{"id":254,"date":"2014-06-12T14:29:28","date_gmt":"2014-06-12T14:29:28","guid":{"rendered":"http:\/\/joshmitteldorf.peachpuff-wolverine-566518.hostingersite.com\/?p=254"},"modified":"2014-06-12T21:02:46","modified_gmt":"2014-06-12T21:02:46","slug":"the-three-day-fast-day-four","status":"publish","type":"post","link":"https:\/\/scienceblog.com\/joshmitteldorf\/2014\/06\/12\/the-three-day-fast-day-four\/","title":{"rendered":"The three-day fast: Day Four"},"content":{"rendered":"

Last week, an article about the cell biology of fasting made headlines in the science news press. \u00a0Valter Longo cites evidence that a 3-day fast can rejuvenate our immune systems, with broad anti-aging benefits. \u00a04 or 5 days may be better yet.<\/em><\/p>\n

\n

 <\/p>\n

Socially, I was a late bloomer, clinging too tightly to\u00a0love, driving away partners until I was in my 20\u2019s. \u00a0I took a full year to allow Marsha into my heart. \u00a0Four years later, she broke up with me, and it launched a full-scale spiritual crisis, beginning with three days in which I had no interest in eating.<\/p>\n

Those of you who have probed my Aging Advice<\/a> page know that I fast a day a week, water only from Wednesday evening to Friday morning. \u00a0I have grown quite comfortable with this routine. \u00a0I ease off other disciplines on Thursdays, take a day off from aerobic exercise, allow myself to sleep more and be less productive. \u00a0I still do yoga, and like to take long walks on Thursdays.<\/p>\n

But not since I was 28 have I fasted three days. \u00a0Monday morning, I awoke with the thought that this is as good a time as any to begin a three-day fast. \u00a0If I wait longer, I will have time for fear and worry. \u00a0My mind will play tricks on me, making it harder than it has to be.<\/p>\n

\n

I first became acquainted with Valter Longo\u2019s work when, in 2004, he published a remarkable paper in Journal of Cell Biology<\/a> based on work he did on yeast cells for his dissertation almost a decade earlier. \u00a0The results were considered so unlikely that it had taken him that long to convince a journal editor to take a chance and publish them. \u00a0What Longo had discovered was that when he starved a colony of yeast cells, about 95% of the cells would commit suicide, using the controlled death mechanism of apoptosis<\/a>. \u00a0They would disassemble their proteins, dissolve the cell membranes, and turn themselves into food for the remaining 5%.<\/p>\n

Impossible! replied the reviewers, schooled in traditional evolutionary theory. \u00a0How could such an adaptation evolve? \u00a0The colony must be closely related genetically, and how could the 5% be genetically different from the other 95%? \u00a0And whatever that difference was, the 5% would pass on their genes, the genes of the 95% would perish, and the next generation would no longer have the suicide adaptation. \u00a0We know this from basic theory, said the reviewers. \u00a0Longo must have made a mistake in his biochemistry. \u00a0These cells are not committing suicide – they are starving to death.<\/p>\n

\u201cExtraordinary claims require extraordinary evidence.*<\/a>\u201d \u00a0The paper was returned to him over and over, demanding more and more validation that what he saw was really apoptosis. \u00a0It took ten years before the paper was finally accepted for publication.<\/p>\n

Today the fact that Longo discovered is widely accepted, though the message for evolutionary theory has yet to filter through. \u00a0But Valter saw the full implication of his work: \u00a0If yeast cells had failed to read the basic textbooks in population genetics, what other animals and plants might have been similarly negligent? Yeast cells are just one example of programmed death in the biosphere. \u00a0I was honored and excited the following year when Valter invited me to join him and Vladimir Skulachev in a paper for Nature Genetics on Programmed and Altruistic Aging<\/a>.<\/p>\n

\n

In the intervening decade, Valter has been a ubiquitous presence in the biology of aging and of caloric restriction. \u00a0Of many creative innovations he has introduced, the one he is best know for is fasting as a cancer treatment. \u00a0He has documented<\/a> that a three-day fast before chemotherapy has a powerful and extraordinary effect on the metabolism: The body\u2019s normal cells are in a heightened state of protection, and are much more resistant to chemical toxins. \u00a0Hence the discomfort, headaches and nausea that generally accompany chemotherapy are attenuated – not to mention the long-term damage. \u00a0At the same time, the cancer cells are sensitized<\/i> <\/strong>by the fast, so that more of them are knocked out by the chemo treatment. \u00a0This is a win-win for the patient, but Valter has undertaken a long and arduous campaign to convince oncologists that such a simple protocol could be so effective. \u00a0Worst of all, no one can make a dollar from fasting.<\/p>\n

\n

And what of the rest of us, who don\u2019t have cancer? \u00a0This is the subject of Valter\u2019s most recent work, that made science news headlines last week. \u00a0He puts together evidence from mice and humans that the three-day fast is a boon for us as well. \u00a0(Here is the full text<\/a>, and here is an editorial<\/a> in the same issue of Cell Stem Cell putting the article in context.)<\/p>\n

 <\/p>\n

Evidence in this week\u2019s Longo Article<\/strong><\/p>\n

The experiment around which the paper is written involves depriving mice of food, then looking at the stem cell environment in their bone marrow. \u00a0Fasting actually increases the number of active stem cells in the bone marrow, even as the circulating white blood count is down sharply. \u00a0Two chemical signals are identified that mediate the process: \u00a0Both IGF-1 and PKA are down-regulated with fasting.<\/p>\n

IGF-1 (insulin-like growth factor<\/a>) is an old friend, first discovered in worms in the 1990s, and later identified as a pro-aging hormone generally. \u00a0PKA (protein kinase A<\/a>) is less well known, and has many independent functions, de-activating several different signals by tacking on a phosphate group. \u00a0The cell\u2019s energy cycle uses ATP, which yields energy and is recycled in its low-energy form, AMP. \u00a0Accumulation of AMP occurs when energy stores are low, and this signals a reduction in PKA.<\/p>\n

The article makes a point that, though the benefits of long-term caloric restriction have been studied extensively, this kind of rejuvenation of the immune system has never been observed with CR alone.<\/p>\n

Much of the article is theoretical, connecting decline of the immune system to many of the medical issues associated with aging. \u00a0Arthritis and even Alzheimer\u2019s disease are rooted in auto-immune reactions. \u00a0The steep rise in cancer with age is believed to be related to the immune system\u2019s failure to detect cancer in its early stages and to eliminate pre-cancerous cells. \u00a0It is to be hoped that rejuvenating the immune system might have broad anti-aging effects.<\/p>\n

 <\/p>\n

Why does it work? \u00a0<\/strong>
\nEvidence for programmed aging<\/strong><\/p>\n

In write-ups of this material, the failure of stem cells with age is described as \u201cdysregulation\u201d, and the reason the strategy works is attributed to a clearing out of damaged and ineffective immune cells from the blood, as they are converted by the body to food. \u00a0Perhaps you have noticed that this makes little sense. \u00a0Certainly Valter knows this better than anyone, given his history, but he has chosen not to fight the abstract battle about evolutionary theory, because he knows it would likely interfere with the credibility of his other, practical and life-saving work.<\/p>\n

The point is that if the fasting body is able to rejuvenate and multiply the bone marrow cells that are responsible for blood and immunity (hematopoietic stem cells), then it is obvious that the body could do this as well or better when it has plenty to eat. \u00a0If it wanted to. \u00a0The fact that hardship and deprivation can induce the body to rejuvenate implies that aging is a programmed choice. \u00a0Even when it looks as though the cells are suffering damage over time, that damage is entirely avoidable (indeed, repairable), and it is only with chemical switches that the repair mechanisms are turned off as we age. \u00a0In PKA and IGF-1, Longo has identified two of the signals that keep the repair mechanisms dialed down, and make our health deteriorate with age.<\/p>\n

Why is the body intent on killing itself? \u00a0It is an adaptation for population regulation, a response to natural cycles of boom and bust in population size. \u00a0When times are good, the population expands too fast. \u00a0Aging is a way of slowing down the population boom. \u00a0This is why we age more rapidly when there\u2019s plenty to eat. \u00a0In times of famine, there is already plenty of death, and the danger is the opposite – that the population might plunge to extinction. \u00a0This is why aging backs off in the face of hunger. \u00a0(Ideas in this paragraph are\u00a0not yet standard evolutionary theory, but this\u00a0is a theme that I have developed in computer simulation<\/a>, and it is the core of my contribution to publications in the field.)<\/p>\n

 <\/p>\n

Fasting in Ancient Religious Traditions<\/strong><\/p>\n

Though they are not controlled and not founded in a knowledge of biological mechanisms, traditional writings nevertheless embody experience of large numbers of people over a long period of time, and I look to them for ideas, for cautions and confirmations. \u00a0Before writing this piece, I had the impression that fasting was recommended in many religious traditions, and I eagerly googled associations with the 3000-year-old Ayurvedic (longevity) tradition <\/a>of India. \u00a0I was surprised to learn that fasting for more than a day is regarded as an extreme practice, and that Ayurvedic texts don\u2019t provide prescriptions or recommendations for long-term fasts, but rather cautions against fasting, suggesting that fasting practice has been prevalent for a long, long time, and the ancient Ayurveda was already reacting against it.<\/p>\n

Frequent 12-24 hour fasts, however are recommended, even prescribed in the Ayurveda. \u00a0Eating the main meal early in the day is a practice that ancient traditions and modern medicine agree on. \u00a0Avoiding food for several hours before bedtime is part of yogic practice. \u00a0For Buddhist monks in the Theravada tradition, all eating is confined to the morning hours, implying a daily fast of 16 hours.<\/p>\n

 <\/p>\n

Implications for the clinician, for you and me<\/strong><\/p>\n

I find it remarkable, if no longer quite surprising, that in write-ups of the therapeutic effects of fasting, medical professionals and researchers focus on what we can learn that will help us produce a drug that mimics the benefits of fasting. \u00a0Fasting is providing all the benefits with little or no downside (except temporary hunger, need for warmer clothing); but medical science is busy search for drugs that will probably target just some of the signals that fasting sends, and will probably have more serious side-effects than fasting. Longo says that the constellation of benefits from fasting \u201cwould be difficult to achieve with any pharmacological or other dietary intervention.\u201d<\/p>\n

It is deep in the culture of today\u2019s medicine that the patient is passive and it is the doctor who is the agent of healing. \u00a0Medical professionals de-emphasize all that the patient can do with diet, exercise and life-style modifications to improve his own health, despite the proven power of these regimes. \u00a0Part of the problem is in the conection to capitalism, which creates a focus on what can be healed profitably, ignoring remedies that cannot be sold.<\/p>\n

 <\/p>\n

Fasting and weight loss<\/strong><\/p>\n

It is my experience that I don\u2019t lose weight from fasting, presumably because I eat more before and after a fast. \u00a0Other people I know have reported similar experiences, and both ancient texts and modern medical advice agree that fasting is not an effective way to lose weight for most people. \u00a0That doesn\u2019t mean it won\u2019t work for you, if you have experience to the contrary.<\/p>\n

Steve Hendricks published in Harpers<\/a> an account of his own 20-day fast, embedded in a very readable account of some fasting history. \u00a0Summary here<\/a> for those without a Harpers subscription.<\/p>\n

 <\/p>\n

Personal experience<\/strong><\/p>\n

I\u2019m now in Day 3, and it seems long only psychologically. \u00a0In my weekly Thursday fasts, I sometimes experience headaches (one week in 5 or 6), and that hasn\u2019t happened. \u00a0I have the luxury of no busy schedule, no deadlines. \u00a0That\u2019s a good thing, because productivity on fast days is not reliable. \u00a0During fasts, I don\u2019t have the focus to be able to write computer code, and writing is often slow. \u00a0But often deep and creative thoughts are given to me during fasts.<\/p>\n

I can sit contentedly for long periods of time without feeling a need to accomplish anything, or even to get up. \u00a0I tend to a shorter night\u2019s sleep, but enjoy naps during the day. \u00a0Once in my life I tried public speaking on a day I was fasting, and I won\u2019t do that again. \u00a0Words come out more slowly, trying the patience of the audience. \u00a0(My one experience was speaking to the Caloric Restriction Society, and my audience understood and were patient.)<\/p>\n

 <\/p>\n

How long is optimal?<\/strong><\/p>\n

I wrote to Valter yesterday, asking this question. \u00a0Does he have evidence from people suggesting how long it takes for the immune reset? \u00a0Is it different for people who start with a lot of fat on their bodies compared to people who have nothing in reserve? \u00a0His answer was short and to the point:<\/p>\n

\u201c3 days is optimal for mice. For humans 4-5 minimum, depending on what you are trying to achieve<\/i>\u201d<\/p>\n

You can already tell I have a lot of faith in Valter as a scientist, and it is easy for me to believe that, from his experience, he knows more than he is able to publish. \u00a0So I\u2019m deep into Day 4 as I finish writing this. \u00a0I’m a little spacey and my rhythms are disrupted, but I’m not suffering or food-obsessed. \u00a0I plan to start fruit or juice soon.<\/p>\n","protected":false},"excerpt":{"rendered":"

Last week, an article about the cell biology of fasting made headlines in the science news press. \u00a0Valter Longo cites evidence that a 3-day fast can rejuvenate our immune systems, with broad anti-aging benefits. \u00a04 or 5 days may be better yet.   Socially, I was a late bloomer, clinging too tightly to\u00a0love, driving away … Read more<\/a><\/p>\n","protected":false},"author":65,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-254","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"\nThe three-day fast: Day Four - Josh Mitteldorf<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/scienceblog.com\/joshmitteldorf\/2014\/06\/12\/the-three-day-fast-day-four\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The three-day fast: Day Four\" \/>\n<meta property=\"og:description\" content=\"Last week, an article about the cell biology of fasting made headlines in the science news press. \u00a0Valter Longo cites evidence that a 3-day fast can rejuvenate our immune systems, with broad anti-aging benefits. \u00a04 or 5 days may be better yet.   Socially, I was a late bloomer, clinging too tightly to\u00a0love, driving away ... 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The surprising fact that our bodies are genetically programmed to age and to die offers an enormous opportunity for medical intervention. It may be that therapies to slow the progress of aging need not repair or regenerate anything, but only need to interfere with an existing program of self-destruction. Mitteldorf has taught a weekly yoga class for thirty years. He is an advocate for vigorous self care, including exercise, meditation and caloric restriction. After earning a PhD in astrophysicist, Mitteldorf moved to evolutionary biology as a primary field in 1996. He has taught at Harvard, Berkeley, Bryn Mawr, LaSalle and Temple University. He is presently affiliated with MIT as a visiting scholar. In private life, Mitteldorf is an advocate for election integrity as well as public health. He is an avid amateur musician, playing piano in chamber groups, French horn in community orchestras. His two daughters are among the first children adopted from China in the mid-1980s. Much to the surprise of evolutionary biologists, genetic experiments indicate that aging has been selected as an adaptation for its own sake. This poses a conundrum: the impact of aging on individual fitness is wholly negative, so aging must be regarded as a kind of evolutionary altruism. Unlike other forms of evolutionary altruism, aging offers benefits to the community that are weak, and not well focussed on near kin of the altruist. This makes the mechanism challenging to understand and to model. more at http:\\\/\\\/mathforum.org\\\/~josh\",\"sameAs\":[\"http:\\\/\\\/AgingAdvice.org\"],\"url\":\"https:\\\/\\\/scienceblog.com\\\/joshmitteldorf\\\/author\\\/joshmitteldorf\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"The three-day fast: Day Four - Josh Mitteldorf","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/scienceblog.com\/joshmitteldorf\/2014\/06\/12\/the-three-day-fast-day-four\/","og_locale":"en_US","og_type":"article","og_title":"The three-day fast: Day Four","og_description":"Last week, an article about the cell biology of fasting made headlines in the science news press. \u00a0Valter Longo cites evidence that a 3-day fast can rejuvenate our immune systems, with broad anti-aging benefits. \u00a04 or 5 days may be better yet.   Socially, I was a late bloomer, clinging too tightly to\u00a0love, driving away ... 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The surprising fact that our bodies are genetically programmed to age and to die offers an enormous opportunity for medical intervention. It may be that therapies to slow the progress of aging need not repair or regenerate anything, but only need to interfere with an existing program of self-destruction. Mitteldorf has taught a weekly yoga class for thirty years. He is an advocate for vigorous self care, including exercise, meditation and caloric restriction. After earning a PhD in astrophysicist, Mitteldorf moved to evolutionary biology as a primary field in 1996. He has taught at Harvard, Berkeley, Bryn Mawr, LaSalle and Temple University. He is presently affiliated with MIT as a visiting scholar. In private life, Mitteldorf is an advocate for election integrity as well as public health. He is an avid amateur musician, playing piano in chamber groups, French horn in community orchestras. His two daughters are among the first children adopted from China in the mid-1980s. Much to the surprise of evolutionary biologists, genetic experiments indicate that aging has been selected as an adaptation for its own sake. This poses a conundrum: the impact of aging on individual fitness is wholly negative, so aging must be regarded as a kind of evolutionary altruism. Unlike other forms of evolutionary altruism, aging offers benefits to the community that are weak, and not well focussed on near kin of the altruist. 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