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  • #61
    Re: Calorie Counting

    Originally posted by WisconsinWildcard View Post
    I "mini fast" myself and I have read most of the literature on the subject (I was at least up to date within the last year). There is a lot of hype and I think over-extension of the data as it suffers from a common problem of a lot of basic research with minimal or flawed clinical data. However I think at this point there are a few things that can be said:

    1. It has reasonable evidence that going 14-18 hours over a 24 hour period with minimal (<100 calories) lowers your A1C (this is the primary reason why I do it)
    2. It is likely not harmful
    3. It may reduce total caloric intake in certain settings
    4. The overall effect on metabolism is complicated and it is probably wise to remain agnostic until better data is presented

    As dx mentioned...you have to be careful to not overeat when you do eat. This can negate the potential weight loss effect. I think one strategy that is successful for me is to step away from eating, or eating much slower, in order to let the feedback from your stomach reach your central hunger centers.
    Thanks for posting this, I kinda just figured most the gains from doing it were solely due to forcing yourself to eat less by skipping a meal but it's interesting to see that there might be some science to it as indicated in #1. Either way it seems to work for me and it's not that hard to skip a few useless calories in the morning.

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    • #62
      Re: Calorie Counting

      Originally posted by trixR4kids View Post
      Thanks for posting this, I kinda just figured most the gains from doing it were solely due to forcing yourself to eat less by skipping a meal but it's interesting to see that there might be some science to it as indicated in #1. Either way it seems to work for me and it's not that hard to skip a few useless calories in the morning.
      To add a little more context, it falls into this camp in my clinical practice: I do not think there is enough evidence to actively recommend it to a patient however, I would not dissuade a patient who is interested in doing it (as long as I do not see any clear contraindications). However much of the other things I have mentioned are part of my standard discussion about weight loss.
      In the immortal words of Jean Paul Sartre, 'Au revoir, gopher'.

      Originally posted by burd
      I look at some people and I just know they do it doggy style. No way they're getting close to my kids.

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      • #63
        Originally posted by WisconsinWildcard View Post
        To add a little more context, it falls into this camp in my clinical practice: I do not think there is enough evidence to actively recommend it to a patient however, I would not dissuade a patient who is interested in doing it (as long as I do not see any clear contraindications). However much of the other things I have mentioned are part of my standard discussion about weight loss.
        The few physicians I know say the same thing- they won’t recommend it, partly due to no real long term studies to show effects

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        • #64
          Re: Calorie Counting

          Originally posted by WisconsinWildcard View Post
          To add a little more context, it falls into this camp in my clinical practice: I do not think there is enough evidence to actively recommend it to a patient however, I would not dissuade a patient who is interested in doing it (as long as I do not see any clear contraindications). However much of the other things I have mentioned are part of my standard discussion about weight loss.
          Assuming lack of formal experimental evidence either way, can you think of any credible theoretical reason why targeted fasting would be a good strategy? I know that for example in exercise it is recommended that if you want to burn fat it's better to do 2x/t amount of work over t seconds than x/t amount of work over 2t seconds because activity doesn't scale evenly -- the same interval of additional work value done above a higher threshold burns more fat than below that threshold.

          Could fasting have a similar effect, exploiting a "market inefficiency" in how the body deals with lack of energy?

          The rule of thumb I picked up off the street is that the body basically works as your evil demon: it will do bad things to you before it takes your fat supplies. That doesn't seem to make much evolutionary sense to me but I have a loose, quasi-crackpot opinion that processed foods create fats that are very hard to break down whereas natural foods create easy to break down fats. Basically, we turned out bodies into landfills and so we're trapped now.

          But none of that is from science -- it's from the general air of fear and loathing of nutrition. Any MDs or nutritionists out there want to take a swing at what the actual science is?

          Wed, 5/1

          Breakfast: none
          Lunch: Roast chicken brought from home and water: 200

          Cumulative 200 but I assume I won't make it to dinner that low. I will do quite a lot to avoid a hunger headache.
          Last edited by Kepler; 05-01-2019, 02:44 PM.
          Cornell University
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          • #65
            Re: Calorie Counting

            For some people, anxiety makes them eat. Anxiety tends to make me not eat. I had my annual physical right before Christmas. My blood work came back OK, my cholesterol was just under what it would take for me to be on medication so some dietary changes were recommended. Then things started going downhill with my father and over the course of the 3-4 months when he went through one medical crisis after another until he passed away last month, I lost close to 15 pounds. Part of it was missing many meals, part of it was literally not having any appetite. While I certainly wish I was able to lose weight any other way, I would like to see if I can keep this weight off since I was pretty much at my heaviest last year. Now that I'm slowly getting back to normal, I can start back to my regular meal planning.

            As for exercise, I am scheduled to have some surgery next month to repair a torn tendon in my ankle. My doctor told me I shouldn't do anything on it so I haven't been walking. I always seem to start walking more when the weather is nicer but now I can't. I'm wondering if I will lose any more when I am laid up afterwards or if I will gain weight because I will be unable to get up and move. Any thoughts on any kind of exercise I can do that doesn't include walking?

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            • #66
              Re: Calorie Counting

              Originally posted by Kepler View Post
              Assuming lack of formal experimental evidence either way, can you think of any credible theoretical reason why targeted fasting would be a good strategy?
              I assume you mean good strategy as in weight loss strategy. I think the data is quite limited in that aspect which is why I would not make that argument in the literature or to colleague without further study, especially clinically. I make a clear and specific distinction between things I actively recommend (FDA approved medication for its intended use, Mediterranean diet for stroke prevention) vs things there is no convincing evidence for but is likely safe in the right setting (where I think intermittent fasting in falls in). With few exceptions, I do not bring up the latter when talking to patients unless specifically asked.

              This review is an OK collection of some of the studies. There is a huge problem of validity and reproducibility in the diet/nutrition literature so all of this has to be taken with a grain of salt. To answer your question, they propose that intermittent fasting may lead to decreased caloric intake overall, although personally I have not been convinced with the data as of yet. There is also a paucity of long term data as previously mentioned by Deutsche Gopher Fan.
              https://www.annualreviews.org/doi/fu...r_pub%3Dpubmed

              I started to "accidentally" fast during the first year of residency. On an average day, I would get to work at 6 or 7, drink coffee, and work basically non-stop until I would leave around 7 or 8PM. I would have one large meal at home and go to sleep. Rinse and repeat. I ended up losing around 30 lbs which was nice and felt OK. I looked into the data at that time to make sure I wasn't actively hurting myself and now continue to do it basically when I feel like it. If I feel my thinking is slow or have other symptoms, I eat. I would not use this as evidence for anything. As most people have mentioned, you kind of have to find what works for you.

              Fasting is not my hill to die on. One well designed study could change my entire opinion on it.

              Originally posted by Kepler View Post
              Could fasting have a similar effect, exploiting a "market inefficiency" in how the body deals with lack of energy?
              In a way, yes. You are probably more likely to go into brief ketosis depending on your meal choice and duration of fast. That, however, is quite the can of worms and will probably bring out some diet cultists

              My experience with the ketogenic diet is mostly limited to epilepsy treatment. In those cases, I work closely with a dietician. Ketosis can be quite miserable, especially at the beginning.

              Originally posted by Kepler View Post
              I have a loose, quasi-crackpot opinion that processed foods create fats that are very hard to break down whereas natural foods create easy to break down fats.
              There are too many loaded words in this for me to comment in the exact spirit of the statement

              Chemically, fats are fats, carbs are carbs (yes there are differences within those categories). "Processed foods" as a whole are just more likely to have higher salt content, higher simple carb content, and less fruit/vegetable content. They are not, by themselves, "unhealthy" but will change the proportion of fats/carbs that you get compared other foods. You lose control over their content, whereas if you cook every meal yourself you know what is going into it and have more control. We can say a lot of bull**** from an evolutionary standpoint, but one truth I will stand by is we evolved to be efficient in processing and storing our calories.

              "Natural" is a word that comes close to rupturing an aneurysm for me. It is about as meaningless, individually defined, and inconsistent word that is put out there in health care discussions.

              Originally posted by Kepler View Post
              Any MDs or nutritionists out there want to take a swing at what the actual science is?
              Remember...a nutritionist is just someone who wants to call themselves a nutritionist

              There is a reason that a thread like this can have everyone come in telling a different thing that works. They probably all do.

              If you take the "Standard American Diet" and put it up against nearly any diet (especially ones that are restrictive in some way like Atkins, Mediterranean, gluten free, etc), the latter will likely show weight loss. There are hundreds of studies showing this which is why you can find support for whatever pet diet you have.
              In the immortal words of Jean Paul Sartre, 'Au revoir, gopher'.

              Originally posted by burd
              I look at some people and I just know they do it doggy style. No way they're getting close to my kids.

              Comment


              • #67
                Re: Calorie Counting

                Originally posted by Kepler View Post
                F-ck it. You good people are going to help me lose weight (5-9, 235) through shame, guilt, and relentless mockery (Catholicism has to be good for something) so I don't have to exercise. Because I hate exercise.

                Tuesday, 4/30
                Breakfast: Special K (120) with 1% milk (50) = 170. Good.
                Lunch: McDonald's quarter-pounder (520), large fries (500) and large Dr. Pepper (270) = 1290. Very bad.
                1460 cumulative, leaving me 540 for the next 12 hours. Considering that includes Trivia Night which means beer and tater tots that's not going to happen. One day plus a bit closer to death.
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                JFC, I'm the Kepler of the midwest.

                Originally posted by dxmnkd316 View Post
                I've never really experienced that except with long-term changes. Short-term, your internal organs aren't going to change size drastically unless something like a spleen and liver are crushing it or you wrap a band around it. As you eat less over weeks and months, sure. Then I would certainly buy that the stomach can shrink.
                Not drastically, but they seem to. During my recent adverse reaction to an antibiotic (the one that kept me from going to the F4), I couldn't hold anything down for a few days and when I finally could I couldn't eat as much as I did for a week after that.

                I've lost about 20 lbs. in the last couple of years. The main changes I made were drinking less pop (I went from 3-4 20oz bottles a day to 1), and trying to eat at least a little better. I've eaten almost no fast food for the last couple of years and have limited myself to only eating pizza once a week (I could probably eat it every day and not get tired of it). My work schedule has also probably played a part. Right now I work from 4PM-2AM. The previous year it has been 2PM-midnight. For whatever reason I'm not hungry when I wake up (varies between noon and 2) and have no problems working my entire shift without eating. If some coworkers do go somewhere to get food, I might get something, depending on where they go, but other than that I will just eat when I get home.
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                • #68
                  Re: Calorie Counting

                  Apparently every poster here (including myself) is losing weight.

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                  • #69
                    Re: Calorie Counting

                    Originally posted by WisconsinWildcard View Post
                    I assume you mean good strategy as in weight loss strategy
                    I meant theory as to why fasting might be effective/ineffective.

                    But your whole response was very interesting. Thank you.
                    Cornell University
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                    • #70
                      Re: Calorie Counting

                      Originally posted by FadeToBlack&Gold View Post
                      My problem with food tracking apps for calorie counting is that if you do your own cooking, you have to enter each ingredient and hope it's both in the database and has the numbers entered accurately. It drives me insane trying to pick from the different brands, serving sizes, and nutrition counts of eggs, veggies, crackers, bread, etc. My Fitness Pal is particularly terrible at this, and I inevitably quit using it after a couple of days.
                      If you cook from recipes, you can import and easily make changes to it. It's slightly time consuming (we're talking maybe 5 minutes), but my type A self doesn't mind. I find logging calories isn't a hardship. Sometimes following it is , but not logging. It helps force me to plan meals. I hate cooking during the week after I get home from work.

                      I do wish they had a little more quality control over people adding things, such as adding minced garlic that is 1600 calories or spelling things incorrectly... but it doesn't annoy me enough to stop using it.

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                      • #71
                        Re: Calorie Counting

                        I brought my own breakfast and lunch today rather than going out for it.

                        May 2

                        Breakfast: one largish-hotdog sized bratwurst (200) and Diet Dr. Pepper (0): 200

                        Lunch: turkey and cheese on a hamburger bun (180) and flavored selzer (0): 180

                        380 and counting.
                        Cornell University
                        National Champion 1967, 1970
                        ECAC Champion 1967, 1968, 1969, 1970, 1973, 1980, 1986, 1996, 1997, 2003, 2005, 2010
                        Ivy League Champion 1966, 1967, 1968, 1969, 1970, 1971, 1972, 1973, 1977, 1978, 1983, 1984, 1985, 1996, 1997, 2002, 2003, 2004, 2005, 2012, 2014, 2018, 2019, 2020

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                        • #72
                          Re: Calorie Counting

                          Unless you absolutely hate all veggies you could add a bunch of those on the side (or on your sandwich) as they're filling and low calorie (if you pick the right ones like spinach or Broccoli). I usually eat a salad with spinach as the base with most meals.

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                          • #73
                            Re: Calorie Counting

                            Originally posted by trixR4kids View Post
                            Unless you absolutely hate all veggies you could add a bunch of those on the side (or on your sandwich) as they're filling and low calorie (if you pick the right ones like spinach or Broccoli). I usually eat a salad with spinach as the base with most meals.
                            Some vegetables are tolerable when cooked, but I thought that defeated the purpose of them?
                            Cornell University
                            National Champion 1967, 1970
                            ECAC Champion 1967, 1968, 1969, 1970, 1973, 1980, 1986, 1996, 1997, 2003, 2005, 2010
                            Ivy League Champion 1966, 1967, 1968, 1969, 1970, 1971, 1972, 1973, 1977, 1978, 1983, 1984, 1985, 1996, 1997, 2002, 2003, 2004, 2005, 2012, 2014, 2018, 2019, 2020

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                            • #74
                              Originally posted by Kepler View Post
                              I brought my own breakfast and lunch today rather than going out for it.

                              May 2

                              Breakfast: one largish-hotdog sized bratwurst (200) and Diet Dr. Pepper (0): 200

                              Lunch: turkey and cheese on a hamburger bun (180) and flavored selzer (0): 180

                              380 and counting.
                              I’d add a piece of fruit and maybe a small bag of chips or crackers to your lunch.
                              Originally posted by BobbyBrady
                              Crosby probably wouldn't even be on BC's top two lines next year

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                              • #75
                                Re: Calorie Counting

                                Originally posted by Drew S. View Post
                                I’d add a piece of fruit and maybe a small bag of chips or crackers to your lunch.
                                Hmm. I could do that. I like fruit a lot. It's probably something I could use for sweetness.
                                Cornell University
                                National Champion 1967, 1970
                                ECAC Champion 1967, 1968, 1969, 1970, 1973, 1980, 1986, 1996, 1997, 2003, 2005, 2010
                                Ivy League Champion 1966, 1967, 1968, 1969, 1970, 1971, 1972, 1973, 1977, 1978, 1983, 1984, 1985, 1996, 1997, 2002, 2003, 2004, 2005, 2012, 2014, 2018, 2019, 2020

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