Jenni Russell
The Times
“Fasting is seen by some as a dietary fad but we now understand that it regenerates the body”
Gerry Gajadharsingh writes:
“I have written many times on the benefits of the Metabolic Balance nutritional program, including one of its key principles of leaving a five-hour gap in between meals which allows the body to down regulate the Insulin response. About 20 years ago the concept of small but frequent meals was gradually introduced into mainstream thinking, as a way of keeping blood glucose, which is one of primary metabolic fuels, consistently available throughout the day, at the time it seemed like a reasonable thought. What they didn’t quite understand was the effect on Insulin, the main hormone which moves blood glucose into cells. Having consistently elevated levels of insulin is one of the main drivers of the negative reactions talked about in the article below.
Because grazing is so endemic in modern society many of my patients who embark on a bespoke Metabolic Balanced nutritional program are incredibly sceptical that they can leave five hours in between their meals, only to discover that in a short period of time, normally between one and two weeks, the clear majority are hungry no more. The key is understanding the type of foods and the combination of those foods that we need to eat for breakfast, lunch, and dinner to gain the fuels, substrates and micronutrients that allows our physiology to function optimally. Another key principle is doing your best not to eat after 9 PM, which allows a more prolonged fast overnight, again allowing the bodies repair processes to work optimally. Then you simply break fast “breakfast” to restart this process, which is a challenge initially for those people who have got out of the habit of eating a proper breakfast. Again after a few weeks on a proper program these people understand how important breakfast is, by seeing a significant benefit in the functioning of their physiology.
Whilst I think the 5:2 concept was helpful in allowing research to really begin to understand the benefits of fasting, in our experience you simply don’t have to starve yourself two days a week to gain the intermittent fasting benefit, talked about below. I think it’s true that for many people sustaining a new dietary regime is always challenging, sometimes it seems easier to get back into the groove of bad habits then it is to continue or develop good habits, maybe that’s just human nature. My focus on the patients who I support is always on their underlying health problems, not just on the weight management aspects of the dietary program. As the journalist below confirms so many chronic health conditions can be positively improved by adopting sensible dietary changes. The problem is we’re inundated almost daily by the latest new “diet” and numerous conflicting research I’m not surprised both patients and clinicians are confused.
Another theme I mention quite frequently, when I write is unintended consequences.
Advising the population to “eat low-fat”, “eat frequent but small meals”, “lower your calorie intake” is increasingly looking like the wrong advice. Don’t get me started on the controversy on recent air pollution, particularly nitric dioxide emitted from Diesel vehicles. The government at the time, encouraged people into buying diesel cars by simply focusing on reduction of CO2, without understanding the whole picture, has now come back to haunt them. I took the decision a long time ago to never buy a diesel car, I remember numerous discussions over the years with car salesman questioning my reasons why I would continue with petrol and not move to diesel, no doubt that they thought at the time I was ignorant or mad or possibly both. When I last changed my car about six months ago I told the salesman that I thought that diesels may be eventually banned, he gave me one of those looks.
What I’ve learnt in my professional practise is that it takes time, to understand a problem, any problem and an ability to think laterally. Our society now lives at such a fast pace we seem to be making numerous problems for ourselves, others and society as a whole. When it comes to eating we simply must give ourselves enough time to eat breakfast, lunch and dinner.”
There was an air of triumphal pessimism in this week’s headlines on the latest dietary research. In a year-long study of a hundred obese subjects, alternate-day fasting had proved to be no better than calorific restriction for weight loss. The implication was that fasting was a fad. Experts who had always been sceptical of it advised that there was no longer any need to suffer the hunger pangs of occasional days of little or no food. Popular fasting regimes such as the 5:2 diet might as well be abandoned in favour of the traditional method of calorie counting every day.
That conclusion would be a mistake. Anyone who is overweight will be healthier for losing it. But there is abundant scientific evidence that fasting creates physiological changes that benefit the body even more than the slow and steady method of simply cutting back slightly on food. Weight loss is only one of its possible effects. It improves the body’s functions at a cellular level, reducing inflammation, replacing damaged DNA, regenerating the immune system and reducing the likelihood of developing heart disease, cancer, diabetes and age-related illnesses.
Fasting’s complex effects are still being explored but one of its most important mechanisms is that it pushes cells into repair mode, through a process called autophagy. After 12 hours or so of no food, a starving cell starts burning up diseased and damaged proteins, tumours and viruses, in a kind of spring-cleaning that only takes place when there are no alternative sources of energy.
Autophagy has been known about for 50 years but not until recently has its essential function been widely understood. In past centuries, when food was relatively expensive and scarce, autophagy happened naturally in the long gap between supper and waking up. Now that food is so easily available many of us eat continuously, from breakfast until late-night snacks, meaning that autophagy cannot take place. That is disastrous for our physiology. Junk and rubbish build up in our cells and cannot be cleaned out. It is as if we are in a car driving continuously with the accelerator pedal down, never pausing to stop at a garage to have the engine parts, brakes, wheels or oil replaced.
Last year’s Nobel prize for medicine went to a Japanese scientist for his groundbreaking work on autophagy. Until Yoshinori Ohsumi’s discoveries, from the 1990s onwards, autophagy was thought of only as waste disposal. Now, as one of the scientists on the Nobel panel said, we know that cells cannot survive without it. It is a crucial defence mechanism against malignancy, infections and neurodegenerative diseases. It regenerates cells in the brain. There is evidence that disrupted autophagy is linked to the development of Parkinson’s, cancer, Alzheimer’s and type 2 diabetes.
“A few days without food was more effective than 20 years’ medical care”
There are now hundreds of studies of the benefits of fasting, even for short periods, from 12 to 24 hours. Last year a study of thousands of women with early-stage breast cancer found that fasting for 13 or more hours overnight cut their risks of developing fresh tumours by a third. A 2015 study of both humans and animals for the Society for Neuroscience showed intermittent fasting improved memory, created new neurons and helped the brain recover from strokes and injury. Research by Mark Mattson at the National Institute on Ageing in Baltimore demonstrated that in mice engineered to develop dementia at a year old, the onset was delayed by a further year when they were restricted to eating every alternate day.
One of fasting’s most exciting consequences is its potential to regenerate the immune system. As I have mentioned on these pages before, I came across this particular research three years ago, just after it was published and just as my own treatment for a long-running auto-immune illness was about to be halted by the NHS because of its tremendous expense.
Valter Longo, a leading anti-ageing specialist at the University of Southern California, had discovered that when mice fasted for three days at a time they generated new stem cells from their bone marrow. This was astounding. It meant that over six months of occasional fasts they replaced damaged immune cells with perfect ones. Potentially, this had huge implications for anyone with an auto-immune disorder and indeed everyone else, since a major cause of ill-health is the deterioration of our immune systems as we age.
Dr Longo warned readers not to try this themselves but I couldn’t wait. With considerable scepticism — but more despair — I imitated the mice, started fasting on water-only for three days at a time, was cured within weeks and have never relapsed. It has made me a reluctant convert to fasting since a few days without food have proved more effective than 20 years of medical care by devoted doctors and £200,000-worth of drugs.
The conclusion we should be drawing from this week’s news is that we need to fast more, not less. Occasional 12 or 24 hour fasts are helpful but profound physiological changes require longer. For those who need that intervention, Dr Longo has just launched a five-day fasting-mimicking diet, ProLon — from which he makes no profit — which is less stressful for the body than no food at all.
Deprivation is never easy but the huge potential rewards are worth it. A longer, healthier, smarter life has to be worth a few hunger pangs