FMD vs. "inverted FMD"

[BrianMDelaney]

Hi everyone,

 

Many people have been asking, both here and elsewhere, about the safety and efficacy of various time-restricted eating schemes.

 

This is of particular interest to me since, for reasons that are irrelevant to most here (an unusual constellation of health challenges), I have been finding conventional CR (=the same, low energy intake per day) unworkable.

 

Before I continue, I should emphasize that the best bet for health and longevity, based on the science we have (which is limited), is indeed conventional CR.

 

But for those who want to try time-restricted eating, I'm wondering about the relative merits of two approaches, and I'd appreciate feedback. I've been thinking this through mostly on my own, and find myself unable to reach a conclusion. Experimental evidence is so limited, I think it's more helpful to reflect a bit on mechanisms, or even evolution. (More helpful doesn't mean very helpful, though....)

 

Type 1: Longo/FMD.

 

The evidence for benefit in both lab animals and humans is limited, but is at least somewhat compelling. It seems unlikely that there's any antiaging benefit per se, beyond that which would have obtained with the same overall ("longish-period averaged") reduction in calories.

 

Type 2: "Inverted FMD".

 

If the Longo approach involves having non-CR signaling patterns (high mTOR, IGF1, insulin, etc.) be the norm, with a sudden several-day period of CR signaling patterns being the exception, "inverted FMD" would be CR, perhaps somewhat mild, as the norm, with a several-day, or week-long period of "feast" signaling. (Credit where credit is due: James Clement is the one who suggested this pattern of eating as possibly better than the Longo pattern.)

 

Type 1 vs. Type 2.

 

Type 2 seems to me to be more like the pattern of eating under which we evolved – scarcity as the norm, with the occasional feast when the tribe came upon a bunch of food – but that doesn't say much about its benefits, though it might suggest that the body would be more adapted to it.

 

Hm.... what we really need is more science on this. Does anyone here know Longo? I've emailed him a couple times and not gotten a response. A small trial comparing the two approaches could be helpful (though only slightly of course, since the main interest of many here is effect on mortality, for which we still don't have great biomarkers).

 

Brian

[mccoy]

Brian, as a matter of fact, in between FMDs Longo suggests his 'longevity diet', which we discussed in another thread, which is basically a normo caloric diet, based on moderate proteins, very little simple sugars, healthy fats, no or almost no dairy products, lots of vegetables, cereals and abundant legumes. By itself such a diet would tend to lower or to check anyway the IGF-1 and the mTOR signals, in a mild way.

 

I find interesting the inverted FMD concept, although it would entail often lower bodyweight and muscle mass, which some people like me do not find acceptable. Whereas type 1 FMD allows to keep muscle mass in between restrictions, which would amount to max 20-30 days  per year for a vegan practitioner. Even by following the longevity diet, Longo does not advise CR and suggests to practice resistance exercise with post workout proteic meals. This would allow conservation of muscle mass.

 

It is not very clear where the advantage of type 2 lays. It's a mild CR as you say with intermittent overamplification of mTOR, which is good to allow for some probably needed proliferation and growth. However, there is a logical framework and conceptualization for type 1 FMD, whereas type 2 has not such a feature. I doubt that Longo would express favourably toward the 1st one, having developed type 2 after years or decades of reasonings and experimentation. Besides, his routine would be the longevity diet, which implies caloric moderation but not restriction.

 

Also, I've grown more and more skeptical about the model of the paleolitic eating patterns. As we discussed, the paleolithic humans had one huge priority, called survival, which overwhelmed longevity. The latter is our priority and the requirements are different for the two. Survival means caloric optimization, eating whatever food provides more calories and requires fewer calories to procure.

 

Basic survival not being an issue now (usually), adopting the paleolithic diet as an example to follow would sound like an evident fallacy.

[BenkRichardson]

Brian, as a matter of fact, in between FMDs Longo suggests his 'longevity diet', which we discussed in another thread, which is basically a normo caloric diet, based on moderate proteins, very little simple sugars, healthy fats, no or almost no dairy products, lots of vegetables, cereals and abundant legumes. By itself such a diet would tend to lower or to check anyway the IGF-1 and the mTOR signals, in a mild way.

May I impose upon you to share any links you have to Longo's longevity diet advice? I have read much about the FMD trials and FMD and interviews with Longo without encountering this. I am particularly intrigued by the recommendation to include lots of cereals and the rationale for it. 

 

My google-fu may work and I will find the content anyway, but if you have anything bookmarked . . . . :-)

[mccoy]

Benk, sorry but I only saw your post today.

 

Valter Longo published his reccomended longevity diet (different from the fast mimicking diet) in his book:

 

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As far as I can remember, there are lots of vegetables, beans, some cereals, some fish, almost no simple sugars and dairy products. Also very little fruit. Sounds like a regiemen which doesn't spike blood sugar, lest we overindulge with the cereals or beans...

[Sibiriak]

Valter Longo,  The Longevity Diet: Discover the New Science Behind Stem Cell Activation and Regeneration to SlowAging, Fight Disease, and Optimize Weight (pp. 62-66).

 

 

What follows is the optimal diet for minimizing disease and maximizing a healthy lifespan based on the Five Pillars.

 

Follow a pescetarian diet. Aim for a diet that is close to 100 percent plant- and fish-based, limiting fish consumption to two or three portions a week and avoiding fish with high mercury content (tuna, swordfish, mackerel, halibut). If you are past age sixty-five and start to lose muscle mass, strength, and weight, introduce more fish into the diet, along with other animal-based foods commonly consumed by populations with record longevity, like eggs and certain cheeses (preferably feta or pecorino) and yogurt made from goat’s milk, all of which are commonly consumed in high-longevity areas.

 

Consume low but sufficient proteins. Consume 0.31 to 0.36 grams of protein per pound of body weight per day. If you weigh 130 pounds, that comes to about 40 to 47 grams of protein per day, of which 30 grams should be consumed in a single meal to maximize muscle synthesis. If you weigh 200 to 220 pounds and have 35 percent body fat or higher, 60 to 70 grams of protein per day is sufficient, since fat cells require lower levels of protein than muscles. Since this minimum requirement can change from person to person, it is preferable to occasionally consult a dietitian, to make sure that a healthy, lean body mass is maintained. Protein intake should be increased slightly after age sixty-five in individuals who are losing weight and muscle. For most people, a 10 to 20 percent increase (5 to 10 grams more per day) is sufficient. Finally, the diet should be free of animal proteins (red meat, white meat, cheese) with the exception of proteins from fish, but relatively high in vegetable proteins (legumes, nuts, etc.) to minimize the former’s negative effects on diseases and maximize the latter’s nourishing effects.

 

Minimize bad fats and sugars, and maximize good fats and complex carbs. Part of the confusion and constantly changing recommendations around diet stem from the oversimplification of food components and their categorization into fats, carbs, or proteins. Every day we hear about “low carb versus high carb” or “low fat versus high fat.” It shouldn’t be a question of either/ or, but of which type and how much of each. In fact, your diet should be rich in good unsaturated fats, such as those found in olive oil, salmon, almonds, and walnuts, but as low as possible in saturated, hydrogenated, and trans fats. Likewise, the diet should be rich in complex carbohydrates, such as those provided by whole bread, legumes, and vegetables, but low in sugars and limited in pasta, rice, bread, fruit, and fruit juices, which are easily converted into sugars by the time they reach the intestine.

 

Be nourished. You can think of the human body as an army of cells always at war. The enemy includes oxygen and other molecules that damage DNA and cells; bacteria; and viruses, which are constantly trying to defeat the immune system. Like an army in need of rations, ammunition, and equipment, the body needs proteins, essential fatty acids (omega-3, omega-6), minerals, vitamins, and, yes, sufficient levels of sugar to fight the many battles raging inside and outside cells. When your intake of certain nutrients becomes too low, the body’s repair, replacement, and defense systems slow down or stop, allowing the damage to accumulate or fungi, bacteria, and viruses to proliferate. (The appendixes include a list of foods rich in each of the important nutrients, as well as sample weekly diets that meet established nutritional targets.) As extra insurance, take a multivitamin and mineral pill, plus an omega-3 fish oil soft gel every two or three days. Purchase these products only from reputable companies, where quality control ensures appropriate supplement content and stability.

 

Eat a variety of foods from your ancestry. To take in all the required nutrients, you need to eat a wide variety of foods, and it’s best to choose from foods that were common on your parents’, grandparents’, and great-grandparents’ table. This does not mean you should eat like your grandparents, but that within the guidelines of this book, you should pick foods your grandparents ate. The human body is the result of billions of years of evolution, and even the last one thousand years have helped filter out people not fit for a particular environment, or foods not appropriate for a particular genotype (the collection of all genes in a person). For example, in many northern European countries where milk was commonly consumed, intolerance to lactose (the sugar contained in milk) is relatively rare, whereas lactose intolerance is very common in southern European and Asian countries, where milk was not historically part of the traditional diet of adults. If a person of Japanese ancestry living in the United States suddenly decides to start drinking milk, which was probably rarely served at her grandparents’ table, she will likely start getting sick. Whether it’s lactose or kale, quinoa or turmeric (curcumin), you have to ask whether these were foods common at the table when you, your parents, or your grandparents were growing up. If not, it’s best to avoid them or consume them only occasionally. The potential problems are intolerances (for example, an inability to break down the lactose sugar in milk) or autoimmunities, such as the reaction to gluten-rich foods like bread and pasta observed in people with celiac disease. Although clear links have not been proved yet, it is possible that consumption of the wrong foods based on ancestry could be associated with many autoimmune disorders, including Crohn’s disease, colitis, and type 1 diabetes.

 

Eat twice a day plus a snack. Unless your waist circumference and body weight are in the normal or low range, it is best to eat breakfast and one major meal plus a nourishing low-calorie, low-sugar snack daily. If your weight or muscle mass is too low or if it’s dropping against your will, then eat three meals a day plus a snack. One of the major mistakes of guidelines on nutrition is blurring the line between what theoretically could work and what actually does work. We often hear that we should eat small meals five to six times a day. Aside from a lack of evidence supporting the benefit of such a regimen in terms of a long and healthy lifespan, it is extremely difficult for most people to regulate food intake when they are told to eat so often. Even if the meals contain 305 calories each, instead of the recommended 300 calories, that extra 30 calories a day, or more than 900 calories a month, means nearly 3 pounds of extra fat every year. Not surprisingly, over the past twenty years— the period when the six-meal diet was popular— America reached a record 70 percent portion of overweight and obese people. If you eat only two and a half meals a day, with only one major meal, it becomes much harder to overeat, particularly on a mostly plant-based diet. It would take large portions of fish, beans, and vegetables to get to the calorie level that would cause obesity. The high nourishment of the food, plus the volume of the meal, signals to your stomach and brain that you have had enough food.

 

In the elderly, this one major meal system may have to be broken down into two smaller meals to avoid digestion problems. Older people and adults prone to weight loss should stick to eating three meals a day plus one snack. For people trying to lose weight or those who tend to be heavy, the best nutritional advice is to eat breakfast daily; have lunch or dinner, but not both; and substitute for the missed meal one snack containing fewer than 100 calories and no more than 3 to 5 grams of sugar. (Do not skip breakfast, as this has been associated with increased risk for age-related diseases in multiple studies.) Which meal you skip depends on your lifestyle. The advantage to skipping lunch is more free time and more energy. On the other hand, there is the possible disadvantage of restless sleep from having consumed a large dinner, particularly for those who suffer from acid reflux. The disadvantage to skipping dinner is that it eliminates the most social meal of the day.

 

Observe time-restricted eating. Another common practice adopted by many centenarian groups is time-restricted eating, or confining all meals and snacks to within eleven to twelve hours or less a day. The efficiency of this method has been demonstrated in both animal and human studies. 6 Typically you would eat breakfast after 8 a.m. and finish dinner before 8 p.m. A shorter eating window (of ten hours or less) can be even more effective for weight loss, but it is much harder to maintain and may increase the risk of side effects, such as developing gallstones and possibly increasing the risk of cardiovascular disease. You should also not eat within three to four hours of going to sleep.

 

Practice periodic prolonged fasting: People under age sixty-five who are neither frail nor malnourished and are free of major diseases should undergo two periods of five days a year in which they consume a relatively high-calorie fasting-mimicking diet, or FMD. Most religious groups— including Muslims, Christians, Jews, and Buddhists— have practiced some form of fast, though some of these practices have been modified or abandoned over time. Muslims practice fasting during the month of Ramadan, but in modern times the daytime fast is often accompanied by overeating at night. During Lent, Christians used to undergo a month of severe calorie restriction ending in a week of fasting, but this practice, too, has largely been abandoned today. In chapter 6, I discuss the remarkable effects of five-day cycles of a fasting-mimicking diet on disease risk factors and the optimization of healthy longevity.

 

Follow the eight points above in such a way that you reach and maintain a healthy weight and abdominal circumference. In a longitudinal study of 359,000 European adults followed over ten years, high waist circumference and abdominal fat were associated with increased diabetes, hypertension, high cholesterol, and heart disease. Having a waist circumference of more than 40 inches in men and 35 inches in women doubled the risk of premature death, compared with having a waist circumference of less than 33 inches in men and 27 inches in women. Following the eight points above will allow you to reach and maintain low visceral fat, and a healthy weight and abdominal circumference.

 

 

For most people, the Longevity Diet can be adopted simply by replacing a limited number of items with foods that are just as enjoyable, if not more so. Virtually all diets fail because they are too extreme to maintain in the long run. They also fail because they require major changes to your habits and lifestyle. For example, many new diets require low carbohydrate intake, but carbohydrates are the food people around the world enjoy the most— whether it’s potatoes for northern Europeans, pasta for Italians and Americans, or rice for Asians. Thus, very low-carbohydrate diets, besides being associated with increased mortality and reduced lifespan, are not sustainable in the long run for most people. Because the Longevity Diet is closer to diets generally adopted by Americans, Europeans, and Asians, it can be embraced by people all over the world. In the following sections I explain how the above dietary recommendations are rooted in the Five Pillars of Longevity, since this is the key to understanding their effectiveness. I discuss studies of the laboratories I direct, as well as those of other laboratories and clinics.

 

 

Interestingly, Longo's "Five Pillars of Longevity"  are sources of scientific knowledge,  not substantive recommendations.

 

 

Pillar #1:  Basic/Juventology Research  (including basic theory/research, cellular studies,   studies with yeast, flies, mice,  etc.)

 

Pillar #2:  Epidemiology

 

Pillar #3:  Clinical Studies

 

Pillar #4:  Centenarian Studies

 

Pillar #5: Studies of Complex Systems   (Engineering approach;  using  analogies to help simplify the complexity of human biochemistry and underline the fundamental link between nutrients, their functions, aging, and disease.)
.

[Sibiriak]

BenkRichardson: I am particularly intrigued by the recommendation to include lots of cereals and the rationale for it.

 

I haven't found any recommendation for "lots of cereals" in Longo's book.    What he recommends is a diet rich in "good fats" (eg. olive oil, nuts) and complex carbohydrates.  The complex carb category  can include whole grains/cereals along with vegetables and legumes,  but should be low in sugars and limited in pasta, rice, bread, and fruit.

 

For example, when he cites centenarian studies, he refers to complex carbs, not cereals specifically.  (The word "cereals" rarely appears in the book).

 

Areas of the world known to have the highest prevalence of centenarians— Okinawa, Japan; Loma Linda, California; small towns in Calabria and Sardinia, Italy; and in Costa Rica and Greece— all share diets that are (1) mostly plant-based with lots of nuts and some fish; (2) low in proteins, sugars, and saturated/ trans fats; and (3) high in complex carbohydrates coming from beans and other plant-based foods. Most of these centenarians ate only two or three times a day, ate light meals in the evening, and were in many cases done eating before dark. They also consumed a limited variety of foods— ones typical of their homelands. In some cases they did modify their diet. For example, Okinawans used to get most of their calories from sweet purple potatoes, but today that is far less common.  (pp. 71-72)

[mccoy]

Re: blue zones low in sugars

 

In Costa Rica they eat or ate fruit=simple sugars.

 

In Sardinia and Calabria, when available (not always) they ate fruit and very sweet fruit like figs (fresh and dried). When in season

 

Ikaria also most probably included figs and maybe grapes (in the early fall).

 

All the above might have included honey.

 

I agree that complex carbs were prevalent (with the possible exception of the costaricans) but at times their diets were rich in simple, natural sugars mostly from available fruit.

[mccoy]

I found very interesting the following excerpt, posted by Sibiriak, from Longo's book:

 

 

 

Whether it’s lactose or kale, quinoa or turmeric (curcumin), you have to ask whether these were foods common at the table when you, your parents, or your grandparents were growing up. If not, it’s best to avoid them or consume them only occasionally. The potential problems are intolerances (for example, an inability to break down the lactose sugar in milk) or autoimmunities, such as the reaction to gluten-rich foods like bread and pasta observed in people with celiac disease. Although clear links have not been proved yet, it is possible that consumption of the wrong foods based on ancestry could be associated with many autoimmune disorders, including Crohn’s disease, colitis, and type 1 diabetes.

 

I myself and others in this forum are following a xenohormetic diet, eating exotic spices and foods like turmeric, quinoa and more. But it is well known that for many people such hormetic foods even in low doses are toxic. Also some foods reputed to cause intolerances, as tomatoes and potatoes, are not really ancestral, since they are a relatively recent addition to the European and American diet.

 

Longo's words are in between those who suggest a xenohormetic diet and those suggestign the contrary, by the simple rule of ancestral regimen.

 

I don't know though how people can know a priori if they can suffer intolerances from non-ancestral food. Most people do not  suffer food intolerances. According to Longo I should eat a mediterranean diet and avoid all exotic spices. Are tomatoes, introduced in Europe 400 years ago, ancestral enough? 8 or less generations are enough to develop a good tolerance?

 

Maybe Longo's suggestions are precautionary but again, who should apply caution and who should not?