Dr. Steven Phinney – Keto-Adaptation

– I’m also a student of biography, and I cherish this slidebecause this is a picture of the two beings facingthe camera, Inuit maidens. This is a photographtaken on the Arctic Tundra in Northern Canada. Taken about 1910. You can see by theirclothing and everything these are people that were following their Aboriginal lifestyle, with a few exceptions. If you appear really closely right here, this is a double cannon shotgun, which wasn’t a handmadenative chase instrument. But the thing they didn’t have is, they hadn’t been developed. They don’t have notebooks and paper and what we don’t have is we don’t have any written records of what their dietary guidelines were.We have anecdotes frompeople who’d watched them and lived among them butthe records are sparse and I want to try and draga little bit out of this because there are a couple of things I think they could have told us. For instance, when theybrought their fox coats into camp, they’ve hunted them, or into the trading posts, they’ve hunted them all wintertime long when the furs were rich and dense and they’d deliver these furs and they’d sell them for things like shotguns and tea and tobacco and sugar and flour. And the anecdotes, there was a book written by a French explorer, Her name was Kabloona, which is the Inuit namefor white guys, and this explorer mentioned that when they came into camp and they traded all this substance, that they made the sugar and flour and substance and they loaded it on theirsleds and they’d go about five miles outsidefrom the trading post. Then they’d set up their camp, and they’d deplete a week or two there dining all the food and they thought that was intemperate of these people.They were feeing all this nutrient, they should make it last-place during the course of the year, and he said they were really slothful and thenthey’d pack up and leave. And I think what happened was they’d feed the carbs which smacked good, and it was Kabloona food. And then they’d expend a week or two going over havingeating, and then go back to their lifestyle, which wasreally physically challenging. So I think that I’mtrying to reverse engineer but I see sample that I can find on literature, or oneof the first illustrations, of Keto Adaptation, which is one of the key things I want to talk about in my segment of this talk.Now this is a pastel, slide that was drawnand published in the magazine of an arctic explorernamed Frederick Schwatka. Schwatka went into thearctic in late 1870′ s and he wanted to find a wayto get up to the Arctic Ocean from the western shore of Hudson Bay and find out what happened to a Royal Navy expedition with 129 “mens and” two ships thatdisappeared in the Arctic in the 1840′ s and wasnever heard from again, and no one had figured out what demise became of these beings. So rather than take a onu of sleighs or take crafts and try to drag them into the Arctic, which waswhat other people had done in many expeditions trying to figure out what happened to the Franklin expedition, and come to grief, hedecided, “I’ll only hire “a couple of Inuit lineages and I’ll “let them take me there.” And that’s what theydid, and you can see he – Oops, wrong button.He does have article and pencil, and they’re writing substance down, and he restrained a journal of that know-how. They traveled 3000 miles in about 13 months. They found artifacts and evidence of where this safarus came to grief. But in his journal, he wrotea really fascinating line. Now let me put this in context. I detected this in the spring of 1980. I just finished doingmy study on Bike Racers and I was trying to write it up and I recalled I’d come up with the idea of setting up Keto Adaptation. Then I’d come upon thisthing where he says, “When firstly through wholly upon the food “of reindeer meat…” bywhich he intends caribou, which is what they hunted in the winter when they were inland- “it seems inadequate “to properly nourish the system, and “there is an apparentweakness and incapacity “to perform severe arctic journeys.”But this soon proceeds apart in the course “of two or three weeks”. What that wants is that thisguy scripted me by 100 times.( faint laugh) But he didn’t write down what they ate. He just said that they didn’t take enough renders with them to have, you know, carbohydrate and carbohydrates, for more than the first few weeks. And after that, for about 13 months, they lived off the ground and there were no fields of waving grain. But then this other Arctic explorer, a very controversial person referred Vilhjalmur Stefansson, who was trained in what we would now call anthropology at Harvard, was fascinated in what the Inuit peoples.By his identify you can tell that he’s of Icelandic origin, but he was born in Canada, and he was interested in first nations, and Inuitlifestyles, and so on. So he went into the north of Canada and invested the better part of 10 times living among the Inuit. He objective up being put ina jeopardizing place where he didn’t haveany food or sustenance for wintertime and so he had actually had to move in with this group of Inuit and when spring developed – and now the winters there last-place 9 months – he spoke their language andunderstood their culture fairly that he could live that life-style. And he did that forprolonged periods of time.He wrote about it in bothscientific papers and in works. And among those things he said, “I could live on a diet of flesh and fatty “without any vegetable matter for more “than two years at a timeand I wouldn’t get sick.” Now if you look at thetiming, between 1914 and 1927 was when allthe vitamins search for and. Some of which, like Ascorbate, are said to be only is located within significant sum in vegetable matter. The people who read his writings who knew nutrition andunderstood the science of nutrition knew he was lying. Because you get scurvywithin three or four months if you dine a food withoutvitamin C in it.Right? So, he was called a liar. He tolerated himself to belocked up in Bellevue hospital. That is now in New York City. It is a place for stupid beings, but it was also a placewhere early scientists who studied had set up ametabolic research facility, and he was incarcerated. Ithink Gary, you corrected me. He was simply in there for like 5 months and then they cause him out on parole.Basically as long as he came in everyday to be checked up on. And he and the other of hisarctic explorer collaborators invested a year living onthe diet of flesh and fat, and they did not develop scurvy. And they didn’t loseweight, and – they didn’t do formal recital testing – but they are able to make them out, escorted and give them march orjog through Central Park and they proved no evidenceof impaired role. And in his bibles, Stefanssondid not give you gram heaviness or macros for what thediet that he had learnt to eat in the Arctic. But fortunately doctors WalterMcClellan and Eugene DuBois did write down what these people devour in their multiple months of captivity, and then tracking theirdiet as outpatients.And what he feed, what they ate was approximately about 15 to 20 percent ofdaily vigour requirement as protein, over 200 grams of fat per epoch. Which is, represents 80 percentage or more. And the only carbohydratethey went was from the glycogen that was in the meat of the animals once they are slaughtered. And as medical doctors indicates, and the people who wrote the Real Meal Revolution point out, they devour nose to tail. They weren’t only eatingfancy cuts of stuff. Because there are different nutrients in different parts of the body and in different animal beginnings. And so I looked at that data and said that if these chaps are trying to prove that you could live ona diet of flesh and fatty, they bet they would be trying to emulate what they did in the Arctic, because they didn’t want to get scurvy and they didn’t want to proveMcClellan and DuBois right. So to me, that the bestthat I could come up with at what was, represented an Inuit diet. But Stefansson was, andremained, very controversial even though this was published in the Journal of Biological Chemistry in 1930. And I matched beings in the 1960′ s and’ 70′ s who told me, you couldn’tbelieve anything he said because the guy was obviously a liar. And those are scientific parties in the metabolism society. And I required … I realize that this is a really busy lookingslide but I just wanted to share this with you becausethis is where I specifying the origins of carbohydrates lading. And this is a paper published in the Scandinavian journal, Scandinavian repositories of physiology in 1939. The deed, it was inGerman, the entitlement of it is – and I’ll slaughter this probably – is ArbeitsunfhigkeitUnternehrung, which I guess – maybe Doctor Lechner in the audience can chastise me – but I think it implies run capability and nutrition. And this is a studydone of three subjects. And the government has three arms of the study, and each of them, eachof the three themes went on either a highcarbohydrates, low fat diet – their ordinary nutrition – or a highfat, low-toned carbohydrate diet. And I gave this stuff up here because I wanna point out that this is the high overweight diet.So overweight food, and if you look at the calories over here from, of solid, that and this is, you can see that there is very modest extents of protein. So there’s 21 grams of protein, I’m sorry, 21 cal- grams of protein. 576 grams of fat , notthe 200 that Stefansson was reported to have, andtheir eating 5000 calories. So this is extremely highfat, hypercaloric food that they were feeding, so this wasn’t patterned after an Inuit diet. And what the fuck is did was they had people, their subjects devour these three diets for seven days each, and the above reasons they picked seven days to eat the diet was they had them doit for three days, and it appeared to be tooshort a period of time for change, so they figured seven days would be a good period of adaptation. And when they did that, and then they had them do exercise on a repetition odometer and that exercising was about 175 Watts. 175 watts, which is apretty, pretty good level of usage for anything other than a professional athlete, and they looked at their patience time to exhaustion, and the high-pitched fatty food, they get precisely a little over an hour and then quit.On the normal diet – they didn’t propagandize them to tired – but they moved longer on the normal diet. And then on a high carbohydrate diet you can see the, going to exhaustion, the duration of exercisewas dramatically longer. And so their conclusion and, the other two themes – thisis just one subject – the other two topics hadpatterns that were very similar.And the second thing I’ll pointout to you, by the way is, one of the co-authors here is “O” Hansen, OweHansen, and if you look at this subject, this subject is subject OH. So this is actually self experimentation. This was not uncommon then, as now, that parties do self experimentation. So, I get interested in this topic. I speak these things after I went interested in this, and I got interested because as Gary pointed out, in1972, Atkins wrote a record called “The Atkins Diet” or the “Atkins Revolution, ” whatever, and said that people would have a lot of energy if they gone on a very low carbohydrate, highfat, high-pitched protein diet.And I knew that was wrong, because from my own personal biking experience, if I didn’t start eating carbs after that first hour and Iwas trying to ride up and down elevations I wouldhit the wall within two hours. So I set out to prove Bob Atkins wrong. I, working with my instructors, Ethan Sims and Ed Horton in Vermont, had the possibility of being do research studies. So we took the group of overweight people who wanted to lose weight and, so we made a bargain with them. We’d fasten them up in ametabolic research division for seven weeks. We’d give them a high carbohydrate diet for 1 week then employ them and do muscle biopsies on them to be informed about what their perseverance time was. And then we would kept themon to , not a high solid, but a very low carbohydrate, very low calorie, ketogenic diet for six weeks.And when we exerted them after one week and six weeks, we compensatedfor their weight loss by having them wear abackpack which contained all the weight they’d lost. So we tried to compensatefor their roughly 25 pounds weight losson average at the end of the six weeks, and “weve had” them do noendurance training during this this weight loss diet period. And what we found at one week was exactly what Christensen and Hansen saw. And that was, comparedto baseline, there was a significant truncationin their fortitude is necessary to subjective fatigue after one week. But after six weeks – andwe shouldn’t have done that. We should have stopped at one week, because then my occupation path would have been very, very varied.( public laugh) But after six weeks, we introduced them back on a treadmill wearing the backpack. You can see that theywent dramatically longer. And well vexed. We could explain part of that, because in spit of the fact that they are wearing the backpack with the load, their effort performance- or their relative percent position to mass – declined from about 60 to 65%, down to 57%. So all of them became more efficient on the treadmill even though they hadn’t qualified during this period of time. But our judgment was that there was a, some retrieval processthat was occurring. And even though the relative severity of recital declined slightly, this looked like therewas some significant recovery of tenacity time to exhaustion. But the problem was A: These were untrained people. They did not know what exhaustion was. And the second problem was that there was weight loss compounding this. So we wanted to find a way to framed parties on a nutrition who can inhabit ketosis and not lose weight, and so this is when I speak the 1929 or the 1930 newspaper from the Stefansson Experiment, and so we adopted a dietthat was essentially the same as the Stefansson diet, and we banked groupings of bike racers.And these chaps who eatham sandwiches clambering up ridge surfaces on bicycles. They have cast iron tummies. We figured, we could get them to eat this. They could munch 80% overweight, and indeed, we worked out a course that that could actually dothat and tolerate that. Unfortunately I was a beggar, I didn’t have a big grant. This was metabolic research district study. And so I had to beg for the chambers. And the longest I couldget apologized deterring any patient, any of my themes in the metabolic precinct was four weeks. So we picked the four week term point.Not six weeks because ofthe financial actualities of being able to make use of the limited time available inthe metabolic research district. And this is a lousy way to show the data but, what I show here is that VO2 max along the top wrinkle, whichis five liters per instant on a round odometer by the way, which is a quiet impressive VO2 max, didn’t modification after fourweeks of the ketogenic diet. When we had them exert to exhaustion, they moved 147 hours at basi word, 151 after four weeks of adaptation.Those figures aren’t different. So unlike the obeseuntrained parties, there was no difference of theirendurance time to exhaustion. But if you look at whathappened to fuel use, this is a respiratoryquotient, 0.85 or 0.83 means they’re burninga little bit more overweight than carbohydrate, but aboutclose to a fifty-fifty mixture. But after really four weeks of modification their RQ dropped down to almost 0.70, which would be almost all fattened. So this is a 90% or moreenergy coming from fat. Add an exercise intensity of 65%, which is over 3 liters of oxygenconsumption per hour, translates to over 900 calories of energy expenditure per hour.This is a much better slide, with most of the same data. It was made by GeoffVolac, and he’s much better at depicting things than I do. And the key thing on this slither, and Professor Knoke established you his slide, and that is, these are the times for each individualsubject, and you see that one person was about the same after four weeks of keto adaptation. Two parties proceeded up andtwo parties was downed. And I’ve been kindacriticized for publishing this data, because, how canyou choose any conclusions about the averageperson’s response to this? And my site is that peoplevary one from another.And it may not be that, it may be that these beings biologicallyare just not designed to function on a high fat food. Or the alternative is, these two parties now necessary a lot longer periodof time to keto adapt. Because we only had four weeks. And basically all the other studies that have been done, includingLouise Berk’s studies, and she knows about this concern, and she fees studies thatare three weeks period. So the question is, how long does it take to keto adapt, and thiswill be my last slide. And this is my best bio marker for metabolic adaptationto a low-pitched carb nutrition. It’s not changing RQ. It’s not the ketonescoming up and stabilizing. It’s the fact that renal handling of organic gases is very important for acid located offset in thebody and metabolic balance.And when you take a person and introduced them on a ketogenic food, and the government has two to three milimolarcirculating ketones, those ketones are an organic acid they, that compete withother organic battery-acids in the body for excretion and the one that we expending testand are concerned about, because of its participation in the cause of gout, is uric acid. And uric battery-acid, if you … and this is data compiledfrom a cluster of studies that I have done over duration. I’m not gonna suffer you with the raw data, but commonly a normal uric battery-acid ranks in the four to seven array, and when you situated someone on the ketogenic nutrition, they’ll double their uricacid during the first week. And it’s not because theymake twice as much of it. It’s because they’re not excreting it because of competition from the ketones. But if ketones stayconstant, and you follow uric acid over the courseof nine to 12 weeks, they find it come back down, which means that’s the duration time in which the body can – at least in the kidney – can adapt for acid-based balance.And if so I had to lookat a minimum numeral for keto adaptation now itwould be in the range of nine to 12 weeks , not thetwo weeks or four weeks or one weeks that have caughttrue in most other studies. And with that ill turn this over to Geoff and let him tell youabout the modern science ..

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