Glycogen debranching enzyme and progressive muscle involvement, with variations caused by age of onset, rate of disease progression and severity. Patients with Type IIIb generally symptoms related to liver disease. Type III patients be distinguished by elevated liver enzymes, with normal uric acid and blood lactate levels, differing from other forms of GSD. In patients with muscle involvement, Type IIIa, the muscle weakness becomes predominant into adulthood and can lead to ventricular hypertrophy and distal muscle wasting. Glycogen debranching enzyme A debranching enzyme is a molecule that helps facilitate the breakdown of glycogen, which serves as a store of glucose in the body,
Cyclic ketogenic diet goals of a refeed are threefold: The refueled glycogen stores can then be used for higher-intensity training to maintain or increase endurance / muscle mass after the refeed. Normally this sort of training would be relatively impossible on a pure ketogenic diet, as glycogen stores in the body are almost constantly depleted. The refeed process can lead to gaining fat if more carbs are consumed than needed to replenish glycogen stores. The timing, duration, and macronutrient composition of a refeed are crucial to the overall success of the diet. According to a published article in the "British Journal of Nutriton"