normal number. And getting down to 200lbs - wonderful!

That is so bizarre that you suddenly had high blood sugars for a couple of months, and then you had even lower blood sugars.

But those were your fasting blood sugars. You don’t know what your blood sugars were doing the rest of the day? The A1C hints that they might have been dropping? It’s supposed to be a 3 month measure.

Other than when I was first diagnosed as diabetic (2002-ish) I've never checked my post-prandial numbers. I was always pretty normal during the day, it was just the dawn phenomenon that needed to be watched. Back then (pre-insulin) I was always in the 200s fasting, but only around 100 or below a couple of hours after eating. Once I started insulin I got my fasting numbers down to the 120/130 range when eating properly, and only about 170 or so when I would cheat and eat pizza or ice cream or whatever. So I haven't been testing other than fasting. I probably should take a look once in a while.

I'm hoping that by this time next year I won't be diabetic at all anymore. I'm still taking Metformin, but after I've been stable FBS-wise for awhile I think I'll stop taking it and see how I'm effected. That would be excellent, if I can drop it.

 

[audreyh1]

So when you were 200s fasting, but then your blood sugar was dropping to 100 or below a couple of hours after eating, was your A1C high? Seems like most diabetic or even pre-diabetic folks have a large rise in glucose 2 hours after a meal.

Well, obviously, addressing the blood insulin issues (lowering it) and adiposity issues are the most important as those things will reduce insulin resistance and should mean better blood glucose control in the future.

 

[harley]

So when you were 200s fasting, but then your blood sugar was dropping to 100 or below a couple of hours after eating, was your A1C high? Seems like most diabetic or even pre-diabetic folks have a large rise in glucose 2 hours after a meal.

Well, obviously, addressing the blood insulin issues (lowering it) and adiposity issues are the most important as those things will reduce insulin resistance and should mean better blood glucose control in the future.

Not really. Other than the very first A1c when I was diagnosed (7.something, 300+ fasting), my A1c stayed in the 5.7-6.0 range. I have a very close friend who is also type II, but our symptoms are so different I don't know how they can label us with the same diagnosis. It was the lack of clear science about type II that caused me to spend so much time reading and learning.

 

[audreyh1]

Not really. Other than the very first A1c when I was diagnosed (7.something, 300+ fasting), my A1c stayed in the 5.7-6.0 range. I have a very close friend who is also type II, but our symptoms are so different I don't know how they can label us with the same diagnosis. It was the lack of clear science about type II that caused me to spend so much time reading and learning.

Interesting, thanks.

Your experience with high fasting numbers, yet lower A1C seems quite different, not that I am an expert on diabetes or anything.

Well, fantastic that you got your A1C down to 5.2, well under the pre-diabetes range. Clearly you are making great progress healing your metabolic syndrome regardless of your unusual fasting fasting blood sugars, although it's good they've dropped too. That your weight loss has been successful also indicates insulin has dropped low enough to allow fat burning, and it's a virtuous cycle now.

Fasting blood glucose (morning) is controlled by the liver, rather than by the food eaten, so that's an entirely different mechanism.

 

[Sittinginthesun]

Thanks for this thread. Motivated me to get back on track and started LCHF 18:6 IF a week ago and feeling better already. A few physical symptoms like mild headache and lack of energy but I am drinking lots of water and will push through. Lack of hunger is incredible! Using MFP for food journaling.