Zero: Better than Nothing

As I have described in several previous posts in this series, intermittent fasting, or time-restricted feeding, is a key to sustainable weight loss.

As I wrote earlier, Dr. Jason Fung has been an important advocate, as he has helped thousands of patients reverse Type 2 diabetes and overcome obesity through fasting.

His simple message: insulin is the hormone that regulates fat storage, and to lose weight and keep it off you need to have prolonged periods with low insulin levels.

That enables your body to switch from fat storage to fat burning. Otherwise you’re always just adding fat.

About a year ago, my daughter Rachel introduced me to a fasting app she had been using, called Zero. As it turns out, the chief medical officer for Zero is Peter Attia, M.D., who is among my most trusted online thought leaders on health and longevity issues. I’ll be talking about him a lot in future posts.

So I started using Zero, and it’s essence is really simple: when you’re done eating for the day, you pick a fasting goal and start the countdown timer.

When you reach your goal, instead of counting down the timer flips to counting up, telling you how long your fast has gone.

The next time you eat, you stop the timer, which records the length of your fast. Then the timer starts again, only now it’s tracking the time since your last fast. (If you forget to stop or start the timer, you can go back and edit your start or end times.)

Here’s how it looks when you’re counting down before reaching your goal, counting up after you’ve passed it, and then tracking how long it’s been since your last fast.

I found the free version of Zero really helpful, so I decided to spring for the premium offering, Zero Plus. It includes lots of video tips as well as well as data about my fasts, like how much time I’m in the various fasting zones, including:

  • Anabolic: the first 0-4 hours after a meal
  • Catabolic: 4-16 hours
  • Fat Burning: 16-24 hours
  • Ketosis: 24-72 hours
  • Deep Ketosis: 72 hours+

My history tab tells me I have logged 293 fasts, including a streak of 202 straight days of fasting at least 13 hours, although most days I go for at least a 16-18 hour fast with an eating window of 6-8 hours or less.

I would encourage you to give Zero a try. I was fasting before I got the app, but using it gave me a little extra nudge to keep that fasting streak going, and taught me a lot about my metabolism. Data can sync with Apple Health or Google Fit, too.

See the whole series about my health journey, and follow along on FacebookTwitter or LinkedIn.

John Bishop’s Journey

My goal in telling the story of my health journey through this blog has been to simply share what I have learned over roughly the last four years, in hopes that others would find it helpful and encouraging.

Together, Lisa and I have lost over 100 lbs. and we’re feeling better than we have in 25 years. As I have shared this series on my social networking accounts, several friends have asked to talk about what we’ve learned, and we have enjoyed the opportunities to discuss with them.

Other friends have already been putting this into practice for themselves, and are seeing great results.

One of those is John Bishop. I got to know John because he is one of our volunteer community mentors in the Mayo Clinic Connect online patient community. Over the last few months I had seen him sharing some of my posts as part of his community moderation work, and encouraging others struggling with weight issues to check them out.

But when I saw this tweet in reply to one of mine about a month ago, I set up a call to talk with him about his experience.

After our phone conversation, I asked John if he would be willing to tell his story in a guest post, and he graciously agreed. Here it is, in his own words:

I’ve struggled with my weight since my mid 30s.  I weighed 215 lbs when I left the Navy and gradually it crept up to 330 lbs in my mid 50s which was when I started being concerned that I had to do something.  I was able to get my weight down to 300 on my own and then found Weight Watchers through a friend and started their program.  Through Weight Watchers I was able to get down to 250 lbs and decided I could do it on my own since I felt I was the one that needed to make changes.

I did fine on my own for about a month, from that point until this year I was constantly trying one diet plan after another and going between 245 and 260+ lbs every few months.  As much as I tried to eat healthy and do some moderate exercise, I just could not seem to stay on track.  It wasn’t until I read @LeeAase’s health journey article on alternate fasting that I got interested in seeing if I could get my weight down to 215 lbs to help with my overall health and my current health conditions (small fiber PN and PMR).

My wife Lavon was already doing a 16/8 daily fasting so it made it easier for me to try alternate fasting.  I started with a 24 hour fast on March 24, 2020.  I planned to do a 24 hour fast every other day. When I read some encouraging results on Lee’s health journey on using the Zero app and a 20 hour fast with 4 hour eating window, I tried it and found it easy to do after a few days.  I’m now doing the 20 hour fast for 3 to 4 days at a time and while sprinkling in 18/6 or 16/8 days when needed to accommodate other plans.

One thing that the fasting and eating window has done to help me is to make it easier to stop my bad nighttime snacking habits which in retrospect are probably why my weight has always been difficult to control even when I thought I was choosing healthy snacks.

When I started my journey back in January, I purchased an inexpensive Bluetooth scale that shows weight, body fat, muscle mass, water weight and BMI.  My first weigh in Jan 18th was 244.7 and my most recent weigh in Aug 2nd was 222.4. I still go up and down during the week but I’m happy that I’m able to keep a downward trend.  When I reach my goal of 215 lbs my plan is to make a new goal of 200 which is one of those “in your dreams” goals but this time I really think it is a realistic goal and one that would be a major health improvement for me.

As you can see in the graph at right from his Bluetooth scale, John’s weight has been on a steady downward trajectory since January.

He’s down 22 lbs. in just over six months.

Most importantly, he’s no longer finding weight loss difficult, and he’s daring to dream of new goals he would not have previously thought possible.

And while the COVID-19 pandemic has caused many to gain 20 lbs. or more, John is going in the opposite direction.

John at 280 lbs. (left) and now at 222 lbs. (right).

John mentioned that the Zero fasting app has helped him and that he learned about it from me on Twitter, but I just realized I haven’t featured it yet in this series.

It’s a great fasting tool, and I’ll tell more about it in my next post.

See previous posts on My Health Journey, and to get future posts follow on FacebookTwitter or LinkedIn.

Fasting for Longevity

One of the well-established findings in longevity research is that caloric restriction (CR) leads to increased longevity in every animal model, and there is significant evidence CR also improves human longevity.

In other words, in rough terms, consuming 30% fewer calories leads to something like a 30% increase in lifespan.

An interesting finding, but few of us would sign up for that kind of regimen, going a lifetime with reduced calories.

The good news, however, is that you don’t have to do CR for your whole life in order to get most of the benefits: periodic fasting does almost as well as chronic CR.

USC Professor Valter Longo, Ph.D. has gone one step further, developing what he calls a Fasting-Mimicking Diet (FMD) that he says gets the benefit of fasting while still having some food each day. He describes the connection between fasting and longevity in this TEDxTalk from 2016:

Dr. Longo is the author of The Longevity Diet, which describes a program of a basic daily diet along with an occasional 5-day FMD. I’ve listened to him be interviewed on various podcasts and have watched several videos, and I think he does a great job of explaining the science of how fasting reboots the immune system.

If the thought of fasting seems overwhelming to you, maybe you should consider FMD. At the very least, I hope you’ll watch the video above for a primer on why fasting or FMD can improve both lifespan and healthspan.

I personally haven’t tried FMD because I have found that fasting isn’t that difficult for me, and so I don’t feel a need to mimic fasting when I can do the real thing.

In future posts I’ll describe some fasting and time-restricted eating strategies that have worked well for me.

See the whole series about my health journey. Follow along on FacebookTwitter and LinkedIn.

We’re an n of 2

The scientific method involves proposing a hypothesis — e.g. “Drug A improves symptoms of Disease B” — and then designing an experiment, or study, to test it.

The “gold standard” studies are double blinded and placebo-controlled. Half of the subjects get the drug, and half get a placebo (or “sugar pill”) that has no expected effect. Neither the investigators nor the subjects know who is getting the real treatment. Then when the data are analyzed, it can be clear that any observed effect is the result of the drug, not wishful thinking.

And to reduce the likelihood that any observed difference is due to chance, scientists design their studies with a sufficiently large n, or number of subjects.

In an earlier post in this series, I conceded that I’m an n of 1. I’m an anecdote. Scientists tend to look down on anecdotal claims. Just because a low-carb diet and time-restricted feeding program has led to me losing 60 pounds doesn’t mean it will get the same results for you.

There could be something peculiar about me that led to this result. Perhaps it’s just a random coincidence. Or maybe just the fact that I had decided to pay attention and try to lose weight was the main factor, and the particulars of what I changed didn’t matter so much.

But together Lisa and I are an n of 2, and we’ve lost a total of 100 pounds on a low-carb diet with intermittent fasting or time-restricted feeding. And the weight loss for her didn’t really kick in until she went low-carb with intermittent fasting.

We’re also not alone. The n of those getting good results from a similar approach is much, much bigger.

And the reality is you can’t do a blinded study of a lifestyle intervention. If you’re switching from pizza and pasta to steak and eggs, you’re going to know it. And if you are going 12 hours a day or more without eating, you’ll know that too. There’s no placebo effect here.

I’m not sharing our stories to boast about our accomplishments. We did have to change what and when we ate, but it truly hasn’t felt like much of a sacrifice.

I’m sharing them because I’m frankly kind of mad that following official government policy (avoid fats, eat lots of “healthy whole grains”) made us fat.

The “eat less, move more” or “calories in, calories out” dogma is trite and simplistic, and doesn’t correspond with the reality of why we get fat.

In the 1950s and 60s nobody worked out. It was only in the early 70s that running and aerobics became “a thing.”

Obesity hasn’t tripled in the last few decades because people don’t move enough. If anything, people in recent decades have exercised much more than our parents and grandparents did.

Exercise is good and important, but its lack has not caused the obesity epidemic.

I’m sharing our stories because I’m pretty confident that among our social connections, and those we can reach through them, there are scores, or hundreds, or even thousands of people who feel as trapped and defeated as we did four years ago.

There is a better way, and there is hope for a reversal of metabolic syndrome. I want to point you to those from whom Lisa and I have learned this.

I’ve previously highlighted pioneers like Nina Teicholz, Tim Ferris, Dr. Jason Fung, Dr. William Davis and Dr. Robert Lustig who have revolutionized our thinking.

As I continue this series I plan to feature several others who also have given us important and life-changing information. Some of those include

I look forward to sharing what we’ve learned from these people and others, and the benefits we’ve seen from applying those lessons. I linked mostly to their Twitter accounts in the list above, in case you want to start following them before I get to writing about them.

Some of them are physicians, while others are Ph.D. researchers, and still others are scientific writers actively poring through the relevant research. They have applied the skepticism of the scientific method to the disastrous dietary dogma that has had such a negative record for the last five decades.

So while Lisa and I together are only an n of 2 and our experience is not definitive, we have seen good results in the last four years through applying what we’ve learned from these people and others.

What other scientific researchers, physicians or writers have you found helpful in understanding diet, lifestyle, weight loss and health? I’d appreciate your recommendations as I continue my journey of exploration.

See the whole series about my health journey. Follow along on FacebookTwitter and LinkedIn.

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.

See previous posts on My Health Journey, and to get future posts follow on FacebookTwitter or LinkedIn.