Exogenous Ketones!

Monday, February 16, 2015

THE VIKING MANIFESTO Part 4: LCHF and Energy Metabolism Within the Muscle

THE VIKING MANIFESTO: Piecing Together a New Approach to Nutrition and Training for Swimmers from Scientific and Anecdotal Evidence.
Part 4:  LCHF and Energy Metabolism Within the Muscle



In part 3 I explained that while VO2 max may be important, focusing training on raising anaerobic threshold to maintain longer durations at high intensities that are close to VO2 max would probably yield more applicable results. I then presented research that implies that a low carbohydrate, high fat diet can help improve this aspect of aerobic conditioning, even in already extremely fit athletes, by making fat a more available and faster burning fuel.  Now I intend to show that the implications for adaptation to the LCHF diet go beyond long-distance swimming at low intensity levels.  

To do this, I must start with some of the perceived limitations to the LCHF diet and why they might not be limitations at all.  

First, I have to make you aware that many people who train with the low carb high fat diet believe that with keto there is a loss in VO2 max and peak power, as though keto-adaptation only serves to improve lower intensity activities and can hinder fast twitch or high-power activities.  This has been backed up in some studies, but it is questionable whether those studies allowed proper conditions to truly know whether this is the case or not.  There are world class triathletes out there who have a train-low/race-high philosophy regarding carbohydrate, simply because they want the adaptations associated with LCHF but want to avoid the limitations associated with glycogen stores not being refueled on race day.  That makes sense, I guess, except that an insulin spike and full liver glycogen stores can stand in the way of ketosis, which I think would be a disadvantage on race day.  Dr Attia actually endorses a product called Generation UCANN, which is what they call a “super-starch”: an extremely low glycemic carbohydrate gel that can feed an athlete carbs without the insulin spike.  It is also known that eating small amounts of non-fructose carbs after exercising hard (creating a glucose deficit) will immediately go toward refueling muscle glycogen first, rather than toward fat storage or replenishing liver glycogen, meaning that you can use your workload to calculate how many carbs you can eat without interfering with ketosis at all.  I don't bother with all that, but there is also some speculation that the little bit of carbs I do eat, in conjunction with the protein amounts I eat which are higher than the typical ketogenic dieter, might be refueling muscle glycogen to some degree anyway since my training load is so low. Ketogenic dieters often try to keep protein intake low so that gluconeogenesis, (creating glucose from proteins,) does not stand in the way of their weight loss.  There is evidence that while a high protein meal might reduce ketosis temporarily, it doesn’t necessarily stand in the way of the adaptations I am looking for, as it is most likely the calories taken in that cause lower ketone measurements after meals, and the protein has other benefits in regard to training that are a good trade-off for athletes.

I am not sure I buy into the whole idea that we need carbs for peak performance and I certainly feel that more science needs to be done.  I don't have specific measurements so my experience is completely anecdotal, but I have never felt better at high intensities than I do now that I eat extremely low carb. Of course, I have been adapted for over a year and a half, and so far no study has even approached this-- especially one with swimmers. I tend to lean toward an almost completely carnivorous diet and I think my results are better when I cut out nearly everything but animal products.

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My wife hates ordering at the drive-thru with me in the car.

There is evidence that with proper adaptation we might not lose that peak power that everyone is so worried about.  Remember those two adaptations that we are training for: increased blood-flow and oxygen supply through capillarity and increased mitochondrial density within muscle cells?  Well, mitochondrial density just might be the main reason the LCHF diet can give us such a boost and it ties directly into being able to churn out high intensity exercise.

Enter Dr Bill Lagakos.  He is a guy who likes to tweet, and occasionally his tweets are links to recent research regarding health, along with write ups to help the layman understand their findings and implications. Dr Lagakos did a write up about two studies recently that showed increased mitochondria in mice with a switch to LCHF, and these adaptations came about within a few weeks. The best part-- these adaptations came about with no additional exercise.  They did not torture these mice on a treadmill.  This means that the diet prompted increased mitochondria on its own.  Could it be that high fat prompted this response, or could it be that carbohydrate was previously holding this natural potential back?  Take a look at it yourself. According to Dr Lagakos, it “increased mitochondrial everything.”  

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Most mice are herbivores.  Get them away from the vegetarian thing and look what happens.

This is a very interesting finding.  In that post, Dr Lagakos makes the analogy that if glucose were gas and mitochondria were hoses, then ATP would be the rate at which you can fill your tank.  He then compares fat to this by likening it to trying to draw syrup from a tree with a spout. Remember how much ATP fat can generate compared to glucose from earlier in my manifesto?:  129 molecules from some fats vs only 2 molecules from glucose...  Keep that in mind when reading as he theorizes: So how would you get your bucket filled with syrup faster?  Try “more spouts.”  And reduce the viscosity of your maple syrup by diluting with some ketones.  More than 3 weeks on a ketogenic diet and you have more better mitochondria and can generate ATP just as fast as high carb.”

Here Dr Lagakos points at a few more studies.  One is from the 1980’s and shows the same improvement in aerobic capacity along with lower RQ that Dr Attia found in his self-experimentation, but this study also includes some athletes whose VO2 max scores improved as well. (Remember how I pointed out that we should focus on improving anaerobic threshold since it is so difficult to improve VO2 max in well trained athletes?  Hmmm…  this indicates that for some we might see an increase in VO2 max as well.)  Of course, Dr Lagakos is basing his findings partly on studies with mice.  We haven’t had a study that shows this phenomenon of increased mitochondria in us that I know of, and we are obviously not mice, but it would sure explain some of the unique attributes of fat-adaptation.  Mark Sisson, a leader in the paleo community, wrote a wonderful article about mitochondria that speculates on this as well, but I encourage you to read it at this link because it goes into a lot more detail about what mitochondria actually do and how we can maximize them through exercise and diet, and his recommendations are pretty much along the same lines.  He even implies that healthy mitochondria can have an anti-inflammatory effect, which is one of the surprise side-effects that continuously pops up on ketogenic diet forums on the web.

It gets even more intriguing though, as Dr Lagakos also points toward two somewhat recent studies showing no loss of peak explosive power in well-trained athletes who switch to LCHF. The interesting thing here in the first study is that the gymnasts being tested lost body weight but lost no power, which improved their body composition with no sacrifice.  This would be valuable in most sports. The other study though, covered a broad range of tests of peak power: handgrip, vertical jump, max bench, back squat, max rep bench press power output, and the Wingate, which is the one that makes me drool the most. (Here's a video of the Wingate.  Damn that looks hard.)  There are of course theories about why these positive results might go against the standard thinking:  the weight loss from the diet might have made these athletes seem more powerful in comparison, or that eating extra protein might have had a “trickle charger” effect by forming sufficient glucose through gluconeogenesis, which could explain why I feel as I claimed above, better than ever at high intensities.  Also based on study design we could guess that peak power isn't diminished with LCHF "given enough recovery time" but more science will need to be done to get a full explanation. This concept intrigues me only because my schedule doesn’t allow for me to train as often as I would like, which would actually contribute to this effect for me and could be diminished in a more hard-core athlete.  I am certainly not needing to manage cumulative fatigue the way I did under my traditional training regimen twenty years ago as I am getting plenty of time to recover between workouts, even though it is not necessarily because I want it that way.

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Hey, making a comeback at age 40 just requires a little extra rest, ya know?!

One thing that is clear though is that well-trained athletes seem to be able to flip the metabolic switch more quickly, which might have something to do with these studies of short duration showing improvements that imply successful fat-adaptation, and this is probably because someone who is in shape is much less likely to have developed a high level of insulin resistance to overcome. (The majority of studies on the ketogenic diet focus on weight loss and thus have subjects who are obese.)  Again, more research needs to be done with well trained athletes who are fat adapted for long periods of time to answer these questions.

The point is that increased mitochondria might be just as valuable as capillarity, even though it is typically accepted that in regard to vo2max, supply (capillarity) is considered more important than utilization (mitochondrial density.)  Of course, once again, when we get into the question of whether VO2 max is an important indicator of success in elite swimming.  A better formula for success might be: Technical efficiency and speed at the intensity as close as you can possibly hold to your VO2 max, for the specific distance of your intended race without the negative impact of lactate clearance not keeping up with production. VO2 max is really only a small part of that equation.  Again, more detail on that later.

Next we get into specificity.  Hold on to your helmets.













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