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Posts Tagged ‘meniscus inflammation’

Alright, so I haven’t updated in a week.  I’ve been very busy retooling the way I go about getting business and the details of what exactly I’ll be doing, but I’ll describe that in a different post…

Now, here’s a time line of what has happened with my knee:

1) I hurt my knee originally at the end of August.  I then did nothing for 5 weeks (neither making it worse, nor doing anything to help it get better other than rest).  Initially, I saw gradual improvement for the first 10 days as the bruising calmed down, but the bruising was replaced by chronic inflammation, as has happened to this knee before.  After 5 weeks the knee was only maybe 25% better, and so I decided to start alternate day fasting and taking some herbal anti-inflammatories to try and treat the inflammation.

2) After a week of alternate day fasting and taking the herbal anti-inflammatories (3 fasting days, with resveratrol and boswellia every day), the knee was maybe up to 40 or 50% better.

3) Continuing the herbal treatments and fasting, I saw dramatic improvement in the span of about 4 days, after I had been fasting for almost 3 weeks (9 fasting days).  This mirrors my experience when I fasted to treat knee inflammation two years ago – I didn’t see any benefit until about fasting day 8 or 9 then either.  I wrote a post about how fasting actually works to reduce inflammation.

4) At the end of three weeks of fasting, I went out and threw the frisbee around and jogged a bit last Saturday, and the knee felt like it was 90-95% better.  Then, the next day (Sunday), I decided to go to pickup ultimate frisbee, and I ended up playing most of an entire game…  Bad idea…  The next day (Monday), my knee was back to only maybe 60% better.

Now, I had been originally planning to taper off the fasting during this past week, but since the setback after Sunday’s game, I have kept going strong.  The knee is back to maybe 80% better, but I plan on taking it a little easier from now on, even if the knee feels really good.  Clearly, I need to be strengthening my legs as a whole and stretching to support my knee, in addition to treating the inflammation.

Fortunately I have found another trick to help make the fasting days easier: celery.  A medium sized stalk of celery is just 5 calories, and a couple of those spread throughout the day give my stomach something to gnaw on, other than my will power.  So, for the foreseeable future, I’m going to keep fasting on alternate days, which will hopefully keep working on reducing the inflammation.  And I’m also going to more seriously start strengthening and stretching my legs to try and give support to my knees.  I’ll post another update on how my knee is doing in a few days…

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Since I’ve been fasting every other day to get rid of chronic inflammation in my knee, I’ve gotten a bunch of questions from friends about how alternate day fasting actually works, so here’s my best attempt to explain it without getting too technical and biological…  If you do want all the biological nitty-gritty behind calorie restriction, here’s a link to a literature review done in 2003.  Warning: It downloads a PDF.

Back in the day, some researcher was playing around with some mice, and discovered that if you restricted the amount of food that mice had access to by 20-30%, the mice would live significantly longer, would have much better health, sleeker coats, and wouldn’t develop degenerative diseases like diabetes or autoimmune disease like allergies.  The same effect was then proven in all sorts of other species like monkeys (closer to humans), and yeast (easier to do genetic studies on).

Many years later, after genomic research became possible, it was identified that the when you restricted calories one of the effects that happened was that a certain gene (called SIRT1 in humans) was activated.  This gene then had many effects downstream, causing repair mechanisms to go into overdrive, and reducing damaging processes such as inflammation and other degeneration, leading to the increases in health and lifespan.

Then the question became why restricting calories leads to such an effect.  Essentially, humans evolved as hunter-gatherers in Africa, and life as a hunter-gatherer, while actually pretty easy, did include periods of famine and involuntary calorie restriction.  When there wasn’t enough to eat, the human body developed mechanisms to direct all the energy of the body towards repair and preservation of the body, so that the moment food did become available again, the individual was fit and ready to go out and get it.  During calorie restriction the body also down regulates any processes that are causing low level chronic problems, and furthermore, the lack of food reduces the oxidative stress on the organism as a whole (oxidative stress is the production of free-radicals that is inherent in metabolism – lower metabolism equals less oxidative stress).

After all this evidence started being reported, there were some intrepid souls that undertook to attempt calorie restriction on themselves for the life-extension and health benefits.  I imagine that it was extremely difficult – can you imagine being hungry ALL the time.  Furthermore, such people were often derided as simply trying to justify and promote eating disorders, which in at least a fraction of cases was probably true.

So, to bring this back to me and my knee, the important part of the whole puzzle was that relatively recently people began studying intermittent calorie restriction, and they discovered that restricting calories temporarily had pretty much the same effects as a permanent restriction.  Due to the lag inherent in body processes, the pulses of SIRT1 activity that come from fasting every other day are sufficient to lead to the same repair, anti-inflammatory, and life extension benefits that permanent calorie restriction does.

And very importantly, alternate day fasting is much easier to do than permanent calorie restriction, even if only for a month at a time, making it possible for me to do this and still function reasonably.

If you want more information on the specifics of the application of alternate day fasting to inflammation, here’s a good summary of a paper linking alternate day fasting to increases in SIRT1, and then another summary of a paper describing how SIRT1 blocks inflammation.

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Alright, for an update to my earlier post on alternate day fasting, I have kept up with the fasting and taking the resveratrol and boswellia extracts to fight the inflammation in my knee.  How has it been going?  Well, the knee is feeling better.  Not perfect yet, but better.  I am going to try and go for a jog later today to see how it responds to that…

Many of my friends (especially my girlfriend), don’t understand how I can make it through the day without eating.  To be fair, I am eating – I’m just limiting myself to 500 calories.  I don’t think I could make it without the 500 calories, but nonetheless, its still not easy.  Fortunately, I have discovered a few tricks that have made it a lot easier to manage.

First off is an herbal supplement called hoodia that is an appetite suppressant.  The Kalahari Bushmen of Africa would gnaw on this plant when they would go on long hunting expeditions where they wouldn’t eat for several days.  Now, you can buy the extract of the plant in capsules, so I take two of those in the morning when I wake up and two in the afternoon.  The effect is pretty dramatic, and it severely cuts down on the gnawing, all consuming sensation of hunger.

The second thing that I do, is I drink a teaspoon of canola oil right when I get up.  Now, I don’t really like canola oil, for other reasons I may write about at some later time, but I discovered some pretty interesting research from a crazy Berkley professor named Seth Roberts that led me to do this.

Basically, Roberts is a madman with a spreadsheet.  And I mean that in the most positive way possible…

What Roberts did, is over the course of many years, he took massive amounts of data on himself.  When he went to sleep, when he woke up, what he ate and when, what kind of mood he was in at regular intervals throughout the day, what sort of allergies he was experiencing, etc.  Then, with years worth of this data adding up to thousands of data points in excel, he was able to tease patterns out of it.

What kind of patterns?  Well, for example, he had bad insomnia for years, and by looking at the data and seeing what kind of things had happened right before or right after nights where he had insomnia, he was able to come up with a list of factors that caused or abated his insomnia.  By avoiding or emphasizing those factors, he was able to effectively cure his insomnia.

Now, obviously his data is only specific to his body, and the exact things he did may not work for anyone else, but there is a high probability that some of the things he did would be effective for at least a percentage of other people.

So, where does the canola oil come from?  Well, he was trying to lose weight, and through making hypothesis and looking at his data, he was able to come up to the conclusion that hunger is connected to flavor, not calories.  We don’t crave calories, we crave flavors, which our body has learned to associate with sustenance.

The extension to this is that if you eat flavorless calories, then your body will receive sustenance without triggering the hunger response later along.  If you get no flavor, then you’re body won’t know what to crave when it later wants calories again, and therefore it won’t give you the sensation of hunger.  You’re basically tricking your body into not giving you the hunger sensation…

In making this discovery, Roberts found that drinking a small amount of canola oil (or other flavorless oil), was the best way to get a burst of calories without any flavor.  He also discovered that it was a lot easier to drink oil if you floated it in a small cup of water first – you don’t get that oily mouth feel…

So, in addition to taking the herbal anti-inflamatories, and hoodia supplements, I’ve also been drinking a little oil every morning that I fast.  Has it helped?  I think so.  Its hard to separate the effects of the hoodia and the oil, but the one day that I didn’t take the oil in the morning felt a bit harder.

Ok, so that’s how I’ve solved the hunger issue, which works pretty well.  I can generally make it to 6 or 7pm on just the 50 calories of oil as long as I take it easy and stay pretty inactive.  There is no question, however, that my ability to act and think decreases dramatically by mid afternoon.  I can withstand the hunger, but my brain and body aren’t able to continue functioning at a peak level.  But that is to be expected, of course, and that’s also why I am doing this as a temporary treatment for an acute problem, and wouldn’t do the fasting thing unless it was for a specific reason.  As soon as my knee is better, I’m definitely going back to eating every day.

The one thing that I do have to say, however, is that never have 450 calories felt so amazing as when you haven’t eating in 28 hours…

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Its 3:30pm, and so far today I’ve eaten 50 calories.  I’m doing a semi-fast today, and plan to eat somewhere around 500 calories for the whole day.

Why in the world am I not eating today?  A great question, especially considering that I eat more than just about anyone I know on a regular basis, and am a food-fanatic.  Sitting at home reading a book or working on a computer I probably burn 3000-3500 calories a day.  This is great, since it means that I don’t get cold as easily, but it also sucks, since it means that I have to eat all the time, and that I am susceptible to crashing if I can’t eat regularly.

Back to the question at hand – the real reason that I’m fasting is that sometimes my knee doesn’t like mountaineering.

Seem like a bit of a disconnect?  That’s because there’s a fair bit in between.  First a bit of history:

I first hurt my knee while mountaineering down in the Chilean Andes while I was studying in Santiago in college.  On that particular trip, I slipped and banged my kneecap on a rock just 200 feet below the summit, bruising it.  Then, I proceeded to descend over 7000 vertical feet on my aching knee, and by the time I made it back to the trail head I was in major pain.  The bruising of the kneecap subsided fairly quickly, but the inflammation of the meniscus would stick around for about three months before a doctor would finally diagnose it correctly as patellofemoral syndrome, and then another two months of physical therapy would remain before my knee was feeling close to its pre-accident form.

Now, four years after returning from my adventures in South America, the meniscus inflammation is back for the third time.  The second time it was caused by doing a 34 mile day hike with over 10,000 of elevation gain and loss.  This time, it was caused by climbing two of the Three Sisters (10,000 ft tall volcanoes in the Cascades just outside Bend) in a day, covering probably 10 miles and 6,500 ft of gain and loss.  Hmm… I think I see a pattern.

The second time I got the inflammation it wasn’t nearly as bad, and so I didn’t feel like paying mucho $$ to go to a physical therapist, but at the same time, it didn’t get fully better on its own.  About this time, a friend of mine told me about this crazy doctor who lived outside of Palo Alto (where I was living at the time).  He was doing research on fasting and starvation and how it affects health and longevity.

Its well known that calorie restriction will lead to increased lifespan, significantly less signs of aging, and a decreased chance of degenerative disease like cancer, Alzheimer’s, cardiovascular disease, and, importantly, chronic inflammation.  There have been many studies showing this in rats, monkeys, and even humans.  Furthermore, restricting calories by 30-40% still leaves you with energy and the ability to work and exercise.

Don’t get me wrong here though – if you eat 30-40% less, you’ll get really really ridiculously skinny.  Some might even call it anorexic.  Plus, it would just plain suck to be hungry all the time.  So, regardless of what kind of inflammation I had in my knee, I’m pretty sure I wouldn’t do the whole permanent calorie restriction thing.

What this doctor in Palo Alto had discovered, however, was that alternate day fasting could give the same effects as permanent calorie restriction.  By alternate day fasting, I mean reducing calories one day, and the next day eating as much as you want of whatever you want.  For me, this means eating probably 5000 or more calories on my “up” days, and I don’t really end up losing any weight (which is good – since I’m already pretty wiry and scrawny).

Additionally, I’m taking two herbal anti-inflammatories, resveratrol (which is also supposed to activate the same gene that alternate day fasting does), and a boswellia extract, which is supposed to regulate the 5-LOX enzyme that also plays a role in inflammation, particularly joint inflammation.

So, with some information from the crazy doctor in Palo Alto, and a little bit of gumption, I did the alternate day fasting thing two years ago, along with taking resveratrol.  Within two weeks, my knee was fantastically better, and I didn’t have any problems again until going mountaineering in the Three Sisters Wilderness a little over a month ago.

Now?  The knee is feeling better after fasting every other day for a week and a half and taking the resveratrol and boswellia.  Not perfect yet, but definitely improving.  As to whether this cures it completely, or whether I need to go see a physical therapist, only time will tell…

Check out my first update to this post here.

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