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Intermittent Fasting — How to conquer obesity and diabetes

The United States has one of the highest obesity rates in the world. As of 2016, 36.2% of the U.S. population was obese (reference). If you include the overweight with the obese (i.e. those with a BMI of 25 or greater) then 67.9% of the U.S. population was either overweight or obese (reference). The U.S. does not fair much better when it comes to diabetes. As of 2010, of the 35 member countries of the OECD, the U.S. ranks number two in diabetes at 10.3% behind Mexico (reference). The health risks linked to obesity and diabetes are numerous (see reference, reference and reference). If interested in knowing your BMI score then go here: BMI Calculator.

Modern medicine regards diet and exercise to be the cornerstone therapies for both obesity and diabetes (reference and reference). Also, modern medicine regards type 2 diabetes to be a progressive disease (Defining and Characterizing the Progression of Type 2 Diabetes) where further treatment (i.e. beyond diet and exercise) involves prescribing oral hypoglycemics (i.e. glucose-lowering medications) followed by insulin replacement therapy when the oral medicine eventually fails (see chapter 8 in American Diabetes Association: Standards of Medical Care in Diabetes—2017). The use of hypoglycemic drugs and insulin replacement therapy are not without side effects. For example, insulin replacement therapy is known to cause further weight gain (How to Manage Weight Gain While on Insulin). Ultimately, diabetes cuts off an average of 8.5 years from the individual's lifespan (What Is The Life Expectancy For Diabetics?).

Other than diet and exercise, alternative treatments have been promulgated for diabetes which include herbs, supplements, and relaxation techniques having varied results (see Complementary and alternative therapies for Diabetes and The use of Complementary and Alternative Medicines (CAMs) in the treatment of diabetes mellitus: is continued use safe and effective?).

The Simple (and Permanent) Solution to Obesity and Diabetes

Although diet and exercise are an important part of a healthy lifestyle, I believe they are *not* the answer to obesity and diabetes. From my reading, obesity and diabetes should be viewed as a hormonal imbalance which can only (and permanently) be solved by restoring that imbalance—i.e. by bringing the body back into homeostasis. In other words, the problem of obesity and diabetes should be understood in the context of an overproduction and mal-regulation of insulin and the underproduction of insulin's counter-regulatory hormone, glucagon. If you are new to glucagon, please watch the following set of videos before going further:

The simple (and permanent) solution to obesity and diabetes is a change in a person's eating schedule—it's not what you eat but when you eat it. Simply stated: If you limit the "eating window" (i.e. the hours when you eat), then you are on your way to solving the obesity and diabetes problem. Adopting a narrow eating window and fasting (i.e. not consuming anything but water) outside of that eating window is what restores the balance between insulin and glucagon. Here is the research:

  • The perfect treatment for diabetes and weight loss. Duration 12:11. Type 1 diabetes is too little insulin; type 2 diabetes is too much insulin. The solution is not to give a type 2 diabetic *more* insulin, but to learn how to reduce the high insulin demand in the first place. Too much sugar yields too much insulin. The most effective solution is to lower both sugar and insulin via intermittent fasting. Also see from Dr. Jason Fung: Dr. Jason Fung - 'A New Paradigm of Insulin Resistance', How to reverse diabetes type 2, and Intermittent Fasting for Weight Loss w/ Jason Fung, MD.
  • The Root Cause of Insulin Resistance. Duration 7:27. Insulin resistance is the body's way of saying "stop taking in more glucose!" What doctors traditionally do is give the patient more insulin to reduce the amount of glucose in the blood—i.e. treating the symptom and not the cause. Excess insulin ultimately results in a fatty liver. The excess glucose is "driven" into the liver where it becomes fat. The liver tries to drive out the fat as triglycerides into the body. This fat in the pancreas makes it fatty and produces less insulin.
  • Intermittent Fasting Weight Loss Diet 101 - Quick Tutorial. Duration 10:56. Presents several photo testimonials and a good example of how to do intermittent fasting.
  • What Is Leptin?. Duration 4:37. Leptin is the "satiety" hormone. It is released by fat cells to tell the brain that you should stop eating. High leptin levels does not necessarily cause one to stop eating, however, because there can be "leptin-resistance" (similar to insulin resistance). Thus, you might have high leptin levels but you are still hungry. A key to restore the leptin mechanism is to lower insulin levels. Again, intermittent fasting can help reset this mechanism in the body.
  • What Causes Leptin Resistance? — Stephan Guyenet, Ph.D. (AHS14). Duration 43:45. A technical presentation for medical professionals. Summary notes: Leptin is widely accepted as the most important known regulator of body fatness in mammals. Leptin is produced by fat cells which travel to the brain and used by the hypothalamus to regulate fat storage, food intake and energy expenditure. Potential causes of hypothalamic leptin resistance: (1) inflammatory signaling, (2) accumulation of lipid metabolites, and (3) excessive leptin exposure.
  • Dr. Benjamin Bikman - 'Insulin vs. Ketones - The Battle for Brown Fat'. Duration 34:33. It is important to know the two types of fat storage in the body: brown and white fat. Effectively, when brown fat is active and white fat is made to work like brown fat, then fat burning is radically increased. This occurs best in a fasted state. Please note: Although the research findings are outstanding, toward the end of the presentation the speaker advocates a low-carb, high-fat diet which has its own set of issues. (More on this later.)

Fasting benefits

Other effective approaches to weight loss

  • Potato diet. Potatoes: The perfect food - John McDougall MD. Duration 4:16. In 1925, two athletes were put on an all-potato diet for six months. The results were surprising. What Eating Only Potatoes For 2 Months Does To Body! Duration 2:32. The man lost 21 pounds in two months and greatly improved his health. Man breaks potato only diet on live tv & epic weight loss journey revealed. Duration 10:28. Andrew Taylor reveals his weight loss journey / transformation / tips in this interview (with before and after photos) where he explains how he slimmed down (lost 50 + kg) without starvation. Instead he followed John McDougall and ate the perfect food: potatoes (vegan / plant based lifestyle) without starvation / counting calories. In this exclusive weight loss testimonial interview with the media and plant based news, he explains all the details and breaks his one-year potato only diet on live TV!
  • Rice diet. Rice Diet CURES Most Diseases - McDougall Duration 4:45. Walter Kempner MD of Duke University designed a high carb, low fat vegan diet that was 90% carbs, 5% fat, and 5% protein. His diet cured type 2 diabetes 100% of the time, reversed heart disease, and cured a host of common degenerative diseases. Introducing the Kempner Rice Diet gives the history of Dr. Kempner and his rice diet. Kempner Rice Diet: Whipping Us into Shape. Dr. Walter Kempner was a pioneer in the use of diet to treat life-threatening chronic disease, utilizing a diet of mostly rice and fruit to cure malignant hypertension and reverse heart and kidney failure. See also: Can Morbid Obesity Be Reversed Through Diet? The first part of this video is good, the balance is techno-babel.
  • Periodic calorie restrictive diet. Fasting: Awakening the Rejuvenation from Within | Valter Longo | TEDxEchoPark. Duration 19:13. The speaker recommends a fasting mimicking diet (FMD). In a nutshell, it's a low calorie diet (around 1,000 calories) for five consecutive days each month. During those five days, avoid protein and eat mainly salads and healthy fats. The rest of the time, eat what you want. The website is IMPACT Life Sciences. They sell a package called ProLon: ProLon allows you to eat while tricking your body into acting like it’s fasting. The ProLon package contains 66 unique ingredients that have been studied for over a decade at USC, under the sponsorship of the NIH, to inactivate nutrient sensing pathways while providing nourishment for the body (macronutrients, micronutrients, minerals and vitamins) as well as mimicking and enhancing a fasting state. ProLon is plant-based and comes in a compact box which contains 5 smaller boxes (one for each day). A typical day box contains a variety of bars, soups, snacks, drinks, and supplements. Day 1 is 1100 calories while each of the other 4 days are around 770 calories. While total calories are one dimension of the product, the most important dimension is the proprietary and patented formulation that mimics and enhances a fasting state. Additionally, ProLon is Gluten and Dairy Free.

Notes on my intermittent fasting experience

My eating schedule involves skipping breakfast—i.e. my eating window starts at 12:00 noon and ends at 6:00 pm. The balance of the time (i.e. 18 hours), I consume nothing but electrolyte water (see below). It took a couple of weeks to adjust to this new eating schedule. Some notes:

  • Hungry near the end of the fast. I experience varying degrees of hunger in the last few hours of the fast, usually from 10:00 am to 12:00 noon. Some days I experience no hunger at all. I can comfortably overcome this hunger by drinking water. I will drink as much as a liter of water (over 32 ounces) during this time.
  • Headaches and sick feeling. In the first couple of weeks or so, I experienced mild headaches and other unpleasantness toward the end of the fast. I assume it was because of the house-cleaning (i.e. autophagy) that was occurring in my body. The urine appeared darker and had a strong smell. These symptoms went away after the first few weeks.
  • Weight loss. Although I am not focused on weight loss, I have been losing about a half a pound of excess weight a week. (I am borderline overweight.)
  • Stomach shrinkage. I get satisfied with less food at a meal. I believe my stomach size has been reduced.
  • Sugar cravings diminished. Although I still have a sweet tooth, my sugar cravings have greatly diminished. Also, my taste buds must have improved, because even bland foods like vegetables taste better.
  • Change in schedule. Occasionally, I will shift the schedule either an hour earlier or an hour later, depending on circumstances. Also, from time to time, my eating window will narrow to 4-5 hours.
  • Better sleep. I sleep better at night and feel a lot more refreshed in the morning.

Electrolyte water formulation

Most electrolyte waters sold on the market use two or more of the following ingredients: sodium (i.e. from salt), potassium, magnesium, and calcium. These are the four main electrolytes in the body, so it stands to reason they are included. However, I exclude calcium from the list because most Americans already consume twice the amount recommended by the World Health Organization. Also, I add Vitamin C to the mix. Here is the formulation:

  • In a one gallon jug (i.e. 128 fluid ounces) add half way with distilled water. (See notes below under "Distilled water.")
  • Add 1 teaspoon of sea salt. I use Morton Canning and Pickling Salt because it has no additives. (See notes below under "Sodium," "Salt" and "Salt additives.")
  • Add 1 teaspoon of magnesium. I use Magnesium Chloride, Hexahydrate (on Amazon) which completely dissolves in water in seconds as compared to magnesium citrate which takes several hours. (See notes below under "Amount of magnesium in a teaspoon.")
  • Add 1 teaspoon of potassium. I use Potassium Chloride Powder Table Salt Substitute (on Amazon). (See notes below under "Amount of potassium in a teaspoon.")
  • Add 1 teaspoon (or more) of Vitamin C. I use the brand Bronson Vitamin C Non-Acidic Sodium Ascorbate Powder (on Amazon), which is 4,000 mg of Vitamin C per teaspoon. Please note: Since I am such a big fan of Vitamin C, I typically add 3 teaspoons per gallon of water.
  • Shake well, fill the balance with distilled water, and pour into smaller, more convenient containers (i.e. 16, 24, or 32 oz. water bottles) to use throughout the day.

For convenience, I measure out a 1/2 cup of each powder ingredient (i.e. salt, magnesium, potassium, and Vitamin C) and mix in a glass container for later use. Then, when ready to make a gallon, measure out 4 teaspoons of the mixture into a gallon of water. However, in my case, since I use three times the amount of Vitamin C, I will add 6 teaspoons per gallon of water which is equivalent to 2 tablespoons (i.e. 1 tablespoon equals 3 teaspoons). If you drink 32 ounces of this electrolyte water per day (i.e. two 16 oz. water bottles), then you are consuming 581 mg of sodium, 125 mg of magnesium, 730 mg of potassium, and 1,000 mg of Vitamin C per day.

Electrolyte water formulation (notes)

  • Distilled water. You can get distilled water from any grocery store for very cheap. However, to save money in the long term, I make my own distilled water. I do a two-step process of taking filtered water from an under sink reverse osmosis system and then distill it via a countertop water distiller. I use the reverse osmosis system from Lowe's (Whirlpool Triple-Stage Reverse Osmosis Membrane Under Sink Water Filtration System), and the countertop water distillers (I have two) from Amazon (Megahome Countertop Water Distiller) and Walmart (CO-Z Stainless Steel Water Distiller). The Megahome distiller is nicer but also twice as expensive. Another plus for the CO-Z distiller is that it completes the distillation in 4 hours versus 5.5 hours due to the higher wattage (i.e. 700 watts versus 580 watts). Also consider iSpring RCS5T 500 GPD Commercial Grade Tankless Reverse Osmosis Water Filter System w/ 1:1 Drain Ratio which sells for around $800.
  • Water distiller cost per gallon. The Megahome Countertop Water Distiller (from Amazon) consumes 2,900 watts to produce one gallon of distilled water (i.e. 5 hours at 580 watts per hour to produce one gallon). Assuming your electricity costs 12 cents per kWh, then the cost to produce one gallon of distilled water is 35 cents (see Electricity Bill Calculator to compute the cost). If you are consuming one gallon of distilled water a day, the water distiller will pay for itself in about a year.
  • Sodium. One teaspoon of salt (NaCl) is approximately 4.2 grams which equates to 2,325 mg of sodium (Na). In a gallon of water, one teaspoon of salt is a mild saline solution which should not be a problem for those on a low-sodium diet. A normal saline solution (found in blood, tears and other body fluids) has 9 grams of salt (NaCl) in a liter of water and is six times as salty as the electrolyte formulation I use. For reference see under "Isotonicity" in Tonicity and under "Normal" in Saline (medicine). Keep in mind that if you sweat a lot (due to hot weather or intense exercise), you can lose as much as 1,000 mg of sodium per hour. If you lose too much sodium, you can experience a condition called hyponatremia. Symptoms include headaches, nausea, and poor balance. When this condition is severe it can include confusion, seizures, and coma. "Hyponatremia occurs in about 20% of those admitted to a hospital and 10% of people during or after an endurance sporting event." The average daily consumption of sodium (Na) in the U.S. is 4,300 mg for men and 2,900 mg for women.
  • Salt. Morton Canning and Pickling Salt is a pure granulated salt which does not contain potassium iodide, dextrose or any anti-caking agent. In other words, it does not contain any additives. Please note that since there is no anti-caking agent added, it may form lumps in humid weather or if exposed to moisture. In other words, keep it in an airtight glass container to prevent lumping.
  • Salt additives. Salts (table or cooking) with the fewest additives lists the ingredients of most common salts. Morton Iodized Salt contains calcium silicate (<0.5%), dextrose (0.04% or 40 mg per 100 grams of salt), potassium iodide. Calcium silicate is a white, odorless, tasteless, anti-caking agent with no nutritional characteristics. Anti-caking agents absorb moisture inside the package that would otherwise be absorbed by the salt. In this manner, it allows salt to keep its free-flowing characteristics. Dextrose is added to prevent iodide from being oxidized and escaping as a purple-pink gas. Iodine is added to the salt to prevent goiter. Potassium iodide makes up 0.006% to 0.01% of table salt by weight which is equivalent to 0.0046% to 0.0077% iodine. See also: Iodized salt.
  • Sufficient iodine intake. Iodized salt in the U.S. contains 45 micrograms of iodine per gram of salt. The recommended daily intake for adults is 150 micrograms, which can be obtained from about one-half to three-quarters of a teaspoon of table salt. However, the Japanese consume 89 times more iodine than Americans, due to their daily consumption of sea vegetables, without harm. See also: Iodine Supplements and Dosages.
  • Amount of magnesium in a teaspoon. If you use Magnesium Chloride, Hexahydrate (on Amazon), then you get 501 mg of magnesium per teaspoon. If you use Magnesium Citrate Powder (on Amazon), then you get 840 mg of magnesium per teaspoon. If you use ReMag (on Amazon), then you get 300 mg of magnesium per teaspoon.
  • Percentage of magnesium in supplements. The amount of magnesium in magnesium sulfate (MgSO4 or Epsom salt) is 19.8%, of magnesium citrate (C6H6MgO7) 11.2%, and of magnesium chloride hexahydrate (MgCl2 6H20) 11.8%. Magnesium chloride is the better supplement of the ones listed, per this commentary: Magnesium Chloride - The Master Magnesium Compound.
  • Amount of potassium in a teaspoon. If you use Potassium Chloride Powder (on Amazon), then you get 2,920 mg of potassium per teaspoon. There is no RDA for potassium other than an AI (Adequate Intake) suggestion of 4,700 mg for both men and women. Most Americans consume only half that amount per day (see Potassium - Dietary recommendations).

Notes

  • Hormone control of hunger. Duration 3:36. Insulin and leptin hormones are hunger inhibitors when they reach the hypothalamus in the brain. On the other hand, ghrelin (the hormone released by the stomach) is a hunger activator in the hypothalamus.
  • Increasing Protein Intake After Age 65. Duration 6:09. The entire video is important. It starts with a shocker: Among subjects with no diabetes at baseline, those in the high protein group had a 73-fold increase in risk, while those in the moderate protein category had an almost 23-fold increase in the risk of diabetes mortality.
  • Impaired Glucose Metabolism from Fluorine Toothpaste. Blood fluoride levels of just 95 ppb produce an increase in glucose levels and a decrease in insulin. (Menoyo 2005). Strikingly, this level is routinely exceeded by about 5 to 10% of children using fluoride toothpaste (particularly those living in fluoridated communities).
  • Caloric Restriction vs. Plant-Based Diets. Duration 4:14. The overweight have higher cancer levels due to higher IGF-1. Also, Protein intake is a key determinant of circulating IGF-1 levels in humans, and suggest that reduced protein intake may become an important component of anticancer and anti-aging dietary interventions.
  • The Perfect Intermittent Fasting Ratio for the Most Weight Loss (Fat Burning). Duration 4:28.
  • Intermittent Fasting: Science or Fiction. Duration 49:49. Discusses intermittent fasting for athletes, benefits in jet lag, etc.
  • Fasting: Molecular Mechanisms and Clinical Applications. Only recently studies have shed light on its role in adaptive cellular responses that reduce oxidative damage and inflammation, optimize energy metabolism and bolster cellular protection.
  • What Causes Insulin Resistance? Prediabetes and type 2 diabetes are caused by a drop in insulin sensitivity blamed on “intramyocellular lipid,” the buildup of fat inside our muscle cells. See also: Diabetes as a Disease of Fat Toxicity. The “twin vicious cycles” explain how the build-up of fat in the cells of our muscles, liver, and pancreas causes type 2 diabetes, which explains why dietary recommendations for diabetics encourage a reduction in fat intake.
  • Sugar Myth 1: Sugar/Carbs Cause Diabetes
  • Fasting triggers stem cell regeneration of damaged, old immune system. Prolonged fasting forces the body to use stores of glucose, fat and ketones, but it also breaks down a significant portion of white blood cells. ... During each cycle of fasting, this depletion of white blood cells induces changes that trigger stem cell-based regeneration of new immune system cells. In particular, prolonged fasting reduced the enzyme PKA... PKA is the key gene that needs to shut down in order for these stem cells to switch into regenerative mode. It gives the OK for stem cells to go ahead and begin proliferating and rebuild the entire system. ... Prolonged fasting also protected against toxicity in a pilot clinical trial in which a small group of patients fasted for a 72-hour period prior to chemotherapy, extending Longo’s influential past research.
  • Fasting weakens cancer in mice. Without exception, “the combination of fasting cycles plus chemotherapy was either more or much more effective than chemo alone. ... For example, multiple cycles of fasting combined with chemotherapy cured 20 percent of mice with a highly aggressive type of children’s neuroendocrine cancer that had spread throughout the organism and 40 percent of mice with a more limited spread of the same cancer. No mice survived in either case if treated only with chemotherapy.
  • Butyrate Increases Intracellular Calcium Levels and Enhances Growth Hormone Release from Rat Anterior Pituitary Cells... Butyrate is a short-chain fatty acid (SCFA) closely related to the ketone body ß-hydroxybutyrate (BHB), which is considered to be the major energy substrate during prolonged exercise or starvation. During fasting when the liver switches to fatty acid oxidation, a rise in serum growth hormone GH is observed together with the accumulation of BHB and SCFA such as acetate, propionate and butyrate.
  • Do Vitamin C Supplements Prevent Colds but Cause Kidney Stones?
  • Calcium Chloride (from Amazon). You can use this supplement, assuming you want to add calcium to your electrolyte water. Again, I personally don't because the American diet gets more than enough calcium and generally not enough magnesium or even potassium.
  • The difference between calorie restriction and fasting. Over six months, weight and body fat loss did not differ. But there were important hormonal differences between the two strategies. Insulin levels, the key driver of insulin resistance and obesity in the longer term, was initially reduced on a calorie restriction but soon plateaued. However, during intermittent fasting, insulin levels continued to drop significantly. This leads to improved insulin sensitivity with fasting only, despite similar total caloric intake. Since type 2 diabetes is a disease of hyperinsulinemia and insulin resistance, the intermittent fasting strategy will succeed where caloric restriction will not. It is the intermittency of the diet that makes it effective.
  • Science of Fasting HD. Duration 56:15. Documentary of fasting in Russia and Germany conducted for decades in research format. Also presents Dr. Longo's research in USC on fasting and chemotherapy.
  • 15 Superhuman Benefits of Fasting. Superhuman: willpower, confidence, brain functioning, clarity and direction, health, motor skills and precision, sleep, productivity, emotions, energy, weight loss, inspiration, appearance, learning, senses.
  • Intermittent Fasting - How it Affects Sleep. Published 1/13/2018. It's common to have sleep trouble with fasting, but intermittent fasting should actually improve sleep.
  • Health lies in healthy circadian habits | Satchin Panda | TEDxBeaconStreet. Duration 16:16. We can tune our daily habits of eating, sleeping or getting the right amount of light to sustain our circadian rhythms. Healthy rhythms nurture healthy body and healthy mind. ... In the process of exploring how the liver’s daily cycles work, Panda found that mice which eat within a set amount of time (8-10 hours) resulted in slimmer, healthier mice than those who ate the same number of calories in a larger window of time
  • Parathyroid hormone and calcitonin by Professor Fink. Duration 27:33. In the first few minutes presents an excellent summary of insulin and glucagon functions in the body.