They think it's all over...

This morning as I gasped my way through my 15C bath, I reassured myself that it would be my last.  It's Day 42!  Six weeks have passed (I added a few days to the end to make up for my gluttonous trip to France).  I can relax - or can I?

Actually, I quickly realised that it just can't end here.  I've been through six weeks of privation, chills, and annoyance - but rather than stop it all, I'd rather make sure I keep the gains that all this has brought me.  I've lost over a stone in weight (about 7 kilos), and I'm fitting my clothes better and looking much trimmer too.

Moreover, I haven't actually reached my targets.  I'd rather carry on while I've got some momentum, than leave it all for another year.  However, it does feel like a good time for a rethink.

What to keep?

The main components of the programme are:

1. max 60g carbs per day
2. cold bath - 15C for 15 minutes each morning
3. delaying food - waiting between exercise and your next meal - which in effect means skipping breakfast
4. three periods of movement each day (45, 30, and 15 minutes)

I'm sure the carbohydrate restriction is a good idea - there is a tremendous amount of research evidence for this, and it also fits with my intention to improve my brain health by restricting carbohydrates, hoping to prevent it becoming insulin-resistant.  It also just feels right - I feel physically better if I restrict carbs.

The cold bath is surprisingly bearable, and I know I am burning fat because the water temperature now typically rises by about 1.4C while I'm in there - and at that point in the morning I haven't eaten yet.  I am tempted to change my regimen rather than dump it.  For example, 15C is extremely hard going, and it also takes a long time - making my morning pretty rushed.  If I were to get up earlier, I could have a more relaxed morning, and have time to do some exercise right after the bath, to warm myself up a bit.

Delaying food turns out to be a lot easier than I expected.  Unfortunately, I'm noticing myself becoming increasingly hungry at my two main meals - the effect of skipping breakfast, I imagine.  Here again, my thought is to stick with the delay, but start managing my other meals more closely in terms of calories, not just carbs.  I'm generally having a healthy mix of protein, fat, fibre (from vegetables) and carbs at each of these meals, but afterwards I feel I've eaten too much.  If I can work out sensible quantities that will give me the energy and nutrients I need, I may feel better and lose more weight.

The exercise has been very hard to fit around my busy schedule.  Once again, an earlier start to the day may help.  It doesn't suit me to exercise in the evenings anyway, so pushing the first session early into the morning might well help.  If I do it after the bath, it could help me recover from the chilling as well.  The second and third sessions similarly need to be more carefully thought out - for example using every break and lunch to go for a short walk or run, and to time this so that I can eat my second and third meals after the designated delay.  It just needs more advance planning, so I don't reach the end of the day and find I haven't moved around enough.

To get my weight properly settled into my target zone, I have more work to do, which means continued work with the programme.  Moreover, I need to genuinely get used to these things in order to maintain that weight.  As you can see from the chart on the right, my weight has hit a plateau.  This is not just about gluttony in France - it's about metabolism.

Now, there is one small wrinkle in the past couple of weeks' programme: I take thyroid hormone because I have no thyroid gland at all, and this hormone regulates energy in the body.  I started running out of my medication a couple of weeks ago, and I was completely out by last Sunday.  Owing to mistakes and poor decisions made by the people at my GP surgery, I only managed to get hold of my medication today (by saying some very forceful things to their receptionist, in person, with other patients able to hear my concerns).  It probably helped that when your thyroid hormone is low, you tend to feel pretty grumpy anyway.

However, the low thyroid hormone levels will have also meant that my metabolism was a little slower than usual.  Not so much that I couldn't run, of course.  However, it may well be that my body just wasn't long maintaining the levels of energy that the cold bath is meant to kick into action each morning.  I should see my weight leave the plateau and start dropping again if I carry on with the programme, now that I have caught up on my medication.

In short, it's not over yet.  They say in the US, "it's not over til the fat lady sings" (a phrase originally coined with respect to opera).  In my case, it's not over til the fat lady is gone.

Days 10-11: wilfully cold

As autumn sets in, this programme is getting easier.  Specifically, it's a lot easier to make my body work hard to stay warm!

Letting the temperature do the work
For one thing, our boiler has stopped, so the house is a steady 16-17C.  I'm deliberately not wearing a sweater or fleece in the house, as has been my habit in the past when it's chilly.  I don't know how many extra grams of fat I'm burning to stay warm, but I figure every little helps.

Secondly, the cold bath is now a lot easier to arrange.  Our mains is a thin pipe running under our front lawn, so the water tends to take on the temperature of the ground a few inches down.  Right now it's running at 16C, so more or less the same as room temperature.

In a previous blog entry I measured the calories my body had burned to raise my bath water 1C.  It occurred to me that I'd also like to know how much fat that might mean I'd burned (on the basis that I'm bathing after sleeping, and before eating, so I must be burning body fat or muscle, not food).  Apparently there are 9 kcal in a gram of fat, so if I've burned 150 kcal in the bath, that would mean I'd lost about 16g of fat, or about half an ounce.  So... lying in a cold bath doesn't result in high levels of immediate weight loss.  I suppose I knew that.  Still, over 32 days (just over a month) of cold baths, that would result in a pound of weight loss - could be worse.

Perhaps a better solution to using cold water for weight loss would be to go for a swim outdoors.  Anyone who watched the triathlon at this year's Olympics probably enjoyed seeing the competitors taking on the Serpentine in London.  Of course, not everyone lives near the Serpentine, but I found a UK organisation called the Outdoor Swimming Society who have maps of places to swim in lakes, rivers, lidos and so on.

Now, outdoor swimming has a certain appeal.  One assumes there are no sharks (I gather you may get fish in some of these locations), and you get fresh air and an outdoor scene to look at.  It's probably quieter than the local pool as well.  Will I ever try it?  I'm not sure, but it's mildly tempting.

In the meantime, I'm hoping that keeping the house cool and not bundling up will help me along a little with this diet.

Who needs carbs?
One surprising aspect of this regime is that when I eat a lot of carbs at once - for instance a packet of cashews - I now feel unpleasantly over-full.  Why didn't I feel like that before?  I don't know, but it's helping me to avoid eating a lot of carbs at one go.  Who needs to feel ill after a meal?  I hate it.

Another very odd change is that I used to have a lot of trouble with burping at bedtime.  Who knows why - I'd tried changing all sorts of things in my diet but nothing got rid of the problem.  Now I'm finding that it doesn't happen any more (hooray!) unless I've just eaten a lot of carbs.  So I'm experimenting to see what I can eat last thing at night without getting all this air coming up when I lie down.

On a high
A less surprising but very welcome change is that I've had a lot of upswings in my mood - even when I'm hungry - but no downswings.  This is undoubtedly making it easier to stay on the OMG regime.  What could be causing it?  Certainly not the exercise, which has been very gentle.  Something is causing those endorphins to flow.  I might do a little research at some point to see what could be causing it.  Better regulation of blood sugar?  That would certainly fit with the book's focus on improving the body's management of insulin.  Who knows, but if it carries on like this, it should make continued weight loss considerably easier!  That's always the hard part - staying slim once you've got there.  I tend to start gaining weight again pretty quickly.  But if I'm feeling cheerful about my new lifestyle (whatever bits of it I try to keep permanent), perhaps I'll find it easier to maintain my new weight.

Day 9: too long in the bath...

The trouble with technology is that you get used to it, and you assume it will keep working, the same as you keep assuming the sun will come up in the morning.  The sun does indeed rise each morning, but technology inevitably fails.

Of course, it is often the fault of the human that this happens, and so it was on the morning of Day 9, my second day with the 19C bath.  I've been using the timer on my phone.  It has always been set to go black when unused, so I can't see the timer running down.  Unfortunately, I had previously also set it to silent, and had forgotten to turn the sound back on.  I didn't notice this with the 2- and 3-minute segments of the bathing programme - I saw the timer light up the phone.  However, I saw nothing during the 10 minute full submersion, for the obvious reason that I was immersed in water, with a bathtub wall in between me and the phone.  After a while, I began to wonder when the time would be up.  And after a very long while, I decided to check the phone.  Of course the timer was finished, and I realised the phone was on silent.  I was also remarkably shivery.  I'd got the bath temperature up from 19C to 20C just by being in it (the room temperature was below 19C, so it really was me).

The result was that I was shivery for more or less the whole day.  Luckily it was a sunny day, and standing in the sun's warmth was very pleasant.  I didn't mind the ordeal in any case - I survived it, and could think of all the fat I was burning!  At any rate, I have now reset the phone so that it doesn't go blank until it has been ignored for 10 minutes.

The science of weight loss
I mentioned last week that most diet books turn me off - they tend not to work, or tell me what I already knew, or are badly referenced so I don't know whether they have real evidence for their claims or just personal experience (which worked for them but might not work for me).  An exception to this is the articles and books by Dr. Briffa, a british doctor and journalist who writes on health generally, including the ever popular subject of diet and weight loss.  He has a regular blog with commentary on recently published medical research, what it might mean, whether it's reliable, and how it fits with what he's said before.  This week he has written about fasting and weight loss in a mouse study.

He is careful to point out that mice are not people, so you can't take all this as being definitely something that would work for our species.  He also provides references to the research, and to other relevant research and commentary.  This approach to writing diet advice appeals to me enormously.  I am inclined to listen to what he has to say because I've been doing so for years, and whenever I've had any doubts, I've read the original medical research, and found that he is drawing sound conclusions.  He also has clinical experience of working with patients who are trying to lose weight, and he is very good about saying when he is drawing on that clinical experience (which is interesting, but not scientific), and when he is reflecting on the results of proper research.

The interesting thing about the current mouse study is that it found a particular state in which fat was not stored, but rather used for energy.  In this instance, mice were eating high fat diets, but their eating times were very restricted, and the result was that they didn't store as much fat as the mice who ate high fat diets but without any time restrictions.

How this fits with OMG
Fulton's diet also makes use of periods of fasting - in other words, restrictions on the times when you can eat.  Everyone notices the advice to skip breakfast, the banning of snacks, and the regimented delay between exercise and eating.  This mouse study is not the first to look at the impact of restricting eating times, but it does show that even on a high fat diet, mice gain less weight if their eating time is restriction (in other words, if they fast), than if they can eat whenever they want.

In short, when it comes to the various ways of restricting when you eat on the OMG diet, there is recent research to support the idea that this should help reduce the amount of weight that is stored as fat when you eat.

Day 8: How thin do I need to be?

There are charts based on body shape, height, and much else.  Some people, for example the author of Six Weeks to OMG don't specify a target weight, but just advise you to get to where you think you should be.  That's all very empowering, but I am trying to achieve a specific health outcome: to reduce my risk of developing dementia.  I need more than a "whatever you like" target.

A good predictor of health outcomes such as alzheimers risk - is the waist-to-hip-ratio (WHR).  An article from the BBC suggests that my current WHR of 0.912 is "extreme".  That's just what I didn't want to hear, but I am not surprised.  It recommends a WHR of 75-80% as "good" and less than that as "excellent".  I have not seen a WHR of 80% in over 25 years.  That in itself bodes badly for my health risks.

There are other measures of obesity - waist circumference and body mass index, for example - but WHR has the advantage that it's not just easy to do, but does take into account body shape (how much of a pear or apple you are).  That means that improvements improve the way you look, as well as your health.

If I were never to lose any weight from my hips, then an 80% WHR would be about 82cm (a reduction of 11cm), an a 75% WHR would be about 76cm, a reduction of 17cm - which is a huge amount of fat to lose!  Still, that is fat currently wrapped around my inner organs, and I'm sure it doesn't need to be there.

Progress
The good news is that my WHR is already a little better - on Day 1 it was 0.956, so in 7 days I have reduced my WHR by 0.044.  I have also lost 10 pounds!  The important thing this statistic shows that not only am I losing weight from thighs, arms and so on, but that I am also losing it from my waist - with luck from around my inner organs - and I'm losing it there faster than around my hips, so my shape is improving.

A 76cm waistline seem like a good target.  At 75% of my current hip measurement it would rate as "excellent", and even if I lose some hip circumference I may still qualify as "good" at an 80% WHR with luck.  That would mean a waistline of just over 28 inches - something I haven't seen in a while, but which would mean I could fit every item stashed away in my wardrobe.  That in itself would be a great reward!

For me, this is rapid progress.  The last time I tried the Atkins diet I did not lose any weight at all.  I had previously done Atkins and lost some weight, but not as much as 10 pounds in a week.  Combining low-carb diet, cold water, and morning fasting does seem to help speed the weight loss along.

Days 6-7 - take a deep breath

Over the past week, I've noticed a number of changes.  Some were expected - I'm often tired and hungry, for example, and I've lost some weight already.  Some are entirely unexpected - and the strangest one is my tendency to take deep breaths.

Now, I've taken deep breaths before, so this ought to be a normal thing - but I can't say I've tended to do it when I'm just walking, or sitting, or standing around.  Deep breaths are for when I'm preparing for exercise, or drinking in a pleasant summer breeze, or just sighing over something.  I've also had to breathe deeply to blow up those balloons that are supposed to make my tummy flatter.

However, over the past couple of days I've frequently felt the urge to take a deep breath, and have been surprised - I can't work out why I want one at that moment.  No matter - breathing deeply feels good, so I'm entirely happy to cave in to these urges.  I'm just puzzled as to why I'm getting them.

For example, I wondered whether I was short of oxygen?  I don't have any breathing problems like asthma or allergies, and I've never smoked; I live and work in a rural area and I get plenty of fresh air.  So I can't see why either my lungs or the air itself should be a problem.

One possibility is that I just need more oxygen on this programme, and my body hasn't yet got used to that so my breathing is bringing in a little less air than I now need.  On average, that might add up to one extra big breath every hour or so.

I've been web surfing to try to find an explanation, and my best guess so far is this: burning fat apparently uses more oxygen (per unit of energy produced) than burning carbohydrate.  In other words, this low carb diet needs more oxygen than my normal diet would have required, just to keep me warm and moving.  In fact, given that I'm moving around a bit more than usual, I probably need still more.  And if my body's expectations of the amount of oxygen I'll need for a given level of exercise were set by my old carb-rich diet, then it may take a while for it to adjust to this diet that has almost no carbs at all.

Thus ends Week 1!  Tomorrow I start the day with a colder bath - 19C instead of 20C.  Can't wait.

Days 4-5: the first weekend

Well, I failed to write a blog entry yesterday, because we had visitors.  However, I managed to stay on the programme.  That surprised me - most diet and exercise regimes just don't go with playing host.  This fit seamlessly.  The cold bath happens at my normal bathtime.  The exercise fits with the housework to prepare for guests, and with a gentle game of badminton in the back garden.  The food restrictions are fine as long as I plan the menu to allow me to fill my plate with allowed food so I won't look as though I'm denying myself.  I blew up balloons for my children and their visitors so they could play with them.

Skinny dipping
The cold bath has been the most interesting part of the OMG plan.  Originally I found it very hard indeed, but this weekend it has seemed much less daunting.  In fact today, I almost enjoyed it!  Of course, a big part of the reason for this is that I've managed to actually brave the bath for 15 minutes as required every day, and have even managed to wash my hair during those baths, so I feel a tremendous sense of achievement.

Immersing my torso (and head) has been a lot harder than my legs, but I've developed a trick - I imagine my children's lives are at risk.  I've got to get the bath water higher or something terrible will happen.  This is silly and should not work, but it does.  I can suspend disbelief for long enough to grab the sides of the bath and push myself further down, until eventually I'm fully immersed.  Once I'm there, it's not so bad - I get used to the cold water fairly quickly.

Another trick that has helped me get going is to put things that I like around the bath - nice-smelling bath scrub, expensive shampoo, a sparkly rubber duck, and a wooden handled back scrubber.  The idea of getting into a cold bath has filled me with dread, but these things have made the "ritual" of getting ready a great deal easier to face.

Yesterday I had a very deep bath and raised the temperature by about half a degree centigrade.  Today I went for a smaller bath and raised it a whole degree.  I wondered how many calories I was burning on raising the bath temperature?

Science interlude
So this morning I measured the depth of the water, and the width and length a bit below the fill line (the sides of the bath slope a bit, so I took a midway point to try to get the estimate more accurate).  The dimensions: 25cm x 46cm x 130cm.  Multiply those and you get 149,500 cubic centimeters of water.

Conveniently, a calorie is defined as the amount of energy needed to raise the temperature of one cubic centimeter (actually, it's 1 gram, but the two are in fact the same thing) of water by 1 degree centigrade.  That means that it must have taken 149,500 calories of energy to increase my bath water's temperature today.  When we talk about calories in food, we really mean kilo-calories - i.e. 1000s of calories.  So to get the calories I must have burned in dietary terms, I divide by 1000.  That means that my body used about 150 calories during the 15 minutes involved just to warm up my bath.  That's equivalent to around 30 minutes of walking at my weight, so in terms of calorie burn, it's pretty efficient in calories burned per unit of time.  Given that I have a busy life, I find that a very appealing statistic.

Black coffee and green tea
I've got more used to hot drinks without milk (or in my case, soya milk).  Although I've decided to allow myself to put soya milk in my drinks, I figured I would do without when I could.  In fact, I've gone without all weekend, without really trying.

In short, at the end of my first weekend, I'm feeling remarkably positive about this weight loss plan.  And of course feeling positive is meant to be good for your brain!  I've been at it for nearly a week, and if it's going to carry on like this, I'm sure I can manage to carry on for the full six weeks.

Day 3 Week 1 - not easy, but easier

Was I more organised this morning?  No.  I tried, but I've come to the conclusion that I'm going to have to get up half an hour earlier - as if the OMG routine weren't a big enough ask.

The hardest part is the bath.  It's painful, yes, but the point is that you've got to stick with it for 15 minutes.  That's a quarter of the hour I usually give myself for getting ready in the morning, and the routine didn't have me sitting and wondering what to do for 15 minutes - it's got to come from somewhere, and clearly my morning ablutions must have been quicker than 15 minutes.  Maybe 5.

At any rate, skipping breakfast today was remarkably easy, and my work day was unusually productive.  I even had an odd sense that I was living off my own fat - very pleasant, but I wonder whether it's that, or just that it was a sunny day.

Unfortunately, my thighs have still not recovered from yesterday's morning run.  I stuck with housework and walking for my movement today, but my legs feel like I have only just finished a 200m sprint.  I think I should avoid taking the cold bath right after a hot run.

Getting through the day with the low carb diet and exercise was easy, though not always easy to remember.  That is the hardest thing about this diet - every day I forget something important.

Day 2 - Ouch!

I wasn't wholly prepared for today.  In addition to getting used to a new routine, I had to get the kids to school for the first day of term, and of course I had to get to work.  I got up at 6am and by some miracle the kids were more or less on time and so was I, but what a rush!

First came the pain, though.  As soon as I was out of bed, I was into my running kit and out on the road.  The sun was out and warm on my face, the roads were quiet apart from a few long distance commuters, and I could smell the faintly musty, warm fragrance of recently harvested grain.  Of course, all this distracted me, and so I failed to stretch before running.  I followed the book - the exercise followed by the long wait before eating - but the book isn't there to remind you to stretch - you're meant to have a bit of sense.   My thighs still hurt, many hours later.

After an invigorating run, I thought I'd be in great condition to brave the cold bath.  Yet again, a triumph of hope over sense.  It was far more painful than yesterday.  By the end of my bath, I'd warmed the water by 1.5C, but I felt nothing like the sense of accomplishment that I felt yesterday - I just felt cold.  Very, very cold.  Nevertheless, I survived the full 15 minutes, including a good scrub and washed hair.  An hour later, as I was finally eating my breakfast, I still felt cold.  I thought my body was supposed to warm itself up - that was how I'd lose weight, by burning fat to stay warm.  Is this working?

Lunch was a huge salad - a whole head of cob lettuce, a tin of sardines, a handful of walnuts.  This was actually pretty satisfying, so I didn't feel hungry at all in the afternoon - but I did need my cups of milky tea and coffee.  You're meant to have these drinks black, but somehow I knew that I needed the white stuff to keep myself motivated.  Never mind the cold bath - I want my tea!  So I have officially decided that black tea and coffee are optional on my version of the diet.  But no sweeteners, and I'm not going overboard, it's still mostly water - besides, I'm using unsweetened soya milk, which has a very low carbohydrate count.

The hardest thing to get used to (at least, as of Day 2) is remembering to plan exercise and waiting time before a meal.  I get to lunchtime, I think - Hooray!  Then I remember that I haven't gone for a walk yet, haven't had the wait.  So today's lunchtime was a walk around our site, followed by making my salad (a shorter wait than I was supposed to have, but it will do for today), and finally the meal.  I got several comments on my "healthy" lunch.  No one has guessed my guilty secret - that I am desperate to lose weight.  Will they notice when I come in wearing a size smaller outfit?

One great relief today - I had no headaches.  I don't know why yesterday was so bad and today has not been.  Have I been slacking, or was it a 24-hour wonder?  I hope it's the latter - a sign that I had some clearing out to do, and that now the worst of the toxins are out of my system.  However, that once again sounds like a triumph of hope over sense.  So have the toxins stayed, and am I in for more headaches?  One thing is for sure - painful thighs are much more tolerable than a splitting head.

Day 1 Week 1

I try not to buy diet books.  They always disappoint - either they're the same old thing in a different package, or they just don't work, or look so badly researched that I'm not even going to try them.

However, what I did pick up this week was the latest edition of The New Scientist, which featured an article on a possible link between obesity and alzheimer's disease.  Because Alzheimer's runs in my family, I've kept an eye out for any research that suggests preventative measures.  This article ticked that box in a big way, and also noted other possible links including stroke and heart disease (which also run in my family, especially stroke).  Having read it, I bought the next diet book I saw, and this turned out to be the unpromisingly titled Six Weeks to OMG by London-based sports scientist Venice A. Fulton.  The book is written in the style of all successful self-help books, full of exclamation marks and enthusiastic statements of the obvious.  However, I was looking for anything that contained a programme, and this book does.  I've tried to lose weight and get fit plenty of times, and without a detailed plan, I tend to drift off course.

This is a seriously eccentric plan.  It combines several conventional ideas with some that are entirely new to me.  The dietary advice is pretty normal - low carb, high protein, plenty of low carb veg, some fasting (skip breakfast), and forget the low fat advice but do stay away from all forms of sugar, especially the sneaky ones with names like high fructose corn syrup.

The exercise plan is not onerous at all, but it contains some truly weird advice.  To get a flat tummy, I am to blow up a balloon 20 times, ideally just before bed.  In the mornings, I have to take a cold (room temperature) bath.  Apart from that, I must do three sessions of exercise per day, including the occasional session of weights (3 times per month ideally).  Eating and exercising are spaced out so that the pattern is exercise - wait - eat.

I'm going to give this a go - why not?  I find weird ideas oddly appealing, and this at least has some familiar aspects that I've tried successfully before, such as the low carb advice.

At the moment I weigh a shocking 168 lbs (76 kg) - the most I have ever knowingly weighed, outside pregnancy.  The last time I went on a serious diet and exercise regime (many years ago) I weighed 66 kg.  Shrinking my belly has enormous appeal, but the main motivation is my brain.  I would rather die of just about anything than get Alzheimer's Disease.  I just hope no one comes up with research later on to suggest that major fat loss increases your chances of developing the disease.

My plan is to keep a record of my progress through this blog.  For one thing, it might help me stay the course.  Also, if it's successful, I'll appreciate having the record of what happened if I ever have to do it again....