Saturday, April 30, 2016

Peak Fasting for Weight Loss — How Long Should You Intermittently Fast?

Do you struggle with excess weight? Are you showing signs of insulin and leptin resistance? Is your fasting blood sugar above 100? If you answer yes to one or more of these questions, you may want to reconsider not only what you eat but when you eat as well.
One lifestyle factor that appears to be driving not only obesity but also many chronic disease processes is the fact that we eat too frequently.
Research reveals that a vast majority of Americans eat all day long.1 Most also consume a majority of their daily calories late in the evening, and this type of eating pattern is a recipe for weight gain and metabolic dysfunction.
The reason so many struggle with their weight (aside from eating processed foods that have been grossly altered from their natural state) is because they rarely, if ever, skip a meal.
As a result, their bodies have adapted to burning sugar as its primary fuel, which down-regulates enzymes that utilize and burn stored fat. In addition, our ancestors didn't have access to food 24/7, and biologically your body simply isn't designed to run optimally when continuously fed.

Biological Repair and Rejuvenation Occurs During Fasting

Research has confirmed that many biological repair and rejuvenation processes take place when there's an absence of food, and this is another reason why all-day grazing triggers disease. Your body never has the time to clean out the garbage and regenerate.
When you go without food for a period of time, the resulting metabolic changes stimulate a natural cleansing process known as autophagy, or mitophagy in the case of mitochondrial autophagy, in which your body detoxifies and rids itself of damaged cells.
When you're in constant "feast mode," your body forgoes many of these benefits. That does not mean you need to (or should) starve yourself for extended periods of time though.
Simply cycling between periods of eating and fasting on a daily or weekly schedule has been shown to provide many of the same benefits as complete fasting, where you don't eat for several days.

What's so Great About Intermittent Fasting?

Intermittent fasting is a term that covers an array of different meal timing schedules. As a general rule, it involves cutting calories in whole or in part, either a couple of days a week, every other day, or even daily, as in the case of the scheduled eating regimen I prefer to use myself.
As noted by Time magazine, intermittent fasting is becoming increasingly popular, and for good reason — it works. And it works whether you're trying to lose weight or simply improve biomarkers for optimal health.
But what exactly makes it so effective for weight loss when other calorie-cutting diets have such a high failure rate? As noted in the featured article:2
"The body converts food into glycogen — a form of energy that it can store for later use. Your body then squirrels away that glycogen in both fat cells and in your liver.
'If you're eating all day, the stores of glycogen in your liver are never depleted,' [neuroscientist Mark Mattson, Ph.D.] says.
On the other hand, after about 12 hours without food your liver runs out of glycogen, at which point your body starts drawing energy from the glycogen stored in your fat cells."
In a nutshell, your body was designed to: a) run on fat as its primary fuel, and b) cycle through periods of feast and famine. Today, most people do the complete opposite. They eat sugar and net carbs (total carbs minus fiber), which is virtually identical to sugar metabolically, all day long.
So, by mimicking the eating habits of our ancestors, who did not have access to food around the clock, you restore your body to a more natural state that allows a whole host of biochemical benefits to occur.

Fasting May Hold Key to Cancer and Dementia Prevention

Besides normalizing your weight, intermittent fasting is also one of the ways by which you can significantly boost mitochondrial health and energy efficiency, which is important for chronic disease prevention, thereby cutting your risk for health problems like heart disease and cancer.
Intermittent fasting can also have a very beneficial impact on your brain function, and may even hold the key to preventing Alzheimer's disease.
Mark Mattson, Ph.D. has conducted animal studies showing that when mice, genetically engineered to develop Alzheimer's, are put on an alternate day fasting diet, they develop Alzheimer's around the age of 2 years, which in human terms is equivalent to being 90.
Normally, they develop dementia in half that time — around 1 year, equivalent to the age of 40 or 50 in humans. When he put them on a junk food diet, they developed Alzheimer's around 9 months! Mattson's research suggests that alternate day fasting can boost a protein known as brain-derived neurotrophic factor (BDNF) by anywhere from 50 to 400 percent, depending on the brain region.
BDNF activates brain stem cells to convert into new neurons. It also triggers other chemicals that promote neural health, and has been shown to protect brain cells from adverse changes associated with Alzheimer's and Parkinson's disease.

Which Intermittent Fasting Schedule Is Right for You?

There are several intermittent fasting schedules to choose from, and the "right" one for you is the one you will actually comply with. Here are a few of the most popular eating schedules. For even more fasting protocols, including ones that are specifically designed to be combined with exercise, please see this previous intermittent fasting article.
5-day fast
In one recent experiment,3 people who fasted five consecutive days once a month for three months in a row saw improvements in biomarkers for cell regeneration. Risk factors for diabetes, cancer, cardiovascular disease, and aging also declined.
You do not abstain from food entirely during these days. On the first day, you eat about 1,000 to 1,100 calories, followed by 725 calories on the remaining four days. Your diet during these days should be primarily plant-based, low in carbohydrates and protein, and high in healthy fat.
Beware that it can be quite challenging to go a full five days with very little food, especially if you've never fasted before, so you may want to work your way up to this kind of schedule.
On the 5:2 plan, you cut your food down to one-fourth of your normal daily calories on the two fasting days of your choice (about 600 calories for men and about 500 for women), along with plenty of water and tea. On the other five days of the week, you can eat normally.
This program is exactly as it sounds: one day off, one day on. On fasting days, you restrict your eating to one meal of about 500 calories. On non-fasting days, you can eat normally.
When you include sleeping time, your fast can end up being as long as 32 to 36 hours. According to Krista Varady, Ph.D., author of "The Every-Other-Day Diet," alternate day fasting can help you lose up to 2 lbs. per week.
Another benefit to alternate day fasting is that your body tends to adapt to the regularity of the program, whereas the randomness of the 5:2 plan can be more difficult to adjust to.4 In trials, about 90 percent of participants are able to stick to alternate day fasting, whereas the other 10 percent drop out within the first two weeks.
One caveat: more recent research5 shows that if you want to lose weight, you cannot binge on non-fasting days when you're on an alternate day fasting plan, which is something you can typically do on the 5:2 plan. Exactly why is still unclear, but it may have to do with the fact that there's less regularity in the pattern on the 5:2 plan.
Peak Fasting
Restrict daily eating to a six- to eight-hour window (the key here is to eat breakfast or dinner, but not both)
Here you avoid eating for 13 to 18 hours. This strategy is more aggressive and, as a result, people tend to see results sooner. The specific time is based on your blood sugar readings. This is my personal preference as it's really easy to comply with once your body has shifted over from burning sugar to burning fat as its primary fuel.
At that point, you cease to experience frequent hunger pangs, and can go for hours without a dip in energy. Fat, being a slow-burning fuel, is what allows you to keep going without suffering from the dramatic energy crashes associated with sugar.
In order to make this schedule work, you need to skip either breakfast or dinner. Which one to omit is up to you. However, if you chose to eat dinner, it's important to avoid eating for at least three hours before going to bed.
The rationale for this recommendation has to do with the way your body produces energy. When you're sleeping, your body needs the least amount of energy, and if you feed it at a time when energy is not needed you end up creating a situation in which your mitochondria creates excessive amounts of damaging free radicals.
I have recently appreciated that this is another important factor that can help optimize your mitochondrial function and prevent cellular damage from occurring.

What You Eat Still Matters

While some intermittent fasting programs claim you can binge on whatever you want on non-fasting days, I strongly recommend paying attention to the quality of your food regardless of the program you choose.
Since you're eating less, you'll want to make sure you're getting high-quality nutrients from your food. Healthy fats are especially important, as intermittent fasting pushes your body to switch over into fat burning mode. If you feel tired and sluggish, it may be a sign you need to increase the amount of healthy fat in your diet.
Cutting net carbs (total carbs minus fiber) is equally important. Fructose is particularly troublesome as it activates a key enzyme, fructokinase, which in turn activates another enzyme that causes your cells to accumulate fat and resist letting any of it go. If you're overweight, insulin-resistant, or diabetic, reducing sugar consumption is really key. So, as a general rule — whether you're fasting or not, and regardless of the fasting schedule you're on — I believe it's important to eat a diet that is:
  • High in healthy fats. Many will benefit from 50 to 85 percent of their daily calories in the form of healthy fat from avocados, organic grass-fed butter, pastured egg yolks, coconut oil, and raw nuts such as macadamia, pecans, and pine nuts.
  • Moderate amounts of high-quality protein from organically raised, grass-fed or pastured animals. Most will likely not need more than 40 to 80 grams of protein per day. (I recommend limiting protein to one-half gram of protein per pound of lean body mass.)
  • Unrestricted amounts of fresh low net carb vegetables, ideally organic.

Peak Fasting — How Long Should You Fast?

Besides when and what to eat, another common question relates to duration. Just how long must you continue intermittently fasting? While some embrace it as a lifestyle (and this tends to be particularly true of those who restrict their daily eating to a specific window of time), it's not something you have to do for the rest of your life. I don't recommend any of the other types of fasting as they have major shortcomings from a metabolic perspective that I will discuss in my new book on this topic.
As a general rule, I recommend a new type of intermittent fasting that I call Peak Fasting, which is done every day rather than a few days a week. However you can certainly cycle in off days due to schedule or social commitments. The key is flexibility. But if circumstances allow, seek to do it every day. The process is simple.
Stop eating three hours before bed and don't have your first meal for at least 13 hours. Measure your blood sugar at that time. You can do this every half hour, and when it starts to dramatically rise, this is an indication that you need to break your fast and eat food.
Why? Because suddenly rising blood sugar when you haven't eaten is a sign that glucogenesis is setting in. By definition, glucogenesis refers to the production of glucose from a nonglucose precursor, such as protein. Once your body starts converting protein to glucose, you're breaking down your lean muscle mass, and this is NOT healthy by any means.
This is also why I strongly recommend avoiding longer complete fasts. Research shows you can lose about ¼ pound of muscle mass per day if you fast for two days or longer! If you reach 16 to 18 hours and your blood sugar still hasn't spiked, feel free to eat if you want to.
If you're overweight and/or have symptoms of insulin and leptin resistance, such as high blood pressure, high cholesterol, or full-blown type 2 diabetes, continue intermittent fasting until your insulin/leptin resistance improves, and your weight, blood pressure, cholesterol ratios, or diabetes normalizes. As an example, if you need to lose 50 pounds, you're looking at about six months or so of intermittent fasting, after which you can revert to eating more regularly.
After that, all you need is a "maintenance program." Keep track of your markers, and if they start sliding, go back on the fasting program of your choice again for a number of weeks or months. Alternatively, you could intermittently fast for say one month, twice a year, as a form of maintenance.
Remember over half of the U.S. population is either diabetic or prediabetic, so measuring blood glucose is a powerful and cheap test. You can purchase the Bayer meter6 on Amazon for $7 and the strips are less than 25 cents apiece. I have tested many meters and this is the clear value winner. For less than $1 or $2, you can accurately and simply identify the ideal time of your intermittent fast.
If you are new to fasting, it may take some time to work up to 13 hours, but once you start activating your fat burning system you will easily achieve this. The most effective way is to limit your net carbs (total carbs-fiber) to under 40 grams per day and do not exceed more than 1 gram of protein per kilogram of lean body mass.

Tips for Making It Through the Transition Period

The toughest part of any intermittent fasting plan is getting through the initial transition, which can take anywhere from 7 to 10 days. Maybe even longer for some people, depending on how insulin-resistant you are, and other factors, like your weight, blood pressure and cholesterol levels, and if you are not consistent with the fasting and wind up cheating.
About 10 percent of people will report headaches as a side effect when they first start fasting, but the biggest complaint is hunger. It may be helpful to remember that part of why you're craving food is because your body has not yet made the switch from burning sugar to burning fat as its primary fuel. As long as you're running on sugar, which is a fast-burning fuel, frequent hunger pangs will be the norm. Fat is far more satisfying, as it's a much slower-burning fuel.
Remember, a diet high in carbohydrates severely inhibits your body's ability to produce lipase and use fat as an energy source. Lipase is inhibited because of high insulin levels, and your insulin rises in response to eating foods high in carbohydrates, so it's important to replace carbs with healthy fat in order to successfully make that metabolic switch-over and become an efficient fat burner.
Another factor that can trip you up during the transition period is purely psychological. If you're used to grazing throughout the day, it may take some time to break the habit. One trick is to drink more water. Oftentimes people mistake thirst for hunger.

Peak Fasting May Be the U-Turn You've Been Looking For

The vast majority of Americans are overweight and most would therefore benefit from intermittent fasting for a period of time. (Adrenal-fatigued individuals are perhaps an exception to this rule). When done correctly, you will inevitably lose weight and your insulin and leptin receptor sensitivity will be optimized, which is really important for optimal health. Fasting also:
  • Decreases the accumulation of oxidative radicals in your cells, thereby preventing oxidative damage to cellular proteins, lipids, and nucleic acids associated with aging and disease.
  • Raises human growth hormone. Research7 has shown fasting can raise HGH by as much as 1,300 percent in women, and 2,000 percent in men, which plays an important part in health, fitness and slowing the aging process. HGH is also a fat-burning hormone, which is another reason why fasting is so effective for weight loss.
  • Inhibits the mTOR pathway, which plays an important part in driving the aging process by increasing mitophagy and mitochondrial biogenesis.
If you decide to attempt intermittent fasting, be sure to pay careful attention to hypoglycemic signs and symptoms, and if you suspect that you're crashing, make sure to eat something, like coconut oil. I do not recommend fasting if you're living with chronic stress (adrenal fatigue), or have cortisol dysregulation. Pregnant or nursing mothers should also avoid fasting, as your baby needs plenty of nutrients during and after birth, and there's no research supporting fasting during this important time.

Thursday, April 28, 2016

20 Ways To Improve Your Health — And Your Life


Fight disease, strengthen your mind and otherwise bolster your overall well-being with these easy-to-implement tips. - 
Allow us to shift your focus for a few minutes. You’ve been putting much thought into your abs, pecs, quads and biceps — and rightfully so — but there are other muscles and bodily systems that need some love, too: your heart, your brain, your trillions of cell membranes. You know, the things that keep you alive. By all means, keep attending to your more visible bodyparts on a regular basis. Just don’t forget to heed these 20 nuggets of health advice, many of which have very little to do with how you look or how you perform athletically but rather with how you feel and how you function in the long, grind-it-out game of life.

1. GET A FLU SHOT ASAP

According to the Centers for Disease Control and Prevention, anywhere from 3,000 to 49,000 people died of influenza annually between 1976 and 2007. The organization recommends that virtually everybody 6 months and older get a flu shot yearly. And it’s best to get your shot as soon as it’s available, which can be as early as October.

2. EAT FRUITS AND VEGETABLES — THEN EAT MORE FRUITS AND VEGETABLES

The numerous cells in your body are constantly under fire by evil enemies, and if fruits and vegetables aren’t plentiful in your diet, you’re not truly fighting the good fight. “Antioxidants found in fruits and vegetables protect your cells and neutralize free radicals, rogue molecules that attack healthy cells,” says Mark MacDonald, a health and nutrition expert and spokesman for the health and wellness company MonaVie. “Active people need at least 15 to 18 servings of fruits and veggies per day to look as good on the inside as they do on the outside.” Single-serving examples include one cup of chopped broccoli, carrots or cooked spinach, one small apple, eight large strawberries, and one cup of fruit or vegetable juice.

3. EXERCISE “DURING” YOUR WORKDAY

Excessive stress over extended periods can wreck your health, and few things frazzle people’s nerves like their jobs. It’s well-documented that exercise can help minimize the harmful effects of stress on the body, and breaking up your 9-to-5 shift with a workout when possible — even just a brief one — can further ease the tension. “One of the best ways to relieve work-related stress is to do something during your workday that’s not work,” says Melissa Carsten, Ph.D., associate professor of organizational behavior at Winthrop University in South Carolina. “And given the positive effects that exercise has on stress levels anyway, getting in a workout on your lunch break will maximize stress relief.”

4. DRINK A GALLON OF WATER ON TRAINING DAYS, HALF A GALLON ON OFF DAYS

Every system in your body requires water to function properly, and even mild dehydration can leave you noticeably low on energy. In other words, water is your body’s most vital nutrient, both from a health and performance standpoint. How much do you need? John Berardi, Ph.D., president of Precision Nutrition (precisionnutrition.com), recommends drinking seven cups of water daily (just shy of half a gallon) when not exercising. “On training days, however, you may require a gallon or more water per day to stay adequately hydrated,” he says.

5. TAKE A MULTIVITAMIN EVERY DAY

Almost nobody gets adequate amounts of all the vitamins they need for optimal health through food. So buy a multivitamin. Follow dosing instructions on the label. Do this every day.

6. FOLLOW THE “60 PERCENT RULE” WITH FISH OIL


Supplementing with omega-3 fatty acids via fish oil lowers heart-attack risk, reduces arthritis, fights depression and does a bunch of other great stuff in the body. But not all fish oil products are created equal; more specifically, some don’t offer adequate amounts of the most beneficial omega-3s: eicosapentaenoic acid and docosahexaenoic acid. Doug Kalman, Ph.D., RD, director of Nutrition and Applied Clinical Trials at Miami Research Associates , offers this sage advice: “To see if your fish-oil product is a good one for the purchase, look at the label to see how much total omega-3 or fish oil is in one serving. Then add up the EPA and DHA (which will be on the label). If the EPA and DHA are not more than 60 percent of the total fish oil or omegas, it means you may be getting a poorer-quality product.”

7. MOVE ONE FOOT IN FRONT OF THE OTHER 10,000 TIMES A DAY

Your work in the gym represents the majority of physical activity you need. But complementing your training by simply walking more the rest of the day can round out your health. “Taking as little as 10,000 total steps per day has been documented to help with weight control, reduce risk of many diseases and promote better overall health,” Kalman says. “If you don’t know how much you walk, run or use your feet daily, pick up a pedometer at your local sports store or online.” Just don’t forget to wear the pedometer all day long, even when you’re at the gym.

8. SPLURGE ON GRASS-FED BEEF

Why spend more on grass-fed? Because it contains more omega-3 fatty acids, conjugated linoleic acid, B vitamins and vitamins E and K (among many other health-promoting nutrients) than grain-fed beef. That’s why.

9. MAKE FRIENDS, NOT FOES

Research — including a 2012 study published in the Journal of Epidemiology & Community Health — shows that having a large social network contributes to better psychological well-being in adults. In other words, the guy with lots of friends is generally happier, and healthier, than the hermit. “Make sure you’re surrounding yourself with people who add to your life, not subtract,” says fitness expert, celebrity trainer and TV personality Lacey Stone (laceystonefitness.com). “You’re a direct reflection of who you surround yourself with — surround yourself with all-stars.”

10. IF YOU’RE GOING TO DRINK BEER, MAKE IT A GUINNESS

There’s a misconception that “low-carb” beers like Michelob Ultra are wiser choices than darker, thicker brews. But a good rule of thumb is that the darker the beer, the more antioxidants it has. So order a Guinness, the ultra-popular, literally black Irish stout. One University of Wisconsin study found that drinking a pint of Guinness a day helped subjects prevent heart-attack-inducing blood clots better than lighter lagers. The researchers attributed this effect partly to the stout’s “antioxidant compounds.” Plus, 12 ounces of Guinness isn’t much higher in calories (126) than an Ultra (95).

11. TAKE A FEW MINUTES (OR MORE) TO MEDITATE

Find a quiet room at home or in the office, shut the door, get comfortable, close your eyes and focus on your breathing for at least a few minutes, preferably on a daily basis. According to a 2012 paper published in the Journal of Psychiatric Practice, meditating (aka “mindfulness”) has “antidepressant and anti-anxiety effects and decrease[s] general psychological distress.” See Page 47 for more on meditation.

12. ADD CHIA SEEDS TO YOUR PROTEIN SHAKE

When the smoothie-bar attendant asks if you want any “boosts” or “add-ons,” say “Why, yes,” and go with chia seeds instead of more protein. (Chances are, your shake already has enough whey in it.) Chia seeds are loaded with omega-3s and fiber, and they’ve also been shown to reduce blood pressure and help control blood-sugar levels.

13. PUT SOME HONEY IN THERE, TOO

Honey has anti-inflammatory properties, helps regulate blood-sugar levels, benefits the skin and hair, and contains flavonoids that fight heart disease and cancer. When shopping for it at the grocery store, look for “raw” honey, which has not been heated for pasteurization and therefore is more likely to retain all its original nutrients.

14. WEAR SUNSCREEN YEAR-ROUND

Cases of melanoma, the deadliest form of skin cancer, have increased 800 percent in young women and 400 percent in young men in the last 40 years, according to the Melanoma Research Alliance (curemelanoma.org). And it’s not only during the summer months that you’re at risk. This winter, if you’re going to be outdoors for any extended period, apply sunscreen of at least 30 SPF to all exposed areas of skin, particularly your face.

15. ADOPT AN ANIMAL

Countless studies have shown that owning a pet can benefit your health in many ways, from enhancing mood to reducing risk of allergies to lowering blood pressure. Dog and cat owners have even been found to have a reduced chance of dying from a heart attack. If having a dog sounds like too much responsibility and cats aren’t your thing, get a fish; your companion doesn’t have to be furry to bolster your health.

16. DO ROMANIAN DEADLIFTS AT LEAST ONCE A WEEK

Being healthy means staying injury-free, and Romanians target two of the most often injured areas of the body: the hamstrings and lower back. When these two intertwined muscle groups aren’t strong and flexible, chronic pain and debility are usually on the horizon, if they’re not already part of your everyday routine. Do Romanians with a barbell, dumbbells or the sandbag you have sitting in the garage. Do them one leg at a time or both legs. Whatever. Just do them.

17. EVERY SO OFTEN, SKIP A MEAL

If your primary goal is building mass, disregard this tip. Otherwise, don’t be afraid to bypass a feeding on occasion, especially if you’re not feeling particularly hungry in the moment. Research has shown that intermittent fasting can help keep blood-sugar levels in check, assist in weight management and improve overall health, and going five or six hours without eating can be considered an abbreviated bout of intermittent fasting. If you’re worried that skipping a meal will slow your metabolism, don’t; it likely takes a much longer stretch for your body to go into starvation mode. “The best thing you can do is skip a meal every once in a while,” says Rorion Gracie, author of The Gracie Diet (graciediet.com). “It helps the body clean itself up.”

18. TURN OFF THE TV AND COMPUTER AN HOUR BEFORE BEDTIME

The light from your flat-screen and laptop can suppress production of the sleep-inducing hormone melatonin, and watching TV tends to stimulate the brain instead of relaxing you. Neither of these circumstances is going to help you get the eight hours of quality sleep a night necessary for optimal health. If bedtime is 10 p.m., turn off all electronics (aside from maybe your e-reader) at 9.

19. TRAIN YOUR BRAIN DAILY

According to the Alzheimer’s Association (alz.org), Alzheimer’s disease is the sixth-leading cause of death in the U.S., with more than 5 million Americans currently suffering from it. One way to protect yourself is to regularly stimulate your brain with mental exercise. “Studies show that doing crossword puzzles, playing games that require eye-hand coordination and, of course, exercise all promote brain neurogenesis and biogenesis,” Kalman says. Aim to read something challenging (Fantasy Football websites don’t count) or do a crossword puzzle for 30 to 60 minutes a day.

20. TRAIN YOUR LOINS WEEKLY

A study out of Wilkes University in Pennsylvania found evidence that having sexual intercourse one to two times a week can strengthen the immune system. Share these findings with your significant other, put this magazine down, then get started.

Top 10 Proven Ways to Cut Body Fat

DO NOT TRY THESE METHODS UNLESS YOU HAVE PROFESSIONAL GUIDANCE

Every year, for every bodybuilder, it's a quest to shed fat to achieve a state referred to as "shredded," "peeled," or "cut." Off-season photos of the professional bodybuilders show that many binge and dine their way to obesity, yet within a matter of months, even weeks, they are once again posing in peak condition. Certainly diet, training and experience play a part in their ability to recover from dietary excess, but as many other athletes discover, discipline and willpower are not sufficient to account for the dramatic changes seen in the pros.

The following discussion addresses 10 of the more common and most effective means of achieving ultra-low body fat content used by the pros and high-caliber amateurs.While these methods are effective, many are illegal and most carry some element of risk. A fair question would be: Why they are used at all? The answer is simple; it's the same drive that causes shareholders to participate in insider trading, college students and professors to plagiarize and cheat, and politicians to lie. It's a desire to be the best, regardless of cost, risk or ethics. Thus, while the techniques may be unique to bodybuilding, or even sports in general, the phenomenon is not. Do not view the following information as an endorsement of these techniques. Rather, use it to approach the decision to use any of the methods described with greater foresight. 

Stimulants 
Stimulants are most easily understood as drugs or supplements that increase fat loss by providing a signal to the body that it's in an excited state and needs to be ready for action. Stimulants act either by stimulating the release of the "fight or flight neurotransmitter," norepinephrine (NE), prolonging its signal, or directly substituting for NE. There are two classic examples of stimulants used in fat loss by bodybuilders.

1.    Clenbuterol.  This drug is a direct beta-agonist, meaning it reacts with the exact same receptors NE uses to stimulate fat loss.1,2 Its main benefit over NE is that it's more specific, attaching only to the beta-2 type receptors. This is important because there are two classes of NE receptors in the fat cell membrane- alpha and beta. The alpha-2 receptors cause the opposite response of the beta receptors in regard to fat loss from the fat cell; alpha-2 stimulation blocks fat release3 while beta stimulation promotes fat release.4 So, clenbuterol is actually a more powerful fat release signal than epinephrine, which stimulates both alpha and beta receptors. 

Clenbuterol, which is used outside the U.S. to treat asthma, has been discovered to also be anabolic when used in extremely high doses in animals.5,6 However, the levels needed to achieve this effect would be toxic, likely deadly to humans, so there's no practical anabolic effect from this drug.2 Clenbuterol is typically dosed in the range of 10-40 micrograms (not milligrams) per day, though some users will develop a tolerance to much higher doses.1 The effects of clenbuterol are short-lived, as the beta receptors will down-regulate, or burn out, within a matter of a few weeks, so many users will either use clenbuterol for only a short period or alternately go on and off the drug every couple of days. Clenbuterol has been associated with serious side effects in bodybuilders.7-9

2. Ephedrine/Caffeine Stacks. These supplements have typically been the top sellers for most health food stores, simply because they are effective. Numerous studies have been published demonstrating the combination of ephedrine and caffeine to be effective in accelerating weight loss, often preserving lean mass as opposed to the muscle wasting seen in unassisted fat loss.10,11 An unprecedented amount of controversy has arisen regarding the safety of ephedrine/caffeine supplements due to a number of adverse events reported among users. Ephedrine/caffeine use has been associated with a number of hospitalizations and several deaths.12-14 However, in studies where dosage was controlled and the subjects were monitored, ephedrine/caffeine has been declared to be safe and free from serious adverse events.10,11,15 

The adverse reports led the FDA to ban the sale of synthetic ephedrine/caffeine (over-the-counter drugs under the jurisdiction of the FDA), which is unfortunate, as most studies used the more tightly controlled and regulated OTC drugs. However, recent published studies have shown that some of the herbal supplements are as effective and seemingly as safe as the OTC version.16,17 Bodybuilders use ephedrine/caffeine supplements not only for fat loss, but also because it is a stimulant and can aid in maintaining energy and motivation during training. 

Unlike clenbuterol, ephedrine does not directly act on the beta receptors, but causes the release of NE, which stimulates both alpha and beta receptors, so the short-term effect of ephedrine/caffeine is not as dramatic as clenbuterol, but the duration of effect is much longer, with ephedrine/caffeine promoting weight loss for at least 24 weeks.10 Doses are typically in the range of 20-25 milligrams of ephedrine and 200 milligrams of caffeine one to three times a day.11,15  

Hormones 
Hormones of the body are involved in energy balance; altering the levels of these hormones can directly affect metabolism, increasing fat loss. Additionally, other effects of these hormones can alter either the rate of fat gain or where it's deposited. Use of hormones for fat loss is particularly dangerous, as an excess of any hormone can cause serious, even fatal consequences.

3. Testosterone and Other Steroids. These hormones are best known for the anabolic effect of the androgens upon the skeletal muscle, causing muscular growth and strength gains.18 By increasing the relative amount of muscle, steroids decrease the percentage of body fat. However, a number of studies have determined that either testosterone, esters or some of the other anabolic steroids can also directly impact fat loss.19,20 The oral drug oxandrolone seems to have a more pronounced effect on subcutaneous fat loss, though the exact cause for this has not been determined.21

4. Growth Hormone. This hormone affects nearly every cell in the body and excess use can cause permanent and disfiguring changes in appearance and health.22 However, GH has gained a great deal of notoriety as a repartitioning agent, meaning it moves nutrients from fat storage to the functioning muscles and organs.20 GH influences growth through a second hormone called IGF-1, but its effects as a fat loss agent seem to be more direct. GH excess interferes with insulin signaling,23 the main driver for fat storage, and also seems to accelerate fat release from fat cells.24-26 GH has been investigated for use in the morbidly obese28,29 and bodybuilders believe doses of four to six IU/day provide the benefits of GH use.22 GH should never be used, or even considered, without considering the serious and long-term consequences, physical and legal.

5. Aromatase Inhibitors. Aromatase inhibitors are drugs prescribed to women with advanced breast cancer to prevent the conversion of androgens to estrogens.30 Bodybuilders have recently added aromatase inhibitors to their arsenal to decrease the estrogenic side effects of many of the androgenic steroids.31 Testosterone and other steroids can be converted by aromatase into an estrogen,32 and an excess of estrogen will lead to water retention, breast development and fat accumulation. The fat cells have sex hormone receptors,33 and the presence of estrogen appears to increase both the number of fat cells and the amount of fat accumulated.34,35 Aromatase inhibitors can decrease the amount of estrogen in a man to very low levels,36,37 allowing bodybuilders to use the more androgenic testosterone esters without suffering from the estrogenic side effects, providing a leaner, harder appearance. Though a few centers have studied the short-term effects of aromatase inhibition in normal men,36,37 there's no long-term data on the effect of these medications. Currently, the selective aromatase inhibitors are limited in availability and are quite expensive.

6. Thyroid Hormone. The thyroid gland is the main regulator of the body's metabolic rate, adjusting the release of T4, a hormone with limited activity. T4 is converted into T3 within the liver and other tissues, with most of the cellular effects of thyroid hormone due to this form of the hormone. T3 is extremely potent and acts upon fat loss primarily by making the body more sensitive to the signal of NE, the stimulant neurotransmitter.38,39 Unfortunately, thyroid hormone, much like GH, is non-specific, meaning it affects nearly every tissue.

An excess of thyroid hormone leads to a potently catabolic state, and though weight loss will be significant, a significant portion of the weight loss will come from muscle wasting.40 Additionally, T3 excess can make the individual very sensitive to other stimulants, or even the natural release of NE, leading to dangerous heart rhythms, sleeplessness and irritability.41 Users need to be very conservative when combining T3 with any of the stimulants. While most thyroid hormone available comes from diverted (black market) T4, which is less effective and slow acting, the preferred drug for fat loss among users is T3, triiodothyronine. Users must increase the dose of T3 slowly and then taper off gradually to avoid overdosing or withdrawal. T3, used without anabolic steroids, will likely result in muscle wasting. Doses commonly used range from 25-100 micrograms daily.41

Training 
7. Cardio. After all the illicit drugs, it would seem a step backwards to consider cardio, but in fact, few of the drugs mentioned will provide much benefit without being used in the proper environment. Cardio is the bane of most bodybuilders, as they commonly do not care for the activities, nor expend the time needed for benefit. There are multiple opinions regarding when and how to do cardio: Low-intensity versus high, one session versus multiple, daily versus rarely, etc. There really is little practical difference between the various programs, none if the cardio is not done at all. 

The effect of cardio, for fat loss, is to increase the activity-related calorie burning experienced by the bodybuilder.42 Resting metabolic rate is thought to rise with high-intensity exercise, though this remains to be proven for long-term conditioning.43,44 Considering that a greater muscle mass elevates the resting metabolic rate, as do stimulants (ephedrine/caffeine, green tea) that argument is marginal. Bodybuilders need to find an activity that will be maintained regularly, preferably every other day. The percentage of fat burned is higher for low-intensity exercise and best in the morning, before eating, with plenty of water and the use of caffeine.45 However, if that is not a possibility, other forms   still provide a benefit. Cardio can add to the caloric deficit, but it must be approached with care to avoid injury or muscle catabolism.

Diet 
8. Ketogenic Diets. This type of diet has been popularized by Dr. Atkins, but represents the carb depletion phase used by bodybuilders for decades. Ketogenic diets require a great deal of willpower, as it severely restricts the amount of carbohydrates, foods commonly preferred in the American diet. Carb restriction will initially lead to irritability, loss of concentration and strength as a person adapts to it, but eventually behavior and training return to normal. 

The purpose and intent of a ketogenic diet is to decrease the amount of insulin released into the body.46 Insulin is a major anabolic hormone, but unfortunately, it is the primary driver of calories into the fat cell and prevents the breakdown and release of stored fat, leading to a build up of body fat.47,48 When carbs are restricted, there is a large initial loss of weight, representing the water associated with glycogen stores in the liver and muscles. This can be as much as ten pounds in the first week. However, the fat loss from ketogenic dieting occurs more slowly and over a longer period. 

Without insulin to block fat release, fat cells are much more sensitive and will respond more aggressively to stimulants and other hormones. By properly monitoring the calories and amount of dietary fat, ketogenic diets can lead to dramatic losses of body fat. Muscle can be negatively affected by ketogenic dieting, as insulin also drives nutrients (sugar, amino acids, creatine) into the muscle cell and prevents the breakdown of muscle protein. But, it appears ketogenic dieting preserves and may increase lean mass.46 Ketogenic diets can be followed for long periods, with many of the Atkins advocates adopting ketogenic diets as a permanent lifestyle.

Other Methods
9. Dinitrophenol. This chemical is used industrially for dye manufacture and in the production of explosives.49 Its effect on weight loss was discovered as a matter of occupational safety, with a number of workers in munitions plants suffering from unusual symptoms, even dying. It was found that they were inhaling DNP dust. DNP is a metabolic toxin, meaning it is a poison that affects the mitochondria, preventing them from being able to function.50 The mitochondria are the "powerhouses" of the cells, creating the energy molecule ATP from glucose or fatty acids. 

In the presence of DNP, the mitochondria fail to produce ATP and energy production decreases as much as 60 percent, though the energy demands of the body remain stable, requiring more "fuel" to be burned to provide for the body's needs.50 While DNP is extremely potent, perhaps the strongest fat loss agent known, it is no longer used for weight loss.51 It was learned that DNP places the body under extreme oxidative stress, causing cataracts and other problems.49 Bodybuilders find DNP difficult to tolerate and typically use it only for short periods.

10. Other Items of Interest. A number of other products have promise for fat loss and are commonly used by bodybuilders. Yohimbine is a drug able to block the alpha-2 receptors, the receptors that block NE's fat-releasing effect on the fat cell.3 Captopril is an anti-hypertensive drug that blocks the activation of a hormone found to be present in the fat cell,52 and may decrease alpha-2 receptors.53 Liposuction is a cosmetic surgery, which can remove specific fat deposits.54 

Bodybuilders will use extreme measures to achieve extreme losses of body fat. As can be seen, most of these methods carry risks and many are illegal for use without a physician's prescription. None of the methods listed above should be used without further educating oneself about the costs and risks. If such a choice is followed, accepting the possible consequences must be considered as part of the price.

References  
1.    Llewellyn W. Anabolics 2002. Molecular Nutrition Press, Patchogue, NY, 2002, p 60-62.
2.    Prather ID, Brown DE, et al. Clenbuterol: a substitute for anabolic steroids? Med Sci Sports Exerc 1995 Aug;27(8):1118-21.
3.    Berman DM, Nicklas BJ, et al. Regional differences in adrenoceptor binding and fat cell lipolysis in obese, postmenopausal women. Metabolism 1998 Apr;47(4):467-73.
4.    Mauriege P, DePergola G, et al. Human fat cell beta-adrenergic receptors: beta-agonist-dependent lipolytic responses and characterization of beta-adrenergic binding sites on human fat cell membranes with highly selective beta 1-agonists. J Lipid Res 1988 May;29(5):587-601.
5.    Carter WJ, Lynch ME. Comparison of the effects of salbutamol and clenbuterol on skeletal muscle mass and carcass composition in senescent rats. Metabolism 1994 Sep;43(9):1119-25