How I starved for 5 days and learned a lot about lipid metabolism

2024 Author: Seth Attwood | [email protected]. Last modified: 2023-12-16 15:55

I will say right away that there are a lot of rave reviews on the Internet about how prolonged fasting helped someone. The negative ones (or at least neutral ones) are several times less. I think this is not only a matter of the mega-usefulness of fasting, but also of reporting bias - those who have gotten worse from fasting are not particularly eager to share their experience: not only is it unpleasant to talk about your failures, but there is also a risk of offending religious feelings of adherents of fasting, which will tell that you did everything wrong, and in general you are lying.

The most balanced, in my opinion, scientific article on the problem of fasting was written back in 1982. In her abstract, the main points are clearly stated, some of which I noticed on myself:

Early fasting weight loss is significant, averaging 0.9 kg per day during the first week and slowing to 0.3 kg per day by the third week; early rapid weight loss is mainly due to negative sodium balance. The metabolically early phase of starvation is characterized by a high rate of gluconeogenesis with amino acids as primary substrates. As fasting continues, progressive ketosis develops due to the mobilization and oxidation of fatty acids. As ketones grow, they replace glucose as the primary energy source in the central nervous system, thereby reducing the need for gluconeogenesis and reducing protein catabolism. Hormonal changes are observed, including a drop in insulin and T3 levels, and an increase in glucagon and reverse T3 levels. Most fasting studies have used obese people, so the results may not always apply to lean or healthy people. Medical complications seen in fasting include gout and urate nephrolithiasis, postural hypotension, and cardiac arrhythmias.

A song of praise for fasting, and all its forms (complete or incomplete, long-term or short-term), was written in 2014 by Walter Longo, the creator of the Fasting Mimicking Diet (FMD) and also the head of the company promoting it. His article describes fasting in an exclusively positive way:

Fasting has been practiced for thousands of years, but it is only recently that research has shed light on its role in adaptive cellular responses that reduce oxidative damage and inflammation, optimize energy metabolism, and strengthen cellular defenses. In eukaryotes, chronic hunger partially prolongs lifespan by reprogramming metabolic and stress resistance pathways. In rodents, intermittent or intermittent fasting protects against diabetes, cancer, heart disease, and neurodegeneration, while in humans it reduces obesity, hypertension, asthma, and rheumatoid arthritis. Thus, fasting can slow aging and help prevent and treat disease, while minimizing the side effects caused by chronic dietary interventions.

At one time, I became interested in the topic of fasting thanks to a book written by Upton Sinclair over a hundred years ago. It's called The Fasting Cure, and here it is in the public domain. I'll make a reservation right away that today I'm pretty skeptical of her.

Also, a few years ago, I was intrigued by the story of the Scotsman Angus Barbieri, who fasted for 382 days (yes, more than a year!), And lost weight from 207 to 82 kg. True, he died in 1990 at the age of 51. A clinical report on his fasting is published here - he was not fasting anyhow, but lying in the hospital under the supervision of doctors.

After reading all these interesting stories, it was almost impossible not to try this business on myself. I started exploring the world of ketogenic diets, intermittent fasting, multi-day fasting, etc. The intrigue was reinforced by various studies showing the benefits of different calorie restriction regimes, as well as the harm from their overabundance - how can you resist?

Towards the end of 2014, I decided to start with intermittent fasting. Given my eternal dislike for breakfast, everything came easy. It was only necessary to hold out without food until lunchtime - and here they are, the cherished 12-14 hours of fasting (from 23:00 to 13:00).

The next step was longer-term fasting. Here the stars matched my long-distance flight schedule (once every 1, 5–2 months) and my dislike for airplane food. Coupled with the scientific evidence that food intake affects circadian rhythms, and the consequent assumption that it’s better not to eat in a new place until morning to combat jetlag, 36 hours of fasting loomed by itself. Had dinner in the evening before departure, and do not eat until breakfast (or even lunch) at a new place.

After 6-7 such flights, I wanted more. The next frontier was the three-day fast. That is 3 days on one water. It was already given more difficult, but it was given. And about six months later, it was decided to take a new height - a week on the water.

But this time I wanted to see if any objective positive effect would be visible - what would happen to markers of inflammation, hormones, glucose, cholesterol. For this I decided to donate blood before and after fasting.

Imagine my surprise when I received the "before" results and saw that over the past 2 years of these experiments of mine, my cholesterol jumped a lot, and the "bad" one increased by 60% (see the table: the blue column is the "before"):

Well, okay, I decided, after fasting, he will definitely have to return to normal, and then we'll see the dynamics. And I prepared to starve for 7 days. As is clear from the title, I lasted only 5. I felt sooooo bad. Especially after the 3rd day, and each subsequent one only got worse. I was exhausted, I slept badly, I was terribly irritable, and I finally learned what “brain fog” is.

At the same time, I followed all the recommendations: I drank 3-4 liters of water a day, added electrolytes (sodium, potassium, magnesium) to it, but I didn't get better. Therefore, having passed the tests on the morning of the 5th day, I decided to stop this self-torture.

But then a new surprise awaited me: the analyzes worsened. Triglycerides jumped, “good” cholesterol dropped, and “bad” cholesterol increased:

To say that it was a surprise is to say nothing. For the next few days, I scoured the Internet looking for someone with a similar experience. And in the end I found it. It turned out that there are many of us, and we are called "hyper-responders":

Hyper-Responder FAQ

The term, “hyper-responder” has been used within the ketogenic / low carb, high fat (keto / LCHF) community to describe …

In short, Hyper-Responders are those who experience a massive 50-100% increase in cholesterol when they switch to a low-carb diet. According to various estimates, such people range from 5% to 33%, and many of them have at least one e4 allele of the famous apolipoprotein E gene (APOE), which correlates with high blood cholesterol levels, and also appears as the main risk factor for Alzheimer's. …

But why does the body react in this way in Hyper-Responders? So far, no one knows for sure, but there is a hypothesis that since the bulk of cholesterol is produced by our body endogenously (and does not come from the outside), then with a decrease in external, dietary cholesterol, the body tries to compensate for this decrease by increasing the production of its own, and in hyper-responders a priori increased endogenous production of cholesterol.

But this was not the most interesting discovery. The author of the above site cholesterolcode.com, Dave Feldman, developed (and tested) a very interesting hypothesis: the level of cholesterol and triglycerides in the blood reflects only your diet over the past three days and nothing more. Moreover, it reflects in reverse dependencies: the more dietary cholesterol and fat you consume in these three days, the lower your blood values will be.

Therefore, it is not entirely correct to draw long-term conclusions based on your unit values of cholesterol and triglycerides - you need at least several points - and 3 days before the intake of which you did not deviate much from your usual diet. By the way, for IGF-1 this is even more true - after all, its blood level is even more labile than cholesterol or triglycerides: alcohol intake can reduce it by 15% in a matter of hours. And a dense protein dinner or physical activity the day before the analysis should be increased.

Returning to Dave Feldman's cholesterol hypothesis, here is a graph of Fat Eaten (yellow, inverted) and Cholesterol 3 days later (blue) from multiple measurements of Dave himself. Note the high degree of correlation:

By the way, here is his full presentation (25 minutes of net time), I highly recommend:

Dave's hypothesis is indirectly confirmed by my experience - since I hadn't eaten anything for 5 days, external cholesterol simply had nowhere to come from. This means that the increase in its level was caused endogenously. I synthesized it myself.

How could this hypothesis be tested? It's very simple - to eat from the belly for a couple of weeks. What can't you do for the sake of science! For purely experimental purposes, a kilogram of mascarpone and a box of oatmeal cookies were purchased. Over the next 2 weeks, my 5 kilos lost in 5 days of fasting were quickly replenished with a daily intake of ~ 3000 kcal. And the analyzes confirmed that the suffering was not in vain. Triglycerides returned to their original value, and “bad” cholesterol dropped by almost a quarter:

What conclusions have I drawn for myself from all this? First, you need to be overweight to fast. If you are initially thin, then you will simply have nothing to starve (my 84 kg with 15% bodyfat is close to the minimum, especially considering my weight loss rate of 1 kg / day). And secondly, different people can have very different responses to fasting. And it is desirable to test these answers BEFORE any significant hunger adventure. Suddenly you are a hyper-responder too.

As a result, I gave up all these diets and fasting. No, I'm still convinced that sugar is evil and that carbohydrates, especially "fast" ones, should not be overused. This is the surest way to shorten your life or earn Alzheimer's.

But beyond the observance of these common truths, for myself personally, to put it mildly, I did not see much benefit from fasting or diets, and so far I do not see much harm from their absence - below are 3 more points for measuring biomarkers without any diets:

Yes, a new unpleasant bell begins to appear in the analyzes - high insulin, but there is a hypothesis that this may even be a consequence of my intermittent fasting in the past, and not my current diet. In any case, I will deal with him separately.

This is my experience. As part of the fight against reporting bias, I decided to share it.