Fasting and digestive health -
And we see shifts that are going on in the overall distribution of the gut metabolites that are occurring that are having an effect on the anterior insular nucleus that then has an effect on the basal ganglia and the ability of movement or the effect on movement disorders.
We see alterations in tryptophan pathways and kynurenic acid pathways that are stimulating inflammatory changes and degenerative changes in the brain.
Do we see impacts to our immune health when we start a therapeutic fasting plan? And so we need to have a balance between all three of those that are going on. That, to me, forms the basis of health is working on the gut microbiome, supporting the immune system, using, you know, foods that are anti-inflammatory in nature.
And that helps to balance the energy production pathways, you know, as well as the overall electron transport chain within the mitochondria to be able to optimize its efficiency for energy production that goes on.
So I like to think of all three of those together. And some of that may be mediated through that apoptosis that we spoke about earlier.
Kalea Wattles: There are so many clinical applications for fasting, and you mentioned earlier that you might be willing to share a little bit about this connection between fasting and the gut microbiome changes and benefits to cancer treatment.
So I thought we could spend a few minutes and I would love to hear your thoughts on this topic. Patrick Hanaway: Well, as you know, this is a personal topic for me. I began really looking at intermittent fasting and fasting-mimicking diet and relating that to other cultures and working with insulin resistance about nine years ago.
And in that timeframe, I found it to be really potent. And I was aware that much of the work that Dr. Valter Longo at USC had done was actually started with trying to do a fasting before chemo as a way of being able to optimize a differential stress response.
You know, that is, how do we make the cancer cells more susceptible and the healthy cells less susceptible to chemotherapy? So that was the research that he had done, and, you know, then moved that into more anti-aging apoptosis, insulin resistance, you know, kind of promoting fasting-mimicking diets in a broader context.
But the genesis of it was from his work on cancer and fasting before chemo. And he showed initial data in through his lab of the benefits of it, and they carried that forward.
And so it was in the back of my head when I got cancer, you know, stage four cancer of the neck, in the aryepiglottic fold with lymph nodes on both sides. And I was doing a ketogenic diet at that point in time, which I later found helps to expand the therapeutic range of the radiation therapy.
How long do you need to fast? You know, and they did fasting that looked at, you know, 24, 48, 72 hours. My weight stayed pretty stable. I think I lost five pounds through the eight weeks of treatment. But for those who are receiving chemotherapy, and again, to be clear, the data has been demonstrated of its efficacy, increased efficacy, and decreased toxicity in breast cancer.
Not all of them are able to do it. And the data in the studies that have been done is calories per day, and I usually focus on a bone broth as a means of being able to do that, you know, in terms of that overall caloric intake during that period of time.
But yeah, it is important and meaningful to me, and I think it made a big difference in my ability to move through, you know, chemotherapy is toxic by nature. How do we focus that toxicity differentially on the cancer cells and not on the beneficial cells of our body?
Kalea Wattles: Well, Patrick, your experience and your story is so powerful and so compelling, and those of us who have heard you speak about your entire journey, I mean, it is really heartfelt, and I think we take away so many incredible insights from your experience.
Do you think that the application of fasting and the ketogenic diet will become more standard in oncology moving forward? I mean, when are we going to see this take foot?
So the first is around intermittent fasting or fasting before chemo. And I think that we have a lot of great opportunity to be able to do that. No one will ever do that. And so the number of dropouts in the studies that have been done are actually quite small, even though it was thought that no one would want to do it.
And then the other part of your question, which was about a ketogenic approach or, you know, a cellular metabolic approach as we see, you know, a number of our colleagues talk about, but that is for specific cancers that are more insulin sensitive.
Not every cancer is going to be affected the same way as, you know, glioblastoma multiforme or the radiation-sensitive cancers like mine and ENT or rectal cancer. Prostate cancer is another one where, like early prostate cancer is much more insulin sensitive than are later prostate cancers, you know?
So we have to really personalize the treatments that we use. And I think time-restricted eating is one great way to do that, is to reset the circadian rhythms that go on.
Kalea Wattles: Well, you have shared so many groups that could benefit from fasting. I mean, is there a fasting regimen for everyone? Can any person find some type of fasting or time-restricted eating that will be appropriate for them? And so do you need the popcorn before dinner or do you need to have, you know, the cream in your coffee in the morning, right?
Do they really count? Kalea Wattles: Everyone who just learned they can have coffee and tea and still be fasting now, it seems so much more realistic. Well, Patrick, we have so appreciated hearing all of these clinical insights today. Appreciate your work. For more information about functional medicine, visit IFM.
Fasting can help improve digestive processes by allowing the body to clear out any accumulated waste or toxins. This can optimize nutrient absorption and utilization when you resume eating. Additionally, fasting has been suggested to increase digestive enzyme production, potentially aiding in the breakdown and assimilation of nutrients.
The gut microbiome plays a critical role in weight management by influencing metabolism, digestion, and nutrient absorption. Certain bacteria in the gut, such as Firmicutes and Bacteroidetes , are found in differing proportions in obese versus lean individuals. When the natural synchronization of our internal body clock is disrupted due to irregular eating patterns, an imbalance in these microbiota, known as dysbiosis , is often linked to weight gain and metabolic disorders.
Fortunately, fasting has been shown to help better regulate your internal clock and the natural circadian rhythms of your cells and microbes within your body.
Time-restricted eating, alternate-day fasting, and multi-day fasting are dietary approaches that incorporate periods of fasting to enhance digestion and overall health. Ranging from daily cycles of fasting and eating to extended multi-day fasts, these practices provide varying levels of rest for the digestive system, promoting cellular renewal and a healthier gut environment.
Time-restricted eating, commonly referred to as intermittent fasting, involves alternating periods of fasting and eating within a daily cycle. The most popular method is the fast, where you fast for 16 hours and restrict your eating window to 8 hours. This approach can provide beneficial effects for digestion, microbiome, and overall health when practiced consistently over an extended period of time.
Alternate day fasting is a form of intermittent fasting where individuals alternate between fasting days and non-fasting days. On fasting days, calorie intake is significantly reduced or eliminated, while non-fasting days allow for normal eating. This type of fast can help reset the digestive system by giving it a more extended period of rest and promoting autophagy, a cellular repair process.
Multi-day fasting involves fasting for multiple consecutive days. Common durations for multi-day fasts range from 2—7 days. These types of fast can allow for complete cellular turnover of the intestinal wall, since the typical rate is between days.
This creates an environment free of potential irritants from food, allowing for your gut to rebuild itself in a time of rest. However, extended fasts should only be attempted under medical supervision, as they require careful monitoring of hydration levels and nutrient intake to avoid potential risks.
Always speak with your health care practitioner to help determine if fasting is right for you. This can help to improve gut health and reduce inflammation. Here are some tips to make your digestive reset fast successful. Fasting for gut rest is a bit different from fasting for metabolic health or weight loss.
In the latter examples, there is a bit more leniency on what breaks your fast , usually allowing for a small amount of calories from food, supplements, and coffee.
Gut rest fasting is a bit more strict, typically allowing only for those foods, beverages and supplements that have 0 calories and that do not stimulate the gut — usually water, plain electrolytes, and herbal teas only.
For example, even though black coffee contains minimal to no calories, it does promote functions of digestion. Coffee stimulates gastrin a hormone that stimulates secretion of gastric acid , gastric acid secretion, and gallbladder contraction, all of which have an impact on our gastrointestinal tract.
Keeping up with your water intake is important. Plus, for extended or multi-day fasts, electrolytes are typically needed. If electrolytes such as sodium, magnesium, and potassium are plain, without other added ingredients, they will not break your fast for digestive rest.
Intermittent fasting, such as the method, can be a good goal to start. Physical activity can help maintain a healthy digestive system , so it is important to keep up your exercise habits while fasting.
So, in that case, opt for gentle exercises like yoga, walking, or stretching. Breaking your fast in a mindful way is crucial for maximizing digestive-system health benefits.
The researchers, following their earlier analysis , had commented that the mechanism could be the benefits seen with changes in metabolism, weight loss, cardiometabolic factors, or even improvements in dietary patterns associated with the two arms of intervention.
Bedford suggested a simpler reason. The dietitian also expressed concern that fasting diets and calorie reduction could cause further harm to people with a history of disordered eating.
Fasting can be performed in a variety of ways. While participants in the study fasted 3 days a week, fasting can also be done for a few hours, or for multiple days in a row. He cautioned that fasting is not a good idea for people with diabetes, since the prolonged lack of food causes fluctuations of blood sugar and insulin levels.
Previous research has found that calorie reduction, if it is too extreme, can cause an increase in pathogenic bacteria in the gut, and may otherwise disrupt the microbiome. Bedford did not question the findings of this research.
However, he suggested that extreme calorie reduction is an unlikely practice. It takes an enormous amount of discipline to do that. And in terms of plants, again, a very limited number of plant products that we also consume.
He noted the existence of so-called blue zones , regions around the world in which people live exceptionally long lives. And it changes the microbiome for the better, and therefore the less disease, fewer issues, and fewer problems.
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