Eat Pizza and Get Lean
My goal was simple. The task was not. I was going to drop from 9% body fat to 6% in just two weeks. It wouldn't be easy, but with an intelligent, educated approach, I was sure I'd be able to come out victorious. I had my plan all drawn out. I knew what to eat and how to train. I even added in a good legal androgen supplement so I could finally drop calories extremely low without having to worry about losing hard-earned muscle. I was set.
Fast forward seven days and what seemed like a hundred hours of cardio and zero calories. Results: 8.5% body fat and about four pounds of water/glycogen loss! Okay, I told myself, no need to get discouraged. All the real fat loss comes during the second week anyway, right? Stick it out another week and see what happens.
Fast forward another seven days: 8.3% body fat and another two pounds of water/glycogen loss! Now I'm pissed! I did everything right! My caloric deficit was enough to net no less than two pounds of fat loss weekly, and then at least another pound a week through increased energy expenditure! Most people would've called it quits at this point, but I was determined to make this thing work for me. So, during my two-week "off period" I sat down, reevaluated my diet and training, made some adjustments, and prepared to give it another go.
One week into the second cycle, I reassessed my progress: 8.0% body fat and, of course, the initial water and glycogen loss. Ugggghhhh! This was getting very frustrating! But I figured I'd stick it out for the rest of the two-week cycle in hope that I might, just might, be able to get down to 7%.
Well, the next day I was invited to a friend's house for some sort of social gathering that included fun, games, and (gasp!) real food. Upon my arrival, I had countless individuals throwing food in my face saying, "Here, eat this!" in one-way or another. My initial response was, "I'm dieting, but thanks anyway," but after walking into the kitchen and seeing pasta, meatballs, cookies, and pastries galore, my "no thanks" quickly turned into an "Aw, screw it!" Three plates of pasta, a couple of pastries, and a few Cokes later, I was sprawled out on the couch in a seratonin-induced coma.
The next morning my diet and life were back to normal. Over the course of the next three days, things were going well: training was intense and the diet was in order. But then on Thursday, temptation reared its ugly head once again. It was pizza night at Joel's house! (For some reason, I didn't know until I got there.) The pies called my name and I answered.
Three more days passed and it was time to squeeze the calipers again. After pinching the routine spots, I nonchalantly glanced down to observe the digital screen: 7.0%. I then set the calipers down, threw on a pair of jeans and proceeded to get ready for my 9:30 a.m. class. Then it hit me. Did that just say 7.0%?! How in the world could the most undedicated, screwed up week of my dietary life yield a 1.0% reduction in body fat and just over two pounds of fat loss? Could it be that those dietary screw-ups actually accelerated my progress?
I needed some further evidence to support this hypothesis, so I decided to stay "on" for another week and a half to see what would happen with some planned cheating. Monday through Wednesday afternoon, I stuck to my strict guidelines, and then Wednesday evening, I forgot about 'em. I woke up on Thursday and got right back to it, then on Sunday evening it was time to pig out again.
When I glanced at that digital screen on Wednesday morning, what I saw was shocking: 5.9%! I've repeated this process several more times, each time netting about six pounds of fat loss during the first two-week cycle. The Cheater's Diet was born.
What Severe Dieting Does
Why did I have such horrid results during that initial two-week severe diet? Well, the human body is amazingly proficient at adapting to the various stressors to which it's continually exposed. This includes severe caloric restrictions. The body quickly catches on to the caloric deficit and then promptly makes the necessary adjustments to maintain homeostasis.
This is a good thing if you're Tom Hanks stranded on a remote, not-so-tropical island in the middle of the Atlantic Ocean, but not so desirable for the dedicated bodybuilder whose goal is to get shredded in a timely fashion. Below are some of the body's major metabolic and physiological responses to severe dieting:
1. Decreased levels of T3 and T4 (2, 4, 10). T3 and T4 levels (thyroid hormones that play a major role in the regulation of metabolism) in underfed individuals actually mimic those of sick euthyroid syndrome patients. In short, low levels of these hormones are anything but desirable for individuals seeking to lose fat mass.
2. Decreased metabolic rate (BMR) (3, 5, 7, 8, 9, 11). This is partially due to the decreased output of T3 and T4; however, many other factors also contribute to the body downregulating its basal metabolic rate. In essence, metabolic rate is decelerated in an attempt to equate energy expenditure to caloric consumption, thus preserving more fat mass.
3. Increased levels and half-life of cortisol (2). Severe dieting and malnutrition undoubtedly spikes and actually extends the half-life of the extremely catabolic (muscle wasting) hormone cortisol. The serum cortisol levels associated with malnourished individuals parallel those linked to individuals suffering from clinical depression. This is clearly not optimal for individuals who wish to retain lean muscle mass while attempting to lose fat.
4. Decreased serum leptin levels (15). Leptin is a regulatory hormone that communicates with the hypothalamus and basically gives the body the "yea" or "nay" to utilize adipose tissue for energy.
Generally speaking, there's a positive relationship between leptin and the amount of fat mass that you're carrying (13, 14). However, certain studies have shown dramatic decreases in leptin when caloric intake is highly restricted, independent of fat mass (12, 15). When low levels of leptin are transmitted to the associated receptors of the hypothalamus, the hypothalamus then begins to send out various regulatory signals to the rest of the body in an attempt to decelerate fat loss and decrease energy expenditure.
One interesting thing to note is that the further you move away from your body-fat set point, the more severe the level of adaptation to a highly restricted caloric intake. Even though individual set points can vary greatly, one thing remains constant: the leaner you get, the worse the aforementioned problems become.
The main reason lean individuals have extreme difficulty shedding that last bit of stubborn fat is that their metabolisms have hit rock bottom. Cortisol is freely running its course, and T3/T4 and leptin are all trickling from their respective sources like blood to the nether regions of an 80 year-old man in the days before Viagra.
It's this same underlying principle that explains why bodybuilders with higher body fat set points find it very challenging to see the calipers yield single digit percentages. The metabolic and physiological state associated with severe dieting isn't a desirable one; however, as I alluded to earlier, there is hope. That hope lies in planned overfeeding.
What Overfeeding Does
Now let's go over the metabolic and physiological responses to an overfeeding session or "cheat meal":
1. Increased T3 and T4 output. An increase in thyroid output equals an increase in metabolism. So, how about boosting your thyroid levels by eating the foods you crave instead of with prescription drugs? It sure beats "doing time" with a hypoactive thyroid!
2. Increased 24-hour energy expenditure (24-EE) and basal metabolic rate (BMR). The shock of a caloric surplus will always cause the body to upregulate its metabolic rate. In a recent study, both fat-gain prone and fat-gain resistant individuals experienced similar and substantial increases in 24-EE in response to overfeeding (9% above baseline) (11).
Keep in mind the study analyzed the percent increase in 24-EE when the subjects were previously consuming their normal diet. Had the subjects been in a malnourished state prior to the overfeed, it's hypothesized that the increase in 24-EE above baseline would be somewhat greater, and substantially greater than the malnourished value of 24-EE.
3. Decreased cortisol levels. A surplus of calories and carbohydrates undoubtedly spikes the antagonist of cortisol: insulin. In addition, the psychological benefit of a high-calorie meal will considerably reduce the extreme levels of stress, and thus cortisol, associated with a strict cutting phase. Along the same lines, many athletes find it much easier to continue with their stringent diets after experiencing the psychological relief of a high-calorie meal.
4. Increased serum leptin levels. Similar to insulin, chronic high levels of leptin can promote insensitivity to the hormone; however, timed spikes can be extremely beneficial (15, 16). The benefits of periodically increased leptin levels include:
• Increased thyroid output
• Increased energy expenditure and BMR
• Spot degradation of fat
• Increased thermogenesis
It's important to note, however, that the physiological benefits mentioned above are only noticeable when an abundance of carbohydrate is taken in during the "cheat." In one particular study, ten healthy females were overfed on either fat or carbohydrates. In the carb group, there was an acute 28% increase in serum leptin levels. (Again, these are increased levels from baseline; leptin levels associated with severe dieting are far below baseline.) However, the Fat group didn't experience any significant change in plasma leptin concentration (1). Other studies have shown even greater acute rises in plasma leptin as a result of overfeeding (6).
5. Increased Thermic Effect of Food (TEF). This is only logical. Think about it: you've been taking in minute amounts of sustenance for the last few days, and then surprise, here comes a few thousand calories!
The TEF for such a meal will be even greater than if you took in the same amount of calories, but preceded it with a few days of maintenance or surplus levels of calories. Some athletes have even reported slight perspiration during or shortly after the ingestion of such a meal. Should this happen to you, don't sweat it (no pun intended); it's a perfectly normal reaction as your metabolism is working hard to assimilate the recently consumed calories.
6. Increased Thermogenesis. By now you should be able to see that all of the above benefits are interrelated in some way; however, the end result is the same: fat loss is accelerated. Sure, there'll be some initial fat gain, but as you get back to your program with renewed dedication, the metabolic and physiological benefits will more than compensate for the slight gain in adipose tissue. Over the course of the next few days, you will get leaner!
The Plan of Attack
Now let's get to the good stuff, the stuff that makes up what I believe to be the fastest, most efficacious way to go about shedding excess body fat.
Obviously, a successful cutting cycle involves more than just periodically overeating. Below is what I believe to be the best schedule to make the most of your attempt to get ripped. After this, I'll provide a quick Q and A section and a training program.
Monday AM
• Ingest 5 grams each of L-glutamine and BCAA's.
• 30 minutes of cardio @ 70% of HR Max.
• Consume your first meal. (Be sure to include about 25 grams of higher GI carbs in this meal.)
Monday PM
• Consume half a serving of Biotest Surge or similar drink immediately prior to or during training.
• Strength training followed by 20 minutes of cardio @ 70% of HR Max.
• Consume half a serving of Surge.
Tuesday AM
• Supplement with an ephedrine-caffeine (EC) stack 30 minutes prior to training.
• Ingest 5 grams each of L-glutamine and BCAA's immediately prior to training.
• 20 minutes of sprint intervals with a max effort to rest ratio of 1:3 (sprint 20 seconds, rest 1 minute).
• Consume maltodextrin and whey protein in a 2:1 ratio (.2-.4g/lb of LBM and .1-.2g/lb of LBM respectively; the amount is dependent upon your caloric needs), along with 5 grams each of L-glutamine and BCAA's.
Tuesday PM
No activity, but don't turn down sex.
Wednesday AM
• Assess body fat. I recommend the Fat Track II Digital Skinfold calipers. For a skinfold tutorial, please see Jason Norcross' article here.
• Supplement with an EC stack 30 minutes prior to training.
• Ingest 5 grams each of L-glutamine and BCAA's immediately prior to training.
• 10 minutes of sprint intervals with a max effort to rest ratio of 1:1 (sprint 20 seconds, rest 20 seconds).
• Consume your first whole food meal, but add about 25 grams of maltodextrin.
Wednesday PM
Starting at dinner, forget your dietary guidelines. Eat the foods you crave and don't be apprehensive. When you're no longer hungry, stop eating. Should you get hungry again, eat what you want. Repeat this process until you go to sleep.
Thursday AM
Same as Monday AM
Thursday PM
Same as Monday PM
Friday AM
Same as Tuesday AM
Friday PM
• 20 minutes of cardio @ 70% of HR Max.
• Consume the next scheduled meal. (Be sure to include 25 grams of higher GI carbs in this meal.).
Saturday AM
No activity.
Saturday PM
Same as Monday PM without the cardio.
Sunday AM
Same as Wednesday AM
Sunday PM
Same as Wednesday PM (Smile, that's the cheat session!)
NOTE: Each sprinting session should begin with a one-fourth mile warm up at around 50% of perceived maximal effort and end with an appropriate cool down (i.e. "walk it off"). Also, it's recommended that you conduct a light stretching session both prior to and following the exercise bout.
As you can see, there are two planned cheating sessions during the week, approximately three days apart. By setting things up this way, we make the strict diet/training segment of the program very effective, and then just as the body begins to "readapt" to the caloric deficit, we upregulate the aforementioned hormones and metabolic processes through overfeeding to ensure continual fat loss.
Questions and Answers
Q: I didn't notice any dietary guidelines, such as calorie and food choice recommendations. Are there any?
A: Yes, but let's remember that caloric needs are highly individual. No matter how complex a formula you use to calculate your "ideal" caloric intake, ultimately it's going to come down to trial, error, and experience.
That said, there are two common methods used to figure out caloric intake when dieting. The first is to take your body weight or LBM (Lean Body Mass) and multiply it by a certain number. For example, multiply your LBM my eight and that supposedly gives you a good number to shoot for when dieting.
The problem I have with this method is that it makes the assumption that all athletes with the same LBM have the same caloric needs – clearly not the case. With this approach, many athletes would severely undercut their maintenance intake and risk losing too much muscle while dieting. Eating too few calories can even slow down the rate at which you lose fat.
I prefer the second method of figuring caloric intake for dieting: take your maintenance level of calories – that amount where you neither gain nor lose weight – and then subtract the necessary amount of calories in order to create the desired energy deficit. Of course, you'll have to know your approximate maintenance level of calories in order to do this and again, that takes trial and error.
How many calories do you drop from your maintenance? Well, I believe that a hard training 220 pound athlete with 10% body fat would have a maintenance calorie intake of around 4200 calories. I've found that a three to four pound weekly loss of adipose tissue is possible while dieting on androgens; therefore, one would have to achieve a 1500 to 2000kcal deficit daily in order to achieve these numbers (the exercise should account for any fat accumulated from the cheating sessions). For our 220 pound bodybuilder, this would be an intake of no less than 2200 calories.
If your maintenance level of calories is below 3000 per day, then subtract 1500 to get the amount of calories you should be eating daily when dieting. If your maintenance level is between 3000 and 4000, subtract 1750 calories per day. If greater than 4000, subtract 2000 calories per day. Once you've figured out your calorie needs, you can find the dietary recommendations for your calorie level below (use your final dieting number):
1500 calories per day and below
• 1-1.25 gram of protein per pound of LBM.
• 10% of total calories should be derived from fat (strictly EFA's) with at least 3 grams of combined EPA/DHA.
• The remainder of calories should be from fibrous, low-GI carbs (with the exception of pre/post-workout supplementation).
1500-2000 calories per day
• 1.25-1.5 grams of protein per pound of LBM.
• 15% of your total calories should be derived from fat (mostly EFA's), with at least 4.5 grams of combined EPA/DHA.
• The remainder of calories should be from fibrous, low-GI carbs (with the exception of pre/post-workout supplementation).
Greater than 2000 calories per day
• 1.5 grams of protein per lb. of LBM.
• 20% of your total calories should be derived from fat (mostly EFA's) with 6 grams of combined EPA/DHA.
• The remainder of calories should be from fibrous, low-GI carbs (with the exception of pre/post-workout supplementation).
Finally, spread your calories out over six meals and adhere to the "Massive Eating" guidelines of never combining carbohydrates and fat (in significant amounts) in a single meal.
Also, keep in mind I'm suggesting you use some sort of androgen when dieting. I used MAG-10. If you're not, then you may need to consume more calories per day. (The use of an androgen helps you diet more severely without the risk of LMB loss.) And remember that these numbers are just a place to start. Experiment and figure out what's best for you.
As for food choices, T-mag has a couple of good articles on that topic. Check out Foods that Make You Look Good Nekid and Lean Eatin' Part II.
Q: Every time I indulge in a cheat meal, all my recent progress gets thrown out the window. Are you sure this approach will work for me?
A: You'll probably be able to get away with cheating more on a severe diet than with a more moderate approach, and for good reason:
1. Glycogen is depleted or near depleted; most of the carbohydrates ingested during the cheating session will be stored as glycogen; as opposed to being stored as fat.
2. The body is longing for something to "jump start" its metabolic rate. It's unlikely that the body will resort to storing a great deal of the ingested calories as fat in an energy restricted, metabolically starved state.
Having said that, an evening of cheating may be too much for some people. In this case, I'd recommend that these individuals limit their cheating to one meal on the designated days. In other words, once you're full, the meal is over; your next meal should be concurrent with the previously outlined diet.
If the above approach is still hindering your progress, then there's yet a third option. The major thing we wish to accomplish while on a severe diet is upregulating serum leptin levels. By doing this, we increase thermogenesis, stimulate the thyroid, and increase BMR. This can be done through a controlled carbohydrate refeed. Here are the guidelines:
1. The meal should consist primarily of carbohydrates with some protein; fat intake should be limited.
2. The meal's caloric value should be triple that of a maintenance meal. For example, if your maintenance calorie intake is 3000, then a typical maintenance meal would be 500 calories (3000/6). Therefore, the caloric value of the carb refeed should be around 1500 calories. This should be adequate to produce a substantial spike in the hormone leptin, thus yielding the physiological benefits associated with such a spike.
Although not as fun as the first two options, a few plates of pasta with meat sauce and grilled chicken can still be very psychologically satisfying.
Q: Do you recommend this diet for individuals with higher levels of body fat?
A: Individuals with higher levels of body fat may or may not be able to get away with as much cheating as leaner individuals can. If you're starting at over 12% body fat, then I'd recommend starting with carb refeeds and gradually progress to cheat meals and then evening cheat sessions as you get leaner. Generally speaking, the leaner you are, the more cheating you'll be able to do.
Q: There's been some talk of priming the system for a cheat meal/session. What are your thoughts?
A: I do recommend that the one or two weeks prior to your cutting cycle be spent at the maintenance calorie level, eating "clean" foods. Also, you may want to skip the first cheating session and extend the cycle an extra half a week in order to allow your body to fully adjust to the severe diet. If your body has not yet adapted to the severe caloric restriction, you'll get sub par results.
Q: Are there any supplements that are beneficial to take in conjunction with a cheat meal/session?
A: Yup, here's a list from Don Alessi's "Cheat to Win" article:
• 14 grams of EFA's
• 200 mcg of chromium
• 50 mg of magnesium citrate
• 1 gram of Vitamin C
Vitamin C should be taken on a daily, continual basis to experience benefits. I recommend three grams, in 500 mg to 1g doses, spread throughout the day. Additional supplements I'd recommend are 600 mg of alpha lipoic acid (ALA) daily, in 100 to 200 mg doses, and an acute 100 mg dose of d-pinitol with each cheat meal/session.
Q: If the cycle was exactly two weeks in length, then I'd be finishing up after my last cheat session? Is that right?
A: First off, the cycle doesn't have to be two weeks in length; however, I believe that shorter cycles will yield greater fat loss in the long run, as they do with muscle gain. Also, it's less likely that you'll overtrain with a shorter cycle.
Secondly, no, the cycle shouldn't be exactly two weeks in length. You should go "off" and increase your calories to slightly below maintenance the Wednesday after your fourth cheat session. This will allow you to fully reap the benefits of your final cheat session.
Q: If I have a substantial amount of body fat to lose, will this diet be safe for the long term?
A: Since the cheating sessions are separated by three low calorie days and tons of physical activity, and each cycle is separated by two to three weeks of "clean" eating, I don't see there being any adverse health effects. However, if you do plan on using this approach for an extended period of time, it's not a bad idea to have your blood lipid levels periodically monitored to be on the safe side.
Q: Are there any foods that are "off limits" during a cheat/meal session?
A: The only thing I recommend you limit is your consumption of fructose, especially in the form of high fructose corn syrup. Since fructose does nothing to replenish skeletal muscle glycogen stores and can easily be converted to fat, it's not something you want to consume a great deal of. Therefore, follow the lead of the hypocritical American and have a diet cola with that double quarter-pounder extra value meal.
Q: Do you have any training and diet recommendations for the "off" weeks?
A: It's fine to continue dieting during your off weeks as long as you increase calories to a level slightly below maintenance (i.e. - 300 to - 500 calories) to prevent LBM loss. As far as training is concerned, if increased muscle tone is your primary goal or if you're prepping for a show, then continue with heavy, low-rep training during the off weeks. If, on the other hand, your goal is to maximize fat loss, then reversing the exercise protocols would be a nice shock to the system. Here's what I mean:
On Weeks
Weight Training Energy Pathway: ATP-Creatine Phosphate.
Tempo: Slow eccentrics (negatives), fast concentrics (positives).
Cardio: HIIT (High Intensity Interval Training).
Off Weeks
Weight Training Energy Pathway: Lactic Acid-Glycolysis.
Tempo: Fast eccentrics, slow concentrics.
Cardio: Moderate Intensity.
The obvious choice to shock your body into burning even more fat during the off period would be to combine something like Meltdown Training with three weekly, 20 to 30 minute moderate intensity cardio sessions.
Q: You said you were using a legal anabolic supplement on your road to 5.9% body fat. What were you using and would anything else work?
A: I was using MAG-10. It's not the only choice out there, but it's the only legal one I'd recommend. This should help you preserve LBM while dieting severely.
Strength-Training Routine
Those of you who read my Ripped, Rugged, and Dense article know that I'm a firm believer in heavy training when attempting to cut up. Many different training programs in the T-mag archives will work on this plan, but below is what I used.
Each exercise should be performed for a total of seven sets with three to five repetitions per set; however, it's not necessary to put forth maximal effort on each and every set. For example, if your five rep max bench press is 200 pounds, your bench session may look like this:
185 x 5
205 x 4 (4 rep max)
190 x 5
215 x 3 (3 rep max)
195 x 4
200 x 3
200 x 5 (5 rep max)
Ideally, your three, four, and five rep max should be separated by sets of lower intensity. There's no standard rule for determining the load for the lower intensity sets, nor should these loads be the same every workout. Each workout should contain three max effort sets, a couple of easy sets, and a couple that are challenging but don't require max effort. The key is to have fun, mix it up, and be sure to select the loads before you hit the gym.
Note: It's not necessary to follow these guidelines with the ab work; five sets of five should suffice.
Casually alternate between exercises A1 and A2. You don't need to time your rest periods, but at the same time don't superset (perform A1 and move to A2 without resting). Instead, take a minute or two between sets. Once you finish, move on to the B exercise should the workout call for one.
Tuesday – Quads, Hams, Back Extensors, Traps, Forearms, and Abs (Rectus)
A1) Wide Stance Squats
A2) Duck Deadlifts
This variation of the deadlift highly recruits the quads. To perform it, place your feet in a "V" position with your heels together and your toes pointed outward. Maintain this foot position during the lift. Don't attempt to keep your knees together; let them bow out naturally.
Note: To increase range of motion (ROM) and put more emphasis on the quads, use 25 pounds plates.
B) Slow Up/Slow Down
Lie back on the floor with your knees flexed to 90 degrees and your feet flat on the floor; don't anchor your feet. Your arm positioning can either be straight out in front of you or crossed on your shoulders. Contract your glutes and slowly begin to curl upward – jerking movements are unacceptable and take the emphasis off the abs by recruiting the hip flexors.
Once you reach the top of the curl, maximally exhale; you should feel an intense cramp in your abdominal region. Continue to hold your breath and slowly lower yourself to the floor; move especially slow during the last six inches of the movement. Your feet are not to come off the ground at any point during the exercise. If the concentric portion of the lift is too difficult at first, do negatives only. Repeat for the desired number or reps
Thursday – Triceps, Shoulders, Lower Chest, and Calves
A1) Weighted Dips
A2) Push Press
Clean a loaded barbell or unrack it from the J-hooks within a power rack; the bar should now be resting upon your upper chest. Dip down into a quarter-squat and then explode the weight overhead while simultaneously thrusting your hips forward, locking out your knees, and rising up on your toes.
Saturday – Upper Chest, Back, Biceps, and Abs (Obliques)
A1) Incline Bench Press
A2) Weighted Chin-ups (palms facing you, intensely contract the biceps for a count of two at the top of the movement)
B) Heavy Weighted Side Bends
Grab a heavy dumbbell; flex your glutes, abs, and pecs and bend at the side in the direction of the dumbbell. Lower yourself until you feel a good stretch in the opposite oblique and the explode then weight back to the starting position.
Conclusion
Getting ripped is never easy, but with a few strategically planned cheat meals and a good training program, it shouldn't be too painful. It takes a little more planning than a normal fat loss program, but in the end your highly visible abs will thank you for it!
References
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2) Douyon L, Schteingart DE. Effect of obesity and starvation on thyroid hormone, growth hormone, and cortisol secretion. Endocrinol Metab Clin North Am. 2002 Mar;31(1):173-89.
3) Dulloo AG, Jacquet J. Adaptive reduction in basal metabolic rate in response to food deprivation in humans: a role for feedback signals from fat stores. Am J Clin Nutr. 1998 Sep;68(3):599-606.
4) Friedl, et al. Endocrine markers of semistarvation in healthy lean men in a multistressor environment. J Appl Physiol. 2000 May;88(5):1820-30.
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7) Kozusko FP. Body weight setpoint, metabolic adaption and human starvation. Bull Math Biol. 2001 Mar;63(2):393-403.
8) Luke A, Schoeller DA. Basal metabolic rate, fat-free mass, and body cell mass during energy restriction. Metabolism. 1992 Apr;41(4):450-6. Review.
9) Mansell PI, MacDonald IA. The effect of underfeeding on the physiological response to food ingestion in normal weight women.
Br J Nutr. 1988 Jul;60(1):39-48.
10) de Rosa G, et al. Thyroid function in altered nutritional state.
Exp Clin Endocrinol. 1983 Aug;82(2):173-7.
11) Weyer C, et al. Changes in energy metabolism in response to 48 h of overfeeding and fasting in Caucasians and Pima Indians. Int J Obes Relat Metab Disord. 2001 May;25(5):593-600.
12) Klein S, et al. Leptin production during early starvation in lean and obese women. Am J Physiol Endocrinol Metab. 2000 Feb;278(2):E280-4.
13) Ahima RS, Flier JS. Leptin. Annu Rev Physiol. 2000;62:413-37. Review.
14) Bowles L, Kopelman P. Leptin: of mice and men? J Clin Pathol 2001 Jan;54(1):1-3
15) Ahima RS, et al. Leptin regulation of neuroendocrine systems. Front Neuroendocrinolgy 2000 Jul;21(3):263-307.
16) van Dijk G. The role of leptin in regulation of energy balance and adiposity. J Neuroendocrinol 2001 Oct;13(10):913-21.
17) Hespel P, et al. Opposite actions of caffeine and creatine on muscle relaxation time in humans. J Appl Physiol. 2002 Feb;92(2):513-8.
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