I don't get the submitted title here claiming that it protects from side effects. The study does not mention this at all, just that the side effects are similar despite omission of dexamethason in the fasting arm of the trial - it increases appetite, so makes sense to omit it if you want any reasonable compliance rate.
As with any fasting and dieting study, compliance is moderate at best. In this study, only 33% of patients were compliant for at least 4 cycles of chemotherapy, out of 12 cycles total. Most of them were compliant with at least once cycle though.
Overall, we need some more research on this in a larger trial. This paper is a call for funders to do just that - the trial ended prematurely due to needing to include more patients but there was a lack of funding to do so.
I'm currently doing research on a similar patient population, so open to answer any questions.
Basically, this?
HAS AGGRESSIVE TUMOR ---> CANNOT DO THE FMD
HAS SLOW-GROWING TUMOR ---> ABLE TO MAINTAIN FMD
Of course, there could be some factors determining aggressiveness and response to chemotherapy that we do not know yet. Unfortunately I'm not in regular patient contact so can't say a whole lot about typical side effect profiles of chemotherapy, but I've heard some anecdotal evidence that for patients treated with immunotherapy, the more severe the side effects, the better the response.
Occam's razor, patients couldn't stick with the diet.
What are some of the downsides to doing this?
One potential downside to steady regimented fasting _when combined_ with caloric restriction, is a decrease in your basal metabolic rate (BMR).
Our bodies are very good at adapting to "the new normal" and will optimize itself to function on the fuel you give it. This is true in both directions. If you eat less, your body will learn to live on less, and if you eat more, eventually your body will ramp up to try and burn more energy to try and reach an equilibrium.
When fasting, it's important to keep your caloric intake up during brief eating windows. Otherwise, your body will adjust, and when you stop fasting, the slightly increased caloric intake will cause you to gain weight before your body readjusts to the new normal. Many fasting theorists suggest that fasting at random intervals is the best strategy for weight loss without reducing BMR. If your body is used to burning 3000 calories a day just to keep you alive, it can't ramp down those cells immediately so it needs to instead convert stored fat to energy and burn that instead.
These aren't fasting specific, but oftentimes in the western world, we begin fasting as a means to an end (weight loss) and often combine it with other dietary changes, like eating less/healthier.
The other downside is literal starvation or the development of an eating disorder, but those are pretty obvious.
I saw a low-budget documentary on YouTube[0] a couple of weeks ago talking about "fasting retreats" in Russia and now parts of Europe that are seeing great results with patients water fasting for 2+ weeks. They're treating everything from Diabetes to arthritis and dementia. Pretty cool stuff.
Personally, I definitely have seen the light and will likely continue fasting regularly in some form the rest of my life. Since I just turned 26 last month, that's going to be a while! I'm currently half way through a 72 hour fast and feeling great. Just had a cup of coffee and some electrolyte spiked water this morning. I still have about 50 pounds to lose but I'm hopefully for my future now and I'm a lot healthier.
Wish you & your wife strength and all the best.
Do anything you can to help her be healthy. Diet is of extreme impoortance.
I'm trying to get people to read the book. Average people, for sure, but also people on boards of research institutions. I wrote this to one of them: https://josh.works/mike-clayville-can-have-a-huge-impact-on-...
[0] https://www.goodreads.com/book/show/23496164-tripping-over-t...
The ideas contained in the book are explosive, with profound implications. It's a riveting read.
Does this not qualify as a protective effect?
My layman guess is that the best schedule is probably the one you can adhere to.
From being a Roman cure for epileptic seizures, through the integral practice in most religions, and to the 21st century where we start to prove that it increases both healthspan and lifespan.
I find it quite interesting that something so simple, which practically anybody can do, can have such a positive effect on one's life. You are literally healing and regenerating yourself by doing nothing! And instead of compounding medical bills you actually save money!
Thank you modern science for validating my no longer fringe medical beliefs :)
As a practictioner of fasting, I don't think that "modern" Ramadan has much to do with fasting anymore - at least, in the way I see fasting working for me. Reason being that at the end of each day of fasting, there is a very large amount of food being consumed, and I mean a lot. Fasting is about calorie restriction for sustained amount of time - modern Ramadan (based on the experience I had in Saudi, which is a very conservative country) is not really about restricting calories, but just shifting the time of the day in which A LOT of calories are ingested.
I agree with the basic premise that religious fasting is an often overlooked but beneficial practice in the modern era.
In India, for example, there are fasting days in a month and many have certain days of the week even where they fast.
Never over two years did I feel any of the mental clarity or more energy you speak of. I follow guys like Cole (snake diet) and even he speaks of the feeling of dying and lying in bed shivering on a 5-7 day.
Are you sure about the metal clarity and energy levels, because I and the folks I know who fast don't seem to have those affects.
Most days I feel amazing, some other days I feel quite tired and I experience some mental fog. I still haven't found the reason for such an oscillation.
I suspect it has to do with what I eat during the eating window (for instance, more sugarish food, more carbs, etc). I think I should record what I eat and compare it with the overall well-being to get to some conclusions.
Mentally however I found myself unable to have too many variables in my head and my mind was not more able to focus on something but less distracted with extraneous thoughts. I could if I wanted to shut off the chatter in my brain and meditation became very easy.
It is definitely a different mode for me and I do appreciate it but I'm told that many people in my family have ADD and that I might actually be showing symptoms that would go away when in ketosis.
It makes sense biologically you would get some heightened awareness mixed with periods of extreme lethargy as your body tried to preserve itself.
I'm very interested in reading more.
This was done in preparation for each chemo treatment.
I have actually completed a 10 day water only fast a few months ago (good use of lockdown), it takes my body around 4 to 5 days to switch completely to ketosis, then to the end of the fast I was burning through 1 pound/~0.5 kg of fat per day. You can watch it happen every morning when you weigh yourself.
i fast twice per week for ~30 hours and drink copious amounts of tea and coffee. but intermittent fasting also works, the really important information is that ketosis can begin after as little as 12 hours, so basically fast for a minimum 14 hours if you want any effect at all, and everything after that is bonus. no extras in your coffees btw, though a splash of milk / coconut oil in your breakfast coffee is acceptable :)
Also it would be weird to see people in those days, allegedly not having access to the cornucopia of yummy food we have in 2020, going into fasting. Maybe more diseases on average made them realize that the less fed survived better ?
Of course there are limits but when done right you end up with a plant that on average is stronger.
"Autophagy", that famous process which supposedly happens during fasting, that miraculously regenerates us, actually happens during caloric restriction, and it's actually a daily process that happens during the night, in everyone, while glycogen stores get naturally depleted.
And we have no evidence that increased autophagy levels are beneficial, quite the contrary, we have some evidence that, right after fasting, the immune system is suppressed. The bigger the caloric restriction, the larger effect on refeeding. An effect very relevant for malnourished populations that suddenly get access to food.
This is basically modern quackery, medical technobabble lacking any evidence other than obscure studies done on mice.
What "healers" and witches used to do, but taken to the next level.
And unfortunately it is also a recipe for serious eating disorders. Hello anorexia.
Is all that really necessary?
When it comes to human health, the unknowns are legion. Medical science is in its infancy, but too many act as though it's a mature discipline built upon rock-solid theories with few problems.
20 years ago, I noticed that my mental fog cleared up and I felt healthier when I ate very low carb, I looked to pioneers like Atkins and others who predicted my results much better than those pushing the "food pyramid". Those pioneers were called "quacks". I was told over and over by supposed experts: "Calories in equals calories out.", "A calorie is just a calorie.", "You're going to ruin your kidneys on a high protein, high fat diet.", and on and on.
The problem isn't science. Science is the best method we have to discover the nature reality. The problem is with science used as a religion or political weapon without humility or appreciation of its flaws and limitations.
Last I looked into it, we didn't really know the autophagy timeline in humans, because we can't really measure it. Of course there's a natural fasting window that every human adheres to while they sleep, but with food available at all times, three meals a day plus snacks, that window may be far smaller than what the body is evolutionarily adapted to. What if autophagy doesn't kick in properly until 10, 12 or 14 hours?
Anecdotally, I've been doing 16/8, 20/4 intermittent fasting and a couple of 24-48h fasts over the past 10 years and have not yet developed anorexia.
https://web.archive.org/web/20110222200902/http://www.soilan...
I had cancer (lymphoma) and did three years of chemo (mostly maintenance/preventative, as it was wiped out in the first couple months). I actually gained an enormous amount of weight, because the steroids I was on (and all the weed I smoked) made me ravenously hungry. If I end up in that situation again, I'm going to make a concerted effort to dramatically reduce my calorie intake, and in particularly carbs, because I've read a lot about the potential benefits of starving the cancer out.
https://l-nutra.com/pages/fasting-mimicking-diet
If I understand correctly this is a low-calorie diet, which is easier to follow than a strict water-only diet, but they claim it is equally effective. They recommend it also for healthy individuals, 5 days a month. Does anyone have experience with it?
Anyway, so after I switched my diet I decided to give his FMD a go and was pleasantly surprised - it's pretty tough, the second and third day were the worst for me, I was just incredibly hungry (and honestly speaking I did'n really achieve any mental clarity during those days), just went on a ton of walks. But I felt I gained a lot of mental strength following that experience, it was easier for me change eating or drinking habits simply because this exercise of control over your most basic need really provides you with a boost of confidence.
You obviously also lose a lot of weight (around 4kg per week) and I've lost even more since then, maybe 20kg since the beginning of the year (though that's a combination of sport, this pescatarian Mediterranean diet, but probably also those 2 fasting sessions). I plan on doing it again, though I want to try out 'real' water fasting next time. I think this is a great starting-point into fasting, though.
Almost no one reads these papers when stuff like this gets posted on HN.
And there is shameful statistical fuckery afoot in this paper. People are only repeating the hype statistics at the top of the paper.
Their "pathological response" rates touted at the top of paper only come from the 1/3 of women able to actually carry out the diet. This is the "per-protocol" language in the abstract. An honest evaluation here would be "intention to treat" and analyze chemo responses in every assigned to each arm.
And they do that evaulation, but bury it later in their paper. Turns out when you account for the 2/3 of women who can't do that fasting, there's NO DIFFERENCE in response rate:
"The overall pCR rate was 11.7% and did not differ between the two groups (10.8% in FMD group versus 12.7% in control group; OR 0.830, 95% CI 0.282–2.442, P = 0.735."
But hold on. Slow down. There's a good chance the "women who fasted had better chemo responses" story completely REVERSES cause and effect. Here's how:
WOMEN 1 - Has indolent biology, slower growing tumor than your average breast cancer at this stage.
- Symptoms: Less pain, neuropathy, less swelling, tumors not affecting distant organs as much
WOMEN 2 - Has aggressive biology, faster growing tumor than your average breast cancer at this stage.
- Symptoms: More pain, neuropathy, more swelling, tumors begin to affect distant organs
Clearly WOMEN 1.
People about to enter hospice and pass on in a few weeks are gonna be way less able to complete it than someone who has months left to live.
But all you've done is stratify your patients.
The triathalon doesn't make anyone live longer.
In the study they say "FMD" or "Fasting mimicking diet", in particular, Xentigen (ProLon?), which is sold by L-Nutra. These are "healthy plant-based meals". [0]
[0] https://l-nutra.com/pages/prolon-nutritional-information
Perhaps, completely changing one's environment. Example going from a city to live in a forrest, might also trigger different genetic pathways, and awaken the immune system.
Many narrative stories have this pattern of someone getting sick and retreating, going into nature, in pursuit of fresh air or sunshine.
Try eating breakfast at 10 am instead of 8(let’s say) for a couple of weeks.
Then see if you can hold off until noon without going to bed later.
If you can eat between the window of noon and 8PM you’re effectively on a 16/8 diet.
After you’re comfortable, try eating no later than 6PM, then try 4PM. Before you know it you’re on a 20/4 schedule.
At least in my experience, the sense of hunger is extremely tuned to one's internal clock. The body seems to absolutely know at what time of day it expects to eat. If I go a long time and never eat before 6 PM, I won't feel even a tinge of hunger until the evening. If I go on vacation, and eat lunch for a week, then the next day I'm ravenous by 12 PM.
The hardest thing about fasting is the transition. Once you've got a pattern, your body seems to pretty much just adjust and it becomes just as normal and effortless as eating breakfast, lunch and dinner. I say that because a lot of people try out fasting for a few days, suffer enormously and decide that the juice isn't worth the squeeze. Whereas I think if you get over the transition hump, most will find it's not nearly as bad as it seems to be when you first start out.
One technique that I think makes for a smooth transition is a modified version of partial fasting. To start, instead of completely abstaining during the fast window, restrict yourself to vegetables and berries. Don't touch the higher caloric density foods like meats, dairy, and starches inside the fast window. Truth be told, this probably isn't that bad a diet just to stay on forever, because it ups vegetable consumption so much. But if your goal is full fasting, it's a good way to make a full transition. Your body's internal clock starts getting used to much lower calories consumption in the fast window, but you don't have to feel like you're starving.
For me at least I go into fasting by first skipping breakfast for a few days, then skipping breakfast and lunch. Skipping dinner is mostly a mental hurdle because there’s so much psychological signaling that you should eat at dinner time and don’t really know what else to do with yourself. Going to bed without eating in a day feels weird at first.
I also make sure to get lots of electrolytes during all of this, magnesium glycinate and lite salt seem to do the trick. Otherwise I start to get shaky and have bad headaches.
The salt and other electrolytes is crucial as you mentioned. If you don't supplement you'll actually get some pretty intense cravings. It was the first time I understood why deer love salt licks. I would have licked on one of those like it was a tootsie pop.
Make sure that you get plenty of water and electrolytes.
Also, if 24 hours is too much, you can try intermittent fasting, and do 16 to 20 hour fasts.
It also seems that some people can't tolerate fasting for whatever reason, so GP might just not be cut out for it.
If you can persuade the normal healthy cells to hunker down and stop dividing for a while, the killing effect of the drugs will concentrate on the cancerous cells alone. This is what fasting is expected to achieve. It is not alone in this regard, anything that inhibits mTOR (e.g. rapamycin) should in theory have similar effect.
How could we know if this was survivorship bias? What if the folks who can best comply with the calorie restrictions are those who are already in a good state?
When you fold back in those 2/3 of people on that arm, the response rate is the same:
"The overall pCR rate was 11.7% and did not differ between the two groups (10.8% in FMD group versus 12.7% in control group; OR 0.830, 95% CI 0.282–2.442, P = 0.735)."I am doing 18:6, so I generally eat from 12pm to 6pm. During that time I typically eat two meals, and one or two small snacks. I try to eat pretty healthy, but there have been plenty of times in the past 5 weeks when I've just pigged out at Waffle House. I still have lost significant weight.
I have two major recommendations: first, drink tons of water. I try to drink about 16oz of water every hour. Besides hydration, it helps a lot with hunger. You will get hungry at times. For me it isn't every day - some days it's easy to stay on track. Others, it's tough. When you're feeling hungry, chug water. It really helps. (tip: try sparkling water to change things up if you get sick of regular flat water).
Second, I recommend using an app to track your fasting. Mine was free and tracks your start and end times for fasting and tells you how long until your fasting period is over. It also lets you track your weight, and even water drinking progress if you want.
Last thing - the hardest day of fasting, by far, is the very first day. After that, it will get easier.
ETA another tip: If you're doing it for weight loss, don't weigh yourself every day. Your weight will fluctuate a pound or two from one day to the next, and even throughout the day. It can be demoralizing to fast for a day and then the scales tell you that you're up a pound. Instead, weigh yourself maybe twice a week, and always near the end of your fasting period.
-- Longo and Mattson
Is this autophagy?
In this interview with Dr. Eileen White, Chief Scientific Officer at the Rutgers Cancer Institute, she mentions that certain types of cancer cells can actually use the effects of autophagy to survive.
It's really unfortunate people use overloaded acronyms like this without a definition.
With almost half of America now obese, we are seeing the downside of ignoring good diet as COVID devastates those suffering from obesity and diabetes.
Ignore below...
Wasn't the whole impetus for getting "medicinal" marijuana for the snacking? Seems like someone is talking out both sides of their mouth.
Nonetheless glad to see additional evidence for fasting's multiple benefits.
Does it mean more deaths or less?
Not here is some Deepak Chopra figure to explain it to you in voodoo