Obesity

Abstract

Santa Rosa, CA, April, 2022 - The TrueNorth Health Foundation has announced today a case study showing that prolonged water-only fasting followed by an exclusively whole-plant-food diet initiated remission of severe plaque psoriasis symptoms in a 47-year-old male.

Intermittent Fasting and Weight Loss
A form of calorie restriction, intermittent fasting may help you lose those extra pounds.

By Jennifer Marano, D.C.

For many people, following a whole-food, plant-based diet is the key to maintaining optimum weight and health. However, for some of us, strictly adhering to a health-promoting diet as well as engaging in a regular exercise program is not enough to keep us where we want to be weight-wise. We just like eating too much; or perhaps we have extremely efficient digestive systems; or our internal calorie counters are a bit off. Whatever the reason, I and many others tend to maintain a body weight 5 to 10 pounds heavier than what would make us look and feel our best. I have been trying various tricks for years—decades, really—to get rid of those final pounds, and I think I have finally found the answer: intermittent fasting.

I have been involved with fasting for over 30 years as co-founder of TrueNorth Health, a fasting and health center in Northern California, and I am very familiar with the tremendous benefits of fasting for maintaining or restoring optimum health. But we have never recommended fasting as a solution for weight loss. It may jump-start a weight-loss program by resetting our appetite so that we enjoy health-promoting food; but maintaining optimum weight is done by consuming a proper diet every day, not by prolonged fasting followed by a return to bad dietary habits.

But what is a “proper diet”? Is it the same for everyone? Over the past few years I have read a lot about the value of intermittent fasting, both for weight control and general health, and what struck me from the beginning is that the daily eating habits we follow in the developed world—three meals a day supplemented by coffee breaks, mid-afternoon pick-me-ups, and evening nibbles—is a very recent development in human history. For most of the world this abundance of food has not been available until very recently; and in undeveloped areas it is still not the norm. But just mention that you are skipping a meal here and there, and you are met with looks of horror and comments about how unhealthy that is.

But is it unhealthy? What happens when we don’t eat for a period of time? We know that when we eat more than we need to maintain our function, the excess is stored as fat. This is one of the adaptations we possess to keep us going during times of scarcity. When food isn’t available we burn our stored fat to keep us going until we can locate more food. We need certain enzymes to help us store fat and other enzymes to help us mobilize our fat stores. But if we are eating all day long there is never a time when we need to burn fat. It takes 8 to 12 hours to digest and assimilate the food from a meal, so most people in the developed world really never have to mobilize fat. And if the body doesn’t need to do something, it tends to not maintain the equipment (think enzymes) necessary to do that task. You know what happens to your muscles if you don’t exercise. And you know what you have to do to get back into shape. The ability to burn fat waxes or wanes in response to use, just as your muscles respond to use after exercise. You can develop the enzyme systems that allow you to switch easily from burning glucose to burning fat, but it takes some time. And while you are developing them you feel hungry; sometimes very hungry. And it is uncomfortable. Even after you develop these systems you still feel hungry (although it isn’t quite as uncomfortable). But it’s okay—feeling hungry is okay.

What is Intermittent Fasting?
So what is intermittent fasting (IF)? How does it apply to humans? Why do it? What can it do for you? And how do you do it?

IF is a form of calorie restriction, which has been studied for a long time, mostly in animals like rats and mice. It was observed that animals fed a restricted diet lived a lot longer than animals allowed unlimited food. There are people who are practicing calorie restriction with the hope that they will greatly extend their lives. But it is a very uncomfortable way to live, and these people can become very gaunt and weak. Not very many are successful at maintaining this lifestyle. The difference between IF and calorie restriction is the “intermittent” part. Yes, calories are restricted, but only some of the time. And recent animal studies have shown that the benefits are actually greater for the intermittent fasters than for those on a calorie-restricted diet; they both live just as long, but the intermittent fasters don’t lose muscle mass or become stunted. And that makes all the difference when it comes to applying the idea of IF to human health and weight control.

Before getting into the various types of IF, I would like to say a little about the physiological changes that occur with IF and how they impact health. One change is that the level of insulin-like growth factor 1 (IGF-1) goes down. High levels of IGF-1 in adults are associated with accelerated aging and development of cancer, so lowering this factor may be one explanation for the life-extension effects seen in animal studies. In addition, genes whose function is to repair are turned on by fasting. An organism needs to be in top shape during times of scarcity in order to successfully find food, so the stress of the fast causes this activation, much as the stress of drought or insect pests causes plants to produce more antioxidants. And a third effect is increased insulin sensitivity. Insulin resistance is associated with type 2 diabetes, and high levels of circulating insulin lead to excessive fat storage. Keep these physiological changes in mind as we discuss the various forms of IF; it will increase your understanding of why IF works for weight loss and also why it can be a healthy lifestyle choice, even after you have reached your ideal weight.

The Alternate Day Fasting Plan
One popular form of IF is “alternate day fasting” (ADF, or ADMF for “alternate day modified feeding”). The modified feeding title refers to a system developed by researcher Dr. Krista Varady of the University of Illinois at Chicago. In her system the fasting days actually involve eating a small meal (500 calories for women and 600 calories for men), while feeding days allow unrestricted eating. Dr. Varady found that, contrary to expectations, her subjects did not go crazy on feeding days. They tended to eat about 110% of what they would eat on a normal day before beginning ADMF. This makes ADMF a very effective weight loss program, but it has its difficulties, particularly socially. Friends and family have a hard time keeping track of when you are feeding and when you are fasting. But it is a good choice for people who have a large amount of weight to loose.

The 5:2 Plan
A more easily followed, yet still very effective version of IF is the “5:2 plan,” which was popularized by Dr. Michael Mosley with his Horizon TV program on BBC and in his excellent book, The Fast Diet. On this plan you choose two fast days a week (perhaps Monday and Thursday) when you will eat 500 to 600 calories. The other five days you eat whatever you want, but preferably a health-promoting diet. This plan has been studied extensively. In one study by Dr. Michelle Harvie in Manchester, England, three groups of women were compared for three months. Group 1 was asked to eat 1,500 calories a day on a Mediterranean diet. Group 2 followed a 5:2 plan, eating 650 calories of low-carbohydrate food on the two fast days. Group 3 was asked to avoid carbs two days a week, but was not given any specific calorie target. At the end of three months the 1,500-calorie group lost an average of 5.28 pounds, and the 5:2 groups lost an average of 8.8 pounds!

The Restricted Eating Window Plan
A third version of IF, perhaps the easiest to follow, is the “restricted eating window plan.” This method was based on a mouse study at the Salk Institute for Biological Studies where two groups of mice were each fed an unhealthy, high-fat diet. Each group received the same amount of food, but one group had constant access to the food, while the other group had to do all their eating in an eight-hour period each day and fast for the remaining 16 hours. After 100 days the “unlimited” group had high cholesterol, high blood glucose, and liver damage, while the “fasting” group put on 28% less weight and suffered less liver damage. The fasting group also had lower levels of inflammation, which we are learning is a very important factor in heart disease, cancer, stroke and even Alzheimer’s disease.

Intermittent fasting can be a powerful weight-loss tool with a bonus of improving your overall health. You can design your own program depending on your goals: ADMF if you have a lot of weight to lose, 5:2 as you get closer to your goal, and you can try a 6:1 plan when you get to your optimum weight so you can continue to reap the physiological benefits of IF. Or restrict your eating window to six or eight hours. If you get a bit off track you can throw in a 500- to 600-calorie day here and there. This approach is endlessly flexible—you just have to figure out what works best for you! And just remember: it’s okay to feel hungry.

Jennifer Marano, D.C., is a graduate of Western States Chiropractic College and along with her husband Dr. Alan Goldhamer is the co-founder of the TrueNorth Health Center in Santa Rosa, California.

Resolving Corruption: How to “Reboot” Your Brain so that Healthy Eating is Preferred

By Alan Goldhamer, D.C. and Jennifer Marano, D.C.

Reprinted from Health Science magazine, Spring 2012

Adopting a health-promoting diet in the modern world is among the most difficult challenges facing humans living in industrialized societies. In the world of our ancient ancestors, the biological imperative of life was getting enough to eat while avoiding being eaten. Most early humans were unsuccessful and did not live long enough to reproduce. The few that survived (our ancestors) lived exclusively on whole, natural foods. They never ate refined carbohydrates or processed oils because these artificially concentrated food-like substances did not exist.

Drugs like alcohol and cocaine create intense pleasure feelings by fooling the brain into producing increased quantities of pleasure-inducing neurochemicals, including dopamine. Eventually, the body becomes dependent on this artificial dopamine stimulation and the person must continue to use increasing quantities of these substances to avoid the pain of withdrawal. They have become addicted.

When we include these processed “chemicals” in our diet, including sugar (C6H12O6) or oil (C17H35COOH) we enjoy the resulting feelings that the production of dopamine induces. We become habituated. If we stop adding these substances, we may experience whole, natural foods as tasteless and unappetizing in comparison. Withdrawal symptoms may be similar to drug withdrawal symptoms, including headache, fatigue, nausea, joint ache, pain, irritability, etc. We have been caught in the dietary pleasure trap. We are addicts.

Unlike our ancient ancestors that usually died from deprivation and predation, modern humans increasingly suffer and die from the results of excesses associated with being caught in the dietary pleasure trap. The resulting obesity, diabetes, cardiovascular disease and autoimmune disorders make up the majority of the deaths and disability that plague humans today. 

Alcoholics must struggle to avoid the use of alcohol, even when they realize their lives are being devastated by the consequences of their addiction. Even with the support of a 30-day, in-patient program, regular attendance at a 12-step outpatient program and family support, well over 70 percent of alcoholics will fail to quit drinking and sustain sobriety.

When it comes to the dietary pleasure trap, the results are even more startling. Over 97 percent of attempts to loose substantial weight and keep it off will fail. We live in a world that is designed to give us what we want (pleasure) not what we need (a health-promoting diet and lifestyle).

The majority of conventional medical care is aimed at treating the symptoms of diseases, particularly our chronic diseases associated with dietary excess. If you have high blood pressure and you follow your doctor’s advice, you will be guaranteed to never recover. You will be on the drugs for the rest of your life (however long that may be), as these drugs will not correct the cause of your high blood pressure. This is also true for diabetes, arthritis, asthma, colitis, and many other chronic conditions.

If your goal is to lose weight and keep it off, conventional medical advice fails. Some doctors have become so frustrated with universal failure that they give up and tell people to just accept themselves as they are, because achieving optimum weight and health can’t be done. Or, they may resort to drastic (and very lucrative) surgeries with all of their attendant problems and risks.

For the past 30 years the doctors at the TrueNorth Health Center have worked with over 10,000 patients, many of whom struggle with the dietary pleasure trap. Some start off unaware of what a health-promoting diet is and have been deluded into thinking that their lean meat, low-fat dairy products, sugar-free sodas, dark chocolate, sugar substitutes, such as honey or agave, and their red wine ARE health promoting.

Others understand that health is the result of healthful living, and that means eating a plant-based diet that is also SOS-free (free of added sugar, oil and salt) but they have trouble sticking to the program, given the temptations that they face each day.

The result for both groups of patients, regardless of their knowledge is the same: obesity, diseases of dietary excess, and premature disability and death. Both groups find that the more the dietary pleasure trap has ensnared them, the less appealing are whole, natural foods. Our work at the TrueNorth Health Center is focused on helping people overcome this trap and adopt a diet and lifestyle that will control and even reverse this process instead of just treat symptoms. It is not easy or simple, but it can be done, as the following examples illustrate.

When the program at the TrueNorth Health Center gained acceptance as a fully covered benefit of a major labor union, we admitted a crane operator who was a very large and rather gruff man. Almost 100 pounds overweight with a history of high blood pressure, diabetes, digestive difficulties and impotence, he questioned me immediately about the need for him to stay at our facility and undergo a period of medically supervised, water-only fasting. I explained that the combination of obesity, hypertension and diabetes increased his chances of dying. 

He reminded me that “we all have to die sometime.” I reminded him that his deteriorating health had led to his use of eight prescription medications costing over $1,000 dollars a month. He countered that his union paid for his medications which cost him nothing. In desperation, I suggested that if the fasting and diet change were successful, there was a good chance we could get him off his medications and do something about his “little problem” he was having with “Captain Johnson.” When he looked up suddenly at the mention of his impotence problem, and I noticed that his neck was bigger than my thigh, I was worried I may have just poked an angry lion in the eye. He looked at me and said, “Well, why the hell didn’t you just say so.” He picked up his bag and checked into his room. 

We tried to feed him a very nice plant-based, SOS-free final meal before starting the fast, but he was clearly having difficulty eating the food. I thought he might have an esophageal stricture from the difficulty he was having swallowing. With each bite his face cringed as if he were swallowing the most bitter and disgusting fare you can imagine. I sat down next to him and said, “It looks like you’re having some trouble eating.” He said, “This stuff is AWFUL! If I have to eat tasteless swill like this in order to get healthy, I would rather DIE!” He suggested that rather than guiding him through a fast, he would prefer that I just go out to his truck, bring in his 12-gauge and SHOOT HIM IN THE HEAD!

After almost three weeks of fasting, the loss of almost 40 pounds and the elimination of all of his medications, the time came to begin refeeding. This time he was able to chew AND SWALLOW his health-promoting fare. When I commented on his improved ability to eat and enjoy whole, natural foods, he suggested that our chef was FINALLY getting the “hang of it.” I told him it was the same food he had tried before. He vehemently denied that and said that the food I had fed him three weeks ago was tasteless swill, but this stuff was “not bad.”

He returned to work as a crane operator. Six months later I ran into him while I was doing blood pressure screening at a union health event. I asked him how he was doing. He said he had stuck to the rabbit food diet, had lost an additional 60 pounds, had used NO medications and, as he made a fist and held his arm up in an “erect” fashion, he assured me that he was doing “JUST FINE.”

Without the benefits of a fast, it would have been very difficult to get compliance with diet change. Improving health enough so that good foods “taste good” is a very powerful benefit of fasting. We call this change "taste neuroadaptation." It lasts as long as people keep eating well. 

One sure sign that someone may need to consider fasting is when health-promoting foods lose their natural appeal. Patients caught in the dietary pleasure trap cannot fully enjoy (or in some cases even tolerate) the pleasure of eating whole, natural foods. For people who have the motivation and determination to stick to a vegan, SOS-free diet for long enough periods of time, many problems of dietary excess will begin to slowly improve. For those who are unable or unwilling to give up their addictions easily, or who do not respond quickly enough, a period of medically supervised water-only fasting can, in some cases, save their life.

Free phone consultation: If you would like to have a no-cost phone consultation with Dr. Alan Goldhamer to determine if a stay at TrueNorth Health Center might be helpful to you, go to the Center’s website at www.TrueNorthHealth.com and click on the "registration forms" button. Answer the health history questions and click "submit" and then call (707) 586-5555 ext. 2022. Dr. Goldhamer will help you evaluate your options.

How does our program work?

1. First we review your medical history and offer a free phone consultation to determine what program might be appropriate.
2. You will receive a physical examination and appropriate testing by a TNH medical doctor.
3. We’ll discuss our various programs: healthy eating, juice fasting or water fasting to eliminate the dependence on medications and dietary chemicals, etc.
4. We’ll help establish a program for flexibility, strength and endurance as well as relaxation and healthy sleep.

Alan Goldhamer, D.C., is the founder of TrueNorth Health Center in California. He is a member of the NHA Board of Directors. Dr. Goldhamer is the author of the Health Promoting Cookbook and co-author of The Pleasure Trap. Jennifer Marano, D.C., is the co-founder of TrueNorth Health Center. Both are Life members of the National Health Association.

This week, I was planning to write about recent research that found a strong, positive correlation between a diet including animal proteins and type 2 diabetes.  The study "Low-carbohydrate diet scores and risk of type 2 diabetes in men" was published in the American Journal of Clinical Nutrition. As I was reading through the articles, though, I found a number of articles in the current volume of the journal that support (albeit indirectly) a whole-food, plant-based diet. Here''s a few of the articles I found:

• A high-fat diet impairs cardiac high-energy phosphate metabolism and cognitive function in healthy human subjects. The American journal of clinical nutrition Vol: 93 Issue: 4 ISSN: 0002-9165 Date: 04/2011 Pages: 844 - 850.
• This was a small study (n=16) of young males that compared a high fat diet (75 +/- 1% of calories) to a standard diet (23 +/- 1%). The researchers measured cardiac functions and cognitive functions. They found that the high fat diet decreased a major biomarker for cardiac function. They also found reduced cognitive abilities from the high fat diet. The real question to me is how did anyone manage to consume a diet with 75% of calories from fat...I can see why they had to use young males in the study.
• High-protein, reduced-carbohydrate weight-loss diets promote metabolite profiles likely to be detrimental to colonic health: The American journal of clinical nutrition Vol: 93 Issue: 5 ISSN: 0002-9165 Date: 05/2011 Pages: 1062 - 1072
• This study followed 17 obese men and put them on both a high protein, moderate carbohydrate diet and a high protein, low carbohydrate for 4 weeks at a time. The researchers concluded: "After 4 wk, weight-loss diets that were high in protein but reduced in total carbohydrates and fiber resulted in a significant decrease in fecal cancer-protective metabolites and increased concentrations of hazardous metabolites."
• Diet, vegetarianism, and cataract risk: The American journal of clinical nutrition Vol: 93 Issue: 5 ISSN: 0002-9165 Date: 05/2011 Pages: 1128 - 1135
• I found this study one of the more interesting because they had a large sample size (n=27,670). The results they published: "There was a strong relation between cataract risk and diet group, with a progressive decrease in risk of cataract in high meat eaters to low meat eaters, fish eaters (participants who ate fish but not meat), vegetarians, and vegans."

The last study in the list is just part of the growing body of large-scale evidence supporting the hypothesis that a whole-food, plant-based diet will lead to better health outcomes that a diet rich with animal foods and processed products. Hopefully I''ll get around to a more in-depth analysis of the type 2 diabetes study next week.