Weight Loss Aside, What Health Benefits From Intermittent Fasting?

I have been asked this question often enough to address it here.

Whether, and to which extent intermittent fasting (IF) transforms human health still needs to be seen, but there are some indications for beneficial effects.

IF refers to dietary patterns in which individuals (a) have no or very little energy intake for extended periods of time (e.g. 16–48 h), while having normal energy intake between these periods, and (b) follow this interval pattern on a recurring basis.

Naturally it is much easier to test the effects of such dietary patterns in shorter lived animals than in humans. Mice, with an average lifespan of 3 years, can give us much faster insight into intervention effects on health and life expectancy.

Some of the more promising effects of IF in animal models is improved glucose handling (relevant for preventing diabetes), and in aging related diseases such cardiovascular disease, Alzheimer’s dementia, and frailty.

One of the key pathways through which IF seems to work is cellular senescence, the aging of cells, that ultimately leads to functional decline and death. The fasting promotes an upregulation of the cellular repair mechanisms that are essential for keeping cells functional and preventing cell cycle arrest.

There is still a lot to be investigated because outcomes vary by animal model, IF protocol, age at which IF is introduced, and duration of the intervention. The same will probably hold true for humans.

Taken together, what we can safely say is that IF doesn’t harm you, in all likelihood improves glucose handling and potentially has some protective effects against cellular aging.

To which extent these effects prevent disease events (such as heart attacks, stroke, dementia) remains to be seen. We simply have insufficient data to claim either way.

The problem is that trials capable of showing such effects need to be of durations that are longer than what human participants willingly endure.

That’s why IF became a surrogate, and more tolerable, protocol for caloric restriction (CR) in the first place. CR refers to continuous restriction of energy intake to 30-50% below normal, while ensuring adequate nutrient supply.

This protocol has produced substantial expansion of life expectancy in primitive organisms, such as C. elegans (a microscopic round worm whose life is measured in days rather than in years).

But the higher up you go on the complexity ladder of species, the lower the returns. Still, in primates, our closest relatives, significant beneficial effects on health and life expectancy have been documented.

Unless you are really prepared to adopt a CR or IF lifestyle for good, my guess is that you may experience some subjective effects on health, but they will dissipate rather quickly, once you return to “normal”.

Let me give you a personal example. My wife and I have made IF a regular affair. Last meal of the day is latest at 16:00, first meal of the following day comes at sometime between 09:00 and 11:00, and always after 60-90 minutes pre-breakfast moderate-to-high intensity workouts.

Let’s call this a n=2 experiment/trial.

It gives us a 17-19 hours food-free period. Deduct from this 4 hours for the post-prandial period (the period of nutrient absorption following the day’s last meal) and we have a net fasting period of 13-15 hours.

We have been doing this for approximately 5 years now.

With my research focus on healthy aging and cardiovascular functionomics, I have, of course, designed this “trial” in accordance with best evidence, and I have the advantage of being able to monitor physiological functions for the 2 of us regularly, using a medical device that I specifically developed (together with my team) for this purpose.

Cutting a long story short: at 64 my wife has the cardiovascular function and fitness of a 35-years old woman, the body contour many 40-year olds wouldn’t mind to have (Just put a few seconds of, admittedly amateurish, video clips together, to prove my point).

At 2 years younger than her, I am not that lucky, but still can compete in the age range of men 20 years younger than I.

I attribute this to the summation of physical exercise, IF and dietary quality. In science speak, this is, however, only anecdotal evidence.

So, if you want to find out for yourself, go with the Nike motto:

Just Do It.

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The Whole Superfood Thing is Way Overblown!

This whole „superfood“ thing is way overblown.

It is not just overblown, it is a confession of failure.

Failure on the part of preventive medicine, of public health, of all of us.

When we celebrate avocados, apples or anchovies as superfoods what does that make us – us, mankind, the most intelligent animal on this planet?

It makes us stupid. Seriously!

Why? Because we have come to a point where something that grows on trees, germinates in soil, or swims in the sea is proclaimed a superfood.

“Super” compared to what?

Quite obviously to what we are eating most of the time. Next to pizza and potato chips almost anything edible that you pluck from a tree, dig out of the soil or catch in the sea is a superfood.

Medicine and public health don’t talk about superfoods. 

Don’t even acknowledge it as a valid term. If they did, it would be the Trumpism of public health: Dressing up a failure as a victory. AND THEN BELIEVING IT, TOO.

No matter how much lipstick you put on a pig. It still is a pig.

How did we get here?

If you ask the left leaning folk, it’s of course the food industry. The evil purveyors of cereals, snacks and sodas. Villains going by the names of McDonalds, Nestle, Pepsi.

No doubt, these companies’ marketing messages contain a high dose of “alternative facts”.

But it’s not that we buy their dreck because they lie to us.

WE BUY BECAUSE WE ENJOY IT.

We create the demand, and they service that demand. So what solution do the left leaning folk offer?

Taxation.

Forgive them. It’s their thing. Their only thing.

They claim the numbers are on their side. And, to some extent, they are.

Increase tobacco tax, and fewer people smoke cigarettes.

Increase sugar tax, and people start to go easy on their sweet tooth.

Across a population taxation translates into some measurable health gains: fewer cases of heart attacks, diabetes, cancer.

Now, I don’t know about you, but with me, this tax thing doesn’t sit well.

For two reasons.

First, taxes punish all those of us who manage to have a healthy relation with enjoyable junk. We indulge occasionally, but we don’t drown ourselves in chips, cheeseburgers and chocolate pies on a daily basis.

If YOU can handle these things AND stay healthy and fit, why should YOU be punished for other people’s sins?

Second, such an “amusement” tax is pure hypocrisy. Just think about the withdrawal symptoms a government would suffer if, all of a sudden, nobody consumed those taxed sugars and junk foods anymore.

Well, we all know, this is not going to happen.

That leaves the government, and the lefties, in the role of cops who tell the junkies on their beat to NOT DO DRUGS - and then happily collect a percentage from the dealers’ trades.

Taxation is all stick, no carrot.

Do the right-leaning folk have a better solution?

Ask them and they will talk about freedom of choice.

Everybody should have the freedom to choose what they put into their mouth.

If you choose the things that make you fat, sick, and ultimately a nursing case, then you are obviously not the brightest bulb in the chandelier. 

The numbers are on their side, too.

The diseases of over-indulgent lifestyles follow an educational gradient. 

In plain English: the lower the education, the lower the rank on the social ladder, and the fatter and sicker the people are and the shorter their lives because of that.

So much about the no-stick, no-carrot approach.

Where left- and right-leaning folk agree is education. Educate the people. Tell them about their risks, about the consequences of living on the sofa with junk food in one hand and the remote control in the other.

Not a bad idea. If it wasn’t for the naïve expectation that education is enough. 

That people who are made to know about their risk will suddenly and willingly jump into line.

If that was the case, we wouldn’t have the epidemics of obesity, of avoidable heart disease and cancer.

But we do.

And the last 30 years of education haven’t changed that.

Neither has public health. They do what Einstein had once described as the definition of insanity (or was it stupidity?): Doing the same thing again and again and hoping for a different outcome.

It’s doomed to fail. That’s where I started this article: the confession of failure. So, what all these articles about superfood really are telling you – in this modern way of blowing everything out of proportion because otherwise we wouldn’t listen – is that the least processed food may actually be far better for you than anything the food industry has to offer.

That’s where the discussion about superfoods becomes meaningful. By alerting you to the fact that what nature provides can hardly be improved upon.

It’s “super” in itself.

So, just be aware of what makes natural food exponentially less super, and you should be alright. No need for gurus’ advice on superfoods.

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Fake Science: Deviant Science? Or Deviant Journalism?

Today, the German media are treating us to science-gate. 
A story about pseudoscientific studies, predatory journals and their publishers.

With the typical subliminal insinuations of an entire science community being untrustworthy.

Do they have a point? Or don’t they?

I believe they don’t. But I am biased. 

"Biased" is something I shouldn’t be as a scientist. 
But remaining unbiased is so damned difficult when some media hacks and talking heads rehash an old, well-known and controlled phenomenon to taint an entire profession’s credibility.

Had those hacks just searched google for “predatory publishing” or “predatory journals” they could have discovered that phenomenon 8 years ago. 
Wikipedia has devoted an article on the matter. 

But claiming “investigative journalism” is a lot cooler than reading Wikipedia. 
And English is also not part of every German journalist’s toolbox. Otherwise, they would have discovered Jeffrey Beall’s list of predatory journals and publishers. 

Already in 2010. 

Since then, the University of Colorado Denver librarian and researcher keeps his list of questionable journals painstakingly up to date. 

No scientist who takes his research work and academic career serious will publish his manuscripts in any of those journals. 

Every one of my colleagues would rather not publish at all than work with any of those journals. 
Not as an author and not as an editor.

But I also know why predatory publishing thrives. 

Part of the blame falls on the reputable publishers and their business model. 
It is insanely attractive to anyone who is after profit margins that exceed even those of Google. 

That’s what the media monkeys either don’t get, or don’t tell their consumers.

You’ll immediately see it when you compare the science publishers’ business model to that of a regular newspaper publisher. 
The latter employs and (hopefully) pays its writers. 
The publisher also needs to employ the editors. 
And he has to do the selling and marketing. 

None of that burdens the science publisher. 
His authors are the ones who hand in their manuscripts. 
His editors are the authors’ peers who review the manuscripts, and who help improve them before these manuscripts will be published. If they get published at all. 

It’s called peer review. And nobody gets paid for it. 
Neither the authors nor the editors.  

How many weekends do we spend reviewing papers. 
Voluntarily, of course. 
Because the publishers flatter us about our competencies. 
And because we feel that we have to give back to the science community on whose members’ reviews of our own manuscripts we depend. 

Until this point, the science publisher has zero costs. 
Other than what is necessary to manage the flood of manuscripts vying to be published. 

And here comes the real genial part of this business model.

The research work that is the subject of a manuscript has typically been paid for by some public institution. 
These institutions are mostly the same that finance our universities and their libraries which have to pay the subscription fees for these journals.

In other words: those who pay for the research, have to pay for the right to read the papers that describe and present the research results. 

No wonder the business model “scientific publishing” churns out better profits than even Google.
And we scientists are doing all the work.

That there is no shortage of willing authors is due to academia’s career model. Publish or perish is what describes it in three words. 

And mind you, getting a manuscript to be published is not a walk in the park. 
Even in low-impact-factor journals the majority of manuscripts received will not make it from the assistant editor’s desk though the peer review and to publishing.

That’s why we often need to submit our manuscripts to several journals. Not at the same time, mind you. 
Because journals frown on parallel submissions, and sanction it heavily if we dare to do it. 

Despite all these obstacles, publishing in predatory journals is not an option for the overwhelming majority of us. 

Not least because of pride. Nobody wants to refer to a paper that has been published in a journal that colleagues immediately recognize as a pseudo-journal. 

Only journalists don’t know that. 

Which bespeaks deviant journalism rather than deviant science.  PrintPDF