COPD Bio-hacking Part II

When I wrote my first article on ketosis and the ketogenic diet back in January this year I thought the topic would create some discussion, which is what I was trying to achieve. I would highly recommend reading the article before this one if you are new to the ketogenic diet.

Nutrition and respiratory disease is generally detached. What I mean by this is most respiratory experts I have talked to, admit they have very little training in nutrition. When we are diagnosed with COPD we are given guidance on medication and the importance of exercise but we are given little information on nutrition.

Update

I’m now 8 months into the ketogenic diet and feel compelled to share my experience which has now encompassed not only the ketogenic diet itself, but the highly sort after ketone ester, which I will discuss in a future article.

It is generally excepted to be in nutritional ketosis and to see the benefits, your blood ketones should measure between .5 – 3.0 millimolar. Blood ketone readings fluctuate during the day and can depend on what you eat and what time of day you measure them. A ketogenic diet is not a diet you can just have a go at.  In order to assess whether it will benefit you it’s important to follow the diet correctly and that means seeking the advice of a nutritional expert with experience in this field.

I would say for me the longer I have stayed in ketosis the more benefits I have derived from being in this state. The four main markers I have used to quantify any changes are blood tests, lung function tests, medication usage and exercise capacity.

Blood Tests

We know that inflammation is a major contributor to respiratory disease, so after consulting some experts in the world of ketones, it was decided there are two blood tests which would be of interest to identify any reduction in inflammation markers.

The first blood test I used as a marker was a C-reactive protein blood test which measures inflammation in my blood. Before my ketosis journey started I had several C-reactive protein tests carried out, they indicated I had very high levels of inflammation in my blood. Since being in ketosis I have now had two more C- reactive protein blood tests, both test have shown a significant fall in my inflammation levels.

The next test on the list is called a cytokine blood panel. Cytokines are signalling molecules that effect the immune system. They can be pro-inflammatory or anti-inflammatory. A cytokine test can indicate the types of inflammation in the blood. Pro-inflammatory cytokines are associated with different diseases. Testing for these particular cytokines can be useful to measure how effective treatments can be in reducing inflammation.

Before going into ketosis, I had a cytokine blood test. This test revealed extremely high levels of pro inflammatory cytokines especially cytokines that are known to directly affect respiratory diseases.

The upside of this test was at least I had a good baseline test and plenty of scope for improvement. My follow up cytokine test will not take place for a little while yet as I have picked up a chest infection whilst travelling which has turned into a nasty exacerbation. It is important when doing these tests that you are clear of any infections that may corrupt the tests results.

Lung function test

In June last year, two weeks before the Gold Coast marathon I had my lung function tested at our local respiratory clinic. It revealed the same result as previous years – a FEV1 of .9lt around 27% lung function, no surprises. My diet back then was a paleo style diet which I was enjoying.

In April, this year two weeks before the London marathon I repeated the lung function tests, this time I was in ketosis. The results showed a significant improvement in my lung function from .9lt to 1.26lt around a 38% increase. While I am excited by this result, it is only one result and more will be needed over time.

Medication

First of all, I do believe medication is a crucial part of managing COPD and would never advocate a change without consulting your doctor. I have maintained my preventative inhaler medication through this whole ketosis experiment, as per my Respiratory Specialist’s instruction and prescription.

What I have found is that my dependency on my reliever inhaler has reduced dramatically. It’s hard to determine whether this is because of the effect of being in ketosis or something else. But given the reported anti-inflammatory effects of ketosis I believe it would not be out of the realms of possibility there is some connection.

Exercise

For those who are regular readers of my articles you would be aware exercise plays a large part of my life. Being able to measure my performance allows me to assess whether different training regimes or dietary strategies impact on my performance.

If we look back at my last three marathons there has been a constant improvement in my overall race times. From the New York marathon to the Gold Coast marathon and my recent run in the London marathon my time has improved 43 minutes overall. That’s a big improvement over that period, but what’s interesting is the only change to each preparation was my dietary strategy.

My exercise program was reduced with each marathon, while I still used a 26-week program I reduced the number of long runs. For the New York marathon, I used a fairly standard high carbohydrate, high protein diet I had used for years. After New York I transitioned to a lower carb paleo style diet which resulted in a 4-kilogram loss in weight between the two races. It would be reasonable to assume the weight loss had some impact on the time improvement I had. After the Gold Coast marathon, I started on the ketogenic diet and lost another 4 kilograms in weight. Yes, that could have impacted on my improvements in my race time.

What was most noticeable out of the three races was the improvement in my breathing. I was far less laboured in my breathing not only on race day but in day to day life.

What can we conclude so far?

The facts are:

• my inflammation markers have reduced;
• the amount of reliever medication I use has reduced;
• my breathlessness has reduced;
• my energy levels have improved; and
• I’m running faster marathons using less energy.

I can show the improvements in my inflammation markers and lung function which could explain why I feel better in my day to day life. Having these positive outcomes gives me reason to continue down this ketogenic pathway.

For me and researchers watching on, the ability to show successive test results including cytokine blood panels, that confirm my initial findings will give more weight to the argument for nutritional strategies for respiratory disease.

Coming soon will be my recent journey into Ketone esters and how a $60 million investment may well have exciting applications in the respiratory world.