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Hello Health Champions. How is it possible, that
even though food is the thing that keeps us alive,
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millions of people get healthier when they don't
eat for a few days? What are the mechanisms for
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that? How does the body change and cope and adapt
when we don't eat? A lot of people have heard that
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fasting is good for weight loss, but they're still
concerned because there's so much conflicting
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information out there. So today I wanted to
explore these mechanisms of fasting in a little
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bit more detail to really help you understand what
happens when you miss a few meals and how it can
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have such a profound impact on health. In the
first 12 hours, not a lot of changes take place.
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You're going to be using up some of the stored
carbohydrates in your body called glycogen your
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blood glucose will probably drop a little bit
unless the 12 hours is at the end of sleep and
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you're slightly insulin resistant then because
of something called dawn phenomenon you might
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actually see the opposite your body temporarily
makes some hormones in the early morning to get
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you ready for the day and you might see a little
bit of an increase instead as you're using
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up some of the stored glycogen your body will
gradually start shifting its energy metabolism
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into using more fat and a byproduct of that fat
is called ketones now this is barely detectable
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at this point but it's a process that's starting
and what we want to understand about ketones is
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that this is completely normal everyone is going
to gradually shift into this the problem is that
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oftentimes this is confused with keto acidosis
which is a very dangerous condition that's
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completely different that's if you have type 1
diabetes and absolutely no insulin in your body
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your blood sugar shoots up your ketones shoot up
and that's not going to happen unless you have
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no insulin instead what this indicates is actually
metabolic flexibility that as one fuel starts to
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run lower your body starts looking for another one
when you're metabolically flexible your body makes
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use of whatever fuel there is the most of most of
the changes that take place during fasting have to
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do with energy because we're not eating anything
that can turn into energy so energy becomes super
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important the only form of energy your body can
use is something called ATP everything that you
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eat all the food whether it's carbohydrate or
fat or protein it eventually turns into ATP which
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is a very specific molecule and here's how you
can think about this there's an adenosine group
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and we hook on three phosphates and these
are high energy bonds so think of these as
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springs that you take a little package and you
push it onto a spring and it snaps in place
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and now we have energy stored in that spring and
then later if we undo the snap then it shoots
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off and the spring releases its energy and that's
exactly how this works so when the body needs more
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energy for anything or every process that requires
energy this is what happens it pops off one of
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these phosphates the spring releases that energy
and we're left with ATP adenosine diphosphate so
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how does that relate to the stuff we eat well if
you eat a calorie we call it a calorie which is
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often written as a calorie I'm just mentioning
that if you see it written don't get confused
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it's basically the same thing so in one mole
which is a huge number of these ATP molecules
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we have seven calories so that means that one
calorie you eat basically has 10 to the 23rd
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of these molecules it's like a one with 23 zeros
it's a hundred million trillion trillion molecules
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in one calorie and if we break that down to how
much you need per second then you need about 2 300
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trillion trillion of these molecules per
second so these are such astronomical numbers
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but if you think about the fact that you have
somewhere on the order of 40 trillion cells
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that means that every cell makes trillions of
these molecules per second to keep you alive
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so that means we have a lot of these molecules
but it also means that we have to recycle it
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in a hurry so as soon as we pop one of these off
the body is busy putting it back on so the body
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uses energy from food to create a type of energy
that you can put one of these back on and that
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process is called oxidative phosphorylation
that's why we breathe oxygen and that oxygen
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goes to the mitochondria so that we can keep this
process going so the goal of the body is to keep
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almost all of these loaded all the time but
when energy starts running really really low
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now we can even have a few of these become amp
adenosine monophosphate so this is a high energy
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state this is like a resting in between but this
is a really low energy state this really signals
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that we have a lack of energy we're
really running out at this point
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and then there's an enzyme so when this starts
building up then it strongly signals to something
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called AMPK which is basically amp kinase it's an
enzyme that tells the body hey we got to get busy
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finding other energy we got to up regulate
something and the first thing that they
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up regulate is fat burning because when
you're not eating basically all your energy
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or the vast majority of your energy is stored as
fat do you recognize this guy his name is Usain
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Bolt and he has a bunch of world records in sprint
and i was never as fast as this guy but i did make
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it to the top 10 in the world in decathlon which
is another track event and because of that i
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had a very inquisitive mind when i went through
school i would constantly just ask questions to
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try to understand my body and what was happening
so here are some of the questions that i would ask
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i would ask how many times in a day does
this ATP discharge and get recharged by ADP
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so that turns out to be about a thousand to
1500 times per day your entire stock load of
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ATP of adenosine gets reloaded a thousand to
1500 times per day and if we just take the
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number of seconds per day and we divide
that out we find that if you completely
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stopped reloading the ATP if you stopped that
process then you would have somewhere between
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60 to 90 seconds to live before you completely ran
out of ATP so we picked the mid-range of that and
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we call it 75 seconds so the next question i asked
was well what about athletes what about sprinters
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because the 100 meter sprint is the highest
intensity that a human can come up with
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you're moving basically all of your muscles
at the same time at the maximum intensity
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and a baseline energy output for a person is
about 90 watts that's your basal metabolic
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rate but it turns out someone did a full study
on this phenomenon called Usain Bolt and they
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found that he uses up he puts out a maximum
power output of 2619.5 watts don't ask me how
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they came up with that but it was a huge project
apparently but what this means is he uses up 29.1
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times more ATP than the base rate so what that
means the gun goes off and he starts sprinting
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and he makes no more ATP than what he had at
the beginning he has 2.5 seconds left to live
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so that should give you some appreciation
for how incredibly flexible and adaptable
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the body is that you think he's busy
sprinting but every one of his cells
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just up regulated their ATP production by many
many many times basically what this means is
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if he didn't make any more ATP after the gun goes
off he wouldn't even make it to the 20-yard line
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and by that time he'd be dead when you've gone 18
hours without food something we also often call
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skip breakfast now you're much more into the fat
burning mode your body is starting to make ketones
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at a measurable level and we want to understand
that ketones are not just fuel but they're also
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signaling molecules and we'll talk more about some
other signaling molecules here but these signal
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reduced inflammation and improved DNA repair
especially in brain and nervous tissue what we're
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also seeing in the brain is human growth hormone
increases it's starting to go up significantly
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along with something called BDNF brain derived
neurotrophic factor and these two together is
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basically what you want to think of as miracle
growth for the brain they are responsible for
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your body repairing and also making more elaborate
neural networks every time you learn something
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you're making new connections new synapses process
called neurogenesis and this is only possible
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if you have enough human growth hormone and BDNF
another thing to keep in mind is that exercise
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will accelerate this process basically everything
that we're talking about happening with fasting
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will happen more if you exercise as well also
at 18 hours we start seeing just the beginnings
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of something called autophagy which is a very
interesting rejuvenation process in the body we'll
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come back to in a minute does it still sound like
breakfast is the most important meal of the day
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i certainly hope that you'll start to rethink
that idea what's sort of sad is that breakfast
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in bed in many cultures we think of it as the
ultimate in caring the ultimate in pampering and
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what are we getting we're getting sugar and sugar
and sugar and sugar and sugar there's basically
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not a single item here that is not going to drive
your blood sugar and your insulin crazy 24 hours
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without eating now let's talk a little bit more
about this autophagy thing so it barely started
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probably around 18 hours and now it's picking up
speed autophagy means self eating that's literally
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what the word means it does not mean that you have
to do like this guy and start chewing on your arm
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this is happening at the cellular level because
you're not eating because you're not putting any
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resources into the body all the existing resources
become more precious and the body has to learn to
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become less wasteful so think of autophagy as
recycling that you always have a certain amount
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of cleanup going on in the body you have a cleanup
crew but the longer you go without food the more
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the body up regulates it starts recruiting
resources into this cleanup crew so after a
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while you have much much much more resources
going toward recycling and it's cleaning up
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old debris and when you don't have so much now you
have to start being more careful like if you're a
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carpenter and you don't have a whole lot of wood
left now you have to pay more attention to detail
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you can't afford to waste anything and if you have
to pay more attention and be careful now you're
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also increasing the quality of work so that's how
you can think about autophagy the things we talked
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about earlier like ketones and growth hormone and
BDNF they keep increasing at this point and we're
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also going to start talking about a couple of more
of these nutrient sensors and signaling molecules
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called AMPK m-Tor and NAD i often say that the
body is not stupid it is supremely intelligent
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everything it does is for a reason so i want
to guide you through some of the mechanics
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of what happens when we're in a well-fed versus
a starving state and I'll introduce a few terms
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don't try to memorize them or get confused or
worry about it I'll talk you through it I'll
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keep it simple and I just want you to focus on
the overall picture so when we're well fed we're
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in a state of anabolism which means to build
up and if we have fuel from carbs then we're
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triggering a nutrient sensor called insulin
because insulin helps that blood sugar to get
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out of the bloodstream and into the cell where
we can use it so insulin is a message to grow
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and divide and synthesize and store so if we need
to make more cells then they start dividing we
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make proteins and hormones and all sorts of new
good tissues and if we have some energy left over
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then we store the excess as fat for a rainy day
but there are more nutrient sensors and one of
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the main ones is called m-Tor mammalian target of
rapamycin and this one sends the same message but
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it's more specific into the building insulin
is more about the energy metabolism the energy
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dynamics and mtor does respond to carbs as well
but more so to the protein that's going to become
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the building blocks both of these are resources
and when we have resources now we can put those
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into energy production so there's a couple of
more signaling molecules that are called nad plus
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and nadh that feed in to the krebs cycle
or the cycle that produces energy in the
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body in the mitochondria and if we have a lot
of resources then we can make a lot of nadh
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and we can feed a lot of substrate into this
energy production and if we're good at converting
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into nadh then we're not going to find so much
nad plus and this becomes important so remember
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that that nad plus is also a signaling molecule
the opposite of well-fed is starving and if we're
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doing it on purpose it's called fasting now we're
talking catabolism which means breakdown and we
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talked about ampk we mentioned that earlier that
ATP turns into adp and the lowest energy state is
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amp so when we have any amount of amp build up
that's a strong strong signal for ampk which is
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an enzyme that stimulates fat burning and another
thing that ampk signals is this autophagy that
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we were talking about the recycling so again
resources are becoming more precious and ampk
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is one of the strongest signaling molecules
for that and all of these signaling molecules
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relate to each other because it's a smart body
so when we're low energy the ampk turns off the
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mtor which is supposed to build things up and
mtor turns off autophagy so it's just another
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reinforcement we said that ampk stimulates
autophagy well it does it two ways because it
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turns off something that turns it off so it's just
another way of stimulating it and then what about
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exercise well exercise also stimulates ampk so
you really want to think about exercise as almost
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synonymous with fasting virtually everything
that happens with fasting you'll do the same
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effect with exercise or you reinforce the effects
of fasting of course i would never suggest that
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you do only one instead of the other because they
have tremendous complementary benefits for example
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exercise is the primary stimulation for your brain
which you will not get the same stimulation from
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fasting only exercise will also turn off mtor so
this again is another stimulator for autophagy
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remember this other thing we talked about the
nad plus is also a signaling molecule how does
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that work when we have plenty of resources then
they feed into this energy production system
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but when resources are low now we cannot convert
very much into nadh and if we can't convert into
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nadh now nad plus starts building up it's like
a bottleneck this is supposed to turn into that
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but if it doesn't then it starts to stockpile
and this is a very potent signaling molecule
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for certain genetic mechanisms there are certain
genes called sirtuins which have been studied
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extensively and they are basically life prolonging
they are longevity they are survival genes what
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about the safety does everybody need to fast can
everyone fast well we want to understand that it's
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all about balance that we always need to have
a balance between feast and famine we need to
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have certain periods where we load up and store
some things and we need to have other periods
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where we unload and burn some of those things
that we stored the problem is for most people
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they have lived most of their lives in the feast
region there's an imbalance here so can everyone
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fast well you got to figure out where you are on
the spectrum if you have more body weight or more
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insulin resistance than you would like then you
are more on the feast side and you have to start
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moving over more to the famine side you have to
eat fewer meals you could eat less at the same
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number of meals but that's very difficult because
you're not addressing the insulin resistance and
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you're not breaking the pattern of frequent meals
if you are under nourished if you're extremely
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thin there can still be some benefits to fasting
but you can't do very much of it or any at all so
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figure out where you are and start creating some
balance so true starvation is never a good thing
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and it's unfortunate when people are forced
into that but when you say that you're starving
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and it's three hours since you had breakfast
and you say oh god I'm starving I can't wait
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to have lunch that's not really starving that
means you have an imbalance that you have
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taught your body to expect frequent meals and that
you have taught it to depend on carbohydrates so
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it doesn't really know what to do if you don't
feed it all the time another thing I've heard
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is that fasting and keto is a way of promoting
eating disorder that they think that low
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fat and six meals a day that's the way to eat
and anything else is an eating disorder and it
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will lead to anorexia and bulimia well these have
nothing to do with each other because anorexia is
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a mental problem it's an emotional problem based
on a distorted self-image they see themselves in
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the mirror and they're skinny as a rail and they
see a fat person that has nothing to do that's
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not a metabolic problem that's a mental problem
what we're trying to correct is the metabolic
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problems and in the process we're also actually
helping people become more mentally balanced and
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not so dependent on food i would actually turn it
around and say that if you need six meals a day
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if you get light-headed and irritable and cranky
if you miss a meal if you can't focus then that
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is actually what an eating disorder is short
of having a mental problem with the distorted
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self-image if you're needing six meals that's
probably more of an eating disorder so why don't
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you if you have followed my recommendations my
principles for a few months why don't you put
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in the comments if you feel like that has made you
have more or less of an eating disorder and don't
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do it for me do it for the people who are still
concerned and confused at 48 hours your growth
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hormone has increased fivefold 500 percent more
and along with that we're also seeing increases
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in BDNF and ketones and your rate of autophagy
of cleanup is also increasing steadily we want to
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remember that ketones are not just fuel they're
also signaling molecules so they contribute to
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this increase in growth hormone and BDNF we have
one more hormone called ghrelin that also helps
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increase growth hormone and BDNF and that makes
sense ghrelin is your hunger hormone so when you
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haven't eaten for a while your body releases
the hormone that signals hunger it says hey
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you know maybe you just forgot but we haven't been
fed for a while so why don't you go eat something
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and the beauty of that is that it's more of a
reminder so whereas ketones are steady and keep
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increasing the ghrelin is temporary it's more
of a reminder and if you just have a cup of tea
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or you go for a walk that ghrelin is not going
to keep nagging you it's going to go away it's
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going to say oh well i guess there wasn't
any food around we'll try again in a few
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hours or maybe tomorrow so ghrelin is more of a
temporary stimulation but the ketones are going
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to be steadily increasing some more benefits
we see at this time is brain repair increased
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longevity wound healing and cardiovascular
health and these are all things that
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the growth hormone and the BDNF contribute to also
at 48 hours we're going to see some of the lowest
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insulin levels we have seen since we started
and when we lower insulin we lower inflammation
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and if we keep this up if we gradually lower
insulin and reduce insulin resistance now
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we're also reversing all of the aspects of
metabolic syndrome the high blood pressure
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the belly fat the cardiovascular risk etc at 72
hours things really start kicking in and we see
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deeper levels of autophagy which means more
cleanup of these things we talked about the debris
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and the waste the misfolded proteins and other
low-quality parts so the body gets really really
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picky because it says you know i really need some
resources i need to build this thing over here
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and this thing wasn't perfect so let's disassemble
that and and rebuild it but here's what
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really starts to kick in that's interesting
at 72 hours and big words hematopoietic
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stem cell regeneration and rejuvenation so heme
has to do with blood and poisons poetic has to
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do with building with making and stem cells
are the cells that are the originator cells
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the cells that become other things so it's like
the baby cells that we use to make other cells
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and therefore this process in other words
is a form of rejuvenation it's rejuvenation
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of the tissues and when we're building the new
tissues it's like a younger quality to it so
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this is pretty profound this is about the white
blood cells which is our immune cells and they
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have found that if you do repeated fasting not all
the time but at certain intervals of 72 hours now
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you get some protection against chemotherapy
so chemotherapy is like an evil fight to fight
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an evil it's a poison and you're giving it
to the body in the hope that it will poison
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the cancer cells more then it will poison the
body cells but it is a burden it's a severe burden
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and therefore it has a tendency to suppress the
body's stem cells and the body's immune system and
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the generation of these white blood cells but what
they have found is that if you do this fasting you
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can offset the damaging effects of chemotherapy so
the people who fast while they're doing chemo they
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maintain their immune system at much higher
levels if we keep going to 120 hours or five days
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then there is nothing dramatically new that's
happening but we are increasing the degree of
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everything that we talked about before it either
stabilizes or builds to higher levels and more
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than that it gives us more time and we have more
time for fat burning if your goal is weight loss
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we have more time for clean up and repair if you
are interested in autophagy and reversing disease
00:28:41
and we have more time to turn around momentum
so think about all of these disease processes
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and all your metabolic pathways as having
momentum and if you go a little bit longer
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now you have higher degrees of turn around
but you also allow more time so it's sort of
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like a super tanker you can't turn it right away
but if you're patient it will happen over time
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and with this you're also allowing the cells to
forget their old set points so again with these
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tendencies we have in the body the body develops
set points there are set points for all sorts of
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different things including your body weight so if
you have a tendency to bounce back then this can
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help in setting a new set point forgetting the
old set point and finally creating a new one i
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often get asked when does it start and people want
a specific timeline like yes but just tell me the
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answer tell me when it begins and it doesn't work
like that so i created this to sort of try to give
00:29:52
you an idea that everything is always there to
some degree but it either increases or decreases
00:30:01
so glucose for example is going to slowly decrease
over several days until it stabilizes because
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glucose is something we have to have blood glucose
it will never go away same thing with insulin
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it will always be needed when you don't eat
you're allowing more time for it to decrease
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but we are going to have a baseline level
that's going to be necessary at all times
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growth hormone is going to have a low baseline
level but it's going to increase so by time we
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hit 48 hours we'll have 500 percent more growth
hormone and then it will probably slowly increase
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but not in definitely it'll hit a plateau and sort
of stabilize at that level ketones and autophagy
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these are things that they're not absolute zeros
but they're virtually zero they're virtually
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non-existent before 12 hours and then they barely
start and then they get some momentum around the
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18 hour mark now take a look at this a lot of
people most people who eat three or more meals
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are never going to get past 12 hours of fasting
so they never will change their baseline markers
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they'll never experience autophagy or any
significant ketones but if you just get to
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18 hours something as simple as skipping
breakfast and having an earlier dinner now
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you're seeing more growth hormone you're seeing
some ketones and you're even seeing some autophagy
00:31:45
kick in at 24 hours we're doing the same thing
we're seeing increases in all of those and if we
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can keep going until 48 hours now we're seeing
dramatic increases in these like we said with
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growth hormone we're up five-fold then if we can
go one more day to 72 hours now we're seeing most
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of the changes that we're looking for if we're
trying to reverse a disease or start affecting
00:32:15
stem cells and things like that now here are
the ranges i think would apply to most people
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it is from 18 to 48 hours and then the 72 hours so
if you have reached most of your weight and health
00:32:32
goals you can absolutely make 18 hour fasting
a lifestyle that's what i do most of the time
00:32:40
not because I'm trying to control anything but
because it is just so convenient i eat twice a
00:32:47
day six to eight hours apart usually and a two
big rich satisfying meals and outside of that i
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have no hunger no cravings no unstable blood sugar
nothing like that a lot of people can do that and
00:33:06
lose the weight but if you're not losing weight
or not reducing insulin with that then you can do
00:33:14
one meal a day if you have really stubborn
weight you can go to one meal every other day
00:33:21
and that is actually quite sustainable that
you can do that for as long as you need to
00:33:28
to reach your weight goals you could not
eat on Monday Wednesday Friday for example
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and if you need to do that for six months or 12
months or 18 months to get where you want to go
00:33:40
then that's absolutely sustainable and then
once you have reached your goals you're
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off your diabetes medication you're at a more
normal weight now you can move back in and
00:33:54
start experimenting with 24 or 18 or 16 hour
fasts the 72 hour where does that come in well
00:34:03
that's a great tool to do once in a while even
if you're healthy if you've reached your goals
00:34:10
it's a great tool for maintenance for disease
prevention now you do a three four five day fast
00:34:18
once a year twice a year or maybe even three or
four times if you feel up to it but you don't
00:34:25
have to do it that often however if you have again
trying to work on something pretty intensely like
00:34:36
severe insulin resistance or stubborn weight you
could do a 72-hour fast every couple of weeks
00:34:44
that wouldn't be a problem and where it really
comes into play is if you're trying to reverse
00:34:50
a severe condition if you have a cancer or if
you're working like we said on chemotherapy now
00:34:59
you do that as often as you need to as often
as you can but again you have to balance it
00:35:05
against getting enough nutrients if you enjoy
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00:35:10
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