More Carb Nite and Carb Back-Loading Tips Part 5

In an effort to stay up to date with all of Kiefer’s prolific work, here is the next series of notes I’ve taken. This is the fourth edition of my Kiefer notes.  Again some of these are from his own site, Body.io and some from when he appears as a guest on other podcasts. For those that don’t know, Kiefer is the author of both The Carb Nite Solution and Carb Back-Loading, both ways of eating that I’ve been playing around with recently.  Here is the official link to all of his guest appearances. Previous Notes:

• Carb Back-Loading Pearls and Criticisms
• More Carb Nite and Carb Back-Loading Tips
• More Carb Nite and Carb Back-Loading Tips Part 2
• More Carb Nite and Carb Back-Loading Tips Part 3
• More Carb Nite and Carb Back-Loading Tips Part 4

Kiefer’s special content released when his new Carb Shock supplement came out:

• Carb Shock Q&A Notes from Kiefer’s Secret Body IO Podcast
• Carb Shock Notes from Kiefer’s Insulin Timing Tricks Webinar Part 1
• Carb Shock Notes from Kiefer’s Insulin Timing Tricks Webinar Part 2
• Carb Shock Notes from Kiefer’s Insulin Timing Tricks Webinar Part 3

• (Bill Lagakos is the author of The Poor Misunderstood Calorie)
• Kiefer brought Bill on because of the great critique articles he wrote
• Kiefer appreciated the critique and recognized that there were a lot of valid points
• Kiefer also really liked the fact that Bill actually read his book, (Carb Back-Loading)
• Bill is a great guest because his work is all about delineating how different things affect nutrient partitioning (how nutrients are stored in fat vs muscle etc.), and how calories by themselves aren’t sufficient.
• Now they’re discussing the study quoted by Saab (sp?) – One of the first studies talked about in the critique, the selection criteria was broad.
• Kiefer brings up the “insulin paradox” which is where people who are gaining weight develop increased insulin sensitivity at night
• Bill was not aware of the “insulin paradox” but brings up that Saab actually confirms a lot of what CBL says, like glucose clearance being better in the AM.
• Kiefer was suspicious of the paper because the BMIs had such a wide range.
• Kiefer stresses that as people gain adiposity (fat) everything starts to change and it’s important to keep this in context.
• Bill clarifies that ‘insulin sensitivity’ doesn’t mean the same thing in all tissues:  in skeletal muscle tissue it means glucose clearance, for the liver it means supression of hepatic glucose production, and for fat tissue, insulin has an anti-lipolytic and enhances fatty tissue uptake.  With blood measures, when people are exposed to insulin, if you see suppression of free fatty acids, this is an indicator of adipose tissue insulin sensitivity.
• Kiefer brings up the work he’s seen that if you introduce carbs earlier in the day, that you suppress lipolysis later in the day – and he wonders if this could’ve skewed the results of the paper
• Kiefer and Bill agree that a lot more research needs to be done in these areas, and that the details are painfully nuanced.
• Rocky chimes in that CBL and CNS will have different effects on people who are obese, and so CBL may not work well for obese folks.
• Bill has not read The Carb Nite Solution
• Bill’s followup critique on CBL is based on his interest in circadian rhythms, but has found that adipose tissue seems to have increased insulin sensitivity as the day progresses, going in the opposite direction of skeletal muscle.  He does qualify that the studies he’s refering to measure things differently so teasing out the data requiers a very nuanced effort, so he is still very cautious of the results.
• It’s important to examine the population that is being selected for
• Rocky says that because he is a family physician, his patient population is skewed towards diabetes, insulin resistance, impaired glucose tolerance, so CBL isn’t the best protocol for them, but Carb Nite is very effective.  So the population that is being selected for actually gets lost when analyzing all of these papers.
• Bill admits that the population subject wasn’t something he took into account, and re-examining one of the papers that he quoted, he now sees that the patient population was in females with gestational diabetes, which is not very applicable to the general population.
• Kiefer says he should’ve been more clear at the beginning of his books that, there are still a lot of issues that still need to be addressed, and when these issues are addressed, it’s mostly done in sick populations that are metabolically deranged.  We don’t address them in healthier people that work out.  Kiefer refers to studies that are done in athletes that show that if someone is a highly trained athlete, it almost doesn’t matter what the composition of their diet is.  It’s only the calories that matter that determine whether they gain or lose the same amount and type of weight.
• So if you talk to someone who only works with athletes, who only preach calories in and calories out, that reflects their experience… but is not applicable to the general population, because these people never step out of that population that they normally work with
• Kiefer asks Bill why he started to deviate from the conventional western scientific approach to nutrition.
• Bill said because his main focus was in biochemistry and molecular biology without much exposure to dieticians, and nutrition was just a side interest, he just somehow ‘miraculously avoided’ being exposed to the conventional wisdom paradigms (heart healthy diet, low fat diet, etc.)
• Now Kiefer asks about Bills’ conclusion that to minimize storage of carbs in adipose tissue, it’s best to eat carbs before working out… because Kiefer is completely on the opposite side of that.
• Bill says he doesn’t feel very strongly about it, and says that he doesn’t think it will affect things very much if you eat carbs 40 min before or 40 min after working out.
• Bill also says he appreciates the impact that exercising in the fasted state will have, ie increaed lipolysis, increased autnomic nervous system activation, he was just thinking that maybe to preserve lean mass.
• Kiefer says that he’s read that if you have low insulin and low blood glucose levels going into training, your muscles are more sensitive to adrenaline and you have a larger and more rapid release of adrenaline.  Kiefer thought this was a superphysiological state, but now realizes that this might be the baseline state that you want because in order to mobilize intramuscular glycogen stores, that relies heavily on muscular sensitivity to adrenaline.
• He says he missed this the first time around, and this is why you don’t want carbs around from recently consumed food so you can preserve the muscular sensitivity to adrenaline.  Unfortunately, Kiefer says he doesn’t have any direct studies comparing performance over the short term from switching from carbs before training vs just making sure glycogen levels are full before training.
• Bill’s take on this is that it sounds very reasonable, and clarifies that at this point they are talking about two different patient populations.  What Kiefer’s talking about is more applicable to heavy lifters and athletes, whereas who Bill is targeting people who’s goal is low insulin levels as much as possible… and that if these folks take carbs before working out, the workout induced adrenaline release will attenuate the effects of the released insulin.
• Kiefer responds that in this case, when adrenaline and insulin are essentially fighting against each other, neither one can do their job well.
• Bill concedes that this makes sense.
• Kiefer says that despite not having clinical trials and research, he’s noticed that a lot of people report in the first few weeks of CBL, they’ve seen noticeable increases in strength, which he posits can be due to the increased sensitivity to adrenaline during the workout.
• This is one of the main reasons Kiefer recommends no carbs before training… because of the performance advantage
• Kiefer also says that you can argue that being able to deplete intramuscular glycogen helps preserve lean mass better than trying to introduce amino acids… we still need more research in this… but there are clues pointing to this now.
• Kiefer now brings up NMR glycogen studies post exercise.  Bill is not aware of these studies.  Kiefer says that the NMR studies show real time glycogen recompensation and what the major factors are.  There are great studies showing that there is a 30-45 min window immediately post workout where glycogen repletion is completely insulin independent.  And then after this window, for the next 2-3 hours, glycogen repletion is completely insulin dependent.
• So there is a small window for the non-insulin mediated GLUT 4 translocation, which is why it’s important to eat carbs immediately after workout.
• Kiefer notes that Alan Aragon… and another guy who argue that it’s not important to eat anything at all after training, fail to mention these NMR studies because it will invalidate their arguements.
• Kiefer asks Bill what his PhD work was in… he studied animal intestinal absorption of dietary fats… unfortunately none of this work is applicable to us now
• Bill says our body is exceptionally good at absorbing fat.  We could eat a pound of butter and absorb the entire thing… without wasting a drop!
• Kiefer asks if there is an upper limit to fat absorption because of the forums guy (man.. this dude get so many mentions in these podcasts!) who was consuming 6000 calories of olive oil, and after a month he complained because he didn’t lose any weight… despite not gaining weight.
• Bill says, he’s guessing the dude absorbed all the fat he was consuming, then Bill quotes a study from 70 years ago where they gave a guy 500 gm of butter in a single feeding, and weren’t recovering any fat in feces.
• Bill says we are capable of absorbing so much fat because our bodies have a lot of enzymatic redundancies to process it.
• Alex asks if the body has a preference for a type of fat to absorb or if it’s all absorbed the same.
• Bill responds by saying that the longer the fatty acid chain and the more saturated it is, the worse it’s absorbed.  And these are quick to form calcium soaps…  Overall, these fats are not very soluble.
• Kiefer and Bill discuss the ‘2nd meal effect’ which helps explain why after eating a mixed meal, can get a somewhat fast rise in blood fatty acids… despite the fact that it takes a long time for ingested fat to be absorbed and processed through the intestinal cells and lymphatics and liver.  The fast rise in blood fatty acids is because there are intestinal cells that store fat and immediately release them immediately after a meal.
• Bill confirms that these ‘intestinal lipid droplets’ is a brand spanking new field (Kiefer really is on the cutting edge…)
• Kiefer talks about a study, that showed that the insulin index of the meal you eat before going to bed will predict and effect the insulin released of your breakfats next morning.  So if you have a very insulin stimulating food before going to bed, your insulin release with breakfast is higher than someone who had a low insulin release before bed.  This starts to skew some of the stuff you’d look at with circadian rhythms.
• Rocky is amazed at the volume of Bills tweets (I agree… so many links and studies sent out per day!)
• Bill’s current interest is in the circadian rhythms and how essential it is to have a good nights sleep.
• Bill discusses a study in which all the participants started out losing weight, all eating isocaloric identical diet.  Had half sleep 5.5 hrs a night and half sleep 8.5 hrs a night.  Amazing that the short sleepers lost way more muscle and way less fat than the long sleepers.
• This one detail illustrates how important it is to have good sleep.
• Kiefer wants to know if this was a mixed diet in this study.
• Turns out… yes.. it was a mixed diet, and probably high carb.
• Kiefer argues that sleep is not as important as we make out because, if you’re on a mixed diet and you are not getting enough sleep, on average your cortisol levels will rise.  Cortisol in a vacuum is actually pretty good because it stimulates release of glucagon, stimulates lipolysis, and stimulates gluconeogenesis from protein break down (I’m not too sure about the benefits of this last item).
• But when you introduce insulin into the picture, cortisol shifts towards more negative aspects of metabolism.  Glucagon is no longer as effective in breaking down glycogen for sugar but is more effective in breaking down protein for sugar.  When cortisol and insulin are together, they prevent lipolysis and stimulate pre-adipocytes to differentiate into mature adipocytes.
• Kiefer argues that if you are on a low carb, ketogenic diet, you would be more able to hormonally deal with deviations in sleep patterns.
• Bill agrees that this makes sense.
• Kiefer says he notices that when he goes through periods of sleep deprivation he experiences more fat loss than at any other time… he eat’s very low carb a lot of the time when he’s doing this.
• Rocky says he was going to say the exact same thing.
• Bill currently spending a lot of time working on his next book about nutrition and circadian rhythms… which is just about done.  He’s about to send it out to publishers.

• (Mark Sisson is the author of one of my favorite books, The Primal Blueprint)
• Kiefer asks what’s the difference between paleo and primal
• Mark says the difference is becoming thinner and thinner… primal initially started out as a kinder gentler paleo.
• Primal started out as a full on lifestyle, how we move, how we sleep, play, sun exposure, microbes in the dirt… all manner of things far beyond the diet
• Initially paleo was just about diet… but now more about lifestyle
• The original paleo was lean meats to avoid saturated fats, avoid all dairy, all grains, all legumes, all alcohol… which made it really restrictive.
• When Mark developed primal, he didn’t want it to be about struggle and sacrifice, so he crafted his eating strategy to include as many foods as possible.  He was a big proponent of saturated fat early on, provided you get rid of sugars and starches.  He also looked at research on red wine that suggested that a little bit of consumption is ok, and he considered it a sensible indulgence.
• With dairy, and lactose intolerance… everyone is lactose tolerant when born, the fact that you lose it over the rest of your life is sort of an anomaly.  You can actually maintain it with continuous dairy intake.  For people who are lactose tolerant, there’s no reason to avoid dairy… especially things like whole fat milk and cream and butter.. things that don’t have too much casein.
• With this program, there was opportunity to eat a lot of things that the original paleo diet didn’t allow.
• Over time, paleo has started moving towards primal allowing dairy back in and saturated fats…
• Rocky says this all looks straight forward and then asks where it all goes sideways
• Mark replies that it goes sideways when people become dogmatic.  This is one reason he employs the 80/20 rule.
• Kiefer has moved back to bay area, not paying attention to his diet, and is just walking alot… and still in great shape.  The only limitation he puts on himself is that when he eats carbs… he only eats it at night.  And every once in a while he even breaks this rule.
• Kiefer just once wants to eat with people who aren’t allergic to everything
• With the gluten free crowd, while Mark thinks that some people really do have serious issues, most people can probably get away with a lot more than they think they can.
• Kiefer asks about Marks opinion on the whole casein and A1 and A2 cow thing.
• Mark says the A2 thing is really starting to pick up.  There’s a company now called A2, and there are lobbying efforts in Australia.  He thinks there’s something to this idea that some people have a difficult time digesting casein from A1 cows, and that there’s a lot of work investigating this, but Mark hasn’t seen enough of this to be thoroughly convinced of this…
• Rocky agrees with this position…
• Rocky brings up his observation that there is a subpopulation who go paleo/primal/low carb who develop abnormalities in their lipids (like me!) and Dr. Gundry alluded to the notion that this A1 casein issue may play a roll in the abnormal lipids.  Dr. Gundry said that when he removed A1 casein from these folks, it resolved the lipids.
• Rocky says he tried removing A1 casein for a month, but it didn’t really make a difference… but it might not have been a long enough time
• Mark doesn’t think the lipids thing is related to A1.
• Neither Mark nor Kiefer nor Rocky drink milk…. they do drink heavy cream, have butter, and cheese… but these are very casein depleted
• Mark says that he’s ok now with certain types of beans because of their resistant starch, and the pendulum against beans is now swinging back
• Mark refers to the carboyhydrate curve he created and says that most people don’t really need to eat more than 150 gm of carbs.. unless they are very physical workers like dock workers, or very high intensity athletes
• Kiefer goes on about his ideas on the microbiome… when we our healthy, our gut bacteria adapts and becomes healthy, when we our unhealthy, our gut bacteria then becomes unhealthy
• They all agree on importance and benefits of becoming a fat burner, and not dependent on carbs.
• Mark says one of the reasons we get sick is because stress is an immunosuppresor.  If you are a sugar burner and don’t eat for a few hours, the brain which is now used to a regular supply of glucose and doesn’t know how to use ketones, the brain induces adrenal gland release cortisol which has lots of detrimental effects: induces gluconeogenesis to break down muscle tissue into amino acids to make more glucose for the brain; stops all growth processes, so bones won’t take in calcium.. which is partially why women who are under stress so much now have low bone density; and cortisol suppresses the immune system
• Glad Kiefer brings up the stuff he was talking about with Bill Lagakos, about how the new research is showing that cortisol actually isn’t that bad, UNLESS we are a primary sugar burner.  If we are a primary fat burner, cortisol actually does some great things… it helps us tap into glycogen stores, release body fat more effectively, and is not immunosuppressive.
• Kiefer says he’s been able to improve the performance of folks, like marathon runners by getting them into fat burning mode, and then super compensating them with carbs the day before the event, so that during the event all they need is water.  They have access to their fat stores AND their glycogen stores.
• Mark refers to Ben Greenfield’s prior experiment duing a ketogenic iron-man who eventually needed gels to get him through the race
• Mark also talks about fatchancerow.org about folks who rowed from California to Hawaii on a ketogenic diet.
• Mark says it seems like the longer the distance of the event, the more it makes sense to ditch carbs in your training, and thinks that we’re going to start seeing world records fall as more people take advantage of this… but at that high level will also need cyclic ketogenesis to optimize mitochondrial biogenesis
• The field of low carb training but utilizing carbohydrate management during the event itself is becoming more exciting.. GLYCOGEN MANAGEMENT
• Kiefer talks about mitochondria and says carb proponents don’t realize that as carbs are metabolized and converted into pyruvate to be burned in the citric acid cycle, the metabolites formed can actually damage the electron transporters of the mitochondrial membrane, so you get carbonylation, which decreases the efficiency of the mitochondria to produce ATP.
• So when you train without carbs, not only do you get more mitochondria, but you also get mitrochondria that are more efficient at generating ATP.

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Body IO FM 34 – Laura Schoenfeld

•  She posted an article that ignited controversy about why ketosis isn’t appropriate for everyone.
• She’s from www.ancestralizeme.com
• Kiefer is ok with ancestral but not paleo… (Hard for me to understand the difference between the two).
• She wrote article in response to clients that she’s been working with since February…  (She’s still a newbie).
• A lot of her clients going on super low carb diets, feeling like crap, fertility issues, adding 50-80gm carbs per day times around their workouts helped changed a lot of their symptoms.
• People who crossfit 4x a week are actually training more than some athletes… And eating super low carb without adequate 1-2 year adaptation period are just asking to be sick.
• Kiefer goes on a little rant against BP coffee.
• He had colleague frustrated about not losing weight on Carb Nite, so kiefer recommended to increase fat intake to around 70% of calories.  Just Jack up the fat.
• After three days a calorie deficit can have a hormonal effect.
• She’s found harder time to convince women to up their calories, but guys are excited about eating more.
• Rocky says that with Carb Nite he doesn’t see thyroid deviations in lab values…. But they have subjective hypothyroid symptoms, and he uses this as a sign to do something different, like upping the calories. Usually the thing is that they need more fat.
• Rocky doesn’t do rt3, which is not covered by insurance, because it is experimental and can cost 200-300$ (It’s only $59 on Requestatest.com, which is what I use).
• She says there is theory that low carb can cause increased RT3 with normal TSH and free T3, because of the cortisol changes with low carb diet.
• Kiefer goes into his cortisol thing on how it is actually a really good hormone when in absence of carbs and insulin.
• But if we are in a state where we are calorie limited or fat limited, then this is what can screw up the cortisol issues.
• Rocky asks if Laura has ever tried to increase caloric load rather than adding carbs in first… And she hasn’t tried it.
• Main issues Laura has seen are mental health and energy related when they go low carb… And it might not be worth losing weight if this is the cost.
• Kiefer says a lot of the things being said have become dogmatic.. Some of the stuff Chris kresser has written and what keto people say.
• Her strategy when adding carbs is to do add it at night and/or after a workout.
• Kiefer tries not to eat vegetables now unless it is super palatable…
• He had a salmon salad and his gut was wrecked for days… (Wow, sounds like he has a fragile system, or maybe just doesn’t do well with seafood salads!)
• Seems like the theme of this entire podcast is that diet is individual, and you need to experiment around with it
• Kiefer likes Laura’s idea that it might be the drastic changes in diets and how that effects gut biome, that causes their problems.
• Laura discusses new lab working on fecal transplants.  Weird that some people ask Laura about DIY fecal transplants.
• Kiefer talks about the latest irrational food fear is gluten or dairy.  Kiefer blames paleo for this
• Kiefer will get a bag of 4-6 filet o fish every couple of months.