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Bonus from the archives: A Guide to the Fasting Mimicking Diet | S8 Bonus
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Hi everyone, I'm Geoff Alex and I'd like to officially welcome you to Season two of the Living well with Ms. Podcast. Thanks to all our listeners for making our first season such a big success. In Season two, we will release a new episode every three weeks that will introduce you to fascinating people and ideas to broaden your perspective on how to live a better, healthier life with Ms. And now on with the show. Support for the Living well with Ms. Podcast is provided by Overcoming ms, a global charity registered in the United States, United Kingdom and Australia whose mission is to educate, support and empower people with Ms. In evidence based lifestyle and medication choices that can improve their health outcomes. Please visit our website at www.overcomingms.org to learn more about our work and hear directly from people around the world about the positive impact overcomin Ms. Has made on their lives. Now on to today's episode.
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Today we are pleased to welcome a very special guest to Living well with Ms.
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Professor Valter Longo, the scientist behind the Fasting Mimicking Diet. Professor Longo is a biogerontologist and cell biologist and serves as a professor at
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the USC Davies School of Gerontology and
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as the Director of the USC Longitivity Institute.
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He is the creator of the Fasting
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Mimicking Diet, a meal program that claims
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to mimic the effects of periodic fasting.
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Now, fasting mimicking diets are not one
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of the seven pillars of oms. However, there is a lot of evidence
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behind them and it's possible that in
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the future this evidence could be strong enough to suggest that they may come into the mainstream OMS protocol. Despite the implication, this is a juicy and timely topic.
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And so onto my chat with Professor Longo.
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B
Thank you for joining us. Professor Longo, before we dive into your dietary recommendations, could you enlighten us a bit about today's rising fascination with fasting diets?
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Yes, I think that it's people do realize that fasting it is still part or it was part of many religions and it's still part of many others. And so I think that people have always wondered why and now science is beginning to show that in fact fasting and particular forms of fasting, I think that we're going to find out that fasting can be both good and bad. We already finding that out but like with old treatments that if you do it in a certain way for a certain length of time that this could be very beneficial. And so I think that lots of people are beginning to realize that I think most people are a little bit over mean they're probably not as aware of the problems as they are aware of the, of the benefits. And so that that hopefully changes so that this doesn't end up as a, is a fashionable thing, periodic fashion, or temporary fashionable thing. And it ends up being a real therapy available in many, many clinics around the world.
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B
And so your diets are often called fasting mimicking diets. So how does fasting mimicking differentiate? How's that different from fasting?
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C
Yeah, so we started with water only fasting. Of course, I started with water only fasting many years ago, several decades ago, in the early 90s. First in bacteria, then yeast, and eventually through mice. We got to patients and realized that maybe around 10, 11 years ago that patients didn't want to fast water only, and that oncologists did not want to warn their patients to undergo water only fasting. So we developed fasting mimicking diets and we got funding from the National Cancer Institute and National Institute on Aging to do that. The idea was, can we get the changes that occur during water only fasting while patients are allowed to eat something very special, but certainly they're allowed to eat what they consider relatively normal food.
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B
Okay. There's another term that comes up as well, is blue zones. So could you explain what blue zones are?
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C
Blue zones are areas around the world that have been designated mostly by National Geographic and then Buettner, as areas containing particular features which include longevity, extreme longevity, and a high number of centenarians. Now, the original word comes from Sardinia, Italy, where some of my colleagues were researching the prevalence of centenarians in certain areas around Nuoro. And they ended up by using a blue pen to circle the area. And that's at least I've been told by them that it's literally just the
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color of the pen they were using. It could have been any color.
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Yeah, I think if they had used a red zone, a red pen, it would have been the red zones, but it happened to be blue. So there you go.
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B
So the. So people in the blue zones live longer statistically, and they live longer because,
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you know, the blue zone criteria is not necessarily about living longer for the population overall, but it may have to do with the number of centenarians frequency, it may have to do with the number of male centenarians or female centenarians, etc.
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B
Okay, but is there a correlation between those zones or between the centenarians and people who are fasting or fasting mimicking?
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C
Not really. No, not really. The fasting and fasting mimicking have been pretty much abandoned by most People including, with the exception of some of the more extreme religious groups. And I don't even mean the Muslims, because, you know, the Ramadan, the practice right now is just fasting during the day, which is not really fasting. It is a form of fasting. But what we're talking about is going three, four, five days or longer with no food or very little food. And that's rarely seen anywhere now in almost any religion or any group of people. So, yeah, yeah, you don't see that anymore. You do in centenarians in these record longevity zones, you often do see people not eating dinner or having a very light dinner. And I would be surprised, at least from where I don't know that it's been formally investigated, but I would be surprised if most of them did not do a 12 hour or a little bit longer fasting period every night. The centenarians seem to be fairly disciplined, and I think in most cases they're not used to eating as we do in the United States and probably in the UK for 14, 15, 16 hours a day.
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B
Yeah, I think the modern day. Well, I've traveled to the US A lot, and it does seem to be that food is available at all times. So you never need to be hungry at all. You just instantly get food.
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C
Yeah, the American, at least some studies indicate the Americans now eat for about over 15 hours a day. And so, yeah, so this is the amount of food, but also the length of feeding has been increasing steadily for decades.
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B
And so in your research, have you found that fasting, mimicking can help people live longer?
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C
Well, nobody's ever done longevity study. I think that would take decades to do, even if you took people that were fairly advanced stages. And so people are now considering those studies. So the fasting vegan diet makes mice live longer. You know, if you take it and you give it to them at middle age, the mice live longer and the cancer goes down about 45%. And, you know, cognitive decline is delayed and inflammation is delayed, et cetera, et cetera, in people. You see something very consistent with that. So we saw that, you know, reduction in inflammation. We see metabolic changes that are very positive. So lower cholesterol, lower blood pressure, lower fasting glucose. And so overall, if you look at it, and if somebody was to do that fairly consistently, and by that we mean three or four times a year for five days. I mean, at least based on what we've seen in mice and human trials, it'd be hard to imagine how they would not live longer. But that's a speculation.
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B
Okay. So this podcast is specifically for people with Ms. So can it help people with Ms. Live better? If not necessary longer would their prognosis likely be better?
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Well, I mean we've done a clinical trial with Ms. And this is in collaboration with Charita Hospital in Berlin. And this was published together with our mouse studies study on multiple sclerosis, or at least encephalomyelitis, which is a mouse model for multiple sclerosis. And you know, in people, the people did report, the clinicians did report an improvement in quality of life by doing a single cycle of a week long of a fasting mimicking diet. So a mice worked very well and there was a reduction of the symptoms in the great majority of the mice and about 20% return normal. So the alkoimmunity was gone. And yeah, so we think it's very promising. And so now we have several multi center trials that are being developed. One is in Italy and involves seven hospitals and the United States. In USC in Los Angeles, there are also very interested in starting a trial. So the difference I think is the size. The original trial was only about 48 patients that completed the trial or so. And now we're looking at about 300 patients and we're looking at, we're going to be looking at plaques. And so this is a much more rigorous trial, much more ambitious trial and also be much more conclusive. If we get to the end of it and we see the difference, then I think it's always be good to do more trials. But certainly at that point this could be widely adapted.
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B
There's lots of different types of fasting mimicking coming around at the moment. There was one that's quite popular in the UK because a BBC doctor did a 5, 2 diet. So you eat normally for five days of a week.
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C
By the way, that's not a fasting mimicking diet. Of course, I know Michael Mosley very well.
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Okay.
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C
And yeah, it's not a fasting mimicking diet. It's basically saying eat a lot less or nothing for one or two days a week. But the fasting mimicking properties have to do with a very precise modification of the diet to cause changes, cellular changes that are equivalent to those caused by water only fasting.
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B
So the 5, 2 or the 16, 8 is the other one where daily?
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C
Well, 168 is a bad idea. Right? So 168 is a bad idea for multiple reasons. 168 is a bad idea because of gallstone formation. We know that if you go 16 hours of fasting every day, you have two times higher chance of needing to have your gallbladder removed. We also have multiple epidemiological studies now showing that people that skip breakfast, and Most people that do 16, 8 will skip breakfast, not only they don't live longer, but they live shorter and they have increased cardiovascular disease. So, yeah, So I think 16, 8 is a bad idea. But I think that 12 hours on, 12 hours off. So 12 and 12 of feeding and fasting, that seems to be very good and not associated with any problems. So I highly recommend that. But I highly discourage 16,8 unless it's for a brief period. And there is a real need and there is a real reason to do that, but in the long run, it's dangerous.
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B
Okay, so the key benefits come from doing perhaps four, five day fasting, mimicking. So four sets of five consecutive days per year.
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C
I mean, you know, the five, two is, that's two days a week. That could be beneficial. I don't know. I mean, Michelle Harvey and others have been looking at it and there's a number of studies that look very promising. So I think that that's interesting and that should be continued and we'll see what it shows. But basically, if you do say one day, particularly as Michael Mosley has been suggesting, and then you go back to the normal diet and do one more day, another time of the week, there's really not enough. You don't even enter really fasting response mode. You enter a little bit of it, but not very much because most of the changes occur after a couple of days. And your brain, for example, fully enters a starvation response mode after two to three days. So, yeah, this is why we're saying, particularly with neurodegenerative diseases and autoimmune disorders, you want to push the system to the level where it fully switched into a ketogenic state and it's burning fat as fuel, it's burning fatty acids and ketone bodies as fuel. Yeah, so that's what we're trying to do. But the main thing, really, the main message is let's not improvise. Because that's what everybody's trying to do. Everybody's improvising, everybody's got a different opinion. And usually those things end up in disaster. They end up in many more people hurt by this than benefited from it. So our point has been, you know, let's be considerate of the medical system. It's not there by mistake. It's been developing for hundreds of years. And, you know, there is a, there is a way, a correct way of doing it, which is you need to have animal studies, you have to have clinical studies, you have to pay attention to epidemiological studies and then you do it. Now, at the same time, you're in a patient advocacy group. I've always been unhappy with the colleagues that say, well, this gotta be tested so much that it's gonna take us 30 years to do it. So I've always said if a patient, say multiple sclerosis patient, If a multiple sclerosis patient, right now we finished this 40, for example, right? We finished a 48 patient trial. We will say, and we finished, we did the animal studies and other groups have shown very similar results. So it looks very promising. But we need the 300 people trial. And that 300 people trial we haven't even started. So it might take us six months to start it and then it takes a few two years. So the point is, let's find a compromise where we say if the patient can wait. Wait, the patient can now wait. Then you should talk to your neurologist and say, okay, there is already a trial, it's already been completed, the diet seems to be safe. Is this something that I should consider? I think it's a very good way to approach it. And the doctor may say no and the doctors may say yes. And I think that's what we've been recommending. So anyways, just a long answer about this, but I think it was very important to say no, that's fine.
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That's similar to, so the overcoming Ms. The dietary part of that is essentially no dairy, low saturated fat, no meat except fish. So there's certain sort of rules and there's a lot of evidence behind this. And I put this to my neurologist and he said, well, it's not proven to help Ms. And it probably never will be because it's quite hard to do double blind trials on diet.
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C
Yeah, I completely disagree with this. I completely disagree with this. We're doing that. We've been doing it for years. We're doing it for cancer, for Alzheimer's. So I think that you're never going to get the perfect trial, no matter what you do, even with drugs. And if you show that a particular diet or fasting, mimicking diet works in a randomized placebo controlled trial, even though the placebo, some people might understand that it is, may not be the fasting diet or whatever, I think that that's very important now is a completely conclusive no. But if you do it two or three times and let's say the diet you just described and you randomize and you show over and over that that results in a better outcome, better slower progression, et cetera, et cetera. I think it is perfectly fine to say, hey, this is a recommend. If we could do a placebo control, double blind study, it is possible that it would no longer be statistically significant. But you do what you can, and if that shows efficacy or if that shows that the group designed it is doing better, then you say, hey, try to do this. And this is associated with improved symptoms. And then, you know, let's see what we're able to do. And now people are not forced to do it. It's up to them. You can say there was not a double blinded study, but, you know, this is exactly the kind of arguments I get into it that seem to be more in favor of the medical establishment than in favor of the patient.
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Yeah. To be fair, my neurologist did say at the end, he said, it's unlikely to be proven. However, there's a good chance that it will be beneficial for your multiple sclerosis and also it will reduce cardiovascular risks. It's probably likely to reduce cancer risks. And there's a lot of probably things. And on the downside, he said, it won't do you any harm, but you might miss cheese. So that was. He basically said it shouldn't do you any harm.
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C
Again, I think that, you know, people are not stupid. You can explain to them that it was not double blinded, that there is a chance that the explanation may not be the change in the diet. And as long as that is explained, it is their choice. Even if it didn't help with cardiovascular disease and et cetera, et cetera, even if it was just something that, let's say that you remove carrots from the diet. I'm just joking now. And that showed to be beneficial to Ms. Patients in multiple trials that are randomized. That would be already something that the doctors could discuss with the patients saying, you know, this is what these trials are showing. Kind of like happened for caffeine and Parkinson's disease. Right. Multiple studies showing that the association between coffee use and Parkinson. Now, yeah, of course, eventually it might turn out that it wasn't really the coffee, it wasn't really the caffeine, it was something else. But. But I think that it's appropriate to explain it to the patient and to say, since it is not a new drug, since the doctor is allowed to say, drink more coffee or less coffee, to discuss it in a very balanced way and inform the patient about what it is that is being found now Most doctors are not trained in nutrition and they don't feel comfortable talking about it. And this is the real reason why lots of the times they don't want to get into it. Not so much because they don't think it could be beneficial, but because they've never been trained on it. And it is a territory that is very tricky for them. And I think it'd be better for a doctor that hasn't been trained on nutrition to say, I just don't know, maybe it's perfectly fine to say, I don't know, maybe there's somebody out there that knows better, that can read the papers and understand it better. But I don't know. Yeah, that would be, I think, a much better way to go for medical doctors that comment on effects of nutrition on diseases.
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B
And so in between, if I'm doing four five day fasts every year, in between those fasts, can I eat anything I want or should I be conscious of what I'm eating between fasts?
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C
Well, I mean, obviously you need to be conscious of what you're eating, but obviously also lots of people are not going to be converted. And so, you know, most people, you can tell them whatever you want about the daily diet that is ideal and they're going to continue to do whatever it is that they do. I mean, in the United States, after the smoking was clearly shown to be responsible for many different cancers, only about half of the smokers quit smoking. And there was as clear message as it gets, this kills you. And yet half of the people kept smoking. So I would say that there's a higher percentage of people than 50% that are not willing to change their diet. And for those certainly think the fasting mimicking diets are a very good idea. But of course for those that can change their diet, I wrote my book the Longevity Diet and all the profits go to research by the way, and charity. And in the book I describe the ideal everyday diet and the use of the fasting making diet. And I also should be done on a need to do it basis. So the people shouldn't just say, oh, it's good, it's been shown clinically to be good. So I'm just going to do it every 15 days. No, I think it should be done only three or four times a year on average by most people. And you know, if somebody has multiple sclerosis, we cannot certainly recommend the fasting for multiple sclerosis, but a neurologist can say, hey, let me look at the data, let me look at the mouse data, let Me look at the clinical trial and let me look at the safety data of the fasting making diet which I think now has been done by over 150,000 people and make a decision, maybe give it a shot, see what happens. And that could be the decision of the neurologist, but only the neurologist will be able to make that decision.
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B
So your long activity diet, you mentioned the book, does that cover really all of the steps that someone needs to go through, how to go about fasting, what they should eat between fasts and so on?
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C
Yeah, I mean it covers all the steps. It also basically says, you know, people should fast with with the clinically proven fasting mimicking diets. And there is one that is available in the uk, it's called Prolon. You know again I donate everything to charity and so I don't make a penny out of this. But I think that as I was mentioning earlier, it is important that we don't forget. I'll give you an example. There was a multiple sclerosis patient in Italy. The doctor, the Italian doctor put her, at least from what newspapers were describing, a three week fasting water only fasting diet. She end up dying and you know, nobody knows why she died. But certainly the report talk about bleeding, internal bleeding and yeah, so then that's my point about improvising. Even if the book is there and reading from a book, I think it's for everyday diet, it's perfectly fine, there is no danger. But when you get to fasting making diets, I think it's better to go with the kit. It's relatively inexpensive if somebody's going to do it a few times a year. So yeah, much better to go that way. And I say that in the book. So I tell people. You do. I mean the book certainly does give you enough information at least for a doctor to come up with the fasting making diet. But we strongly, strongly discourage it also because is, you know, the actual what's been tested clinically is much more complex than what I describe in the book. So I think that yeah, people should do their own daily diet but when it comes to the fasting making diet, they should probably go with the kit.
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B
So what is the prolonged diet kit?
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C
Yeah, the prolong is a five day fasting mixing diet. That's the one that has been tested in multiple clinical trials and the safety record is extremely good. We recently collected data from 400 doctors representing 4,000 patients. And, and soon we're going to report on all the side effects and all the problems that we're seeing in this population and it looks very good. So they're really only minor problems. And that's really what you want. You want to first do no harm and make sure that the diet is safe. And hopefully, I think now there are going to be 42 clinical trials that are either running or will start soon enough. And you know, so we, to be sure, and each trial is going to test a different type of fasting making diet. For example, the one for multiple sclerosis lasts seven days and it's got a very particular composition. And yeah, so I think that. Eventually people will have to if it works.
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B
Okay, so what sort of things would I, if I buy a prolonged diet kit, what sort of things would I be eating and drinking?
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Yeah, the prolonged kit has, it's all vegan now. I think it's gluten free. It's lots of vegetable soups, lots of nuts bars that contain almond and hazelnuts, et cetera, et cetera and chips and certain other supplements like algal oil. And yeah, so that's the composition of it. We try to make it fairly straightforward, but in fact it is a fasting mimicking diet. So it does cause the changes that you normally see when you do water only fasting.
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B
But there's also some beneficial nutrients in there as well.
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C
There is also beneficial nutrients. So for example, we just published a paper on inflammatory bowel disease, another autoimmune disorder. And we shown that had the inflammatory component, human inflammatory component, but most of the study was in mice. And it showed that if you did, when the mice were put on a water only fasting, the gut became more leaky. And lots of the effects that we saw, the beneficial effects that we saw with the fasting Mickey diet, we did not see with the water only fasting. And so we concluded that most likely the prebiotic content of the vegetables in the fasting Mickey diet, where we knew that there was a major reprogramming
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of
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the microbial flora in the gut. And that was very important for the effects that we saw on this autoimmunity. And so our conclusion was that the type of not just the fasting, but the type of ingredients that are used, which by the way come from the blue zones. Right. So there was the reasoning, let's just combine fasting with the diets that everybody agrees that come on denominator that everybody agrees this is extremely healthy for you. And yeah, so that was the reasoning and it paid off because I think that that help additionally, in addition to the fasting component, helped with the dampening of the inflammation of the autoimmunity list in the mice, but also in people. So we have multiple papers now showing in humans clear decrease in C. Reactive protein and systemic inflammation and also leukocytosis, the white blood cells going up in response to inflammation. And in people they are reduced by the cycles of the fasting diet. So certainly even Prolon, which is not specifically designed for multiple sclerosis or autoimmunities, is already showing effects on systemic inflammation and very good and fairly potent ones. Yeah, now we have to demonstrate or at least test whether this could work in reducing autoimmunity in various diseases.
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B
So in the future maybe there'll be specific prolon diets for specific conditions.
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C
It wouldn't be a Prolon diet. Prolon is just a. Stands for prolongevity is really about, you know, going after fundamental changes in the body to keep you as healthy as possible. So prolonged is really going after the aging process. But the fasting making diets that you know now are being developed for autoimmunities for Alzheimer's, for cardiovascular disease, for cancer, etc. Etc. Yeah, each one is different. Some of them last four days, a very low calorie, some of them last seven days, higher calories, some of them last five days and you know, even higher calories. Yeah. So in each, for each disease and use we're. We are developing or we have developed a different fasting mimicking diet that addresses the. What we know about that particular disease.
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B
And is that something we'd like to hear about soon?
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C
Yes, I think very soon. Hopefully the plan is to begin to, to have fasting mimicking diets that are already addressing not the disease because the regulatory agencies do not allow that until there is a. Let's say the FDA does not allow anyone to say this can prevent or treat a disease until you have a formal process with the fda. And I'm assuming the UK is similar to. But what we are developing is a series of fasting making diet that address specific problems like inflammation, for example. And yeah, so those. So the problem at the core of the disease before the disease is there. So those I think are going to be available very soon and hopefully in the next six months or so. But yeah, for the ones that are specifically proven to help treat diseases, then we have to wait for the results of these larger randomized clinical trials.
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B
Okay, that's been very interesting stuff. So as a starting point of people, so people who are following oms, they're probably already not eating meat except seafood. They will have cut out dairy they will have cut out saturated fats. They'll still have things like olive oil, but reducing saturated fat substantially and removing fried food from their diet. So that's, that's where most people following oms would be. But for those people, it would be worthwhile. They're initially having a look at the longitudinal diet book, considering Prolon and maybe speaking to their doctors as well. Is that the best advice?
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C
Yes, I think so. So read the book and get a sense for, you know, why different foods affect the aging process, affect inflammation, etc. These are eaten every day and they get a sense for, you know, what happens when you do a periodic fasting making diet like Prolon. And then, then, yes, certainly talk to your neurologist. If you can now wait for the clinical trials to be over, then that would be a good discussion to have. Is it safe enough that I give it a shot and see what happens to me? And then in combination with the standard of care, by the way, so not removing any standard of care, so any standard drugs that are already being given to the patient. So the trial, by the way, we're doing it together with the drugs. So this is not replacing drugs, it's combining with drugs both in cancer and in multiple sclerosis. We're doing it with drugs. But it doesn't mean eventually we might not be able to show that even without drugs this is effective, at least in the prevention or maybe the recurrence of the disease, et cetera, et cetera. So yeah, so, but still lots of, lots of trials going on and we just have to wait and see. But the good news is a lot that people can do and patients can do right now.
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B
Okay, that's fantastic. Thank you very much for joining us for the podcast.
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C
You're very welcome.
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A
With that, I would like to thank you all for listening to this episode of Living well with Ms. Remember that there is a wealth of information@overcoming overcomingms.org including show notes and an archive of all Living well with Ms. Episodes. Once again, that's overcomingms.org there you can also find OMS friendly recipes and exercise tips. Connect with other OMS's in your local area through our OMS Circles program and learn about the latest research going on in the Ms. World generally and related to OMS specifically. I encourage you to register on the site and stay informed about the latest news and updates. I also encourage you to subscribe to this podcast so you never miss an episode. And please feel free to share it with others who might find it of value. Let us know what you think about the podcast by leaving a review. And if you have ideas for future episodes, we'd love to hear from you. So please contact us via our website, overcoming ms.org thanks again for listening and for joining me on this journey to overcoming Ms. And living well with multiple sclerosis. I'm Geoff Alex and I'll see you next time.