I am old enough to remember the liquid protein diet. My dad went on it, lost a lot of weight, became quite ill and later developed myasthenia gravis. Who knows if there is a correlation? Nevertheless, I have seen people become quite sick from an overabundance of simple carbohydrate, less so from an overconsumption of protein and none from not consuming enough protein.
Phinney thinks Long term fasting no benefits
OldDoug
(Doug)
#22
As @richard notes above, itās far from that simple. Surely, this is a place where hormones/thryoid stuff comes into play. Thereās also a common idea that muscle tissue burns more calores than it actually does. Over the years Iāve seen a bunch of posts, blogs, etc., claiming stuff like āeach pound of muscle burns 50 calories per day.ā Ha, I wish! 
Muscle cells are definitely more metabolically active than fat cells, burning about 7 calories per day per pound, versus roughly 2 for fat cells. So we have a net difference of close to 5 calories per day per pound. (Quoting from livestrong.com, āIn one study that examined 468 men and women and was published in a 1985 issue of the āJournal of Applied Physiology,ā researchers determined that men had an average of 72.6 pounds of muscle compared to the 46.2 pounds found in women.ā)
Using these figures, putting on 10lbs/4.5kg of muscle will thus mean an additional 70 calories burned per day. Losing 10 lbs/4.5kg of fat and adding the same weight in muscle means an additional 50 calories burned per day.
I donāt know if this is relevant but there is a famous French documentary about long fasting as medical treatment. Here is an article in English about it.
As Gary Taubes has shown it in his books, the science of nutrition and the understanding of obesity were far more developed in Germany pre World War II and all the results were lost after the defeat of Germany. It seems that the same thing happened with therapeutic fasting : the practice was developed in Russia by the Dr. Yuri Nikolayev but due to the Cold War, all the medical articles were muted in the āWestā.
Moreover another medical practice was lost during the Cold War : virus phage therapy. Pre World War II, antibiotic and phage therapy were developed at the same time. After the war, antibiotics prevail but phage therapy was still used in Russia and nowadays their scientists are leading the research in this domain.
Here is the website of the Buchinger Wilhelmi Clinic. I canāt find more informations about their protocol but they seem to use fasting for all kind of treatment. The clinic has been featured in a French article here and the Dr Wilhelmi de Toledo has written a book about therapeutic fasting : LāArt de jeĆ»ner.
I love 2KetoDudes and all the experts of the Obesity Code podcast. But, I think that English speaking community should look more in the direction of other langage communities (German, Russian, Frenchā¦) in order to foster the Keto/LCHF lifestyle and studies.
(I hope that my broken English is comprehensible ^^, Iām French)
tsyork
(Tim)
#24
I found your last line quite funny because I was internally complimenting your writing as I read.
Great post. I look forward to reading through the material you linked to.
Jennifer_Fawcett
(Jennifer Fawcett)
#25
Feed a cold, starve a fever? Sometimes, old wives tales have a nugget of truth.
sks23cu
(Steve Stephenson)
#26
Hear, hear!
Dr. Phinney admits his bias here:
āI canāt live another 40 years ā¦ā if a death causes the LCHF adoption to be shut down. So his bias is based on ego and economics (threat to his new company), NOT on science. And the science Dr. Phinney cites is OLD and based on carb burning patients, NOT fat burners.
Dr. Phinney claims the data in the studies cited by Dr. Fung in his fasting book were misstated. It would be interesting to have someone experienced in study analysis, e.g., Zoe Harcomb, analyze those studies cited by Dr. Fung.
One major problem Dr. Phinney references is the so-called Refeeding Syndrome:
During refeeding, insulin secretion resumes in response to increased blood sugar, resulting in increased glycogen, fat and protein synthesis. This process requires phosphates, magnesium and potassium which are already depleted and the stores rapidly become used up.
So if you could refeed with a food that does not raise insulin levels much and contained phosphates, magnesium and potassium, like small amounts of fresh fatty meat, refeeding syndrome should be completely avoidable.
Do NOT refeed with plant based foods like āeasily digestableā porriage and bread! We know that plants contain antinutrients (poisons) as a defense against predation. People who have been starved may have compromised immune systems that will be hypersensitive to any poisons. OTOH, fresh meat is digested easily and thoroughly in the human small intestine.
Why fasting doesnāt cause muscle loss:
richard
(Richard Morris)
#27
Perfectly understandable 
Do you think we should have French language sub forums? I mean we let the Kiwis have a black channel back channel all for themselves
https://www.ketogenicforums.com/c/community/new-zealand
If enough people would get benefits form a French language sub-forum ā¦ Weād be glad to add one.
marklifestyle
(Mark Rhodes)
#28
@carl On the various fasting Facebook sites this argument comes up frequently. I adhere to the idea that autophagy frees up much ājunkā amino, collagen and even damaged triglycerides. On a 5 -7 day fast I time my workouts to take advantage of the dramatic increase of autophagy & HGH. I have gained LBM weight ( how much to be determined by next weeks Dexascan) and continue to measure and look leaner besides a more youthful āglowā on my 53 year old chassis.
marklifestyle
(Mark Rhodes)
#29
and @OldDoug Some of us have speculated that being fat adapted allows us to bypass the need to get into ketosis and thus may enter autophagy sooner than sugar burners. I havnāt found a lab to test for autophages yet near me but I am very interested in this.
Seems to me that just getting into ketosis is not enough. Early in this WOE having HIGH BHB did not equate to high levels of lipolysis. My body made ketones but it had a difficult time using them efficiently. being adapted to using them efficiently I think we have greater access to lipolysis and the other health benefits.
I also speculate that repeated extended fasts may also train the body into the recognition that a refeed will be along shortly and that there is no reason to downshift metabolism. This is based on my experience with each successive fast I seem to get far better results other than survival mode.
JayTee
#30
Iām so glad you posted this. I saw this information just a few days ago on a video and was wondering. What is the real time function of protiens in redundant skin after large weight loss? Isnāt this available non essential protiens to fuel our body? Any information you have will be greatly appreciated. Thanks.
Well, I really donāt know 
If necessary I suppose that French speaking people will speak up loudly. We are known for being grumblers.
OldDoug
(Doug)
#32
Mark, this stuff is very interesting. 
I did not know that ketosis had anything specifically to do with autophagy, other than presumably occurring at the same time if one is burning fat. In reading about it, you are definitely right - ketones do stimulate at least one type of autophagy - called āchaperone-mediated autophagy.ā
Iāve fasted 15 times or so, from 3 to 5 days, and just finished one of 10 days. Iāve never felt ālow energyā and only once - on the third day of my very first fast (which went 4.5 days) - did I sense any āturning down of the thermostat,ā cool feet one night. I am certain that we get used to fasting, and that we get better at it.
Autophagy apparently doesnāt occur at the same time and pace in all parts of the body. It increases greatly in mice after 24 hours of fasting and goes up a little more by 48 hours. I canāt find information on when it peaks in humans. Iād think we are certainly no āfasterā than mice in this respect, so Iām guessing our peak comes after 48 hours, but donāt know how much after.
marklifestyle
(Mark Rhodes)
#33
Iām currently taking the EdX program on autophagy and perhaps I will know more in 3 weeks 
. Best of my current knowledge there are three distinct types of autophagy. I also am very interested in apoptosis but have not really did a literature review of this and fasting.
I too have had no problems going past 72 or 144 hrs. In fact I think its easier than starting and stopping with OMAD and other IF. I do notice a very big increase in adrenaline on the 5th day. I am thinking in particular it is norephedrine but again, thatās suspicion.
Fungās remarks are often based on the 1982 study of one individual who did a 40 day fast. This is where the 330% increase in HGH and 430% increase in autophagy comes from on the IDM. Could be we all have lesser or greater responses. Everyone does seem to agree that one needs to deplete glycogen and enter ketosis (likely for energy needs, primarily). As we here are already in ketosis it just seems that other timelines would be pushed up.
VLC.MD
(VLC.MD)
#34
Almost identical thread.
Phinney missed the mark on this blog post.
More misinformation than information.
/Sad
OldDoug
(Doug)
#35
Cool, Mark. I bet we see an explosion in knowledge about autophagy in the coming years. Iām certainly sold on it - the prevention of neurodegenerative things and from what Iāve read a lessening of the chance of developing at least several cancers; hey, Iām in.
PaulL
(Bacon is a many-splendoured thing)
#36
Because protein is the only macronutrient that contains nitrogen. Carbohydrate and fat are made exclusively from carbon, hydrogen, and oxygen. Since your muscles are mostly protein, it is reasonable to worry that they are where the nitrogen is coming from. Whether future research will confirm this worry or not is a different matter.
Iāve watched a number of videos in which Dr. Phinney makes these same points. He claims, however, that his concerns are based on data from studies that so far have not been refuted, and that he will change his mind if someone comes up with better data. I know what Dr. Fung says about fasting, but I havenāt heard him produce any studiesāperhaps thatās simply because I havenāt pursued the matter of fasting far enough. So letās see the science. On what studies is Dr. Fung basing his enthusiasm for fasting? I already know which studies Dr. Phinney is referring to, and Iād like to compare the data from both sides of this debate.
Madeleine
#37
Unfortunately I think that studies on fasting are almost impossible because ethical review boards wonāt allow them. There are even pretty short windows allowed for animals in fasting studies. Itās considered inhumane.
4dml
#38
Dr Fung doesnāt have studies, as a practicing physician he has cases. His license is on the line, if a patient following his directions gets sicker he is liable for malpractice. Thatās why most doctors blindly follow whatever the established standard of care is.
Itās easy to stand at a podium espousing studies before an audience. It takes guts to take patients youāre responsible for through uncharted/unstudied waters.
Unless youāre a researcher, ultimately, all that matters is n=1. Studies can help us save some time by elucidating which tools may be more effective. But we can figure what works for us by trial and error. Itās easy enough to try fasting and see what benefits it bestows on n=1.