I hesitated to put my superfast transcript notes just from the fasting part here since of course this is the 2KD forum and we want people to listen to their show. But I listened and it wasn’t until the end it came on. There were a few words/names I didn’t recognize (in parens).
This is very interesting stuff. @Karim_Wassef you might find it so.
Phinney podcast with 2KD posted 29Jul2019
- fasting - are you and fasting people coming to some consensus?
I’m a student of history… including published data… pub data on safety of long term… intermittant fasting no problem… more than 2-3 days … there are concerns in terms of preservation of lean body mass, and providing adequate mineral (and nutrient?) … cause if you’re doing a total fast, a water fast, your body is still excreting minerals, but you’re not taking 'em in… and if people are living on a margin, particularly around the central minerals, I won’t get into sodium, but potassium and magnesium are minerals that we have to deal with actively in many of our patients, and if part of the time they’re not getting any of it in, that means we have to do even better on the days when they ARE taking in nutrient dense food.
- so what about fasting with electrolytes then?
but then there’s still the loss of lean body mass … you know, people deny that it’s important, they call it autophagy, and there is animal data and some human data that says that’s important, but I’ve not seen any data that says that if you’re – let’s say you’re following a ketogenic diet, THEN you add a fast, that you get benefits from this process, that people call autophagy, because we know that ketones are a clean-burning fuel, and they preserve mitochondrial function better than if you’re not in nutritional ketosis. And that’s really what you’re trying to achieve with autophagy, and you may have already gotten there. So adding it in, I’m not convinced is beneficial. So I want to see published data in peer reviewed journals. I mean we’ve made that commitment, and I’m not throwing out a challenge, I’m just saying if you’re evaluating for yourself what has proven beneficial, I would look at what’s published in the peer reviewed literature. Realizing that it is very hard to get countervailing data like ours and their published, but we have to do that.
- we had to get fasting studies published through an (IRB??) so it’s almost impossible to get a starvation study – we couldn’t repeat, we probably couldn’t repeat the starvation studies George Cahill’s starvation studies now I don’t think, because of that, we couldn’t probably, we couldn’t do it with animals, I could be wrong –
I think that that, I would say that’s probably would not be the case for durations of one to two weeks. Bruce Bistrian published a paper in 1977 where he had people on a weight loss ketogenic diet and for two weeks – three weeks – and looked at how their bodies responded in terms of giving them adequate protein, and even in the first week of a protein-supplemented modified fast, which is under 800 calories a day but enough protein – for the first week they were losing lean tissue even though they were eating the protein and minerals. The second week they were coming almost up to zero. By the end of the third week they were up to zero, then even though they were eating under 1000 calories a day they were preserving lean body mass. And that was radical data back in the late 1970s. But then he – they were already three weeks into the adaptation process and then he had them do a one week fast. Now this is on – in a metabolic research ward under observation – and they immediately dropped down to losing something in the range of 1/3 to 1/2 a pound of lean tissue per day. And then that week they were showing they were beginning to re-adapt, at that. But there’s – I don’t know of any evidence that says that in terms of lean body mass preservation, that any form of fasting beyond a couple days is benign in terms of that.
- so is this subject to the adiposity of the subject? So (…) bodyfat can deliver so much energy per day, are we talking about energy insufficiency during a fast? Some people have enough energy on their body that they’re not gonna be energy insufficient in a fast.
You would hope that’s true. And it works in hibernating bears. People’ve actually done studies – and bears they don’t hibernate they sleep in their dens, but people have climbed in the dens of wild bears as they’re sleeping and drawn blood samples on them and then hustled their butts out of there really quickly – but they’ve looked at the ability – and bears can preserve lean tissue by running just on fat. Humans cannot do that. And fat mass does not protect us from protein catabolism. We can reduce it down to, after a month of total starvation, losing just a quarter pound of lean tissue a day. But we’re still losing that. And so again, this is not completely theoretical, because the other risk of prolonged fasting is that depending on how you end your fast, there is a potential of having acute shifts of fluid and minerals into cells, which can lead to abnormal heart rythyms and sudden death. And that was reported in multiple situations during WWII when people were subjected to prolonged privation in lifeboats or in concentration camps or something, we killed people with kindness by giving them lots of food. You have to introduce the food slowly. And just telling someone, well don’t binge when you come off this, is I think not adequate in terms of safety.
Well I think
46:50 downloaded audio file lost audio (continued playing just no audio)
Went to online original. He ended the interview there anyway. 
