Type 1 Keto

Dr Ali Ibrahim Blog

A bit about me!

I’ve just finished my postgraduate medical training, and started my first job as a consultant two weeks ago! It’s been an incredible journey, 15 years! Apart from gaining knowledge and skills, medical training has taught me to value the failures in life. You derive the greatest amount of learning and growth from failure: it reveals your shortcomings and helps you progress – we just need to pay attention, be brave enough to accept them, and use the experience to propel progress and development. 

So, when Ian asked me to participate, I was thinking: this is an important cause, as it can change the treatment paradigm for people with diabetes. However, I may or may not succeed in this experiment. But, it’s an opportunity to learn, use your mind and body in ways people would never dare to imagine is possible and test the limits of the human spirit, but of course, metabolic and physiological functioning! In reality, am I really doing this to find out, just how powerful is the human mind? The old mantra of: you can achieve anything if you put your mind to it, just how far can your mind take you ? And can theoretical physiological plausibility help with that… Now, that I have been metabolically fat adapted for the last two years at least, in theory there’s no reason physiologically why this experiment shouldn’t be possible …. what stands in my way is strength of belief and strength of mind! Let’s put it to the test!

Diary:

Day 1, 19th Sept

I slept for an hour last night! I wish I could say it was the excitement of the anticipation for this event… absolutely not! I was doubled over in pain in my tummy and feeling sick from the bowl full of…. not cereal!! …. wait for it! beef fat!! Yes a great whooping 200g of the stuff polished over with a total of just over 1kg worth of sirloins, 6large eggs, scrambled and prepared with a large helping of beef fat and almost half a block of butter! Right!! So, my idea of successful preparation of upping the amount of fat from calories to way over 80% for the last 5 days may have increased my fat stores, but these kind of amounts obviously don’t sit comfortably in my gut! Somewhat less would have probably done the job, without the discomfort! Not an experience I shall repeat. So, with next to zero hours sleep, still felling sick in the morning, stuffed from a meal I had at 3pm the previous day, the doubts were definitely kicking in so hard in my head… I had the perfect excuse to pull out now.. I mean let’s face it.. how on earth was I going to run 20 miles a day for 5 days fasted! No chance! I have done previous endurance events, but nothing like this before, and I haven’t had time to train recently.

I started seeing the messages coming through from the others, excitement building up, Ian texts to say “you’re up! get yourself over here Ali, I’d really like to meet and chat” …. this is real, I think to myself – am I going to do this despite the pain and sickness, or will I be the guy that bailed out!

I arrived in Henley, and my head is focussed on nothing other than “I can do this, I will do this” yet my body still feels heavy and sick from all that fat I ate yesterday! I see the others arrive, my head still fuzzy from the lack of sleep …. I’ve no idea what I am doing here! It dawns on me that this has become real… trouble is – I’d actually visualised every step in this journey in my minds eye – sickness and bloating certainly wasn’t part of those visualisations, I guess I’d come here to learn, and what I learnt today was that – yes large amounts of fat in my diet have made me feel great overall – but too much fat and forcing it down your gut – not such a good idea! My first lesson of this experiment (before even getting started!) learnt! Although, on the plus side Pete, the lovely man doing our metabolic tests, tells me I’m a “100% fat burner” well that sounds like it should help! 

As we set off running I gradually start feeling less uncomfortable as the day goes on. By the end of day one I’m feeling slighted less “stuffed” … certainly not hungry… interestingly not thirsty either … no fluids on board at all during the run! Despite a very hot September day! 20 miles done! I’m in, successfully started! One step at a time, one day at a time – a lesson I should apply as a principle in life in general, not just this event.

So, what have I learnt today that I’ll take forward for the rest of my life. Well firstly, fat fuels your brain and makes you feel good, certainly did that for me for the five days pre event when I increased my fat intake – but definitely don’t overdo it, unless you want to be up all night with a bellyache. Second thing I’ve learnt, is in life, pace yourself, it’s never about racing ahead, it’s about making every moment count. Third, if you focus your mind, your body can achieve anything, you need to believe you’re able and visualise the reality of what you’re trying to achieve. 

I reeeeeally need some sleep now! 

Day 2, 20th Sept 

Managed a good nights sleep, fresh and top of the day! The idea of running actually feels appealing today. Rearing to go! At the 10mile point – absolutely wasn’t expecting I’d covered that much ground! I take a moment for a drink and to appreciate how lucky I am. The last two days have been beautiful.., perfect weather… the countryside is serene , listening to the bird song, and the soothing sound of the running water stream of the canals, the narrow boats passing along, it feels like something out of a fairytale… something very strange happened, towards the end of our 22 miles today – it almost felt like a switch had been flicked in my head … it was real and palpable, almost sudden, I can’t explain this biologically… but I’m suddenly feeling euphoric and full of energy! I start doing some intense sprints at the end, it’s not that I want to spirit…it feels like an absolute need! I’m high as a kite, this must be how it feels being on drugs! Not an hour goes past and colours start looking brighter…I test my ketones back in the hotel room, ummm 0.3! The lowest so far in this experiment, yet the best I’ve felt! Ive Absolutely no idea what’s going on! I doubt I’ll sleep much tonight… I feel like going out and running the entire distance all over again, I feel so full energy, mentally clear, yet relaxed and calm….

It has just dawned on me I’ve never been able to push through more 2 days of fasting! First time ever in my life I’ve gotten to this point, I’m feeling fantastic!

I’ve learnt so many things today, but one life lesson that certainly stands out for me is that the most amount of pleasure is derived directly from effort and challenging yourself – right, so no wonder why people feel so good going to the gym or exercising despite it being uncomfortable! It’s a curious thought though – as humans we avoid discomfort – but to a degree it can be the greatest source of pleasure… I wonder whether this explains why so many people are unhappy and depressed in our modern world – are we making ourselves too comfortable, so to speak, which is stopping us from experiencing the full spectrum of pleasure and happiness in life… Curious, is not it, that the more we’ve enabled our lives to be easier, delegated manual labour to machines, delegated the sourcing of food to supermarkets and factories, even delivered directly to our doorstep, the less happy we’ve become as a society collectively over time, and the the greater the amount of mental illness … I wonder if paradoxically, in mental health we should help people find happiness and pleasure in their lives by giving them the permission to be uncomfortable and push themselves, rather than advising rest! Something to ponder over tonight!

Day 3, 21st sept 

There are times in life when you know you’ve crossed a bridge! I didn’t sleep last night, but I’ve never felt happier, more energetic, or clearer in my head than this moment. I am feeling pure pleasure from everything, the sound of the birds outside as I’m sat on the bed, the rustling of the leaves, the tingling on my skin, and the electric current of euphoria running through my entire body. My mind is calm and still, I see everything differently than I ever have done before. Of all the happy moments in life, this for me is up there ranking as one of the very best – I’m not worried about what’s to come or the fact I haven’t slept and not thinking about the last two days… I’m simply present in the moment, and boy is it sweet! Curiously, no muscle aches or soreness! I’m really excited what I will discover about myself, my mind and my body today! The smell of coffee is so appealing – needs to wait until after seeing Pete for my daily metabolic tests! Can’t wait to be out in the sun enjoyed another day of this beautiful experience. 

I avoid concluding the day with sprints after the 20 miles today, purely to see how it would impact my ketones. Isn’t the human body just fascinating! Ketones 2.5, so my sprints yesterday changed my body metabolically in some way! Curiously, glucose 2.5! I mean this really is all new to me, and really emphasises the point that we should be continually learning – I was always taught as a doctor that such low glucose levels are dangerous and a medical emergency – there’s obviously something about my ketotic state (and potentially other factors we’re yet to learn!) that’s making me feel this good and energetic, despite the very low blood sugar levels! 

Guess what!- penultimate day tomorrow! Here’s what I’m feeling tonight… I don’t really care if we finish or not – it’s the journey that has given me the greatest satisfaction and happiness… I’ve enjoyed the learning, the feelings I experienced in my mind and body, meeting some amazing people and a week I’ll treasure for the rest of my life. Tonight the concept of completion feels like an added bonus, not the goal! So if I had that attitude through all the difficulties and failures I experienced in life, it may have made the journey so much more enjoyable – certainly the biggest lesson today is to learn to enjoy the moment, regardless of the outcomes. It is the experiences along the way and journeys that bring us the greatest happiness.

Day 4, 22nd sept

Omg! Really, have we really gotten this far! No here’s the thing that’s most surprising: the degree to which my mind feels calm, clear and laser sharp focussed is utterly unreal! I see things around me and life in general with a new and fresh perspective. No here’s the thing: nothing and no one can actually do or say anything that would upset me, which is at total odds to my usual self … I see things around me in dimensions and perspectives I have never experienced before… I know I’m sounding high right now! But the reality is, I’m not wired or edgy, or too excitable, I’m simply clear, focussed and calm…. all my senses have become heightened, I see colours as fluorescent. Oh and hunger I hear you ask! Not an ounce, food isn’t on my mind… what I am thinking is I want to experience this to it’s optimum, I really want to take in my surroundings today while running ….I can confidently say that I have never felt so mentally and emotionally present as I do in this moment …

My learning today also involves an unexpected surprise. I am dyslexic. Now here’s the thing, there’s something about the metabolic shift that my brain has experienced, which has allowed me to read the book I read tonight in a completely different way to how I experienced reading before. This must be the effect of ketosis on the brain. There is accumulating evidence that ketone bodies are helpful for brain functioning, but it was interesting to have a personal experience of this. The pages were coming to life and the words were speaking out from the page. Previously reading was effortful, now it’s seamless. But that wasn’t the best thing I discovered tonight. I have previously been told that I have the so called ‘dyslexic advantage’ one of which is having a fast understanding causal relationships. Now here’s the thing, this I knew I had, but tonight its amplified ten fold, and allowing me to create multiple parallel links and associations simultaneously and use my mental imagery in ways I’ve not done before. I pick up another book, it doesn’t stop there, it’s not enough, I’m now having to refer to multiple research papers and online resources and creating multiple webs of association in my head… let me tell you this – whatever metabolic shift my body has undergone during this experiment – if it were a drug produced by a pharmaceutical – I swear it would be the most expensive drug in the world! 

Day 5, 23rd Sept 

The thing I can’t believe is the lack of muscle soreness, no aches, no injuries! It’s unbelievable really, I’ve never done this kind of mileage on consecutive days, let alone fasted! So it was another sleepless night last night, not that it’s made an ounce of a difference to how happy, energetic, calm and cheerful I am this morning! Although the advantage of having been up all night is that I discovered something through a little experiment I did. I measured my ketones every hour from 4am, and they increased gradually every hour from 2.5 at 4am to 5.3 at 8am, I am still maintained blood sugars consistently lower than 3, between 2.5 and 2.9. What this means is we as scientists and medical professionals really ought to have a think about our current understanding of human physiology: blood glucose levels below 3 are physiological in ketosis.

I can’t say I’m not looking forward to finishing, but equally, I am really enjoying the way I am feeling and really hope I can maintain this … perhaps, intermittently fasting and continuing to enjoy a healthy high fat diet to maintain ketosis to fuel my body and brain -perhaps not quite as long as 5 days fasting thought! 16 to 24 would do for me I would think. 

Ok so here’s the deal, what I loved about today was the scenic route and my mental clarity… what I certainly did not enjoy was going off route! And hitting some gigantic, steep hills! The hills (maybe because of the raised heart rate involved) were not pleasant at all!! But the idea of a coffee at the end was soooo appealing …. interestingly wasn’t too concerned about having my first meal… contrary to my prior beliefs and expectations, I wasn’t ravenous or feeling famished and eager to eat … it was more a “well that would be nice” type of thought ! 

It must be said my first meal, was an absolute delight: 6 scrambled eggs, prepared with sour cream, and beef, after some delicious, warm bone broth! I was surprised that despite the large (but high fat and low carb) meal, I maintained low blood sugars and high ketones for many hours afterwards! It will be interesting to see what happens tomorrow and into next week.

It was surprising that some of my team mates were criticised about the idea of “encouraging eating disorders” on their social media pages. Nothing was further from the truth: our group of volunteers with a background of high fat diets represent quite the opposite: none of us were malnourished and the fasting was time limited. We have demonstrated the benefits and physiological adaptations when the body is fuelled by fat metabolism – benefits which are at odds with malnutrition in the context of eating disorders! 

However, I think some of the observations we made during this experiment have relevance to the understanding and treatment of eating disorders, although it wasn’t the objective of the study. We will explore this in future publications in more detail, and I will say no more about eating disorders in this blog!

What I will say though, is that this whole experience has been an absolute blast! I wouldn’t do it again, but boy, I am pleased I was there!

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