Start the #3DayCancerPreventionFast in Ketosis

Yesterday I shared the results of my #3DayCancerPreventionFast that allowed coffee with a bit of cream, as compared with a previous water-only version of the same fast.

Despite having two tablespoons of heavy whipping cream in my morning coffee, twice each day, I achieved 27 hours of Glucose Ketone Index (GKI) <1, and at least 85 hours of GKI<3.

Results were close to what I did with water-only, and my different exercise pattern explained some of the lag in getting to my GKI targets.

My wife Lisa did the same fast, and her results were even better:

She had GKI<1, the highest therapeutic level, for 60 hours, and has had GKI<3 for about 100 hours as I write this.

As my daughter-in-law would say, Lisa smashed my face!

Note also the significant difference between her results on the coffee and cream version of the fast as compared with the water only.

Some key observations:

  • Her GKI was much higher at the start of the water-only fast. This was because her last meal before that fast was taco salad with chips, along with two cinnamon rolls with frosting.
  • In the coffee and cream fast, by contrast, she was in nutritional ketosis from the start, and was below 3 on the GKI at just 16 hours, a full 10 yours earlier than on the water fast. She reached GKI<1 at 25 hours, almost a full day ahead of what she had done in January on the water-only fast.
  • The big lesson here is that coming into a fast already in ketosis dramatically improves the results, to the point that even with up to four tablespoons of cream per day her readings were far better than those when she started a water-only fast from a high-carb state.

Importantly, we supplemented magnesium and sea salt daily throughout the fast to keep electrolytes in balance, and broke the fast with a small meal of scrambled eggs, bacon, cream cheese and guacamole to prevent refeeding syndrome.

Lisa and I both found this fast immeasurably easier than a water-only fast, both because of the taste of cream and also because we didn’t get the caffeine-withdrawal headaches.

We may try a black-coffee version of the fast sometime, but with results like this that are relatively easy I think including a little cream will be our standard practice for the preventive fasting.

Check out My Health Journey for the full story of our health improvements, and my #BodyBabySteps for an approach to how I would do it if I were starting today, based on what I’ve learned.

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#3DayCancerPreventionFast: Water-Only vs. Coffee with Cream

I have undertaken several extended fasts for cancer prevention, and in January Lisa joined me for our first joint #3DayCancerPreventionFast.

Because we wanted to ensure that we were reaching the optimal therapeutic level of ketosis, we did a water-only fast that first time.

To gauge the fast’s effectiveness, we took blood glucose and ketone measurements several times each day using our Keto-Mojo meters, which provided a Glucose Ketone Index (GKI) score.

On a Standard American Diet (SAD), ketones are essentially nonexistent because glucose levels are high, and therefore insulin levels also are elevated. The liver produces ketones from fatty acids in the bloodstream, but this only happens when insulin levels are low enough to allow fat cells to release the fatty acids.

Professor Thomas Seyfried developed the GKI score to compare the levels of glucose and ketones in the bloodstream. A GKI less than 3 is considered a high level of therapeutic ketosis, while the highest level is <1, which is what Seyfried seeks to achieve in studies treating cancer patients.

Since Lisa and I are seeking to prevent cancer instead of treating it, we decided to set two GKI targets on our #3DayCancerPreventionFast:

  • At least 72 hours with GKI<3 (High Level)
  • At least 24 hours with GKI<1 (Highest Level)

In our January water-only fast we easily met those goals, as I had 44 hours of GKI below 1 and more than 70 hours below 3.

Lisa and I completed another three-day fast on Tuesday, but this time we allowed ourselves coffee with two tablespoons of cream, twice per day.

If we could make this accommodation while still reaching our GKI targets, this would make our monthly three-day fast much easier.

Here’s a graph of my GKI values for the water-only fast (blue line) as compared with the coffee + cream fast (green line):

One additional difference between the two fasts is that the first time I did an intense cardiovascular workout at about the 18-hour mark, while for the second I ran two miles when I was 26 hours in to the fast.

Both had the effect of raising blood sugar levels in the short term, breaking down liver glycogen in the first instance and through gluconeogenesis in the second, while also burning some of the ketones I was already generating.

Because I burned the ketones during my run they were no longer in my bloodstream, which temporarily boosted my GKI. This meant that in the second fast I was delayed by about 7 hours in getting below 3 GKI.

Still, I reached a GKI of 3 at the 36-hour mark, and stayed well below it for the next 64 hours. (In fact, my GKI this morning was 1.5, so I’ve had 76 hours so far in high-level therapeutic ketosis, and I had 27 hours below 1.)

Here’s a comparison of my ketone levels over the course of both fasts. Another key difference is that this time I went into the fast with higher ketone levels.

Three Lessons and a Caveat:

  • Lessson 1: It’s good to start a fast already in dietary ketosis. For this week’s fast I was at GKI of 4, while I was at 15.3 when I started the water-only fast in January.
  • Lesson 2: Intense cardio the morning after beginning a fast is better than doing it later in the afternoon. It burns through liver glycogen and accelerates progress of the fast.
  • Lesson 3: Starting in ketosis and having a small amount of cream with coffee made this fast pretty easy. I really wasn’t very hungry, and I didn’t have caffeine withdrawal symptoms.
  • Caveat: I don’t know that GKI<1 for 24 hours and GKI<3 for 72 hours are the right targets. Given the purpose of our fast, to accelerate autophagy in healthy cells and to put serious stress on (and hopefully kill) any cancer cells by depriving them of glucose, those seem reasonable to me. If you think different targets are appropriate, I’d like to hear your reasons in the comments below.

What’s next? When we do this again in April, I will plan to be sure I’m well into dietary ketosis as I’m starting the fast, and will do the intense cardio exercise early on the first morning.

Tomorrow I’ll share Lisa’s experiences in the two versions of the #3DayCancerPreventionFast.

To get these updates on a regular basis you can subscribe by email, or follow me on FacebookTwitter and LinkedIn, where I’ll also be posting links.

Check out My Health Journey for the full story of our health improvements, and my #BodyBabySteps for an approach to how I would do it if I were starting today, based on what I’ve learned.

Extended Benefits of Extended Fasts

As I noted in an update the day after my Stepping Off the Wagon post, I was shocked that after eating a whole pizza and more than one gluten-free beer, I was still able to stay in therapeutic ketosis.

Since Lisa and I concluded our #3DayCancerPreventionFast on January 27, in addition to January 31 we have stepped off the wagon two more times: February 11 and last night.

While Lisa has stopped the daily glucose and ketone measurements between our monthly extended fasts, I have kept them up since then. My readings for the 24 hours after the first excursion are above, and below are those for the period after the February 11:

I technically was out of GKI ketosis on the morning of the 12th, but by fasting as I stepped back on the wagon I was back to moderate ketosis by dinner time.

So because we’ve handled our off-wagon ventures with few negative effects, and because Lisa was away most of the day yesterday, we decide to exchange Valentine’s Day presents a day late. Here was hers to me:

Some in the low-carb/ketogenic community believe it’s essential to always rigorously limit carbs to avoid undoing all of the good of ketosis, and that one step off the wagon will undo weeks of effort.

They say it puts you right back to square one.

I cautiously disagree, at least for myself and for Lisa.

One way it could derail us would be if it became a gateway to ravenous, uncontrolled carbohydrate indulgence.

I’m confident that won’t be the case for us today, because it hasn’t led to this in the past.

We will enjoy our black coffee this morning, and fast until dinner.

The other way it theoretically could cause a problem would be if it reversed the fat-adaptation we had achieved. I think the ketone readings above in my post-pizza periods – all of them 0.5 mmol/L or higher – show that the ketone production is continuing.

That’s a secondary benefit of extended fasting, on top of a generally low-carb eating pattern.

In addition to activating autophagy and apoptosis, an extended fast flips the fat-burning switch to high gear.

The fundamental idea behind ketogenic eating and fasting is to restore metabolic flexibility the ability to use both sugar and fat for fuel.

Unfortunately, the typical American diet has so much sugar and starch in their various forms that it destroys fat-burning capability.

As I finish this post before starting work, and having just taken my morning readings, I’ve seen my ketones dip to 0.4 mmol/L, the first time I’ve been below 0.5 in a month.

So it suggests I probably should wait until after the next #3DayCancerPreventionFast for another pizza night.

Update: I tracked my “day after” glucose and ketones three times today, and here were the readings:

With plenty of carbs in my system from a whole pizza and a couple of gluten-free beers, and with the normal morning rise in glucose levels, I wasn’t too surprised that ketones dipped a bit further even at noon. But with only black coffee in the morning and coffee with cream at noon, I’m now solidly back into GKI ketosis.

Time for some scrambled eggs for dinner!

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Weight Loss Side Effects of the #3DayCancerPreventionFast

In a comment on LinkedIn this morning, Janet Kennedy asked:

I’m glad she asked, because it highlights an important positive side effect of the #3DayCancerPreventionFast.

You may have noticed that I haven’t said anything about weight loss in my previous posts about this experiment, because that wasn’t the main goal.

The goal of our fast was getting to a high enough level of therapeutic ketosis that it would stimulate autophagy (recycling of damaged or inefficient cell organelles, especially mitochondria) and put any cancer or precancerous cells under enough stress that they would trigger apoptosis, or programmed cell death.

Another major benefit of extended fasting is a recharged and rejuvenated immune system, so if apoptosis doesn’t cause the cancer cells to commit suicide, maybe they’ll be weakened enough for our natural immune defenses to kill them.

And there’s this virus going around, perhaps you’ve heard of it, that seems to generally cause more severe consequences in older people than it does in children and young adults.

A rejuvenated (literally “made young again”) immune system would seem to come in handy for that, too.

Although weight loss wasn’t the main goal of our #3DayCancerPreventionFast, it was a beneficial side effect. A nice bonus.

As Dr. Jason Fung says, the basic logic of fasting is simple: “If you don’t eat, you will lose weight.”

Here’s what we found:

  • Lisa and I each lost six pounds from our Sunday morning weigh-in, before starting the fast, to our low point post-fast on Thursday morning, after we had concluded the fast on Wednesday.
  • My weight went up a little on Monday morning because I had two meals on Sunday, beginning my fast at 4:30 p.m., so the loss from my high point was 8.8 pounds.
  • The high point of our weights early in the month correspond to the visit of my daughter Ruthie and her husband and daughter. They’re missionaries in Bulgaria, and were back in the country around the holidays, staying with us from Jan. 3-8. That was a feasting time, and we could revel in it without fear or guilt because we balance it with fasting.

I call that a balanced diet – balancing feasting and fasting – not seeking some kind of equal partitioning of carbohydrates, protein and fat.

We enjoyed having Trevin, Ruthie and Noa Hoot home with us to start the New Year with a feast.

To answer Janet’s second question, as you can see in the graphs above we’ve reached our weight goals, and had been there before the holidays. Now as we head into February with no major feasts on the schedule, we will settle into a more normal rhythm, gradually eating a little more toward the end of the month, so that after our next fast we’ll be again about at this level.

In future posts I’ll do a deeper exploration of how our fast affected blood sugar and ketone levels, workout capacity and sleep, as well as some overall reflections and our plans for February and March fasts.

And if you, like Janet, have other questions about, please ask them in the comments and I will be happy to answer them.

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Check out My Health Journey for the full story of our health improvements, and my #BodyBabySteps for an approach to how I would do it if I were starting today, based on what I’ve learned.

#3DayCancerPreventionFast: Day 2

Some thoughts at the end of the second full day of our three-day water-only fast, which we began on Sunday, Jan. 24, as Lisa and I have 15 and 18.5 hours remaining to hit our 72-hour goal.

So far we have been able to stick to the water-only regimen, with a mix of filtered water and mineral water.

We are big coffee drinkers, and were both pleasantly surprised that we didn’t have caffeine-withdrawal symptoms Monday morning. Unfortunately that surprise didn’t last, as the withdrawal symptoms came a little later, as Lisa felt really low in energy and I got a headache in the afternoon and early evening.

Taking a tip from Dr. Peter Attia, I did an early morning workout on Monday, both bench press and high-intensity rowing. The idea is to burn out the stored glycogen to accelerate the move to fat-burning.

Interestingly, my blood glucose and ketone readings from before and after my Monday morning workout (at right) showed an increase in blood sugar from 88 mg/dL before my workout to 104 after I had showered and settled in to work.

That’s totally normal, and is the result of my liver releasing glycogen for use by my muscles.

I took readings again at the 24-hour mark of my fast and then at bedtime, which showed that my glucose levels were stabilized due to gluconeogenesis (my liver creating new glucose from amino acids and other circulating substrates), and ketones had begun to climb, reaching 1.1 mmol/L.

With a Glucose Ketone Index (GKI) of 3.6 at bedtime, I was nearing the high level of therapeutic ketosis, but getting there would need to wait until Tuesday morning.

My early morning glucose Tuesday was again 73, but ketones had climbed to 2.2, and by early afternoon those readings were 67 and 4.2, respectively, giving me a GKI of 0.8.

The caffeine withdrawal symptoms were gone, too. We’re supplementing magnesium and salt to maintain electrolyte balances, and mineral water also helps.

In keeping with Dr. Attia’s advice to do lower-intensity cardio on the second and subsequent days of extended fasts, I waited until after work today to do a 45-minute rowing session. Here were my readings before and after the workout, and at bedtime:

Even though I hadn’t eaten for more than 48 hours, because of gluconeogenesis I maintained adequate blood sugar. And with climbing ketones I have had a GKI under 1.0 for the last nine hours.

I got a Keto-Mojo meter for Lisa, too, and as of this evening she also had reached the 1.0 GKI threshold. Our target is to be below 3.0 for a couple of days, and ideally below 1.0 for a day, for maximum therapeutic benefit.

We’re glad to be in the last several hours of our #3DayCancerPreventionFast. Neither of us would say it has been easy, although we really haven’t felt hungry. Empty is different from hungry. Lisa really misses her coffee, and in future fasts we will likely experiment with allowing coffee, and maybe even coffee with a little cream, and see how our glucose and ketone levels are affected.

I think it’s really helpful having a glucose/ketone meter when doing an extended fast like this. It gives us hard data that what we’re doing is having the desired effect, and when we take readings every few hours we can see the progress.

You may not be able to imagine doing an extended fast for cancer prevention, and if you haven’t done some preparation and adaptation I wouldn’t recommend just diving into it.

Check out My Health Journey for the full story of our health improvements, and my #BodyBabySteps for an approach to how I would do it if I were starting today, based on what I’ve learned.

For us it seems like a worthwhile investment in our long-term health, and I’ll share tomorrow’s experience including breaking our fasts in my next post.