Friday, 26 December 2014

Low Carb High Fat - How fast can we go?

http://www.runonfatmovie.com/

You may remember from several posts this year that the big question on my mind has been "How far can we go on LCHF?"  And at the Beachy Head marathon I went a reasonable way towards discovering the answer to this question for myself. Last week I heard from a local runner who has done a lot more; and here is an account from Luke Ashton who ran up and down a nasty hill 40 times covering a distance of 116 miles in 27 hours and 20 minutes. http://lukeashton.blogspot.co.uk/2014/12/the-hill-ultra.html. Luke uses nuts, cheese, olives,  avocado and olive oil as his principle ultra-running  fuels (he adopts an interesting no sugar no grain diet) and has run for up to 8 hours with no fuel but water; although he does have a ‘trickle’ of sugar on longer runs which is not surprising as we do indeed need some glycogen in the tank when moving at pace (as I described here: http://lchf4runners.blogspot.co.uk/2014/07/lchf-and-distance-running.html) . Luke’s achievement is all the more impressive when you consider that it was early December and very cold on that hill.

I am hoping to go a little further than before (perhaps 5-6 hours) at some point next year, but for now my attention has switched to the opposite end of the low-carb debate. “How fast can we go?”.  

It is a long-held belief that fat-adapted runners can’t go fast; apparently you need to be burning glycogen in order to train hard and race.  Right from the outset I have been rather skeptical about this suggestion. The science behind this is partly based around The Crossover Point Hypothesis which was developed by George Brooks et.al. at UC Berkeley; this describes the point at which we cross over from burning fat to carbohydrates. This investigation established that athletes, depending upon level of aerobic training, “crossover” between 35-65% of their VO2Max. Now I have already established that with the complete absence of carbohydrates to fuel on I can work for normal periods of training at much higher than 65%. The established science (from Venables et.al.; “Determinants of fat oxidation during exercise in healthy men and women: a cross-sectional study”) states the absolute maximum amount of fat an athlete can burn is about 1.0 grams/minute. For normal athletes (including myself) this is not enough to train at high intensity.  One important thing to note from this study is that it was performed upon normal healthy people, not on fat-adapted runners. The body is not a chemistry set where all things remain equal, in the absence of carbs we  adapt to use fat more efficiently. Regardless of this the conventional wisdom has relied upon this kind of science to convince us that fat is only a fuel for gentle endurance and that we will burn-out if we speed up. Our fear of failure, or perhaps out fear of looking odd has prevented us from testing this wisdom for too many years - my ‘Fuelled by Fat’ running shirt certainly seems to mark me out as a bit of a weirdo amongst serious runners, until I run past them that is! 

Thankfully the science is being tested again. A recent "FASTER Study" by Jeff Volek (read this report by ultra runner Zack Bitter) appears to suggest that the 1 gram per minute limit is not correct at all and almost twice as much fat burn can be achieved, leading to the possibility that much more energy for hard work can be derived from fat that was previously thought possible. This study is not yet complete but an initial review of the data available so far is here: http://www.ultrarunning.com/features/health-and-nutrition/the-emerging-science-on-fat-adaptation/

Last January when I set out on LCHF I was not particularly fit. My recent average mileage was about 20 miles per week but I had been doing a little speed training and had notched up a couple of local Strava segment records in December.  I had been expecting the first few weeks on LCHF to be hard work but perhaps luckily for me they were not. I ran 21 times in the first 4 weeks, including both distance on hills and hard speed sessions.  In week 5 I was getting into what I would regard as 'hard' training. I then had a couple of non-running injuries that put me out of action for several months but I was left with the impression that after the initial period of adaptation I had been able to train and race just as hard as ever. 

For the record by ‘hard’ I mean sessions like 4*1 mile reps at 5K PB speed or 3*1K hill reps at PB minus 30 seconds pace. This is as almost as hard as I have ever trained.  Since then I have been aiming at distance running, but I have always had the feeling that I could push a lot harder if necessary and I’ve still notched up another fistful of Strava records without any speed training.

It’s important to have this understanding of what constitutes hard training, because what I am hoping to do in 2 months time is to break my 5K PB. I am no longer a sprinter and have not raced for less than a mile in 10 years and so there would be no direct comparison to be made by running a fast 400 meters; but I set a 5K PB of 18:57 at Hove ParkRun 2 years ago on the back of several months of hard training and so that sets a carb-loaded benchmark that feels like an appropriate target.

I have done no speed training at all since January and have only just started with steady half mile reps in the last week. So I think that this situation represents a fair test of what can be achieved on LCHF. I aim to follow my normal plan of 1 speed, 1 tempo, 1 longish and perhaps one fartlek run each week for the next 8 weeks; and all being well I will have a pop at my PB at ParkRun in February.

By the way, I am in no way suggesting that running on fat is better for performance than running on carbs. I am simply trying to help remove the barriers that have been put in our way and enable people to make a better informed choice about what they eat, rather than follow the received wisdom. I do believe that eating LCHF is a better public health choice than eating HCLF as we have been instructed to do for the last 30 years.

It is no coincidence that this challenge is timed to happen at about the same time as the Premier of the new Cereal Killers movie – “Run on Fat” (http://www.runonfatmovie.com/). My wife and I contributed a tidy chunk of money to help make this film and we will be holding a public screening of it in Hassocks when the film premiers. One of the suggestions in this film will be that, like any other form of training, fat-adaption is a steady process of change and the longer we spend adapting the more efficient we can get; this leads to the possibility that we can adapt to the point where we can run fast as well as long. Now I have no problem in believing this as I feel that I have experienced it already; but it would be fun to put this one to the PB test.

So, call it vanity or perhaps even science, but I’d like to have some evidence of my own to help support this myth-busting production.

Monday, 8 December 2014

LCHF and Cancer - Let food be thy medicine


Hippocrates, the "Father of Medicine" who lived in Greece around 400 BC came up with this catchy line.  He is also credited with being the first to recognise the difference between benign and malignant tumours. In fact, the name cancer comes from the ancient Greek word for crab (think zodiac signs), as scientists at the time thought that clusters of cancer cells looked like the legs of a crab. So cancer has been around for a long time.

For a rather shorter period of time (perhaps a year or so) my wife has been referring me to the suggestion that low carb diets might have a relationship with cancer treatment.  The theory is that unlike healthy cells that can use either glucose or ketones (fat) for energy, cancer cells cannot consume ketones and so if we starve them of glucose then they will not be able to grow.  So I thought I’d take a close look.

As a background to this subject it is useful to note that some cancers have been increasing in frequency over the last 40 years. In a stable population this ought not to be the case.

It may be that there have improvements in detection over the last 40 years, but even so this recent trend has led some people to speculate whether some modern lifestyle factor might be responsible for the apparent increased rate of cancer cases.  And one of the first places to look is the growth in obesity; the increase in obesity has shown a similar rate of recent change over recent years. There is a good correlation here, but might there be a relationship too? Well, there is a proven relationship with obesity and an increased risk of developing cancer, but what is the nature of this relationship?

A good way to look at this is to start with what we know about what causes obesity - and that we do know. Perhaps what is good for obesity might also be good for cancer more generally?

I’ll assume for now that if you are reading this blog then you probably accept that a LCHF diet is thought by many to be good intervention for managing obesity. What if it were (separately) to be a good intervention for cancer?

Many decades ago, Otto Warburg stated that a hallmark of cancer was the uptake of glucose by cancer cells (1).  Cancer cells rely on glucose for energy; therefore any method of limiting this may help to “starve” cancer cells.  Recent data from several universities, including Johns Hopkins have shown that in brain tumors, the higher a patient’s blood glucose level, the lower their survival.

This research is referred to in an interesting TED talk  on discovering how LCHF diet and high levels of oxygen may combine to starve and damage cancer cells. https://www.youtube.com/watch?v=3fM9o72ykwwThe untested suggestion here is that a combination of LCHF diet and periodic treatment in a pressure chamber might be helpful for some cancer patients.

Further to this, eating a low carb diet not only reduces glucose levels (possible cancer fuel) in the body, it also reduces levels of the growth hormones insulin and IGF-1, meaning cancer cells might not get the signal to divide (see http://www.dietdoctor.com/cbs-using-a-ketogenic-diet-to-starve-cancer). This could explain why several cancer patients have reported how a LCHF diet appears to have halted their cancer growth. One of the best known of these patients is Alix Hayden, who has written about her experiences in her blog http://greymadder.net/

Here is a widely read article introducing these issues. The key suggestion being that cancer is a metabolic disease, not a genetic one, and hence can be affected via dietary changes.
http://www.examiner.com/article/low-carb-ketogenic-diet-beats-chemo-for-most-cancers-says-dr-thomas-seyfried The arguments given seem a bit simplistic to me. Cancer is complicated and I don't see a need to categorize it as purely one thing or the other; more likely it is a bot of both. And I don;t like the suggestion that ketogenic diet beats chemotherapy; there is no data to prove this at all.

Some people have hypothesized that ketones themselves may fight cancer.  This is more speculative with little data, but reports on many separate societies, most notably those in Southern Africa and the Inuit Eskimos of northern Canada reveal few cases of cancer; the diets of both societies include almost no carbohydrates.  Dr FP Fouché (2) reported that in six and a half years as district surgeon in Orange Free State he never saw a case of gastric or duodenal ulcer, appendicitis or cancer amongst a native population of 14,000, even though these diseases were common in the local white or European population on a 'modern' diet. Dr. JA Urquhart (3) served as the district surgeon of the far north of Canada in the 1930s, and in 7 years, with all the x-rays and surgical equipment of his day, has published that he never saw a single case of cancer, and this was in people of all ages.

These are fascinating observations, but without further analysis it is not possible to determine if these are just correlations (with some other unmeasured factors at play) or if there is some direct causation at work here.

When we look at the available science on the subject it is pretty sparse. The data provided so far, principally that of Dr Thomas Segfried, the most vocal advocate of the cancer-as-a-metabolic-disease idea, is very limited and proves nothing either for or against the idea.
It would be great to have some wider trials and research further into this subject, and fortunately there are some good studies happening now. So we should know a little more about this subject soon.

If you want further reading then there is a thorough review of this subject here: http://www.sciencebasedmedicine.org/ketogenic-diets-for-cancer-hype-versus-science/#more-32073. Be prepared for some un-minced words though. The author clearly likes the subject and thinks there might possibly be something in it, but tends to be pretty dismissive of anything not backed up by solid scientific research; but that is to be expected from sciencebasedmedicine.org.

But for now I think I'll chalk this one up as a 'maybe'.


References
1.          Warburg O: On the origin of cancer cells. Science 123:309-14, 1956,http://www.ncbi.nlm.nih.gov/pubmed/13298683
2.          Fouché FP: Freedom of Negro Races from Cancer. Br Med J 1, 1923
3.          Urquhart JA: The most northerly practice in Canada. 1935. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1336486/?page=1




Tuesday, 25 November 2014

LCHF diet brings unexpected cure for mouth ulcers

Since the age of 5 I have been affected by bouts of mouth ulcers. Not the kind that are gone in a few days, mine last for weeks. They are painful and once I get one a batch tend to come along so that I might have 4 or 5 for up to 5 or 6 weeks.  It’s not nice and I’ve tried all the medicines available to no avail.  Friends have recommended other alternatives, like giving up bread or wine (a ghastly thought) but this did not work.

As I have grown older the problem has grown worse.  Last year I had a bout of ulcers that lasted 5 months.  This is no joke, permanent pain day and night - I would have paid a lot of money for a cure. So I had a series of very expensive examinations from one end of my digestive tract to the other, and after 3 months the consultant gastroenterologist was no better off than I. He suggested a bowel biopsy might reveal something, but then it might not; I declined.

This year after changing to a low carb high fat diet in January my mouth ulcers have gone. I mean totally gone. I had one hint of an ulcer in July but it went after 3 days. And now when I bite my cheek accidentally (always the prelude to a fresh bout of ulcers) there is nothing but a faint tingling for a couple of days.


My guess is that this relates in some way to carbohydrates and their relationship with inflammation. But this is just a guess. All I know is that I am pain free, and even if there was nothing else of interest in the LCHF diet (which of course there is) I would stick to it.  

Thursday, 13 November 2014

LCHF Catalyst Documentary - fresh from Australia

Just watched the latest Catalyst documentary from ABC Australia on Low Carb High Fat diets. It was shown for the first time today.


It was very well made and great credit should be given to presenter Dr Maryanne Demasi and the Catalyst team for producing another documentary after they were so badly treated for their previous expose on Cholesterol & Statins which got recalled due to ruffling too many feathers.
http://freetheanimal.com/2014/05/australia-catalyst-cholesterol.html.

Tim Noakes stars as ever and the addition of Stephen Phinney and the Cricketer Shane Watson add more science and accessibility to the subject, but it is the testimony of Diabetes patient Gabrielle Brunsdon that really makes you stop and listen.

I also like the way that Catalyst post the transscript from the documentary on their web page.
Here it is: http://www.abc.net.au/catalyst/stories/4126228.htm

And if you like that, then you will love this!
https://www.kickstarter.com/projects/835313616/cereal-killers-2-run-on-fat







Monday, 10 November 2014

Shedding a load

It had been a long weekend of carb eating. A funeral is no place to get all egotistical about diet and so I tucked into the sandwiches, the scones, the cakes and later on the full-on curry along with everyone else. There was lots left over and so the following day was a tidy-up session with very little going to waste. And I have to say that I did enjoy the experience. It turns out that a few of the relations read this blog and so it was pleasantly hypocritical to mull over the pros and cons of LCHF while scoffing a bacon croissant at breakfast time.

Come Sunday the time for feasting had passed. Back to a normal 2-egg breakfast but I felt bloated and needed to get outside for a run. I have a minor achillies injury so a 20 minute recovery/stretching  jog just didn't provide the relief I needed. Out with the road bike then, and I took off with nothing but a sip of water in the bottle and a vague idea of where to go.  At 10:30 I passed a remembrance parade in Hurstpierpoint but dodged by just before the Sargent Major strode into the road to stop the traffic. I was appropriately dressed in red and black (the Aspire colours!) but I’d done enough looking back for one weekend.

I was feeling sluggish sill; but there was no hurry. I normally like the road out towards Henfield but got angred by a couple of un-explainable near-misses and I raced for a mile, regretted it, cursed a lot and wished I was on a grassy trail somewhere instead.  

After an hour or so there was a chimney fire at the Crabtree Inn. I stopped to watch as 2 fire engines arrived. And then a strange thing happened. I got back on the bike and sped off up the hill, and I felt lots better. After a few more miles of sunny roads to the south of St Leonard's Forest I realised that I was flying. With no GPS reminder of how fast each mile had passed I had been unaware of getting faster and faster.

After about 90 minutes of reasonably hard work I hit “The Bliss Point”. The road was gently hilly but I was cruising well above 20 mph, enjoying the scenery and wondering why everything felt so easy. Maybe I was still burning carbs or perhaps I had reverted to fat-burning, perhaps it was a bit of both. Either way it was the most pleasant 60 minutes of riding I can remember.  Even the interjection of 3 sharp hills near Ardingly did little to dent my happy mood, and 45 minutes later I arrived home thoroughly cleansed, feeling positive about life and not the least bit hungry or thirsty after nearly 40 miles of riding at what, for me at least, was a cracking speed.

Sometimes when your body and mind are have been stressed out, a long run or ride is the only thing to turn the tide. 

Monday, 27 October 2014

The Beachy Head Marathon on Low Carb High Fat

When I started writing this blog I had one particular target in mind. The Beachy Head Marathon. This has been my favorite event for some years now and I have a decent record in it, finishing in 3:36:30 4 years back. Not bad for a 45 year old.  The blog has often wandered into the public health aspects of the diet as that has become a topic of great interest to me, but today I’m wandering back to where it all started: how fast can I run my favorite race on LCHF?

Ascending the last hill in the BHM on a good day

It’s been a difficult year of injuries and frustration and at times it seemed like I might not be running this marathon at all, never mind performing well in it. But something happened on holiday in France; my back got better, my walks turned into runs and for the last 2 months I have had no pain at all. I have not done any speed training, just hoping that I might be able to run at all has been enough; but I have done more distance training than ever before with three 20-mile plus runs in the last month including a steady circuit of the Edale Skyline, which is actually rather harder than the BHM.

I’ve notched up a fistful of decent tempo ParkRuns in the last 4 weeks (including 3 in a row last Saturday); each time reminding myself to take it easy when the temptation is to start at the front with the big boys. Then a fortnight back I surprised myself by coming 2nd vet in the 20 mile Jog Shop Jog, a traditional hilly warm-up for the BHM. And gradually I came to realise that I would not only be running the BHM but might actually get to go quite fast. Even so I set a reasonably safe target of under 4 hours and would honestly have been very happy with that.

The LCHF diet can be a bit hard at times.  I still crave a peanut butter sandwich some days. But the knowledge that I have been getting fit again has spurred me on. I think that this is why exercise and diet work so well together. I strongly believe that weight loss is mostly about the diet, but you need motivation to stick with diets (even LCHF at times) and getting fitter provides a huge boost to your sense of well-being and hence to your commitment to other things that are good for your health. For me it is not about weight loss, but for so many people less fortunate than myself that is all it is about.

In a previous post on LCHF and distance running I referred to the optimal output at which we can keep going for long periods as a fat-burner: (http://lchf4runners.blogspot.co.uk/2014/07/lchf-and-distance-running.html) Finding this optimal level of effort is relatively easy to measure in a lab but the only way for most of us to find it is to get out there and run; hence the long hilly training runs over the last month. Apart from the obvious need to train long, in this time I hoped to have learned enough to know what level of effort I could sustain for 4 hours of hill running.  

And in order not to burn out (by which I mean to start burning the few scraps of glycogen that my liver makes to keep my brain happy) I need to try to stick at this same level of effort as consistently as possible. So I planned go up the hills rather slower than I once did, and to come down them rather faster. I have trained for this also and my past fell-running experience is a big help here.

With 1 day to go I ditched the carbs altogether (from my norm of about 50 grams per day). There may have been about 10 grams of carbs that day but no more. For breakfast on the day I had a cup of soup, a cup of creamy coffee, 4 slices of streaky bacon and 2 buttery fried eggs. After that just a cup of water at each of the feed stations and 4 salt tablets.

The start of the BHM can be chaotic. After 100 meters there is a steep hill rising up about 90 meters towards Beachy Head on a narrow path with several flights of steps. In order to avoid the mayhem I put myself near the front next to a chap dressed as Gandalf, knowing that I would be going up a bit slower than many others. This was a bit selfish I know, but I knew I had to get into my tempo straight away and the chaos behind me would have made this very difficult. About 100 people passed me on that first hill! I soon re-passed most of them as I started to get into my stride on the hill-top.
Gandalf follows the race winner up the steep first hill

We passed the lone piper playing his pipes at the same place as usual and the pace and crowds started to settle down. The sun was out, the air was cool and the views were opening up. It was a beautiful and a nearly perfect day.


I had barely slept the night before. A dear friend named Piglet had died in the early morning after a long struggle with cancer and I had spent the night wondering what on earth I thought I was doing going off and running a marathon. Piglet had loved the hills though, and always supported my running. On several occasions over the last 10 years she and my father-in-law had driven out into the countryside to provide me with a meal or a drink as I was passing through someone remote farm or hilltop. And Beachy Head was one of her favourite places. I know that she would have approved. There were a few tears in my eyes at times, but they were good tears.


The lone piper playing an appropriate lament

For the next 10 miles I played an amusing game of see-saw with a group of perhaps 20 runners. They would pass me going up the hills and I would pass them going down them. This gave many of them the opportunity to see the “Fuelled by FAT” message on my shirt and I had interesting but rather too brief discussions on the subject with several of them.

Jane and the kids we planning to meet me at Bo-Peep hilltop car-park and I was sorry not to see them there. I cursed myself for telling Jane that this was half way and that I’d not be there before 10:45; I’d forgotten that it is actually about 12 miles, and I passed thought 10 minutes earlier. 

The next 4 miles are mostly downhill and I got a bit despondent for missing Jane on this section. I knew my speed was lower than previously here too. But I reminded myself that I was actually well within target as I went through half way in 1:45; and I resisted the temptation to stick with a number of runners who passed me on this section.

The BHM route profile

There is a feed station at High-and-Over at 15.5 miles and it was here that I saw the first signs of what was to come for the next 10 miles. Several runners were stopped there, feeding and feeling sore. You can see most of the 12 remaining hills from this point and it is a daunting prospect. I breezed through the station and flew down the hill quite happily. Things were looking good. I then slipped and fell flat on my face in the mud at the bottom of the hill! I gave myself a big telling off for that.

The next hill out of Litlington is short and steep and I have always walked it before. This time I ran it. There are then 2 long sets of stairs on the hills in the Charleston Estate that everyone walks most of; I got half way up each of them before reverting to walking (I use the fell-runners technique with hands on knees supporting your upper body in the lift phase of each stride). A chatty couple passed me easily but I passed another 10 runners on that section.

Exceat hill is where it has always started to go wrong in the past. At 18 miles you still have the Seven Sisters and Beachy Head to go, but first they make you run 60 meters up this hill and back down it again before you start the Sisters. I have always got hamstring cramps at the top of this hill before and lost several minutes stretching and trying to relieve the cramps over the next hour. But this time it felt different and I was confident that this was not going to happen; I put this down to either the salt tablets or the diet or the distance training, most likely a combination of all three. There was just one calf twinge when I tripped on a stone, that was all. 

Marcus from Arena 80 caught me up on Exceat hill and we ran together for a while. He was going well and was confident of a PB having done the Marathon De Sables earlier this year.  

Marcus passes me on Exceat Hill

Marcus’s pace was a bit quick for me though so I let him go ahead, but I kept him in sight as we traversed the Seven Sisters with a steep jog/walk up the face of each one and a long-striding decent on the downside. I passed another 10 or 15 runners here and started to feel that I had something in reserve despite going longer that I have run at pace for a long time. 
Descending to Birling Gap in my first BHM in 2007

I came down into Birling Gap at good pace and passed another group of runners at the feed station. Still no sign of Jane and the kids but this time I didn’t mind, I was in no mood to stop as I passed another group of runners on the next hill up towards the Belle Tout lighthouse.

I have always prided myself on running up all of Beachy head. This may sound a bit daft to some runners, it is only 150 meters high after all; but after 24 miles and about 17 hills this last one looks like a monster. I was gradually catching up with Marcus again and it was at the top that I caught him. Neither of us had any breath left for chat but I think this spurred him on a bit and he stayed with me for a while.

I was feeling great (in an almost completely knackered kind of way) and looking forward to the best finishing mile of any race I know. The last mile of the race is back down the big hill towards Eastbourne finishing  with the same wickedly steep slope that we started up; and I have always regarded this as a bit like a fell run.  I caught and passed another 3 or 4 runners including another Arena 80 colleague Andrew on the top half of the hill as I got faster and faster.

The last very steep section I took about as fast as I can run with my arms flying out like a bird as I tried to keep my balance. My son Cam was there at the top of the finishing slope; I knew Jane was there below but at the pace I was going I couldn't afford to look up. There was another runner about 100 meters ahead of me at the top of the slope and I caught him just before the line by sprinting down the hill and leaping over the long sets of concrete steps near the bottom . It was dangerous and perhaps a bit stupid but  I loved it!
Cam and me on the finishing slope

It was lovely to see Jane and the kids there at the end. Great to share this moment with my family. I couldn't quite believe it when a young chap gave me a ticket that said I’d clocked  3:38:31. I’d stopped looking my watch at about mile 15. I knew I had done well but that was only 2 minutes away from my PB.

It was the second half of the race that made the difference. My steady fat-burning pace paid off and I was only 8 minutes slower on the second half than the first. 

In fact it seems that the whole LCHF approach to running has paid off, in exactly the way that I hoped that it would. I can now truthfully say that a half decent club runner like me can run a marathon on LCHF at about the same pace that I ran on carbs. And maybe next year with a bit more training I might go even faster!

Saturday was also my 49th birthday. It was a sad day and a happy day and it marked the start of my next big adventure, which my family and I have named 50@50. Starting and finishing with the BHM I plan to complete 50 challenges in my 50th year, followed by a suitably big party. 

Some challenges will be big, some not, some on my own but most with family and friends; some will be running but others (like the “All You Can Eat Sausage Challenge” with Cam, or the “Shop Till We Drop” challenge with Molly) will not. I’ll try not to bore you with them all but I am looking forward to the coming year enormously!


Wednesday, 22 October 2014

Carb Loaded? Not today thanks

With 3 days to go before a big marathon thoughts usually stray to the subject of carb loading.

When I ran on carbs I always found carb-loading to be widely misunderstood. The intention is supposed to be to increase the ratio of calories consumed from carbs as opposed to fats or proteins, the general idea being to increase the consumption of low GI carbs (and lower the consumption of fats in particular) in the last few days so as to steadily build up muscle glycogen stores.  

Most carbs are not low GI and fructose (fruit, juices and 50% of table sugar) doesn't get converted to muscle glycogen very well, so they are a bad idea when carb-loading.  Some folks think you need to eat a lot and others not. Some say eat big meals, other say graze.  

It’s all actually rather complicated, and represents a change that you have possibly not tested unless you are a regular distance runner. And when you consider that carbohydrate loading is estimated to improve performance over a set distance by just 2-3%, is it really necessary? Add this to the ubiquitous advice "Don't try anything new just before Marathon day" and you may have a big dilemma to deal with. My advice: don’t try it unless you have tested it first.

Clearly carb-loading is a thing of the past for me on LCHF but it is interesting to consider if there are any last minute dietary changes that fat-adapted runners like me should be adopting. Prior to a big race should we eat more fat, less protein or even, dare I say it, more carbs?

Some fat burning runners chose to train low and run high. They will train on LCHF but load up on low GI carbs the day before and use gels during the race to supplement their fat burning. I have to confess I don’t really understand this fully as insulin generated by eating those gels may directly block our ability to burn fat during exercise. Are these people actually training better and longer on fat but racing purely on carbs?  Mark Sisson of Primal Living talks about this approach here:  http://www.marksdailyapple.com/how-to-fuel-a-marathon/#axzz3GraMzjck

Others, such as Bruce Fordyce, a prolific ultra-marathon runner and past winner for the Comrades Marathon will eat normally on LCHF up to race day, have nothing before the race except a cup of coffee with cream and then run for many hours on water alone. http://citizen.co.za/153910/looking-beyond-carbs-can-pay-major-dividends/

For now I prefer, like Fordyce, to change nothing.  Just eat normally and re-hydrate normally. I have practiced the early breakfast routine that gets my breakfast of eggs & bacon digested before a 9 a.m. start and that  is what I will be doing again come Saturday morning.

Tuesday, 30 September 2014

The lows and highs of LCHF eating abroad

Travelling and dieting is hard, no matter what diet your on. Let's face it, airports and stations and coffee shops want to sell you coffee and cakes and sweets. Remember how I couln't find anything with no sugar in but water in WH Smiths? Well that's what you eat when your travelling, unless you have brought a picnic.

This week started out badly, a tasteless coffee at Gatwick, a nicer one on the train from Schiphol to Rotterdam; cakes everywhere and not a sausage or hunk of cheese in sight. Arrived late and caught a Caesar salad in the bar. It was gone in a minute and I went to bed hungry.

Woke up hungry and had breakfast at 6:30. The 'raw' milk separated in my cup and the second cup scolded me. Quick scrambled eggs but I had to be with the client early so no seconds. There was nice looking sugary stuff all around me. My little chimp sat on my shoulder asking why I didn't just take one of those pain au raisins? No one would notice, would they? Someone told me the other day to feed my chimp so I took a banana from the stand and put it in my bag for the chimp to have later. That shut him up.

It had been 6 hours since breakfast and I was hungry again. I wandered for 40 minutes looking for some lunch that I could eat; coffee bars with cakes and paninis, corner shops with 100 varieties of sugar. Nothing. Then a student told me about a shop that sold salads, it was back in the Medical Center where I am working. So I find the shop and found the salad but, get this, they can't take credit cards, and they can't take cash. Just cash cards. A couple of nurses look at me as if I'm some kind of freak but a nice chap says there may be a restaurant nearby that takes MasterCard.

I follow his instructions and find it. A cashier confirms that they can take my card. I see soups and salads and I think I may be in heaven. I wander around and choose some spicy soup, a plain salad with thick balsamic oil, a tuna wrap (I will bin the wrap) and a boiled egg. That should do nicely. I take this manna to the cashier and she say's 'oh!' perhaps we can't take your card after all. Or those nice fresh Euros you have!  I must have been looking desperate as she calls the smart young manager and he looks me up and down; I think he can sense the pain I am feeling at having to walk away from that tuna, and, cool as anything he says; 'Enjoy your lunch sir; you can pay me next time". Nice one sonny; I might just remember to do that.

This evening after a modest set of mile reps in the park I am hungry again. There was nothing to eat this afternoon as my kind of snacking is just impossible away from home unless you can find a supermarket big enough to stock <5% carb stuff. I must remember never to leave Britain again without M&S Luxury Nuts.

There is a Michelin starred restaurant in my hotel but I can see the look on my boss's face when I present that expense claim; so I head to the bar where I eat possibly the best burger I have ever eaten. Sans pain it came with super-sized egg, a bacon, red-onion and asparagus compote and a truffle-cream sauce; with a side of sweet-chilli prawns. The meat was like something I'd never seen or tasted before; a cross between fillet steak and mince. Perhaps it was a returned tartare that they couldn't bear to bin. It was sublime. I was just washing it down with a glass of fine red when suddenly the bar erupted into euro-vision song time.  Time for bed then.

Got to take the rough with the smooth with the rough I guess.

Thursday, 18 September 2014

Obesity - the new Smoking - is LCHF the new cure?

The new head of the NHS Simon Stevens is worried. Worried that if we carry on in the direction we are going then the NHS will not be able to fund the treatment costs for metabolic syndrome and diabetes.


He is about to publish his new 5-year plan in which he will be looking for lifestyle interventions.

Surely LCHF has to be regarded as a strong case for intervention. It is relatively easy to implement, it is proven to work (see my previous post at http://lchf4runners.blogspot.co.uk/2014/06/gps-report-success-when-recommending.html) and the perceived risks are being systematically dismantled with modern research and clinical experience.

Quite frankly Simon, what have you got to lose?



Sunday, 14 September 2014

Is running LCHF harder for the first 20 minutes?

Here’s An Idea.

“While adapting to burning fat instead of glycogen it may take up to 30 minutes to get into your stride on longer runs”.

This is a thought that has been crossing my mind during the first 2 weeks of reverting to a LCHF diet after 2 weeks on carbs on holiday in France.

The French Experiment is starting to look like a success - by which I mean can I go on a carb-bender for 2 weeks and then easily switch back to LCHF? - after just 8 days back on LCHF I managed a gentle 13 mile run (longer than I have run in 5 months) with none of the classic fatigue symptoms that hit me when I first tried the diet in January.  The intensity is less, and I am mixing the exercise with cycling, but it has been a problem-free return to LCHF so far.

One thing that I have noticed, and I recall this from January; my longer runs and rides have tended to feel harder at the beginning, much harder . In some ways this is not surprising – I'm not an early riser and the knowledge that I am nearing home often lifts my mood and my speed. This week though I have noticed my energy levels rise significantly after 20 minutes or so and then remain that high for the rest of each run/ride.

If true this could explain a lot about why some people reject the diet –“it made me feel worse than ever before when I was running”. But didn't we all feel this way for the first week or so when we first started running? The body has to adapt; only this time it is the energy supply that is adapting rather than the muscles. If false then no matter, it's just an idea.

I have precisely no data to back this idea up; but today's 17 miler was a good example; the first hill was lousy and I had to walk some of it, which is a rear event. Then after 40 minutes I had to slow down a lot as I was daydreaming and casually running much faster than I had planned (my coach/wife thinks this is why I get injured so much!). The second hill at 9 miles was a breeze, as was the third and it was only the fourth at 14 miles that actually had me properly knackered.  








Perhaps it was the gentle breeze behind me!









I don't have a good explanation for this experience; apart from the idea that maybe when we first set off our muscles have some stored glycogen and they want to burn it; but there is not enough so they can't perform; once this runs out the fat-adapted state wakes up and gets to work. 

I can find no articles on the internet that talk about this subject. So, head down and time to find out more. 

Wednesday, 3 September 2014

Obesity - Eat less Move More?

This weekend there was a call for a task force to tackle obesity. http://www.bbc.co.uk/news/health-28985874. Doctors, schools and nutritionists were encouraged to get together and make a plan.

However doctors are not generally well-trained in nutrition (I have this on authority from Aseem Malhotra) and the nutritionists have been failing in this task for ages. So what is going to be different this time unless something else is to change?

The advice in the comments section on the BBC article shows that the people concerned enough to comment generally seem to think that “Eating Less and Moving More” is what the fat people should be doing. and that self-control is what the fat people need; with many commentators suggesting that the sell-off of school playing fields leading to less school sport is greatly to blame. 

This mantra is too simple and rather patronizing and tends to be the advice of the lucky slim commentators, who as a consequence of their interest in health are likely to have a 'healthier' diet already. It is what they eat, not their willpower and Sunday morning jogs that is keeping them slim.

Assem Malhotra's advice: “You can’t out-run a bad diet!“ has become a favorite slogan of mine. Yes exercise is very good, but diet is a much bigger factor in weight management.

Over the past 7.5 months of LCHF diet my weight has consistently been about 11 stone 6 lbs. My average training has been low (due to injuries) about 4 hours per week.  We just had a 2-week holiday in France during which I reverted to a carb-based diet, I did not noticeably eat more than normal although I was not counting calories – I never do.  I trained for about 8 hours per week and my weight rose to over 12 stone.

This is not exactly clinical research but something tells me that my weight is controlled more by my choice of diet than by my levels of exercise.

Losing weight is not as simple as ‘eat less move more’. Yes, we have to aim to eat less, but how? The carbohydrate-loaded diet recommended to us by the NHS leaves us feeling hungry too often and this leads us to eat too much and too often.

We need the NHS to recognize the role of carbohydrates in fluctuating blood sugar levels and leading us to feel hungry more quickly and hence to eat more food. The obesity epidemic is directly related to the growth in the consumption of carbohydrates.

Imagine what would happen if we led half a class of children to a table covered in sugary drinks, sausage rolls, sandwiches and and donuts (typical kids party food) and the other half to a table covered in water, chicken salad, strawberries and cream (a typical adult summer lunch in Hassocks). We then invite the children to eat as much as they like. Lots more food (and lots more calories) would be eaten by the first half, even though many children and adults would admit that the second table tasted just as good or better.

A fat-based diet stabilizes blood sugars and suppresses hunger; so we eat less and less often. As humans this is how we have evolved. Carbohydrates are relatively new and we have not evolved to tolerate them very well yet.

Eat real, unprocessed food – and this includes fat.

To tackle the obesity epidemic we need to change the way we eat.  And to do that we have to challenge the myth that fat is bad. 


Monday, 1 September 2014

Low fat, weight gain and back to running

So after 3 months of almost no running due to back and calf problems I am now moving again on two legs, albeit rather slowly! In order to recover carefully I have been mixing fast walking and running. This allows different muscle groups to take turns and lessens the stress on a recovering body; it is also the method by which I now plan to complete the Beachy Head Marathon in 8 weeks’ time as I doubt that I will be able to run it all as I have in the past.

We just had two weeks in Bordeaux and when in France we eat like the paradoxical French; which means croissants and baguettes. A beer or two by the lake in the evenings is also a tradition that we are unable to drop.  I put on 8 lbs during this brief return to low-fat living!

Luckily another holiday tradition is that it includes lots of activities, principally running in the woods and down to the sea, windsurfing, kayaking and cycling.  I think that perhaps camping is good for my back – sleeping on a harder bed and moving about all day long being so much better that sitting in a chair for 9 hours per day. There were still twinges in the calf but these settled down with my Roman March style of walk-run soon becoming more of a run than a walk. I also find back in Blighty that this approach gives me more opportunity to enjoy the scenery on our local hills rather than just watching out for flints the whole time. So despite the weight gain I feel fitter than I have for some time.

So I am back to training for over 2 hours at a time and soon back to what I see as the investigative side of LCHF Running.  Only eggs and bacon for long-run fuel. It will be interesting to see how long it takes to switch back to burning ketones instead of glycogen. Will my previous adaptation allow me to switch back more quickly than the first time? Will the side-effects be less? Will I be able to train enough over the coming 8 weeks to cover the Marathon at a good pace on zero carbs?

Monday, 11 August 2014

Not all saturated fats are the same!

Major new research from Cambridge University and the Medical Research Council suggests that some saturated fats are associated with type 2 diabetes, while others are not.

http://www.nhs.uk/news/2014/08August/Pages/Saturated-fat-in-dairy-may-reduce-diabetes-risk.aspx

The research shows that odd-chained fatty acids contained in dairy in particular are associated with (but do not necessarily promote) better health, whereas foods with even-chained fatty acids such as red meat, alcohol, soft drinks, margarine and potatoes, are associated with a greater likelihood of developing type 2 diabetes.  

More research is needed to determine if this association is a by-product of some other process or a direct link to development of diabetes, but the this represents a big step forward in our understanding of diet and diabetes.

Clearly the policy of regarding all saturated fats as bad, and replacing them with something that is worse (carbohydrates) is starting to unravel, and it is no surprise to learn that some of these natural foods are actually likely to be good for us. 

I think that this research shows that we have to be prepared to learn more about the food that we eat rather than adopt the sweeping generalisations promoted by the food and drugs industries.

Monday, 4 August 2014

Statins - I do love it when the right side wins


Congratulations to the British Medical Journal for coming to the only sensible conclusion in the statins war with Professor Rory Collins. http://www.bbc.co.uk/news/health-28602155

As you may recall from my previous posts i-do-like-good-fight & i-do-love-good-battle, the drugs companies, headed by the venerable Professor Collins tried to get the BMJ to retract a couple of marvelous papers (by Dr John Abramson and Dr AseemMalhotra) describing how little net benefit there is from taking statins, and that the central basis for their use (lowering cholesterol) has no effect on cardiovascular disease for most people.  

Dr Collins' pride (and possibly his pension) was wounded by the presence of a minor error that both papers made relating to the risk of side effects. The drugs companies claim that these risks are very low - they generally pre-qualified the more likely victims out of truly random trials (it would be inhumane not to!) and so their research gives a lower value than that quoted in the 2 articles. In the real world doctors don't have the luxury of ignoring the more vulnerable members of society and they report that their patients are living with higher rates of side-effects. *

In the business of criticising drug companies you are only allowed to publish data that results from clinical trials - real world experience does’t seem to count for much, and the drug companies go to great lengths to ignore it.


Anyway, the demand that a well-written article ought to be withdrawn because of a minor error is patronising in the extreme. Dr Collins' central argument appeared to be that he was more important than anyone else so we should all just do what he says. However the editor of the BMJ and the investigating panel are not to be bullied in this way; concluding that "The error did not compromise the principal arguments being made in either of the papers".

It is probably true to say that The Origin Of Species contains some minor errors of this nature, but where would we be without it? 

And indeed where would we be without authors like Dr Malhotra who are brave enough to stand toe to toe with the drugs companies and put their fists up?



* Please note that this suggestion is my own and not claimed in either of the BMJ articles. MR.

Friday, 1 August 2014

Change4life or Change4fat?

The Change4life campaign has always got my goat. At first it was the way that they embraced partnerships from companies like Nestle who gaily abused the crusade for their own sugary profits (http://www.bbc.co.uk/news/health-11541433). Now it’s  their unquestioning support of the war on fat that winds me up.

I don’t mind so much that their whole message is pro-“healthy-balanced-diet”, after all there is not that much wrong with the diet that they recommend if that is indeed what you end up eating – the trouble is for a growing  percentage of people it is clearly not; and the patronising & blinkered NHS advice is not helping to change anything as far as I can see.

This is the mouthpiece of the NHS, the voice we rely on to TELL US THE TRUTH about our health.





















People make such a song and dance about whole milk. But milk is not a high fat product, and whole milk is more nutritious than semi, the Daily Mail are good on health issues:








The low-fat message has become so pervasive. It is hard to get a coffee these days with full-fat milk in, despite the fact many of us think that it tastes so much better - Starbucks don't sell whole milk..  In a world where personal choice is everything we must clearly all have received the wisdom that fat is bad!

Anyway, what really gets my goat is the simplistic nonsense that change4life are peddling about fat being the root of all evil.  Here is some typical content from http://www.nhs.uk/Change4Life/Pages/facts-about-fat.aspx with some red appendages from me.

Where does the fat we eat go?
Ever wondered where the fat in foods goes? Here's more about what it does in our bodies....

Get ready to learn something…..

1. Brain
When arteries get clogged up this can stop blood getting to the right parts of our brain and can cause strokes.

This statement is true but it does not mention the word fat, so what is it doing here on a web page about fat?  Dietary fat does not ‘clog up’ arteries. This is misleading. No marks. Please try harder!

2. Heart
Arteries carry blood around our bodies. Over time, too much saturated fat can clog up our arteries and restrict the blood supply to our heart which can cause chest pain (angina) and if completely blocked heart attacks.

No it can’t.  Firstly, you would probably die long before your arteries were completely blocked. Heart attacks and stroke happen when arterial plaques break off and block up somewhere important like the heart or brain.  Secondly saturated fat is no worse than any other fat in this context (http://online.wsj.com/news/articles/SB10001424052702303678404579533760760481486).
Atherosclerosis (the blocking of arteries) is caused by inflammation, and the role of fats (or rather cholesterol) in the inflammation process has recently been discovered to be improved by a high fat diet (http://www.dietdoctor.com/dr-oz-changes-his-mind-on-cholesterol).  Sorry NHS, this 'clogging-up' message is out of date and wrong. No marks! 

3. Pancreas
Eating too much fat can make us put on weight. Being overweight or obese can stop our pancreas from producing enough insulin and cause type 2 diabetes.

Poor quality again. Eating too much of anything can make us put on weight. Eating fat does not make us put on more weight when compared to eating a similar amount of carbohydrate. Yes there are slightly more calories in a gram of fat but in practice eating fat normally helps us lose weight as we feel full sooner and end up eating less than we tend to on a carbohydrate-based diet.  The second sentence is correct but not correctly implied by the first, so 3 out of 10 for trying!

4. Bowel
Being overweight increases our risk of getting bowel cancer - but a diet high in fibre and low in saturated fat keeps our bowel healthy and reduces the risk.

This may be true, but the jury is currently out on this one. It is quite possible that the problem here lies with processed meat, rather than saturated fat per se. A 2011 meta analysis showed no link between dietary fat intake and bowel cancer (http://www.cancerresearchuk.org/cancer-help/type/bowel-cancer/about/risks/food-types-and-bowel-cancer). Besides, who said that you should stop eating all fibre?  There is plenty in the veg that you should be eating anyway; just don’t feel that you have to go as far as All Bran (or even cardboard) to get your daily fix. No more that 5 marks out of 10; please try harder.


5. Body
If we eat too much fat we store the fat in our bodies which can lead us to put on weight.

Don't be silly; exactly the same is true of carbohydrates! I might as well say that if we ate too many donuts we would store the excess glucose as fat in our bodies which can lead us to put on weight! We all know this but the statement is simply not relevant unless you put it in some context which change4life have not done.
0 out of 10.

Total marks 8 out of 50. 10%, D-.  Not good enough!

So, a whole lot of spurious advice and misinformation. And this is what the NHS believes we should all know about fat.

Now when you consider that change4life is a top programme in implementing Government policy. https://www.gov.uk/government/policies/reducing-obesity-and-improving-diet then I would say we have a big fat problem on our hands.

Now let me show you where the fat that I eat goes. And let’s be clear about this, I eat a lot of fat, but then I burn more energy than most with my running and cycling.



































Now this diagram is slightly complicated but if you see my smiley red face it is there because the fat that I eat is being oxidized for energy. If I was also eating more than a small amount of carbs it might be stored as triglycerides in fat cells, but I am not, so it is not (or not much of it).

Like many LCHF dieters my triglicerides (the amount of actual fat being transported about my body looking for a nice home) are very low. So I can control my weight by eating more or less fat, depending on how much energy I am using.

On the left-hand side of the diagram (crossed out as I don't eat very much of them) is what we should be learning about carbohydrates. If we don’t burn them now we will store them as fat - we really can’t store very much as glycogen. This is the obesity epidemic at work.  And protein? Eat more than you can quickly turn into new things (like muscles) and the excess will be stored as fat. 

Unsurprisingly we see than anything we don't use we store as fat. But there is nothing special here about dkietary fat, is there? So why do we make out that fat is the devil's food? 

Read the article and you will also see how saturated fat is not making my cholesterol levels dangerous; in fact it is making them safer. My post at http://lchf4runners.blogspot.co.uk/2014/04/time-to-help-bust-that-cholesterol-myth.html explains this key point in detail.

So given the choice of carbs that can do nothing but help you move or make you fat, or fats that are highly nutritious and can make you more healthy, I have chosen fats.

Come on NHS, it's time to change4fat!