December 1, 2014
It was in a podcast episode last month with James Swanwick that a crazy thought entered my mind.
During the podcast (yeah, this is a mouthful) “How Quitting Alcohol Helped Today’s Guest Lose 30 Pounds, Make More Money, Attract Better Friends And Lovers, And Got A Job Hosting SportsCenter on ESPN (And Your Formula For Reducing or Quitting Alcohol)”…
…I asked James if he actually got any blood testing before and after quitting alcohol.
He said no (but he wished he had).
So after I recorded the podcast, I e-mailed the good folks at WellnessFX, and said, “Hey look – it would be an incredibly interesting experiment to take some guy or girl who is drinking alcohol pretty liberally and to test their blood biomarkers, then have them quit alcohol for 30 days, and then re-test – just to see what happens inside your body when you quit alcohol for 30 days.”
Within about 5 minutes, I got an e-mail back.
They said, “Let's do it.”
Not only that, but WellnessFX graciously offered their flagship “Baseline Package”, which includes an advanced biomarker analysis and an intuitive health dashboard to track the results.
My next task?
Find a willing, drinking victim who would not only give up alcohol for 30 days, but would do it between the celebratory holiday time frame of Thanksgiving to Christmas day and be willing to have all their health results publicly released here on BenGreenfieldFitness.com. In other words, they'd need to not only sober up cold turkey, but also be a glutton for some pretty serious self-control under intense public scrutiny.
How To Find A Crazy Person Who Will Give Up Alcohol For 30 Days
So, knowing that most of my followers tend to err towards the edge of biohacking and self-experimentation, I posted the following on the BenGreenfieldFitness Facebook page:
The post received 108 entries.
Of those 108 willing participants, I chose one lucky guy named Jason Sissel.
So…who is Jason? Here’s his photo and stats…
- Former Wall St. professional
- Left the corporate world to run own businesses (founded a pediatric cancer non-profit, investment/consulting business, software business, and to inspire others to pursue what makes them happy in life)
- 38yrs old, 5'11”, ~180lbs
- Sponsored ultra-endurance athlete
- Estimates he is probably about 20 pounds overweight due to taking the entire last year off (after cycling across the USA), exacerbated by poorer-than-normal eating and drinking lots of wine and beer. Quite frankly, he got physically burnt out and let himself get in an unmotivated funk.
- He loves motivating and inspiring people – particularly the few hundred folks who have joined his foundation to raise funds for kids in cancer treatment by doing endurance events.
- Cycled across USA (self-supported)
- 1x Ultraman World Championship
- 1x Ultraman Canada Championship
- 3x Ironman
- 1x Marathon des Sables (a marathon in the Sahara Desert);
- 1x Texas Time Trials 24hr Bike (2nd, A.G.)
- Climbed 3 of the Seven Summits
Wow. So obviously, Jason is no joke.
You may wonder why I picked a person who is so physically fit and active, rather than some sedentary, beer-chugging couch potato. Easy: most of the readers of this blog: A) drink alcohol; B) exercise hard. So Jason was a natural choice, since his lifestyle reflects the majority of folks who are going to benefit from the results of this experiment.
OK, OK, Jason was possibly drinking more than most readers of this blog, and said in his submission:
“…for better or worse, I also love red wine and beer and usually find myself enjoying a few bottles of wine per week or a few beers while watching sports…”
A few bottles of red wine a week?
Dang. I'm a glass of wine a day guy, but couldn't tell you the last time I punished several bottles in a 7 day time span.
Plus, Jason obviously appears not to be some kind of a flake who would derail himself halfway into this experiment at some kind of booze-infused holiday party. In other words, he freaking ran across the Sahara desert, so I figured he could last 30 days without drinking.
Here's Jason's current drink chart going into the no alcohol experiment:
Jason's Pre No-Alcohol Stats
Jason was required to keep a strict nutrition (food and drink), exercise and sleep journal for the 15 days prior to his first WellnessFX blood lab draw, and he is also required to continue these logs during the entire 30 days of the no-alcohol period.
Since he's a bit of a self-quantifier geek, Jason was actually able to supply even more data prior to quitting the alcohol, including a resting metabolic rate test and a DEXA scan (a very accurate method of body fat testing that allows you to see where body fat is actually distributed).
And of course, we also get to see half-naked photos of Jason before and after, which he was a bit embarrassed to submit – but hey, ya gotta play by the rules, right?
In just a moment, I'm going to give you a very helpful walkthrough of all these documents, but in the meantime:
Click here to read Jason's first blog post “Biohack: 30 Days No Alcohol” (and follow his own thoughts on this 30 day experiment)
Finally, below are Jason's pre-30 days no alcohol front and side photos.
The 30-Days No Alcohol Bloodwork
OK, as promised, here is my walkthrough and explanation of Jason's WellnessFX blood results, metabolic test results, and DEXA Scan.
Below, I've taken a screenshot of each of the components of Jason's WellnessFX dashboard. I should note that this was Jason's second blood panel that he's done with WellnessFX, and that his previous blood panel was kind of a “Cadillac” panel (WellnessFX's Premium Panel) and tested for even more than the Baseline panel that he went through as part of the no-alcohol test. So on the screenshots below, the dots that are farther to the left are from bloodwork that Jason did in October of 2013 and won't be taken into account for this experiment or explanation.
OK, a few things to note here on Jason's vitamins and minerals. The first is that his Vitamin D is low…really low. Ideal ranges for Vitamin D are 40-80 and he is at 11. It is well known in nutritional science that drinking too much alcohol can interfere with your body’s ability to absorb and activate Vitamin D.
Vitamin D only becomes physiologically active after it’s been chemically modified in the liver and kidneys. Since the liver must carry the majority of the burden of alcohol metabolism, excessive alcohol consumption puts an unhealthy overload on the liver and makes it less able to perform its other duties. This overload on the liver can eventually result in a number of disorders, including fatty liver, alcoholic hepatitis and cirrhosis. By compromising normal liver function, alcohol interferes with the conversion of both dietary (from food) and endogenous (from sunlight) vitamin D into its active forms. As a consequence, heavy drinkers will tend to have low blood levels of vitamin D.
Jason will not be adding any extra Vitamin D supplementation over the next 30 days or increasing his sunlight exposure significantly, so it will be interesting to see how cutting alcohol affects his Vitamin D.
You'll also note that Jason's magnesium levels are low (although this value is taken from his October 2013 results). Although quite deleterious (since magnesium is involved in over 300 different enzymatic reactions), a magnesium deficiency is actually quite common among endurance athletes. As Rhonda Patrick notes in this WellnessFX article on magnesium deficiencies, alcohol can literally DOUBLE the excretion rate of magnesium in both acute (one time) and chronic (frequent) alcohol consumption cases.
As you can see, Jason's red blood cell count, hematocrit and overall oxygen carrying capacity is chugging along just fine, with no apparent issues with anemia, iron, etc.
However, when you look at his white blood cell count, you can see elevated eosinophils along with low neutrophils.
An abnormally high amount of eosinophils in the blood can suggest a variety of different problems, such as allergies or infections, and I often see this in individuals who are A) eating lots of foods that create autoimmune issues, such as commercial wheat, soy, or dairy; B) have some kind of a gut infection, such as bacterial overgrowth or a parasite.
Neutrophils are white blood cells that help fight infections. Low levels can indicate an immune weakness or deficiency, while higher levels can indicate increased inflammation or infection. While full-on alcoholism and high amounts of liver damage can indeed cause a low white blood cell count due to the vitamin deficiencies and low protein that accompanies liver inflammation,. a moderate consumption of alcohol should not really affect white blood cells. So I highly doubt that Jason's level of alcohol consumption is deleteriously affecting his counts, but it will still be interesting to see how his white blood cells respond to 30 days of no alcohol.
In the meantime, if white blood cell counts are abnormal and accompanied by gas, bloating, diarrhea, constipation, or indigestion, I will typically recommend a Complete Gut Panel to test for bacteria, parasites, yeast, fungus and microbial status of the gut.
I've already addressed Jason's low Vitamin D status, which is repeated in the bone biomarkers section of this blood panel, but here you can also see Jason's electrolytes and kidney function. All is relatively normal here.
When looking at an electrolyte panel, however, one important variable to pay attention to is CO2, also known as biocarbonate. Bicarbonate (HCO₃⁻ ) is the main form of carbon dioxide (CO₂) in the blood. Bicarbonate acts as a buffer against acids in your blood, so a low bicarbonate suggests too much acid and a high bicarbonate too little. You can see that Jason's bicarbonates are borderline high (at 29), suggesting that he may be bordering on a bit too alkaline. You can read up on metabolic alkalosis here, but I find Jason's values interesting because I'd expect to see more metabolic acidosis in a heavy drinker, since alcohol has potential to create a net acidic state.
This slight alkaline state could be caused if Jason has very poor breathing patterns (shallow, chest breathing all day long), was taking a lot of bicarbonates or antiacids (like Tums, for example), engaging in heavy use of licorice-based supplements (glycyrrhizinic acid) or had a low level of potassium. But none of these seem to be the case with Jason, so this is a bit of a head scratcher for me, and I'll be interested to see how his values change after 30 days of no drinking.
In addition, as you can see, Jason's kidneys look fine. No issues there.
As I would have expected due to his level of alcohol consumption, Jason has elevated liver enzymes. His Alanine Aminotransferase, or ALT, is especially elevated. This is an enzyme in liver cells, and liver damage or disease causes a release of ALT from the liver cells, increasing the amount in the blood. AST and ALP are found in cells other than liver cells, while ALT is more specific to liver cells.
High alcohol intake and high body fat percentages can both increase liver enzymes. I suspect we'll see some very favorable decreases in Jason's liver enzymes at the end of 30 days.
Here you can see that Jason has high fasted blood glucose and high hemoglobin A1c (a 3 month snapshot of his average blood sugar levels). Since alcoholic drinks contain high amounts of sugar from both glucose and fructose sources, this is no surprise. In an active athlete like Jason, I'd expect to see fasted glucose levels that are below 90, but instead, he appears to have chronically elevated blood sugar levels and is relying upon carbohydrates (not fat) for energy. In Jason's resting metabolic rate results farther below, you'll see that this is indeed the case.
In addition, Jason has a very elevated TSH (Thyroid Stimulating Hormone). TSH triggers the thyroid gland in your neck to produce thyroid hormones T3 and T4, which are crucial for your body's use of energy. The amount of functioning thyroid hormones gives your brain feedback as to how much TSH to release, so the brain will release less or more TSH as it senses is necessary. Low thyroid function can cause weight gain, fatigue, cold intolerance and brain fog.
Prior to this test, Jason was aware that he was hypothyroid, and is currently on 75mcg per day of Synthroid (Levothyroxine). This is definitely not my top pick for thyroid supplementation, as it is a synthetic form of thyroid and contains only one of the two major thyroid hormones: T4. I'm a much bigger fan of a full spectrum of thyroid hormones that includes T1, T2, T3 and T4. In the past, I've recommend natural thyroid replacement supplements such as ThyroGold for this reason.
While alcohol isn't always the culprit when it comes to low thyroid function, it can certainly play a role. It has been shown to cause direct suppression of thyroid function by cellular toxicity, and indirect suppression by blunting the release of an important thyroid-related hormone called thyrotropin-releasing hormone (TRH). With elevated chronic use, it can also cause a decrease of peripheral thyroid hormones like T3 and T4, primarily due to it's deleterious effect on liver and gut conversion of thyroid hormones to their active form.
My guess is that Jason experiences a distinct drop in TSH after 30 days, indicated improved thyroid function.
Jason hs-CRP – a primary indicator of inflammation, is just fine. If anything, I'd expect it to decrease at the end of the next 30 days to below 0.2, as alcohol is both acidic and inflammatory.
Jason has some pretty serious lipid panel “issues”.
For example, Jason's Triglyceride to HDL ratio (one of the first values I pay attention to on a lipid panel) is very high, at 5.9 (I like to see it below 1!). Excess triglycerides can be stored in blood vessels, contributing to atherosclerosis and cardiovascular disease. Higher amounts of HDL can carry these fatty deposits away from blood vessels and be protective. So the ratio of triglycerides to HDL can be a valuable measure to help predict cardiovascular risk.
Due to it's high fructose content, most forms of alcohol can shove triglycerides through the roof. Alcohol has an especially significant additive effect on the postprandial (after a meal) triglyceride peak when it accompanies a meal containing fat, especially saturated fat. This results from a decrease in the breakdown of cholesterol due to an acute inhibitory effect of alcohol on the activity of the crucial fat burning enzyme lipoprotein lipase.
Alcohol also increases the synthesis of large VLDL particles in the liver, which is the main source of triglycerides in the high triglyceride state so often seen with chronic excessive alcohol intake.
Now don't get me wrong – I'm not completely demonizing alcohol here. Low to moderate consumption (such as a glass of red wine a day) has actually been shown to increase HDL and favorably affect blood lipids. But it appears Jason has definitely exceeded this beneficial amount.
The 30-Days No Alcohol Body Fat
Below are Jason's DEXA scan numbers, which he got from DEXAFit Chicago.
Although not quite as accurate as underwater weighing (hydrostatic measurement) Dual-energy X-ray absorptiometry (DEXA) is one of the better methods for measuring body fat. This test is performed by lying in a giant scanner that passes over your entire body, and then generates a three-dimensional model that shows fat-tissue mass (subcutaneous fat and internal “visceral” fat), lean muscle mass, and total body mineral content (total skeletal mass and bone density).
One of the advantages of the DEXA scan is that it also indicates regional body fat distribution – such as fat tissue percentage in your left arm vs. your right arm, trunk, left leg vs. right leg, and perhaps most importantly, android versus gynoid fat (fat carried on the waist or apple shape versus fat carried on the hips or pear shape) .
This is important because carrying too much fat in the wrong area can make you more disposed to serious health problems. For example, seeing the ratio of android to gynoid fat distribution will give you a good indication of your susceptibility to heart attack, diabetes and other chronic diseases. Excess android fat around the abdomen and trunk and inside the abdominal cavity potentially puts you at greater risk for metabolic disorder, heart disease, and stroke.
One study based on 14 years of data from a Centers for Disease Control and Prevention survey found that, when it comes to your risk of early death, being obese overall may not be as important as where on the body your fat is distributed. In the study, apparently thin people who were of normal weight but had a lot of visceral or belly fat were twice as likely to die early as people of normal weight with no gut, or people who had more of their fat distributed through their body, such as their ams and legs. People with lots of concentrated belly fat also had a higher risk of death than people who were simply obese all over.
Ever hear the phrase “beer-belly”? In case you hadn't already guessed, excessive alcohol consumption is one of the most potent ways to increase your android belly fat and make you prone to all the dangers that accompany full-on obesity, even if you're thin.
Below, you can see how Jason measures up. A full 45% of his android tissue is composed of fat, compared to only 29.5% of his gynoid tissue. Between his trunk and his belly alone, he has over 41 pounds of pure fat, with a total body fat % of 29.9!
Now granted, Jason has not been training much lately, and admits that he hasn't trained for ultra-endurance since cycling self supported across USA (~100mi/day) last summer. At this point, he's simply running aerobically 3-4 days per week for 30 minutes, and doing kettlebell swings, core strength and stability drills on another 3-4 days per week.
But despite having a strong history and jam-packed resume as an ultra-endurance athlete, Jason is at high risk for cardiovascular disease and other metabolic disorders. Jason is likely going to read this statement and cringe, but at least he's serving as a warning beacon for the rest of us. Just because you run across the Sahara desert does not mean you're healthy on the inside. You simply can't outrun a bad diet, or excess alcohol intake.
If you'd like to read up more on body fat distribution and cardiovascular disease, here's an excellent paper, and the helpful graphic I've taken from that paper is shown below Jason's DEXA scan results.
The 30-Days No Alcohol Metabolic Results
Jason also underwent a resting metabolic rate test (RMR) to see how many calories his body is burning at rest. During this test, you simply sit quietly and breathe in and out of a tube as your respiratory gases are measured. At 1848 calories, Jason's metabolism is slightly low, which is no big surprise after seeing his thyroid numbers.
But check out Jason's RER (in the second graphic below).
The RER is the ratio between the amount of CO2 produced and O2 consumed in one breath. Measuring this ratio can be used for estimating the respiratory quotient (RQ), an indicator of which fuel (carbohydrate or fat) is being metabolized to supply the body with energy.
An RER of 0.70 indicates that fat is the predominant fuel source, RER of 0.85 suggests a mix of fat and carbohydrates, and a value of 1.00 or above is indicative of carbohydrate being the predominant fuel source.
When I tested my RER after turning myself into a fat burning machine, my RER was approximately 0.66.
Jason's RER is 0.90. He is a carb burning machine.
In other words, as we would have suspected based on his fasted glucose and hemoglobin A1C numbers from his bloodwork above, Jason is nearly unable to tap into his own body fat or to burn fat for fuel. Despite being an endurance athlete, his RER is actually well above the population norms of above 0.8.
You can read about all the dangers of chronically elevated blood sugar levels here. I would very much expect and hope for Jason's RER to drop significantly after 30 days no alcohol, although this value could be highly related to Jason's food intake, and not just his sugary drink intake.
So what the heck kind of food has Jason been eating that would be affecting his metabolism so baldy? Despite popular belief that a consistent negative caloric balance can cure all metabolic issues (similar to the popular belief that ultraendurance athletes are metabolically bulletproof), Jason's actually isn't overeating. He's simply eating a high amount of crappy, processed lean proteins and carbohydrates, combined with a low intake of healthy fats. Here are a few days worth of his eating going into this blood panel:
All that bread, cheese, grain, sugar and dairy isn't doing Jason any favors, and is in fact likely oxidizing that big portion of morning fat from the butter coffee he's drinking, rendering his breakfast into an artery-clogging nuclear bomb.
In a nutshell, once this 30 days no alcohol challenge is over, Jason should consider drastically changing his diet too.
So that's it!
In approximately 30 days, I'll be releasing a follow-up blog post with all Jason's new numbers, which will show the exact acute effect on your internal biology when you quit alcohol cold-turkey. Although it is possible that in 30 days, Jason may be settling down with a nice glass or two of a decent red wine or microbrew, I'm highly doubting he is going to be back up to a few bottles of red a week after reading this article.
Want to stay tuned to the rest of this 30 Days No Alcohol series? If you're not already subscribed to my free newsletter, be sure to click here to do so and you'll get an instant alert when I release Jason's final results, along with any other updates along teh way.
In the meantime, leave your questions, comments and feedback below, and click here if you'd like to get your own lab testing.