100 day commitment is fulfilled today. I was successful in terms of eating macronutrient ratio to goal with caloric limit in mind, with the exception of 5 days total, and that includes an intern year graduation extravaganza and vacation with friends and family. Below are the numbers:
It should be noted that no extra exercise from what I would do at baseline was conducted during this time. This is comforting, as I know as soon as I engage in consisted exercise, with a blend of cardiovascular and hypertrophic weight training the body re-composition process will only hasten.
In some ways I am disappointed that I "only" lost 28.6 pounds. On a day where I was coming off of a 3 day fast and had not had nearly enough water, I maxed out at nearly 35 pounds lost. That was a couple of weeks ago. That day I was uncomfortable with how dehydrated I was and am certain that I was down 5 or 6 pounds just from volume depletion. And last week had me in Oregon, celebrating and seeing old friends and family and eating, always eating! If not over on my carbohydrate intake, I was definitely way over on my caloric intake on most of those days. Even on a ketogenic way of eating, the 2nd law of thermodynamics rules all -- and when I take a step back and realize how I would have eaten in those settings prior to this project, I am proud of myself and realize that a couple of days of wonton celebration and revelry will not undo 97 days of consciously deployed self-discipline, and all while finishing out intern year of residency.
This diet is restrictive, but if you're willing to eat meat -- a lot of meat, and cheese and green leafy, and cruciferous vegetables to exclusion you will be just fine. This is the food I naturally am drawn to -- I yearn not for pastries and pies but pork butt and pastrami. And with this the negative aspects of this end. I don't mean to diminish the sacrifice that will come, and the obsessiveness that develops from fear of clandestine carb ingestion -- checking labels, asking coffee shops if you can scan the barcode of the almond milk container. Requesting bunless burgers. Please hold the hashbrowns and may I have a side of bacon with my meat-lovers omelette? Going to Red Robin, against all better instincts because they have "bottomless" broccoli with a burger -- a bunless burger of course. All these are bad enough, but the worst of the diet stems from having to explain yourself to others. As a doctor I may be able to get away with criticism, at least to my face, relative to others who find themselves trying to defend how their high fat diet will not push the inevitable myocardial infarctions into high gear. Fighting against a whole generations indoctrination concerning the evils of dietary fat and cholesterol is so disheartening -- from corruption and greed comes deception and the unwitting betrayal of a populace medical sciences is sworn to protect. From this comes distrust of the faces of medical sciences -- physicians. And here we are, with a nation, and now world that has let the industrialization of agriculture and processed food-like products become so prominent that eating whole foods, whether it be meat, vegetable or fruit is for the more fortunate of our society and stretching a budget to include these fresh items is often unrealistic. We are a nation that has armed forces facing difficulties finding recruits who are physically fit enough to serve. This should be seen as a national security liability and a nationalized healthcare safety net system which includes cost effective preventative medicine should be funded by the pentagon. Our society has a lot of easily prevented chronic medical issues, and the pennywise pound foolishness of our leaders will cost us in the long run.
I count myself as being among the fortunate who are able to afford whole foods and eating poorly is a matter of poor choice, not financially mandated and for that, I'm very thankful. Last year when we moved to Long Beach I bought a "Red Egg" which is a knock-off Green Egg. My version is about $400 cheaper, and as long as I don't leave it in the rain it will last forever. It has been dormant in the garage since last summer and the last effort to smoke some ribs went awry. I thought I could wing it and just figure it out as I went. They were burnt. Badly. Last week I was at a cousin's house, and her husband smoked some ribs on a traditional smoker and from that, the inspiration to finally properly smoke ribs in the red egg sprung. A meal to celebrate.
Found myself at Costco yesterday, having to get passport photos for well, not only passport but my medical license as well. I picked up these pork ribs there. I put together the rub myself, large components include smoked paprika, kosher salt, black pepper, garlic powder, Lawry's salt, some random other things. No overt sugar added, notice, and the only carbohydrate stems from the small amount of sugar in the small amount of Lawry's Seasoning that I added. I may get some sugar-free, low carb barbecue sauce when it comes to eating these things.
Yesterday I watched a bunch of YouTube videos about how to smoke ribs in the Egg, regardless of color. Heat control is a big thing, along with varying opinions about foil wrapping, mustard as mortar, apple juice vs water, water pan vs dry smoke. All very helpful, but what I learned most is that it seems to be only big-bellied white dudes with Southern Accents make Egg smoker videos. On a sidenote, I think that one of my last big biases, one that insidiously creeps its way into my thinking, is that I automatically assume someone with a thick Southern Accent is less intelligent than average. I know it is not always true and honestly, I don't run in to many with these accents on the West Coast anyway, but I am aware of this and hope to be less critical in the future. Anyway, all the videos were helpful.
The average calorie per day is interesting to me, as seen above. 1702 per day. That is a fairly low number for me, as a larger person, with a higher than average lean body mass to maintain and it is no wonder that I lost weight. But there is more behind this number in that I began to employ fasting on a regular basis, especially the last half of the 100 days. Forcing one's body to use stored fat as a fuel lends itself to fasting quite naturally. This is what I found. Many days I would just not eat because I was not hungry, and through this process I feel like I have an increased capacity to listen to my body and take the clues and surmise what was needed. I made it a habit to fast 2 days per week, at least. Many days were eating one meal a day, or not eating until dinner. Even for me, trying to take in 1700 calories in one meal is a challenge, and this process, regardless of hormonal benefits, lends itself to decreased overall caloric intake. As the weeks of fasting continued, it turned into a period I really looked forward to and I began to read about fasting research and was quite pleased that many benefits are derived from fasting. I may continue to incorporate elements of fasting for the rest of my life. Eating to engender ketogenic metabolic processes and water fasting provides a state in which lean body mass is preserved; anecdotally, I can corroborate this with vigor as I feel as if my muscles are getting bigger -- most likely not the case, but is due to the adipose tissue melting away. Perhaps I would feel the same way if I was simply following a "CICO" (calories in calories out) manner, but most likely I would have lost more lean muscle mass operating under that edict.
I'm continuing this project for now, and with intern year behind me and only a handful of brutal months and call shifts left before this whole thing is over, I'll be working my way back into the gym.
Near the beginning of this 100 day commitment it became obvious that I didn't want to write about the process on here, or even talk about it. I don't fancy myself being one of those people who interject my personal behavior at every opportunity. I try not to be. Now that things have calmed down, and our household is humming along with keto friendly foods it seems like a perfectly normal thing to eat like this and while I'm sure I'll have more posts concerning my ongoing experiment with regaining my health while I still can, I hope to get back to other more interesting and less inwardly focused blog posts.
The ribs turned out well. Next time I will take care to spray them down with at least some water through the process. I think that I took them off the grill perhaps 30 minutes too early. Some of the smaller, thinner end pieces were burning. I should have just pulled those pieces off and let the larger, thicker sections simmer in the smoke just a bit longer. The rub was super simple and just perfect for these ribs. I never did get any sauce and these really don't need any. The dog is very happy and she'll continue to have bones for the next few weeks as a treat.