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Research

The team will be conducting the research project which aims to provide critical data for future study by academics.

The goal of the research is to focus on the metabolic impact on the body when exercising in a fasted state. We want to measure the impact on blood glucose, ketones, fat oxidation, fuel preference/availability.

Research Team

Prof Lloyd Leach

Prof Susan Bassett

Dr Barry Andrews

Dr Sunday Olawale Onagbiye

Mr Makhaya Malema

The Project:

A group of 8 - 10 runners, aim to cover 160 km over five days, between Vredenburg and Cape Town, consuming zero calories. The Fasted Fat Fuelled Freedom Run (FFFFR) is planned by Shaun Waso and Sam Bell, both Low Carb mentors, aiming to explore the safety and effectiveness of fueling from stored body fat during a five day fasting and endurance exercise.

This project was built on existing research, which shows a low carbohydrate lifestyle results in a metabolic shift from carbohydrate to fat metabolism, when the body’s main fuel source is fat and ketones rather than glucose. This has been shown to stabilise blood glucose levels and reduce the need for insulin treatment in diabetes. Nutritional ketosis is a physiological response to a high fat, moderate protein, low carbohydrate diet. It is not to be confused with diabetic ketoacidosis, which is the result of poorly controlled diabetes.

An endurance event was chosen to demonstrate how fat metabolism can be used as an alternative to traditional carbohydrate-based fueling in a group of volunteers. A detailed series of metabolic tests and health checks along the way will make this a serious scientific endeavour. The data-gathering exercise will explore the science and will produce informative data for the public via written results and articles for academia and mainstream media, YouTube videos, a possible film, and a website.

The safety of the project is carefully planned and monitored by the team’s experts, who have considerable experience in a low carbohydrate lifestyle from a variety of backgrounds.

The Route:

From Vredenburg, to Milnerton, Cape Town staying off the busy R27 as much as possible. We travel through Saldanha Bay, Langebaan, Yzerfontein, Darling, Atlantis, past Koeberg Nuclear Power station, Melkbosstrand, Bloubergstrand and Milnerton. The project will take place from 23rd to 27th April 2021.

The Rationale:

A ketogenic diet (< 50g carbs per day) observed over a period > 2-4 weeks puts the body into fat burning mode, allowing access to a large and (in our society) increasingly untapped reservoir of energy. Participants with diabetes have shown a ketogenic diet can be used to control diabetes and improve metabolic health in patients more effectively than conventional medical and nutritional advice. All types of diabetes affect 8% of the population (7 million people) in South Africa at the cost of ZAR 100 billion per year. The situation with Type 2 (T2D) is predicted to get even worse. Fewer than 10% of people with T1D reach the NICE guideline target with conventional management (National Diabetes Audit), whilst 90% achieve it on a ketogenic diet (Lennerz-Ludwig). Hence, there are evidence-based alternatives to standard care available, and we need a radical rethink of how we manage the condition. This applies to the general population, and is especially crucial for pandemic preparedness in 2020, given that significant comorbidities for Covid19 are metabolically driven (obesity, high blood pressure, diabetes, cardiovascular disease). Complications of diabetes are mainly iatrogenic (use of high volumes of medication and higher than necessary carbohydrate recommendations). Diabetic iatrogenic illness is potentially preventable & does not need to be thought of as an inevitable consequence of life-saving medication management. This project is designed to be a significant personal challenge for each participant, but also to explore concerns expressed by sports scientists and medical specialists regarding the safety and practicality of ketogenic diets, especially in the treatment of diabetes. It was deliberately ‘extreme’ to explore the practical limits of a ketogenic lifestyle. Findings should then easily translate to normal and diabetic ketogenic lifestyles.

Carbohydrate vs Fat Fuelling:

Advice via dietary guidelines to consume 55% of total energy from carbs makes it incredibly difficult for a person with diabetes to control their condition since they are essentially carbohydrate intolerant. Hence, current dietary advice is akin to pouring fuel on the fire of diabetes. The body has the potential to store energy for future use. Glucose is stored as glycogen and has a capacity to provide around 2000 calories of energy. By contrast estimated fat stores in normal-weight individuals are vast. For example, a 60kg woman with a typical 25% body fat has 135,000 calories of fat stored in her body. We aim to explore the potential of that fat store and prove that starvation would not occur, also that there would be no significant muscle protein breakdown during the event. The event distance approximates to a mere 20,000 calories, at the very low end of the range of the fat ‘tank’. Metabolic testing will show our bodies predominantly burn fat throughout.

Measurements:

LIPOGRAM (FASTING):

HDL CHOLESTEROL-S

TOTAL CHOLESTEROL-S

LDL CHOLESTEROL (MEASURED)-S

TRIGLYCERIDE-S

INSULIN (FASTING)

CORTISOL RANDOM – S

TESTOSTERONE – TOTAL

GROWTH HORMONE

GLUCAGON

CATECHOLAMINES (Adrenaline, Noradrenaline)

CONTINUOUS GLUCOSE MONITORING

WEIGHT

KETONES

LEAN BODY MASS

BMR

MOOD

Objectives:

We aim to demonstrate the following:

Participants have stable glucose levels throughout the 5 days.
Nutritional Ketosis does not lead to ketoacidosis.
Fat stores provide enough energy in ketogenic-adapted individuals to complete the event without hitting the wall.
Participants experienced improved mood, mental clarity and focus.

Re-Thinking Diabetes Treatment Options:

Through our research and experiences in training, and as we hope to prove in this event, we expect this project will help remove current obstacles that appear to be getting in the way of providing an option that will reduce the disease burden of diabetes (both T1D and T2D) and metabolic ill health. Some of the safety concerns holding back delivery of low carbohydrate lifestyles and fasting in healthcare settings should be answered. Clinicians and people with diabetes on this project feel ketogenic diets should be a management option that can be delivered with skill: should a diabetic patient (T1D or T2D) decide to take up this option.

Disclaimer:

It is not the intention to present this project as validation of cessation of eating for those with eating disorders. Eating disorders require specialist management well beyond the findings of this project. Neither is it a recommendation to anyone to copy the method. This project requires careful planning over several months. All individuals are physically and mentally fit, and well nourished. They train in both fasting techniques, and in covering the distance needed per day. Individuals are free to cease participation at any time.

The team is not advocating anyone to undertake such a project themselves. Neither are they advocating that this is an optimal or desirable form of activity. It is an experiment in metabolic performance. This is not a test to assess the limits of human performance. Nor is it an experiment in starvation. There are significant differences between fasting and starvation. Fasting is time delayed eating in well-nourished individuals, as opposed to starvation which results in nutritional deficiencies and malnutrition.