Valter Longo interviewed by Rhonda

[Todd Allen]

I'm surpised by the details of the FMD as posted by mccoy in the other thread.  It's less restrictive than I expected, a day at 1100 kCal and 4 days at 900, even in carb and fat calories with protein restricted to 100 kCal/day.   

[Matt]

Rhonda is like a real life walking pubmed. You should check her out on Joe Rogan on youtube. 3 hour conversions about lots of health related topics. There are a few videos.

[mccoy]

 

In the book he just says full fast for 5 days is very hard to follow and weakening for most people. His published clinical trials on humans yielded pretty good results, they almost sound too good to be true.

I'm looking forward to start a FMD, I'd like to recoup some weight though before that. I'm one of those guys who favours a good BMI. I lost 6 pounds in a recent low-carbs experiment, starting from an ideal weight.

 

The results of his pilot clinical trial on a n=19 human sample (besides mice) have been published in a full report. Full and extended PDFs are freely available.

 

http://www.cell.com/cell-metabolism/abstract/S1550-4131(15)00224-7

Thanks for the reference, I already know this work (As most people here I guess).

 

My question was regarding if it is better (health wise) to do a 5 day full fast compared to 5 day FMD?

Let's assume I don't have an adherence problem   

And if Longo actually compered those two in a clinical trial.

 

In his book I don't remember he cited any similar comparisons, which would be indeed interesting.

Of course, 5 days only water is not an easy task, whereas his FMD is a cinch compared to a full fast and can be repeated multiple times in a year.

My absolutely subjective and unsubstantiated belief is that a full fast only on water is best healthwise.

[The Observer]

I do like the idea of a regular "autophagy party" (timely given today's Nobel Prize announcement).

Thanks for the links, Gordo. It inspired me to undergo a 40 hour water only fast. It's perfect for me.. I ate my last meal in the evening, 4 hours before going to sleep. I also slept a bit longer due to obvious reasons, a total of 18 hours over the 2 days.. And since you do not suffer during sleep, plus I did not feel hunger in those initial 4 hours and also the first 2 hours after waking up on day 1, this means a total 18+4+2=24 hours of free ride and only 16 hours of suffering. Doable!

 

I've been doing 24 hour water only fasts once a week in the last 5 months or so, but I will now incorporate one 40 hour fast (instead of 24 hour) once a month into my lifestyle. 

[Gordo]

Observer - just curious, how did you end up picking "40 hours"?  I will probably start once a month 48 hour water only fasts.  I've only done a single 3 day (72 hour) water only fast, and it was a good experience but it was pretty disruptive to my routine, harder to focus on work, difficult to get things done requiring physical labor, etc.  I'm thinking 48 will not be so bad though, and based on the published science, it seems like a reasonable fasting period.

[mccoy]

I'm going to custom-tailor Longo's diet. His FMD is very good and it's the real breakthrough, whereas his longevity diet I find not suited to everyone.

For example, true vegans and lacto-ovo vegetarians won't eat fish. Also some omnivore won't eat it either. There is no alternative to fish indicated. I figure it maybe meat for omnivores and cheese or eggs for lacto-ovo. He puts in many legumes. Not everyone is starch tolerant. He puts in little fruit.

Whereas I find his suggestion to take supplements only 2-3 times a week sensible.

 

 

Anyway, I'm starting to get accustomed to legumes. Tonite alas I forgot to take digestive enzymes before the meal, so I'm feeling a little bloated. Together with 500 gr green cabbage I ate 150 gr chickpeas. They tasted good with lots of olive oil and chili. I added 20 grams of parmesan cheese.

One observation: 20 gr of parmesan supply the same amount of proteins as 150 gr of lentils. Eating legumes is maybe not an efficient way to nourish oneself but is a good way not to overeat cheese for me and comply with the state of the art suggestions on a longevity diet.

[The Observer]

Observer - just curious, how did you end up picking "40 hours"?

 

Ah, nothing scientific really. I just though about minimizing the hours of feeling hunger, maximizing the sleeping hours during the fast and go to bed on a empty stomach only once.  And since I am a night owl who likes to sleeps-in in the morning, and lunch being my favorite meal by far, this is what I came up with. Perhaps I could extend it to 48 hours, but I already lost quite a bit of weight and I have been continuously adding different diet changes and CR/fasting practices to my lifestyle, so I do not want to venture too deep into this rabbit hole. One can easily become obsessed, if it's not already too late for that. Perhaps many of us here are already too far gone. Maybe Dean saved himself in the nick of time. 

[Sthira]

https://www.youtube.com/watch?v=1yCeFmn_e2c

Haha, awesome.

 

I love Dr. Longo but really I think these FMD boxes are for sick people with cancer (?). And honestly while he says danger Danger DANGER Beware of the (Gulp): Five Day Fast, I think he's only saying that so he won't get sued? A five day fast is doable for most people (except children and preggos) I mean your body gets it even if your mind rebels; I think it's equal parts exhilarating and uncomfortable but certainly worth the experience. Like hitching around in Cameroon it's vaguely safe and well-traveled, then again you never know until you actually go there for yourself. Try it -- the fasting I mean.

[mccoy]

Sthira evidently i must count myself among children and preggos since my only 5 days fast,water only, was not easy at all.

One major drawback in longer total fasts is refeeding. It is very tricky and it requires total self control.

[Sthira]

Sthira evidently i must count myself among children and preggos since my only 5 days fast,water only, was not easy at all.

One major drawback in longer total fasts is refeeding. It is very tricky and it requires total self control.

For me I look at fasting as an acquired skill like learning to play a weird musical instrument, the theremin hmm. Meaning we don't learn a new skill instantly, it takes practice and devotion, I start humbly by skipping meals here and there, then maybe a day, and when I'm more comfortable maybe two days, a long weekend, then five after some time spent regathering. And so forth.

 

Eating for most of us is more of a habit, and often more about psychology than physiology. It's interesting that even in people who mentally resist, they may find that the body adjusts just fine. In fact the body may thrive.

 

As far as refeeding I'm not sure what you mean by tricky. I've never really had a problem with reintroducing food, and I find that my body adjusts equally well whether I carefully refeed or just go ahead and eat whatever I feel like. The stomach shrinks during longer fasts so we're naturally prevented from gorging. And if you lose self control and pig out, well, so what? It's not like gorging will make you die. You'll get sick and discover plainly, well, don't do that next time. It's a learning curve.

 

There are so many myths surrounding the 5,000 year old practice, so Fung calls it an ancient secret for this reason. People are spooked, and I believe Big Food profits off getting people to eat as much as possible as often as possible.

 

Also about refeeding, many who publically fast are vegans or fruitarians, so when they trumpet their refeeding ideas they tend to push the watermelon. Which is great, love em. To refeed mindfully feels obvious. And if it matters or not precisely how we refeed, and we require independently replicated clinical trials to get a grip, well, who knows since evidently the study of fasting in people is super duper hard and expensive and complicated and studies would probably cost millions, hundreds of millions, and they would take years, decades to discover and publish replicated results. Meanwhile: tick tock. Nothing yet works to retard aging, maybe not even CR. So fasting offers a free and interesting alternative.

 

Now get off your soap box, sthira

[mccoy]

I've been a faster in my youth, when my will power was greater. I had occasional problems in checking hunger when refeeding. I relaxed my habits now, out of lazyness mainly. I basically agree with what you say and am a strong supporter of total fast, only water. Of course a full fast it's better than a mimicked fast, but we may concur that better to mimick a fast than to do nothing at all.

Basically, Longo proposes a 5-days restriction, which has been observed to yield results which approach those provided by fasting. Most probably total fast provides a more thorough regeneration of the immune system. 

[Sthira]

Will power, yeah I get it, man, sometimes it's like that and you need will power because sometimes fasting sucks and sometimes, as I'm nearly fainting, dizzy, collapsing, my mind is asking, hey, why not just wear a hairshirt and sleep with wooden pillow, you masochist? But then, like moments later, that noise clears and I'm like oh, wow, nice, this feels better, this feels about right. Our bodies are very strange creatures. I mean, when people start saying they understand these bodies and they understand what these bodies can do and cannot do based on these studies and those studies, well, that's when I'm like sure, thanks for the added knowledge.

[Thomas G]

It seems like other people have the same question I do but none of us have been able to find the answer. If Longo is devising a diet that is a compromise between what he thinks people can do and what the science says to do, then what would an uncompromising optimal fast look like? Would it be a five day water only fast or a two or three day water only fast? I've been poking around everywhere I can (still lots of Longo research I haven't been able to get through, however). Does anyone have an idea?

 

I was doing a water only fast every Wednesday for the first couple of months that I was on CR, but I was losing weight too quickly and was trying to deliberately slow down so the fast was one of the things I stopped doing. I didn't want to do it during the summer because our CSA was so bountiful it was hard to keep up with it and skipping a day made it harder. But this week was the last share of our CSA and that food will run out in a couple weeks. At that point I think I would like to experiment with fasting again.

[Todd Allen]

Thomas, I've been contemplating the same questions.  I don't think there is an answer and even if/when the studies are done, the answer won't be conclusive and it surely won't apply to everyone equally.  To optimize I think we need to test each approach ourselves.  The hard part is measuring/evaluating the results and making appropriate conclusions.  And that is where the experiences shared through this forum are so helpful.

 

Myself, I almost feel lucky in that my progressively degenerative neuromuscular disease shifts my focus towards immediate physical performance versus long term health concerns everyone else here has for longevity because it is easier to optimize with a short time frame.  Perhaps it is due to starting from such an impaired state, but while optimizing for daily performance I've been having much success so far in improving bio-markers of long term health.

[Mechanism]

Edited

[Sthira]

It seems like other people have the same question I do but none of us have been able to find the answer. If Longo is devising a diet that is a compromise between what he thinks people can do and what the science says to do, then what would an uncompromising optimal fast look like? Would it be a five day water only fast or a two or three day water only fast? I've been poking around everywhere I can (still lots of Longo research I haven't been able to get through, however). Does anyone have an idea?

I wish I did have an idea; but I'm guessing the answer to what's an optimal fast is "it depends." From my Longo reading I've gathered that if you're overweight and have many health issues, then the more you fast the better. And if you have cancer, then fasting before chemo seems to be beneficial for preserving healthy cells while killing cancerous cells. For the rest of us who are healthy, don't have cancer, and eat mindfully non-processed, plant-dominated, whole foods diet, then less fasting is necessary. Maybe fast every new season for several days, or once or twice per year.

 

I've been going on the (perhaps misguided) idea that more fasting is better even for healthy people; less food (even if it is healthy food) may be better, and no food may be best given your individual circumstances. But I'm probably wrong; I'm usually wrong about stuff in general. But I'm sharing here anyway, even though it all seems pie in the sky.

 

I was doing a water only fast every Wednesday for the first couple of months that I was on CR, but I was losing weight too quickly and was trying to deliberately slow down so the fast was one of the things I stopped doing. I didn't want to do it during the summer because our CSA was so bountiful it was hard to keep up with it and skipping a day made it harder. But this week was the last share of our CSA and that food will run out in a couple weeks. At that point I think I would like to experiment with fasting again.

I guess I'm not too afraid of losing weight; but I would like to stay strong. And so far despite repeated fasts, I'm strong. That is, I'm losing no muscle or endurance (except during and immediately after longer fasts).

 

My opinion about Longo's FMD boxes is that the small amounts of healthy calories are probably more about the psychology of eating than about what's good for the body. Then again, it's all clear as mud, and the answer is usually "it depends..."

 

Another thing I'd like to add is I'm just assuming my body has millions of cancer cells despite healthy, clean living. And maybe fasting helps to kill cancer cells even if I've never been diagnosed.

[mccoy]

Which are the exact questions we might pose to Valter Longo? His collaborators in Italy might forward to him such requests. But I'm going to review his book first in case he wrote something relevant I don't remember.

[Thomas G]

Hi mccoy, if I could ask Longo and his collaborators questions I would want to know the following. Assuming that adherence was not an issue, what would their ideal recommendations be? How long and how frequent should a healthy person fast? Should they try to increase the calories they eat prior to the fast? What would the ideal meal to break the fast look like? Is this a process that should be spread out over several days (say 1000 cal to break the fast the first day, 1500 the second, 2000 the third, or something else)?

 

I can't wait to read his book when it comes out in English.

[Sthira]

Q: I've heard Dr. Longo say it took more than six years to complete a fasting study because they couldn't find willing participants -- this despite the fact that hundreds, if not thousands, of people are willing to pay lots of money to water-fast at retreats in Costa Rica, True North, and Dr. Fung's clinic. How do you account for this disconnect?

 

Q: Do you have any future plans to study fasting in adults, and if so how would we know and how would we volunteer?

[Sthira]

Here's what Reason over at the Fight Aging site had to say https://www.fightaging.org/archives/2016/10/a-calorie-restricted-medical-diet-to-be-filed-next-to-selling-ice-to-eskimos/

 

"...Calorie restriction is a particular challenge... It is a lifestyle choice, not a drug or an antibody or something else that the medical industry understands how to package, market, and sell. It is nothing more than eating sensibly and eating less. Anyone can choose to do it. It is free and straightforward and well-documented. Yet the effects on long-term health and aging in ordinary individuals are much larger than anything that can be generated by the presently available panoply of drugs and other interventions. That, I should say, is more a statement on the poor quality of present medicine when it comes to treating aging as a medical condition than it is on the benefits of calorie restriction. It is a case of something being better than nothing: no presently available medicine deliberately addresses the root causes of aging, for all that the first therapies that will do that are in development at various stages. The nature of calorie restriction means that there has been little to no for-profit investment aiming to better characterize its benefits. Rather, all that funding was directed towards mapping the biochemistry and haphazardly testing the established drug libraries to find something that triggered any of the same effects. The search for such calorie restriction mimetics is well documented elsewhere, so I won't dwell on that, beyond noting that the outcome of ten to fifteen years of work and a great deal of money is, so far, nothing of any practical use.

 

"So to calorie restriction itself, and how to obtain for-profit funding for research into eating less, and eating less in an effective way. The innovators here are Valter Longo and colleagues, who have achieved the goal of pulling in for-profit funding on the backs of turning specific implementations of fasting and low-calorie diets into FDA-approved therapies, such as an adjuvant in cancer treatment. The magic of regulation means that companies can manufacture a medical diet on the basis of research, and then use the barriers set up via intellectual property and regulatory pronouncements to charge an inordinate amount for what is, basically, a little bit of food that anyone could throw together after reading the papers to obtain the target calories, protein, micronutrient levels, and so on. That in turn means that the principals of these companies are willing to pay for the supporting research. On the one hand it's a depressing example of the distorted priorities that emerge from regulation of medicine, on the other one feels a certain admiration for Longo et al for having successfully hacked the system to fund the useful results they have produced these past few years. Quantifying the degree to which fasting alters the immune system, and quantifying the degree to which low-calorie diets and fasting are effectively equivalent in altering metabolism, are both helpful new information for those who practice forms of calorie restriction and intermittent fasting. In any case, here is a pointer to the less useful outcome from all of this, which is to say the medical diet. It comes across as a bad parody of itself, but that seems fairly true of most medical diet products.

 

Inroducing ProLon

 

Quote:

 

'Industry leading nutritechnology company L-Nutra has announced the release of ProLon, a groundbreaking 5 days per month only natural plant based meal program that nourishes the body while convincing it that it is fully fasting. This is the first time in history that 'Fasting with Food' is possible and is therefore called the Fasting Mimicking Diet (FMD). Developed at the Longevity Institute of the University of Southern California (USC) and under the sponsorship of the National Institute for Aging and the National Institute of Health, ProLon induces the body to protect itself and rejuvenate in response to 5 consecutive days of fasting.

 

'In the latest clinical trial conducted at USC's Longevity Institute, 100 participants on 3 cycles of ProLon (5 days only per month over a 3-month period) showed statistically significant improvements on various health metrics: decrease in body fat; decrease in body weight; preservation of bone density; reduction in fasting glucose and insulin resistance; optimization of cholesterol and triglyceride levels; decrease in IGF-1 (aging marker); decrease in C-reactive protein; elevated mesenchymal/progenitor cells (rejuvenation marker). This 'fasting with food' program features meals ranging from 770 to 1,100 calories per day.'

 

"Needless to say you can do all of this yourself, and whether or not you happen to have cancer at the time. It isn't hard to construct and follow a diet to a specific target of calories and nutrients: it just takes the willingness to do it. When presented with the above, and there's more along the same lines if you want to explore the ProLon website, it has to be said that it is more of a challenge than usual to remain optimistic that the first generation of rejuvenation therapies after the SENS model, such as senescent cell clearance, will be able do without the ridiculous marketing language that characterizes present day efforts such as the one above."

[Sthira]

Hi mccoy, if I could ask Longo and his collaborators questions I would want to know the following. Assuming that adherence was not an issue, what would their ideal recommendations be? How long and how frequent should a healthy person fast?

Fast, he says to you healthy one, for up to five days a few times per year. Don't fast, he says, without your "doctor's supervision."

 

Should they try to increase the calories they eat prior to the fast?

Probably not. I do know from lil ole me n1 that stuffing myself before a fast tends to make fasting vaguely more uncomfortable (i.e., hungrier)

 

What would the ideal meal to break the fast look like?

A modest amount of steamed greens, some legumes, a little fruit. Don't go crazy. Eat humbly and allow time for reintroduction. Having said that, neither are most healthy mammal bodies fainting flowers of fragility. We're tough, we're adapted to fasting and refeeding, we get to keep our ability to think and restrain while refeeding.

 

Is this a process that should be spread out over several days (say 1000 cal to break the fast the first day, 1500 the second, 2000 the third, or something else)?

I seriously doubt it matters very much. Don't gorge while refeeding -- exercise the same discipline that brought you here to CR. But if you do screw up and chow-holla-hey-chomp until you're a swollen puff of misery, then expect to feel terrible for a few hours. And farty. And grumbly. And wiser for the life lesson.

[mccoy]

Hi mccoy, if I could ask Longo and his collaborators questions I would want to know the following. Assuming that adherence was not an issue, what would their ideal recommendations be? How long and how frequent should a healthy person fast? Should they try to increase the calories they eat prior to the fast? What would the ideal meal to break the fast look like? Is this a process that should be spread out over several days (say 1000 cal to break the fast the first day, 1500 the second, 2000 the third, or something else)?

 

I can't wait to read his book when it comes out in English.

 

Thomas, as Sthira has already explained, some rules are basic and probably there is no need to ask Prof. Longo. My answers are similar to Shtira

 

Should they try to increase the calories they eat prior to the fast?: NO, there is no point in gorging before a fast, although it may be a mental suggestion dictated by survival instinct.

 

What would the ideal meal to break the fast look like?: In the book from Dr. Shelton there is a whole chapter dedicated to refeeding. The strategy to break a fast should be very rigorous in long fasts (10 days and more) a little more relaxed in shorter fasts.

My advise would be to follow his suggestions anyway for a 5-days fast: half a whole fruit (for example half an orange) every hour in the morning, then one orange every 2 hours in the afternoon.  Or some watery fruit like cantaloupe or watermelon, or tomatoes. Extreme hunger must be fought and many small meals in such a case are necessary, always being careful to stop as soon as we feel the stomach a little bloated. in the evening some nuts and a salad, for example. Often breaking a fast requires more discipline than the fasting itself.

 

Is this a process that should be spread out over several days (say 1000 cal to break the fast the first day, 1500 the second, 2000 the third, or something else)?: Possibly so,  very carefully following instinct, digestive power and being very careful in not bloating. Better to err on the safe side. The 3-days refeeding strategy you mention would be pretty good after a long fast, whereas on the 2nd day after a 5-days fast you might relax a little and on the 3rd day back to normal. There is not a set rule since it depends on people. First rule is to be careful though, since after a water only fast the body is very hungry and you might compromise all the advantages of a proper fast. This is my personal experience. I remember I broke my 5-days fast with 2 or 3 peaches, the available fresh fruit in that season. The morning is all right, then you may get very hungry and exercise restraint.

[mccoy]

Hi mccoy, if I could ask Longo and his collaborators questions I would want to know the following. Assuming that adherence was not an issue, what would their ideal recommendations be? How long and how frequent should a healthy person fast? 

 

An healthy and not overweight person, according to his book, should engage in a 5-days fast twice a year. Of course he speaks about his mimicked fast. But I think a proper length is of importance here, possibly more important than full or semi fast.

[Sthira]

Yes, I agree with you McCoy. And I guess my point is breaking a fast is individual and perhaps more discipline is required for some. Doesn't seem to matter for me, though, and I feel like I've tried many, many approaches of refeeding. What works for me best, though, is just returning to a smaller version of my regular vegan strong diet: beans, greens, berries, citrus, nuts and seeds. I think we adapted as animals through the long span of time to be feast-famine critters. Eat when you have food, then don't when you don't have food. For millions of years we scruffy hominids probably scraped along the edges of starvation in desperate little tribes.

 

Also, the more you fast the easier it gets. The less hungry and weak you become as the body naturally figures shiz out.

[Thomas G]

Just to clarify, when I suggested eating more calories leading up to a fast, I wasn't talking about gorging myself. One of my concerns with a fast is that I will lose weight too quickly. Right now I've got chronometer set to lose 0.5 pounds a week. I was thinking that in the week prior to a 5 day water fast I should switch chronometer to gain one pound a week. 

After the refeeding maybe go a couple of days at the gain a pound a week and then revert back to losing 0.5 pounds a week. That way the fast overall wouldn't throw me too far off course. But maybe I'm over thinking this.

 

Right now I'm thinking that the second week of Nov. might be a good time to try a 5 day fast.