Wednesday, February 26, 2014

Ketogenic Diet for Athletes/Agility?

Wow, where did that come from?  I've been down some rabbit holes the past 2 weeks, mostly doing research for my weight loss clients.  I mostly don't give out dietary advice.  People come to me with their own plans for weight loss and I help them with the behavioral changes they need to make for their plan to succeed.  I urge them in the direction of eating healthy portions of healthy, whole foods and I leave it up to them to decide what that means.  Because there are a lot of voices out there having a big old food fight over what is a healthy diet and I'm not about to start throwing plates of spaghetti around in that mess.

Nonetheless I've had some clients who claimed to be eating a healthy diet, calorie restricted (some so much so that I wondered how they were still standing by the end of the day), getting regular exercise.  For some reason eat less/exercise more/healthy whole foods (whatever that means) wasn't working for them.  And I wanted to know why.  Were they deceiving themselves?  Underestimating how much they were eating, overestimating their exercise, overeating to make up for their exercise?  Or was something else going on?  I didn't feel comfortable just brushing them off, after seeing enough of them, hearing their stories, I felt like I was missing something and I felt I needed to find out what I was missing.  No point helping people change their behaviors if they succeed in making those changes yet still don't reach their goals.

So many voices out there, so many opinions, so much bad science and politics and bad studies and even worse science and politics and ranting and raving.  This journey is not for the faint of heart.  In the end the conclusion I came to, and have been coming to for about 5 years now, is that insulin is largely at the heart of it all for many people who struggle with their weight.  And this means restriction of carbohydrates, even whole grains.  It's taken me a while to fully understand this because I could think of so many exceptions, so many people for whom 'eat less, exercise more' works.  But the idea that's emerged this time down the rabbit hole is the notion that insulin sensitivity is different in different people.  And that there are people out there who are 'insulin resistant' and these folks can't tolerate carbs.  They can cut calories down to ridiculous levels, exercise 2 hour a day and still not lose weight if they're following a high carb/low fat diet.

Case in point, Dr. Peter Attia.  He has a great blog called The Eating Academy, very technical, maybe you need a degree in biochemistry, but still very interesting.  Below he describes how he lost a bunch of weight and turned around his metabolic disease and improved his cholesterol numbers by following a ketogenic diet consisting of 80% of calories from fat.  Yeah, you heard that right.  All I can say is watch the video.  And be prepared for charts and graphs.  Lots of charts and graphs.

This led me to start looking into low carb/high fat diets.  Of course these are nothing new, Atkins back in the 70's and in fact these diets were used to treat kids with seizures as far back as the 1920's.  And here's where the politics comes in and the conspiracy theories that are maybe not so wacky and Nixon and the Farm Bill and suddenly fat is bad and carbs are good and now 40 years later we have a worldwide obesity epidemic to beat the band.  Probably some of the best voices here are Dr. Robert Lustig and Gary Taubes.

Do not mess with Robert Lustig, he is on a mission from Sugar.  I think he is kind of my hero.

Gary Taubes (the intro is 6 minutes  if you want to skip to the lecture though the intro is interesting)

Yeah, I know, it's a lot of material but very worth it if health and nutrition are important to you.  I found a lot of my ideas about 'healthy' turned upside down, inside out and scrambled around.  Like someone declared it Nutrition Opposite Day.  And I became even more surprised when I decided to track my own diet for a few days and found that I naturally eat more fats than carbs (average of 47% fat, 33% carbs, 20% protein).  And I found that with a few minor tweaks (eg, no more toast with my eggs) I was able to bring it to 58% fat, 22% carbs, 20% protein.  A ketogenic diet would call for something like 70-80% fat, 15% protein, 5-15% carbs (usually 20-50g of carbs depending on insulin resistance but some high volume athletes can maybe go to 100 g), depending how insulin sensitive you are among other things.

There are a lot of voices out there.  Very loud and shouty voices, very sure they know the answers.  I'm not saying these guys and only these guys know all the answers.  If this subject interests you you should investigate it for yourself and most importantly experiment with your own diet and decide what works for you.

And in that spirit I've become interested in the potential advantages of a ketogenic diet for triathlon and agility.  Over the years I've become less and less able to tolerate sugar and processed carbs (especially pasta and bread, even the whole wheat versions).  I cut breakfast cereal out many years ago.  I can eat these things but they cause bloating and a even a mildly ill sort of feeling sometimes.  I eat them but rarely and usually on the weekend when I've got a big training day planned.

Further I discovered that carbs and all that I knew about timing of meals pre and post workout might not only be wrong but actually might be having a detrimental effect to my triathlon training.  For the first time I was unable to tolerate the sugary gel packets in my last 2 races last year and in fact they made things worse for me.  My theory is that I've finally become unable to tolerate sugar even during races.  One of the reasons I switched to racing Xterra's is that they're shorter and require less energy bars and gels both in training and races (plus the added benefit of they are so much more fun).  But they still require some fueling.  Or do they?

Nutritional ketosis is difficult to explain and requires diagrams and chemical equations and maybe even a biochemistry degree.  Hands up who remembers the Krebs cycle?  Well I remember learning about it somewhere at some point a long long time ago.  But in short the idea is that you limit carbs and keep protein low so that the body burns fat rather than glycogen.  Because we can only store about 2000 cals of glycogen but fat stores are endless, even in a scrawny triathlete.  Plus the claims that the brain stays more alert when running on ketones.  Imagine feeling mentally sharp for that Snooker run at the end of a long agility day.  I've been entering half days of agility these days because after about 3-4 hours I'm tired and crabby and mentally drained and don't want to be there anymore.  Would a ketogenic diet allow me to handle a full day?

Some ultrarunners and endurance athletes are adopting these diets and I'm intrigued.  I've bought a $6 e-book from Amazon called 'The Art and Science of Low Carb Performance' and it's fascinating stuff.  One of the authors discusses the concepts and recent research findings below.

Jeff Volek

I'm interested enough to consider giving it a try.  I have the added challenge of being a vegetarian so I'm not entirely sure how this will work but I think I can find some hacks for it and I know Peter Attia has said that's it's possible.  I'm not completely sold but I love a good experiment.  I'm going to start gradually, not going to shoot for ketosis right away but I'm already a good way of the way there so I'm not anticipating too many problems at first.  The biggest challenge is the world at large, eating out or at other people's houses.  And Jonny who does most of the cooking and still likes him his grains.  He was not happy with me picking out 2/3 of the sweet potatoes from dinner the other night.  But I think if I leave my carb allotment for dinner we should be able to live in peace.  My grocery cart is getting weirder that's for sure. And if there are any athletes out there who have given this a try please feel free to offer up experiences.  For those who are interested, the Paleorunner blog has loads and loads of podcasts offering up all manner of opinions about diet and training.


  1. Hi Elayne. I know I am just a bit late here, but am fascinated by your posts on your eating. Are you still at it? How are you feeling?

    I am fortunate in that I've never had a weight problem, but I've also for the most part naturally leaned towards a fairly protein-rich, whole foods diet. That's just what I crave, and the older I get the less processed foods I've eaten, and it seems to at least keep me on the level for the most part.

    I try to eat well at trials but I also run out of steam at the end of the day. Would love to have a revamped strategy for how to properly fuel throughout the day. I am always worrying about the dogs and I get short shift in the care and feeding department. Know I'm not alone on that front. :)

    Havent watched the videos yet but I will, and again would love to hear how the diet tweaks are treating you.

  2. I'm formulating a post about it. In short I've decided against going the full adaptation to ketosis right now because I'm starting my triathlon season training and I can't afford to be dragged out for 2-3 weeks (or longer) but I have cut out wheat/grains except for occasionally some white rice after a big workout and I'm keeping the carbs lower than I was, more fat and the difference is HUGE for me, especially with cutting out wheat. Did feel a lot more mental energy at my 3-day Agilitython a couple of weeks ago. I'll write in detail later. I've been down some very interesting and weird rabbit holes and I'll write about it all.

  3. The video from Jeff Volek is the one most relevant to diet/ketosis and athletic performance/mental functioning. I'm hoping to eventually do some video interviews/podcasts with some people regarding some of these things but I'm working out the technology and equipment I need to make that happen which is largely why I've been absent from the blog.

  4. Sounds great, I look forward to what you find out.

    I saw that you say you are a vegetarian, so are you adding more animal-based fats or...? I'm not a veg, but I am curious how you would do this sans meat.

    I'll watch the Volek video as well. Thanks for sharing.

  5. I do eat dairy - eggs, cheese, heavy cream, sour cream, etc. Organic and pasture fed when I can get it. A true ketogenic diet doesn't require a huge amount of meat because that would add too much protein. You almost have to get the rest of the fat from other sources like olive oil, coconut oil, coconut milk, olives, avocado, I'm not even sure what else. That's been my challenge, trying to get fat up and protein down. Even as a vegetarian I eat 125% of the RDA of protein. The diet is do-able for vegetarians and even vegans. Volume-wise most of the food is veggies anyway unless someone is really seriously trying to restrict carb to maybe 5% of calories and then they'll even barely eat veggies. This would be for someone who's seriously metabollically compromised or someone with cancer or some other serious disease.

    Volek is in the process of doing experiments on elite endurance athlete's and I'm hoping the results will come out before fall.