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.

This interview originally appeared in Integrative Medicine: A Clinician’s Journal (IMCJ), June-July 2014, vol 13, no 3

Interview by Craig Gustafson

Alan Goldhamer, DC, is the founder and education director of TrueNorth Health Center in Santa Rosa, California. Under his guidance, the center has supervised fasts for thousands of patients and grown into one of the premier training facilities for doctors wishing to gain certification in the supervision of therapeutic fasting.

Dr Goldhamer is on the faculty at Bastyr University in Seattle, Washington, where he teaches a course on clinical fasting. He is the primary investigator in two published, landmark studies that demonstrate the benefits of water-only fasting, and is the author of The Health Promoting Cookbook and co-author of The Pleasure Trap: Mastering The Hidden Force That Undermines Health and Happiness.

Integrative Medicine: A Clinician's Journal (IMCJ): What made you interested in pursuing the effects of fasting?

Dr Goldhamer: I got started very young—about 16, actually. I wanted to be a better basketball player than my friend, Doug Lisle, who currently is the director of research and a clinical psychologist at TrueNorth Health Center. We grew up together and he could always beat me in basketball. I was looking for an edge.

So I started reading and came across the books on natural hygiene by Herbert Shelton and others, and it made a lot of sense. Ultimately, I met Alec Burton, MSc, DO, DC, who specialized in fasting supervision. He was the president of the Pacific College of Osteopathic Medicine. After I graduated from chiropractic college at Western States, I went to Australia, attended Pacific College, and did an internship with Dr Burton.

There, I had a chance to see what happens when you do nothing intelligently or use fasting appropriately. And it was pretty mind-bending. So I saw a lot of people who I had been trained to not get well, get well, and they did that consistently through the use of fasting and a vegan SOS-free diet—a plant-based, whole-foods diet free of sugar, oils, and salts.

They applied this regimen in a variety of conditions from diabetes and cardiovascular disease to autoimmune diseases. Conditions that seemed to be tied to dietary excess tended to respond predictably to the use of fasting followed by a health-promoting diet.

To read the article in its entirety (7 pages), please click here or on the attachment below.

Though current medical and surgical treatments manage coronary artery disease, they do little to prevent or stop it. Nutritional intervention, as shown in our study and others, has halted and even reversed CAD.

Authors: Caldwell B. Esselstyn Jr, MD; Gina Gendy, MD; Jonathan Doyle, MCS; Mladen Golubic, MD, PhD; Michael F. Roizen, MD; The Wellness Institute of the Cleveland Clinic, Lyndhurst, Ohio

This original research article appears in the Journal of Family Practice in July 2014, vol 63, no 7

ABSTRACT
Purpose: Plant-based nutrition achieved coronary artery disease (CAD) arrest and reversal in a small study. However, there was skepticism that this approach could succeed in a larger group of patients. The purpose of our follow-up study was to define the degree of adherence and outcomes of 198 consecutive patient volunteers who received counseling to convert from a usual diet to plant-based nutrition.

Methods: We followed 198 consecutive patients counseled in plant-based nutrition. These patients with established cardiovascular disease (CVD) were interested in transitioning to plant-based nutrition as an adjunct to usual cardiovascular care. We considered participants adherent if they eliminated dairy, fish, and meat, and added oil.

Results: Of the 198 patients with CVD, 177 (89%) were adherent. Major cardiac events judged to be recurrent disease totaled one stroke in the adherent cardiovascular participants—a recurrent event rate of .6%,
significantly less than reported by other studies of plant-based nutrition therapy. Thirteen of 21 (62%) nonadherent participants experienced adverse events.

Conclusion: Most of the volunteer patients with CVD responded to intensive counseling, and those who sustained plant-based nutrition for a mean of 3.7 years experienced a low rate of subsequent cardiac events. This dietary approach to treatment deserves a wider test to see if adherence can be sustained in broader populations. Plant-based nutrition has the potential for a large effect on the CVD epidemic.

To read the article in its entirety (11 pages), please click here or on the attachment below.

The below article was featured in the November 2013 issue of GQ Magazine.

What if there were a cure-all treatment for high blood pressure, migraines, chronic pain, arthritis, and, of yeah, fatness? The catch: You'll be really, really hungry. Ben Marcus spends a long and profoundly satisfying week on a strict diet of absolutely nothing but H2O.

DAY ONE: “HORIZONTAL IS YOUR FRIEND”
On my first morning at TrueNorth Health Center, the only medically supervised water-fasting clinic in America, a Dr. Michael Klaper shows up to check my vitals. He is tall and lean, with white hair and the glowing young face of the little brother I never had. He is either 75 years old and absurdly youthful or 30 with a case of premature white hair. A hunger artist? I want to see health and wellness on these premises, impossibly fit bodies with a blinding glow. Something post-human, to prove that fasting works. Dr. Klaper will do fine. He makes me think I can fast my way back to childhood. Maybe infancy. I could return home a smooth, cooing baby and see if my wife will still have me.

It's the first day of my six-day fast at TrueNorth, an anonymous-looking cluster of buildings on a quiet street in Santa Rosa, California. A water fast is not a juice fast or a honey-lemon-cayenne fast or any of the body-hacking protocols or superfood regimens, sometimes rich in calories, that are mistakenly called fasting, however cleansing they might be. This is hard-core, a diet of nothing, a full-body reboot. Dr. Klaper and his colleagues tout their regimen as a potent balm for not only weight and digestive problems but a litany of ailments that plague mankind. Detractors, including my wife, liken fasting to starvation, because without food we turn into ashen little wastrels, crying for help in tiny voices. Right?

Dr. Klaper tells me the rules. No leaving the grounds. I might get confused, or I might fall down. It turns out you get dizzy without food. “Horizontal is your friend,” the doctor advises me. Also, no toothpaste, no lotions or creams. And no showering. Not because they want me dirty, but, again, because I might slip and fall down.

Dr. Klaper takes my pulse and pronounces it “lovely.” He thumps my chest, sounding the cavity, and says my heart is normal-size. I shudder at either alternative.

A technician draws my blood. They're testing lipids, vitamin D, inflammation markers. I ask if they'll test for allergies, because I've always suspected I'm allergic to animals, plants, people, maybe even myself.

They can do that, Dr. Klaper says, but after hearing my description of the nose faucet I wake to every day, and the leaky, bloodshot eyes, he smiles and tells me not to bother with a test. Those symptoms will be gone after my fast.

I like this man.

The good doctor dismisses me, and I stroll outside to sit in the sunshine, waiting for hunger, watching the other fasters come and go. Some are here not to fast but to eat clean for a while, to see the doctors and maybe get some treatments. But the water fasters stand out, because they cling to the wall when they walk. They take the stairs slowly.

TrueNorth lacks the whorehouse comforts of a spa. There isn't even a pool, which seems to violate some central tenet of California apartment complexes. It feels more like a scientific-research center. There are daily lectures and cooking demos, and the guest rooms are stocked with DVDs of slightly NSFW health documentaries. Today at the clinic they showed a grim video called The Pleasure Trap, an unflinching lecture on why we eat, and eat, and f***ing eat, what isn't good for us. Salt, sugar, and fat, combined with chemicals in processed foods, trick the brain in the same way as cocaine, and the brain flushes our bodies with dopamine, perhaps the most blissful, and addictive, homemade chemical we have. Once we find a way to trigger it, we kill ourselves to get more. Literally.

That evening, with no dinner to cook, eat, and clean up, I prepare my water smoothie, made of nothing but distilled water, and turn on the Food Network. If I can't eat food, I'll watch some. On TV, pre-scandal Paula Deen and her son are making corn dogs, fried okra, croissant-dough muffins with caramelized pecans. These things look gorgeous and obscene, like the invented genitalia of a new species. But after watching The Pleasure Trap, it seems wrong to refer to this stuff as food. More like recreational drugs for the mouth, with nasty side effects like diabetes. Still, I'm drooling. I love these recreational drugs. I go to foreign countries just to try exotic versions. I'm a user. I do food.

Just not today, and, if I survive, not for the next five days.

DAY TWO: WHAT WOULD GANDHI DO?
When I first called to arrange my stay, the co-founder of TrueNorth, Alan Goldhamer, cautioned me about the difficulty of water fasting: “It can be an intense, miserable experience, but when people are successful they forgive us.”

On my second day of fasting, I wake up at 4 A.M. in an unforgiving mood. Rise and do not shine. Rise and moan. It's dark and cold. Once you take digestion out of the equation, you save tremendous energy, which can make you restless at all the wrong times. Like the middle of the night. I take my sad glass of water and weigh myself in the kitchen. I'm down three pounds from yesterday. And then I notice that there is something seriously wrong with the air.

Guests are asked not to use scented cosmetics, because fasters have, I'm told, heightened smell. This morning that fact hits hard. I smell breakfast. Maybe miles away. Down the road someone is whipping eggs in a bowl, touching them off with cream and herbs. Butter sizzles in a pan, and when those eggs seize in the hot fat, the smell hurtles up the street. Gandhi said to chew your water, but mine keeps sliding out of my mouth. I guzzle it instead.

Over lunch with Alan Goldhamer—his lunch, my water—he refers to water fasting as “doing nothing, intelligently.” Some of our most common diseases, he claims, including diabetes, hypertension, some forms of heart disease, asthma, arthritis, and certain autoimmune conditions, are diseases of excess, not deficiency. They used to be called the diseases of kings, since only the wealthy could afford to shovel down ultra-rich, low-nutrient food in banquet quantities. Peasants did not get diabetes. Of course, this was before processed food, which is often the cheapest thing to “eat” now, and also the most damaging. Too much of this toxic stuff overloads our livers and kidneys, whose job it is to get rid of waste. As this material accumulates in our system, it can lead to inflammation and sickness. Fasting, the theory goes, treats these diseases by purging the excess. The digestive system gets a rest.

But how do we survive without nutrients? Some doctors argue that fasting is a counterproductive detox tool, robbing the body of the nutrition it needs to effectively cleanse itself. But our bodies are designed for scarcity, or at least well prepared for it. We store fat, and store it, and store it—sometimes renting a whole bunch of extra storage space inside our backs and bellies and asses—precisely because our bodies might need it someday, when the food is gone.

There are, of course, downsides to relying solely on your natural larder. So far they include vicious headaches, dizziness, and a sad, hollow feeling that water does not soothe. But I still want this, mostly for what might wait for me on the other side, when I get my food back. I don't have diabetes, and I'm not fasting to lose weight. I played contact sports in school, and now, in my middle forties, it hurts. I have a ripped-up knee, a trick neck, toes that feel stiff all the time. Sure, I wouldn't mind losing a few pounds, but mainly I'm fasting to relieve my chronic pain, a body ruled by arthritis and a paralyzing nerve disorder that cold-cocked me a couple of years ago.

One morning back in 2011, I woke to searing pain in my arms. A flamethrower directed at my arms is what it felt like. The hospital offered morphine, but one shot did nothing. A second and then a third shot only made me sob more quietly. Finally Dilaudid, at ten times morphine's strength, cooled off the pain. Several doctors and hospitals later, I was diagnosed with a rare autoimmune disease in which the nerves that branch from the neck and power the arms are bulldozed by the immune system. There's no cure, just a blitz of medicines to blanket the suffering. So I embarked on a grisly medical protocol: monster doses of steroids, antiseizure agents for nerve pain, and a lot of craft beer, ice cream, and chocolate for the larger problem of what it now felt like to be me.

I've since weaned myself off the steroids and quit the nerve-pain drugs. But a disease like that, out of nowhere, coming on hard and weird, makes you wonder not just what the hell happened but what exactly you can do to stop it from happening again. I'd tried the brutal meds, and now it was time to try the absence of them, the absence of everything. I was ready, or so I thought, to take the nothing cure.

DAY THREE: BED, BOREDOM, BATHROOM
Fuuuuuuck.

Life without food is darkness and headaches and restlessness. I can't sleep. I can't read. Music—even soft, ridiculously washy music—seems jarring.

My wife calls and asks how it's going at Camp Starvation: Am I dead yet? Not dead, but pissing the day away. Pissing on the hour and the minute and the second. If all else goes bust here, at least my man-Kegels will be super ripped.

I hadn't bargained for so much bed rest, and if you can't sleep or have sex in a bed, it's just a slightly softer floor, and you're lying on it in the middle of your room, starving, wondering when they will come and find you.

DAY FOUR: PROGRESS? MAYBE?
I wake up feeling slightly better, if hollow and weak. My headache is nearly gone, and I've lost another three pounds. My stomach growls so slowly I can almost pick out words. Weirdly, though, I am not hungry. Shouldn't my body be tweaking with hunger right now? Apparently it should not. This is just the physiology of fasting at work. Even though I'm eating nothing, I am feeding very well, thank you. On my own damn self.

DAY FIVE: DRAWING THE LINE AT SALT
I've lost twelve pounds. They say it's mostly water weight. Why am I carrying around all that water? Dr. Klaper lectures me on salt, a piece of nutritional apocalypse he clearly enjoys sharing. When you eat too much salt, your blood gets saltier, so your brain tells your body it's thirsty. So you drink more water, diluting your salty blood, and with more blood pumping through your system, you get high blood pressure. Boom.

I blink at him hopefully. There must be a loophole. Please? My wife packs a little Ziploc of Maldon sea salt whenever we leave the house, and we litter it over even perfect bowls of food, like ice cream. Klaper and I will have to disagree here, even though he has decades of credentials and experience over me.

DAY SIX: I WAS FAMISHED BUT NOW I SEE
On my final day without food, I wake up at 5 A.M. I slept in! And all of a sudden, I feel tremendous. Light, energetic, unreasonably cheerful. This is maybe the runner's high of fasting, and it's hit me just as my fast is ending.

Throughout my stay, a six-day fast has been regarded with amused smiles. Pathetic amateur, they don't say. One doctor says everyone should do a long fast at least once in their lives. What's long, I ask. Twentyone days. Maybe thirty. Now I see the appeal. Once you get over the misery of the first few days, things start to look up and you get this feeling that something profoundly necessary is happening inside you. I've lost sixteen pounds, and a deep bend at the knees is surprisingly pain-free. My hands no longer ache. My skin is clear. The whites of my eyes look Photoshopped.

Dr. Klaper comes by to discuss my food plan going forward. A water fast is pointless if you kill it with a cheeseburger. In the morning I'll have a juice of watermelon and celery, some grapes and melon at lunch. For dinner I get something they refer to as sloppy, wet greens. Perhaps they did not want to use the word watery.

Then we discuss what I'll eat when I get home and, ideally, for the rest of my life. It's pretty clear now what's really being promoted at TrueNorth. Fasting is not the star but just a tool to get you to radically change the way you eat. They call it a plant-strong diet. I call it vegan minus joy, where joy equals salt, sugar, and oil. Processed foods are out, and so is anything scooped from an animal's body, however local or hand-groomed the beast was. Some people would rather die than eat this way. Actually, if you believe that the diseases of kings are nutritional diseases, diseases of excess—some do. In ever increasing numbers.

DAY SEVEN: (AND BEYOND)
On my first morning among the eaters, down seventeen pounds, it takes me an hour to drink my juice. The mouthfeel of this liquid is superior. Why even swallow? But when I do feel that juice roll down my throat, it's killingly decadent, as delicious as anything I've ever tasted, and the calories hit me like a jolt. I feel brand-new.

I re-feed slowly, as advised, but it takes me days to feel deeply hungry again. That ache and itch I used to have in my mouth, only to be soothed by salt and sugar and fat, is gone. My arthritis has eased up, too. My blood pressure, usually around 125/80, is now 95/69. Dr. Klaper says I have the stats of a teenage boy. Not quite the infant I was shooting for, but it's close.

It's time to go, and what I feel most strongly is that I could have fasted longer. A week more, maybe two. On the flight back my ears pop, easily, and the noise rushes in. My ears have never popped well in the air, and the pleasure of this effortless head-clearing is nearly sexual. It feels like someone has Hoovered out my sinuses.

When I get home, I'm still pecking lightly at food, suspicious. Every meal looks like my undoing. Salt looks like lye. Oil looks, well, really oily. We eat that why? Oh yeah, because it's a thick golden pleasure-delivery system. I take the stairs down to the street, and something is different. They've redone the steps in my building. They're easier, almost horizontal. But of course they aren't. It's me who's easier. I have no pain in my toes or knees, and I can make a fist, no problem. It's days after my water fast ended, I've been eating solid food again, and it would seem that my arthritis is really gone.

But it's hard to believe this sudden absence of pain will last. Maybe the fasting spooked my system, scared me out of pain. Check with me after the extreme reverse fast I face now that I'm home: the summerbarbecue months. And that's the problem. If there's a downside, it's not with the fasting itself. It's that the diet required to sustain the tremendous effects of a fast is rigorously difficult and, for many, probably unrealistic. The challenge in the kitchen is how you get to delicious—or maybe how you learn not to care, which is too grim to contemplate. Fasting helps kill your cravings, and it stokes your passion for fruits and vegetables, whole grains, and nuts. To a certain degree. But what I notice is that I start to look at food as medicine, and the decisions I make at mealtimes have to do with what kind of medicine I want to be taking: the clean, bland kind with maximum benefits and zero negative side effects, or the lewdly delicious bad medicine with too many side effects to name?

There's a deep canyon between the real world, or at least my real world, and the spartan ways of the plantbased whole-foods diet. If I lived alone and shopped and cooked for one and had no life, this would be a cinch. If this sounds like I'm blaming my friends, I probably am. For now, I'm going to see if that old, sad approach called moderation has any sway here. It's never worked for me before. I tend to want my cake and your whole family's cake, too. But if I feel the pain coming back, seizing my joints, I know now that I won't be reaching for pills. Particularly when doing nothing at all seems to work so much better.

BEN MARCUS's next book, a story collection called Leaving the Sea, comes out in January. This is his first article for GQ.

(Click on the attachment below for a PDF of this article)

Fasting at the TrueNorth Health Center goes mainstream with an article featured in this month’s GQ magazine. Click here to read the entire article. 

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.

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

Reprinted from Health Science magazine, Fall 2012
 

When readers of Health Science are asked, “What should I eat,” the first thing that probably springs to mind is to recommend a vegan, meaning plant-based, diet. But just recommending a vegan diet is not enough. The average American diet is not health-promoting, as we can tell by looking at the average American: most likely overweight or obese, and frequently suffering from such degenerative diseases as diabetes, high blood pressure, cardiovascular disease, cancer, and arthritis.

So, to tell the average American to stop eating animal products is not a sufficient amount of information. If the average person just removes the animal products from his/her diet and ate more of the non-animal products they were currently eating, they might be in far more danger than before. There are many very bad vegan choices out there, and it is entirely possible to consume a totally vegan and terribly unhealthful diet.

Dietary choices will have a profound effect on the quantity and the quality of each person’s life. You and everyone around you are faced with thousands of decisions a year regarding what fuel you will feed your body, so it is imperative that everyone have a basic nutritional information framework to help guide them in making these choices.

In order to make wise choices we must think about the caloric density of foods. Our brains are wired to crave the most concentrated sources of food available. This ability to distinguish between calorically dense foods, such as bread and avocados, and foods less dense in calories, such as salad and vegetables, was a useful talent in times of scarcity. This talent seems so obvious to us today that we tend to ignore it. We don’t think about why we prefer bread or pasta to salad. We don’t think much about why gelato tastes “better” to us than non-fat ice cream. In the distant past we never had to think about what to eat — we just ate whatever we could get our hands on. Consequently we are not well prepared to live in an environment of abundance, not only of natural foods, but an environment of artificial food-like substances designed to seduce our brains and extract money from our wallets while making us sick. At TrueNorth Health Center we call this modern dilemma the “pleasure trap.”

Two main keys to making wise dietary choices are knowing the difference between caloric density and nutritional density, and understanding the role of food processing. That probably sounds a bit complicated, but it isn’t, as we shall see.

First, density: Fats and oils contain more calories per gram than any other nutrient, so any food that contains a lot of fat or oil is a high-calorie food. All natural foods contain some fat. Most vegetables and fruits have small amounts, while nuts, avocados, and olives, and, of course, meat and fish contain a lot more. Natural foods also contain carbohydrates and protein, and again, amounts vary. Grains and root vegetables are more concentrated and contain less water, and thus have more calories, while fruits and green vegetables are less calorie-dense. But natural foods, particularly fruits and vegetables, are very high in nutrients other than calories. These include vitamins, minerals, antioxidants and other compounds that are essential for our health. This is what is meant by nutritional density.

The second key is understanding food processing. Processing is anything you do to the food to alter its natural state. You can cut it into smaller pieces to make it easier to eat. You can cook it, which softens it and makes the nutrients more available. You can grind it up to avoid having to chew, as in blended salads. These are fairly minimal forms of processing, and thus do not change the nature of the food too much.

But humans have learned to do a lot more than simple processing. We can squeeze the juice from fruit and get rid of all the fiber, leaving a very sweet, concentrated liquid. We can remove the fibrous coating from grain and grind it up very finely to make flour and then turn that into bread, a highly concentrated food. We can extract the fat or oil from foods and bottle it to be sold separately or add it to other foods. We can extract the sugar from cane or beets or corn and then use the concentrated sugar to concoct foods that do not exist in nature. Essentially, we’ve learned to isolate the various components of foods that we find most desirable (mainly sugar, starch and fat) and combine them to form cookies, cakes, ding-dongs — you name it! And it is these artificially concentrated, food-like substances that lead us straight into the pleasure trap.

We have to think about the food we put in our mouths if we want to promote optimal health. There just isn’t any getting around it. We don’t live in an environment where we can rely on “instinct.” We need foods with high nutritional density and we need to be aware of, and probably limit, how much high calorically dense food we eat. We need to avoid foods that have been processed to the extent that the fiber has been removed and the sugar and fat content has been concentrated or artificially enhanced.

We know that smoking is addictive, that heroin and cocaine are addictive, and that alcohol can be addictive. But we don’t often think about how artificially concentrated foods packed with added sugar, oil and salt can act just like drugs by over-stimulating the reward centers in our brains. But large food processing companies understand how this works, and they put a lot of effort into designing products that activate this addiction-like reaction and keep us coming back for more.

As a result of this dietary pleasure trap, many people are suffering from the diseases of excess that were previously mentioned. Fortunately, adopting a health promoting diet is a cost effective and reliable way to achieve optimum weight and avoid, and even reverse, the diseases associated with dietary excess.

The most effective way to get the proper nutrients without overdoing the calories is to include large quantities of high nutritionally dense and low calorically dense vegetables in your diet. This includes salad greens (lettuces, spinach, mesclun, sprouts), root vegetables (carrots, beets, jicama, sweet potatoes, white potatoes), dark greens (kale, chard, collards, purslane), cabbage family (broccoli, cauliflower, bok choy), and green beans and squashes. Most of these can be eaten raw, juiced, blended, steamed or baked. If you are trying to lose weight, these vegetables should be eaten first, before any more concentrated foods are eaten.

In addition to vegetables you will want to include fresh fruit and whole non-glutinous grains like brown rice, quinoa, millet or corn. Also, beans, including lentils and peas, may be included. Limited quantities of high-fat vegetable foods such as nuts and avocado may be included, depending on your goals regarding weight.

A vegan diet lacks a significant source of vitamin B12. We recommend that all vegans consume 1000 mcg per day of vitamin B12 in the form of methylcobalamin in order to insure that adequate vitamin B12, an essential nutrient, is present.

An excellent resource for preparing this type of diet is a cookbook called Bravo! written by our own chef here at TrueNorth Health Center.

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 article originally appeared in Health Science Magazine.

In the world of our ancient ancestors, fasting occurred primarily by force, not by choice.  Humans would fast when resources became scarce, such as when Spring came late. The ability of humans to fast was a biological necessity born from the disproportionate use of glucose by the brain. Were it not for the biological adaptation we call fasting, our species would never have survived. During fasting, the body preferentially utilizes fat for energy and breaks down other tissues in inverse order to their importance to the body.
 
Today, the environment of scarcity has largely been eliminated in the industrialized countries and has been replaced by an environment of excess. Surprisingly, the physiological process of fasting, which once kept us from dying of starvation, can now help us overcome the effects of dietary excess from the consumption of “pleasure trap” chemicals including oil, sugar, and salt as well as highly processed flour products and factory farmed animal foods that have resulted in an epidemic of obesity, cardiovascular disease, diabetes, autoimmune disorders and cancer.  We can use the natural process of fasting to counteract the effects of poor diet choices and to help make the transition to a health promoting diet.

Would fasting help?

In the past 30 years, I have witnessed the effect of medically supervised, water-only fasting in over 10,000 patients.  There is nothing that is more effective than fasting when it comes to treating the consequences of dietary excess.  Not every condition will respond to fasting. Genetic disorders and certain types of kidney disease, for example, may not respond. But many of the most common causes of premature death and disability respond, and often spectacularly.
 
Who benefits from fasting? The following are six of the most common conditions that respond well.
 
1. Obesity is primarily the result of addiction to the artificial stimulation of dopamine in the brain by the consumption of chemicals added to our foods, including oil, sugar, salt and dairy products. The answer to obesity is to adopt a health-promoting diet derived exclusively from whole natural foods including fruits and vegetables, raw nuts and seeds and the variable addition of minimally processed, non-glutinous grains and beans. When fully implemented, in conjunction with adequate sleep and activity, predictable, consistent weight loss will occur that averages 1.5-2 pounds per week for women and 2-3 pounds per week for men.
 
If your goal is to lose excess fat and you have trouble adopting a health-promoting program, a period of fasting may be of benefit. The protected environment of a fasting center provides a focused opportunity for intense education and the social support needed to escape the addictive forces of the dietary pleasure trap. The fasting experience functions like rebooting a corrupted computer. After fasting, whole natural food is once again appealing, making adopting a health-promoting diet more achievable. 
 
If your goal is to lose weight and escape the pleasure trap of processed foods, a period of fasting from a few days to a few weeks may be beneficial.
 
2. The dietary pleasure trap is insidious, and the con-sequences of poor dietary choices go beyond obesity.  Overstimulation by artificially concentrated calories can confuse normal satiety signals resulting in persistent overeating. Over time, this results in the degenerative diseases of dietary excess including high blood pressure and the resulting cardiovascular disease.
 
For people who have fallen into the dietary pleasure trap and developed high blood pressure, medically supervised water-only fasting has been shown to be a safe and effective means of normalizing blood pressure and reversing cardiovascular disease. In a study conducted at the TrueNorth Health Center in conjunction with Cornell University Professor T.Colin Campbell, the use of fasting for 2-4 weeks in patients with stage 3 hypertension resulted in reductions of systolic blood pressure of over 60 mm/Hg. This is the largest effect size of any study published to date.  At the TrueNorth Health Center we routinely see patients normalize their blood pressure and eliminate the need for medications.
 
If your goal is to normalize elevated blood pressure and reverse cardiovascular disease, a period of medically supervised fasting may be beneficial.
 
3. Diabetes is a condition that is increasing in epidemic proportions. Largely the consequence of dietary excess,  the resulting alteration of physiological functions such as high blood sugar levels and insulin resistance results in a cascade of consequences including blindness from retinal damage, heart attacks and stroke, reduced healing capacity, nerve damage, impotence, gangrene, etc. Fasting, along with a health-promoting diet and exercise program, can dramatically increase insulin sensitivity and bring blood sugar levels under control.
 
If your goal is to normalize blood sugar levels and avoid or eliminate the need for medications and their consequences, a period of fasting may prove beneficial. Most patients with Type 2 diabetes are capable of achieving normal blood sugar levels without the need for medications.
 
4. Drug addiction has become the norm. Nicotine, alcohol, caffeine, and a plethora of prescription and recreational drugs dominate the lives of the majority of people living in industrialized society.  The supportive environment of a fasting center can be helpful in getting safely through withdrawal symptoms and more effectively establishing healthy habits while eliminating the perceived need for addictive substances.
 
If your goal is to escape addiction and live a life free of dependence on health-compromising chemicals, a period of fasting may prove to be beneficial.
 
5. Autoimmune disorders including Arthritis, Lupus, Colitis, Cohn’s disease, Asthma, Eczema, Psoriasis, and environmental allergies are becoming more common and more debilitating. One possible contributing factor to the aggravation of autoimmune disease involves gut leakage. The absorption of antigenic substances into the blood stream as a result of increased gut permeability appears to be a factor in the aggravation of these conditions.  Fasting can help to normalize gut permeability and ease the transition to a health promoting, low inflammatory diet.  Many of our patients are able to effectively manage the symptoms of autoimmune disorders, thus eliminating the need for medication.
 
If your goal is to eliminate the problems associated with autoimmune disorders, a period of medically supervised fasting may be an important component in a comprehensive program designed to save the quality and quantity of your life.
 
6. Exhaustion, both physical and emotional, has become increasingly common in our fast-paced lives. Feelings of fatigue and depression can compromise the quality of your life. Reliance on artificial stimulants compounds the problem. The lack of adequate sleep and exercise and poor dietary and lifestyle choices work together to interfere with  the ability of many people to enjoy their life or fulfill their potential. Fasting can give your body and your mind a complete rest.
 
If your goal is to “recharge” your system, fasting may help you accomplish your goals.
 
When properly utilized, fasting can be a powerful tool in helping your body do what it does best…heal itself. It is the answer to a surprising number of questions.