The 4-Hour Body Part 53

Did not start exercise after starting diet 19 19.

116 116.

Women with children

12.

16.

DISTRIBUTION OF RESULTS.

NUMBER OF PEOPLE.

Gained 022 lbs 4 4.

Lost 010 lbs 39 39.

Lost 1120 lbs 68 68.

Lost 2130 lbs 35 35.

Lost 3140 lbs 16 16.

Lost 4150 lbs 11 11.

Lost >50 lbs 10 10.

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(Potential) Weaknesses of the Data The data here, while fascinating, are not perfect. Here are two stand-out weaknesses of the methodology, and of polls in general: PEOPLE COULD BE MAKING THINGS UP.

Though we removed obvious duplicates, omitted garbage data ("I lost 650 pounds!," "I weighed 35 pounds at the beginning," etc.), and flagged questionable entries, no one was checking IDs or making in-person visits. Unless you're conducting a controlled trial, it's hard to avoid this problem.

THIS DATA SET MIGHT NOT ACCOUNT FOR DROPOUTS-THE PEOPLE WHO TRIED AND GAVE UP.

Given the number of failures in the 3,000 comments reviewed, between 3% and 5%, one would expect more failures reported. Of 194 respondents, only four gained weight or remained the same. Don't forget: these respondents were reached after leaving comments on a blog post or self-selecting by responding to Twitter or Facebook.

The challenge of the missing dropouts belies a common weakness with questionnaires that are open to the public: those most likely to respond are often those who have had positive results.8 This is a form of This is a form of survivorship bias survivorship bias, a concept well worth understanding.

Looking at average mutual fund returns from last year to pick a winner? Don't forget that you are asking the survivors. The casualties-what Na.s.sim Taleb refers to as "silent evidence"-aren't around to be polled. The "average" returns are less impressive if you can include the people who bet the farm and lost. Finding those dead bodies is hard, especially in finances, when there is so much incentive to cover them up.

In practical terms, does this mean our diet results are bogus? Not at all. The possibility of survivorship bias isn't proof that the numbers aren't representative. Two things to keep in mind: 1. Based on all available empirical reports on the diet, the failure rate shouldn't exceed 5%. This is incredible by any conventional measure of diet compliance.

2. Nearly all reported failures are due to not following instructions.

If we include only those people who followed directions exactly and provided feedback, the success percentage is as close to 100% as I've seen anywhere.

Discussion of Results How should you read these data? How should you plan or change your diet based on these results?

Let's look at where you might make common mistakes. This is a practice run of our Spotting Bad Science 101 training.

Taking a first glance at the data, there are a few things we might conclude produce greater fat-loss, especially if we're presented with impressive-looking graphs that omit important details: [image]

Based on the data, here are some knee-jerk conclusions we could make about variables that result in more weight loss (bolded below): Eating just two meals per day, vs. five meals, the second-most-common number of meals (39- vs. 23-pound average loss) vs. five meals, the second-most-common number of meals (39- vs. 23-pound average loss)Eating a vegetarian diet (23- vs. 21-pound average loss) (23- vs. 21-pound average loss)Counting calories (27- vs. 20-pound average loss) (27- vs. 20-pound average loss)Skipping breakfast (23- vs. 21-pound average loss) (23- vs. 21-pound average loss) Those of you who've been paying attention will realize that, for most people, I recommend the opposite of these four conclusions. Did I just get it all wrong? It wouldn't be the first time.

But let's look at those bolded conclusions again.

This time, the numbers in parentheses before 194 (X/194) indicate how many people (X) did what is mentioned out of the total number of subjects (194).

Eating just two meals per day vs. five (39- vs. 23-pound average loss) (8/194) vs. five (39- vs. 23-pound average loss) (8/194)Eating a vegetarian diet (23- vs. 21-pound average loss) (10/194) (23- vs. 21-pound average loss) (10/194)Counting calories (27- vs. 20-pound average loss) (35/194) (27- vs. 20-pound average loss) (35/194)Skipping breakfast (23- vs. 21-pound average loss) (29/194) (23- vs. 21-pound average loss) (29/194) Remember that it's impossible to determine cause and effect from the above. These are correlations. The next step would be to test them with both control and experimental groups.

But in the meantime, let's look at two of our bolded knee-jerk conclusions: EATING TWICE A DAY SEEMS LIKE A NO-BRAINER, BUT IT'S NOT.

39 pounds lost vs. 23 seems to paint a clear picture. But let's ask ourselves what we don't know: how many people tried two meals and dropped out because it didn't work? Only eight of 194 people ate two meals a day. Also, how big were the people who ate twice a day? Perhaps they were 250300 pounds, making it easier to rack up total pounds lost, even though the weight lost as a percentage of body ma.s.s was more impressive for other smaller people. The vast majority of the total (144), those who averaged 1920 pounds lost, ate three or four times per day, as recommended.

COUNTING CALORIES SEEMS LIKE A NO-BRAINER, BUT IT'S NOT.

27 pounds lost vs. 20-again, the conclusion may seem obvious: calorie counting helps. Alas, it just ain't that simple. First, more than in any other cohort in these data, this is where I suspect survivorship bias applies. 35 of 194 respondents counted calories. How many tried to count calories, which I do not recommend, and quit the diet altogether after finding counting tedious, impossible, or inconvenient? Second, do calorie counters really lose more weight because of counting calories? Or is it because they're more attentive to the tracking in general and hold themselves more accountable? I suspect these calorie counters did a better job, on average, in more important areas like tracking protein intake and recording exercise progression.

Does this mean you shouldn't track calories? Not necessarily. Feel free to test it. It's possible you'll be in the minority who benefit. If not, and if you're in the majority who find it boring and awful, just be sure to stop the calorie counting and return to basics before you quit the entire program.

Conclusion Though the data can point in interesting directions for further testing, I'll let someone with more budget and interest attempt the controlling. The upshot is: The Slow-Carb Diet works.

If you want to replicate the formula that has proven most effective for the most people, follow the rules in "The Slow-Carb Diet."

Enjoy cheat day. For that matter, eat a chocolate croissant for me. Those bad boys are delicious.

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End of Chapter Notes 8. Unless we're dealing with customer service complaints, in which case there is an incentive: something can be fixed after-the-fact. Unless we're dealing with customer service complaints, in which case there is an incentive: something can be fixed after-the-fact.

s.e.x MACHINE II.

Details and Dangers Too much of a good thing can hurt you. Toxicity is serious business. If the topics of testosterone and libido are important to you, it's better to know too much rather than too little. This chapter will help you avoid problems, provide more background, and amplify results by personalizing the prescription.

If overwhelmed after your first pa.s.s-through, just remember the synopsis in s.e.x Machine I, which wraps up the general program in concise terms. That said, do not ignore the warnings here.

Here's the nitty-gritty on both protocols.

Protocol #1: Long-Term and Sustained FERMENTED COD LIVER OIL + VITAMIN-RICH b.u.t.tER FAT- TWO CAPSULES UPON WAKING AND TWO CAPSULES BEFORE BED.

I began taking fermented cod liver oil and b.u.t.ter fat after conversations with several MDs trained at Harvard and UCSF who cited the findings of Weston A. Price (18701948).

Price, nicknamed "the Charles Darwin of Nutrition," was a researcher and dental surgeon who traveled the world throughout the 1930s recording the health and whole-food diets of isolated indigenous populations. Using meticulous notes and hundreds of photographs, he then compared each group with members of the same populations who had moved into cities and adopted industrialized diets. Through hundreds of settlements in 14 countries, from the remote villages of Lotschental, Switzerland, to the Jalou tribes of Kenya, from the American Indians to the Aborigines, he doc.u.mented a diverse range of traditional diets.

Some contained almost no plants, while others contained a plethora; some ate nearly all food cooked, whereas others preferred all foods, even animal meats, raw. Despite these differences, there were a few commonalities among the diets of the groups with the least incidence of disease. Three types of food are of particular interest in our libido discussion:

1. Lacto-fermented foods such as sauerkraut, kimchi, or j.a.panese natto, which appear a few times in this book, were staples.

2. 10 -fold the U.S. consumption level of vitamin D and vitamin A (animal-based retinol, not plant-based carotene) were consumed from sources such as egg yolks, fish oils, b.u.t.ter, lard, and foods with fat-rich cellular membranes (fish eggs, sh.e.l.lfish, and organ meats).

3. The diets included foods rich in what Price called "Activator X," now thought to be vitamin K(2) based on a.n.a.lysis performed by Chris Masterjohn. Common sources included fish eggs, cod liver oil, organ meats, and the deep yellow b.u.t.ter from cows eating rapidly growing green gra.s.s. If "Activator X" is, in fact, vitamin K(2), then j.a.panese natto is perhaps the best traditional source at 1,103.4 micrograms per 100 grams. It outguns goose liver pate (yum) (369 micrograms) in second place and the hard cheeses (76.3 micrograms) in third place by almost 3 times and 14 times, respectively.

Why are these three relevant to our discussion?

Vitamin A has a direct positive effect on testosterone production in adult testes, and supplementation along with zinc has been shown to be as effective as anabolic steroid administration (oxandrolone and testosterone depot) in stimulating growth and p.u.b.erty, the latter defined as an increase in testicular volume of 12 milliliters or more. has a direct positive effect on testosterone production in adult testes, and supplementation along with zinc has been shown to be as effective as anabolic steroid administration (oxandrolone and testosterone depot) in stimulating growth and p.u.b.erty, the latter defined as an increase in testicular volume of 12 milliliters or more.

Vitamin K(2) activates vitamin A- and D-dependent proteins by conferring upon them the physical ability to bind calcium. Dr. Price had no shortage of real- world examples of how K(2) amplifies the effects of A and D: activates vitamin A- and D-dependent proteins by conferring upon them the physical ability to bind calcium. Dr. Price had no shortage of real- world examples of how K(2) amplifies the effects of A and D: Cod liver oil, which is high in both vitamins A and D, partially corrected growth r.e.t.a.r.dation and weak legs in turkeys fed a deficiency diet, but the combination of cod liver oil and high-Activator X b.u.t.ter was twice as effective.

It has also been hypothesized that vitamin D toxicity is often a result of vitamin K deficiency. If you choose to supplement with vitamins A and D, as I do with cod liver oil and liquid vitamin D, it is important to ensure adequate K(2). Suggested sources include b.u.t.ter from gra.s.s-fed cows and the aforementioned lacto-fermented foods.

In practice, and as a personal example, this just means I have a few forkfuls of kimchi or sauerkraut in the morning while I wait for my scrambled eggs9 to cook in-what else?-b.u.t.ter from gra.s.s-fed cows. Easy peazy. to cook in-what else?-b.u.t.ter from gra.s.s-fed cows. Easy peazy.

VITAMIN D3-6,00010,000 IU PER DAY FOR FOUR WEEKS One of the top sports scientists in the United States, who wished to remain anonymous, recounted a single anecdote that led me to a closer reexamination of vitamin D:

One NFL player I ended up treating had experienced debilitating shoulder pain for years and had two surgeries as a result, all to little or no effect. Upon testing his vitamin D levels, it became clear that he was severely deficient. Six weeks after taking vitamin D, his shoulder pain was nonexistent. He had two surgeries for no reason.

Vitamin D, it turns out, does a lot more than most vitamins.

Once vitamin D is activated within the body as calcitriol, it acts as a steroid hormone and regulates more than 1,000 vitamin Dresponsive genes, including those that code for specific muscle fibers. It can increase the size and number of type 2 (fast-twitch) fibers, which, as indicated earlier, have the greatest potential for growth. It is one of the most overlooked "sleeper nutrients," according to John Anderson, professor emeritus of nutrition at the University of North Carolina.

The effect can be substantial. Even at just 1,000 IU10 daily for two years, 48 elderly females deficient in vitamin D (as I was) daily for two years, 48 elderly females deficient in vitamin D (as I was) tripled tripled their percentage of fast-twitch muscle fibers and their percentage of fast-twitch muscle fibers and doubled doubled fiber diameter in functional limbs. The control group experienced no gains. fiber diameter in functional limbs. The control group experienced no gains.

Peak athletic performance appears to begin when blood levels approach those obtained through persistent persistent full-body exposure to natural summer sun: full-body exposure to natural summer sun: 50 ng/ml 50 ng/ml.

Do you think you get enough sun? It's unlikely. Even in the endless summer of subtropical Miami, a surprisingly high incidence of vitamin D deficiency has been recorded, as most people either use sunblock or avoid prolonged sun exposure. Forty percent of Louisiana-based runners tested in another study, all of whom trained outdoors, registered insufficient vitamin D levels. Indoor workers and athletes are top candidates for major insufficiencies: Lovell and collaborators found 15 of 18 elite female gymnasts tested to have levels below 30 ng/ml, and 6 to have levels below 20 ng/ml.

Simple at-home tests (see the resources listed in the "Getting Tested" appendix) can tell you where you are, and consistent UV-B or sun exposure (2030 minutes at least twice per week, depending on lat.i.tude), along with sublingual D3, can get you to our minimal target of 50 ng/ml. More than 100 ng/ml is considered excessive, and more than 150 ng/ml is considered toxic.

If you don't get tested and blindly take vitamin D, you run the risk of overdose. One mild overdose symptom can be a metallic taste in the mouth, which Neil from "Occam's Protocol" experienced. In our rush to start the program, and based on the average deficiencies I'd seen in the blood reports of past subjects, we neglected to get his vitamin D tested. I didn't realize that he surfed for several hours a day.

Establish your baseline first.

My ExperienceBaseline from first blood test: 32 ng/ml 32 ng/mlSecond test on 8/20/09 (after two months of taking 1,000 IU/day and 20 minutes of sun exposure daily): 35 ng 35 ngThird test 5 weeks later on 9/25/09 (after increasing intake to 7,200 IU/day): 59 ng/ml 59 ng/ml I split the 7,200 IU into two doses: 1.5 droppers full of Now liquid vitamin D3 upon waking and again before bed. It's important to test droppers, rather than trust label claims: even though the bottle claims 5,000 IU per dropperful, the average dropper yield was just 24 drops and 4 drops is 400 IU, so the average full dropper therefore contained 2,400 IU-roughly half of the label claim. liquid vitamin D3 upon waking and again before bed. It's important to test droppers, rather than trust label claims: even though the bottle claims 5,000 IU per dropperful, the average dropper yield was just 24 drops and 4 drops is 400 IU, so the average full dropper therefore contained 2,400 IU-roughly half of the label claim.

I saw the greatest impact on performance once I crossed the 50 ng/ml barrier and reached 55 ng/ml, after which the effects plateaued. The performance enhancement of vitamin D is well doc.u.mented, at least as a result of using UV lights:

In 1944, German investigators irradiated 32 medical students, twice a week for 6 wk, finding irradiated students showed a 13% improvement in performance on a bike ergometer, whereas performance of the control students was unchanged. In 1945, Allen and Curaton measured cardiovascular fitness and muscular endurance for 10 wk in 11 irradiated male Illinois college students, comparing them with 10 matched unirradiated controls, both groups undergoing similar physical training. The treatment group achieved a 19.2% standard score gain in cardiovascular fitness compared with a 1.5% improvement in the control students.

Shed some light on yourself or take some drops.

Supplemental vitamin D increases your need for vitamin A, so don't forget the aforementioned cod liver, which includes both.

SHORT ICE BATHS AND/OR COLD SHOWERS- 10 MINUTES UPON WAKING AND BEFORE BED.

Using ice baths and cold showers to affect s.e.x hormones is largely untested in the literature, but there appear to be plausible mechanisms.