Intermittent Fasting – A Few Comments

Nutrition, health, and fitness

Last night I listened to the FLCCC weekly webinar with guest Dr. Pradip Jamnadas and was immediately concerned at the video clip that they played at the beginning. The presenter made a comment that the only way to eliminate toxins from the body was through intermittent fasting, and the irony was that I was listening to this while climbing into my NIR sauna for 40 min of sweat! Now I was pleased to note that during this live interview, it was clearly stated that NIR sauna DOES eliminate toxins (and actually this applies to any form of sauna as it is the sweat, not the NIR light, that detoxifies). Let me go on to say that overall it was an excellent presentation, and I strongly recommend it to all. I do have a few issues I wish to address, however.

My differences with some of what was stated result from a different starting point. Dr Jamnadas is a cardiologist & has been treating people with known disease or ‘on the way’ with obesity & impaired glucose tolerance. My focus is generally not on such patients but rather that of wellness and from a background in athletic competition & coaching. After making my comments about the presentation & subject matter, I will add a little personal history that can shed a bit of light, especially for those of you who are fit, not overweight, and may have had similar experiences.

In my opinion the case of sugar ‘addiction’ was a bit overstated. Yes, there is research evidence demonstrating dopamine release in association with sugar, most of the research being conducted in rats. There is no question that some people are quite compulsive with sweets, but as someone treating addicts for over 30 years, the statement that sugar is more addictive that cocaine is overstated. The statement by itself could be viewed as a ‘throwaway’ but I saw a problem later on. He spoke of people struggling as they were trying to adapt to intermittent fasting and he described any complaint of not tolerating it or feeling bad as “sugar addiction.’ Well there is a big difference between ‘sugar addiction’ (such as seen in the person who compulsively eats a bag of sugar candy) and simply having a metabolism that is such that the person is ‘running out of gas’ and needs to eat. People WILL adapt, virtually everybody eventually will (still allowing for the truly odd individual metabolism) but it is not going to be a uniformly tolerable approach.

Again, he is dealing with a clinically sick population and I am sure that he does see more ‘addictive eaters’ (and that goes far beyond a simple response to sugar) than in the normal population. Telling someone “this is sugar addiction, get over it!” is going to be quite demoralizing for people who have differing physiology. As someone prone to hypoglycemia (see below) I can identify with the effort involved in adapting to not eating before noon. Case in point: earlier this week while seeing a patient, I had to eat a protein bar a little before 11 as I was starting to feel jittery. So by all means give intermittent fasting a go, stay with it & allow 3 months to assess how well it works for you, and BE GENTLE with yourself!

Another point that I disagree with was his rejection of grains. As someone who bakes whole wheat bread (with coconut oil, it preserves against mold!) and eats it, not by itself but in conjunction with fats & protein, the overall effect is a modest glycemic impact. I know … GLUTEN!!! … I will stay off of my soapbox, but it appears that true gluten intolerance is less common than gut problems such as disbiosis. But for a moment, let’s avoid gluten: eat OATMEAL! Now I am NOT talking about sugar laden instant oatmeal, that stuff is gunk. I am talking about steel cut oats, soaked for 16+ hours, with some dried fruit (raisins, which add some sugar NECESSARY to make it palatable!), walnuts, and natural applesauce (or chunks of apples). This is a low glycemic meal (needing some additional protein on the side, however; that also lowers the overall glycemic effect) which is also extremely beneficial to your microbiome. The soluble fiber does a remarkable job of feeding the good bugs.

You may have noticed I said apple & walnuts, yet in the interview they restrict fruit. The issue here is restricting CERTAIN fruits. Apples are extremely low in available sugar, UNLESS you get these newer varieties bred for sweetness. Stay with a moderate-to-tart apple & you are in good shape. Pears & peaches are low glycemic fruits, as are berries. Now bananas are DEATH! I laugh as people think they are healthy because “potassium” but are mostly rapidly absorbed sugar. Grapes are little sugar bombs, but the red ones have lots of good bioflavenoids. Muscadines are even better, and actually have far less sugar (and aren’t so sweet). These grapes do need to be moderated, and as I mentioned I like raisins in oatmeal; by soaking the sugars move into the oats & sweeten the mix. Walnuts? Yes, WALNUTS! While most nuts are almost all omega-6 fatty acids which are pro-inflammatory, walnuts are the exception, though they do have omega-6 they do have a good bit of omega-3 fats, fiber, and a bit of protein. They are a superb addition to oatmeal.

Dr. Jamnadas mentioned BCAAs – branched chain amino acids – as something to avoid. These are essential amino acids that have an anabolic effect, that is they increase muscle tissue. Bodybuilders & other athletes commonly supplement BCAAs or use a whey protein isolate supplement with high concentrations of BCAAs. These are important in the athlete population, and avoidance is a bad idea. Let me again remind you that Dr. J is a cardiologist, he is dealing with people with heart disease. Data has been collected that demonstrates problems with high levels of BCAAs in cardiac patients. Some of that may be more ‘effect’ or association than ‘cause’ but also there is evidence that this may contribute to cardiac hypertrophy. For you healthy, non-cardiology patients, especially if you are a serious or even semi-serious athlete, I would advise against restricting BCAAs in your diet.

REMEMBER: we need to individualize our approach to optimal health!

Other than these minor points, I think it is a great presentation, one for you to watch and to share with others. The potential metabolic effects are dramatic, and as Dr. Marik has been preaching for several months, the stimulation of autophagy is crucial for those struggling with spike protein disease in their bodies (whether through long COVID or the jab). Below I am going make some further remarks addressing both my own personal experiences, and general information related to athletes.

The ZONE and Glycemic Index

In the 90s a book became a bestseller from a doc named Barry Sears called ‘The Zone Diet.’ At the time it was groundbreaking in its approach to macronutrients, that is the proportions of fat, carbs, and protein in the diet. Dietary fat had been touted as the great health evil, yet Sears provided evidence that we needed to add fat & lower carbs. My wife immediately dropped about 10# that had slowly accumulated on her fit body, while I found I couldn’t train as hard. I needed a higher percentage of carbs in my diet. But it really got us thinking, and in particular brought ‘glycemic index’ to the fore.

Glycemic index is the measured effect of any given carbohydrate on blood sugar. Basically it is a measure of how quickly your body can turn food into glucose. What was fascinating to me was that by combining fats & proteins along with carbs, the glycemic index was dramatically lowered. I suspect most of my readers know this today, but 25 years ago it was revolutionary! What we have come to understand is the devastating effects that high glycemic foods can have on some people.

Wait a minute … did I just read SOME people? Well, yes. Again, people are different, and there are circumstances where we actually benefit from a high glycemic meal. When? Immediately after a really hard training session or competition. I learned early on that a vital element of improvement through training was recovery. In the first hour or two after a strenuous workout your muscles are literally SCREAMING to be refueled! That is the time that rapidly absorbed sugars are not bad for you! Now I am NOT talking about ½ hour walk around the block. I am talking about completing a two hour cross country race where I just about fall off the bike, and immediately drink my recovery drink containing 30 grams of high quality protein and 120 g of carbs (maltodextrin as a significant component). During such a time your muscles will suck up the sugars and proteins. When I finish writing this article, I will head downstairs to my gym in the basement & hit the weights (and do a little warmup on the rowing machine). I happen to have a brownie that has been calling my name for the past 2 days, and THAT will be part of my post-workout recovery meal!

Personal Examples from my Own Life – differing needs for carbohydrates

As a child I was always active & athletic, and my mother generally had food available in between meals. In high school I began working construction jobs during the summer, and I can clearly remember the summer between 10^th & 11^th grade working on a crew putting in 10-12 hour days. I carried a lunch with me (sandwich, apple, chips, etc) and by the time lunch rolled around, I was famished. In the mid-afternoon I had difficulty with onset of fatigue & feeling shaking. Eventually I realized that bringing an extra sandwich & apple for that time was necessary. Years later my wife was running a home health company, and when the rep dropped off two samples of the new glucometer, she brought one home. On multiple occasions when I would start feeling shaky my blood sugar would be in the low 50s. So I had symptomatic hypoglycemia, as a fit athlete (running 20+ miles/week & lifting weights). I found I am extremely sensitive to rebound hypoglycemia from ‘mid-morning break’ at medical conferences. They would have pastries & coffee/hot tea, and after a couple of times realized that if I ate a sugar bomb & drank a cup of hot tea, 90-120 min later I would be shaking, lightheaded, and possibly sweating!

In my mid 30’s I had a second knee injury playing basketball and was told to stop playing basketball, and “oh, you also have some degenerative changes in your articular cartilage, you need to stop running as well!” What was I going to do for fitness? I had run a marathon & did a weekly long run of 12.5 miles along with 4-5 other days of lesser distances. I decided to start cycling, and soon began racing mountain bikes. I had always had an interest in exercise physiology & nutrition and was writing a wellness column for a hospital. The competition spurred me to learn everything I could about the applicable science, and eventually I hired a coach who I had determined to be the sharpest exercise physiologist in the country (for cycling, anyway). He taught me a great deal, and at some point I may outline a few training principles I gained.

As I studied nutrition and also read other things by cyclists, I saw how my own physiology did not fit ‘the norm’. Many cyclists would describe going on a moderate effort ride of several hours, but I simply could not do this because I got hypoglycemic. There is a process called ‘enzyme induction’ where repeatedly exposing your body to certain conditions can increase particular enzymatic activity. This is quite commonly seen in alcoholics who will metabolize alcohol far faster than occasional drinkers. The enzymes are ‘induced’ meaning increased, and they may work on other chemicals as well. Similarly, utilizing fat as an energy source involves certain enzymes to mobilize fat from adipose tissue (the bit of fat stored in muscle is readily available & is utilized easily, but it is limited in amount), that is to get it out of your ‘love handles’ and into the bloodstream, as well as to ‘burn’ it for energy.

Within 60 minutes on a moderately paced ride I would begin to feel tired & weak without ‘trickling in’ a little Gatorade or other ‘sugar water.’ What I did was carried water and some gatorade, and kept pushing myself to go further each time on my 67 mile loop before shifting from water to gatorade. I carried a couple of ‘gels’ as a ‘rescue’ should I get too hypoglycemic. I distinctly recall one afternoon at the top of the last major climb and I literally wanted to get off the bike & lie down to sleep! Over a number of weeks of this truly intensive effort I was able to induce fat-burning enzymes, but still was far slower than if I were drinking some gatorade. In contrast, my wife could do the same ride on water & be fine, although she was certainly stronger if she drank some gatorade along the way.

People are INDIVIDUALS! As I have been reciting like a broken record, we MUST seek to understand the person and individualize treatment or training. In the same manner there are differences in terms of ability to perform hard workouts & recover without going into a state of overtraining. That is a topic for another day.