Heal the Body With Extended Fasting
Episode Stats
Summary
Steve Hendricks is the author of The Oldest Cure in the World: Adventures in the Art and Science of Fasting. In this book, he takes a deep dive into the history and science of using fasting as a medical treatment. In part 1 of this conversation, we offer a thumbnail sketch of the history of extended fasting as medical treatment, and what emerging modern science is showing as to how prolonged fasts lasting days or even weeks can prevent and even cure a variety of diseases from type 2 diabetes to rheumatoid arthritis. We then talk about fasting s effect on cancer and how it may address mental health issues by offering a metabolic reset. We end our conversation with how to get started with extended fasting.
Transcript
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Brett McKay here, and welcome to another edition of the Art of Manliness podcast.
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In the last several years, intermittent fasting, only eating for a short window each day,
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has gotten a lot of attention, particularly for the way it can facilitate weight loss.
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But as my guest will explain, going longer than a few hours or even a full day without
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eating also has some striking, potentially life-changing benefits too, and may be able
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to heal a variety of health issues. Steve Hendricks is the author of The Oldest Cure in the World,
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Adventures in the Art and Science of Fasting. He spends the first part of this conversation
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offering a thumbnail sketch of the history of extended fasting as a medical treatment.
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From there, we get into what emerging modern science is showing as to how prolonged fasts
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lasting days or even weeks can prevent and even cure a variety of diseases, from type 2 diabetes
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to rheumatoid arthritis. We then talk about fasting's effect on cancer and how it may address mental
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health issues by offering a metabolic reset. If you're an intermittent faster, you'll be
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interested to hear why it is you should ideally schedule your eating window for earlier rather
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than later in the day. We end our conversation with how to get started with extended fasting.
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After the show's over, check out our show notes at aom.is slash fast.
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All right, Steve Hendricks, welcome to the show.
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So you published a book called The Oldest Cure in the World, Adventures in the Art and Science
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of Fasting. In this book, you take a deep dive into the history and into the science of using
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fasting as a medical treatment. I'm curious, what was going on in your life where you wanted
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Yeah, I first got interested in fasting about 20 years ago, partly for the same reason a lot
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of people get into it. I needed to lose weight, but partly because there was some very intriguing
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research that showed that fasting made animals live longer, nearly twice as long in some cases,
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and they live those long lives with a lot less disease as well. And the research suggested that
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we might just be able to live longer and with less disease too if we fasted.
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So I experimented with fasting and I wrote a bit about this. And about 10 years ago, I was approached
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by a couple of publishers to write a book about the history and science of fasting. I said no.
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Frankly, I thought that the history would bore me to death, but mostly, I just didn't think the
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science was far enough along to make a compelling book about fasting as a medical treatment.
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What changed was that over the last decade, the science of fasting has just blossomed in the most
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beautiful way. I also started looking more deeply into the history of fasting, and it turned out to just
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utterly fascinate me. And I had also, in this time, fasted quite a bit myself. And I'm certain that
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fasting helped me recover my own health, which had taken a real nosedive in my 40s. I'm 52 now.
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So a couple of years ago, I finally thought I had enough between the science, the history,
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and my own experiences to make what I hope turned out to be a compelling book.
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Well, let's dig into a bit of the history of fasting as medical treatment.
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You start off talking about human beings have probably been fasting since human beings were
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human beings, but it was probably unintentional, right? Cavemen maybe went days, weeks without food
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because they didn't get a hunt or there was a famine. But in the historical record, when do we
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see humans fasting? I'm intentionally fasting. I'm intentionally abstaining from food. When does
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Yeah. Unfortunately, we don't have much evidence from archaeology, which is really good at showing
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what people did, what they ate, for example, but not so good at showing what they didn't do,
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like not eating. So the first strong evidence of intentional fasting shows up shortly after the
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first writings emerge in various parts of Asia, Africa, Europe. Those first writing fragments date to
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about 5,000, 6,000 years ago. And once we get fragments long enough to have sentences,
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fasting shows up pretty quickly and does so all over the place in almost all cultures and religions.
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Now, it was almost always religious fasting, not fasting for health, although most ancient people
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wouldn't have made that distinction because they didn't view the body and spirit as separate.
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But it's pretty safe to say that this fasting, which was quite intentional, was for the spirit
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and not for health. And it dates, as I say, to the earliest human writing records that we have.
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Okay. So fasting started off as a spiritual practice. When did we start seeing fasting not
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just as a spiritual practice, but also as a medical treatment?
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It really began with the ancient Greeks, specifically the Hippocratic writers 2,400 years ago.
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There's a body of about 60 texts associated with Hippocrates, who probably wrote very few,
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if any of them. They're the work of his disciples and family. But whoever wrote them, they're remarkable
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because they're the first to say, disease isn't caused by supernatural phenomena. It's not caused by
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evil spirits and so on. Diseases have natural causes that we can try to understand and can sometimes
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treat. Unfortunately, there was a taboo on dissecting human bodies, so the Hippocratics couldn't
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look under the hood and figure out how things worked. They just had no idea. So they concocted
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all kinds of nutball theories about disease and how to cure it. A few of the Hippocratic writers
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briefly mentioned fasting, but they just didn't know how to use it. So there's a text called
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Aphorisms, for example, in which the writer said that spasms and hiccups could be cured either by
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fasting or by not fasting, specifically overeating. And, you know, the reader sitting there wondering,
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well, which the hell is it? Do I stuff myself or do I fast? Even so, one or two of the Hippocratic
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writers were on to something. There's a writer of a text on acute illnesses, things like fevers,
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colds, who suggested that fasting for a few days to treat those illnesses would be useful,
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and who also suggested periodic fasts as a kind of reset for the body. But unfortunately,
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his good advice was mixed up with all the chaos and craziness of early medicine. And fasting,
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though it got its birth with the ancient Greeks, was never used rigorously or scientifically or,
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When did fasting really start picking up steam as a medical treatment? Was it after the Renaissance?
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Yeah, you're right. Right after the Renaissance. It really was until the birth of a more scientific
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outlook with the age of reason, so let's say 16th, 17th centuries, that finally sort of threw out all
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the quackery that was medicine throughout pretty much all of recorded history to that point. But the
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progress was really slow, so it wasn't really until the early 19th century that you start getting pretty
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impressive accounts in the U.S. and Europe from doctors who began to notice that when there was,
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say, an outbreak of typhus or yellow fever, their patients who refused to eat often did better,
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usually did better, than their patients who ate. They also observed that patients who fasted did better
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than patients who took their rudimentary medicines and their other crude treatments of the day, which
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were things like bleeding and, you know, purging people to give them diarrhea and giving them
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emetics to make them vomit and things like that. These early doctors who turned to fasting at this
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time were really on to something that could have been deeply helpful to patients because medicine in
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that era was still almost entirely quackery. Unfortunately, what happened is most other
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doctors called these fasting doctors quacks. They just could not accept that conventional medicine
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was, as it in fact was, doing more harm than good, and it was too counterintuitive for them to
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understand that by not treating the body at all, that by taking away food, the body could heal
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itself better than the doctors could with their so-called medicines. So conventional doctors kept
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fasting well off to the margins, which unfortunately is a theme that has continued for the last couple
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hundred years. And it makes sense why. I mean, you imagine the doctor is thinking, well, you know,
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I'm here to treat the person. Fasting is like, I just, I'm not doing anything. It's like, why do you even
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need me? And so I can see why, well, we're not going to do that because that requires me not to
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use my services. It makes total sense, both from a very, you know, sort of practical economic view
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and personal view of what you're talking about. The doctors, the doctor has come there to do the
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healing. So the doctor wants to give a medicine and the patient, frankly, wants to receive a medicine
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and be cured. But there's also this bigger thing going on where fasting is quite understandably deeply
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counterintuitive. Everyone knows that food makes you healthy. You eat food, you feel better,
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you grow up, you grow big and strong. Everyone knows that when you don't eat, you feel like crap,
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you feel weak. And to think that this could actually help you, that there are repair mechanisms going
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on when we stop eating. That's just a very foreign concept to people. And it's very understandable why.
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So in the 19th century, you had some doctors experimenting with fasting as a medical treatment,
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but what was happening to in the culture, there was just people, regular folks who were just kind of
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doing individual experiments on themselves to help them get better. And then fasting also became
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kind of, sort of like now, it was kind of like a fad, like people were seeing each other doing
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fasting and I want to see if I can up this guy. And there's this guy you start the book of,
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Henry S. Tanner. Tell us about this guy and what influence did he have on bringing fasting to the
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wider culture? Yeah, he is the father of modern fasting for sure. Henry Tanner was what was called
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an eclectic doctor, which would be something like a naturopath today. And he had experimented
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on himself with fasting for a few days and also with his patients. In 1877, when he was living in
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Minneapolis, he fell ill with what was probably a stomach flu. He said he had a rheumatic heart,
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which is kind of a heart inflammation and something like a nervous breakdown, probably because his wife
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had just ditched him and his medical practice was tanking. So Tanner decides he's going to fast
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until he either cures himself or kills himself. And by one account, he didn't care what the outcome
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was. At the time, men of science thought you couldn't go longer than eight to 10 days without
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food. But as Tanner approached that supposedly fatal 10th day, he actually found his ailments dropping
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away one by one. And eventually he felt so good that he, for example, resumed his daily walks. We're
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talking like 15 or 20 mile walks. He ends up fasting 41 days. Word gets out about his fast and
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he's widely ridiculed and called a liar. No one can believe that this has happened. So a few years
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later, when an opportunity arose in 1880 to fast on a public stage in New York City, he took the chance
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to redeem his reputation. And this fast in New York got enormous public attention, partly because he got
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involved with a very personal duel of words with a famous New York doctor, a former surgeon general
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of the United States who said all this fasting stuff with nonsense. And at first, the press and
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public took that famous doctor's side and ridiculed Tanner too. But eventually, all the big newspapers sent
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these tag teams of reporters to watch him 24 hours a day and report on him there on the stage of this
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lecture hall where he fasted and slept and lived in full view of the public, who were just captivated,
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especially after Tanner passed the supposedly fatal 10th day and was still alive. He was a huge
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sensation, bigger than the presidential race that year. It was reported on not just in every newspaper
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in the United States, but in great many newspapers in Europe, Africa, and Asia. He eventually fasted for
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40 days. The trouble was, unlike in his Minneapolis fast, he didn't have any illnesses to cure in New York.
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So while he had proved that you could fast for a long time without harm, and that was important,
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he hadn't proved that fasting could cure anything. Still, the publicity that he got was so substantial
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that it kicked off the modern interest in fasting, which eventually led people, including scientists,
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to give fasting a much closer look. And we are still benefiting from that work, that showmanship
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Yeah. And you also talked about another guy that popularized fasting in America, a guy named Bernard
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McFadden. We did a podcast about him a while back ago. That's episode number 624. If you want to check
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it, this guy's crazy. He's just a crazy guy, but he was like the first fitness influencer. He had this
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slogan that I love. It's like, weakness is a crime. Don't be a criminal. But he was really big into
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fasting, and he helped popularize it. And then throughout the 20th century, fasting was still
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kind of on the outskirts of traditional medicine. You said now, with the research that we have about
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fasting, people are starting to take it more serious. Doctors are starting to take it more
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serious. Let's talk about what some of this research is showing about the benefits of fasting
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as a medical treatment. So for starters, what does a fast look like to get these benefits? So it sounds
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like some of the things you've been talking about. This is not just a one-day fast. This is like
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multiple-day fast, correct? Yeah. Basically speaking, there are two kinds of fasting.
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There's daily fasting, which a lot of people call intermittent fasting, which is just narrowing
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your eating window each day. And that has shown very impressive results for preventing diseases we
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don't yet have. But then what we've mostly been talking about is prolonged fasting, which is fasting
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for multiple days, even weeks. And that has been shown not just to prevent disease, but in many cases,
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reverse diseases that we already have. And we're talking about some of our leading killers like
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cardiovascular disease or type 2 diabetes or other conditions that are becoming epidemic like
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irritable bowel syndrome or non-alcoholic fatty liver disease. So yes, research into such fasts for
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such conditions has been growing and a few doctors are starting to recommend it.
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And these are water fasts. You're drinking water, but you're just not eating, correct?
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For the most part, yes. Fasting doctors in the US fast their patients on water only. In Europe,
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most fasting doctors use a different form of fasting. It's called a modified fast. And people
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take about 250 calories a day, mostly in vegetable broths. That's not too many calories that it will
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bump you out of fasting metabolism, but it is enough calories that it gives you some energy. You're able
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to do some things like hiking and you can have fewer side effects like headaches and nausea, which some
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people get on a water only fast if it goes long enough. How long are some of these fasts? So,
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you know, Henry Tanner went 41 days, like he bested Jesus. What's the longest fast that we know about?
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Yeah. So you can fast as long as you have the fat stores to live on. So the longest fast on record
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was a fast of 382 days by a Scotsman in the 1960s who weighed 456 pounds at the start of his fast.
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He wanted to get down to 180 pounds. And after more than a year of fasting, he did so.
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So what goes on in the body that allows for an extended fast like that? And sometimes you can not
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only survive it, but you can thrive like this, you know, Henry Tanner, but other people talk about
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10 days in their fast, they're feeling great. They can go on hikes. So what is going on physiologically
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in our body in a prolonged fast that allows for that? Yeah. We survive by living off of our fat,
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which is technically actually off a breakdown product of our fat that a lot of people are
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familiar with now called ketone bodies. The body's preferred fuel is glucose. That's the sugar from
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the carbohydrates in our meals. But when we go without food for long enough, the body will shift its
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metabolism so that it can run on ketones. And in some respects, the body may even actually run more
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efficiently on ketones. As it does so, the body turns on, when it gets into this fasting metabolism
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of ketosis, it also turns on a bunch of repairs. And these are partly responsible for what allows us to
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thrive while fasting. See, our bodies are these marvelous self-healing machines. They're constantly
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making repairs all the time in our cells to spare us from disease. But they usually make these repairs
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only at a very low rate because they're so busy most of the time doing all the other things that
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make up our lives. And one of the biggest tasks is digesting our food each day, processing the
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nutrients from that food, and putting the nutrients to work in cells all over our bodies. But when we give
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our bodies a break from that immense labor, evolution has endowed ourselves with these beautiful
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mechanisms that take advantage of the rest to ramp up cellular repairs. These are repairs like patching
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up more damaged or miscopied DNA, which if not fixed could cause disease, and increasing the recycling of
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cellular parts that have gotten worn out and could also cause disease if not fixed, or increasing the
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antioxidants in our bodies that wipe out the free radicals that can damage our cells. When these repairs
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go on during a prolonged fast, we see immediate, very healthy changes. High blood pressure drops and starts
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to normalize. People who are insensitive to insulin grow more sensitive to it. The repairs that I'm talking
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about do happen on the daily fasts with the narrowed eating window each day, but they really happen with
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And this sounds, I mean, again, people hear this, like this sounds counterintuitive. You can go
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a year without eating and you're okay. Because I think a lot of people might have heard this about
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this experiment. You talk about it in the book. It's the Minnesota starvation experiment, which
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happened during World War II. The military just basically wanted to see what would happen if we
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don't give a lot of food to our soldiers out in the battlefield. And so they took conscientious
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objectors and there's an experiment on them and didn't feed them. And these guys didn't do very
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well. So why was it like these guys in the Minnesota starvation experiment, why did they fare so poorly?
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But that Scotsman guy who went a year without eating, he's okay. What's the difference between the two?
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Yeah, great question. The problem is that eating half rations, which is what these guys were on,
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for six months, they were eating 50% of their normal amount of calories each day.
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And eating half rations is very different metabolically from fasting. So for a start,
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there's the fact that when you're fasting and living on your own fat, the ketones that are the
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breakdown product that you're actually using for fuel from the fat suppress hunger. They actually
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suppress your hunger hormones. What drove these Minnesota starvation experiment people just half
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crazy. I mean, one of them resorted to taking an ax to chop off some of his fingers in order to get
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out of the experiment. And then was so confused, he couldn't explain why he thought this was the best
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way of getting out of the program. But they were just driven half mad by hunger. So when you fast,
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the irony is eating zero calories as opposed to eating 50% of your calories results in zero hunger.
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So it's a much easier thing to maintain. But there's more than that. If you're eating as the men were in
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the Minnesota experiment, even if it's just half rations, your body doesn't go into the repair
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mode that it goes into when fasting, your body still has enough work to do processing those half
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rations, that it doesn't have time to make all of these repairs. So you don't get fixes to your DNA,
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you don't get a decrease in high blood pressure, an increase in insulin sensitivity, or a decrease in
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body wide inflammation the way fasters do. So you might say that half rations is all pain and little gain,
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whereas fasting is something like the opposite. So you mentioned some of the conditions that can
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be treated by fasting. I'd like to go more detail about this. Let's talk about metabolic conditions
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like type 2 diabetes. This is increasing significantly in the West and other countries that are starting
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like a Western-type diet. So what happens in an extended fast that can help treat things like type 2
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diabetes and things like that? Yeah, so scientists are still figuring out the mechanisms.
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We know that fasting clinics report reversing as many as 80% of their type 2 diabetes cases with
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prolonged water-only fasts, and a very large proportion of cases of other metabolic diseases
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like non-alcoholic fatty liver disease, which hurts us by smothering the liver in fat and is becoming
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epidemic. What we know so far is that when we fast, our bodies have this knack for burning a lot of the
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most harmful fat first. The fat that seems to do us the most harm seems to be the visceral fat,
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the belly fat, which is behind diseases like fatty liver. During a fast, we burn off way more visceral
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fat than we do the other less harmful fat. Scientists also think that fasting does a great job of getting
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rid of the fat inside of our muscle cells and inside of our liver cells, and this is the kind of fat that
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causes type 2 diabetes. We often think of diabetes as a sugar disease, and in a way it is, but the
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research is clear that the inability to tolerate sugar is much more of a symptom of diabetes and
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not the cause. The cause is the fat inside our cells that makes the cell's insulin receptors
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malfunction. So when insulin comes knocking at the cellular door and says, hey, let the sugar in,
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that's insulin's job to move sugar out of our arteries and into the cells, the cells can't hear
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insulin knocking at the door. So the sugar stays in our arteries where it dings them up, causes them to
00:22:01.880
harden, which leads to strokes, heart attacks, dementia, a bunch of other awful stuff. But once
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you get rid of the extra fat in the cells, as happens on a fast, the cells become much more sensitive to
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insulin, which is then able to move the sugar from our arteries into the cells. There are
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undoubtedly other mechanisms at play, but one of the frustrations of fasting is as beautiful as the
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science is that has blossomed in the last decade or two, we just don't know anywhere near as much
00:22:33.320
about it as we would hope to. Many, many, many mechanisms remain to be discovered, and that
00:22:38.300
includes for diseases like type 2 diabetes. So one thing that doctors have noticed with anyone who does
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a prolonged fast is that their blood pressure drops. What's going on that allows blood pressure
00:22:50.680
drop during a fast? Yeah. So we have excellent studies going back 20 years that show fasting,
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and just about every case that's ever been looked at lowers high blood pressure. One of the fascinating
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things is if your blood pressure is normal, it doesn't lower it. So it appears to only be treating
00:23:07.460
disease. I mean, it'll lower your blood pressure a little, but not to a completely unhealthy
00:23:12.260
level or anything. It's not like you keep fasting, your blood pressure just drops out the bottom and
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you die or anything. I don't think scientists really know why fasting has this effect. What they do know
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is that the greatest drop in hypertension ever reported in the peer-reviewed scientific literature
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came not from pills, came not from a conventional procedure, but from fasting for 10 days at a fasting
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clinic. And in that study, the average drop in high blood pressure was 37 over 13 points,
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which is like double or triple what most blood pressure pills can achieve. And the best news is the
00:23:47.780
sickest patients, those with the worst stage 3 hypertension, got a drop in their systolic pressure, which
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is the top number in a blood pressure reading, of 60 points, 6-0. That is just off the charts. Conventional
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medicine can't touch it. Unfortunately, we don't have, you know, much more data than that, but that's still
00:24:09.480
enough to go on. Even if you don't know the mechanisms behind it, right? You have, you know,
00:24:15.340
getting the cure, one would think would be great because most medical organizations will tell you
00:24:21.480
they don't have a cure for high blood pressure. And yet, despite this research having been in the
00:24:26.920
scientific literature for two decades and with follow-up studies and so on confirming these results,
00:24:32.580
most doctors who are dealing with hypertensive patients know nothing about it and do not suggest
00:24:38.280
that their patients look into it, which is quite a pity. Another contributing factor to cardiovascular
00:24:43.260
diseases like lipids, so cholesterol, triglycerides, what does fasting do to that stuff?
00:24:48.680
Does fantastic things for them. Again, both daily fasting and prolonged fasting. You find studies
00:24:55.920
where people are having their, you know, triglycerides and cholesterol drop 10, 20, 30, sometimes even 40 or 50
00:25:02.800
points. Sometimes when you do a prolonged fast, your triglycerides in particular, I think it is,
00:25:08.960
certainly some of your lipids will rise, which originally led some doctors to be concerned.
00:25:14.840
The rise appears to be temporary. It rises because you are mobilizing all your fat, your lipids,
00:25:21.440
your stored cholesterol, and so on. That gets into your blood. And after a few weeks, you know, after the
00:25:26.340
fast, it goes away and you end up quite usually with lower lipid readings than you had before.
00:25:32.800
We're going to take a quick break for your words from our sponsors.
00:25:43.880
So there's a lot of people out there that have autoimmune diseases, I think lupus,
00:25:48.260
rheumatoid arthritis, and this is a debilitating condition where you're basically your body's
00:25:52.340
attacking itself. Your body's immune system is attacking your body. And the treatment for this
00:25:57.440
is sort of, you can manage symptoms often, but then there's research that shows that fasting,
00:26:02.900
prolonged fasting can help with even autoimmune disease. Can you walk us through some of the
00:26:08.520
Yeah, you're right. The, you know, autoimmune diseases like rheumatoid arthritis, as you
00:26:12.880
mentioned, ulcerative colitis, lupus, psoriasis, these diseases where the body is attacking itself,
00:26:18.080
the body seemed to calm down and the attacks lessen and sometimes even go away completely
00:26:23.580
when people do prolonged fasts. The best studied of these conditions is RA, rheumatoid arthritis.
00:26:31.300
There were a few pilot trials back in the 1980s that found when people with RA fasted,
00:26:37.240
their neutrophils calmed down. Now neutrophils are normally good things. They're white blood cells
00:26:42.700
that kill harmful bacteria. But in RA, they turn on the body, they attack the linings of the joints,
00:26:48.700
which lead to these really nasty, inflamed, often deformed, very painful joints. So finding this
00:26:55.460
mechanism and finding benefit from fasting, there was a more rigorous, randomized controlled trial
00:27:01.660
that was set up. Randomized controlled trials are the gold standard of clinical research, a very good
00:27:06.700
trial. In that trial, a bunch of people with RA fasted for a week and then they ate a plant-based
00:27:12.700
diet for a year. Now the background for this is that we don't have a cure for RA. We've got
00:27:19.340
drugs with pretty terrible side effects that can slightly slow the progression of the disease, but
00:27:24.540
nothing that can reverse it. In this fasting trial though, both during the fast and then afterward on
00:27:31.300
the plant diet, the volunteers showed remarkable improvements. They had less inflammation, less pain,
00:27:37.460
less morning stiffness, better ability to grip things, and on and on. The control group who didn't fast
00:27:44.100
didn't improve at all. In fact, they got worse. Now this study was so convincing that in 1990, its
00:27:50.580
results were published in The Lancet, which is one of the world's most prestigious medical journals.
00:27:56.980
Now again, remember, we've got no conventional treatment that can reverse this disease,
00:28:01.440
and here the researchers had shown that fasting reversed it, but the medical establishment simply
00:28:07.260
couldn't accept it. They just roundly rejected it, forgot all about it if they ever paid attention to
00:28:13.020
it at all. To me, that's the real quackery, even though they were calling fasting quackery. The more
00:28:20.680
scientific approach would have been for the rheumatologists to heed the science presented in this very good
00:28:26.500
trial and advise their RA patients who've got nothing else to go to a fasting clinic.
00:28:32.480
So another area you explore how fasting can be used as treatment is cancer. And you start off the
00:28:39.320
book with the story about a woman who got diagnosed with cancer, and then she decides to go to this
00:28:44.680
fasting clinic in Northern California. And when I first started reading the story, I'm like, oh my gosh,
00:28:49.620
this sounds like Steve McQueen when he had cancer, trying all these treatments that ended up
00:28:54.500
probably speeding up his death. But this woman, cancer started going into remission when she started
00:28:59.460
this extended fast. So tell us about that experience and what the research is showing about fasting and
00:29:06.340
Yeah, so this woman had follicular lymphoma, which is a cancer that attacks the lymphatic system.
00:29:12.320
And your note of caution is right, and I'll get to why we should be cautious in a moment. But in her
00:29:18.120
particular case, she went and fasted for, I believe it ended up being about three weeks at this fasting
00:29:24.040
clinic, and her tumors disappeared. She had some very good scans and so on that were done before
00:29:30.460
she went to fast and after she went to fast that could verify that these tumors went away. Now,
00:29:36.520
follicular lymphoma is a weird cancer. It's very slow developing. It can come and go. There are often
00:29:43.040
spontaneous remissions where the cancer looks like it's gone away, and a year later, two years later,
00:29:49.000
it comes back. Well, years past, her cancer never came back. So the doctors and researchers at this
00:29:55.040
clinic wrote up her case for a very important medical journal called the British Medical Journal
00:30:00.860
Case Reports, and it was published. When her cancer still didn't come back years later, they published
00:30:06.620
another study showing that it hadn't come back. It's now been eight years. I talked with her a few
00:30:13.000
months ago. She is still cancer-free. Now, so we think that fasting can, in fact, entirely eliminate
00:30:21.320
follicular lymphoma, at least in some patients. There are also very credible anecdotal reports. These
00:30:27.920
aren't published in the peer-reviewed literature, but they're credible, and they suggest that fasting
00:30:32.240
can slow or even reverse other cancers. But here's the catch. Temporarily, all right? The problem is that
00:30:40.400
cancer is crafty. It almost always finds a way around the hurdles that fasting throws up.
00:30:46.460
So most people, if they've got cancer and they go to fast, they may get some good result from a
00:30:51.820
little while, but they're probably going to end up dead if that's all that they're relying on.
00:30:56.660
We have no evidence that fasting can reverse the great majority of cancers in humans, though it's
00:31:02.380
possible we will find some more because we do have evidence that it can reverse certain cancers,
00:31:07.480
in lab animals. But it's really hit and miss, like fasting can completely retard, eliminate one form
00:31:16.340
of leukemia in mice, but not another form of leukemia in mice, and scientists don't really know why.
00:31:23.380
What they're excited about and where they think fasting's real promise seems to lie for cancer
00:31:27.960
is in using it as an adjunct to conventional treatments like chemotherapy. Because scientists
00:31:34.020
have found that prolonged fasting does indeed weaken some cancers, and it does this by starving them of
00:31:40.240
their preferred fuel, which is glucose, which obviously is gone during a fast. Fasting also
00:31:46.180
tamps down on the growth factors that cancer hijacks to divide and spread. And fasting also ramps up the
00:31:53.640
body's immune cells that attack cancer. So that's all really good news. Now, at the same time,
00:31:59.400
when a cancer patient fasts for just a few days, their healthy cells go into a protect and repair
00:32:05.900
mode. They kind of hunker down and they lick their wounds. So when cancer patients fast and then get
00:32:11.980
chemo or radiation, their healthy cells do a better job at repelling the devastating effects of those
00:32:18.080
treatments. So their cells either aren't as badly hurt, or do a better job at quickly fixing whatever
00:32:24.500
damage it is that they suffer from those treatments. The result, and this is the headline here for chemo
00:32:30.960
and radiation patients, is that they have far less nausea when they fast a few days around their
00:32:36.100
treatment. They have far less vomiting, less diarrhea, fewer headaches, less fatigue. That is just huge.
00:32:43.360
But the final piece of it, which may be even better, scientists are still trying to figure this piece
00:32:48.740
out, is that during the fast, the patient's cancer cells, unlike the healthy cells, which are hunkering
00:32:54.640
down, the cancer cells pay no attention to the fast and they continue with their single-minded mission
00:33:00.040
to grow at all costs. They just keep gobbling up any and all inputs, including the chemo. Because the
00:33:05.880
fast has already weakened the cancer, the chemo may kill more of the cancer cells. And since the healthy
00:33:11.980
cells are better protected and the cancer cells are more vulnerable, doctors should be able to give
00:33:17.860
higher doses of chemo to kill even more cancer without killing the patient. And that, at least,
00:33:24.800
is what happens in mice. And we have trials underway now to see if the same will hold true in humans.
00:33:31.260
So again, this is a prolonged fast. I think the way you described it, when chemo patients do
00:33:35.080
try to combine fasting with the chemotherapy, they might do like a 36-hour fast before their chemo
00:33:41.000
treatment and then like another 24 hours after the treatment, correct?
00:33:44.500
Pretty close. They tend to be 48 to 72-hour fasts before the treatment and then 24 hours
00:33:51.500
after the treatment. And there's a very prominent researcher at the University of Southern California
00:33:56.800
named Walter Longo, who has come up with a fasting-mimicking diet for people who are scared
00:34:02.580
of fasting or don't want to fast that gives you a few calories. It's 200 or 300 calories a day,
00:34:07.820
very specially calibrated so that if you want to have a little bit of food to see you through that,
00:34:13.560
you can do that. So it's fasting. We're fasting-mimicking diets for a few days before and
00:34:18.920
And is the research ramping up on this with fasting and cancer?
00:34:22.800
Yeah, it's huge. Now, the catch is, so Longo, who I think is a fantastic researcher,
00:34:28.660
he's really just done some of the most amazing work. When he was trying to put his trials together,
00:34:34.920
he found that oncologists and patients were extremely reluctant to fast. I mean, you can
00:34:41.020
understand this. People who, many of them, most of them probably have no experience with fasting
00:34:46.020
and they're, you know, saddled with cancer, which is horrible. And then they're told they're doing
00:34:50.900
chemotherapy, which is all the worse. And then you ask them to fast on top of it, they just completely
00:34:56.840
freaked out. And so he had a very hard time convincing oncologists and patients to go along,
00:35:02.140
which is why I think wisely he came up with the fasting-mimicking diet. The catch is this,
00:35:07.420
you can make a lot more money off a fasting-mimicking diet, a product that you can sell
00:35:11.920
for a couple of hundred bucks for, you know, four days or so, than you can off just telling people
00:35:17.420
not to eat. So almost all the research into fasting and cancer treatment is going into actually
00:35:25.200
fasting-mimicking diets and cancer treatment because the company that's, you know, behind the diet
00:35:30.780
wants to do that research. Fasting clinics don't have a lot of extra money. They're not doing this
00:35:36.020
kind of research, even though they are doing a little bit of research. So there's a shortage,
00:35:40.960
I think, of actual research into actual fasting for cancer. And, you know, knock wood,
00:35:48.060
So you mentioned that fasting has been shown, or prolonged fasts have been shown to help us live
00:35:55.420
Yeah. So when we fast, the biomarkers for longevity move in the right direction, often in a big way.
00:36:02.060
Some of these biomarkers are ones that we've talked about, like lower blood pressure, greater insulin
00:36:06.760
sensitivity, and so on. But some of the markers are quite specific to longevity. There's a gene called
00:36:13.440
SIRT1 that's sometimes called the longevity gene because of several things that it does, like making
00:36:19.700
more antioxidants or protecting our telomeres, which are the protective tips that keep the ends of our
00:36:25.820
DNA from unraveling, like the plastic tips on the ends of our shoelaces. In one study, when volunteers
00:36:32.600
ate for just four days in a daily fasting pattern, in this case, they were eating for six hours a day
00:36:39.020
in the morning and early afternoon, and then fasting for the other 18 hours, the activity of SIRT1
00:36:45.080
increased by 10%, which is an astonishing gain for just four days of changing not a thing about what
00:36:52.460
they ate, only when they ate. Even bigger was an increase in the recycling of worn-out cellular parts.
00:37:00.380
That process, which some of your listeners probably know, is called autophagy, which protects us from
00:37:05.160
disease. One marker for autophagy in this four-day study increased by 22%. That is just simply astounding.
00:37:13.680
Again, not a single change to their diet, only a change in when they ate the same foods that they
00:37:19.820
would have eaten otherwise. So, scientists believe that increases in these kinds of markers will
00:37:25.880
eventually translate into longer life. They will result in less disease, and they shouldn't result
00:37:31.460
in more longevity, though, of course, it would take, you know, a 120-year study for us to verify that.
00:37:36.900
So, it's partly speculation, but it's really well-grounded speculation.
00:37:40.620
So, we've been talking about extended fasting's effect on our physiology. It could be autoimmune
00:37:47.520
diseases, diabetes, cancers. What does the research say about extended fasting and mental health?
00:37:54.040
Yeah, this is another area where we need far more research, but what we do know is extremely
00:37:58.260
intriguing. The best work on this was done clinically by a Russian psychiatrist named Yuri Nikolaev
00:38:04.560
between about 1948 and 1990. Nikolaev decided that the barbaric treatments of the day, things like
00:38:12.180
electroshocks, were more harmful to mental patients than helpful. And he had grown up fasting now and
00:38:18.920
then, so he decided to give this a try on his patients at the large mental hospital in Moscow where he
00:38:25.100
worked. And the results were spectacular. We're talking hardcore schizophrenics, institutionalized
00:38:32.020
people who were very severely deranged, who seemed to be beyond all help, often recovered with fasts of
00:38:39.840
about three weeks. Nikolaev ended up fasting about 10,000 patients, and many of them, I think the
00:38:46.420
majority, became completely normal and resumed healthy, happy lives. And he maintained their remissions
00:38:52.980
by having them eat a vegetarian diet and doing periodic maintenance fasts of a few days here and there.
00:38:59.940
Now, he didn't have the research to say why fasting helped them. And even today, we don't have a ton
00:39:06.480
more, but we do know a few things. For example, one of the ketones that's burned for fuel and fasting,
00:39:13.100
it's called BHB, beta-hydroxybutyrate. This ketone increases something called brain-derived
00:39:19.660
neurotrophic factor, BDNF. BDNF is important for our brains because it grows new neurons, it maintains
00:39:26.860
existing neurons, and it forms new synapses between neurons. So when we fast, we get all these benefits
00:39:33.820
in our brain. Fasting also increases the amount of feel-good hormones we have circulating, like
00:39:40.720
endorphins, and what might be called feel-good neurotransmitters, like serotonin and endocannabinoids,
00:39:48.460
which is like your body's own cannabis. So we have a few details, they're all very encouraging,
00:39:54.180
but we are a very long way from understanding all of this.
00:39:57.900
Yeah, and you provide stories. These are all, again, you got to be clear, these are anecdotal
00:40:01.000
stories from doctors who were treating patients with mental health problems. Like I think there
00:40:06.000
was one, there was a woman who was just severely depressed and she didn't want to eat. And the
00:40:09.800
doctor was like, okay, well, just don't force her to eat, just give her water. And she basically
00:40:14.340
started this unintended extended fast and a week or two weeks into it, like she started feeling better
00:40:23.300
You're right. And these are just anecdotes. It's a good thing to remember. These are not
00:40:29.240
randomized controlled trials. However, when the weight of the anecdotes piles up over 150 years
00:40:36.780
of fasting doctors recording what they've seen and patient after patient, for instance,
00:40:41.960
in mental institutions who refuse to eat, get better, it should, to the scientifically-minded
00:40:48.780
researcher or doctor, pique their interest in, well, I don't know, this is really strange,
00:40:56.060
but why don't we put it to the test and try a trial and see what happens? Unfortunately,
00:41:01.540
it is so counterintuitive that that sort of scientific part of the doctor's and scientist's
00:41:06.940
brain just goes out the window. They can't even see the evidence before their eyes. But it is
00:41:12.620
important to note, as you say, these are anecdotes. There could be something else going on there,
00:41:17.380
but it seems awfully likely to be the case that it is the fasting that is bringing about these changes.
00:41:23.140
Well, in the section on fasting, it reminded me of a recent podcast we did with Dr. Chris Palmer.
00:41:28.960
He is a Harvard psychiatrist. He just came out with a new book where he lays out his theory that
00:41:33.880
all mental illness, whether it's depression, anxiety, schizophrenia, addiction, the underlying
00:41:40.880
cause is a metabolism issue. And so it made me think that fasting helps improve our metabolism
00:41:47.980
because it just basically allows our metabolism to reset. So maybe that's what's going on with
00:41:53.400
fasting and mental illness. It's just helping our metabolism improve.
00:41:57.120
Yeah. Palmer's theory is certainly provocative and interesting. It's certainly possible. I mean,
00:42:03.020
our psychology is so complicated. I mean, your metabolism can be great,
00:42:07.300
but if, you know, I don't know, you live in a war zone or something, you may well be depressed.
00:42:12.820
You know, I have found one of the problems that I had for most of my adult life was clinical
00:42:18.560
depression. And I had been on antidepressants for a quarter of a century. And I thought, well,
00:42:25.760
gosh, wouldn't it be interesting if I tried going off my antidepressants? Now, for the previous
00:42:30.580
25 years, anytime I had done that, I would last about three or four months and I would completely
00:42:36.660
crash. It was just, you know, grim times. This time, however, when I tried it, I didn't crash.
00:42:43.140
It's been almost four years now that I've been off antidepressants, the longest that I have
00:42:48.100
ever been off antidepressants before. And I do think it has a great deal to do with exactly what
00:42:53.720
you're saying. Some metabolic reset that we don't yet understand that happened in my fast.
00:42:58.320
And then that I maintained, and this is another important part, by changing my diet to a far
00:43:04.320
healthier diet. Because you have to ask yourself, well, look, if the condition gets better when we
00:43:09.460
take the food away, is it possible that there's something in the food itself that might be causing
00:43:15.380
this illness? And researchers like Christopher Palmer, who you mentioned, are on the forefront of
00:43:21.960
trying to look at what these nutritional contaminants, for lack of a better word, are,
00:43:28.120
is that throws off our nutrition and throws off our metabolism and contributes to, for some of us,
00:43:36.180
You also mentioned that when we eat, when we do eat, can have a big impact on our health.
00:43:41.900
Talk more about the research there, like how the time we eat can either be detrimental or help us.
00:43:46.600
Yeah, this is really new and really exciting research, just in the last decade, some of it
00:43:52.580
just in the last couple of years. And to summarize it, scientists have found two very important
00:43:58.580
things. The first is that our bodies make more repairs during our overnight fasts, right? We all
00:44:04.620
fast overnight. It's just a question of how long. Well, our bodies make more repairs during those fasts
00:44:10.220
when we fast for at least 12 hours each night, which of course then means limiting our eating
00:44:15.840
to no more than 12 hours a day. These repairs increase dramatically if we limit our eating even
00:44:22.440
further, cutting our eating window down to eight or even six hours a day. That's why you see so many
00:44:28.100
people these days following, say, a 16-8 eating pattern, where they're eating for eight hours a day
00:44:33.980
and fasting the other 16. I mean, actually, most of them are probably doing it to lose weight,
00:44:38.400
but a bunch of them are doing it because they're aware that it steps up our repairs.
00:44:43.500
The second big recent finding, and this one almost nobody knows about, is that our eating window is
00:44:49.540
far healthier if we put it in the morning and early afternoon. See, most people who practice daily
00:44:55.560
fasting do, as I did when I first started it, they skip breakfast. They want to eat dinner, so they start
00:45:02.200
eating around 11 a.m. or noon, and they knock off after dinner maybe around seven o'clock. That's the way I
00:45:07.300
did it for a couple of years. But it turns out that our circadian rhythms have hardwired us to process
00:45:14.300
food most efficiently in the morning and early afternoon, and we get worse and worse at it as
00:45:19.920
the day goes on. By nighttime, we're frankly pretty terrible at processing nutrients. So when we eat
00:45:25.980
later in the day or at night, nutrients linger in places where they shouldn't, and our overnight
00:45:32.680
repairs become interrupted, and there seems to be just nothing we can do to change this circadian rhythm
00:45:39.220
that governs all of these processes. So from these two findings, researchers think that the healthiest
00:45:46.060
eating window, the one that will maximize our literally vital overnight repairs that our bodies
00:45:52.220
make each night, is a window that starts about an hour or two after we wake up and continues for about
00:45:58.500
six hours. So for many people, that would be something like an eating window from 8 a.m. to 2 p.m.
00:46:06.000
Now, I know that that sounds crazy, and believe me, I hated hearing this news because I just loved
00:46:12.040
eating late. I nearly always skipped or skimped on breakfast, and I did not want to try this, but I
00:46:18.180
wanted to follow the science, and so I experimented. And as I describe in the book, I actually found it was a
00:46:23.600
surprisingly easy change to make, as if my body had kind of been waiting for me to be eating in sync
00:46:30.260
with its circadian rhythms for half a century, and, you know, hooray, I finally got around to it and had
00:46:35.200
more energy and many other benefits. But I will say this, of course, most people want to eat dinner.
00:46:42.040
Most people with their work schedules will need to eat dinner. And for these folks, scientists think
00:46:46.100
there may be a compromise. Scientists say that you can probably get a lot of the same health benefits of
00:46:52.300
eating in an early window if you just take the great majority of your food each day in that early
00:46:57.780
window. So doing most of your eating before mid-afternoon and then trying to keep your dinner
00:47:02.900
early and light. So it turns out that the adage coined in the last century to eat breakfast like
00:47:09.820
a king, lunch like a prince, and dinner like a pauper was actually good advice.
00:47:16.440
So people who are listening to the show about this extended, prolonged fast and think,
00:47:20.440
I might want to try that. Is this something you need to do under medical supervision?
00:47:25.840
Yeah. So fasting doctors have mixed opinions on how long people can safely fast without medical
00:47:32.480
supervision. And we don't have great research to say, so we're really reliant on the fasting
00:47:36.800
doctor's clinical experience. Some of them say if you're in good health, you've got no diagnosed
00:47:42.320
conditions, you don't suspect any illnesses, you're on no medications or supplements, you can safely
00:47:48.600
fast on your own for up to a week. Other fasting doctors say, well, there are some people out there
00:47:54.360
with very rare disorders. People, for example, who can't process the byproducts of the fat that
00:48:00.400
they'll burn during a fast. And these people could end up in a coma or even die. Now they're really few
00:48:07.260
and far between, but they do exist. So some doctors think that no one should fast on their own
00:48:12.280
for more than about a day. Now, where all doctors agree is they say that if you do have a medical
00:48:19.240
condition, you're taking some meds or something like that, you should never fast without medical
00:48:24.140
supervision. And I think they're wise to say that because lots of things can happen to people who
00:48:29.760
aren't in great health when they fast. Even if you're healthy, none of the doctors recommends fasting
00:48:34.540
on your own for more than a week. Because even healthy people can run into trouble on a fast,
00:48:39.220
and an experienced fasting doctor should be examining you physically each day, checking your
00:48:45.000
pulse and things like that, testing your blood and urine periodically, and doing other things that
00:48:49.960
will help the doctor spot trouble signs that may come up. Those are all the caveats. So that said,
00:48:57.860
if you are in fact healthy, you're not on meds, you can just stop eating and see how it goes. But there
00:49:03.420
are a couple of things you need to be aware of, and I'll just try to very briefly mention them.
00:49:07.640
The first is that you have to drink lots of water to stay hydrated, like half a gallon or more a day.
00:49:14.460
And the second is you need to be aware that the greatest danger of prolonged fasting isn't what
00:49:19.700
people usually think it is. It's not usually, you know, damage to your heart or your liver or
00:49:23.960
something. It's fainting. Because when you fast, as we discussed, your blood pressure will drop.
00:49:29.300
That usually starts about a day or two into the fast. And if you stand up too quickly,
00:49:33.620
your blood may not stand up with you and get to your head quickly enough, and you can faint.
00:49:39.540
Very simple remedy. Fasting doctors advise that you just pump your legs before you stand up to
00:49:44.800
get the blood flowing. Then you stand up in stages, but just be ready on a moment's notice to sit right
00:49:52.340
back down if you feel lightheaded. You do that. Most people, almost everyone, is safe on a week-long
00:49:58.420
fast who are healthy. Should you do this on a vacation or like a week-long week? Let's say
00:50:03.080
you want to do like a three-day fast. Would it be good the first time you do it like on an extended
00:50:06.740
three-day weekend? Yeah, so it's highly variable. That's the way I would do it. I would try doing
00:50:12.820
it at a time where I can rest and I don't have to work. Some people, when they fast, they get more
00:50:17.860
energy. You know, writers, artists, composers talk about, you know, creating their whatever it is
00:50:24.040
they're creating and just a flurry during their fasts. If you have that kind of response to a
00:50:28.920
fast, heck, you may, you know, just do it during the work week. However, a lot of people feel extremely
00:50:35.820
tired, exhausted, you know, just the whole sort of catalog of being worn out. For those people,
00:50:41.920
I think you'll want to do it on a weekend. You know, part of the answer is it depends on why you're
00:50:46.580
trying to fast. If you're trying to fast just because you're interested in seeing how it goes,
00:50:51.080
or you want to get some of these repair and maintenance benefits, but you don't have an
00:50:55.540
illness or something, you may not need rest as badly as someone who's actually trying to cure an
00:51:01.420
illness. So, if that's you, fasting doctors recommend resting the body in order to give your
00:51:07.620
body, you know, if you're not moving around, your body has fewer functions to attend to. The theory is
00:51:13.520
it can attend to those repairs more. So, you know, depends on why you want to do that fast.
00:51:18.980
What does your fasting protocol look like right now?
00:51:21.640
So, I do a daily fast every day at just my normal eating pattern where I eat from most days about
00:51:27.780
eight in the morning till oh, two, three in the afternoon. And I'm flexible about it. I will,
00:51:33.520
you know, if we're having friends over for dinner or something, I'll eat at the normal dinner time.
00:51:37.700
And then I do a prolonged fast about every six months of approximately a week on my own at home.
00:51:44.400
And every so often, I want to, I don't want to fast for more than a week on my own because I don't think
00:51:50.800
it's especially safe. And so, every so often, I want to go to a fasting clinic and maybe try fasting
00:51:57.100
for a couple weeks. But that would be about every, say, two, three years. See, as I mentioned, my health
00:52:03.320
was terrible in my 40s. And I do credit fasting and my dietary change with helping me get my health
00:52:09.580
back. But it's only been, you know, two, three, at most four years that I've really started to feel
00:52:14.880
healthy. And I feel that the fasting, or at least I should say, I hope that the fasting, and I think
00:52:20.600
the research supports this hypothesis, at least, will help me maintain these gains. I sort of still
00:52:27.000
see myself as a recovering sick person and not a fully healthy person. If I were in perfect health,
00:52:33.100
I would probably only do a prolonged fast once a year for about a week, call it good, and then just
00:52:38.480
do my daily fasting. Well, Steve, this has been a great conversation. Where can people go to learn
00:52:42.520
more about the book and your work? Thanks. My website is probably the best place. And that's just my
00:52:47.540
name, stevehendricks.org. The book is a narrative about fasting. It's not a how-to, though you can
00:52:55.400
get a lot of how-to information out of it. But to help people who want even more how-to than is in
00:53:00.440
the book, on my website, there is a frequently asked questions page. And people have, I think,
00:53:05.000
found that pretty helpful. They're, gosh, I don't know, 10,000 words of answers to the most common
00:53:10.160
questions I get about how to fast, mostly. So those would be the places to start.
00:53:15.700
All right. Well, Steve Hendricks, thanks for your time. It's been a pleasure.
00:53:20.680
My guest today was Steve Hendricks. He's the author of the book, The Oldest Cure in the World. It's
00:53:24.260
available on amazon.com and bookstores everywhere. You can find more information about his work at
00:53:27.760
his website, stevehendricks.org. Also check out our show notes at aom.is slash fast,
00:53:32.300
where you find links to resources, where you delve deeper into this topic.
00:53:41.840
Well, that wraps up another edition of the AOM Podcast. Make sure to check out our website at
00:53:45.760
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00:54:08.180
this is Brett McKay, reminding you to not only listen to the AOM Podcast, but put what you've