Fasting for Health, Wellness, and Disease Prevention

I want to start by just thanking Capital Region for having this Community Education room that we can use for this talk and Betty Berenson who works with corporate and community health to really put it all together and my staff – some of which are here today want to raise our hands back there yeah in medicine I trained as an emergency physician and I practiced for twenty years saw a lot of people in acute with acute illnesses that would come into the ER but many of those were based on chronic illnesses that they developed throughout their lives right and and what I recognized is and this is really the the focus of my second kind of part of my career in medicine is that many of these are preventable the things I was seeing in the ER much of that's preventable with the right sort of nutrition and it's really interesting these days and this is about the faceting it's not just what we eat and we're going to talk just briefly today about what to eat what science tells us but it's really about when to you as well and the power the power of of when to eat Thanks so why fast historically we facet because we had to food was limited right there were times over there was plenty to eat and there were times in the winter or other other times where there was famine and there wasn't any food heed we necessarily had the fest so the human body the human physiology adapted to that and it turns out that we're good at it and we actually need fasting as you'll see to really be in our prime and our best health we also fasted because of religious traditions you know when people fast there's a there's kind of a deepening of thought and it can intensified it's actually kind of can it create some kind of an altered state of thought a bit that can intensify religious experiences and spiritual experiences of course we fast to lose weight I think it's the most common reason people fast it's one of the most powerful strategies in weight loss and it's there to help treat medical conditions fasting around the world in places like Russia and Germany and Europe fasting is used for many things like chronic liver disease it's used for hypertension where they may fast somebody seven days on a low calorie just 300a for seven days twice a year to treat their hypertension they may use it to treat multiple sclerosis which is an autoimmune condition well though we're they'll use a fast of seven days low calorie about 300 calories a day which is very low to treat multiple sclerosis and they may do that every quarter so every three or four months and they it helps to reset the immune system it helps to reverse and turn around diabetes it's really very very powerful and its really it's it's really more than just for weight loss of medical conditions it's really about improving health span and I'll talk to you about why that is why how fasting actually helps us live longer stronger we're going to look at the science behind fasting and you know human tradition it's certainly been a part of that for a long time but now the science is catching up to why it works so well it helps to really promote tissue rejuvenation and repair and calorie restriction I'll show you some great studies in monkeys and other animals that it really increases lifespan but also that health span that is more life in the years we have and the importance of circadian rhythm health how when were when our sleep cycle and our eat cycle is coherent that our body works better in many ways we really need to be on for energy during the day and our body needs to be off in our liver and our pancreas and our GI tract really needs a shutdown at night so that we can repair the whole body well look at the types of fasting and I think many of you have heard about fasting thought about fasting in the last couple years because it's really in the public sphere these days right it's kind of a zeitgeist where people talk about things like intermittent fasting has anybody heard that term yeah and that's a nebulous term really because it means that you might fast intermittently you might skip lunch or you might skip breakfast or you might skip food for a whole day for example so that's intermittent and a more useful term these days is something called time restricted eating where we decrease the the window in which we eat during the day so we might eat in an 8 or 10 hour window and fast overnight for save 12 to 14 hours something like that and it's that that creates much of the benefit and I think a time restricted eating I think about when someone you know you the cook or the mom or whoever takes care of the food at home how they they kind of shut down the kitchen and even me they put the dishes in the dishwasher clean off the the counters and and it kind of cleans things up for the next day right well that's what this time restricted feeding does on a nightly basis for us to help our body repair and rejuvenate when we think about more prolonged fasting we think about more prolonged fasting it can be something like a water fast is really challenging certainly people do it for three days five days seven days or even longer honestly it can be done and then there's the fasting mimicking diet which is a way to do that that is too too fast for a longer time while you're still having some calories and it's going to make it very workable and I'll talk to you about that the end but when I think about these more prolonged fast what I think about is not just cleaning off the counter and putting the dishes in the dishwasher I think about cleaning out the pantry cleaning out the cabinets and maybe even cleaning out that refrigerator too and you might do that every quarter or twice a year to really kind of help restore your cells challenge your body to go in and and move out some of the cells that aren't doing their job help some of the cells that need to be repaired repair over that time and to reboot the system these longer fasts are really powerful for that we'll talk towards the end about safety considerations as well and I'm gonna take a drink of my carbonated water not a Coke so I really do try to do my best to model the behaviors I teach and and I do I do love the teacher I'm so glad you're all here today you had a question Liz yes I want you to hear can you turn it up in the back it's up as high as it goes I'm gonna put this a little higher how's that better great yeah thank you so this is an inscription on a pyramid 3,800 years BC and it said humans live on one quarter of what they eat and on the other three-quarters lives they're doctors so that was a sage of antiquity that came up with that and then modern sage said this a little starvation can really do more for the average sick man and can the best medicines and best doctors you know I think there's real power to that I might take a little exception to it but there is immense power to fasting folks you will see as we go through this this is the cover of The Economist magazine and and I the this is not meant to offend anyone and it's not meant to say that people that have obesity I think that that the food environment that is the United States of America in 2019 is toxic and I'll show you why that is why it's really the the food environment is one that creates obesity and in fact since 1970 obesity has tripled diabetes the most costly medical condition in in American around the world these days has went up Sevenfold cancer continues to increase Americans are eating three to four more calories every day so you know a pound is 3,500 calories so if you're gonna lose a pound over a period of a week or a couple weeks you have to decrease your intake by 3500 calories now get this if humans are eating Americans are eating three to four more calories than a day than they did back in 1970 then every 10 days they're going to gain a pound and in fact the average American now is about 35 pounds heavier and they were in 1970 and the bad news is is throughout the 20th century lifespan increased and in the 21st century lifespan is decreasing this is a touch a touch good environment two million years ago until until 1900 food was scarce fasting was inevitable activity was abundant 1970 till present food is abundant feasting is almost inevitable and activity is scarce a researcher from the Salk Institute such as panda developed a program in some studies where he has people take a cell phone picture of the first meal they eat and meals throughout the day and then at the last meal of the day and he finds out that the average American is eating 15 hours a day and that is virtually from the time we open our eyes until the time we close our eyes at night this graph talks about this and shows it in more detail the Green Line is the amount of calories we are eating and the change in calories in the last 50 years the blue line is the percent of ecity in our country down here and the green line we were eating about 2,200 calories a day on average in 1960 over 2600 calories a day now 363 calories so that's one pound for American every ten days and what they can gain obesity was at about 12% now it's over 30% so how can we move the arrow back that way there's really only one only one way there's only one way we need to calorie restrict we cannot eat as much as we're eating this is this is the standard American palate this is the food right and this food is hyper palatable you know when Lay's potato chip said you can only just eat one you can't only just eat one they were you know they knew they knew the science behind it that the that the that the carb that the crunch that the salt that the fat was hyper palatable that means human beings have a hard time staying away from it the heart high-carbohydrate food is danger is is it's not helpful for us and I want you you know I'm not going to spend very long today talking about the quality of the food but this is very very important high carbohydrate food particularly processed carbohydrates so when we you look at their we're talking about the crust in the pizza we're talking about the the the week that's in that bread that's the bun there we're talking about the potatoes these are carbohydrates that are rapidly digestible rapidly digestible drive our blood sugar up very quickly increase our insulin in insulin increases obesity and fat storage in fact these foods could not be designed any better for humans to gain weight on these foods could not be designed any better and liquid calories they're really deep it's really dangerous but it's the processed carbohydrates I want you to look at these foods the chips the potatoes the breads these are not foods that humans evolved on these are not healthy for us and these are the foods that's caused this surge of obesity and diabetes in our country out of Harvard David Ludwig his book is called always hungry he's a famous researcher in this area and at Harvard now they have something called a carbohydrate insulin hypothesis and what that says is when we eat these carbohydrates it drives insulin insulin drives hunger and it drives at a paucity it's the insulin and it's the carbs that drives the insulin so the way we need to do this is we need to really limit processed carbohydrates and that's what I said early on about folks that have obesity it's we're designing to put on weight when we eat that sort of food this is the real food pyramid lots of veggies beans and lentils fruits less fruit if you're a diabetic meats fish poultry and eggs whole fat dairy whole fat dairy not low-fat dairy nuts of all kinds lots of oils particularly olive oil avocado and very few sweets the sweets are at the bottom and notice breads aren't on there cereals aren't on there this is the this is the diet that creates the healthy response of our human metabolism the most common way we lose weight in America now is by fasting that is we're just gonna eat a little less we're gonna calorie restrict there are other diets there's the low carb diet the keto diet etc etc but the most common one in the u.s. and 2018 is fasting one of shift gears a little bit here I want to talk a little bit more about this concept of health span lifespan and how we age the greatest risk factor for all of these chronic diseases from osteoporosis to diabetes to macular degeneration to arthritis the stroke is aging and and that may seem so obvious that it's silly but it's not because now we know in medicine is that if we can slow down the aging process we can slow all of these things and the way we do that is by using fasting and in a therapeutic way to lower our calories have a lower carbohydrate diet but it's using using this in great studies are going on around the country on this idea of slowing down the aging process – to put out – to make it so that these diseases of chronic illness are late life and I want to show you another curve that helps us understand that better so this is the lifespan healthspan curve the average American lives about 79 years the average health span is 63 years so at about 63 years most Americans are going to have some significant chronic illness that's going to slow them down so what we want to do here is I want you to look at the healthspan curve versus a lifespan curve the health span is the one on the right and and so typically we decline and we get a lot of these chronic diseases but if we can push those chronic diseases off longer our healthier years we may not live a lot longer and not longer at all but when we live we're gonna have more life in our years because we'll have less chronic disease and that's the kind of idea is that you're out in the field at ninety you've been working all day and this happens if you know you go to bed that night you don't wake up the next morning rather than having chronic diseases that slow us down send us to the doctor off and create a lot of need for medication pain suffering etc this can really be impacted so this is the lifespan down there and that's the health man that we want to improve so what improves health span we know that nutrition does we know exercise does we know that good deep sleep knows we know that social connectedness does we also know a calorie restriction reduces all of these chronic illnesses like diabetes arthritis cardiovascular disease osteoporosis delays and our delays the loss of our cognitive abilities delays muscle loss muscle is very important for us as we get into our older year so that we can get in and out of chairs and don't slip and fall in these sorts of things protects our colon calorie restriction does delays brain atrophy and it lowers cancer occurrence and cancer progression calorie restriction as all of this we know in studies starting in the 1930s that when we calorie restrict the animals like yeast in worms and mice and monkeys that they live longer sometimes 1.5 times longer and they live stronger they had less chronic disease let me show you a very striking picture on the left is a monkey that ate the standard monkey Chow over a 20 year study this is a very famous Wisconsin monkey study where they they broke the group into two the one portion of the group at a standard child they ate what they typically would eaten ate as much as they would like the monkey on the right got 70% less calories sorry I said that correctly got 30% cut less calories so they had 70% of the typical diet and that monkey his coat is thicker his skin is better his muscle mass is better in fact he and she lived longer what they said is after 20 years 50% of the control animals animals on the left survived as compared to 80% of the ones on the right and in fact when I went to the fasting the first international fasting conference at USC in the beginning of November was very interesting the researchers from this study the University of Wisconsin were there they still have some of the control of the the calories restrict animal are still alive they're in their 40s these monkeys don't typically live that long and they had less diabetes less cancer less heart disease and less brain atrophy of power of calorie restriction so much power that we're seeing it being used around the world and this guy is part of the calorie restriction Society and he would typically eat as a man 2,500 calories a day but he reduced his calories to 1,800 a day and many of his friends and colleagues in that group and they're trying to live their life that way we know calorie restriction in humans decreases chronic disease we don't know if it's going to extend life yet because if you know humans live too long and we just haven't had that much time to study it but we do know that the studies are ongoing now at no less than Washington University in st. Louis and they're doing a study and I think is kind of an interesting name to the studies called cronies calorie restriction for optimal health at Washington University so this has caught the attention of major institutions around the world this is a picture of the calorie restriction Society now the problem is is that this guy wasn't able to stay in the society because he couldn't do that so you know very few people are gonna be able to live their life I think with 70% and 30% less calories 70% of their normal calories I don't think it's going to work for most people so what I need to do today and in my clinic when I teach people how to prevent and reverse some conditions I need to teach them ways to use the benefits of calorie restriction and make it workable in their lives and we have some of those answers for you today let's talk a little bit about the physiology and biochemistry of eating you know when I say the word biochemistry I know that some of you are going this isn't gonna be a little too complex and I also know that some of you are medical care professionals so it's not going to be too complex for you at all I will tell you that everybody everybody here is gonna go home with good ideas whether you had biochemistry in college or not so don't worry about it there are three macronutrients carbohydrates fat in protein and those create the energy and the building blocks for our bodies to do its work when we fast what our body does is he goes to our fat stores maybe the abdominal fat stores that many of us have or around our subcutaneous fat stores and it uses those for energy it breaks them down in the liver the liver is so important here and create something called ketones ketones are small portions of the fatty molecule it's actually a two carbon molecule that is the energy currency for the body just like a some automobiles can run on or trucks can run on you know gasoline or diesel they can flip the switch right they can do run on different so what the secondary fuel for you in beings at least now anyway is is fat and we use we burn ketones and it turns out that ketones are very important for energy but they have much much more to add for us and most of us most of them most of us in this room hardly ever ever break down fat to make ketones so we know that ketones create energy we also know they facilitate weight loss they decrease the risk of cancer by talking to our DNA and improving our immune surveillance of our white blood cells they increase brain health when ketones go up the brain likes it and creates a chemical called brain derived neurotrophic so that's brain derived miracle-gro it's something that really helps the nerve cells in the brain you stronger and actually reproduce when we start to burn fat and create ketones in our blood it lowers our hunger isn't that kind of paradoxical that it would change you would think it would make us more hungry when we're fasting and having ketones go up but the ketones lower our hunger and then they they flip this powerful metabolic switch when ketones go up the whole game changes in regards to health and repair and it turns on a process called Auto Fujii and a tough aging means in Latin it means eating oneself so the body goes in find cells that aren't doing their job that are that are in ill repair or just not working as well senescent there are older cells and it either fixes them up I put a new carburetor in and giving them a tune-up or it just built it just takes them and takes their raw material and puts it into other cells this is the process of autophagy and ketones make that happen so it's a cleaning up a cellular renewal and revitalization of the human so when we're fasting obviously we're gonna have less energy going into our body less glucose and protein and fat and when we have less of this calories ketones go high and to other growth hormones that actually help increase the risk of cancer go down something called mTOR and igf-1 insulin-like growth factor-1 so to go down and one go up the two that go down are the ones that cost cancer the one that goes up is the one that helps for cellular repair and revitalization that's a toughie G cell recycling cell repair cell renewal and the body is so wise that it knows which cells need that repair which cells aren't keeping up with their duties which cells are kind of broken down which cells need to be repaired in all aspects of our body from our brain tore skin to our gut to our red blood cells to our white blood cells this is a little bit of a complicated slide you can this is two days worth of eating for a for a normal human being the standard American diet starts at 12 a.m. one day 12 a.m. again in the middle in 12 a.m. at the end at the top those little blips or when they eat say it you know eight o'clock and noon and 6 p.m. or something like that and then a snack at night so you see those blips during the day then you see the time during the night when they're not eating and then you see the blips again at the bottom you see the ketones notice that ketones are low you they don't go up at all because that person is so fed by eating that 14 or 15 hours a day never does the body fast long enough to need to go to the body store fat to make ketones so this is a with intermittent fasting where this individual did fasted for a whole day had water that David took in no calories and so there's no blip in the glucose or that whole first day and then you can see the ketones go up can't you so after about 10 hours of fasting the body's ketones go up and that starts to flip that powerful metabolic switch turn on the ketones that are great for the brain great for cellular repair and renewal that's by fasting just one day so that's a great thing and you can do that once a week or once a month and and that would be good for you now this is something called time restricted eating and I think this is really foundational way to live because if we compress the time we eat into about say 10 hours a day every night will fast for about 14 hours and that's what you see here they fast long overnight and through the night the ketones go up and then they have their meals in their window of about 10 hours or 11 hours and they fast through the night the ketones go up so every night they're taking advantage of this powerful metabolic switch these processes that are dual driven by ketones to call the cells that aren't doing their job on our body try to repair them if not just completely rework them and to rejuvenate the body on a nightly basis this is one of the big things you should go home with the power of time restricted eating so typically about types of fasting we know that calorie restriction is what somebody does when they want to lose five pounds before they're you know some some upcoming event so they'll just try to eat less every day for two three four weeks and they'll lose some weight so their calorie restricting and I talked to you about that more powerful calorie restriction as well and then there's the intermittent fasting where you skip a meal or skip up skip food for a whole day we know that say for most of us to do and it's a great way to to really to have some advantages time restricted eating is where you eat in that more limited time period say 10 hours a day and have the fastening of 13 or 14 hours overnight and noticed that there's no caloric target so I'm not saying Oh decrease your calories I'm saying eat what you normally during that time be thoughtful hopefully lower carbohydrate nutrient dense and colorful and wonderful in all those ways but it's not specifically eat 2,000 calories or 2,400 calories and no counting of calories here and then there's things like water fasting and we've talked about how that people certainly do that I'll bet you some of you in the room have done done that for a day or two at some point in your life and there then there's the fasting mimicking diet and this is a more prolonged fast it's five days long and you're allowed to have 800 calories of food a day and when you use the fasting mimicking diet it turns on ketosis that development of those ketones in a big powerful way this is what I talked about not just cleaning off the counter and the dishwasher but cleaning out their fridge in the pantry in regards to rejuvenating the body it's very powerful it's a fasting or their their numerous from weight loss to Lourdes glucose to decrease cholesterol to decrease risk of cancer the lower inflammation enhance brain health testing has many many many powerful benefits okay we're gonna turn their clock here and talk a little bit about how the circadian rhythm plays into all of this if our circadian rhythm is balanced we all know this you know if you're sleeping you get a good night's sleep and you're kind of on the same rhythm your going to bed at the same time getting up at the same time you're gonna have better sleep better mood turns out that your blood pressure will be better to that your hunger will be less when a human being wakes up after only three or four hours they're much more likely to have higher hunger particularly carb carbohydrate cravings you've may experience because you kind of you're kind of low on energy what can I do to get me going you know it's some coffee in something sweet right when our circadian rhythm is balanced we repair ourselves better we have better immune function or white blood cells work better when our circadian rhythm is chaotic we're not getting the sleep or were sometimes we're up half the night and the next time we have to get up early the next day many things are compromised sleep mood blood pressure alertness decision-making reaction time cellular repair so the circadian rhythm is very important this looks at it some so we know for example that our digestion is best at noon and in some cultures they eat their largest meals around noon some of you may do that in your own lives right now because you've kind of figured that it works better for you insulin a hormone that helps us process our food in important ways helps us use our food for energy because one of the things it does is if we're busy and active during the day and we eat a meal it's gonna make that insulin excuse me the glucose that we eat the sugar that we go into our muscle so we can do work right so insulin is very effective about noon hunger is highest about 8:00 p.m. unfortunately and fat storage insulin stops working very well and fat storage goes up at night so you're much more likely the meal that you have at night after the Sun Goes Down is much more likely to end up as visceral adipose tissue we call that VAT visceral visceral adipose tissue the fatty tissue that's in and around our organs and that fatty tissue that visceral adipose tissue is an angry fat it causes inflammation in our blood vessels and our brain increases the risk of diabetes it increases the risk of cancer it turns out that many other things hormones and other parts of our body worked better at certain time today like her livers better in the middle of the day our microbiome the bacteria that's in our gut actually functions you know it's not just bacteria in there it's a it's a part it's another organ system for us and it works better during the day and it actually shifts at night when the calories are low and some of the byproducts that our microbiome makes helps us sleep better so when we don't feed it at night it allows us to sleep better and when so there's all sorts of things that when they're in coherence in regards to the light-dark cycle so if you're eating when the light is of the days there your body is going to be able to accept that use that for energy and if you're eating at night when the Sun Goes Down you're much more likely to store that as fat and you're much more likely to create diabetes in yourself some very interesting studies in the last few years about cancer occurrence and when we eat so not what we eat but when we eat so shift workers have been found have an elevated risk of cancer here's another study these are this is a study in nurses that one of the most famous studies in the world the Nurses Health Study it's a it's a national treasure for the US it's been going on for more than 40 years and we have some nurses in our Hospital here that are part of the study actually they said that rotating nightshift work was associated with a higher risk of breast cancer in particularly in women who did this early in their lives this is a study out of Spain fasting two or more hours before bed decreased the risk of breast and prostate cancer by 20% just fasting two hours before bed so that we can start to align our circadian rhythm with our food and food intake as well we know that light really sets our circadian rhythm the bright light in the morning turns on a lot of these processes and wakes us up it turns on digestion there's all sorts of things helps our athletic performance we also know that food is involved here as well so there's a there's a pacemaker in the brain in this area in the deep center of the brain that's called the well it's the circadian pacemaker and both light and food affect that and when they're in sync we have better athletic performance we have better sleep we have lower blood pressure our liver functions better we talked about the gut there in the microbiome so many things work better when these things these two factors heating when we eat and when we're exposed to lighter and sink and you know the thing for many of us these days is were exposed to blue lights at night and you know about you know TV screens and our cell phones and our computers that that blue light disrupts our circadian rhythm decreases the the elevation of melatonin that would naturally happen when the light goes down at night so be careful about that and try to make those kind of changes in your life as well this is a state a lot of studies in medicine on mice they're not little human beings but they do give us some information about physiology there that many things are very similar nicer excuse me mice mice are nocturnal animals so their day is the night so they're up and active at night in this study they had two groups one group they fed they fed during their usual active time their night time in the other group they fed during the day they fed them the exact same amount of Chow the mice fed in the misaligned way through their circadian rhythm gained significantly more weight on the same amount of Chow so this really fits with what we're saying about eat when the light is shining the best that you can this is a study in human beings in 2015 the National Academy of Sciences and what they found is in human beings when we feed them in the evening when they get more of their calories in the evening their blood sugar levels are higher their insulin is higher and remember insulin is a hormone that actually increases our risk of fatty deposition and also the cancer the blood pressure was increase in they didn't sleep quite as well by eating at night this effect was much larger than expected they said and so back to eat when the natural light is shining the best you can at least most of your food so this is a talk a little bit more about time restricted eating really what I think is the foundational way that human beings should eat most of the time to promote good health and cellular repair in their body so your first meal may be at 8:00 a.m. and your last meal at 7:00 p.m. that doesn't sound too difficult and that would give you 13 hours of fasting overnight and 3 hours of fasting before bed and we know both of those are very helpful and again no specific caloric intake so we're not counting calories we find that when people do this that their metabolism is better their cholesterol is lower their blood sugar is lower their insulin is lower they increase visceral adipose tissue burning which is kind of a atm for energy in the body this fat around our organs they decrease fatty liver disease and that's the most common reason these days for people who have liver failure in lower inflammation and it leads to natural ketosis every night it's okay to drink things like water tea black coffee etc and it turns out actually just a study that was just reported from the University of San Diego San Diego that if you're fasting overnight and you decide to have maybe put your break breakfast out a little bit if you have some black coffee in the morning just a good cup of black coffee it doubles the ketones in your body within the next few minutes so yeah so tea may not have the same benefit of coffee but you can we know that teas have great benefits somebody asked about what about tea and so non-caloric beverages of course you should drink you don't want to become dehydrated so much it's about shutting down the kitchen overnight so that you can repair now the other cool thing about this is that the benefits are seeing in human beings and animals if it's just done five days a week so you know on Wednesdays or something you get you have a time where you're gonna go up with girls or over the boys or you want to go with your family and have dinner late well go ahead and do that you know it's not about being rigid it's about finding ways that's what I really want to do in my clinic is help people find ways to make being healthier and preventing illness easier and workable and solutions for that this is another mouth study and this kind of shows about this okay so the top panel there start with obese mice and give them the standard American Mouse diet and let them eat ad libitum that means as much as they want is you know all day long all night long and they get even more obese but if you time restrict them in to about a nine hour window a day they become fit don't change their calories or what they ate they're still eating the mouse diet and then the second panel here start with a lean mouse and they get the standard Chow and high-carbohydrate and maybe some liquid calories and they can eat anytime they want ad libitum they become obese but if the timer struck them they stay lean and fit and if you do the same sort of thing and let them party two days a week on the weekend kind of stay off get off their schedule a little bit they still stay lean and fit so this is what we see in human beings too so time restricted feeding that means eating in a window of nine to twelve hours probably nine or ten is best for maintaining weight and becoming healthy if you really want to lose weight you might constrict at two four or six hours a day if you really want to lose weight you might many days eat from noon to six okay but the really to optimize good health it's that nine or ten hours in of a window something like that we know that it decreases obesity yes yes so time restricted eating is a is a great way to stay healthy in general so have you know fasting 13 or 14 hours overnight is good and foundational for most of us we should do it I I don't like to use the word should but it's healthy for us to do that most nights if you want to lose weight you you want to intensify or narrow that window even further and you might eat for example from noon to 6 p.m. or from 10:00 to 4:00 or something like that so a more narrow window it's even more powerful for weight loss I think so thank you for that question so even when we're not eating great food and I know that after our talk today you guys are gonna go eat nutrient-dense colorful wonderful low carbohydrate food right not processed but even even when they were eating pork chow they still did much better if they time restricted and it even works if it's interrupted a couple of days a week for example the weekends this looked at a more intensified time restricted eating pattern from 10 a.m. to 6 p.m. so that's 8 hours of eating during the day over 12 weeks these individuals lost 3% of their body weight and their blood pressure decreased by 7 points and decreasing the blood pressure by 7 points is about as effective as one blood pressure pill so that if they were on blood pressure pill they could probably come off one so this is time restricted feeding but using what we know about the circadian rhythm and that is if you do it earlier in the day and that can be a challenge for us I know that if you do it early in the day it's even more effective so if you start your first meal let's say you know 8 a.m. and you're done by 5 or start your first meal at 7 a.m. when the Sun comes up and done by 3 or 4 it's even more powerful and again benefits are seen at just 5 days weekly this is a study where they looked at obese women with diabetes or prediabetes and there were two groups the first they they were all on a calorie restriction diet so they had a total of about 1400 calories a day in the first group they had a small breakfast 200 calories a moderate lunch and a larger dinner 700 calories for dinner in the second group they flip-flopped it the big meal was in the morning so they were more in sync with their circadian rhythm and they did much much better greater weight loss smaller waist circumference lower glucose and insulin lower triglycerides less hungry while losing weight and increased fertility and I tell my women that talk to me about how to enhance their fertility eating a big breakfast smaller dinner enhances fertility we see that so the old adage to eat breakfast like a king lunch like a prince and dinner like a pauper is really right and if you do that your shape might change from left to right there okay when when people do this time restricted feeding they feel better they sleep better they have less reflux they have better cholesterol they have less inflammation all of these things I see in my clinic over and over and over their health gets better this is such in Panda and he is a professor at the Salk Institute and many in this room know about the Salk Institute because of the polio vaccine in the 1950s came from there and they've had a few other Nobel Prize winners he just may be one of these he's a major researcher on circadian rhythm and health and he's got a terrific book out called the circadian code don't have this book listed but many of you probably know dr. oz and you might remember dr. Rosen that used to work with dr. oz dr. Rosen is the chief wellness officer for the Cleveland Clinic and he's got a brand new book out it's called what to eat when what to eat when dr. Rosen ah Rosie ien fabulous book this has this concept of time restricted eating game fat fasting is not a fad this is this is about linking the way we eat the way we live with what we know about optimal human health and physiology and and we're starting to get it and really understand it and we're starting to get it out to all of you so that you can use it in your lives and and and tell your friends about it too family members so what about breakfast skipping is it okay I mean I heard that that's the best most important meal and better eat your breakfast right I'm sure that most of you know that is a kind of a I don't know cloak will is amore a wisdom out there and so studies show that people that don't eat breakfast tend to be heavier they tend to have more high blood pressure pre-diabetes further studies showed that well these breakfast skippers tended to have donuts for their morning snack and then very recent studies show that there in fact reck Fitz breakfast skippers have no change in obesity no change in hypertension no change in pre-diabetes unless they ate their dinner late so it's okay to eat your breakfast late say at 10 a.m. and eat your dinner early in fact some of my retired semi-retired folks do that they have two meals a day you know the cool part about that you only have to clean up the kitchen twice right and and and you eat two great meals and but you do it a little later and a little bit earlier and you may have that coffee in the morning if you're a coffee lover like I am and that'll increase your ketones too and it's interesting it's okay to go exercise well while fasting it's okay to go exercise there's there is no as long as you're well hydrated right Izzard you know you don't go in there you know dry and parched but it's well hydrated it's just fine exercise fasting in the morning and I want to teach a little trick about in meal timing glucose levels this is very simple this is in the American Diabetes Journal 2015 glucose levels blood sugar that is was decreased when vegetables and protein were eaten first before the carbs well what happens when you go to a restaurant or what happens when you go out to a Super Bowl party you're gonna eat the chips first or maybe the bread right and so the that the take-home point here is eat the bread last if you're gonna have it a really you know this sort of highly process you know fine powdered red it's not good for us anyway but if you're gonna have a you know if you're gonna enjoy a wonderful snack it's okay to have a little bit of a sweet after meals and when you've got the protein in there in the and the and the fats in there and the vegetables already in your system you don't get a big surge of glucose like you would you know your body it's hard for people to really get this you know you think that whole wheat bread is good for you well whole wheat bread is ground into a fine powder and then it's made into bread our Cheerios all we owe it's our grind into a fine powder and then made into a know when those hit your stomach they go and they liberate their glucose immediately right so there's there's there's problems with these in the way they they absorb so your body doesn't know any difference between a bowl of cereal and a bowl of sugar below the neck so you might taste a little different when you crunch it in your mouth but the way your liver and your pancreas and your organs and your bloodstream and your blood glucose feel about it it's the same as sugar this is I think one of the most powerful studies and it brings it all home Journal of the American Medical Association oncology so a very esteemed Journal April of 2016 the title is prolonged nightly fasting and breast cancer prognosis so this study was done with 2,400 women in San Diego with breast cancer they were followed for seven years half the women were asked to fast overnight for 13 hours and three hours before bed five nights a week so you can see where these human studies are now really using this data these women had a 36% decrease risk of recurrence of their breast cancer by doing that simple thing not changing what they ate but when they ate this is fabulous medicine research we can all use this now if you think this can help a woman that has breast cancer and I hope it helps anybody that you know that might have breast cancer and I don't think it's out enough I don't think enough people know about it but if it helps prevent the recurrence of breast cancer in women what do you think it does in regards to preventing the old currents ever of breast cancer or other cancers or other cardiovascular diseases in men and women this pattern they had a 22% decreased risk of dying for any cause in those seven years and women that ate pass it over 913 hours in three hours before bed and by the way when they were tested their cholesterol was lower there were average blood sugar the a1c was lower they had less reflux and they had better sleep wow what what about those side effects side benefits right this powerful stuff really really really powerful stuff so we know that calorie restriction helps with weight loss but it helps all of these other things and we know we can benefit from calorie restriction by using time restricted eating most nights now I want to shift to the fasting mimicking diet in the power of that and how we can do one of these more prolonged fast the ones when we're gonna clean out the cupboard in the fridge and everything else for five days and do it in a way that's really livable for people this is doctor Valter Longo he is a young guy but he is an esteemed professor on both sides of the Atlantic Ocean at the University of Genoa and the University of Southern California and he developed this fasting mimicking died after do in many many years of research and longevity it's 800 calories a day of a vegetarian diet five days in a row vegetables fats and fruits it has to be low sugar and it has to be low protein it very powerfully turns on not tofu G that's cellular renewal and it activates stem cells so we know that our body has stem cells so when a piece of cartilage breaks down or a blood cell needs to be renewed or a skin cell needs to we use stem cells in our body to renew those cells and when we're young we have all sorts of stem cells so we heal really quickly when you do the fasting mimicking diet for five days and if you're healthy you might do it once a quarter or once or twice a year when you refeed on those days after the fifth day so six six day and seventh day an eighth day your body stem cells are so high you remarked that they're about the same as a three-year-old in regards to cellular renewal this fasting mimicking diet helps promote cellular cleaning it reduces weight particularly visceral adipose tissue and the folks in my clinic and we've had many many people go through our clinic to do this fasting mimicking diet they always tell me that they their belt cinches in a couple more notches after they've done the fasting mimicking diet and it decreases these abnormal growth factors the igf-1 and other things that are implicated in disease in cancer so the fasting mimicking diet helps to normalize glucose in pre-diabetes and I want to just stop there a second do you know that that as I mentioned diabetes is the most costly medical condition in in the United States and probably around the world now do you know that diabetes adult onset diabetes is preventable anybody know that well I'll tell you that it's not only preventable but it's reversible and in the integrative clinic we've reversed people's diabetes over and over and over again and the way we do that is we go to the foundation how do human beings need to eat they need to eat it a nutrient dense low carbohydrate real food diet and they need to time restrict we need to bring down their visceral adipose tissue and their hemoglobin a1c goes from eight point three to seven point nine to seven point five to six point five of five point three it's real it does happen I see it over and over and over and it's not managing it like the American diabetic Association says the management take your medications go ahead and eat like you like you know go ahead and eat like you have been that's not the best way to do it it takes a little bit more effort but I think that so many people don't realize that it's truly reversible and it's so wonderful to see it you know it's really made the second half of my professional career just very rewarding for me to see that in folks so the faceting mimicking diet normalizes glucose it decreases that igf-1 that's associated with cancers it decreases CRP which is a marker of inflammation it increases those those wonderful reparative stem cells it decreases senescence cells those are the cells that are kind of in our tissues in our body that are doing they're just they're they're laggards they're not doing much and sometimes they're actually making the surrounding tissue less healthy so it decreases senescence cells and it improves the immune system so one of the things that happens as we age is that our ability to fight infection and the ward off cancer goes down because our immune system become senescent senescence of our immune system and the fasting mimicking diet and the time restricted feeding is something that restores that revitalize it review you know it creates more vigor in those white blood cells to fight off disease lots of media about the fasting mimicking diet from the Time magazine to National Geographic to major newspapers the BBC I mean this is something that's getting a lot of attention around the world the fasting mimicking diet is a medical food that's made by USC and it's packaged in a box and it's a couple hundred bucks to buy it for five days and it's just like this it's got great vegetarian food it's all made it's very simple very effective and many of my patients like it and they say to me yes it's a couple hundred dollars but I would have maybe spent a hundred dollars on food that week so it was worthwhile and was easy but you don't have to use the packaged medical food if it doesn't fit your budget because you can make a you can make a vegetarian food and you can make your smoothies or something like that so it's got to be eight hundred calories every day it needs to be vegetarian no meat no sugar so very little fruit so it has all of those things it'll meet those criteria so for some people it makes a lot of sense just use the medical food because it's convenient it tastes good it's readily available and like I said many of my patients have used that but you can also do it yourself this is doctor Longos book called the longevity diet terrific book and oh that's dr. link hanging around with dr. Longo that was in November at USC when you refeed after you just need common sense you don't want to go out for a big meal right after you've fasted for five days start slow smaller meals maybe soups smoothies give your body a chance to ramp up a digestive system again huh safety considerations type 1 diabetics those on insulin would not be using this and less would not be using it type 2 diabetics even if they're on insulin can use it if they've got it by a physician if you're 70 and older it's okay to fast but it should be guided by a physician and not everybody 70 and older it's what it's wise to do any significant fasting time restricted feeding may be original but longer fast so you may not well we know is that if it causes a lot of stress in white knuckling that's probably not good for any of us and when we get older were going to be less tolerant to that but I do have people in their 70s that do fasting for sure if you have hypertension your blood pressure during that five days will go down some so if you typically have high blood pressure you're on medications for blood pressure your blood pressure will go down we'll need to monitor that and make sure you get plenty of fluids maybe a little extra salt in the meals on some folks I have them skip them one of their blood pressure pills possibly through the week particularly if it's a diuretic for example but again that would need to be guided by the provider dehydration can be a problem but that's easily overcome with a little extra salt in water and these I went through this ready there's a lot there's there's a legion of benefits from the Festing infesting in the fasting mimicking diet including healthy aging that is again kind of pushing that healthspan out longer so that we live healthier and functional for longer with less chronic disease and the types of fasting that I find most important is the time restricted eating and the fasting mimicking died in my clinic on the left is the science of fasting this is a movie that's available on on Amazon and it looks at Russian and German fasting and I didn't mention this earlier but in Germany the largest hospital in all of Europe is in Germany and one whole floor they use for fasting and that fella that German physician was at the international conference it was great to see him the magic pill is I think my favorite movie of this last year this is on Netflix and it looks it follows several different families and people that have different conditions from asthma autism diabetes cancer etc and even follows a group of Aboriginal women from Australia where they took these women who had obesity and and chronic medical illness and they put them back on there in on their indigenous diet for a few weeks and found out how much better they did a magic pill of course is food and many of these people came off medications magic pill is food and and really the magic pill is that get back into a healthy food environment you know eat real food and and to really move away from the processed foods that became part of our our food environment in this last 50 years you know when I grew up I was born in 1960 and there were too many fast-food restaurants I don't remember too many when I was you know a young boy and then you know you just look at you know Missouri Boulevard here there's fast-food restaurant after food restaurant it's hard to get good quality food there you can if you're careful and you're very selective you can but it's hard to do that uh dirt-eating in one of my favorites ages Benjamin Franklin said to lengthen my life lesson nine meals time restrict eating it safe ineffective George Burns has another quarter and put in here George Burns I he said something like you know once you make it to a hundred you got it made because hardly anybody dies over a hundred all right so we're gonna that's the end of the talk I'm gonna open it up for questions thanks so much for your attention I really hope that that all of you can take something home here for you that you can add to your life and even in small steps make a difference and add up over time [Applause]

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  1. This is awesome!!! I subscribed!!!

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