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3 Months 3 Ways – Month 2 in review: Keto

Background: what is the 3 months 3 ways experiment?

Between mid-September 2018 and mid-December 2018, I ‘m experimenting with a different diet each month while undertaking intensive strength training. The diets are: Paleo, Keto, and Carnivore. Throughout the experiment I share updates and insights on Instagram [https://www.instagram.com/damcgrath/]. The effects on my body from the different diets are being monitored using a range of tools including the FreeStyle Libre [https://www.freestylelibre.com.au/] for 24/7 blood glucose, Oura ring [https://ouraring.com] for sleep, Sweatbeat app [http://www.sweetwaterhrv.com], Polar H10 chest strap [https://www.polar.com/au-en] for Heart Rate Variability (HRV), an extensive panel of blood work through iMedical [https://imedical.com.au], and strength and body composition assessments from Recomp HQ [https://recomp.com.au], with dexascans from MeasureUp [http://www.measureup.com.au/melbourne/]. My food consumption, macro and micronutrients are being captured through Cronometer [https://cronometer.com]. My strength training is under a coach at Recomp HQ. It involves two very intense weightlifting sessions a week with strength gains and calculated one rep mass tracked for each exercise each session. Changes in body composition are measured fortnightly using a 9- site caliper pinch test. Baseline body composition and strength assessments were done before commencing the program, throughout, and at the end of each of the experiment periods. No other exercise is done for the three months. Sauna and infrared protocols are used throughout to support recovery.

Why am I doing it?

I have eaten a variety of diets over the years. Some for weight loss, some for energy, some for optimising my performance or other health reasons. When I dived into the data at times and experienced different levels of ‘success’, I felt they all worked to some capacity, and I realised how adaptive my body is. I was curious to learn which of these different ways of eating were ‘optimal’ for me by comparing them through an experimental science-based protocol. Naturally, ‘optimal’ is subjective depending on what outcomes I may seek. Last month I shared some of results from my first month: Paleo, which can be found here [https://www.diannemcgrath.com.au/3-months-3-ways- paleo/]. For month 2 I ate a ‘standard’ ketogenic diet.

Macros, 5% C, 22% P, 73% F

Macronutrient ratios during Month 2 – Keto

From mid-October to mid-November 2018 I ate a ‘standard’ ketogenic diet starting at 1601 calories, gradually titrating down to 1356 calories. What did I eat? By ‘standard’ I allowed myself a variety of protein/fats, including more omega-6 based fats, while maintaining a higher Omega 3 ratio over all. Normally I do not consume many plant-based proteins and limit my plant-based fats, but I wanted to eat a broader keto diet to see what would happen, and to reflect what I see others eating online or being sold in stores and online. The most commonly consumed foods in my keto month included:
Protein: fatty meat (lamb, lamb and lamb), fatty fish (salmon), offal, eggs, bone broth, collagen and other animal-based protein sources, with the occasional protein powder drinks and bars
Carbohydrates: small amounts of rocket, spinach, chard, flax, raw cacao, coconut flour, nuts and occasional protein powder drinks/bars and;
Fats: lard, butter, cream, EVOO, eggs, nuts, raw cacao, 100% dark chocolate, goat cheese, and occasionally protein powder drinks/bars.

Some insights from month two’s end
Sleep

Eating more fat was magic for my sleep. I rarely woke during the night, and obtained on average 1 hr 13 mins deep sleep a night, with a max of a sensational 2 hrs 17 mins of deep on 4 November. Ahhhh! As Figure 2 illustrates, my sleep became better and better by the day, both in deep sleep, and in the Oura ‘sleep score’. Oura calculates the sleep score by considering total sleep, efficiency, disturbances, REM, deep, sleep latency, sleep timing and light sleep. More details can be found here: https://ouraring.com/sleep-score/. Comparatively, my average deep sleep on paleo was 1 hr 1 min with a max of 1 hr 39 mins , and sleep score 87%, and these declined over the month.

OuraSleep pattern graph

Deep Sleep (LH axis) and Sleep Score (RH axis) during Keto month (Oura measurements)

From the literature supporting women sleeping better eating less processed carbs, I continued the practice from later in my paleo-month whereby I ate almost all my carbs in the morning, leaving a higher fat and protein load in the evening. [1,2] Also, while a study in healthy men only with no female subjects, a very low carbohydrate diet significantly increased slow wave sleep (deep sleep), while decreasing REM. [3] I’m a bigger fan of deep to REM due the healing and life critical qualities deep sleep is associated with, so that’s a winner for me.

Exercise

I continued to achieve strength gains and alterations to my body composition (see Table 1 ). I felt that I’d had more energy lifting when I was eating paleo in month 1, however, how much of that was due to higher calories or the foods consumed it is hard to say. Also, due to my ability to achieve new PBs most sessions, this may just have been a case of perception vs reality, [4] as there is no significant difference in strength performance between ketogenic and non-ketogenic diets in athletes. [5]

  Baseline

End Month 1

(%change vs baseline)

End Month 2

(%change vs baseline)

[%change vs Month 1]

Body comp      
Weight 61.6kg

62.7kg

(1.8%)

61.5kg

(-0.16%)

[-1.9%]

% body fat 18.3%

16.1%

(-12.0%)

14.5%

(-20.7%)

[-9.9%]

Lean muscle mass 50.3kg

52.6kg

(4.6%)

52.6%

(4.6%)

[0]

Fat 11.3kg

10.1kg

(-10.6)

8.9kg

(-21.2%)

[-11.9%]

Strength (calculated 1RM)  
Squat 60kg

69kg

(15%)

69kg

(15%)

Bench 30kg

50kg

(66.7%)

50kg

(66.7%)

Dead 100kg

110kg

(10%)

110kg

(10%)

While the calculated strength figures above appear to show no change from the month prior, my calculated 1RM for specific exercises saw a dramatic change for the few I continued across both months:

  • bench press: month 1 1RM 56kg, month 2 1RM 2 60kg (7.1% increase)
  • cable row: month 1 1RM 64kg, month 2 1RM 69kg (7.8% increase)
  • lat pulldown: month 1 1RM 58kg, month 2 1RM 75kg (29.3% increase)
  • leg press (hold onto your hats folks): month 1 1RM 286kg, month 2 1RM 313kg (9.4% increase).

So on keto I got leaner, preserved lean muscle mass, and increased my strength.

Blood panel/biomarkers

I saw some tweaks here and there to my blood pathology results. As per last month, I’m only going to comment on the most significant change: Growth Hormone: Like last month my Growth Hormone (GH) was also markedly higher than baseline by 500%, although three-times lower than last month’s remarkable figure. This will be interesting to track over time on the conclusion of the 3-month experiment as women see a dramatic drop in GH after 50, which I will be turning next year. [6] The same study indicated that the lower the BMI, the higher the GH, so maintaining a healthy BMI will be helpful as I hit the second half of my century. As a reminder, a number of factors may have contributed to this change over baseline, including but not limited to increasing: a. Estrogen levels (which was 34% up on baseline) [7] b. Protein consumption [8] c. Resistance training [8,9] d. Sauna [10] e. Cold exposure, [11] and f. Having low body fat percentage (very strong trend, but not statistically significant). [12]

Mental health

Last month (paleo) HappyTracker told me that I experienced 5 mornings out of the month where my mood was ‘meh’. Every other morning my mood was ‘happy’. I did not experience any ‘sad’ mornings. This month (keto) I did not have a single ‘meh’ start to my day. As mentioned last month, research shows that healthy middle-aged women with lower cholesterol have a higher prevalence of depression. [13] How much cholesterol should we eat? Australian guidelines still set a limit of 300mg, [14] whereas in 2015 US guidelines removed any upper limit. [15] This recognises that our bodies actually make a lot of the cholesterol we need if we ‘run short’ through our diet. Cronometer reports that I consumed around 412mg of cholesterol daily during keto, and actually a bit more (433mg) on paleo, so that doesn’t really explain the difference in mental health. I suspect it may be associated with carbohydrate consumption, which has been suggested in the literature. [16] According to Cronometer, my average daily total carbohydrate consumption on paleo was 78g, and on keto it was 16g (79.5% less). Perhaps…

What’s next?

Month 3: Carnivore! Other than coffee, not a single plant-based food will pass my lips for the month!

References

1. MP St-Onge, A Mikic and CE Pietrolungo 2016, ‘Effects of Diet on Sleep Quality’, Advances in Nutrition, 7(5): 938-949 [URL: https://www.ncbi.nlm.nih.gov/pubmed/276331090].
2. MP St Onge et al. 2016, ‘Fiber and Saturated Fat are Associated with Sleep Arousals and Slow Wave Sleep’, Journal of Clinical Sleep Medicine, 12(1): 19-24 [URL: https://www.ncbi.nlm.nih.gov/pubmed/26156950].
3. A Afaghi, H O’Connor and CM Chow 2013, ‘Acute effects of the very low carbohydrate diet on sleep indices’, Nutritional Neuroscience, 11(4):146-54 [URL: https://www.ncbi.nlm.nih.gov/pubmed/18681982].
4. AM White et al. 2007, ‘Blood ketones are directly related to fatigue and perceived effort during exercise in overweight adults adhering to low-carbohydrate diets for weight loss: A pilot study’, Journal of the American Dietetics Association, 107(10): 1792-96 [URL: https://www.ncbi.nlm.nih.gov/pubmed/17904939].
5. A Paoli et al. 2012, ‘Ketogenic diet does not affect strength performance in elite artistic gymnasts’, Journal of the international Society of Sports Nutrition, 9(1): 34 [URL: https://www.ncbi.nlm.nih.gov/pubmed/22835211].
6. F Roelfsema and VD Johannes 2015, ‘Growth-hormone dynamics in healthy adults are related to age and sex, and strongly dependent on body mass index’, Neuroendocrinology, 103(3-4)335-44 [URL: https://www.ncbi.nlm.nih.gov/pubmed/26228064].
7. AG Frantz and MT Rabkin 1965, ‘Effects of estrogen and sex difference on secretion of human growth hormone’, The Journal of Clinical Endocrinology & Metabolism, 25(11), pp.1470-80 [URL: https://www.ncbi.nlm.nih.gov/pubmed/5843702].
8. DS Rushdy et al. 2018, ‘Impact of resisted exercises and whey protein on growth hormones and testosterone in normal subjects’, Journal of Medical Sciences, 18, pp.27-33 [URL: https://scialert.net/fulltext/?doi=jms.2018.27.33].
9. BW Craig, R Brown and J Everhart 1989, ‘Effects of progressive resistance training on growth hormone and testosterone levels in young and elderly subjects’, Mechanisms of Ageing and Development, 49(2), pp.159-169 [URL: https://www.ncbi.nlm.nih.gov/pubmed/2796409].
10. K Kukkonen-Harjula and K Kauppinen 1988, ‘How sauna affects the endocrine system’, Annals of Clinical Research, 20(4), pp.262-6 [URL: https://www.ncbi.nlm.nih.gov/pubmed/3218898].
11. G Gerra et al. 1992, ‘Sex-related responses of beta-endorphin, ACTH, GH and PRL to cold exposure in humans’, Acta Endocrinologica, 126, pp.24-8 [URL: https://www.ncbi.nlm.nih.gov/pubmed/1310561].
12. A Weltman et al. 1994, ‘Relationship between age, percentage body fat, fitness, and 24-hour growth hormone release in healthy young adults: effects of gender’, The Journal of Clinical Endocrinology & Metabolism, 78(3), pp.543-548 [URL: https://www.ncbi.nlm.nih.gov/pubmed/8126124].
13. M Horsten et al. 1997, ‘Depressive symptoms, social support , and lipid profile in healthy middle- aged women’, Psychosomatic Medicine, 59(5), pp.521-528 [URL: https://www.ncbi.nlm.nih.gov/pubmed/9316185].
14. Victoria State Government 2018, ‘Cholesterol’, accessed 16 December 2018, available: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/cholesterol.
15. Healthline 2018, ‘How much cholesterol should I be having each day to be healthy?’, accessed 16 December 2018, available: https://www.healthline.com/health/high-cholesterol/rda.
16. RJ Wurtman and JJ Wurtman 1989, ‘Carbohydrates and depression’, Scientific American, 260(1): 68-75 [URL: https://www.jstor.org/stable/24987109].