Welcome to Season 5 of Living Well with MS, the Overcoming MS podcast where we explore all topics relating to living well with multiple sclerosis (MS). In this episode we are pleased to welcome Steve Hendricks, the author of The Oldest Cure in the World: Adventures in the Art and Science of Fasting as our guest!
Overcoming MS 00:01
Welcome to Living well with MS. This podcast comes to you from Overcoming MS, the world's leading multiple sclerosis healthy lifestyle charity, which helps people live a full and healthy life. Through the Overcoming MS program. We interview a range of experts and people with multiple sclerosis. Please remember, all opinions expressed are their own. If you were able to, we would be grateful if you could donate to help support the podcast and other work of Overcoming MS to help give hope to those impacted by multiple sclerosis. And now here's your host Geoff Allix.
Geoff Allix 00:38
Joining me on this episode of living well with MS is Steve Hendricks. Steve lives in Boulder, Colorado, and is the author of The Oldest Cure in the World: Adventures in the Art and Science of fasting about the history and science of fasting, which is published by Abrams press, and there'll be information in the show notes about that. So welcome, Steve.
Steve Hendricks 00:57
Great to be with you, Geoff. Thanks for having me.
Geoff Allix 01:00
And could you start off by introducing yourself and tell us about your writing career? And what led to you writing about fasting?
Steve Hendricks 01:08
Yeah, so I'm a freelance reporter. And most of my writing has been about politics. This book on fasting is my third book, my previous two books: one was about the American FBI. One was about the American CIA and some of the atrocities that they carried out. So this book, in some ways, is quite a departure for me. However, I have been writing about fasting, I first started writing about fasting about 10 years ago. And that was a cover story that I wrote for Harper's Magazine over here in the States. And the emphasis on that was what was sort of a bit like the book, it was a mix of the history of fasting and the science of fasting. But it was built around my own experiences with fasting as well. And that was to do with a 20 day fast that I had done many years ago. And the way I the way I came to writing about fasting was just that I happen to be someone who writes and I came to fasting for my own reasons. And I came to fasting kind of for two reasons. One was the reason that a bunch of people do it. And that's that after, you know, 15-20 years of being an adult, I put on a pound or so each year, and suddenly, I found myself weighing more than I wanted to weigh. So like a lot of people I wanted to fast to lose weight. I was also interested in fasting, though, and this is perhaps what has propelled my writing interest in it. Because I was interested in fasting long term effects on our health, I was especially interested in what we could do with our, with our diet to try to live longer. And I had first been drawn to caloric restriction, which is just eating fewer calories each day, which in virtually every animal it's ever been tested has extended their lives incredibly, and in humans, the biomarkers look very impressive. The problem is it is murderously hard to walk around just ravenously hungry all the time. And I thought this is just a miserable way to live.
Geoff Allix 03:06
That's the diet industry. Isn't this? Just eat less.
Steve Hendricks 03:13
But in coming to caloric restriction, I stumbled upon a lot of people do the ultimate caloric restriction, which is fasting, eating nothing. And it turns out, the hell of the irony is you actually are less hungry when you eat nothing than when you eat something. And so that's how I sort of got into fasting and what has sustained me since is this interest in what fasting does for our health in the long term in preventing us from getting diseases we don't yet have and reversing some diseases in some cases that we do have.
Geoff Allix 03:48
I would agree with that. I think my experience of fasting is it's not actually that hard. But when you start eating, then you feel hungry. I mean, they call it an appetizer. I don't know. I think it is it gets you, you know, everything starts going and you you start to become attuned to eating. But actually, if you don't eat, I find for a day, I don't feel massively hungry. But then if I start again, when I start eating again, then I feel really hungry. So I feel more hungry when I've started eating after fast than I did during the fast which is a bit strange.
Steve Hendricks 04:27
There's physiological reasons for that, and one of them just has to do it's sort of like the exercise principle. If you've never fasted before, and you fast, you skip a couple of meals, you're going to be hungry. But once you've done it and your body knows what to expect, you're less hungry. But also if you fast long enough, you actually get to a point where you're starting to burn some of your fat, your fat gets broken down into ketone bodies, famously that's the root of the ketogenic diet and the state of ketosis. You go into a longer fasts and ketones, researchers have found in the last decade or two actually suppress your hunger hormones. So when you're burning your own fat, it's this wonderful evolutionary mechanism that takes away the hunger while you're doing that's just fantastic.
Geoff Allix 05:12
I'm gonna get I mean, yeah, the evolutionary thing, because surely, in a sort of caveman times, if you're really hungry, then making it difficult for you to perform athletically and catch food, or wherever you're doing is not going to be a good idea, you probably need to be at your peak, don't you, you need to be able to perform.
Steve Hendricks 05:33
That's certainly the idea. You know, we of course, don't know, it's all speculation that may just be a just so story that you just told. But I've told that story too, because it seems the most likely reason as to why we evolved this way, your body does quite often make it a little hard for you the first few days of of a fast, we can talk about why that is. But once you get more deeply into a fast once your body is accepted, look, there's no food coming in, it's day five, or whatever. Without food. Yeah, we think what's happening is you need to have more energy to go out and forage for whatever it was that they were foraging back then. And you need also to be sharper with your senses, which also people report and scientists have found happens quite often, with prolonged fasts so that you can spot that sprig of carrot or whatever that's hiding beneath the leaves are still on or, you know, see the animal that you're, you know, trying to hunt, these heightened senses. And this sometimes heightened energy that people sometimes feel on a fast, not all the time, but sometimes we think probably came about because of that evolutionary reason that you just gave.
Geoff Allix 06:45
So one of the things comes up a lot with MS is this idea of leaky gut syndrome, that, that it's it's quite likely that things are getting from the gut into the bloodstream, and then ultimately, actually, the from the blood brain barrier as well. So it's the things being in the wrong places. So firstly, what is a daily fast and how can of daily fast help with leaky gut syndrome?
Steve Hendricks 07:12
Yeah, so broadly speaking, there are two kinds of fasting there's daily fasting, which is just narrowing your eating window to a shorter amount that you would normally eat in each day, the number of hours you're eating, and then there's prolonged fasting, which is just fasting for multiple days, quite often for weeks, sometimes even for months. So, so the daily fasting, the reason that scientists have found just in the last 10-15 years, that this is important, is that we make more repairs when we are not eating the longer fast, we do even just start overnight fast, right? Wherever everyone's fasting, we're all fasting overnight, what scientists have come around to asking is, are we healthier, if that fast is longer or shorter each night? And the answer they've come on is that we're healthier when it's longer. And the reason is our body takes the opportunity of the break from food to step up the amount of repairs that it makes. See our bodies this like marvelous self healing machine, that's making repairs all the time that sparing us from disease, but most of the time, these repairs are happening at a very low rate. That's because our body is busy with all the other things that make up our lives. And one of those like big energy sucks, is that we are constantly eating food. It has to digest the food our body does has to process the nutrients from the food, it has to put the nutrients to work in cells literally in just every part of our body. When we give our bodies a break from that very heavy work, it will do all kinds of amazing repairs that otherwise doesn't have time to do. It will fix damaged or mis-copied DNA. That being enormously important because DNA is our instruction manual for everything that happens in our body. When the manual goes wrong, we get disease and early death, it will increase the recycling of worn out organelles within the cells that will break them down into their constituent components, and then send them on elsewhere to be used in fresh new healthy parts. That's called autophagy. And when these and many other repairs happen, we see some wonderful changes, drops in systemic inflammation, increase in insulin sensitivity, which is important for moving our glucose out of our bloodstream and into the cells where it belongs. And you know, many other very important changes happen. Now there's a catch. And the catch is it's not as though we eat our last food for the night and our body says "okay for fasting now, we're going to switch on repair mode." All right, your body has there's a metabolic cost to making the switch from you know, being in your normal fed nutrient processing metabolism to going into repair metabolism. Your body doesn't want to pay that metabolic price until it's sure you're done eating. It doesn't want you to stop eating and then two hours later stick another big mac or broccoli doesn't matter if it's, it's just calories doesn't matter if they're healthy or unhealthy, it will disrupt the cycle. And it would have to go back into nutrient processing mode from repair mode, it doesn't want to do that. So what the body does is it waits to start stepping up the repairs. And those start at about six hours after our last calories. But even then, the repair sort of only amp up kind of slowly. And not until 12 hours after our last calories, do we get into some, you know, serious kind of overdrive repairs. This is why scientists in the last handful of years have found that people who eat in an eating window of 12 or fewer hours each day down to about six hours and the repairs increase the health improves with every hour, you shave off your 12 hour window down to at least six. These people are getting healthier, and their their biomarkers for disease are dropping down. Now the problem is most of us survey show are eating something eating or drinking something caloric across 14 or 15 hours a day. If you're doing you're taking calories, 15 hours a day, you're only fasting nine hours a night, the repairs again, don't start till six hours into your fast you're only getting three hours of repair a night, right? You're never getting to that overdrive repair at 12 hours, whereas someone who's doing say a 16:8 eating program that most people have probably heard of, you're eating in eight hours, you're fasting 16 hours, now you're getting 10 hours of repair, four of those hours are in the overdrive repair cycle, right? So this is why longer overnight fasts make us healthy. T here's a second part to it, which we can get to later, which is that not all eating windows are created equal and eating window earlier in the day is better than later in the day. But that's that's another story. Sticking with this story of the narrow window. So there are all these tasks that our body has to do overnight. One of them is repairing the gut. All right, we have a lining that is only one cell thick, that separates the food in our gut, from the rest of our gut. That lining gets abraided every time food drags across it during the day. That's fine, that's normal. But but it's an enormous surface area with about 4000 square feet of lining in our gut, that's, you know, that's three times the size of my square footage in my house. And our body has to scan that every single night. And every single night, it needs to replace about 10% to 14% of that gut, it's about like recarpeting a couple of bedrooms or something every single night. If it fails to do that, then all kinds of things, food, pathogens, you know, bacteria and viruses and things like that can leak out. And we get leaky gut. And they go in places where we don't want them. And it's conceivable, as you mentioned that that is contributing to or even causing outright MS. There are other repairs that have to go on in the gut as well. For example, we have mucus that helps the food slide across the membrane of our gut without abraiding it so much and the body has to replenish that mucus every night. You probably see where I'm going with this, this is a lot of work. And this is just a small piece of it, we got to clear out all the detritus from our brain activity during the day. We've got to, you know, clear out things in our bones, we got it, it's happening all over our body. The longer we give our bodies each night to do all this work, the better it does them. If we eat late if or you know, eat late and then eat early. If we narrow our fasting window too much, our body will not be able to make these repairs and Chronobiologists biologists who study the timing of our bodies think that it's highly likely that our you know long eating windows and narrow fasting windows each night are one of the contributors in addition to our crappy diet to leaky gut syndrome.
Geoff Allix 14:15
So you touched on when you eat as well. So that's something I haven't really come across. So you certainly it has to be one continuous block, you can't say, oh, I'm going to break up 16 hours of fasting into into two eights and in the middle. I get that, so you've covered that but when you eat so I've done 16 Eight quite a bit and I'll do it I'll sort of do both ends of when I'm sleeping so I won't eat an early breakfast, and I won't eat a late evening meal. And then everything can be in an eight hour window relatively easily. Because you're 12 through to eight or 11 three to seven is quite manageable that I can eat with The family in the evening. I just have a later breakfast but but is there a difference between if you started eating at 8am? Finished at 4pm? Or if you started at 12 noon and finished at 8pm?
Steve Hendricks 15:16
There is and the way you're doing it is exactly the way I did it. It's the way almost everyone does it. Anyone who's doing 16:8, nine chances out of 10, they're skipping breakfast to taking their first meal at 11am or something. And they're you know, finishing eating at 7pm. Right? And it makes sense. At least it makes intuitive sense. That's why everyone does it. And it makes sense because we like eating dinner more than we like eating breakfast. It's the most social meal of the day. Kids come home from school, everyone's home from work. Right? Okay, that all makes sense. However, I have bad news. Scientists have actually done a very good job. And this is very recent science. We're talking the last three, four or five years, these studies have just been coming out and asking which of those windows is the best. And it turns out, what they have found is is that our circadian rhythms have just hardwired us to process food most efficiently in the morning and early afternoon. By the mid afternoon, we start to get, you know, poorer and poorer at it. And by nighttime, we're frankly terrible at it. We're just awful. The mechanism that has been best studied with this is the one related to insulin and glucose. Glucose, of course, is just the sugar from the carbohydrates in our meal, it's our body's preferred fuel, most of our cells want to run on glucose. Insulin moves that glucose out of the arteries after it's been digested and sent into the bloodstream and into the cells where it belongs. And as every diabetic tells you, if you don't move that glucose out of the arteries, the arteries can get dinged up by the glucose. They will eventually harden which can lead to kidney disease, strokes, heart attacks, dementia, just all kinds of awful things. We make a ton of insulin in the morning. Our circadian rhythms command it and we cannot change it. We evolved this way probably because there was in the plains of Africa where we evolved, there was no reason to be eating at night. Those who ate at night were in danger of being picked off by nocturnal predators. So there was every reason to eat during the daylight hours. But for whatever reason, we make a ton of insulin in the morning, it starts and our cells are also through another process, more sensitive to When insulin comes knocking on the door saying let the glucose into hearing the insulin and letting the glucose in. By mid afternoon circadian rhythms command our insulin production to shut down, they command our cells to no longer hear the knock of insulin as well. And so the glucose lingers longer in the cells. This circadian rhythm is so powerful that you can take pre-diabetic people people and give them a meal at 7am feed them the same meal at 7pm. Their blood sugar will only rise a little bit after the morning meals. They will test many of them fully diabetic after the 7pm meal. You take healthy people do similar experiments, and after the late meal, some of them will test pre diabetic. The study that really brought this home to me though, is just a brutal, sad study was a study of 15,000 attempted suicides in Sri Lanka. Sri Lanka has just been devastated by the global market. Many of the people there are farmers, and they tried to commit suicide when they're just ruined by capitalism, by drinking their own pesticides for their crops. What the study found was was that people who attempted suicide in the morning were twice as likely to die as people who had attempted suicide by swallowing the poison in the evening. And the reason was, was that in the morning, their nutrient processing system was so efficient, it had shuttled the poison all over their body. And by the time they were found rushed to a hospital, it's too late to save them. Those who took the poison in the evening, however, their nutrient apparatus was shutting down, the poison barely moved through their system, and by the time they got to the hospital, they could often be saved. So this is just an extremely powerful window and there appears to be nothing. It doesn't matter if you change your sleep schedule, your exercise schedule, doesn't matter if you've been eating on a different schedule for 50 years, we appear to be just powerless to change this. So what scientists have increasingly found is that the healthiest eating window seems to be start one that starts about an hour to two hours after we wake up in the morning and runs for, you know, ideally as short as six hours, but it could be longer if it needed to be so for a lot of people, that would be an eating window of something like 8am to 2pm or maybe 9am to 3pm. Now I'll close close with this, because this is quite a soliloquy here. But I hated hearing that news. I had, you know, I'm 52, for 49 years of my life, I had eaten dinner, you know, every night that I can remember. I love eating late my favorite countries to visit are Italy and Spain, because you can stay up eating and drinking. And it's just fantastic, right? So I did not want to hear this news. Most of the scientists who stumbled on this research didn't want to hear the news, either. But what many, many, many people report is and this was certainly what I found to be the case. If you make this change, it's as though your body has been waiting for you to do it all along. It was one of the easiest big changes I ever made. It was as though, I assume it's because I'm was now eating with my circadian rhythms. My eating window is generally about 9:30am to 2:30pm or so. And most importantly, in addition to finding I didn't miss dinner, I wasn't hungry, I, you know, didn't have any physiological problems. I had a lot of benefits. I instantly noticed my energy getting better. I instantly noticed within three, four days I had fewer food cravings. I also was someone who had sugar crashes quite often, and those went away, I found my weight vastly easier to manage than ever before in my life. So that's not to say there aren't some social costs, right. And a little flexibility helps if we're getting together with friends for dinner, we get together with friends with dinner, and I just break my window. But it helps that I'm a freelance writer who works at home who can set his own schedule. And I know that not everyone can do that. So the final thing that I will say on this is that is that scientists think that there may be a compromise for people who don't want to or can't eat everything in an early window. And that compromise is simply this: put most the vast majority of your calories in that early window, and then keep your dinner light and early. So in practice, that means a bigger breakfast and lunch, and just a lighter earlier dinner. It turns out that that adage to eat breakfast like a king lunch like a prince and dinner like a paupper, when it was coined in the 1950s there was no research to support this. But it turns out that nutritionists who coined that got it right, that's pretty good advice. And for people who still want to eat dinner, that may actually be something that would greatly improve their health.
Geoff Allix 22:31
Yeah, grandparents would always come up with some good stuff as well. So for disease prevention, I mean, this is an MS podcasts. But I mean, it covers pretty much everything, because there's a lot of comorbidities that people with MS don't want to get as well. So just in general, is there a scientific background to the benefits of fasting for disease prevention and cure?
Steve Hendricks 22:54
So yes, so you know, on on these early time restricted eating windows, so what they're known as in the scientific field, there's a lot of very good research for supporting that it will prevent diseases. All the biomarkers that you would expect when you eaten one of these early time restricted windows improve. So if you have high blood pressure, your blood pressure drops. If you are insensitive to insulin, you become more sensitive to insulin. You know, if you, if you have high cholesterol, your cholesterol tends to decrease and so on. They're also sort of more esoteric, but very important and interesting markers. There's one great study from just a few years ago, that found after just four days of eating in one of these early six hour windows from like, you know, 8am to 2pm or so, the amount of autophagy. That was the cellular recycling that I mentioned earlier, these old and worn out parts that are going to cause disease if we don't recycle them increased 22%, after just four days of not changing a thing about what the people ate only when they ate it narrower window earlier in the day. All right. So it's very strong. When you see all these markers heading in the right direction, we think it's going scientists think it's going to prevent a lot of disease. Now for disease reversal. There, you're talking about prolonged fasting. We don't have any data to support that if you eat on a 16:8 early, you know eating window that you're going to, you know, reverse your long standing diabetes or something, you may improve it a little bit, but you're not going to reverse it greatly. You're certainly not going to cure it. We do, however, have more than a century of clinical observations from fasting doctors, across multiple generations, multiple countries, mostly in the US, Germany, Russia, who report very credibly many cases of reversals of cardiovascular disease through poor prolonged fasting by prolonged fat sitting in this case, I'm talking fast to a week, two weeks, sometimes up to 30-40 days, depending upon the condition. Cardiovascular disease, type two diabetes, skin diseases like psoriasis and eczema and acne, asthma, allergies. It's a very long list of interest to your listeners for some reason, you know, fasting doctors routinely report that prolonged fasting is good for autoimmune diseases. So rheumatoid arthritis, ankylosing spondylitis, ulcerative colitis, almost all of this is in the realm of clinical observation, because our, you know, human trials and mouse trials and so on, they're almost all funded by pharma companies, by device manufacturers, or by the government, you know, programs that they're not entirely in the pay of Big Pharma or whatever, but they sort of dance to Big Pharma tune and they're, you know, very much in sync with with with their wishes. So, so fasting researchers have almost never had the money to conduct good human clinical trials, certainly very few randomized controlled trials. We do, however, have very good human trials showing that fasting can reverse (prolong fasting) high blood pressure in almost virtually every single case of someone with high blood pressure. It can reverse a very wide range of cases of children with epilepsy, it seems to be less good with adults with epilepsy for reasons that are still being teased out. But epileptics who are resistant to the various anti-seizure medications often respond very well, to prolonged fasting. We also again of interest to your audience, have a very good randomized control trial that was done 30 years ago, showing that seven days of fasting can reverse rheumatoid arthritis, seven days of fasting followed by a vegan and vegetarian diet for the remainder of the year, as opposed to people who didn't fast the control control group just ate normally and so on. This trial was extremely impressive. It was published in one of the most prestigious medical journals in the world, the Lancet. There were other trials that were going on sort of around it that looked at some of the mechanisms for what might be happening. They didn't tease them all out, but they found that the neutrophils - Neutrophils are white blood cells that normally attack harmful bacteria - we want our neutrophils to be active and doing that can sometimes become overactive. And in rheumatoid arthritis, they appear to be part of what's attacking the linings of the joints and inflaming the joints. Anyway, the neutrophils during fasts calmed down. Alright, we don't know why. There wasn't enough science, and there wasn't enough interest, even with this very prominent publication. But it was a very good randomized controlled trial. We don't have a cure for rheumatoid arthritis, you would think that, you know, rheumatologist would be packing off their patients to fasting clinics to to see if it would work. Now, it didn't show a complete cure. It was just a seven day fast. It wasn't a long, long, fast, but these people had better grip strength, they had better motor, you know, capacity, they were less tender in their joints, they woke up less stiff in the morning, it was a very impressive study.
Geoff Allix 28:25
So because you're talking about prolonged fasting being, like seven days, but you mentioned eating in a six hour window, so I think most people would go on, where people are likely to think that that's possible if they're coming from nothing. So they're thinking, okay, 16:8? Yeah, that sounds quite achievable. Because a lot of that time I'm asleep anyway. So that's, I think most people could think I could manage that. And then if we pushed it a bit further, so is there a benefit? Because I think most people, if they're coming from nothing would see a seven day fast as not being achievable at first, at least. But is it worth moving from a six hour window or a 16:8 through to 24 Hour? Your 36 hour? Is there? Do you get a sliding scale of benefits as you move through?
Steve Hendricks 29:19
So so the answer is we don't have enough science to say where the sweet spot is. I'll tell you what we do know. So I'll go back half a step. If you're if you have multiple sclerosis, or you have any diagnosed disorder whatsoever, you shouldn't be fasting, prolonged fasting for seven or more days on your own. So that those are fasts, you know, in a fasting clinic, or at least with the supervision of a doctor who's at a fasting clinic and maybe supervising you remotely each day or something. Okay, so that's the first thing that you're right. That would be very daunting and intimidating to anyone, whatever diagnoses or medications or whatever they're, they're taking and doing. Putting all that aside. So, so yes, people often say, Well, what about a two day fast, a three day fast and so on. Here's what we know about what happens when we fast, okay? Your body wants to run on glucose. And that's what it's doing right now for most all of us. After about 24 hours, almost all of us will run out of all the glucose in our body, the glucose, that we have glucose, it's just sort of floating around from our last meal, we also have glucose that's stored in chains called glycogen in our liver and in our muscles, after about, you know, less than 24 hours for most people, but you know, no more than about that we run out of it. And then you're starting to get more into a fasting metabolism. Now, here's another catch. The catch is this, you don't run out of glucose, and your body says, "ah, we've got all this fat hanging around, let's run off the fat now." It doesn't do that it wants to keep running off off the glucose, possibly to give you a disincentive to fast possibly to give an incentive to go out and keep finding food. It makes life difficult for you, because the way that it goes about getting more glucose is by breaking down some of your protein. It breaks down protein in a process called gluconeogenesis, which just means making new glucose. And when it does, that, it's extremely inefficient, it's not a good way of going about getting glucose. But on day two, day three, day four of a fast that's when this gluconeogenesis is really ramped up and really happening, which is why people often find if they're doing a prolonged fast, the hardest part is that sort of second, third, fourth day, somewhere in there, it varies. Okay, so eventually, by day five or so, your body says, Oh, well, I guess we're not getting any more glucose. And I don't want to go through all my protein. By the way, people get freaked out, when they hear that your proteins being broken down, we have protein everywhere in our body, it's not like your muscle or your heart is being broken down. It appears to be our hormones are made out of proteins, most of them and so on, it appears to be it's taking the old and worn out stuff, it's just breaking that down. And then when we refeed it'll all rebuild with healthy new stuff is what seems to be going on. Okay, so around day five or so your body says alright, we're not getting any more glucose. Let's go ahead and burn the fat and it starts transitioning more and more and more to burning fat. People end up feeling better. So why am I going into all this? I'm going into all this because the story that I've just laid out, there seems to be what is happening, but researchers don't have the entire story. And so some fasting doctors have a little bit of a concern. They're like, Well, look, why would you fast? You know, if it's 24-36 hours, fine, not a problem, but 48 hours, 72 hours, why would you fast into the hardest part in the fast, where you may be, you know, going through this metabolic cost thing, without getting to the very deeper repairs that we know that happen when you get deeper into ketosis, you're burning your fat and so on. So they're like, look, we think it's just a speculation, but they have good cause to think this, we think rather than doing a three day fast this month, and a three day fast two months from now and a three day fast couple months. Why don't you do a six day fast, you know, now and then another six day fast six months from now or something if, if that's what you want to do that the benefit would be better that way. Now, if people were just kind of experimenting at home, and they want to see what a two day fast or a three day fast feels like, most fasting, doctors say sure, go for it, try it. But as a sort of regular habitual thing, they have questions, and I'll emphasize, they're just questions. We don't have the data to say we may find 15 years from now, heck, a three day fast is the healthiest thing in the world. But they want to exercise some caution, because we don't know. And we do know that a longer fast is healthy, if you're doing it under proper supervision and not taking crazy risks.
Geoff Allix 34:01
But if you say just to reiterate, if you're going to look at seven day fasting, you should get professional help to do that. supervision or with a fasting clinic. And so so but you think there is some benefit from from doing so 36 hour fast? Over and above? Would you would you combine that with saying well, day to day I in a shortened window? And then maybe weekly? I have a 36 hour fast? Is that a beneficial way to go about it?
Steve Hendricks 34:32
So so there are pros and cons. So the pros would be, it seems to be the case that these deep repairs that I'm talking about that you get into after 12 hours. You know, if you're doing a 16 hour fast, you're only in that deep repair for four hours. If you're doing a 36 hour fast, you're in those deep repairs for 20 hours. That's pretty awesome. So that would be the Pro. The Con and there's a researcher who's really sort of raised this concern he does v ery good work. His name is Satchidananda Panda. He's at the Salk Institute outside San Diego here in the States. And what what he is concerned about is is what he calls basically, metabolic jetlag. He's afraid that if you sort of constantly start and stop, you're, when you're eating when you're doing like a 36 hour food free period or something, if you're doing that every week, you're sort of throwing yourself into jetlag. And the reason is, our circadian clocks are controlled, our circadian rhythms are controlled by two kinds of clock in our body. One is a master clock that's in our brain, and it's entrained by the light of daytime around us, that's what sets it. But then we have these peripheral clocks that are in all the cells practically of our body, and they are entrained by food. So if you're still seeing light each morning as you will, when you're doing your 36 hour fast, but you're suspending food, that the cue that your peripheral clocks are getting from food, your peripheral clocks become disjointed. From your master clock, if you're doing one long, fast of seven days or 14 days, apparently, our bodies are pretty good at figuring that out and handling it. But if you're constantly, you know, taking these peripheral clocks offline, and de-syncing them from the master clock, there may be some price to be paid for that disruption. But again, it's a question we don't know, it seems to it certainly seems to be the case, if you're doing as I tried, about a decade ago, doing it every other day fast, where you're fasting 36 hours every other day, you know, and then refeeding, during one day, and then another 36 hours, and then refeeding, and so on. It was the worst month of my life, it was absolute hell, and I strongly suspect it was because of that decoupling, if you're only doing a 36 hour fast, once a month, or once a week, as that really gonna cause you problems? We don't know.
Geoff Allix 37:01
Okay, but but that idea of doing alternate day fasting may not be a good idea. So but maybe 36 hours or so. So it would be good that I think that's probably actually quite a good story for most people. Because if they, if they think, okay, I can manage the reducing the time window that I'm eating. And then you're not telling me that I need to eat every alternate day as well, that's probably an easiest way to go. But equally, because I've done 36 hour fast, I don't find it a huge problem. But maybe that that's something a monthly thing would be actually maybe more beneficial than doing it more frequently may not be a good idea.
Steve Hendricks 37:42
Right? I mean, it depends on what you're trying to achieve. If what you're if what you're looking for is sort of, you know, health maintenance, then a 36 hour fast once every two weeks or once every month or something, you know, whatever, that may end up making great sense. If you're talking about disease reversal, then you're talking about getting into these longer fasts.
Geoff Allix 38:04
Yeah. And then we're looking at a professional advice. But there is one other one, which in the UK, been talked about a lot, which is five:tw o because a doctor is quite a long time ago now. A guy called Michael Mosley, who does a lot of work for the BBC. And he, he came up with this idea of five to fasting and I don't think he came up with it. But he certainly publicized it. And he wrote a book about it. And it's with five:two, they were talking about the you actually would two days a week, you weren't fully eating nothing, but you were reducing calories to I think 25% of normal on two days a week. So is there any benefit to that sort of approach? I think that was done because people found it more manageable.
Steve Hendricks 38:51
Yeah, so there are some benefits. One thing to be clear of up front, so we call it the five:two fasting or the five:two diet or something. One thing to know is it is not fasting, because when you are eating, so there are various kinds of five:twos, so on your two fast, so called "fasting days," you might be eating as few as 500 calories on some programs that might be 800 calories, or even 1000 calories. Even if you're down at 500 calories, that is too many calories for your body to go into the fasting metabolism and get some of these deep repairs that I'm talking about. So you're not getting the repairs you get from fasting, do you get benefit? Absolutely. There's benefit as I mentioned earlier, from caloric restriction. It's not, you know, so here's, here's what people find. If you're normally eating 2000 calories a day and you drop down to 500 calories on your fast day. Then on your next eating day you think I need to eat 3500 calories to make up for the 1500 calories that I that I missed and on the five:two plan you're usually allowed to eat whatever however much you want on your feast days, studies show that people don't do that, they end up not making up all of those 1500 Lost calories, they make up 800 of them, or even 1000 of them or something like that. But they're in some kind of calorie deficit. And since most of us are over eating, we could use a calorie deficit, most people end up losing some weight. When that happens, your blood pressure tends to drop, your cholesterol, if it's high tends to drop, good things do happen, all right. However, it's not. If you're looking at those, what I would sort of call superficial markers. Mind you very important. I'm not you know, if you have high blood pressure, get it down, right? No doubt about it. But you're probably not going to be seeing I imagined, if you if you ran the sophisticated tests that some of these labs are doing in these fasting studies, you're not going to be seeing an increase in repair of DNA, you're not going to be seeing an increase in cellular recycling that process of autophagy that I talked about. So it can be a very helpful tool. Now it's not separate, you can do a five:two eating plan. And still fast 18 hours a night if you want, right? So you could combine them if you wanted. But if I had to choose one or the other, if it were just me, I would choose the longer overnight eating fasting period and the earlier eating window, because I think you're going to get a lot of the exact same stuff that you get from the five:two way of eating. But you're also going to get these deeper repairs that you know are hidden from us most of the time. But you know, we'll show up in 10 years in disease if we're not making them.
Geoff Allix 41:39
And so you said that so eating sort of 500 calories that your your body, it knows is eating, you're not actually truly fasting. What about drinking? So I mean, I'm assuming if you're doing a seven day fast, clearly you're drinking water. Is it just like pure water? Is there anything else you can drink? Or if you're doing a shorter fast? Would you try? And because I know some religious fast they actually don't even drink water. And it's like, is water fully allowed? Or is there other things you can drink?
Steve Hendricks 42:11
Yeah, so both with daily fasting and with prolonged fasting for that matter, normal life. The best drink is just plain water. That that is the that is the drink that we evolved to drink. And it suits us extraordinarily well. During your fasting period. You do want to make sure whether it's daily fasting or prolonged fasting to get enough water so you do want to do that. The question that everyone wants to know is well what about caffeine? Can I have my coffee? And the short answer is is caffeine whether it's in a caffeinated beverage or or excuse me, whether it's in a caloric beverage or not. So if you're drinking your coffee black you know you don't have any cream don't have any milk you're drinking your you know Earl Grey tea and you're not adding any milk to it. It's just the coffee just the tea, it does disrupt a fast. The catch is we do not know I keep saying the catches are all these catches. The problem is is that we do not know the science is not good enough to say how it's disrupting the fast. Is it a big disruption? Is it a small disruption? Is it disrupting perhaps this repair but maybe not that repair? We just don't have any idea. All right, so if you want to be absolutely safe, don't drink caffeinated beverages during your fasting window if you're aiming for that fasting window to get you repairs that will keep you healthier. You know the purest fasting doctors will say drink nothing but water if you want a hot drink heat it up less pure loads to do more of a compromise say look, you know an herbal tea is not going to you know cause you that much grief. A decaffeinated coffee is not going to if it's truly decaffeinated and not loaded with chemicals that a lot of them are decafed with you know if it's unhealthy organic or whatever yeah it's not gonna it's not going to be much of a problem but unfortunately for people who are wanting their you know cup of caffeine you know before their you know when they first thing when they get up in the morning and not break their their fasting window it seems like that's going to be a problem.
Geoff Allix 44:10
And wine and beer is definitely out.
Steve Hendricks 44:13
Wine and beer is definitely out. It can be fun to drink but it's not health food
Geoff Allix 44:19
to that's the problem with the wind and so what you're saying because there is a there is a social element as well I think that is important because you said and I think that that was a good point. If you've got friends coming around then friends came around for dinner. Okay, well that's fine. I'm gonna eat with my friends. You know we're in I think this this is a current rule when this episode is going out. That's when we're recording it is end of November stopped December sort of time. So it's a holiday so you know, there's you've you've just had Thanksgiving, we've got Christmas coming up. It's a time when people do these things and there is a social element. I do think that is important as well. You know, we're social animals, and so on. I quite like that idea is okay. Yeah, Friday night, got friends coming around, we're gonna eat with friends. That's what we do. It's nice. And then maybe have a glass of wine and that's fine. But on other nights, you'd be like, okay, that so that eating window if your six hour eating window and it's just mostly in the morning, then you're not drinking in the evening, you know, certainly not drinking alcoholic things. And a cup of coffee with milk and sugar, absolutely not. It's that that would break your fast.
Steve Hendricks 45:31
Correct. Yeah. So yeah, so you have one of two choices, and I've chosen both of them. Because I like to have my cake and eat it too. Choice one is, as much as possible, try to reroute your social life. You know, I've rather than having friends over for dinner Friday night, wanted to come over for lunch on Saturday. And you know, we'll have a beer or glass of wine with it. Now, mind you, I'm not advocating alcohol. I subscribed to the science that says, there's no healthy amount, literally zero. And all of its unhealthy. But that doesn't mean I never do it. So we often do things that aren't, you know, perfectly healthy. But you know, I moved my drinking, the rare times I do drink, I move it earlier in the day and try to get friends to go along with that. Or if it's just my wife and I at home, and we want to open a bottle of wine, we'll do it on Sunday afternoon it you know, 1pm. And what you what you quickly find is, it's just as lovely is doing it at, you know, Sunday night at 7pm. And we'll do a whole lot less harm it would seem. Choice two is to say, well, the world's not gonna bend around my crazy new schedule. And just to esteem to that, and I do that as well. So if I'm getting together with friends, I will go ahead and I will eat dinner with them. If there's you know, wine on the table, I will have a glass. But here's what my my study of this. And, you know, I, again, I did not eat this way I did not drink this way. Before working on this book, it was coming to this science as I was researching this book that led me down this path. But what I what my research has told me is look, so just don't eat a huge dinner and don't have three glasses of wine, like have a smaller dinner, because you've eaten most of your calories earlier in the day anyway, and have a glass of wine, and you'll be doing your body you know, less harm. And I do find I sleep better. No surprise there when you're not drinking wine before bed. I feel better in the morning. And those kind of incentives as reinforcements are what helped keep it going. But yeah, the flexibility. I think, you know, we gotta live in the world. And you're right. we're social creatures.
Geoff Allix 47:45
And so I think we've got an awful lot of information there. And I think that things that people could try from that. But to finish up, could you share a favorite anecdote from the long history of fasting?
Steve Hendricks 48:00
Yeah, so it's less an anecdote than a study. It's one that we didn't get to yet. And it's about specifically fasting for multiple sclerosis. Well, I'll give you an anecdote and then I'll give you a study if I may. So the lead researcher and former director of the Buchinger Wilhelmi clinic, which is the world's largest and one of the oldest fasting clinics in Germany, they have a campus in Spain as well, fasted people for 100 years. I think they fasted more than 250,000 people. In their time, Françoise Wilhelmi de Toledo, this research director, told me the story of a young man who had multiple sclerosis. And he was told by his doctors, there's nothing we can do for like he was he was nearing the end in effect. And they said, you know, you're you're beyond beyond hope, in effect. He couldn't walk in the door of the clinic. He couldn't sign his name when he arrived. He fasted there for two weeks, and Buchinger Wilhelmi stayed another week, I think it was to refeed. And at the end of those three weeks, he walked out of there under his own power, and was able to sign his name. Now he wasn't cured, all right. But he had a regression of his symptoms. And these kinds of heartwarming stories have been told, by fasting doctors throughout at least the last century about people who are struggling with multiple sclerosis. And the study that I will talk about, I know you had Valter Longo, the professor of the University of Southern California, who's one of the world's leading experts and fasting on the program a couple of years ago. And I know he talked about his study, but I frankly, don't think he stated it in strong enough terms. So I'll tell you what he found. This was done in 2016. It was a study with mice, and he found these were mice who had been given a mouse model of multiple sclerosis slightly different from the human model, but essentially the same thing. He put them on three days of a fasting mimicking diet. which is a very low calorie, it'd be the equivalent about 200 calories a day for us diet that mimics many of the effects of fasting you get many of the same repairs, even though you're taking a few calories, three days on this diet than four days of normal eating, he did this three times. All right, right in sequence, he found that the inflammation in the mice dropped pretty radically. He also found that these FMD cycles not only prevented the demyelination and damage to the axons, which is you know, are the parts of the nerve that conduct impulses but also began to remylinate some of the stripped off myelination on those same parts of the nerves. In consequence, the mice did better on motor tests, they did better on mental tests. And here's here's the sleeper headline that didn't make headlines anywhere but should have: 20% of these mice appear to have been cured. All their symptoms were gone. Absolutely everything you know that the researchers checked to see where's the MS? It was gone. So the pretty moderate amount of fasting cure MS in mice. Hello. That's a huge headline, right? It was so promising that Longo started a very small human pilot study, it was very simple. It's just we'll put you on a similar fasting mimicking diet for one seven day cycle. And then we're going to check you six months later. I mean, it's a very easy amount of fasting. And because it's a fasting mimicking diet much easier to do than actual fasting. Six months later, we're going to check how you are their EDSS score, their expanded disability status score, in fact, did decrease their MS had improved with just that very limited amount of fasting. So this has been so good that Longo over the last few years has been, he and other researchers have been conducting trials in people with MS with various kinds of diet and fasting mimicking diet to see if he can replicate some of the success he had in mice more broadly. Now, to me the importance of all this is this, we know that supervised, medically supervised prolonged fasting is safe. We know that even if it didn't help your MS, it would absolutely help with other things. It makes other repairs when we do these longer fasts. So there's no cost other than the literal cost of paying a fasting clinic. But there's no physical cost or anything, there's no risk to doing a medically supervised fast. So what what I hope will eventually come out of this is enough awareness that people will you know, the people with MS will say, "Well, what do I have to lose? If I have the time? If I can take two or three weeks? Why don't I go and fast and fast in clinic and see how how it affects me if it doesn't help at all? Fine, I don't have to go back. If it does, maybe I want to do this every year."
Geoff Allix 53:01
Just there was that was gonna be the last point. But there's one thing that I didn't ask you, which is so if I was doing a 36 hour fast, how do you break that fast? Do you go full on, I need to catch up with because I don't need to lose weight, fortunately. So am I going to be like, Okay, I need to catch up with those calories I've lost, I'm going to have the immense meal, or do you start back slowly?
Steve Hendricks 53:29
Yeah, I would start just a little slowly but you don't have to be super careful. If you're doing a long fast you know, you're doing it let's say an eight day fast, you need to ratchet up your food over half the amount of time that you were fasting so if you're doing an eight day fast, you need a four day refeeding period the first day you might have three or 400 calories the next day 600 The next day 1200 Or something like that you would do it very gradually. A 36 hour fast your your digestive and nutrient processing apparatus hasn't been shut down for long enough for your body to freak out when it gets food but I wouldn't gorge I would wake it up a little slowly, you know have something that's very easy to digest you know, it could be as simple as rice or potatoes or something you know like that or it could be a broth or a banana you know, something really simple like that. But, you know, within a couple hours, your digestive system will wake up you just go right back to eating you know your normal diet, which hopefully is, you know, a lot of healthy plants.
Geoff Allix 54:31
Okay, and with that I've found this absolutely fascinating personally, and I hope all our listeners have as well. So there'll be show notes which has links to everything but could you just tell us where can we find out more about your work and the book the old if so hopefully I get this right The Oldest Cure in the World: Adventures in the Art and Science of Fasting.
Steve Hendricks 54:52
Yeah, is that correct. That is absolutely correct. You did great.
Geoff Allix 54:58
Fasting book it would have made my life a lot easier.
Steve Hendricks 55:01
You know, people like The Oldest Cure in the World. But yes, the subtitle is a bit ponderous. Isn't that? So yeah, you can buy the book anywhere books are sold. In the US, one of my favorite places is bookshop.org, which will, you know, works just like Amazon, but your money doesn't go to Jeff Bezos. Oroceeds go to your local bookstore, to consortium of local bookstores. I believe there's a similar one as well. In the UK. What is it? hive.co.uk? Yes.
Geoff Allix 55:31
Yeah. I'm not sure it's dot co.uk. Based hive. Yeah, search for hive. Yeah.
Steve Hendricks 55:36
Anyway, there are links to both of those on my website, which is another place you can go at, certainly, you can go there to contact me as well. That is SteveHendricks.org. And the one thing I would point out about that website, so my book is not a how to book. It's a chronicle of fasting and it's telling a story, you can glean a lot of how to information from it. But because it's not a prescriptive, "Do this, do that" book, I get a lot of questions. How do I fast? What should I do on a fast and so on? I've put the most common of those questions under my creatively named Frequently Asked Questions page, where there are maybe, I don't know, 10,000 words of answers to the most common questions I get. So a lot of people told me they found that relatively useful.
Geoff Allix 56:19
Okay, and with that this has been quite a long episode already. So I think we should wrap up and thank you very much for joining us. Steve Hendricks.
Steve Hendricks 56:28
Thanks for having me Geoff. It's been great.
Overcoming MS 56:32
Thank you for listening to this episode of living well with MS. Please check out this episode's show notes at overcomingms.org/podcast you'll find useful links and bonus information there. Have questions or ideas to share? Email us at podcast@overcoming ms.org or you can reach out to Geoff on Twitter @GeoffAllix. We'd love to hear from you. Thanks again for tuning in and see you next time for tips on living a full and happy life with MS. The Living well with MS podcast is for private non commercial use and exists to educate and inspire our community of listeners. We do not offer medical advice for medical advice please contact your doctor or other licensed health care professional.