← The Rich Roll Podcast
The Rich Roll Podcast
Fasting Compilation: Leading Experts On Water-Only Fasts, Fasting Mimicking Diets & The Optimal Fasting Window For Longevity
01:08:45
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- [00:03]
Dr. Satchin Panda
Eat for 11 hours or 12 and fast for 13 hours or 12.
- [00:07]
Dr. Alan Goldhamer
The fact is it can be done safely, it can be done effectively, and when it's needed, there's nothing else that does exactly what water only fasting does.
- [00:15]
Dr. Michael Greger
Some studies show it's great for you, other studies show it's terrible for you, has all these negative metabolic consequences.
- [00:21]
Dr. Alan Goldhamer
People are oftentimes medicated for their diet and then after we're done, most of the time there's no need for medication.
- [00:28]
Dr. Michael Greger
Intermittent fasting. Water only fasting, you know, 5, 2, 25, 25.5 time restricted feeding. What is going on here?
- [00:46]
Rich Roll
Fasting has become quite the popular thing lately. But what is fasting? It can mean many different things. There's intermittent fasting. There is time restricted eating, there is alternate day fasting, twice weekly fasting. There's the fasting min mimicking diet, minimally supplemented fasting. So what is fasting? What are we talking about when we're discussing this topic? We're going to get right into it in a sec. But first, Today's episode is brought to you by Roka. You know, it's funny, we don't often think of eyewear as performance gear until it starts to get in the way. And if you're like me, somebody who has contended with eyesight impairment my entire life, it's a very real thing without a real solution for athletes, I cannot tell you how many times I've been mid run, constantly shoving my glasses back up my nose, tripping on roots and rocks because I couldn't see them, or my glasses had fogged up. Or what about out on the bike where the treachery is obviously far more intense. Well, this is why Roka has been a godsend for me, approaching prescription eyewear from a performance perspective first, but not at the cost of fashion. I should say helping not only people like me, but all kinds of athletes, including Tour de France cyclists and ironman champions with everyday frames disappear. Their secret is their proprietary gecko technology. Patented nose and temple pads that grip even more securely when you sweat. No slipping, no distractions. And they're insanely lightweight. Most frames weigh less than a pencil. Super light even with prescription lenses. Beyond the function, the craftsmanship is next level. Razor sharp optics, durable construction, and a design that actually is beautiful and keeps up with you. So put them on, feel the difference and wear without limits. Unlock 20% off your order with the code rich roll@roka.com that's R O K A dot com. I got news for you. The holidays are coming and with them, all these questions kind of start swirling in our minds about what we're going to give people that we care about. And honestly, it's really hard because most gifts just end up forgotten somewhere. But the gifts that actually do get used are ones that make someone want to use them. And on does exactly that with their incredible line of high quality running and hiking gear. Shoes like the Cloud Ultra for trails, the Cloud Runner 2 for roads, the Club Hoodie for recovery days, hiking stuff for exploring nature in the mountains, and even accessories like performance socks, caps, hydration packs, backpacks, and travel bags that work as amazing stocking stuffers. So here's the thing. The real gift isn't the gear. It's what becomes possible when the gear gets out of the way. Those early morning runs where your mind just clears that trail you've been meaning to hike, that runner's high, or that silence at the summit when everything just clicks. Movement changes things. And sometimes all someone needs is the right gear to make movement more fun, more stylish and more accessible. So move yourself on over to on.com richroll to explore my picks for holiday gifts. For over four decades, Dr. Goldhamer has been at the forefront of using fasting as a powerful tool for healing and longevity, and our conversation dove deep into the science behind fasting and its potential to revolutionize our approach to chronic disease.
- [04:33]
Dr. Alan Goldhamer
Well, the type of fasting that we do is the complete abstinence of all substances except water in an environment of complete rest. So it's therapeutic, medically supervised water only fasting. There's a lot of fasting mimicking programs out there, and they all have potential benefits and uses. Some of them have many advantages over the prolonged water only fasting in that they don't require the level of supervision, they don't require aggressive withdrawal of medications, they don't have the risk profile that medically supervised water only fasting could have if it's not done properly. So particularly, Valter Longo has popularized a program where it's, you know, limited nutrition intake. It can be done by most people at home. It can be very helpful to the degree that it's used. But it's not long term water only fasting. And as beneficial as these intermittent fasting programs can be in helping with weight loss and helping people make behavioral changes, they're not necessarily the same thing you'll see in patients, for example, that have specific illnesses and need to reverse those diseases that you would see with long term water only fasting.
- [05:41]
Rich Roll
So is that a way of saying that in your experience, prolonged water only fasting is a superior protocol when it comes to helping people with acute or chronic lifestyle diseases. Like why is it that you've chosen to focus on this rather than these other protocols that are seeming to be much more a part of the mainstream discourse around fasting?
- [06:07]
Dr. Alan Goldhamer
Well, I think that when you can accomplish your goals with intermittent fasting or these other programs, that has advantages. As I said, safer profile, simple doesn't require going to a place and requiring medical supervision. But many conditions won't respond to those protocols. And when they don't respond, that's oftentimes when we see people, when they've done their best, they've made diet and lifestyle changes, they've done what they can do to resolve the problem, but the blood pressure still persists. I know. My colleague John McDougall calls us the punishment that if he has a patient, for example, that doesn't resolve their hypertension, which most do, but for those that.
- [06:45]
Rich Roll
Don'T, he'll, you get the hard cases.
- [06:48]
Dr. Alan Goldhamer
He'Ll send us over with apologies.
- [06:50]
Rich Roll
Yeah, yeah, yeah, yeah.
- [06:52]
Dr. Alan Goldhamer
Because what we do is a more intense process. It's not something that, you know, you'd necessarily look forward to if you're ill. But the fact is it can be done safely, it can be done effectively, and when it's needed, there's nothing else that does exactly what water only fasting does.
- [07:07]
Rich Roll
Right. So at true north, the typical hard case that finds his or her way to your doorstep is somebody that you're going to supervise over a period of how long as they undergo this protocol.
- [07:23]
Dr. Alan Goldhamer
Fasting ranges from five to 40 days on water only, and there's a period of half the length of the fast recovery in a supervised setting. So a typical patient might fast for two or three weeks, they might be with us a month. And those patients will oftentimes come in with specific complaints, high blood pressure, type 2 diabetes, autoimmune diseases, or some forms of cancer, particularly things like lymphoma.
- [07:43]
Rich Roll
Right. And how do you decide then how long this fasting protocol is going to be on a case by case basis? Like who, who are the people that, that you recommend a 40 day fast versus, you know, just a handful of days.
- [07:56]
Dr. Alan Goldhamer
Right. So you don't know with certainty before the fast exactly how the fast is going to go. And so what we do is we try to estimate long and then, you know, if we can get it done quicker, that's great. I've had enough experience and fasted enough people. I can usually by looking at their medical History reviewing their lab get a pretty good idea of what that range is likely to be. But there are patients that we expect to go a long time, but they get well really quickly and so we just don't need to do it. Other people we're hoping are going to be a shorter fast, but it ends up being it, it takes longer to get the job done. In some cases it's pretty simple in the sense that like for example, if you have high blood pressure, we want to fast you till you have normal blood pressure so that when you eat well, you don't have to be dealing with medications and the risk profile. And we know based on how high your blood pressure is, what your medical history is in terms of kidney disease and other things, how long that's likely to take.
- [08:48]
Rich Roll
Right.
- [08:48]
Dr. Alan Goldhamer
We can do the same thing with type 2 diabetics. We can look at your hemoglobin A1C, get an idea of how much insulin resistance there is. And a big factor is how much extra weight and extra visceral fat do you have. Because it's the obesity, the extra weight and the visceral fat that's responsible for producing the inflammation that causes these problems. And so we want to bring people as close as possible down to their optimum weight. Now, in some cases people are not overweight, but they're over fat. And so those individuals, you have to stay within the reserves. Other people might have plenty of fat reserves, but they may not have electrolyte reserves or they may have other issues that become eliminating factor. And that's why we're carefully monitoring patients, examining them twice a day, monitoring their lab, their urinalysis, the variables that we can monitor so that we can get a good indication. And we know we do that safely because we've published a safety study where we have actually shown that if you follow this protocol, you know, everybody that walks in gets to walk out.
- [09:49]
Rich Roll
Right. What do we know and not know about the causal or highly correlative relationship between visceral fat and the cascade of chronic lifestyle diseases that seem to proliferate across the world these days?
- [10:05]
Dr. Alan Goldhamer
You know, everybody's worried about obesity and being fat, and they think of it often as a cosmetic issue. And it's far from just a cosmetic issue. On your body there's a type of fat called visceral fat. It particularly accumulates around the abdomen and the organs that has hyper metabolic effects. It produces inflammatory products, IL6 TNL alpha, acute phase reactive proteins. And these inflammatory components are thought to be responsible for the heart disease, the diabetes, the Autoimmune disease and some forms of cancer. So getting rid of. You can think of visceral fat like a tumor. So if you had a multi pound tumor in your body, you would be appropriately alarmed because of its effects. And we go to inordinate effects to get rid of those types of tumors. And interestingly enough, let's say you went on a fast and lost 10% of your body weight. You might think, Well, I lose 10% of my visceral fat. But that's not the case.
- [11:02]
Rich Roll
You may be losing subcutaneous fat or muscle mass.
- [11:07]
Dr. Alan Goldhamer
You would lose all those things. You'd lose muscle fiber, glycogen, water and fat when you fast. And when you come off the fast, you regain water, fiber, glycogen and protein, but not fat. When you follow a whole plant food SOS free protocol, you'll continue to lose fat. And what's interesting is you don't just lose equal amounts of fat and visceral fat. You will lose disproportionate preferential mobilization of visceral fat. For example, we used a DEXA scanner to do some studies. Typical male fast for two weeks loses 20% of their total fat, but 55% of their visceral fat. So the visceral fat is being mobilized much like tumors are. In other words, if you lose 10% of your body weight, you don't lose 10% of your breast tumor. You might lose 50% or all the breast tumor. So how does the body know that it wants to get rid of the breast tumor versus anything else? Because there is mechanisms in the body that preferentially mobilize materials in inverse proportion to their need. And visceral fat shouldn't be there. And as a consequence, the body appears to go in and deal with that first, which is really great because it's one of the great benefits of fasting is the preferential mobilization of visceral fat.
- [12:14]
Rich Roll
So people going in might think, I'm here to lose my subcutaneous fat. But the sort of good news and bad news is maybe not more of the visceral fat, but that's actually in your best interest. And I suppose there are people who are relatively lean who nonetheless and unsuspecting to themselves, also have high stores of visceral fat. Is a DEXA scan the only or the best way to figure out whether visceral fat is a problem for you if you're not kind of overtly obese?
- [12:45]
Dr. Alan Goldhamer
Well, a DEXA scan with specific software that's designed to measure body fat, which is what we used in our studies will do that. I don't know that it's necessary for people to do that. Because what's great is if you adopt a whole plant food SOS free diet, engage in exercise, get enough sleep, your body's gonna take you down to optimum weight. And even if you're at optimum weight, it's gonna start the conversion process of mobilizing fat and replacing it with muscle.
- [13:13]
Rich Roll
Next we have Dr. Valter Longo. Valter is an expert in gerontology and biological science as well as the author of an extraordinary book called the Longevity Diet that he then combines with this periodic fasting protocol that he calls the fasting mimicking diet.
- [13:32]
Dr. Valter Longo
Yeah, so I would say that at.
- [13:34]
Dr. Satchin Panda
Least in my opinion now the more clear evidence for fasting is in the time restricted eating domain. You know, so the daily fasting, and I think we discussed it before, but I stick with the 12 hours of fasting and 12 hours of feeding per day. And there's new data indicating that in fact maybe the problem of skipping breakfast and doing 16 hours of fasting and skipping breakfast may not be about skipping breakfast, but maybe about the 16 hours. Right. So we don't know, but certainly that's a possibility. And So I think 12 hours is a much safer way to go. And not as effective, of course, as 16 hours of fasting every day, but still effective. And so I think Satchin Panda and I will agree on the, say 11 to 12 hours daily time restricted period. So, you know, eat for 11 hours or 12 and fast for 13 hours or 12.
- [14:34]
Rich Roll
My understanding, correct me if I'm wrong, is that we still need more research to really drill down on the efficacy of these specific windows. But as of right now, it's sort of a safe Bet like this 12 on, 12 off seems to be the one that kind of works for all purposes. Whereas others may have benefits or deleterious impacts that we're still trying to better understand. But as of right now, this seems to be the window that is the safest and most predictable in terms of outcomes.
- [15:07]
Dr. Valter Longo
Yeah, the easiest, safest.
- [15:10]
Dr. Satchin Panda
No physician will ever argue that that's a bad idea. And really not a single paper saying that this is not safe or that is not effective or at least partially effective in preventing and treating a number of diseases.
- [15:28]
Dr. Valter Longo
So yeah, so I think it's a.
- [15:30]
Dr. Satchin Panda
Good compromise and I think something that everybody should do that's also consistent not just with the epidemiological data, the clinical trials, also consistent with what Centenari I've been doing for 100 years or more. So I think that the 12 hours is one.
- [15:49]
Dr. Valter Longo
And then I've always argued against the.
- [15:51]
Dr. Satchin Panda
Alternate day fasting, the 5, 2. And not because they're not effective, but again, they're very demanding. So not eating every other day, it's going to be something that very few people will ever be able to do. And then you get into again the territory of are there side effects caused by not eating every other day or not eating for two days a week? So I would say in general, I just don't see a big future, at least not for the general population. Some people can do it, we'll see about the efficacy and the safety. But I think that in general I will say that at least I'm not enthusiastic about either alternate day fasting or two days a week of fasting. Then of course I'm enthusiastic about the fasting mimicking diet. So in addition to the time we're still eating daily, then the cycles of the fasting, baking diet. And so this is a plant based, low calorie, low sugar, low protein, high plant based fats. The program that we've been testing, we and many universities have asked to test it, have been using it for all kinds of diseases from diabetes, prediabetes, cancer, Alzheimer's, autoimmunities, et cetera, et cetera.
- [17:12]
Rich Roll
For people that didn't listen to our previous episode, the fasting mimicking diet is essentially a way of eating a calorie restricted diet with a very specific kind of menu that physiologically mimics what the body would experience had it been just fasting. Correct? Did I say that accurately?
- [17:33]
Dr. Valter Longo
Yeah, that's accurate.
- [17:34]
Dr. Satchin Panda
So then there was first developed in mice. And so we used certain markers to make sure that there is a fasting response equivalent to that of water only fasting. And then the same was done in people. And again, we're looking for certain factors in the blood that would show that in fact that person has responded as it would if it was not eating at all.
- [17:59]
Rich Roll
Before we move on from time restricted eating in this 12 hour window, you know, to restrict your eating to a 12 hour period isn't really fasting at all. It's sort of like if you get up at 8 in the morning and you go to bed at 9 or 10 at night, like there's literally only an hour or two in which you're not meant to be eating. Right?
- [18:16]
Dr. Valter Longo
Yeah. And that's very important. Right. Because if you look at Europe, 60%.
- [18:20]
Dr. Satchin Panda
Of people are overweight or obese and the United States is 75%. So we're in a world, I think, and this is not just Europe, Europe and the US it's the whole world with few exceptions. So it's a very undisciplined world. And so that's very important to also say not just what would be most effective, but what will be easiest for people, realistic for people. And so I think that 12 hours, a lot of people say that's not fasting at all. Well, it is fasting because now on average, and this is work by Panda, people were eating for about 15 hours a day.
- [18:53]
Dr. Valter Longo
So. Yeah. So people all over the world like to eat for long periods every day.
- [18:58]
Dr. Satchin Panda
Yeah. So then somebody may start at 6:00am and end at 11:30pm Right. And so that, you know, the three, four, five hour restriction can make a big difference. It can make a big difference not just in reducing calories because you have less opportunities, but also in metabolic switches. They may make energy expenditure higher, let's say. Right. And also help people sleep. So those are some of the things that are emerging in mouse and human studies.
- [19:29]
Rich Roll
If people are eating on average 15 hours a day, is there evidence or is anybody kind of looking at the co founding factor of the impingement on sleep that would be impacting deleterious health outcomes? Because if you're eating for that many hours, you're probably staying up late and not getting the eight hours that you should be getting or seven hours. Yeah.
- [19:51]
Dr. Satchin Panda
So Satchin Panda published on that and showed that in fact when they reduced the eating window from 14 hours and above, if I remember correctly, to less than 11 hours, there was an improvement in sleeping quality. So yes, so that seems to be the case. And I've always been also preaching not eating for the last three hours before you go to sleep. So that's consistent.
- [20:15]
Rich Roll
That's still the hardest thing for me. It's really difficult for me to go to sleep when I don't have a full stomach or am feeling hungry at night. It's just a mountain I still have not mastered. Yeah.
- [20:28]
Dr. Satchin Panda
And I think it's important. The foundation clinics, everybody's got a different method. Right. So I think it's important. So for example, it's better to eat a light dinner, but I have a very big dinner. Right. So because I would be unhappy having a big lunch and a small dinner.
- [20:47]
Dr. Valter Longo
So to me it works for me it works.
- [20:49]
Dr. Satchin Panda
And so I think it's okay. I sleep well or pretty well unless I'm traveling like I just did. But yeah, if you eat late and that's a Big deal to someone. But that doesn't really affect you negatively. I don't think there is too much data suggesting that you're going to live 10 years shorter because of that.
- [21:11]
Dr. Valter Longo
Right.
- [21:11]
Dr. Satchin Panda
So if you're sleeping well, that's probably okay. And okay compromise.
- [21:15]
Rich Roll
I do notice though, if I overdo it in terms of volume and hour of the evening, I'll generally wake up around 2 or 3 in the morning. And when I was wearing a CGM, I would notice these spikes and these drops that would occur, you know, over the course of the evening that don't happen when I eat earlier or like reduce the volume.
- [21:35]
Dr. Satchin Panda
Right. And as you get older they might get worse.
- [21:38]
Dr. Alan Goldhamer
Right.
- [21:39]
Dr. Satchin Panda
So then yes, the recommendation stays eat earlier and eat within 12 hours. And then, you know, if somebody's not affected by eating later, it's probably okay until that becomes a problem. Right. So I think that's a good way to look at it. And of course you have to know that it's a problem. But you know, not sleeping well, most people will not even without a bracelet or you'll know.
- [22:06]
Rich Roll
Yeah, you don't need any kind of like data feedback to know whether you're sleeping well or not, honestly. Who's Next? My friend Dr. Michael Greger is next. That's who. Dr. Greger. For those that don't know, he's the man behind the Nutrition Facts website, which is an incredibly robust resource for searching for the latest, most up to date information on a vast spectrum of medical, nutritional and lifestyle topics. He is an incredible communicator of nutritional information. I love him to death. So here is a clip between me and Dr. Michael Greger.
- [22:45]
Dr. Michael Greger
In the morning, your body has to make glycogen stores for the rest of the day. And instead of just using the energy, if you take the little chains of sugars and starches and make them the glycogen in your muscles and liver, that's an energy intensive process and then you break it back down to be used later on. And so the fact that you're using energy to basically get the energy right back is kind of energy intensive process. That's one of the small reasons why eating in the morning, when your body knows it's got a whole day ahead of it, where you have that glycogen building signal earlier in the day, but a lot of the chronobiology stuff, we just don't know in terms of what exactly is going on. But everything from body temperature to testosterone to cortisol levels, everything goes on this wild daily cycle. And then there's seasonal cycles. Weight loss, the weight you put on in the kind of winter months for the holidays may have a roll upon.
- [23:50]
Rich Roll
How far the earth is from the sun.
- [23:52]
Dr. Michael Greger
That's crazy, right? The rotation. So that was, I mean, that's. That just blew me away. So you can put people on 2,000 calories, the exact same 2,000 calories as one meal at breakfast or one meal at supper. The army did this, and the evening group, same calories, gains weight and the breakfast group loses weight. Such a trap. It's crazy. And so then that really opened my eyes, like, okay, well now anything's possible. And so then really kind of dug deep and came up just what are the criteria for optimum weight loss? Like, what would a. What would the optimal weight loss diet look like from kind of from the ground up? Just because originally, how not to Diet, it was gonna be a chapter on each of the latest diet trends and just, you know, going through what's the science behind each. But I realized the book's gonna be out of date before it even comes out. You know, I'm part of the U.S. news & World Report, you know, diet panel, you know, and so we get dozens of new diets I've never heard about every year that we have to go through. And I just realized, well, wait a second, that's not the right. It's like whack a mole. So instead of said, let's just here's the criteria against which you can look at any future diet and see kind of where it would fall along this range. And then the second half of the book is, regardless of what you eat, there are kind of tips and tricks that can. And tweaks that can get you to accelerate, right?
- [25:13]
Rich Roll
Like the water thing and focusing on nutritional density and caloric dilution, things like that.
- [25:18]
Dr. Michael Greger
So, yeah, nutritional density, that's really the first part. I mean, that's part of a good weight loss diet. It's a weight loss techniques. But like the water, right? Water preloading. So if you drink two cups of water before eating a Whopper, you'll gain less weight then. I mean, so, I mean, so it's regardless of what you eat, that's the whole second half. And the hope is people won't just kind of jump to the second half, you know, actually do a safe, sustainable, nutritious, healthy diet.
- [25:40]
Rich Roll
But in terms of the foods to eat, though, I mean, it harkens back to the previous book and it kind of orients around the daily doses.
- [25:49]
Dr. Michael Greger
It ended up. I mean, it ended up that way Based on those criteria, like we want to be fiber rich and you know, low and added sugars, low in added fat and you know, you know, water rich and all these the same, you know, vegetables and kind of on down the list. And that was the, that was the, the, you know, the criticism we got from the Daily Diet, the daily dozen app that we released. It's, you know, I had a million downloads and there's two camps of criticism. One is, oh my God, it's too much food. I can't eat right it all. And which gets too much food, too much, oh my God, I can't go.
- [26:22]
Rich Roll
Through all this stuff, make sure you get all of that.
- [26:24]
Dr. Michael Greger
Well, I mean that. But look, it's aspirational. Like, you know, it's just. And you can, you know, make it game and see how many you can get. If you don't do good one day, you can try better the next day. And that was actually this, I mean, I'm hoping to, you know, after you checked off those boxes, only so much room for pepperoni pizza at the end of the day. I mean, it's, it's this kind of, it's this kind of eat more approach, but it's really hoping to kind of push out some of the less healthy options. But the other group of criticisms came in, it says not enough calories. It's like, look, I'm training. There's no way I'm getting enough calories eating this kind of stuff. I was like, well, look, this is the minimum you can eat more food. I'm not saying this is all you can eat. I just want people to hit this. But then I realized, well, wait a second. Oh, too much food, too few calories. That sounds like a good weight loss diet. And the fact that these are some of the healthiest foods on the planet is a good bonus as well.
- [27:12]
Rich Roll
Right? Did you come across some interesting research on intermittent fasting? Because that seems to be the thing that a lot of people are talking about and thinking about and practicing right now. And I've had a couple people on the podcast speak to it.
- [27:25]
Dr. Michael Greger
That's the biggest chapter is the fasting chapter. So much information. I remember looking to fasting because it's been a common interest for years. People ask me about it and anytime I only want to say I don't know once ever, even if it's the most esoteric question in the world, I want it. The next time someone asks me that, I'm going to know an answer to it. And so people can ask me about fasting and there just was no data. And so that's why if there's a condition or food that you can't find on nutritionfacts.org, the number one reason is probably because there's just no good data out there. I mean it's not like I'm trying to ignore it, it's just like we don't know. But just in the last few years there's been explosion of research into intermittent fasting, water only fasting, 5, 250, restrictive feeding, all these. And so tremendous literature. And what's interesting about the intermittent fasting literature. Well, so in terms of intermittent fasting, no benefit in terms of compliance or lean mass conservation or weight loss compared to continuous caloric restriction. And the longest, largest studies to date shows increasing cholesterol for people that have the same caloric restriction doing alternate day modified fasting. And so I would encourage people not to do it or at least get their cholesterol checked. But the time restricted feeding where you try to narrow your eating window to 12 hours or less and so you're fasting at least half the day.
- [28:56]
Dr. Alan Goldhamer
This.
- [28:56]
Dr. Michael Greger
Was one of the research areas where there was diametrically opposed. Some studies show it's great for you, other studies show it's terrible for you. It has all these negative metabolic consequences. And so it was my job to like what is going on here? And it turns out it's timing early versus late.
- [29:16]
Rich Roll
So when do you break the fast?
- [29:18]
Dr. Michael Greger
So your window. Right. So if your window is late, you get the negative biological consequences of eating at night and shifting your calories towards later in the day. And so people that skip breakfast had these negative metabolic effects of time restricted feeding. Whereas people that did early time restricted feeding not only got the chrono biological benefits of shifting their calories towards the beginning of the day, they also got the time restricted feeding benefits. And so that is really the, that, that, that's, that's one of the things in the book that actually changed the way my family eats.
- [29:52]
Rich Roll
Yeah, you just rocked me with that. Because I do it where I eat at night. If you're going to, but I don't eat during the day.
- [29:57]
Dr. Michael Greger
If you miss any meal, it should be, it should be supper, not breakfast.
- [30:01]
Rich Roll
Right. Breakfast is called break fast for a reason.
- [30:04]
Dr. Michael Greger
Yeah, I mean that.
- [30:06]
Rich Roll
Wow.
- [30:06]
Dr. Michael Greger
Yeah. I mean, and that actually may be one of the reasons that the Seven Day Adventist vegetarians live the longest living population in the world. Right. Okinawa, Japanese were the number two and now they're eating kfc. There's really only one Blue zone that continues to this day. It's in Loma Linda, California. These Seven Day Adventist vegetarians, longest living formally stopped study population in the world. But one of the reasons may be because they practice this early time restricted feeding, often skipping supper. The teachings of the church are like two meals a day and you know, make lunch the biggest meal of the day. Hasn't been put to the test, but given all this short term data.
- [30:44]
Rich Roll
Yeah, that's super interesting. That may be.
- [30:46]
Dr. Michael Greger
Oh no, that'll be the next book, how not to Age. I'll look deep into that.
- [30:54]
Rich Roll
Good lord. The holiday season. I can't believe it. But once again, it's here. A time of year that I tend to find overwhelming because I'm a creature of routines and I don't like my routines. Means being disrupted. But that's just the deal with holidays, all the travel, the family gatherings, eating patterns that go sideways. I think it's okay to admit that it can all be a little bit too much at times. To combat the chaos, I try to double down on portable routines that work and don't demand that much time. And at the top of that list is AG1 Next Gen, who's sponsoring this episode. It is a daily health drink that combines your multivitamin, pre and probiotic, superfoods and antioxidants into one simple green scoop that's clinically shown to support gut health and fill in common nutrient gaps. In order to stick, routines need to be simple. So I keep it that way. Just cold water, a scoop of AG1. Done. One solid health decision. Just locked in before the day gets away from me. 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Okay, once again, here's me and Alan Goldhammer. If somebody has anorexia nervosa or if somebody is, you know, on the other side of chemotherapy, where they're maintaining their weight is an issue, I would suspect that that's probably not a great candidate. What about somebody who's coming in and they're on a battery of medications? You would have to wean them off of that, I would presume on some level before they could undergo this.
- [36:44]
Dr. Alan Goldhamer
Yeah. You know, there's most medications you do not water fast while you're taking medications. Those have to be weaned down beforehand. But we have physicians that are experts at helping people unwind the consequences of their medical treat, treatment and most medications. Interestingly enough, the day you change the diet, you have to begin changing the medication profile.
- [37:04]
Rich Roll
Right. Because most people medications are treating the diet.
- [37:07]
Dr. Alan Goldhamer
Most people are being treated that is medicated for their diet. When you change their diet, the need for medication dramatically response, you have to reduce the blood pressure medication, you start crashing these patients because they're not going to be hypertensive once you eliminate the reasons why they're hypertensive and they're not going to be needing the same level of medication Once you normalize their dietary intake as far as their diabetes or getting them off their pain medication. Once they don't have the pain, they don't need to be on all that oxy because now the pain is being reduced because the inflammation has been reduced because of the dietary change and then ultimately the fasting. So that's one of the reasons why fasting does need to be done in a controlled, medically supervised setting. It's not the kind of thing that you do long term fasting at home.
- [37:50]
Dr. Valter Longo
At home.
- [37:51]
Dr. Alan Goldhamer
So you do that in a controlled setting where there's been a proper history, exam, lab and daily monitoring. So we're seeing each of these patients twice a day and that's how we're able to ensure that this is a safe and effective experience. So they may withdraw their medication with careful feeding, initiate the fasting, normalize the condition, and then after we're done, most of the time there's no need for medication because their blood pressure, they've gone from 220 over 120, cap that on five meds to being 120 over 70 off medication. And so there's no reason for anybody to want to put them back on drugs that cause chronic cough, fatigue, impotence and premature death if the condition's actually normalized. Now, the side problem is you have to keep on the healthy diet and lifestyle because you're not curing anything, you're just managing it.
- [38:34]
Rich Roll
But you've rebooted this operating system and wiped the slate clean so you can build a new foundation.
- [38:40]
Dr. Alan Goldhamer
It's very much like treating, you know, when your computer becomes corrupted and you don't know exactly what's wrong, but, but you turn the thing off, you turn it on, you can't explain. But now it's working right?
- [38:49]
Rich Roll
And it seems to be, when in doubt, reboot.
- [38:50]
Dr. Alan Goldhamer
And we're trying to figure out exactly what those changes are that's occurring in fasting. I know the pharmaceutical industry is very interested in what's happening because they want to come up with what are called fasting mimicking drugs. They want drugs that'll do just what fasting does to you, but without that nasty fasting and something that they can sell in a pill. So a lot of the research that's of interest is trying to figure out what exactly is it that's happening in fasting that's allowing the body to get well so that we can try to reproduce that without having to go through the process.
- [39:18]
Rich Roll
Right. I mean, that's my next series of questions, like, does it have to be water only? What is it about that deprivation protocol that is so special, you know, physiologically that is causing this cascade of positive impacts? Like what would happen if you were eating a little bit? I mean, I know Longo has his fasting mimicking protocol where he is allowing people to eat something like, I don't know, 600 calories a day. And he's able to reap some of the benefits of what you're experiencing without having to go on a complete water fast. But what is happening to the body when you're depriving it of food in such a, you know, comprehensive way?
- [40:00]
Dr. Alan Goldhamer
Yeah, the intermittent fasting protocols are just that, fasting mimicking diets or fasting mimicking programs trying to reproduce some of the changes that we know occur with fasting without the risk profile or the complications of long term water only fasting. And I think they can be very effective. Effective as they've demonstrated. However, long term water only fasting has a much more profound impact on these mechanisms that are associated with fasting. For example, just the most obvious is weight loss. You know, when you're water fasting, you're going to lose an average of a Pound a day. Now some people say well you lose weight but then you gain it back afterwards. Now interesting. We've done a study, we have now recently acquired a hologix DEXA scanner with the new software that allows you to do whole body detail composition. It looks like not just at percent body fat, but how much visceral fat there is. And we have a paper that'll be coming out that looks at the fact that yes, you lose a bunch of weight fasting and you regain some weight after fasting. But it turns out the weight you regain after fasting when you're eating a whole plant food diet is exclusively water, fiber, glycogen and protein. There is no fat. In fact the fat profile continues to drop during refeeding even though the scale weight obviously goes up as you rehydrate, put some fiber back into the gut.
- [41:14]
Rich Roll
As long as you adopt, as long.
- [41:15]
Dr. Alan Goldhamer
As you continue adopt the whole plant food, healthy dietary style. But the point that the old wives tale was well you lose fat and you just gain the fat right back. Well that might be true if you go back to eating greasy, fatty, slimy, dead, decaying flesh processed foods. But that's not what's happening in these patients that we're refeeding appropriately. And so weight goes up, but the weight that goes up is realimenting your glycogen stores and muscle stores, which is really exciting. So preferentially, not just do you lose fat fat but you preferentially lose visceral fat. That the ratio of visceral fat to adipose tissue loss is 3.0. In other words, there's a significant preferential mobilization of this very type of fat that we think is most compromising to health. The fat, the abdominal fat, the fat it stores around the organs. So now we have what may turn out to be an effective strategy of specifically mobilizing visceral fat. Now we've done some preliminary work work, we're actually enrolling patients in the study starting in August, looking specifically at body composition changes long term with follow up. So you know, we'll be able to speak more definitively about it by the end of the year. There's also a process that happens in water fasting that you don't see as profoundly influenced in juice diets or modified diets. And that's naturesis. There's a selective mobilization, elimination of excess sodium from the body. And water fasting it has happens right away. It's very powerful. More powerful than say taking hydrochlorothiazide or a diuretic and it's responsible for the big dump in fluids that happens initially on fasting, that drops blood pressure so dramatically, gets rid of the congestive heart failure symptoms that eliminate some of the arthritic symptoms and joint swelling and the non healing wounds. And this body selectively getting rid of this excess sodium that's accumulated that the body's having to deal with because of the dietary choice. The traditional justification for fasting was the idea of detoxification, this idea that there's toxins in the body. And now we know that's true. They've actually been able to.
- [43:11]
Rich Roll
That's controversial.
- [43:12]
Dr. Alan Goldhamer
Well, it's actually not controversial in the sense that you can take a fat biopsy of a human and break it down and you'll find there's hundreds of different chemicals there at various concentrations. Pcb, dioxin, pesticide residues, mercury. And the only thing that's controversial is, oh well, it doesn't matter. Well, it turns out it does matter. It just matters at different thresholds to different people. And so this idea of rapidly mobilizing toxins during fasting has been so well accepted by some that they say that's the reason not to fast, is the body would rapidly mobilize these fat soluble nutrients too quickly and your body wouldn't know what it's doing and it would overload your system. Unless you take their proprietary products, then apparently it's okay. But what our experience has been that there is a rapid detoxification. We know that there's some studies looking at, they've even done total body load measurements before and after fasting and show that PCB levels would drop clinically.
- [44:04]
Rich Roll
So you're not taking any chemicals into your body and you're allowing the liver and the kidneys to just do what they do. Right.
- [44:11]
Dr. Alan Goldhamer
But it's more than just what you would calculate through burning 2000 calories of internal fluids. There's a selective and rapid mobilization. For example, example with tumors, let's say you have a breast tumor and you lose 10% of your body weight. You would assume that you'd probably lose 10% of your tumor weight. But what happens in the, for example, in lymphoma, you lose 100% of the tumor. So the body's preferentially mobilizing some nutrient stores versus others. And it seems to be able to do that in inverse proportion to the value of those tissues to the body. So it's getting the visceral fat, which we think isn't probably healthful fat, before it's, it's mobilizing adipose fat, and certainly before it's getting to critical nerve tissues and other things that are preserved. The body has an intelligence where it's unwinding itself. And what we're suggesting is it appears that both endogenous and exogenous toxins are preferentially mobilized in water only, fasting at a much more powerful rate than they are, say, when you're going on a healthy diet and lifestyle. And that may be a way, a justification for trying to facilitate and speed this process. There's also the effect on enzymatic induction. Think about athletes. One of the things of being a trained athlete is you induce, for example, glycogenogenolytic enzyme systems, you get better at mobilizing glycogen stores, and you know, this whole business of carb loading and trying to increase glycogen storage so you have more to pull on so that you don't hit the wall so quickly when you're running that marathon or whatever. You get through that process, though that is induced with persistent exercise. The same enzymatic production for glycogen, for lipolytic enzymes, for, for protein, for gluconeogenesis enzyme systems is induced during fasting because you have to mobilize all your glycogen stores. You're emptying the chamber, you're taking that battery and draining it all the way down. And it suggested that not only do you induce improved efficiency of enzyme systems, but they persist after fasting. Which is just like you get better and better at exercising every time you do it, you get better and better at fasting every time you do it. Which is perhaps one of the justifications for intermittent fasting. If you fast 16 hours every day and you limit your feeding window to an eight hour window, you may be inducing some changes in that, even that limited fast, that 16 hour fast, day after day after week after month. Cumulatively that may have a very profound effect on body physiology. And that's one of the suggestions that's being made by those advocating intermittent fasting or short periods of fasting, that cumulatively it may be. Well, when you do a long term fast, this is a, a huge impact. And now this is some of the stuff we're working with, people like Luigi Fontana from Washington University, where they're looking at changes in microbiome, changes in whole body composition, changes in these, these various exotic biomarkers. And what happens in short term and long term fasting, nobody knows yet, because we're really the only people doing and monitoring long term water only fasting and its physiological effects. So this is all virgin data and very exciting, exciting.
- [47:05]
Rich Roll
Once again, this is me and Dr. Valter Longo with this understanding the kind of basic tenets of what comprises a diet that promotes longevity. Based on this research, where does fasting come in? Like what is the relationship between these dietary pillars and these protocols around fasting or fasting mimicking?
- [47:34]
Dr. Valter Longo
So I think there are two. I always look first at the safety factor, right? So what is it that we don't know if it's safe or not? And then I just exclude them until we have many decades, I think of evidence. But if you look at safety and efficacy both, I think you come up with 12 hours every day as being very solid. I always say I've never seen a study showing that, that if you do 12 hours of fasting a day, you're gonna have a problem when you get to 16. And as we, I think already discussed before, you get to 16 hours, you get to breakfast skipping. I see meta analysis, not just studies, but studies of all studies showing increased mortality, reduced lifespan. Now what is the reason for it? We don't know. Probably there are double edged swords, right? So for example ketone bodies, maybe fatty acids. Ketone bodies are going both ways, right? They're helping you on one side and they're hurting you on the other side. But so 12 hours, very solid. And the work by Satchin Panda and everything else is supportive of it. And then I would say probably people, we eat all the time and so in the thousands of years ago, but as humans evolved, we evolved probably insulin resistance as a way to survive the winters, right? So you eat as much as you can during the summer or whenever food is available, you become diabetic, essentially pre diabetic or diabetic, you put everything away and then the winter comes or some period where there is no food and then you become insulin sensitive again. So I, I think what happens now is everybody is insulin resistant all the time or somewhat insulin resistant all the time because the winter never comes. And that's where this prolonged not just 16 hours of fasting, but say five days. That's what we've been working on. That's where they come in. It seems to be pretty clear now we have three more clinical trials that we are about to publish. Very clear that they switch you into an insulin sensitive mode. So and also they switch you into a long term anti aging mode. So for example leptin. And now this is about four clinical trials that we've done. Leptin stays low for a long time after you return to normal diet, IGF1, the central growth factor pro aging stays down for months. So we, in the first trial, we showed that, that after three months from the end, IGF1 was still lowered. Yeah. So then I think that there is, on one side, insulin sensitization. So the system now goes into a fat utilization mode versus building, and the system also goes into a maintenance mode. So now I'm just going to protect myself as much as possible, age as slowly as possible, waiting for the next wave of lots of food where maybe I can focus on reproducing.
- [50:39]
Rich Roll
Right. So with this understanding that there is no winter, the winter is not coming, and everybody's kind of hurtling towards some degree of being pre diabetic because of the western way of eating, how malleable is that? Like, if somebody has been in that pre diabetic state or in a, a situation where they lack insulin sensitivity for a prolonged period of time, what is your sense of how one can repair that? Obviously, if you've just arrived in that situation, it's probably gonna be easier for you through fasting and these other protocols to bounce back and create some insulin sensitivity. But if you've been in that state for a decade, does it become more difficult or can you still repair it?
- [51:30]
Dr. Valter Longo
You can still repair it. We just finished like a trial on diabetes in Holland, 100 patients. And I mean, I cannot tell you the results, but I can tell you that even if you're diabetic, you're obese, you've been taking medicine for years and years and years. No problem. We can bring it back. We cannot bring it back in. Everybody but I would say the great majority of people, you have the team, the physicians, the dietitian, and you have to have the method. And in that trial, it was just fasting, mimicking diet, no longevity diet. In the clinic, we do both. Right. But again, we don't push you to 1500 calories. If you had 2,500 calories. We push you to keep the calories maybe just a little bit lower, maybe go from 2,500 to 2300. And then we work on the Nutritech, what I call nutrient technology. We work on making it easier for you to lose weight rather than starving you for a year, hoping that you stay like that for the rest of your life, which you're never gonna do.
- [52:32]
Rich Roll
So in the four years since we sat down, there's been quite an explosion of interest in fasting. It's gone from this kind of curious endeavor into something that has truly gotten Mainstream attention, a lot of discussion about different ways of fasting and many different, as you mentioned, different types of, types of thinking about fasting, intermittent fasting, alternate day fasting, time restricted eating, fasting, mimicking. Maybe it would be worth kind of just talking about fasting in general and the validity of these various protocols and why you feel so strongly that the fasting, mimicking, approach is optimal.
- [53:14]
Dr. Valter Longo
Yes. So alternate day fasting, it's an extension of the 16 hours, let's say. Right. So there is no doubt that if you do 16 hours of fasting every day or you don't eat every other day, you're gonna get a lot of metabolic effects. The problem and the question is now that we have meta analysis showing that if you skip breakfast, you live shorter and you have more cardiovascular disease and probably more cancer, et cetera, et cetera. Is there some issue with these ketone bodies, with these fatty acids, et cetera, et cetera? So no arguing with the metabolic effects short term, but a big problem with long term. Right. So I would say don't do it. Certainly don't skip breakfast. Now what we're starting a trial is now what happens potentially if you skip lunch. So you keep the 12 hours and then skip lunch. That's what I've been doing for 20 years. But now we're going to finally get to test. We don't know, but let's see. And so that's alternate daily fasting, or let's say 16, eight. Then you have let's say fight two. Right. That's another popular one. Well, what happens if you do two days a week of fasting or semi fasting? Well, we don't know because there is not very many studies. There's a few. It looks promising. The problem I see with that is most people have a difficult time. I say going from four coffees a day or three coffees a day to two coffees a day. Half of the people that used to smoke are still smoking, even though we know that it kills you and it saves that on the package. So is that gonna really be more than a small, small percentage of the population? So even if we show that was effective active, who's going to do that? Right? I mean, I don't know. Personally, I don't know anybody that would go two days a week without, you know, eating anything. Right. I don't know a single person. But that doesn't mean it could not be effective and it doesn't mean there are, there are not people that could do it long term. So I'm not arguing that, you know, with the effectiveness, and I'm not arguing that some people could do it. I will say the great majority of people are not going to do it. And then I will say we even don't know what will happen long term. So we gotta go with things that are more realistic, less invasive. And that's where the Fasting Mickey diet comes in. And this is again 30 years of work since the Walford years, right? So it's not an idea that I say, oh, I see a few patients in my clinic, they're doing so well with these five days. I'm just gonna do that as it happened for many very popular diets in the past. So this was 30 years of building, building, building from all these pillars, right? And then you get to a point you say, where you say this looks very promising. Like, what if we made people do this three times a year for five days, four times maybe? And if you have diabetes, in the diabetes trial, we did one cycle a month for 12 months, but most people did not do 12 cycles, some people did two, some people did six, some people did eight, and some people did. So now we're going to analyze the data and we'll be able to tell who's doing well. But overall they all did well. So I think that two to four times a year, let's say some people may even last somebody like you probably a couple times a year, it'd be more than sufficient.
- [56:42]
Dr. Satchin Panda
But for most people, let's say three.
- [56:43]
Dr. Valter Longo
To four times a year, that seems to be very realistic. It's clearly showing this long term efficacy. It allows for fda, like, it doesn't have to be fda, but FDA like procedures where you can say, hey, this was tested. That's exactly the way you should test it. And everybody can test it, everybody can grab it. So now we have 30 clinical trials running. Some of them, we help them with, some of them, people just get it and they do their own trial. So that's the way you should allow everybody to test it. And let's see, right, eventually we're gonna see these are millions of people and we're gonna see the reports from it. And I really think that that's slowly moving in the toolkit of physicians on one side for lots of diseases, but it's also moving in the toolkit of the people that are paying attention and they want something that is being clinically tested.
- [57:43]
Rich Roll
And just because we haven't defined it, it. Essentially what you're saying is this is a five day protocol where we provide you through prolon this meal delivery, meal kit situation. And when you eat this way, you're mimicking your biological response to fasting without being overly calorically deprived.
- [58:05]
Dr. Valter Longo
Yeah, I cannot talk about products, you know, because I'm prohibited from doing it. So in the fmd, for example, for cancer it's four days. It's very different from the one for normal people which is five days as you just mentioned. Then we have one for autoimmunities is seven days. We have one for Alzheimer, we're testing now in Italy, which is five days, but then it has a daily supplement for the in between. So it's really about nutrient technology. But yes, the fasting mimicking diet, let's say it goes from four to seven days in most cases, plus or minus. What could be supplements. For example, in the Alzheimer, we were worried about people losing weight and some people did lose weight and so that's why we give them a supplement between the 25 days, between one cycle and the next of the fasting, mixing diet. We also, because they're so old, let's say 75, 80, 85 years old, we give them a higher calorie fasting making diet.
- [59:04]
Dr. Satchin Panda
Right.
- [59:04]
Dr. Valter Longo
So, so yeah, so we adjust based on the age on the disease and eventually I think there might be adjustments also. For example, now we're developing a non inflammatory one. Lots of people with inflammatory bowel disease, colitis, gastrointestinal problems. We're developing something that is non allergenic, non inflammatory, which I think it's gonna be very important. And we, I mean the university, I don't mean, I'm not talking about company. So yeah, I think that's, that's certainly. I'll be very surprised if this doesn't move into more of a mainstream and started competing with the drugs. Right. I mean that's what we're trying to say. Like let's start thinking about repairing systems, you know, based on all the things that we discussed and not just putting a band aid on it. You have diabetes, drug number one, then you escalate to drug number two, then you get cardiovascular disease and you have two more drugs there. And this is what happens. It's really criminal, I think in the United States, in Europe, all over the world. I call it unconspired conspiracy. Right? So everybody is going along with this system and you have a lot of bad food and a lot of drugs that people take and the whole system is profiting from it. But people, the average 45 year old now has got two chronic conditions in the United States. And so by the time you get to 55, 60, you probably have about three chronic conditions, taking lots of drugs, Right. So they were saying, what is the system? Not to just block that, but to bring you back to a healthy status. And it used to be ideas. Now we see in the clinical trial, but we also see it in the foundation clinics where we follow lots of people. So we're very confident that this can work, but it's not going to work unless you have the team that I was discussing earlier, the doctor, the dietitian, and the knowledge, and probably also the molecular biologist when you get to complex. So we get people at the clinic all the time and they have very complicated problems. And so you have a very busy physician, even our own. Right. And you have a very busy dietitian. And I think that the molecular biologist specialized in whatever field, could be the key person. Right. So the strategist, like I am. Right. So this person comes in, works with the physician and works with the dietitian to strategize how do I solve the problem? This person got three chronic conditions, where do they come from? And how do I solve them without creating another problem? Right.
- [61:53]
Rich Roll
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- [64:56]
Dr. Alan Goldhamer
Valter Longo has 10,000 offices making Prolon available. Many of those doctors might be supportive. And then once a doctor has one patient and they have success, all of a sudden we're seeing all kinds of their patients. Now again, some people are better candidates for inpatient care, some people are fine for outpatient care. And one of the benefits of the free consult that I do with people is to help them. Are they a candidate for fasting? Are they a candidate for home fasting? If so, then we can hook them up with a doctor that provides those services. If they really need to do it inpatient, they can come to the center, they can go to the other places that do this kind of thing. Or maybe what they need to do is just adopt the diet and lifestyle principle long enough to where then they become a good candidate for those changes. So we're trying to make sure that whoever does it, does it intelligently and does it safely. Not everybody's gonna follow our advice, but at least we can feel good that we've done our best to make the educational services available to everybody, to make the services available to people at home that are good candidates for that. And we have a facility for people that are better candidates to come inpatient.
- [65:59]
Rich Roll
Who isn't a good candidate for inpatient.
- [66:03]
Dr. Alan Goldhamer
So a person that's on medications that you can't safely withdraw, for example, if you've had a recent pulmonary embolism, cardiac arrest, you have atrial fibrillation, and you're on an anticoagulant therapy medication, you don't just stop those drugs because it can induce a stroke. Stroke. So it's very careful protocol to withdraw those meds. And you don't fast on those medications because they can become like many medications, greatly potentiated during fasting. They will work differently in the physiology of fasting than they are in the physiology of feeding. And so fasting medications don't go together. There are a few exceptions. Sometimes we'll allow some hormone replacement therapies, like thyroid replacement therapy stuff to modify the dose and monitor it. But, you know, it's not an absolute barrier. But we discuss that in detail and can fasting save your life? We talk about who's a candidate, who's not a candidate, you know, what has to happen in terms of medication. But it's basically, you have to get people stable off meds. You have to have people that have a condition that we believe are likely to respond to fasting. We don't want to be doing experiments on people particularly remotely unless we kind of know what their condition is and what symptoms they're likely to experience so we can educate them about that. You need to have a person that's willing to try to eat healthfully after fasting. It's no good to do a fast and then go on some crap diet and get terrible symptoms and then blame fasting. You know, that's, I'm not interested in that. We're trying to actually get a good net long term result. And that means we have to limit working with people that are, you know, willing to try to do these things. Not everybody's going to be perfect. A lot of people are going to struggle. But if they aren't going to make a good faith effort, it's probably not the best thing to do. They should be doing, doing some other kind of program that isn't, you know, going to.
- [67:43]
Rich Roll
How do you make that determination during the intake process to gauge willingness?
- [67:49]
Dr. Alan Goldhamer
Well, first of all, they filled out a detailed medical questionnaire. So I have their medical history that I've reviewed before, I've talked to them and we ask those questions in the questionnaire to gauge where they are. And also I've interviewed tens of thousands of people. I mean, essentially that's, that's what I do is I talk to people on the phone about their specific issues and try to direct them in the right place. And I've been doing it for 40 years. I got a pretty good idea who's likely to behave and who's not going to behave and who's a good candidate and who's not. And you know, witness that Everybody that's walked into the center, 25,000 people now for fasting, probably close to 40,000 people overall. Everybody that's walked in has walked out. So we're pretty good at making sure we don't bring in people that are not good candidates. Not everybody has an uneventful stay. There are patients that have serious side effects that we have to deal with. Occasionally we'll have to hospitalize a patient if they get into an issue. We'll get, you know, have to get diagnostics done, whatever. But as the safety studies show, this is a comparatively safe process when it's done according to protocol. Protocol.
- [68:58]
Rich Roll
What is your personal fasting practice?
- [69:02]
Dr. Alan Goldhamer
I fast every day. And it's.
- [69:05]
Rich Roll
So you never eat?
- [69:06]
Dr. Alan Goldhamer
I fast every day for 16 hours or as close to 16 hours as I can manage.
- [69:12]
Rich Roll
You're on a 65 year fast?
- [69:14]
Dr. Alan Goldhamer
I fast every year.
- [69:16]
Rich Roll
So you do a 16, 16 hour fast every day? Every day. So you eat between the hours of what and what?
- [69:24]
Dr. Alan Goldhamer
Well, I usually have depending on which morning it is because I play basketball in the mornings. So depending how long the basketball goes, I'm eating between 8 and 9 in the morning. I'm not eating after 5, 5:30 at night. So I have a window in there of feeding and then I don't have anything before or after dinner. So I do that every day. I fast once a year. I fast for a week. If I'm doing okay, no symptoms, then I'll stop it. If I have symptoms, I'll go however long it takes to resolve, resolve the symptoms. I don't like fasting. You have to rest when you fast. You can't play basketball. It's really annoying. My wife is, Dr. Morano is really strict about it because I fast. She's my supervisor when I fast and she won't let me have my computer. That's the hardest part of all. I let the patients have their computer.
- [70:08]
Rich Roll
What do you do all day?
- [70:09]
Dr. Alan Goldhamer
Oh, I just lay around and meditate and rest and it's awful. But, you know, I don't have symptoms, which is interesting because I've done this. I mean, I've, you know, I never smoked, never had a drink. I never, you know, I've been a vegetarian since I was 16 years old, so I've not had the exposure. So there's not a lot. I don't use medications, I don't use drugs. So the fast itself is boring. Nothing happens in terms of untoward symptoms. But you still have to rest. And for me, that's the big challenge is slowing down And I do, I find it. Some of the most beneficial intervention I do do is fasting, but it's not pleasurable.
- [70:46]
Rich Roll
Sure. And your blood work is a. Yeah, it's gonna be. Yeah, my blood works good.
- [70:51]
Dr. Alan Goldhamer
My blood works.
- [70:52]
Rich Roll
Yeah.
- [70:52]
Dr. Alan Goldhamer
My blood pressure is great. You know, but again, I, I started as a kid, so, you know.
- [70:57]
Dr. Valter Longo
Right.
- [70:57]
Dr. Alan Goldhamer
You'd expect it to.
- [70:58]
Dr. Valter Longo
You've been doing this a long time.
- [71:00]
Rich Roll
It's so interesting. It seems so severe and radical to undergo these things, but so many people, thousands and thousands of people have benefited from what you're doing. You practice it yourself.
- [71:16]
Dr. Alan Goldhamer
What is radical, though? Radical is radicus. It means root or cause. That's the fundamental thing we're doing, is we're actually getting to the reason people have these problems. We spend all of our time and money treating the leading causes of death, heart disease, cancer, stroke, diabetes. Instead of the. The leading cause of death, we don't deal with the actual causes of death, which is smoking, drinking, eating animal foods and highly processed refined carbohydrates. If we put our time and energy treating the actual causes of death instead of the leading causes of death, we'd probably be a lot better off.
- [71:50]
Rich Roll
The reason isn't going away. We talked about the statistics earlier, they're quite dire. But I don't see an eradication of highly palatable, ultra processed foods disappearing from our food environment anytime soon. If anything, it just continues to metastasize and people are getting more and more sick and fatter and fatter. It doesn't appear to be headed in a great direction which demands these types of interventions to save people's lives and get them on a different track. What is your prescription for the world? Like, how are we going to, as a collective, conquer this challenge that we have in terms of our food system to create something better? I mean, honestly, for the sake of humanity.
- [72:40]
Dr. Alan Goldhamer
Yeah. You know, to me, if I look at humanity as a whole, it would be very stressful and I don't like stress. So what I do is instead I look at the fact that I'm going to do everything I can do to influence the one or one and a half or 2% of the population that are hungry for information, willing to make these changes and hope that if we can get those people optimizing their health, that they'll set a good example and the hundredth monkey effect will kick in and maybe it'll have some downstream effect, maybe not in this generation, but in future generations. So I'm not going to try to take on the world as a whole. I only want to work with the highly motivated people that are willing to do what it takes to actually get and stay healthy and prove that this is an approach that can help them, you know, spend the last 20 years of their life healthy and happy and.
- [73:22]
Rich Roll
To kind of end this. Maybe, you know, look to camera and say what is the message that you want the person who's listening to this or watching to understand? Maybe that person has their own health challenges, they're trying to figure out what to do about it, they're a little bit scared or intimidated by what you shared and aren't really, you know, sure footed about how to take that first step or where to begin.
- [73:47]
Dr. Alan Goldhamer
Well, health results from healthful living. So if you want to be healthy, you got to pay the price and live healthily. That means diet. Our particular version is a whole plant food sos free diet. Other people have different opinions, but a healthy diet, whole food, regular exercise within your capacity, abundant sleep. So developing the ability to get to sleep in a cool, dark and quiet place and maintain good sleep hygiene. Fast every day for 12 to 16 hours. Fast occasionally as appropriate and try to figure out strategies to minimize stress, perhaps by only focusing on the things you can do something about and not worrying about the things that you have no potential to control. Roll.
- [74:29]
Rich Roll
There you have it. I really hope you enjoyed these highlights and in closing, I just want to say that I'm genuinely grateful for all the guests who share their wisdom and also for you, our listeners, our viewers without whom this show just wouldn't be possible. So thank you if any of these snippets piqued your interest. I encourage you to watch the full episodes links to which you can find in the show notes on the episode page of richroll.com as well as in the YouTube description.