Phinney thinks Long term fasting no benefits

fasting
phinney
(VLC.MD) #41

@ianrobo - great thread BTW. Important to discuss these things. The science will never be complete on this topic. In the end, estimations and guesses will always be a part of human nutrition. Respected opinions by Phinney and Fung are needed to further understanding of human nutrition. Thankfully, there are professionals trying different things to help people improve their health. Especially because there are many types of people with many MANY different reasons why they need to lose weight. Phinney knows alot about science. ALOT. And Fung knows alot about bringing science to actual people sitting in front of you wanting help. If you just rely upon Science, you end up missing the important piece … THE PATIENT. I’d go to Dr. Fung to lose weight and if I needed a Keto experiment done, I’d ask Phinney to run it.

Let’s have a group hug

LCHF / Keto / IF / EF are all on the same team in many respects.

(Nicole Sawchuk) #42

Thank you everyone for your input onto this topic. I posted this on another fasting FB group and got kicked out because I dared question Dr Fung. Its weird because I religiously follow Dr Fung and fasting has given me my life back! I just wanted to have a scientific discussion and hear everyone’s opinions because I continually want to learn more and understand other points of view. There was no explanation why I was removed. It felt like I got dumped! But that’s life and its nothing to dwell on.

This respectful discussion here showed me there is still so much to learn and talking about the science and everyone’s theories is valuable! I will continue fasting as my body sees fit and will continue trying to understanding the science behind it all!

Thanks again!

(Steve) #43

I second Nicole’s sentiment.
Very interesting discussion and something I hoped would happen when I first saw a tweet about this.

(Doug) #44

True, Madeleine. I wonder if human trials will increase, what with the interest in autophagy as treatment/prevention for disease.

Most of the studies I’ve seen deal with mice - where autophagy is really kicking in as we get to 24 hours fasted, and further increases at 48 hours. That time window is pretty good size, I think - if a mouse doesn’t eat for 2 days, it doesn’t have much time left.

(Bunny) #45

Extended Fasting EF does not look good for Weight Loss because it can cause “ADRENAL STRESS” or fatigue and cause excessive Cortisol spiking that will block fat oxidation because the entire homeostatic function of the body is kicked into survival mode (body is trying to protect internal organs from external predation utilizing fat) and holds on to the fat!

If the goal is AUTOPHAGY then that is a whole different animal!

One must cognizant that Cortisol is the number #1 fat blocking hormone!

Look at the Cortisol spiking pattern?

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(Doug) #46

Bunny, what is the actual risk of that, though? No doubt there “can” be problems - there are billions of people on earth, and no big trick to find cases where extended fasting isn’t good and isn’t indicated.

I think if one’s body is going into ‘survival mode’ then one will be aware of it - feeling very low energy and likely pretty darn crappy.

Just finished a 10 day fast, and I could feel the fat going away. Between days 4-6, 6-8, and 8-10, my pants felt differently when I put them on, and by pinching the fat around my middle it was obvious that things were changing and shrinking.

(Gabe “No Dogma, Only Science Please!” ) #47

Indeed, @carl, as you probably know, Phinney has openly scoffed at the existence of “autophagy.” While @richard is far more knowledgeable about the science than I probably ever will be (and his detailed replies getting into the weeds are much appreciated), I respect Phinney enough to take him seriously on this issue.

If one of the fathers of the ketogenic lifestyle opposes extended fasting, I think I’d be mad to dismiss his view out of hand. I’ve been meaning to try EF for some time, but Phinney’s view has remained at the back of my mind.

Of course if people don’t eat for several days at a time, they’ll lose weight. And I’m aware of many spiritual traditions in which fasting takes place sometimes for days or weeks at a time. So maybe it’s healthy, maybe it’s not. According to Phinney, we don’t have RCTs to support EF at this point.

Did humans evolve to frequently fast for days or weeks at a time? That’s a very different question, as Phinney points out, from “Can we survive fasting for days or weeks at a time?” Were our ancestors frequently going through periods of starvation? I don’t know. Maybe, maybe not. You can imagine both scenarios being true.

I reserve judgment on this issue and, while I may try EF, it seems as if it’s a trend without sufficient scientific evidence at this moment to prove that it’s a healthy long-term strategy.

Then again, I’m one of the biggest heretics on this forum! :wink:

(Bunny) #48

Yes, there will be some weight loss with EF (depending how long you fast?) but the problem is with conceptualizations, goals or objectives?

Somebody with more excessive body fat and in poor metabolic condition would not be capable of achieving what you have done!

I really do not think people really understand how powerful Cortisol riding on Adrenal is!

Intermittent Fasting or IF tricks the body into not trip hammering that survival mode mechanism as much! (as you can see in the chart from my previous post in this thread)

Too much Cortisol will block Human Growth Hormone or HGH (the most powerful fat burning hormone that exists in your body) from doing its thing!

Note: It (EF) will also cause fat to more specifically populate around internal organs also. That is why you want to do EF on rare occasions for the purposes of AUTOPHAGY!

(ianrobo) #49

I love IF and do it on my rides etc and believe it is fantastic for me not least stimulating HGH just that I have issue with days of fasting and exp over 5 days but that’s just me :stuck_out_tongue_winking_eye::+1:

(Todd Allen) #50

The prevailing view, backed by quite a few scientific studies, is that cortisol promotes lipolysis, ie fat breakdown. Where some get into trouble is that chronic stress and continuously elevated cortisol increases hunger. Also the increase in blood glucose can increase insulin levels, particularly in the insulin resistant, which I think is what your graph is showing. The spikes in your graph are due to the circadian rhythm of growth hormone at night and cortisol by day, which rise in response to falling blood sugar as glycogen stores deplete as those two hormones are needed to stimulate gluconeogenesis and keep blood sugar from dropping too low. Both hormones stimulate both lipolysis and elevating blood sugar but differ in that cortisol drives protein break down while GH stimulates protein synthesis.

(Bunny) #51

I completely understand the variables your discussing but the over all consensus in the graph is FASTING!

And the most important thing to remember, is your creating a serious dueling match between Cortisol (other fat blockers are estrogen and insulin) and HGH (and 5 other fat burning triggers); the longer you fast. Cortisol will always WIN against all fat burning hormones!

That’s why people get confused about EF? And is the reason as to why people are scratching there heads wondering why nothing is happening if the goal is weight loss? (utilizing extended fasting; irregardless of those variables you are discussing!)

#52

Anthropologists tell us that ancient humans experienced periods of food scarcity. Even in not too distant past there have been periods of famine. All of my great grandparents (2 of whom lived enough for me to know) faced hunger during the Great Depression.

Humans did not evolve to eat 6 meals a day or buy food from the likes of McDonald’s/Taco Bell/Dunkin Donuts or consume high fructose corn syrup. Modern food culture has wrecked our metabolism. Extended fasting is a tool for fixing it.

(You've tried everything else; why not try bacon?) #53

Dr. Phinney is a physician as well, not just a researcher, and it is his stated concern for the well-being of his patients that is behind his concerns about the long-term effects of fasting. If Dr. Fung doesn’t have any research, then so much the worse for him. If it weren’t for Dr. Phinney’s research, we wouldn’t have as much understanding as we do about ketosis and its benefits. And as Gary Taubes and Dr. Attia point out, we still need much more good-quality research on LCHF, not only to prove indubitably that it really does work, but also to show that it doesn’t have any dangerous long-term consequences, such as the SAD has turned out to have. But if Dr. Phinney weren’t already standing up at podiums, telling us about his research, we wouldn’t even know to be doing N=1 studies on ourselves.

Please remember that a lot of menopausal women seemed to derive a great deal of benefit from hormonal replacement therapy, but it was research, not clinical practice, that brought out the dangers of that treatment.

Forty years ago, everyone’s anecdotal, N=1 experience told us that you cured peptic ulcers with careful diet, but then Robin Warren’s and Barry Marshall’s research showed that peptic ulcers are caused by a bacterium and are cured by administering an antibiotic. And, God help us, there are still doctors in practice who didn’t learn that in medical school, who aren’t yet sure they believe it, and whose clinical practice seems to bear them out.

A hundred and some-odd years ago, the N=1 experience was that fatalities from child-bed fever were caused by miasmas, and it wasn’t until Semmelweis broke his heart promoting the result of his research and not really until after his death that obstetricians finally started washing their hands before delivering babies and eliminated deaths from child-bed fever.

Sorry for the rant. Perhaps you can tell that I believe medical research and evidence-based medicine to be very important? And isn’t the motto of these forums Show me the science?

(Bunny) #54

I totally agree with Dr. Phinney because he is 100% correctomundo!

(Doug) #55

Well, If he’s doing that now, then it’s just plain silly. We are firmly beyond that.

To varying degrees, we humans like to have our “gurus,” and we make take positions - even on dietary matters - and get all religious about them, almost always to the detriment of the discussion if not our own health, in my opinion. Not that I see you doing this, Gabe, and this whole thread is a good discussion.

I would not say that “everybody should do extended fasts.” I do think everybody needs autophagy. Thin people can get neurodegenerative diseases and cancer too.

My great-grandmother (father’s side) was born in 1878, and lived to almost 100. She was a hard old girl in her own way, rather critical of younger generations, but full of memories - and yeah - we have it rather easy now.

Her grandfather was in the U.S. Civil War, Northern side, captured by the South and imprisoned for almost a year at (the notorious) Andersonville Prison. A big guy, he went in at well over 200 lbs, came out at 90. Still lived a long life thereafter, worked his farm, had 5 or 6 kids. Best extended faster in my family, as far as I know, though it was not by choice.

(Doug) #56

Often, yes - we humans are a wacky bunch. :slightly_smiling_face: While I cannot rule out problems with cortisol or other hormones when doing longer fasts, at the worst I’d say “Well, we can watch out for problems, but if they don’t appear, then great. Meanwhile, we’ll likely be one of the vast and increasing number of people who have benefitted and are benefitting greatly by fasting.”

People get weight-loss stalls while not fasting and eating ketogenically (or not) as well. If something isn’t working right, it can be addressed. I think, however, that it’s wrong and needlessly alarmist to act like there will be problems long before that is necessarily true. The same for the unqualified statement by Drs. Phinney and Volek: “After just one day of fasting, you begin to lose body protein from lean tissue – from places like muscle, heart, liver, and kidneys. These organs and their functions are things that we want to preserve, and definitely should not be given up lightly.”

The reader: “Oh my god, if I fast I will be giving up my organs!!”

To the doctors there, I have to say, “C’mon, guys… that’s ludicrous.” This thread has quite a few people presenting facts and examples to support that.

Gotta say you’re 100% wrong, there, Bunny. I’m 58, and mostly sedentary, and was officially Type 2 Diabetic as of April this year. There are people who are older - I’ve seen them be 60, 70, even 75, and worse off metabolically, and some have lost over 200 lbs. of fat.

If we are generalizing, then I’d say the more fat one has, the easier it is to start losing it, all other things being equal.

Perhaps most don’t understand that. But so what? Again - if it’s not a problem, then it does not matter. From what I have seen, it is only a very small percentage of people who do longer fasts and don’t lose (enough) weight or have hormonal problems stemming from the fast. Vastly more people do lose weight and do improve their hormonal situation - witness the improvement in insulin resistance and blood sugar control.

I just don’t think that’s true - that EF causes that fat buildup. I think you’re attributing it to the cortisol effect, and that is at issue.

(Doug) #57

Paul, I really enjoy your posts, and that was a really good one. Such interesting stuff! Love the references to other times in medicine. I swear, this forum is like taking 3 or 4 college courses at the same time - and the weird thing is that every course holds your attention.

Dr. Phinney certainly deserves his due. I don’t see that excusing scoffing at the existence of autophagy, or acting like fasting will have people in effect “giving up their organs.” The science is not on his side, there. I wondered if perhaps the two doctors were not the ones actually writing that Virtahealth blog post, but as far as I can tell, they are. I wonder why they weren’t more careful.

I’ve seen Dr. Fung overgeneralize incorrectly, etc., too. Not at all taking sides among these docs.

(Gabe “No Dogma, Only Science Please!” ) #58

What evidence do you have that our ancestors weren’t nibbling on berries and stored meat snacks all day? Maybe they ate 25 times a day? Do you have any solid academic research that proves definitively how many times a day our ancestors ate?

You are quite wrong to imply that questioning – questioning! – the safety and efficacy of extended fasting is to support the consumption of processed food. That’s a classic false dilemma.

Those of you who buy into EF, that’s your right. You can believe everything that comes out of Dr Fung’s mouth if you like. I am simply saying that I don’t believe anything anyone says until I see a slew of RCTs showing that they’re right.

We still don’t have any proper research showing that keto is safe or efficacious in the long term either. And while I am convinced 100% that sugar and processed foods are unhealthy for us, I am less than 100% convinced that LCHF (beyond the Mediterranean diet’s macros) are healthy and effective long-term, and I am even less completely convinced of this regarding a VLCKD (ketogenic diet). The jury is out. At this point, we’re all running the experiment on ourselves.

(Bunny) #59

I think our mental compass should be based on a basic understanding of biology before we can believe anyone because the most highly educated scientific and medical personnel can deceive everyone because they have a vast understanding of such things and know all the bits and pieces of the puzzle already.

They will only reveal bits and peices to make a profit so they can leave you stumped in mystery and bewilderment so you will buy their next new book to only give you a fraction of what they know!

“… I just don’t think that’s true - that EF causes that fat buildup. I think you’re attributing it to the cortisol effect, and that is at issue. …”

…No not “fat buildup” redistribution or shifts in visceral fat cells to protect organs when in survival mode! (where it accumulates after the fact)

THE SCIENCE:

Age Related Shift in Visceral Fat
Gary R. Hunter, Barbara A. Gower, and Brandon L. Kane

Hormonal environment and shift

“… Women with a history of bulimia nervosa have more visceral fat and increased adrenal gland volume than women matched for age, BMI, weight and muscle mass who are non bulimic 24. Consistent with the hypothesis that the adrenal gland could be playing a role, patients with Cushing’s Syndrome have elevated visceral fat as well as chronically elevated cortisol levels 25. …” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4018766/

(Sjur Gjøstein Karevoll) #60

Cortisol is not the only stress hormone increasing during fasting.

This study is interesting because it compares fasting in normal and epinephrine deficient mice, and it shows that while epinephrine isn’t needed for glucose counter-regulation (which is one of its jobs), the deficient mice developed “severe ketosis and hepatic steatosis, with evidence for inhibition of hepatic autophagy, a process that normally provides essential energy via degradation of hepatic triglycerides during starvation.”

That sounds like what cortisol would do, but only in the absence of epinephrine.