Alternate day semi-fasting

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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@...

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