Fasting by
Ray Sahelian, M.D. Benefit and
Risk of Fasting - Consider Diet Rx appetite suppressant
There is no doubt that we are exposed to countless
harmful substances in our environment - hormones, pollutants, pesticides, drugs,
oxidants, toxins, and heavy metals. We are exposed to these toxins through food,
water, air, and skin. And in many cases it is relatively easy to point the blame
to these harmful substances for causing or aggravating certain diseases. For
instance, it is clear that many inhaled pollutants can aggravate asthma
symptoms. But, many people are eager to blame their symptoms to toxins even if
there is no proof that they are the cause. For instance, toxins are certainly
not the cause for the majority of cases of fatigue, yet some people who are
tired all the time are ready to blame toxins for their condition. And then they
undertake drastic steps - for instance a water or juice fast - which in some
cases makes them feel even worse. And when they feel worse, they incorrectly
think the reason is because toxins are being removed from their body. Most
likely the reason is low caloric intake, low protein intake, muscle tissue
breakdown, low glycogen stores in the liver, low blood sugar, etc.
We probably all have toxins accumulated in our system. And what is the best way
to deal with them? I believe undertaking several long term measures are a better
approach than drastic short term steps (although perhaps a minority of those
trying a drastic diet may notice some benefits such as mental clarity or a sense
of wellbeing, others may get worse). For instance, rather than fasting for a few
days, I prefer reducing caloric intake to perhaps 1000 or 1200 calories a day
over a period of 2 to 3 weeks. I am not convinced that any of the so called
drastic "detox diets" that recommend a strict regimen of lemon juice, olive oil,
apple cider vinegar, cayenne, etc, etc, are beneficial. Through all my years of
medical education, I have come to realize that the body does not like going off
balance too much and for too long. Our body tries to maintain homeostasis, a
balanced state where everything is functioning properly. Fasting, or these
drastic detox regimens alter this homeostasis, often in a harmful way. Liver
glycogen stores are depleted, alterations occur in the mineral and electrolyte
balance in the blood, muscle and bone tissue start breaking down, changes occur
in the acid base balance, alterations occur in the fatty acid composition of
cells, and immune function may be impaired. Having said this, I think early
research shows that going without food for half a day or a day each month could
provide health benefits.
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Better option than a total fast
Eating a very healthy diet, low in calories, is a better option in
the long run. Eat more raw, fresh and organic fruits and vegetables, reduce
dairy intake, reduce meat products, eat more whole grains, consume fish caught
in the wild, drink more varieties of teas, drink fresh vegetables juice, add
more herbs to your food, avoid or dramatically reduce sugar and baked goods, use
some antioxidant supplements and herbs (there are many to choose from). Also,
drink filtered water and wash your fruits and vegetables.
Fasting may benefit the heart
People who skip meals once or twice a month are less likely to be diagnosed with
clogged arteries than those who do not regularly fast. When people take a break
from eating a half a day or a day, it forces the body to dip into fat reserves
to burn calories. It also keeps the body from being constantly exposed to sugar
and having to make insulin to metabolize it. When people develop diabetes,
insulin-producing cells become less sensitive to cues from eating, so fasting
may provide brief rests that re-sensitize these cells and make them work better.
However, fasting is not a good way for long term weight loss. Fasting resets the
metabolic rate slowing it down to adjust to less food. This leads to the body to
store calories as soon as a person resumes eating
Fasting or caloric restriction -
Alternate day fasting is one option
Cutting calories by fasting every other day may
make cells less prone to becoming cancerous. Scientists at the University of
California, Berkeley, found that when they put mice on a routine of
alternate-day fasting, it reduced the rate at which the animals' body cells
divided and proliferated. Because cancer begins when abnormal cells are allowed
to divide and spread unchecked, this slowed-down cell division could
theoretically reduce the risk of tumor development. However, it's too soon to
draw that conclusion, since the study did not look at cancer incidence among the
animals, said Dr. Marc Hellerstein, who led the research. The study, published
in the May 2005 issue of the American Journal of Physiology, Endocrinology and
Metabolism, adds to a growing body of evidence that links calorie cutting to
both longer life and lower cancer risk in animals. Whether fasting could help
people lower their cancer risk or prolong their lives is not yet known. But the
encouraging finding from this study is that it didn't take
substantial calorie deprivation to influence beneficial cellular
changes. The mice fasted four days a week and allowed to eat as much as they
wanted on non-fasting days. The net effect was a five-percent lower-than-normal
calorie intake, which in humans would amount to eliminating about 100 calories
per day. The impact of this modest calorie reduction on cell division was nearly
as significant as what Hellerstein's team saw in a group of mice whose calorie
intake was slashed by one third.
There are a number of theories on why limiting food might make for
a longer, healthier life. One idea is that slowing the rate of metabolism
reduces the generation of oxygen free radicals. When it comes to cancer
specifically, research has suggested that calorie cutting could be beneficial in
a number of ways -- with reduced cell proliferation being one. Exactly why
fasting or general calorie restriction might dampen cell proliferation is unclea. What the signal or signals
are is unknown, but one possible player is
insulin-like growth factor type 1 (IGF-1) -- a protein that helps spur cells to
multiply and has been implicated in the cancer process. Previous animal research
has shown that calorie restriction reduces blood levels of IGF-1. American
Journal of Physiology, Endocrinology and Metabolism, May 2005. book on fasting
Alternate-day fasting
may provide health benefits
Calorie restriction and alternate-day fasting are different forms of caloric
restriction. In terms of diabetes risk, animal studies of alternate-day fasting
find lower diabetes incidence and lower fasting glucose and insulin
concentrations, effects that are comparable to those of calorie restriction. In
terms of cardiovascular disease risk, animal alternate-day fasting data show
lower total cholesterol and triacylglycerol concentrations, a lower heart rate,
improved cardiac response to myocardial infarction, and lower blood pressure. In
terms of cancer risk, there is no human evidence to date, yet animal studies
found decreases in lymphoma incidence, longer survival after tumor inoculation,
and lower rates of proliferation of several cell types.
Juice fasting
I'm not so sure juice fasting is healthy since it exposes the body to lots of
fructose, particularly if the juice is mostly fruit.
Fasting for weight loss
Fasting may lead to short term weight loss but it is uncommon to keep the weight
off permanently without making some permanent lifestyle changes.
Fasting Research Update
Mediterranean diet and extended fasting's influence on changing the intestinal
microflora, immunoglobulin A secretion and clinical outcome in patients with
rheumatoid arthritis and fibromyalgia: an observational study.
BMC Complement Altern Med. 2005 Dec 22;5(1):22
Alterations in the intestinal bacterial flora are believed to be contributing
factors to many chronic inflammatory and degenerative diseases including
rheumatic diseases. While microbiological fecal culture analysis is now
increasingly used, little is known about the relationship of changes in
intestinal flora, dietary patterns and clinical outcome in specific diseases. To
clarify the role of microbiological culture analysis we aimed to evaluate
whether in patients with rheumatoid arthritis (RA) or fibromyalgia (FM) a
Mediterranean diet or an 8-day fasting period are associated with changes in
fecal flora and whether changes in fecal flora are associated with clinical
outcome. RESULTS: We found no significant changes in the fecal bacterial counts
following the two dietary interventions within and between groups, nor were
significant differences found in the analysis of sIgA and stool ph. Clinical
improvement at the end of the hospital stay tended to be greater in fasting vs.
non- fasting patients with RA (p=0.09). Clinical outcome was not related to
alterations in the intestinal flora. CONCLUSIONS: Neither Mediterranean diet nor
fasting treatments affect the microbiologically assessed intestinal flora and
sIgA levels in patients with RA and FM. The impact of dietary interventions on
the human intestinal flora and the role of the fecal flora in rheumatic diseases
have to be clarified with newer molecular analysis techniques. The potential
benefit of fasting treatment in RA and FM should be further tested in randomised
trials.
Incorporation of fasting therapy in an integrative medicine ward: evaluation of
outcome, safety, and effects on lifestyle adherence in a large prospective
cohort study.
J Altern Complement Med. 2005 Aug;11(4):601-7.
The aim of this study was to implement fasting therapy in an inpatient
integrative medicine ward and to evaluate safety, acceptance, and effects on
health-related outcomes and lifestyle adherence. This was a prospective
observational study with consecutive inpatients over 13 years. Inclusion and
exclusion criteria for fasting therapy were checked by treating physicians and
recommendations given. After receiving full information patients decided whether
they would participate in fasting. Outcomes were assessed on admission, at
discharge, and 3 and 6 months after discharge. Subjects were newly admitted
inpatients with chronic internal diseases and chronic pain syndromes, with
lengths of hospital stay of >3 days. All patients received intensive integrative
treatments including Mind/Body Medicine, acupuncture, nutritional/lifestyle
education, and hydrotherapy. Fasting patients participated in a 7-day juice fast
(intake <350 kcal/day) with accompanying bowel cleansing, 2 pre fasting relief
days, and 3 days with stepwise reintroduction of food. Outcomes were assessed
based on rate of participation in fasting, severity of main complaint, quality
of life, safety, lifestyle adherence to recommendations given (relaxation, diet,
exercise). Of 2121 patients with complete discharge questionnaires, 952 patients
participated in fasting, 873 had a normocaloric vegetarian diet, and 296
patients had other diets and were excluded. Response rates were 71% and 56% at
3- and 6-month follow-up. The main disease-related complaint at discharge was
significantly greater improved in fasters versus nonfasters. Patient QOL
increased significantly and comparably from baseline to discharge in both
groups. Fasting was well tolerated and no serious fasting-related adverse
effects were reported. In all, 743 (78%) of fasting patients reported
improvement of their health through fasting. Descriptors of lifestyle adherence
showed higher levels of related activities in the 3 and 6 months of follow-up.
CONCLUSIONS: Fasting can safely and successfully be implemented in an inpatient
integrative medicine concept and is perceived as a health-promoting method by
the majority of patients. Potential effects on disease-related complaints and
lifestyle adherence should be further evaluated in randomized trials.
Fasting emails
Q. "I'm starting a detox program to clear out toxins from my body," said a
friend. "What's your opinion?"
Recently, several friends and patients have asked my opinion on "detox diets."
Others have asked me about "liver or colon cleansing," or fasting. I know many
people who have tried various "cleansing" methods including olive oil/lemon
juice programs, colon irrigation, water and juice fasts, etc. I even came across
some infomercials promoting herbal tablets that supposedly cleanse and rid the
body of toxins. Do any of these work? And besides, what do people really mean
when they use the words "detox" or "cleanse?" Many people who suffer from
depression, fatigue, anxiety, allergies, digestive symptoms, headache, vague
aches and pains, etc, think that these symptoms are due to accumulated toxins in
their body. Are they right, or are they misdiagnosing the causation of their
symptoms?
Q. Dear Dr. Sahelian, My wife and I love your site and info. We would like your
opinion about something. We just read a book which mentions a cleansing diet
consisting of:
2 Tbsp. lemon or lime juice (organic)
2 Tbsp. genuine, pure, organic maple syrup
1/10 tsp. cayenne pepper
10-12 oz. purified water
The book states this cleansing diet helps purify the liver and:
-helps dissolve and eliminate toxins and congestion.
-helps cleanse the kidneys and digestive system.
-helps purify the glands and cells
-helps eliminate unusable waste and hardened material in the joints and muscles.
What do you think?