The Other Side of Fasting

Dr. Jason Fung calls fasting “medical bariatrics.” For patients with type 2 diabetes it has the same benefits (under proper medical supervision) as bariatric surgery, but it’s totally reversible.

And compared to surgery or medications, it has radically fewer side effects. It’s been used by literally billions of people throughout history and has been part of every world religion.

And it’s even better than free. It actually saves money.

The other major positive aspect of fasting is its flip side. Fasting isn’t a continual pledge of self-denial. It’s a decision to forego eating for a time. And when the fast is over, it’s time for…

The Feast.

It’s not a great idea to break an extended fast (2-3 days or more) with a huge meal. That can be a shock to your system. But if you regularly maintain a narrow feeding window of perhaps 8 hours or less, and occasionally throw in a 24-48 hour fast, it frees you to really enjoy occasional excess without guilt or fear.

So as Dr. Fung says, “Enjoy that birthday cake!” Relish those holiday meals.

For me, another big application is when I travel to our Mayo Clinic locations in Phoenix and Jacksonville. I get to each of them perhaps twice or thrice per year, and so I make sure to visit my favorite gluten-free restaurants in each city.

When I’m in Phoenix, I make sure to eat once at Picazzo’s Healthy Italian Kitchen, where I get the Meaty Meaty pizza with gluten-free crust:

The Meaty Meaty at Picazzo’s

I also eat at Zinburger, where in addition to gluten-free burgers and double-chocolate milkshakes they have a separate fryer where they prepare French fries loaded with cheese and bacon.

Thankfully, when I visit I’m usually there a couple of nights, so I can make it to both places.

As I write this, I’m in the Sky Club in Atlanta on the way home from a couple of days in Jacksonville. That meant on Thursday night I got to visit V Pizza in Jacksonville Beach, where I had the Carnivora with gluten-free crust:

The Carnivora at V Pizza in Jacksonville.

The great part about fasting is that I can look forward to meals like this because I know I will have them a few times a year at most. So I couldn’t develop a habit of visiting these restaurants more frequently even if I got a sudden craving.

When I do eat there, I typically have fasted since dinner the night before, and will fast the next morning as well.

So even though I’m eating 10-15 times the carbs I usually have, within a day or two of my feast I’ll have burned the sugar and starch and be back to gluconeogenesis and maybe even moving toward ketosis.

If you haven’t tried fasting, I’d encourage you to investigate its benefits. Read about our 10-week alternate daily fasting experience. And again, if you’re on diabetes medications or insulin you absolutely do need medical supervision to prevent hypoglycemia.

Once you’ve developed a time-restricted feeding or intermittent fasting pattern or mindset (especially a low-carb diet), you’ll not only be free from the tyranny of cravings and having food seem so important.

You’ll also really enjoy the times when you do feast.

If you want to explore why intermittent fasting works, this video featuring Dr. Fung is a great way to start.

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The Blessings of Celiac Disease

When I was first diagnosed with celiac disease in March 2009, it was easy to focus on the sense of loss, that never again could I have foods containing wheat, barley or rye because of the presence of gluten.

No sourdough bread. No quick and easy fast-food burgers and fries.

And especially no croissants.

That’s one that still stings a bit to this day. I didn’t eat them often, but I love croissants. And there’s just no way to engineer a light and fluffy croissant without gluten to hold it together.

Switching quickly to glass-half-full mode, however, I soon began to emphasize the things I could eat, like steak and baked potatoes with sour cream. And it wasn’t too long until some more edible gluten-free breads became available, including the Udi’s line of hamburger buns, bagels

Those foods, combined with my newly restored villi increasing their absorption in my small intestine, led to me gaining more than 40 lbs.

In the last three years, I’ve become convinced that excessive carbohydrates were a major cause of weight gain for me and likely are for our society as a whole. So in addition to experimenting with intermittent fasting and time-restricted feeding, I’ve cut out sugar and have significantly curtailed carbs, particularly the highly processed ones.

In many ways, my celiac disease experience made the transition easier. It put me on a path where “anything goes” eating wasn’t an option. Lots of breads, pancakes and pasta meals were already off limits.

My original thankfulness for the celiac disease diagnosis was more related to what it wasn’t: my iron deficiency anemia could very well have been a sign of colorectal cancer. Indeed, for a high school classmate and good friend who also had anemia, it was due to somewhat advanced colorectal cancer.

I recognize that some of the dietary changes I have been and will be describing in this series may seem extreme. I also understand that’s even more so for those who haven’t had to deal with medically prescribed dietary restrictions.

So today I can say I’m totally thankful for my blessing of celiac disease. It jolted me out of the “anything goes” approach to what I eat, which was part of my journey to a low-carb lifestyle that’s delicious and healthy.

I’m at a retreat for work this morning where breakfast is being served, and while bacon and eggs would have been a plus, it’s amazing how satisfying nuts and berries can be. It’s a little higher in carbs than I would ordinarily eat, but the fiber in the whole fruit is a plus.

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Weekend Watching — Sugar: The Bitter Truth

For your weekend enjoyment (or perhaps engagement) here’s a video featuring Dr. Robert Lustig from University of California, San Francisco.

While I don’t necessarily associate myself with all of his comments (I don’t think Richard Nixon is behind all of the problems in modern society, for instance), I think his message is important.

If you want to understand how sugar is processed by your body, and particularly why fructose is so dangerous, you will find this fascinating as I did.

What do you think about this?

What steps have you taken (or do you plan to take) to reduce your sugar and fructose consumption?

“What if we’re wrong about diabetes?”

That’s the title of this video, which came up in Lisa’s YouTube related videos feed about a year ago.

It’s a gripping TEDMED talk from 2013 by Dr. Peter Attia, who confesses the judgmental attitude he had harbored six years earlier toward an obese patient who had come into the emergency department with foot ulcerations.

She obviously must have let herself go, he thought, consuming too many calories and not moving enough.

But then three years later he found himself 40 lbs. overweight and with metabolic syndrome, and he knew that physical inactivity was not the cause in his case: he had been “exercising three to four hours every day, and following the food pyramid to the letter.”

It led him to wonder whether, in the case of obesity, insulin resistance and type 2 diabetes, the medical community might have the chain of causation backwards.

Watch this video. It’s totally worth the 16 minutes.

I have found Dr. Attia one of the most thoughtful online voices when it comes to evaluating and making sense of dietary and lifestyle research related to both longevity and healthspan.

As he says in this video, perhaps he’s been humbled by what the thought he knew that turned out to be mistaken.

I expect I will have several more posts in this series that feature (or at least mention) Dr. Attia. His website is an amazing resource, and his podcast, The Drive, is the only one for which I pay for premium access.

Like Tim Ferriss, Dr. Attia also has introduced me to many other leading researchers and thoughtful analysts. Follow him on Twitter.

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Our 10 Weeks of Alternate Daily Fasting

As I mentioned in this post, when I heard Art De Vany say he eats “two meals a day, sometimes one, sometimes none” I thought that was unfathomable.

But after reading The Obesity Code and The Complete Guide to Fasting, in which Dr. Jason Fung described his experience with his Intensive Dietary Management clinic and how he would get many patients with type 2 diabetes off insulin and diabetes medications within just a few weeks through extended fasting, Lisa and I were ready to give it a try.

Neither of us had even been diagnosed as prediabetic, but Lisa’s fasting blood sugar had been 102 in October 2016, which is what got us started on this dietary and lifestyle journey.

In The Obesity Code, Dr. Fung cited a study of 70 days of alternate daily fasting in which body weight was decreased by an average of 6%, while fat mass decreased by 11.4%, with no loss of lean mass. He also said

Studies of eating a single meal per day found significantly more fat loss, compared to eating three meals per day, despite the same caloric intake. Significantly, no evidence of muscle loss was found.

The Obesity Code, p. 243, Jason Fung, M.D.

It’s important to note that with alternate daily fasting, you’re still eating every day. Typically you eat dinner every evening, and skip breakfast and lunch every other day.

So on Sunday you would eat all three meals, but then on Monday skip breakfast and lunch, limiting yourself to water, black coffee or tea. Then repeat the cycle.

Two Three important additional points:

  1. If you are taking insulin or medications for diabetes, you absolutely need to have medical supervision while fasting to prevent dangerous low blood sugar episodes.
  2. If you’re eating lots of carbohydrates, you will be miserable on an all-day fast. It’s best to get at least somewhat converted to fat metabolism before starting fasting. Eggs, meat, avocados, nuts and other foods relatively high in fats and with moderate protein, combined with limiting carbs to 25-40g per day, will help convert your body to burning fat.
  3. I’m not a doctor. I’m not giving medical advice. Check this out for yourself and make your own decision in consultation with medical professionals you trust.

One more tip: a good way to start is with time-restricted feeding, just skipping breakfast every day and eating lunch and dinner during a 6-8 hour window. This still gives you an extended period of lowered insulin levels, and isn’t quite as extreme as going 24 hours without food.

With all of those caveats, here are my weekly bluetooth scale readings from our 10 weeks of alternate daily fasting. I weighed every day, but for simplicity am just sharing the Wednesday morning readings.

With the caveat that the body fat and muscle percentages seem to be calculated by some voodoo electrical signals running through the soles of my feet, at least all of those readings were coming from the same scale.

So the bottom line is that I lost about a pound of fat per week while essentially preserving muscle mass. (The other 4 lbs. lost, according to the scale, were water weight .)

Note also that when we started the 10-week experiment I was already down 37 lbs. from Peak Lee, as demonstrated in my “before” pictures. So presumably I had already lost the “easy” weight.

And in keeping with the study cited by Dr. Fung, my body weight was reduced by 6.2%, while my body fat was reduced by 18.1%, during the 10-week period.

Have you tried intermittent fasting or time-restricted feeding?

If so, how did it work for you?

If not, what questions do you have?

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