This month I want to talk about the latest buzz word in longevity, weight loss and possible brain health…yes you guessed it, FASTING.
In my keen 20’s when living in Japan I experimented with fasting, managing 24 hour fasts every so often and one time, at a yoga dojo just below Mt. Fuji, managed a seven-day fast, all the while doing strenuous yoga and early morning runs. So you see I was a little mad, even in those days.
But things have moved on in the last forty years and all across the world, no longer just in Europe and the USA, chronic non-communicatable disease is replacing infectious disease with remarkable speed, as the major scourge of our time. The two most common conditions I see in practice are Pain and Fatigue.
We know that one of the simplest and cheapest diagnostic tools any one can access is… a tape measure. According to the National Institute for Clinical Excellence (NICE) Men who have waist circumferences greater than 40 inches, and women who have waist circumferences greater than 35 inches, are at higher risk of diabetes, dys-lipidemia, hypertension, and cardio-vascular disease because of excess abdominal fat. Individuals with waist circumferences greater than these values should be considered one risk category above that defined by their BMI. While the BMI, or Body Mass Index, has its problems as a measurement, used with care it can be a quick and simple guide to where one is in the greater scheme of things. To estimate BMI, multiply your weight (in pounds) by 703, then divide by the height (in inches) squared. This approximates BMI in kilograms per meter squared(kg/m2).
All clinicians know how hard it is to achieve significant and lasting weight loss. In fact it is now well-known that, ultimately, most diets end up making you fat! Some weight may be lost in the short-term but can often end up swapping lean body mass for fat over the longer term as the effects of the different diets take their toll. Followed up over time few manage to significantly change their weight unless they find a long-term sustainable way of eating that will significantly reduce their excess weight and at the same time, allow them a healthy and permanent means of doing so. This is hard to do in our dysfunctional food and farming environment. While exercise is vital for health and most soda manufactures will try to shift the focus onto that important area, the great majority of influence on our weight is food, and things like soda, so laden with sugar or other dubious non-foods, have a massive influence on how we link pleasure and food in our brain’s reward centres and hence our health and weight.
Around the time of the London Olympics, the BBC on the 6th of August 2012 put out an interesting Horizon science programme, fronted by Michael Mosley catchy titled, Eat-fast-and-live-longer . You should still be able to watch it on iPlayer, worth your time. Mosley toured the Universities in America interviewing researchers who were digging up interesting evidence on the health and longterm benefits of such high nutrition low-calorie eating.
The evidence seems strong that, for those who can sustain this way of life, the health benefits are enormous. Much of the work has been done on lab rats. Their chow can be exactly controlled, while we, who have free will and both a long genetic programming to eat all the food that we can get hold of, and who, suddenly in meer decades, are surrounded by almost unlimited, low-cost, low nutritious, high sugar ‘food’, cannot be controlled like lab rats. However hard we try, mostly we put on any weight we loose in the subsequent months or years after dieting.
So what to do?
Mosley, was keen not to go the way of his father with diabetes and a premature death, and after tests saw that while not overtly fat, he had considerable hidden visceral fat and poor blood indicators. He looked at all the options. From the strict calorie restriction dieters who manage impressive blood stats but under the kind of life-long eating that few would take to and, for some, seems to verge on an eating disorder.
Professor Longo was able to show that genetically engineered mice could live 40% longer by reducing levels of growth hormone I.G.F.1. This is the ‘go-go’ hormone. With less of this the body has the time to slow down the production of new cells in order to fix the cells it already has so repairing damage. Protein when eaten builds cells but also locks us into the go-go mode and can encourage too fast a growth, leaving no time for repair. Eating less protein and less often seems to help reduce IGF1 as well as the crucial glucose levels.
Dr. Veridy working in Chicago showed that by alternate day fasting, many key biomarkers we greatly improved and people rarely over ate on their ‘feed’ days. Professor Matteson at the National Institute on Aging has shown that intermittent fasting can increase the resistance of neurons in the brain to dysfunction and degeneration in animal models of Alzheimer’s, Parkinson’s and Huntington’s disease and stroke. It appears that alternate day fasting seems to stress your grey matter like exercise stresses and benefits your muscles.
So far it seems that Intermittent fasting causes cellular responses that reduce oxidative damage and inflammation, optimize energy metabolism, and bolsters cellular production. However while it is not for everyone, and more research is needed on humans rather than animal models, it looks encouraging for some as a means to control the spread of all those negative things that tend to kill us, long before our time.
From this experience Mosley, along with Mimi Spencer wrote the book The Fast Diet or 5:2 which has become quite a runaway bestseller since publication. This was followed by the helpful Fast Diet Recipe Book by Spencer alone.
The Alternate Day Diet by Dr. James Johnson has been selling well since 2008 and, along with Mosley’s book, gives both a good background to the important science that is underpinning these regimes, as well as practical advice as to how to successfully pull off the challenging thing of changing such a fundamental thing as what and when you eat.
My own experience in trialing this 5:2 regime over the last year is that is an effective and do-able means of stopping the rot. While I was more interested in protecting my brain, I did loose 6 kilos and discovered a long-lost, ageing six-pack, under my belly, that was hiding there all along. However it seems to be that my love of food is such that I will always have to keep to this discipline if I am not to quite rapidly put on the kilos again as soon as I stop. However even at is worst my own BMI etc. was never too bad. For those with major weight issues it might well be a greater challenge and certainly would take a longer time to see results.
Gastric band surgery seems to be one of the more hopeful, if drastic, methods that may be an answer for those who have struggled all their life with obesity and are now looking type 2 diabetes in the face with all its risks. Certainly, at £5000 it is a cost saving for the NHS saving about £90,000 over the costs of looking after morbidly obese patients with all their raised risk factors and costs to the health service long-term. But it will take another decade or more before we know for sure what the long-term implications for this are, and the fear is that patients will swap one high risk of illness and death for another kind of malnutrition and its ills. Such are the challenges of the twenty-first century. And this is not just in the richest countries, such hazards are pressing down on many countries such as India even while millions still do not have enough to eat.
So if you are interested get that tape measure out and see where you stand. You could do worse than get some of these books and giving it a go. Reducing your intake of food from around 2000 calories a day to 5-600 for two separate days a week seems a gentle and do-able plan for many of us.
Of course making sensible and healthy choices to ensure that nutritional quality rather than quantity is the key at all times is a good way to go. More plants, less meat, especially processed, smaller plates/portions, less sugar and alcohol seem a clear guide that is unlikely to change. But don’t forget to enjoy the food that you are lucky enough to be able to eat.
We live in a country that throws away 20% of all the food we produce/import! Let’s be grateful for what we are given and eat it in a spirit of gratitude, joy and thankfulness.