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Weight loss, Keto Diet and Energy Balance

Ketogenic diet and weight loss

The ketogenic diet was first introduced in 1920 as a treatment for children with epilepsy (Wheless, 2008). As more research was done on the effectiveness of the ketogenic diet, it was reported that the traditional ketogenic diet consisted 1 gram of protein per kilogram body weight, a restricted carbohydrate intake of 10–15 g and the remaining calories in fat per day and the purpose remained primarily as a treatment for epilepsy (Wheless, 2008). When carbohydrate is restricted, the body can go into a state of ketosis, where blood ketone concentrations increase to ~3-4 mmol/L, compared to <0.3 mmol/L with a regular diet (Paoli, Rubini, Volek, & Grimaldi, 2013). In recent years, predominately after the discovery of insulin, the carbohydrate-restricted diet started gaining popularity as a treatment for diabetes (Feinman et al., 2015). In his review on carbohydrate restriction for the management of diabetes, Feinman et al. (2015) defined a very low-carbohydrate ketogenic diet and a low-carbohydrate diet slightly differently. He defined a ketogenic diet as very low-carbohydrate, at either 20–50 g of carbohydrates per day or less than 10% of a 2000 kcal per day diet. He also made a note that while his definition was derived based on the carbohydrate levels required for the body to reach a state of ketosis, because of the variability between individuals, ketosis still might not occur. He defined a low-carbohydrate diet as less than 130 g of carbohydrate per day or less than 26% of total energy.

Using those similar definitions, a review done by Noakes and Windt (2017) summarised the effects of both a very low carbohydrate high fat (ketogenic) diet, and low-carbohydrate high fat (LCHF) on various parameters. In terms of weight loss, the evidence gathered for this review demonstrates that both a ketogenic and LCHF diet can lead to greater or if not equal weight loss compared to the other diets that were used in all studies they reviewed. All the diets that were tested were effective in short-term weight loss but most of the time would be followed by some regain of weight as adherence to the diet was reduced. Their hypothesis was that the weight loss from a LCHF diet could be a result of the advantageous adaptations in the body’s metabolic function such as an increase in the thermic effect of protein, an increased turnover of protein for gluconeogenesis and energy loss through the passing out of ketones in sweat or urine. There have been suggestions that the weight loss from a ketogenic diet is due to the loss of water (Yang & Van Itallie, 1976). However, a study which measured body composition using dual-energy X-ray absorptiometry (DEXA) indicates that the weight loss from a carbohydrate-restricted diet is a reduction in fat mass (Volek et al., 2009).

Energy Balance and diet

According to the principle of energy balance, a change in body weight will occur when energy intake is not equals to energy expenditure over a period of time (Hill, Wyatt & Peters, 2003). When energy expenditure is greater than energy intake, this is described as a state of negative energy balance that will usually result in a loss of body mass, which translates to weight loss. A diet that follows the principle of energy balance is essentially looking at achieving negative balance by reducing energy intake. Using mathematical modelling, Hall et al. (2011) presented that even though the way an individual’s body weight responses to changes in energy intake is highly variable, which can lead to different changes in weight, loss in body fat was still reported in all diets that reduced energy intake in the short run. The effectiveness of exercise on weight loss is also not entirely dependent on the exercise, but on the individual’s variability on substrate utilization as well (Barwell, Malkova, Leggate, & Gill, 2009). While reducing energy intake has shown to result in weight loss, the broad interpretation of a diet that follows energy balance may be less straightforward and fairly complicated when attempting to adopt a diet based on the principles of energy balance for weight loss on your own.

A Ketogenic diet can follow the principles of Energy Balance

A ketogenic diet can be described as a protocol-based diet where macronutrients are pre-determined. A diet that follows the principles of energy balance approach to weight loss is to achieve non-equilibrium, which does not necessarily provide a guideline on the breakdown of macronutrient intake. Due to individual variability in baseline body composition, energy expenditure and substrate utilization, one would need to have some familiarity and/or be in-tune with their own physiological parameters in order to decide the macronutrient breakdown on their own. Even though the principle of the ketogenic diet has been widely explained as a very-low carbohydrate, high fat diet approach, it does not indicate that it does not follow the principle of energy balance. A ketogenic diet can therefore also be a diet that follows the principle of energy balance. It is interesting to note that the study by Johnstone, Horgan, Murison, Bremner, and Lobley (2008) which compared a high-protein, low carbohydrate diet to a high-protein, medium carbohydrate diet, referred to weight loss in both diets as an indicator of negative energy balance. The study by Partsalaki, Karvela, and Spiliotis (2012) looked at the effects of a carbohydrate-restricted diet compared to a calorie-restricted diet because the traditional recommendation for the management of obesity, which is a calorie-restricted diet, seemed to be theoretically based on maintaining negative energy balance. They reported weight loss in both diets, greater for ketogenic diet, even though there was no calorie intake restriction in their ketogenic diet protocol. Evidences cited in the review by Noakes and Windt (2017) also highlighted that a low-carbohydrate, high fat diet is able to control energy balance as well as encourage the intake of high nutrient density foods. With guidelines on the composition of carbohydrate and fat in a ketogenic diet, along with instances of reported weight loss of >10% (Mark et al., 2016), it seems to be the easier and effective approach to adopt.  While it might seem straightforward to implement a ketogenic diet, it still might not be suitable for everyone due to individual variability. Nutrition strategies to be fundamentally based on managing energy balance and ensuring high nutrient density is still recommended (Noakes & Windt, 2017).

Metabolic Efficiency Test at the Sports & Cardiology Centre

Maintaining physique

One way of quantifying physique is with body mass measurements, a full anthropometric profile and somatotyping (Slater et al., 2005). Of the three somatotypes, mesomorphy, which is used to describe muscloskeletal robustness and ectomoprhy, which is used to describe linearity or slenderness (Carter, Carter, & Heath, 1990), both could be classified as a lean physique. Choosing a diet to achieve a lean physique can either be to support the goal of reduction of fat mass or increase fat-free muscle mass.   

As both a ketogenic diet and a diet which follows the principle of energy balance can be as effective in weight loss and helping to achieving a lean physique, diet adherence could therefore be a factor in determining their effectiveness in maintaining a lean physique. It has been shown that there is no increased risk of cardiovascular disease with a carbohydrate-restricted, high fat diet in the short term of 12 weeks (Volek et al., 2009) as well as no adverse metabolic effects on the body nor an increase risk of cardiovascular disease from long term (>1 year) adherence to a low-carbohydrate, high-fat diet (Grieb et al., 2008). Multiple studies cited by Noakes and Windt (2017) also found that there is no evidence or epidemiological data to support the theory that intake of saturated fat is the cause of coronary artery disease. With that in mind, both the ketogenic diet and a diet which applies the principle of energy balance would be safe to sustain long term when adopted safely and appropriately. In terms of attrition rate, three studies cited in the review by Noakes and Windt (2017) reported that adherence to low-carbohydrate, high-fat diets were the same as low-fat, high-carbohydrate diets. A systematic review conducted by Hession, Rolland, Kulkarni, Wise, and Broom (2009) highlight a higher attrition rate of low-fat, high carbohydrate diets compared to low-carbohydrate, high diets, across 13 studies with a total of 1222 participants. A ketogenic diet with low carbohydrate intake has also been shown to be able to reduce perceived hunger, leading to a reduced intake of food (Alexandra, Graham, Sandra, David, & Gerald, 2008). Choosing the diet to help sustain a lean physique could then be down to the individual’s motivation to achieve the goal and their adherence to the diet they have chosen.

When quantifying physique by somatyping, it would be interesting to note that the study done by Silventoinen et al. (2020) found that genetics plays a role on the relationship between children’s somatotype and their physical fitness. It might therefore be worth taking into account an individual’s genetic background and inherited physique when deciding, and evaluating the effectiveness of any diet intervention on achieving and sustaining a targeted physique


Wheless, J. W. (2008). History of the ketogenic diet. Epilepsia49, 3-5.

Paoli, A., Rubini, A., Volek, J. S., & Grimaldi, K. A. (2013). Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. European journal of clinical nutrition67(8), 789-796.

Freeman, J. M., Kelly, M. T., & Freeman, J. B. (1994). The epilepsy diet treatment: an introduction to the ketogenic diet (No. Ed. 1). Demos Vermande.

Feinman, R. D., Pogozelski, W. K., Astrup, A., Bernstein, R. K., Fine, E. J., Westman, E. C., … & Nielsen, J. V. (2015). Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutrition31(1), 1-13.

Noakes, T. D., & Windt, J. (2017). Evidence that supports the prescription of low-carbohydrate high-fat diets: a narrative review. British journal of sports medicine51(2), 133-139.

Yang, M. U., & Van Itallie, T. B. (1976). Composition of weight lost during short-term weight reduction. Metabolic responses of obese subjects to starvation and low-calorie ketogenic and nonketogenic diets. The Journal of clinical investigation58(3), 722-730.

Volek, J. S., Phinney, S. D., Forsythe, C. E., Quann, E. E., Wood, R. J., Puglisi, M. J., … & Feinman, R. D. (2009). Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet. Lipids44(4), 297-309.

Hill, J. O., Wyatt, H. R., & Peters, J. C. (2012). Energy balance and obesity. Circulation126(1), 126-132.

Hall, K. D., Sacks, G., Chandramohan, D., Chow, C. C., Wang, Y. C., Gortmaker, S. L., & Swinburn, B. A. (2011). Quantification of the effect of energy imbalance on bodyweight. The Lancet378(9793), 826-837.

Barwell, N. D., Malkova, D., Leggate, M., & Gill, J. M. (2009). Individual responsiveness to exercise-induced fat loss is associated with change in resting substrate utilization. Metabolism58(9), 1320-1328.

Johnstone, A. M., Horgan, G. W., Murison, S. D., Bremner, D. M., & Lobley, G. E. (2008). Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ad libitum. The American journal of clinical nutrition87(1), 44-55.

Partsalaki, I., Karvela, A., & Spiliotis, B. E. (2012). Metabolic impact of a ketogenic diet compared to a hypocaloric diet in obese children and adolescents. Journal of Pediatric Endocrinology and Metabolism25(7-8), 697-704.

Mark, S., du Toit, S., Noakes, T. D., Nordli, K., Coetzee, D., Makin, M., … & Wortman, J. (2016). A successful lifestyle intervention model replicated in diverse clinical settings. South African Medical Journal106(8), 763-766.

Slater, G. J., Rice, A. J., Mujika, I., Hahn, A. G., Sharpe, K., & Jenkins, D. G. (2005). Physique traits of lightweight rowers and their relationship to competitive success. British journal of sports medicine39(10), 736-741.

Carter, J. L., Carter, J. L., & Heath, B. H. (1990). Somatotyping: development and applications (Vol. 5). Cambridge university press.

Grieb, P., Kłapcińska, B., Smol, E., Pilis, T., Pilis, W., Sadowska-Krępa, E., Sobczak, A., Bartoszewicz, Z., Nauman, J., Stańczak, K., & Langfort, J. (2008). Long-term consumption of a carbohydrate-restricted diet does not induce deleterious metabolic effects. Nutrition research28(12), 825-833.

Hession, M., Rolland, C., Kulkarni, U., Wise, A., & Broom, J. (2009). Systematic review of randomized controlled trials of low‐carbohydrate vs. low‐fat/low‐calorie diets in the management of obesity and its comorbidities. Obesity reviews10(1), 36-50.

Alexandra, M.J., Graham, W.H., Sandra, D.M., David, M.B., Gerald, E.L. (2008) Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ad libitum. The American Journal of Clinical Nutrition, 87(1):44–55. https://doi.org/10.1093/ajcn/87.1.44

Silventoinen, K., Maia, J., Jelenkovic, A., Pereira, S., Gouveia, É., Antunes, A., … & Freitas, D. (2020). Genetics of somatotype and physical fitness in children and adolescents. American Journal of Human Biology, e23470.

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What bicycle should I get?

If you’re looking to start cycling, getting your first bicycle should not be a daunting and mind boggling task. The thought of having to deal with the technicalities might be foreign to you and the preconceived idea that it could be a hefty investment may be a few of the contributors to procrastination. But with a little focus and some support, it could turn out to be something you might enjoy in the years to come. Here are a few things you can think about which can hopefully help you make the decision.




It could be getting your kid started, an alternative mode of transport to work, a form of family activity or exercise, having a clear idea on what you want to use it for helps to get the ball rolling.

Bicycles are usually grouped into 4 broad categories: Road bikes, City/Leisure bikes, Hybrid Bikes, Off-Road bikes. These can be further divided into subcategories, for example, Mountain Bike, Cyclocross and Gravel bikes are usually considered Off-Road bikes. The name typically suggests what the bike is designed and/or should be used for. For example, if you are looking for a bike to primarily get around town, to the shops or to work, start by looking at bikes in city/leisure, road or hybrid category but that’s not to say you cannot consider a Mountain bike either. Whereas, it is going to be very very difficult if you want to ride a full mountain bike trail on a road bike, or complete a Grand Fondo on a city bike.

It depends on how much detail you want to go into. For example, mountain bikes may have a slight weight penalty on the tarmac but the wider, knobby tyres make it easy to get through the narrow drain openings along the park connectors, compared to traditional road bike tyres. The more specific you are on the type of riding you want to do, the easier it is to narrow down the categories.


Then comes a list of other factors to consider: budget, comfort, size, weight, space constraint, durability, aesthetics, after-service. The key is to prioritise and be honest. If you absolutely do not have space in your residence to park a full-sized bike, or if you plan to take it up the trains and buses, folding bikes are an option. We also have to be honest with our expectations. I have had many conversations with people asking me what type of bike they should get to start doing some leisurely rides. Similar to taking up any new hobby or exercise, there will be a change in your existing lifestyle and it can be difficult to predict whether we will stick to it, drop out after a week, or go on to become a regular enthusiast. How much time are you going to spend on it? Where will it be on your list of daily priorities? Do you have a buddy to help get you started? If you already have a particular look in mind, you want the flash, or feel the heavier mtbs or hybrids are too slow (slow is relative and can be a function of not your bike but your fitness level) for your liking, you have to bring those up as well. People tend to leave certain information out for fear of being judged.

Unless it is in your nature to always go all in right from the start or have a bottomless budget, the common and recommended approach is to gradually progress with your equipment. Don’t short change yourself either by starting right at the bottom. The more you spend does not also necessarily mean the better your chances are that you will stick with it. Get out that checklist of criteria and be honest with how much effort you are willing to try.

Everyone should get a chance to have a go at all sports and that includes cycling. Even though cycling has a bit of a reputation for being an expensive sport, if you don’t get sucked into all the flash and glam, you can definitely still enjoy the sport without short changing yourself. Don’t be overwhelmed when you walk into a bicycle showroom. Have a clear idea what you want it for and be honest with yourself on what your main considerations are. Don’t feel shy to ask questions. Speak with someone you personally know who you think has similar buying habits and considerations. If circumstances allow it, try out the bike. If it’s your first bike, it would be a really tricky task of getting it online without trying it out. Nothing is worse than riding a bike you don’t feel comfortable on. Take your time, don’t rush it. When you have decided on one, don’t second guess yourself.

Now go out there and enjoy the ride.

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Training, Coaching, Exercise

The number of exercise and/or fitness programs has certainly increased in recent years. Along with our society promoting greater accessibility for an active and/or healthy lifestyle, it’s so much easier now for someone to pick up a new sport and/or a new fitness regime.

I don’t have the figures, but I’m fairly confident that just based on your social circle, the number of people who is a member of a gym or part of a fitness/exercise group of some sort now as compared to just 5 years ago, has drastically increased.

We all have our reasons for partaking in exercise. Again, with no figures for verification, my assumption is that the vast majority are on the path of active lifestyle or as a social activity, or both. There is the growing minority who have set themselves slightly more tangible goals. It could be an aesthetic goal: to slim down, build muscle etc. It could be a competitive goal: to prepare for a sportive, race, etc. It could be a quantitative goal: to lose or gain X amount of weight, lift X amount of weight, run X distance in X amount of time. It’s easy to transit from one to another to another and back to where you started.

You hear ‘I’m going for training’ being used often. If you have a competitive or quantitative goal, you are training for something. But if you aren’t, you are exercising. Describing your time in the gym or your run session as training to have an active lifestyle can be slightly exaggerating. Your body does need time to adapt to increased physical activity. But I would hardly consider that a training regime.

From 2007 to 2011, I was training to qualify and compete for the Olympics. The goal was crystal clear. So were the short and mid term goals. I fell short of that. To be precise, I was never given that chance in 2011 to attempt for qualification. When I switched to racing bicycles, the goal was not crystal clear and I didn’t have the short and mid-term goals. In short, it was a complete mess. I made the huge mistake of not getting a coach on board, primarily because of the costs involved. I began straddling the line until the grey area got too big that I went no where.

It’s not just about telling your mates that you’re going for training or exercising. Knowing where you are on the spectrum affects a bunch of other factors in your life: lifestyle and diet choices, work and/or study vs life priorities. If you have goals you are working on achieving, and serious about it, I strongly suggest getting a coach on board.

A coach should not only be giving you a training program to follow, you have to trust him/her as a life mentor. There’s much more to do between the ears than most would expect.

There’s now a whole bunch of cycling coaching groups/companies out there. If you don’t know where to start, give Kristján Snorrason, aka Snozza, a ping through his website:


His knowledge and experience in sport, along with his people skills, naturally steers people to put trust in him. Trust that he will get the best out of you, trust knowing that he has your best interests at heart.

After all, it’s still a two way street. There is no template to find out who you trust your personal goals with. But if even we ourselves aren’t sure what they are, no amount of training or exercise is going to get us there.

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Getting back in

All has been on the quiet front here and it’s probably a good time to kick start things again.

Being able to ride my bike has been absolutely brilliant. Another is going back to rekindle an old flame with my first love, rowing. I haven’t got around to getting back in a boat, but the erg has definitely sparked something. They say looking back isn’t particular helpful in moving forward. I do however believe in never forgetting your roots and to always have the people who have stood by you, close to your heart.

I’m excited to pilot Row Revolution‘s technique workshop class, where I will be sharing with you the little experience I have gained throughout the years with all my amazing rowing team mates and coaches, and hopefully help you to row better on the ergo.


Row Revolution, Singapore first and only indoor rowing studio is a great platform to experience and give indoor rowing a go. With 12 Concept 2 rowing ergs, it is also an excellent venue for crossfitters to get in a solid rowing workout with your squad.

Their class timetable is available here. The technique workshop will kick off on 8 May, 2019, at 7pm.

I will also be taking the regular workout classes pretty soon! Ping me if you want to find out more!


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