Re: Alternate day semi-fasting

March 11, 2006

Hi Al:

WOW. Thank you! Another great study on this topic. If it goes on

like this then pretty soon the hucksters who have been 'hawking'

fasting supervision services for a fat fee at various internet sites

will finally have some serious evidence to support their claims of

benefit!

Reading between the lines (which, of course, always entails the

danger of perhaps reading information that is not there) this seems

to be further support for the idea that, in order to obtain the

benefits of CR one needs, one way or another, to fool the body into

believing there is a famine in progress. But there seems to be a

variety of different ways that can be achieved .......... 30%

restriction each and every day is not the only way, perhaps.

Just this week I began to shift towards an alternating day-to-day

caloric intake. On a very preliminary basis my 'sort of' plan is to

greatly reduce (70%? 80%? 100%?) my intake Monday, Wednesday and

Friday, and eat ad lib the other four days. In many mouse

experiments they were FED only three days (not four) and were 100%

restricted the other four days. And they did very well indeed.

But of course we are not mice.

Rodney.

>

> Does eating only a small amount on alternate days at ad libitum

levels overall of

> calorie consumption provide the benefits of regular CR? The below

pdf-available

> paper may pertain to this question.

>

> Of note, for formulating the basis for the experimental regime, the

authors

> reported:

>

> " Several leading authors have cited a study by Arias

Vallejo [2]1

> published in 1956 in the Spanish journal Revista Clinica Espanola

as the

> only example in the medical literature of calorie restriction in

humans in

> which good nutrition was practiced ... After examining the original

Spanish

> article, we believe that there was no calorie reduction, but that

there was

> a pattern of eating in which on alternating days subjects ate less

and more

> than their daily caloric requirement. The study was carried out in

an old

> age home run by a religious order (St. ph) in Madrid ... "

>

> How do the authors ascertain that that the subjects are conforming

with the

> caloric restriction directives on the low calorie or even not over-

eating on

> the high calorie days?

>

> The effect on health of alternate day calorie restriction: Eating

less and more than

> needed on alternate days prolongs life

> Med Hypotheses, In Press, Corrected Proof, Available online 10

March 2006

> B. , R. Laub and Sujit

>

> http://tinyurl.com/ova9u

>

> Restricting caloric intake to 60–70% of normal adult weight

maintenance requirement

> prolongs lifespan 30–50% and confers near perfect health across a

broad range of

> species. Every other day feeding produces similar effects in

rodents, and profound

> beneficial physiologic changes have been demonstrated in the

absence of weight loss

> in ob/ob mice. Since May 2003 we have experimented with alternate

day calorie

> restriction, one day consuming 20–50% of estimated daily caloric

requirement and the

> next day ad lib eating, and have observed health benefits starting

in as little as

> two weeks, in insulin resistance, asthma, seasonal allergies,

infectious diseases of

> viral, bacterial and fungal origin (viral URI, recurrent bacterial

tonsillitis,

> chronic sinusitis, periodontal disease), autoimmune disorder

(rheumatoid arthritis),

> osteoarthritis, symptoms due to CNS inflammatory lesions

(Tourette's, Meniere's)

> cardiac arrhythmias (PVCs, atrial fibrillation), menopause related

hot flashes. We

> hypothesize that other many conditions would be delayed, prevented

or improved,

> including Alzheimer's, Parkinson's, multiple sclerosis, brain

injury due to

> thrombotic stroke atherosclerosis, NIDDM, congestive heart failure.

>

> Our hypothesis is supported by an article from 1957 in the Spanish

medical

> literature which due to a translation error has been construed by

several authors to

> be the only existing example of calorie restriction with good

nutrition. We contend

> for reasons cited that there was no reduction in calories overall,

but that the

> subjects were eating, on alternate days, either 900 calories or

2300 calories,

> averaging 1600, and that body weight was maintained. Thus they

consumed either 56%

> or 144% of daily caloric requirement. The subjects were in a

residence for old

> people, and all were in perfect health and over 65. Over three

years, there were 6

> deaths among 60 study subjects and 13 deaths among 60 ad lib-fed

controls,

> non-significant difference. Study subjects were in hospital 123

days, controls 219,

> highly significant difference. We believe widespread use of this

pattern of eating

> could impact influenza epidemics and other communicable diseases by

improving

> resistance to infection. In addition to the health effects, this

pattern of eating

> has proven to be a good method of weight control, and we are

continuing to study the

> process in conjunction with the NIH.

>

> It is well established that by reducing the number of calories

required for weight

> maintenance to 60–70% of normal, lifespan is increased up to 40%,

with near perfect

> health across a broad range of species.

>

> Application of this calorie restriction (CR) principle to humans

would be of

> enormous value, but such severe restriction makes compliance

impossible on a daily

> basis. Many animal studies of intermittent feeding (24 feeding, 24

h only water)

> have demonstrated health-promoting physiological changes. Recently

in Lancet,

> Mattson [1] wrote an editorial to encourage increased study of the

effect of

> (reduced) meal frequency on health. For two years we have

experimented with an

> alternate day pattern of eating in which intake is limited to 20–

50% of estimated

> daily requirement one day followed by ad lib eating the next day.

This alternate day

> calorie restriction appears to have health-promoting effects in the

absence of

> weight loss.

>

> In support of our hypothesis is our re-interpretation of a study in

the medical

> literature.

>

> Several leading authors have cited a study by Arias Vallejo

[2]1 published

> in 1956 in the Spanish journal Revista Clinica Espanola as the only

example in the

> medical literature of calorie restriction in humans in which good

nutrition was

> practiced [1], [2], [3], [4], [5] and [6].

>

> After examining the original Spanish article, we believe that there

was no calorie

> reduction, but that there was a pattern of eating in which on

alternating days

> subjects ate less and more than their daily caloric requirement.

>

> The study was carried out in an old age home run by a religious

order (St. ph)

> in Madrid over a three year period on a population of 120 men and

women " in perfect

> health " over the age of 65. Sixty treatment subjects were fed on

odd days of the

> month a diet containing 2300 calories with 50 g of protein and 40 g

of fat. On even

> days, they were given one liter of whole milk and 500 g of fresh

fruit (about 900

> calories). Literally translating from Spanish, the 60 controls were

fed " the first

> diet " ( " la primera dieta " ) , referring to the diet which was

described first in the

> text (2300 calorie with 50 g protein and 40 g of fat). Stunkard

analyzed the Vallejo

> article in 1976 and stated that the control group was fed 2300

calories per day. No

> such statement appears in the original article and Stunkard's mis-

translation led

> subsequent authors who relied on his description to incorrect and

impossible

> conclusions. We believe what Vallejo meant by " the first diet "

was " ad lib

> consumption of the standard institutional diet in the nursing

home " , but not 2300

> calories per day, as discussed below.

>

> There was a highly statistically significant difference in number

of days in the

> infirmary (123 treatment group, 219 for controls, p < .001) but non-

significant

> difference in deaths (treatment 6, controls 13). Vallejo and other

authors conclude

> that the study suggests the regime employed might prolong lifespan

in the elderly.

>

> The error in previous analyses is in estimating daily calorie

requirements. We were

> unable to find data for calorie consumption in people over 65 in

Spain in the

> mid-1950s, but an estimate of daily calorie requirement can be made

by using the

> average of male and female body weight and height among Spaniards

in the 1960s, age

> 20–49 (Eveleth and Tanner, Worldwide variation in human growth,

1976, pages 33, 34,

> 285, 287, Ref. [9]). Applying the Benedict formula for

calculating calorie

> consumption and assuming an inactive lifestyle, the figure

calculated for the

> younger age group is 1600 calories per day, and may have been

slightly lower for

> these elderly people.

>

> Various authors have stated that there was a 35% calorie deficit in

the experimental

> group [4], [5] and [7] By this reckoning each subject would have

lost an average of

> more than 38 kg in the first year of the study. It is difficult to

imagine that the

> subjects, their families, Dr. Vallejo or the St. ph nuns would

have permitted

> significant weight loss in these elderly subjects. Further, there

is no mention in

> the article of calorie restriction or synonyms or weight loss among

the subjects,

> and the two tables in the article label the two groups as " dias

alternos " (alternate

> days) and " dieta normal " (normal diet) strongly suggesting the

control group was

> simply fed ad lib the institutional food.

>

> It is inconceivable that the controls were eating an average of

2300 calories daily,

> at least 44% more than daily requirement by our method of

estimation.

>

> Adding the daily intake of 900 and 2300 and dividing by 2 yields

1600 calories per

> day, equal to our estimated daily requirement for this group of

elderly people.

>

> Thus it appears the treatment subjects were either consuming 700

calories less (900)

> or 700 calories more (2300) than the daily requirement of 1600

calories on the two

> days. This study is therefore not a study of " caloric restriction "

but instead is a

> study of an up and down pattern of consumption with no change in

body weight.

>

> On the fruit/milk day, the actual calorie intake as a function of

daily requirement,

> (900 divided by 1600) is 56% of daily requirement. Based on our

anecdotal

> experience, compliance with an alternate day restriction of this

degree is not

> difficult for a motivated individual to follow.

>

> Recent animal evidence [10] suggests that body weight or body fat

content may be

> unrelated to health-promoting physiologic changes (improved glucose

metabolism and

> neuronal resistance to injury) seen with intermittent fasting (24 h

of ad lib

> feeding followed by 24 h of only water).

>

> We have had anecdotal experience with over 500 subjects for up to

2.5 years

> following a repeating pattern of ad lib eating one day followed by

20–50% of daily

> estimated calorie requirement the next day. We have observed

improvement in a

> variety of disease conditions, starting within 2 weeks, including

insulin

> resistance, asthma, seasonal allergies, autoimmune disease

(rheumatoid arthritis),

> osteoarthritis, infectious disease of viral, bacterial, and fungal

origin(toenail

> fungus, periodontal disease, viral URIs)inflammatory central

nervous system lesions

> (Tourette's syndrome, Meniere's disease) and cardiac arrhythmias

(frequent

> extrasystoles, atrial fibrillation), menopause related hot flashes.

>

> Based on a broad range of calorie restriction studies in animals in

which virtually

> all diseases are delayed, prevented or ameliorated by calorie

restriction, we

> propose that this dietary pattern, with or without weight loss,

will delay, prevent

> or improve a wide variety of human diseases in addition to the

above, including

> multiple sclerosis, Alzheimer's disease, Parkinson's disease,

atherosclerosis,

> NIDDM, congestive heart failure, and resistance to brain injury

from thrombotic

> stroke.

>

> Clearly, if our interpretation of the Vallejo study and our

anecdotal observations

> are correct, the implications for improved human health are

enormous if this pattern

> of eating were widely adopted. Aside from individual health,

widespread use could

> alter patterns of epidemics such as influenza because of resistance

to infection

> imparted by the calorie restriction mechanism presumably activated

by the

> intermittent pattern of consumption.

>

> We have also found this pattern of eating to lend itself to weight

control. It

> allows the subject to eat normally every other day and thus avoid

the endless

> horizon of deprivation chronic dieters envision. It is our

observation that this

> alternating day pattern of calorie intake makes this method

feasible for weight

> control while simultaneously conferring improvement in all aspects

of health.

>

> In collaboration with Mark Mattson, PhD, Chief, Neurosciences

Laboratory,

> Gerontology Research Center, National Institute of Aging, National

Institutes of

> Health, we are nearing completion of a manuscript describing an IRB

approved 8 week

> pilot study of the effect of following a repeating pattern of

eating ad lib one day

> and 20% of daily caloric requirement the next day on subjects with

moderate

> persistent asthma. Preliminary results show highly significant

improvement in

> parameters of pulmonary function and markers of inflammation and

oxidative damage

> and will be submitted to a peer-reviewed medical journal.

>

> -- Al Pater, alpater@...

>

> __________________________________________________

>

March 11, 2006