I completed my first 5 day extended fast! I have read a lot of research and anecdotal information regarding therapeutic fasting, intermittent fasting, and the difference between fasting and starvation. A number of reference links are posted at the end of this post. I chose to do an extended fast for fat loss and to promote autophagy as much as possible. My fat loss has slowed and though my insulin resistance is improving I saw an extended fast as a tool to shake up my metabolism and do some internal healing and repair.
My 5 day fast was a combination of the definitions below. The definition of water fasting is standard. The others are my interpretations and nomenclature.
- Water Fasting – complete abstinence from all substances except water.
- Muddy Water Fasting – complete abstinence from all substances except water, black coffee or plain tea.
- Supported Fasting – abstinence from food, allowing the consumption of water, coffee with or without cream, tea with or without cream, and bone broth.
Autophagy is a fascinating topic. When I read articles on the topic I would like to transform into biochemist or physiologist in order to understand all of the technical explanations of this process. Since my first posts on this topic, I have learned that the consumption of protein turns off autophagy. “What turns off autophagy? Eating. Glucose, insulin (or decreased glucagon) and proteins all turn off this self-cleaning process. And it doesn’t take much. Even a small amount of amino acid (leucine) could stop autophagy cold.” This is a relevant point if you are fasting for autophagy.
It is not clear to me how long protein ingestion interferes with autophagy and I do not understand the impact of being in therapeutic ketosis would have either, thus I did not consume bone broth during this fast. I consumed coffee with cream 4 out 5 days, and I consumed a small amount of unsweetened dehydrated coconut on 2 occasions. One tablespoon of heavy cream contains 0.3 grams of protein consisting of primarily casein and serum (whey) protein. Twenty grams of unsweetened dehydrated coconut contains 1 gram of protein, which has a balanced amino acid profile. I can only hope that the small amount of calories and protein I consumed during this fast only partially interfered with autophagy. There is balance to be had between fasting and supporting continuing a fast. I am satisfied with being able to complete 5 days of fasting regardless of the purity level of the fast. I am a pragmatist, not a purist, and believe individuals need to find what works for them.
GKI
Another measure I referenced is Glucose Ketone Index (GKI). This is a ratio blood glucose (US units of mg/dL need to be converted to mmol/L) and blood ketones. The GKI is being researched as an indicator of metabolic health.
From Optimising Nutrition
According to Seyfried, the goal for cancer patients using a therapeutic ketogenic diet is to have a GKI of less than 1.0. Patients with chronic disease like cancer typically have glucose to ketone index values of 50 or more.
For most people who are not trying to slow cancer growth or combat epilepsy through a ketogenic diet, anything under 10 is considered to be a “low insulin condition”. This is indicative that you are not significantly insulin resistant.
From Heads Up Health
Despite its roots in cancer treatment, the index can also be very helpful for those using metabolic therapy to treat (and prevent) diabetes, obesity, cancer (particularly cancers that express aerobic fermentation) and other metabolic conditions. By using an index that tracks glucose and ketones TOGETHER, we can develop zones that are optimal for addressing various health conditions.
The table below outlines some generally accepted zones of treatment using the glucose ketone index:
I have read that if you get past 48 hours you enter the fasting sweet spot from a hunger and physiologic stand point. I was surprised that I experienced strong hunger in the evening on day 3, 4 and 5, especially since I have been in nutritional ketosis for months. I was really surprised to feel so hungry on day 5. I mean, I was really hungry and could not wait to end the fast.
Each person’s experience is different. I felt good overall during the fast. I did not feel weak, dizzy, tired or nauseated. I experienced insomnia which was not surprising as I have insomnia intermittently. My heart rate also increased. This was also not surprising as I have read about adrenalin increasing during a state of extended fasting. This is a brief summary of my fast:
| Day | Blood
Pressure |
Pulse | Glucose
Ketone Index |
Comments |
| Pre fast | 112/67 | 83 | 5.8 | The measurements are from my last recorded tracking and not literally the day before starting the fast. |
| 1 | No measurements for this day as I decided to do a 5 day fast on a whim. I did not experience much hunger during this first day. | |||
| 2 – AM | 101/65 | 124 | 5.7 | Good mental clarity and energy; slight hunger |
| 2 – PM | 125/79 | 89 | 2.5 | Strong hunger started around 5PM and lasted about 4 hours. I had 1 serving of dried coconut and hunger lessened and eventually went away. |
| 3 – AM | 110/78 | 111 | 3.7 | Good mental clarity and energy; no hunger |
| 3 – PM | 133/76 | 106 | 1.4 | Moderate hunger started around 5PM and lasted about 4 hours and then went away |
| 4 – AM | 128/83 | 105 | 1.3 | Good mental clarity and energy; no hunger |
| 4 – PM | – | – | 0.9 | Light hunger that started around 5PM; I was able to push through by drinking Dandy Blend non caffeine beverage with a little cream |
| 5 – AM | 104/69 | 111 | 1 | Good mental clarity and energy; no hunger |
| 5 – PM | – | – | 0.7 | Intense hunger started around 4PM and seemed to intensify. I don’t know if this was psychological or physiological. I ate some coconut but it did not help. I had considered extending this fast until the next morning but I broke the fast as planned due to intense hunger. |
| 5
after breaking fast |
– | – | 1.3 | My “break fast” meal was consumed over 2 hours. I had 1 fried egg, homemade sausage, smoked sockeye salmon and a “shake” comprised of kefir, 3 raw eggs and a few drops of vanilla stevia. I do not generally burp, but I did burp a few times after my meal. |
| 6
morning after fast |
105/77 | 105 | 1.7 | I was surprised that my GKI was still in optimal range after having broken my fast the previous day. The total scale weight lost during the fast was 9.4 pounds. It is not unusual for half of the scale weight lost to return when eating resumes. |
Related reading:
Dr. Jason Fung’s 7 part blog series
- Fasting – A History Part I
- Fasting Physiology – Part II
- Fasting and Growth Hormone Physiology – Part 3
- Fasting and Lipolysis – Part 4
- Fasting Myths – Part 5
- Fasting Regimens – Part 6
- Longer Fasting Regimens – Part 7
Archived, informative reading from Soil and Health :
Autophagy
Glucose Ketone Index
- The glucose ketone index calculator: a simple tool to monitor therapeutic efficacy for metabolic management of brain cancer
- the glucose : ketone index
- Blood Sugar Converter
Other
- How to Renew Your Body: Fasting and Autophagy
- Why Fasting Is More Effective Than Calorie Counting
- Top Ten Fasting Myths Debunked
- Differences Between Fasting and Starving
- Why Fasting is not Starving (and clearing other confusions as well !)
More to come…..
Obtain and Maintain 
Pingback: Muddy Waters Fasting – Round 2 | Obtain and Maintain