

My Journey into the World of Intermittent Fasting

Kenneth R. Szulczyk

I wrote this book accurately as possible and tried to stick to the known facts of fasting. Although I hold a Doctor of Philosophy (Ph.D.), I am not a medical doctor. I research renewable energy and behavioral finance – i.e., studying the behavior of investors in the financial markets.

Any recommendations and suggestions that I have made in this book are for entertainment purposes because fasting constitutes a dangerous activity. A faster with health problems or medical complications, or a person fasting for an extended time can jeopardize their health and life. Any person wishing to fast should consult a medical doctor or professional before proceeding. The author or publisher is not liable for readers abusing the information in this book.

The author mentions and refers to many trademarked products in this book. The author does not endorse nor receive any financial support mentioning those products.

My Journey into the World of Intermittent Fasting

Copyright © 2019 by Kenneth R. Szulczyk

All rights reserved

Cover design by Kenneth R. Szulczyk

Published 2019 by Smashwords ISBN: 9780463193150

Edition 4.0, November 2019

Table of Contents

Preface

1. Introduction

What is Fasting?

Fasting versus Starvation

Fasting Ensures Life's Survival

The Fasting State

2. Health Benefits of Fasting

Autoimmune Diseases

Autophagy

Cancer

The Digestive System

Heart Health

Insulin and Diabetes

Brain Function

Human Growth Hormone

Psychological Problems

Other Health Benefits

3. Fasting and Longevity

Human's Lifespan

Theories of Aging

Prolonging Life

The Soviet Union

4. After Effects of Fasting

Allergies and Skin Rashes

Eating and Satiation

Metabolism and Weight Loss

An Accidental Athlete

Become Younger

Drug Testing

Repel Sickness

Extreme Fasting and Enlightenment

Complications and Death

5. Types of Fasting

Who Should Avoid Fasting

The Juice Fast

Intermittent Fasting

The Prolonged Fast

The Dry Fast

Hormesis

6. Fasting Friendly Drinks and Supplements

Broth

Coffee

Exogenous Ketones

Flavored Water

Soda Water

Tea

Vitamins and Minerals

Vaping and Smoking

7. Fasting Diets

The Ketogenic Diet

The Fasting Mimicking Diet

Popular Fasting Diets

8. Alternatives to Fasting

The Obesity Epidemic

Calorie Restriction

Exercising

Bariatric Surgery

9. The Backlash against Fasting

The Medical Establishment

The Food Industry

The Government

Myths of Fasting

10. Tips and Recipes to Promote Healthy Eating

Tips on Healthy Eating

Beans

Bone Broth

Carrot and Cucumber Salad

Carrot Salad

Green Papaya Salad (Som Tom)

Homemade Salsa

Lime Juice

Lime Soda

Soursop (Guyabano) Smoothie

Three Sour

11. The Conclusion

12. References

# Preface

Fasting is a journey with many twists and turns. Perhaps we are not exploring ancient stone ruins in the jungles of Cambodia or savoring the exotic flavors of spicy Thai cuisine from the food carts on the streets of Bangkok. However, fasting entails many different methods and strategies, which is why I call it a journey, a journey to a healthy body. Fasting has impacted my life profoundly. I did not uncover the fountain of youth. Instead, I discovered a lifestyle to keep my body performing at its best. I feel better and am in better shape at 51 than when I was at 20!

I, thus, had to write a book about fasting because fasting embodies a simple strategy – abstain from food for a period. It cannot get simpler than that. For example, I researched many types of supplements. I read articles on the Chinese medicinal herbs as I shopped at the Chinese herbal stores in Malaysia. When I discovered hyaluronic acid, astaxanthin, and lingzhi, I thought I had found three powerful supplements to keep me young, the fountain of youth contained in bottles.

I chose these supplements because of their anti-aging properties. Hyaluronic acid is scattered across the human body and concentrated in the skin, eyes, and joints. Hyaluronic acid, an anti-aging agent, gives people a youthful appearance. Then astaxanthin, a powerful antioxidant, neutralizes free radicals in the body. Free radicals, i.e., charged molecules, harm cells and tissues. One theory of aging blames free radicals as the culprit in aging. At last, lingzhi comes from Chinese and Japanese herbal traditions. Lingzhi, a mushroom that grows on dead trees, is another anti-aging herb; some take lingzhi to treat cancer. People make a tea by simmering the dried, sliced mushrooms in water or taking capsules of crushed lingzhi spores.

Then I discovered fasting. If you asked me to pick the best antiaging agent, I unequivocally would choose to fast. The herbs and supplements do not come a close second. That idea blows away the mind. We always search for something to add to our diets to make us healthy. Who would have guessed that the practice of refraining from food for a period would awaken powerful repair processes in the body? Of course, humanity has always known because most of the world's religions advocated fasting. However, our modern society has ignored these ancient religious practices even though it appears we have many sick people walking among us. Modern medicine scoffs at fasting as it sweeps fasting under the rug of superstitious beliefs. Instead, the pharmaceutical companies have every young American hooked on a cornucopia of drugs. Many countries have followed the United States and encourage the heavy medication of their citizens. Then we see obesity and poor health exploding across the world. I live and work in Malaysia, considered the obesity capital in Asia.

I took everything that I know and read on fasting and compiled it into a book. I look at a variety of sources including articles in scientific journals, books, and blogs. Although we should be careful of blogs because anyone can write and post blogs on the internet, the bloggers provide testimony and information on fasting because they practice fasting. For example, I came across blogs where fasters claimed they excreted dead worms on their fifth day of fasting. Intestinal worms and flora like yeast love sugar and carbohydrates. So, a fast starves intestinal parasites. I also examine old references such as Upton Sinclair – The Fasting Cure (1911) [1] and the medical doctors Dr. Edward Hooker Dewey (1900) [2] and Herbert Shelton [3]. Dr. Dewey wrote his book in 1900, when he advocated readers to skip breakfast to improve their health. Dr. Shelton conducted over 30,000 fasts and published the first edition of his book in 1934 [3].

This book provides a wealth of information. I hope people will use this book to change their lives for the better. Perhaps we can revive one of the ancient practices of humanity and restore balance in the world.

# 1. Introduction

"A genuine fast cleanses the body, mind and soul. It crucifies the flesh and to that extent sets the soul free."

– Mahatma Gandhi

We start the chapter to explain the definition of fasting, and how fasting differs from starvation. Then we connect fasting to the animal world since all living forms have internal mechanisms to help them survive periods of famine. Finally, we describe the fasting state and what fasters experience.

## What is Fasting?

We define fasting as abstaining from all food and drink except water. Water is one of those vital substances that we cannot go without for a prolonged period. Although we fast, we should still drink water because water comprises about 60% of an adult man's body while adult women carry about 55% [4].

The growing popularity of fasting has spawned several variations of fasting, which some experts believe are not true fasts. For example, the purists do not accept words like the juice fast because the juice faster does not abstain from juice. Instead, the faster drinks fruit and vegetable juices as part of his or her fasts. Furthermore, the purists reject the notion of the fasting cure. Technically, fasting is a state. That state allows the body to switch on repair processes. Of course, we should not fuss about exact definitions because life is too short. However, we must use precise definitions, so we stay on the same page. The word fasting in this book refers to fasters abstaining from food and drinks except water.

Humans fasted since the dawn of civilization. Fasting intertwines with the world's major religions. The three great prophets, Prophet Muhammad, Jesus, and Buddha fasted. Furthermore, the American Indians and people from ancient Assyria, Egypt, Persia. Babylon. Scythia. Greece. Rome. India, Palestine practiced fasting as religious rites [3]. Thus, all religions embed fasting.

The following famous biblical characters fasted.

  * Both Moses and Jesus fasted for 40 days (Exodus 34:28 and Matthew 4:2 [5]).

  * David fasted seven days (2 Samuel 12:16 [5]).

  * The prophet, Elijah, fasted for forty days (1 Kings 19:8 [5]).

  * Esther fasted for three days (Esther 4:16 [5]).

  * Luke fasted twice a week, which we call intermittent fasting (Luke 18:12 [5]).

  * Saul, the ruthless prosecutor of early Christians, met the reincarnated Jesus on the way to Damascus. At the site of Jesus, Saul became blind. He abstained from all food and drink for three days and regained his eyesight. Saul transformed into Paul, one of the most influential disciples of Jesus. Paul spread the Christian faith across the Roman Empire (Acts 9:9 [5]).

Various religious groups fast:

  * Mormons of the Church of Latter-day Saints fast one Sunday out of each month. They practice dry fasting when they abstain from both food, drinks, and water.

  * Followers of Judaism practice dry fasting during Yom Kippur, or Day of Atonement, the holiest day of the year.

  * The followers of the Jain religion perform extreme fasting. The Jain religion, an offshoot from Buddhism, was founded in the fourth century, B.C., in northern India [6]. The Jains fast until they starve themselves to death as a way to reach spiritual enlightenment [6].

The early Christians combined prayer and fasting, but the Bible and church with its numerous denominations have no doctrine that requires fasting. Christians usually fast during Lent and Advent but have fallen out of practice in the West. On the other hand, Eastern Orthodox Christians fast regularly during religious holidays.

Muslims are required to fast and must abstain from all food and drink between sunrise and sunset during the month of Ramadan as directed by Allah. The Muslims do not have a choice. Muslims also perform the most difficult fast, a dry fast when they cannot even drink water during the fast. The Prophet Muhammad also advocated that Muslims should fast twice a week on Mondays and Thursdays during all months except Ramadan. Ramadan serves as the annual cleanse while the twice-weekly fasts serve as maintenance fasts otherwise known as intermittent fasting.

Buddhism, similar to the Christians, do not have a doctrine for fasting. However, Buddhist monks in Thailand and China practice intermittent fasting. The Thai monks finish their last day's meal at noon and do not eat again until the next morning every day. The Thai monks start breakfast at 8 A.M. [7]. Thus, they have an eating window of four hours and fast for the remaining 20 hours every day.

Several famous people fasted to boost their brain power and intelligence such as the three great Greek philosophers – Socrates, Plato, and Pythagoras. Socrates and Plato fasted for 10 days periodically while Pythagoras fasted 40 days before taking his entrance examination at the University of Alexandria. Then Pythagoras required his students to fast for 40 days before they could enroll into his class. We see in Chapter 2 that research indicates that fasting boosts brain function. Now it makes sense the connection between fasting and prayer in many religious faiths and why some intellectuals fast.

Political dissidents fast as a political weapon. For example, Gandhi, the national Hindu leader, fasted to gain India's freedom from the British Empire. A doctor monitored Gandhi to ensure Gandhi did not endanger his health or life. Gandhi fasted 17 times as a political statement with the longest fast of 21 days [8]. Members of the Irish Republican Army (IRA) such as McSwiney and Joseph Murphy went on a hunger strike while incarcerated in a British prison. Murphy died after 68 days without food while McSwiney died in 74 days. Their political fasts failed against the British as the British allowed them to waste away in their jail cells.

A leader imposes a fast upon his or her citizens to unite the country and brings God's favor. The King Jehoshaphat "proclaimed a fast throughout all Judah" as a vast army marched towards the cities of Judah (2 Chronicles 20:2-3 [5]). The king and his people wanted God's attention, so God would help Judah defeat its enemies.

Some fasters sought fame and popularity by public fasts because fasting freaks people out. In the 19th century, Succi, Merlatti, and Jacque performed public, extended fasts and charged admissions fees. They fasted between 21 and 46 days as the audience watched and gawked [3].

People, at last, fast for health reasons. Mother nature has programmed fasting into our bodies. When we become sick, ill, or injured, we lose our appetite [8, 9]. When the flu bug strikes, our bodies refuse to keep down any food or drink including water. Thus, our bodies force us into a dry fast. Many times, we go against our bodies' wishes. We have this warped perception that we must eat to maintain our health and strength. Plus, fasting freaks us out. We sabotage ourselves and drink 7-up because we can keep 7-up down. Thus, the 7-up ends the dry fast. Since we know the power of fasting while being sick, we should only drink 7-up if we feel dehydrated, or we need that sugary energy. Otherwise, we should fast during sickness.

## Fasting versus Starvation

Researchers and scientists often confuse fasting and starvation. They are different processes. Then reporters and journalists provoke public fear when they attributed the dangers or side effects of starvation to fasting.

Dr. Jason Fung defines fasting as the voluntary abstaining from food while starvation is involuntary [10, 11]. This definition rings true because people practicing fasting do voluntarily abstain from food for a period. However, unfortunate events force some unwilling people into fasting. For instance, sailors shipped wrecked on a deserted island, or miners trapped in a collapsed mine were forced into fasting if they had no food or rations [3, 8]. In some cases, the sailors and miners with some food rations were in worse shape than the ones who were forced into fasting [3]. The sailors and miners with food rations force themselves into a starvation state and not a fasting state. Other unfortunate events force people into fasting such as famine from drought, crop and cattle failure, floods, tornadoes, earthquakes, snow storms, and wars [3].

As food becomes scarce, people spread their limited food over a day. For example, a person with only 1,000 calories of food will divide the food ration into three meals during the day. In this case, the person keeps the body in starvation mode because the periodic feeding hampers and halts the fasting state. If that same person eats all 1,000 calories in one meal, then the person enters a fasting state at least 12 hours later. One meal a day is close to a 24-hour fast. Once the faster has depleted their fat reserves, then they enter a starvation state [8].

Fasting and starvation impact the organs in the human body differently. Fasting uses the least vital tissues first such as stored fat [3]. For example, fasting consumes 97% of the body fat in regards to weight while the spleen loses 67%, the liver 54%, and testes 40% [3]. The liver loses weight from the loss of glycogen and water [3, 12]. The body stores glycogen in the liver and muscles. At last, the nervous system and heart lose the least weight, about 3% [3]. On the other hand, starvation consumes the body's critical tissues and organs and jeopardizes the person's life [3, 8]. Then starvation causes a person's core body temperature to drop as the body scrambles to conserve all energy [13].

## Fasting Ensures Life's Survival

Biologists define two cycles of life: Anabolic and catabolic [3]. Living organisms build structures during the anabolic phase and break down complex structures into simple ones to release energy during the catabolic phase. We refer to the two cycles simply as feasting and fasting.

Fasting is a part of the cycle of life because all lifeforms alternate between periods of feasting and fasting. Feasting supplies the body nutrients to build structures while fasting performs the house cleaning and maintenance of the body. Somewhere in our history, we have forgotten fasting. Even in 1911, Upton Sinclair wrote how doctors objected against fasting [1], and we still witness this hostility towards fasting today. Everyone in the modern world clings to feasting while they neglect fasting. Then the healthcare industry cannot prevent or cure heart disease, diabetes, and obesity.

Many animals switch between feasting and fasting. For example, animals and insects build body structures during the spring and summer months and hibernate during the late fall and winter months. During hibernation, the bears, gophers, chipmunks, and squirrels fast as they survive on their fat deposits. During warm winter days, bears may come out of hibernation to search for food while squirrels awaken and consume some of their stored nuts [3]. Finally, queen bees burrow into a hole in the ground while wasps hibernate in loose bark on dead trees [3]. Then they survive winter on their stored energy.

Tropical countries alternate between wet and dry seasons. Accordingly, animals, insects, and reptiles become dormant during dry seasons in tropical climates as food becomes scarce. Fish, crocodiles, and frogs burrow themselves in the mud as the dry season starts, a process called aestivating. The mud hardens while the fish and reptiles go dormant entombed in the dirt. At the beginning of the wet season, the torrential rains soften the mud; then the creatures exit their dens as food becomes plentiful again [3].

All species of life have fasting built in. Cats, dogs, cows, horses, deer, and other animals fast when injured or sick [3, 8, 13]. Dr. Shelton provided many examples of injured dogs that fasted to cure themselves [3]. For example, one dog was hit by a truck and suffered multiple broken bones and internal injuries. Another dog accidentally ate rat poison while a third lost an eye to a cat. The dogs abstained from food for three weeks and survived their injuries.

Cats, to the annoyance of their owners, will hide if sick or injured. For example, I gave my cats deworm medication because two of the cats displayed symptoms of worms – a bloated, inflated abdomen, and one cat had poop covered with white specks. The two cats abstained from food for two days to allow their digestive system to heal. They lost that pudgy look and became slender and active. Please refer to Dr. Shelton's book on more examples and stories on animals fasting [3].

I also provide a tip on fasting for animals.

  * **Tip #1:** Don't fast your kitties. A cat's liver cannot process large amounts of fats during fasting or starvation because the liver becomes swollen, yellow, and fatty [14]. A cat will die if the liver shuts down. Thus, I feed my kitties twice per day, once at 6 AM and again at 6 PM. Furthermore, they have one hour to eat all the food they want. If we keep refilling the food dish, the cats turn into snackers as they return every several hours to snack. Then they gain weight. Thus, the strict feeding regimen keeps kitties slender, active, and a little naughty. For other animals, we must research their nutritional needs.

Humans similar to animals can survive without food for extended periods because we carry vast stores of fat. For example, a man weighing 200 pounds (90.9 kg) with a body mass index of 25% stores about 50 pounds (22.7kg) of fat. One pound of fat consists of 3,500 calories, and a person usually loses a pound of fat per day on a fast [3]. Therefore, a man could survive 50 days of fasting because the body has plenty of fat reserves to power the body. Most likely, a man will experience health problems when the fat reserves drop below 10% body mass index, which gives the man 30 days of fasting. Thus, the human body can survive without food for extended periods.

Fasting is built into the body as if by intelligent design [3]. The body consumes tissue and internal reserves by the ease of rebuilding them when food becomes available again. After the body processes the last meal, the body begins utilizing glycogen from the liver. As the reserves of glycogen start dropping, the body switches to burning fat. As the body depletes fat reserves, the body begins consuming the nonvital tissues first such as muscle. Of course, the body reserves the critical organs for last such as the brain, heart, and lungs [3].

## The Fasting State

The body needs time to transition from the feeding state to the fasting state. After we had eaten our last meal, our digestive system takes between three and five hours to process that meal [9]. Hence, the meal provides energy and powers our bodies. After our digestive system has processed the meal, then our bodies burn the stored glucose, called glycogen. The liver holds between 100 and 125 grams of glycogen, which equals between 400 and 500 calories of energy [8] while the muscles store between 1,400 and 2,000 calories. An average, moderately active male needs about 2,800 calories per day while a woman needs about 2,000. After 24 hours, the liver loses about 57% of its glycogen for healthy young males [12].

After we enter a fasting state, our bodies switch from burning glucose, i.e., sugar and begin burning fat. Experts believe we enter a fasting state between 8 and 12 hours after the last meal [9], but it depends on the person and how active the person is. (It sounds like the body scrambles to search for nutrients even though the liver has lost about 29% of its glycogen [12]). Subsequently, a person's insulin level starts dropping. Of course, we can use one trick to enter the fasting state sooner, which leads to the second tip.

  * Tip #2: Exercise allows fasters to enter the fasting state sooner. We should do aerobic exercise within five hours after eating our last meal. Aerobic exercise depletes the stored glycogen in the muscles. For example, I run on the elliptical trainer for 45 minutes and burn between 400 and 500 calories. The aerobic exercise also imparts many health benefits that complement the health benefits of fasting.

The body enters ketosis between one and three days after beginning the fast [8, 10]. Lean individuals enter ketosis quicker than the obese [15], which seems quite unfair. In addition, women enter ketosis quicker than men [8, 15] and experience quicker drops in blood glucose [15]. Unfortunately, the timing does not add since fasters feel the effects of fasting after eight hours after the last meal. Where does the body get its energy? Don't worry; we'll answer that question later.

During ketosis, the body opens the fat stores while our liver metabolizes the fat into ketones. The liver breaks down the fat, i.e., triglyceride into three molecules of fatty acids and one molecule of glycerol [10, 15]. The tri in triglyceride refers to the three fatty acid molecules. Then the liver converts fatty acids into ketones – acetoacetate and beta-hydroxybutyrate that most cells in the body use as energy and create acetone as a waste byproduct [3, 16, 17]. For example, on the day of fasting, people experience a four- to six-fold increase in ketones compared to their feasting day [18]. The body's cells improve the conversion of ketones into energy as opposed to sugar [16]. The presence of ketones could also be the mechanism that suppresses appetite [19]. Although we do not emphasize this, most cells in the body can burn fatty acids directly except the brain and red blood cells.

Several cells of the body still burn glucose for energy such as the liver and red blood cells [8, 15]. Furthermore, the brain requires up to 25% of glucose with ketones supplying the rest [10]. We needn't worry about the absence of sugar because the liver manufactures glucose from amino acids or glycerol using a process called gluconeogenesis [3, 10, 15, 17]. Gluconeogenesis stands for glucose in gluco, neo for new, and genesis for creation [10]. During fasting, the body breaks down muscle into amino acids, or the body breaks down fat, i.e., triglycerides into fatty acids and glycerol [10, 15]. Then the liver manufacturers both glycerol and amino acids into glucose. At last, gluconeogenesis consumes energy, which helps explain why fasters experience a boost in metabolism [20].

Amino acids are the building blocks of proteins. Our bodies require nine amino acids: Histidine, isoleucine, leucine, lysine, methionine, methionine, phenylalanine, threonine, tryptophan, and valine. Here is the beauty of fasting. Fasting places the body into scavenger mode as it searches the body for amino acids. One source of proteins are muscles. Several studies show a loss of muscle mass during fasts [8, 20, 21]. After two or three days, muscle wasting slows, called muscle sparing [8, 15]. Autophagy and programmed cell death also supply amino acids, which we discuss in Chapters 2 and 3. Then the body switches to ketones as its fuel source.

Several other factors induce ketosis other than fasting such intense, prolonged exercise, low-carbohydrate diets, alcoholism, and starvation.

Some people confuse ketosis and ketoacidosis. People with Type 1 diabetes can suffer from the dangerous condition of ketoacidosis when both the glucose and ketones rise significantly in the blood at the same time and turn the blood into acid. The immune system of Type I diabetics attacks the pancreas, so the pancreas no longer produces insulin to reduce sugar blood levels. In addition, alcoholics starve their body of glucose in the presence of alcohol that could also lead to ketoacidosis.

The body possesses powerful control systems to prevent ketoacidosis. Ketones do not elicit an insulin response with the absence of glucose [22]. However, in the presence of glucose, ketones especially beta-hydroxybutyrate amplify the insulin response or at least in mice [22] and dogs [23]. Then the insulin messages the cells to utilize glucose for energy and the fat cells to store sugar and stop releasing fat. Thus, ketones and blood glucose would never be high at the same time for people with a normally functioning pancreas.

Because of the Ketogenic diet, a diet high in fat and low in carbohydrates, dieters purchase various devices to measure ketones. Fasters may also use these devices to measure the degree of ketosis in their bodies and the strength of the fast. The measures include:

  * **Ketosis Test Strips:** People can buy these strips over the counter in any pharmacy for about $10 for 50 sticks. The strips test for acetoacetate. People just urinate on the stick for two seconds, shake the stick, and wait 15 seconds for the stick to change color. The sticks pose two problems; once a faster adapts to burning fat, that person may stop excreting acetoacetate, which the test strips check for. In addition, excessive water drinking and dehydration may cause inaccurate ketone readings.

  * **Electronic Keto Breath:** The faster breathes into the device while the machine determines the level of acetone in the breath. The body produces acetone as a waste product. The machines range between $50 and $100. I am not sure of the accuracy.

  * **Blood Ketone Meter** : The machines are similar to glucose meters that diabetics prick their finger and measure their blood glucose. The machines are inexpensive, around $30. However, the ketone test strips cost about $1 each. Ouch! The meter tests for the ketone, beta-hydroxybutyrate. We discuss this ketone further in this book because of its role in the regeneration of the body's cells.

Once the fasters or dieters have tested their ketone level, they compare the ketone level to Table 1 to indicate the strength of the fast. A strong fast means a person's body burns more fats. People in good health should never exceed 4.0. Fasting beyond 3 days may raise beta-hydroxybutyrate around 6.0 [17], indicating a strong state of ketosis. Any readings above 8.0 indicate strong ketosis and possible ketoacidosis. Ketoacidosis requires a high blood sugar level while the blood becomes more acidic. Thus, we rush to the hospital as fast as we can.

I have fasted twice per week for a minimum of 24 hours per fast for a year and a half. After fasting for 24 hours, the urine keto sticks indicate zero ketones. However, once I make it to 30 hours, my body begins excreting acetoacetate. I also noticed if I eat two high fat, low carb meals before the fast, jog at least 30 minutes while fasting, or do both, the keto sticks detect ketosis much sooner. According to the urine test strips, the strongest state of ketosis I have experienced was a 4, but I had never fasted beyond two days.

We must remember; the urine ketone sticks may not be accurate. If fasters want an accurate measure and strength of ketosis, the blood ketone meter offers the best option.

***

We switch our attention and discuss what the fasting state feels like. Fasting resembles exercise. The first mile (or kilometer) we run, we feel the strain and pain. The sweat burns our eyes while the joints and muscles creak and ache. Then we return home and collapse on the bed. Then each time we run, we become stronger, faster, healthier. The pain subsides. The body recovers quickly while each mile (or kilometer) becomes easier. Then in no time, we run 6.7 miles (10 kilometers) with ease.

Fasting resembles exercise. The more we practice fasting, the easier we can abstain from food and drink. Don't get me wrong. I thought I would die when I did my first 18-hour fast. I felt awful and weak. I became dizzy after standing up. After each fast, the process became easier and more comfortable. After six months, I have little difficulties entering a fasting state as fasting has become second nature.

When I started fasting, I needed a crutch to survive the fast. So, I ate two hard boiled eggs with hot sauce eight hours after my last meal. Technically, I violated the fast by eating the eggs, but I needed a little help to get me through. Once the fasts became easy, I no longer need a crutch.

  * **Tip #3:** We use a crutch to help our bodies adjust to fasting. We eat a high-fat, high-protein snack or add a little milk or cream to our coffee and tea. The Ketogenic diet also suggests many low-carbohydrate snacks.

I could sense when I enter a fasting state. A euphoria and peacefulness swept across my mind after eight hours after my last meal. My senses sharped and became more sensitive. Colors were brighter while sounds and smells became stronger. I enjoyed riding my motorcycle at dusk and watching the vibrant Borneo sunsets or going to the cinema to watch a movie with friends. I'm a young kid again jolting and screeching during the scary parts of a good movie. If I fast during the day, I must wear sunglasses as the bright, intense sunrays blast down upon me.

  * **Tip #4:** Most fasters experience the fasting euphoria. If we experience the euphoria, we should enjoy it, such as watching a good film or connecting with nature by gardening, hiking, or taking the kids or pets to the park. We can also let the rolling ocean waves soothe us as we stroll along the beach. Fasting connects us with nature and unplugs us from the modern world for a while.

The euphoria comes from the adrenaline our bodies produces when entering the fat burning state – no wonder why many religions incorporate fasting. Fasting is spiritual and awakens an inner peacefulness.

When we begin fasting, we must be careful the first several times. For instance, the euphoria makes me a little spacey. Several times, I almost turned in front of oncoming traffic on my motorcycle. Furthermore, we should avoid exercising during the first several fasts. However, once fasting becomes second nature, we can return to our exercise regimens. I experienced no problems doing my resistant training or running on fasting days. I find running helps intensify the water fast as I deplete and burn the sugar in my body.

A faster will notice several things to indicate that he or she is fasting. After eight hours into the fast, we should smell ketones on our breaths. We call this the Adkin's or Keto breath after the Adkin's or Ketogenic Diet because the low carbohydrate diet triggers ketosis and the associated bad breath. As the body metabolizes ketones for energy, the body produces acetone as a waste product. The body expels acetone in the breath and urine, giving fasters that nasty, foul-smelling breath. The ketones also suppress appetite and hunger pangs [19].

During a fast, a white coating covers the tongue. Dr. Shelton and Dr. Weber and the writer, Upton Sinclair, claimed a white tongue indicated that the body was expelling toxins [1-3]. We can debate this notion. Some claimed that fasters experienced bacteria and yeast overgrowth in the mouth during a fast. That is illogical because these organisms crave sugar, and the body has already metabolized the sugar. Thus, the yeast and bacteria should die from the lack of food. Logically, the food acts like sandpaper to the tongue especially the tortilla and potato chips. When the faster stops eating food, the tongue keeps producing the cells that coat the tongue. Thus, the tongue turns white as a faster abstains from abrasive food.

Dr. Dewey, Dr. Shelton, and Mr. Sinclair used the tongue as an indicator [1-3, 13]. When the tongue had returned to its normal color, or the faster's hunger had returned, or both, the person ended the fast [1-3, 13, 24]. Dr. Shelton and Sinclair performed extended fasts of two weeks or more [1, 3] while Dr. Dewey skipped breakfast daily except to enjoy his morning cup of coffee [2]. However, waiting for the tongue to return to normal color may be an unreliable indicator.

Fasters will notice other signs such as the disappearance of allergies. I'm allergic to tree pollen. Unfortunately, the Year 2018 was my worse year for allergies because I lived on Borneo, Malaysia, where a tree bloomed every several months. However, my sinuses and nose cleared after I had abstained eight hours from food. The redness of my eyes faded; I still sneeze occasionally, but I could sit under the offending tree with no ill effect. The culprit is the body producing histamines to combat the pollen.

Other fasting effects include:

  * **Constipation** : No food coming in means nothing going out [8, 10, 13]. Some fasters mention they still have healthy bowel movements during the fast. During the early 20th century, doctors performed enemas on fasters because the doctors thought the stools would solidify into a rock, or the body's colon would assimilate decaying waste [1, 3, 13, 24, 25]. Although these fasts extend beyond two weeks, we can debate whether we need enemas.

Some fasters claimed they excreted dead worms and parasites from five-day fasts. Intestinal worms and parasites crave sugar. Hence, fasting eliminates their food source. What I find odd is scientists have fasted worms in the laboratory. Those little critters still survive after consuming most of their body during a fast. Thus, the critters can fast too which extend their life.

  * **Dark Urine** : Some fasters report dark urine while other fasters describe a black sediment in their urine during extended fasts. Of course, fasting cleanses and detoxifies the body. During the feasting cycle, the body sweeps the dust and debris under the rug to get rid of it. The body usually tucks toxins in the fatty tissue. Subsequently, fasting burns the fat and releases the toxins into the body again. Then the body must rid itself of these toxins during a fast, such as the urine.

  * **Headaches:** Some fasters experience headaches. The headaches may result from the body ridding itself of toxins, or the faster has abstained from caffeine.

  * **Metabolism** : Fasting boosts metabolism [20], or at least it does not slow it down for fasts with durations less than 36 hours [26].

  * **Periods of Weakness** : Fasters alternate between periods of high energy and weakness. For example, I usually have energy during a fast. However, when I started fasting and occasionally during a fast, I feel weak and sluggish. The temporary weakness goes away. Please note, if we feel terrible during a fast, then we should eat something to break the fast. Our health comes first than the duration of a fast. We can always live another day and fast at another time.

  * **Insomnia** [8, 13, 25]: Some fasters sleep better while other fasters sleep around four hours [13] and report disturbances in their sleep [27]. Unfortunately, I experience sleeping problems during extended fasts. I often sleep five hours while fasting rather than my usually eight hours. However, I still function normally throughout the day on partial sleep.

  * **Feeling Cold** : The faster feels cold because the body conserves energy during a fast [8, 25]. The faster should dress warmly and cover with a blanket.

  * **Blurry Vision** : Some fasters experience blurry vision or have trouble focusing their eyes [25].

  * **Hair and Fingernails** : The hair softens in texture [3]. Meanwhile, a faster experiences slower hair and fingernail growth especially during extended fasts [3]. Some fasters experience hair loss during extended fasts [25]. The body prioritizes its energy consumption when the energy source, i.e., food becomes scarce. The body assigns hair and fingernail growth as low priorities.

Of course, the best part of the fast is breaking the fast. Our taste buds are sensitive. Our digestive system has rested and roars to process food again. When we take that first bite, an explosion of taste sensations tickles our tongues. Food is delicious. That is why I appreciate the engineering and creativity from the corporations designing our food. I broke fasts with a bag of Doritos and a Snicker's, a Big Mac with French fries, and pizza, of course, not at the same time. Thus, a fast allows us to enjoy food during our feasting cycle.

After fasting intermittently for nine months, I no longer get the white-coated tongue, smell the ketones on my breath, nor experience sensitive senses. My taste buds lack sensitivity when I break a fast. Now, I feel little difference between fasting and feasting. Usually, I must fast beyond 30 hours to experience the faster's euphoria. However, I'm not a junky chasing after my first high. I define clearly why I fast; I fast to get the health benefits. That is why I do not extend my fasting time to capture these secondary benefits. Health and safety come first.

# 2. Health Benefits of Fasting

"Fasting is no cunning trick of priestcraft, but the most powerful and safest of all medicines."

– M. L. Holbrook, a Hygienist

Many diseases originate from chronic inflammation. Inflammation is a natural part of the immune system as white blood cells hunt down and destroy foreign invaders like bacteria and viruses. As we age, cells become damaged and begin releasing chemical messengers that cause the immune system to go into overdrive and lead to chronic inflammation. Chronic inflammation harms our cells, organs, and tissues and triggers many diseases. A group of Japanese researchers believe low levels of inflammation was responsible for the long life of centenarians [28].

Fasting reduces inflammation and, hence, cures many diseases. Upton Sinclair and Dr. Shelton claimed fasting cures all human ailments except for tuberculosis [1, 3]. Upton Sinclair was a prolific American writer at the turn of the 20th while Dr. Shelton supervised over 30,000 fasts [3, 13]. Although Dr. Dewey does not mention tuberculosis, he encouraged intermittent fasting to cure a wide spectrum of illnesses. Tuberculosis differs from other illness as a nasty bacterial infection attacks the lungs and easily spreads from one victim to the next through sneezing, coughing, or talking.

As we will see, fasting impacts the body profoundly as fasting gives the body a rest from the feasting cycle and allows the body to cleanse and repair itself.

## Autoimmune Diseases

Fasting helps reduce the problems of autoimmune diseases. The immune system searches the body for foreign material such as bacteria and viruses. Sometimes, the immune system makes a mistake and attacks healthy cells and tissues instead, which we call autoimmune disease [8]. The disease depends on which tissues and cells the immune system attacks.

The antibodies identify the foreign substances in the body called antigens [8]. The antibodies mistake the body's cells if the cells become too polluted or abnormal [8]. Then the antibodies attach themselves to those abnormal cells and form an antigen-antibody complex [8]. The antigen-antibody complexes can lodge themselves in the tissue and trigger inflammation [8]. For example, people suffering from rheumatoid arthritis experience redness, stiffness, and pain in the joints as the antigen-antibody complexes buildup and create chronic inflammation in the joints [8].

Fasting is one of the strongest agents to combat inflammation [8]. Thus, fasting reduces the impact of autoimmune diseases quickly [8, 29]. Fasting provides three effects on the body. First, the fasting gives the digestive system a rest and allows the digestive system to heal itself [8, 13]. That way, food and foreign substances do not enter the bloodstream. The food leaking into the bloodstream forms antigens that swing the immune system into overdrive [8]. Second, the joints heal as they receive more oxygen and nutrients because the joints rely on the joint fluid to transport the nutrients and oxygen [8]. Hence, fasting increases joint circulation [8]. Finally, fasting helps the body clear the antibody-antigen complexes and reduces inflammation during and after a fast [8].

Some people report that fasting cures the following ailments.

  * **Multiple Sclerosis** [8, 13, 30]: The immune system attacks and destroys the myelin sheath that covers the nerve cells [8, 31]. The sheath forms insulation around the nerve like insulation covering wires in your house. The insulation prevents the wires from shorting out and starting a house fire.

  * **Grave's Disease** : The immune system attacks the thyroid glands [8].

  * **Lupus:** The immune system attacks itself [8, 29]. This disease usually inflicts women because high estrogen levels make women more susceptible [8]. Lupus affects the joints, skin, and kidneys and gives sick women a rounded appearance [8].

  * **Psoriasis:** The immune system attacks the skin [8].

  * **Rheumatoid Arthritis:** The immune system attacks the joints [8, 31]. Fasting reduces pain and stiffness, so that patients reduce medications [29, 30, 32].

## Autophagy

Autophagy comes from the word auto, meaning self and phagein, which means to eat [10]. Literally, the word paired together means "to eat oneself" [10]. I know how gruesome this concept sounds, but the body needs autophagy to maintain the body in the best health. Autophagy is the process to break down damaged and worn out parts within a cell and recycle the components [10, 33-36]. Autophagy also ensures cells survive periods of starvation [35, 36]. Then a cell uses the recycled parts to rebuild new structures in the cell [10, 36]. Thus, we are remodeling the kitchen to make it new, sleek, and modern even though we live in an old house.

Autophagy depends on a pathway called the mammalian target of rapamycin, or mTOR for short [10, 35-41]. Every cell in the body possesses the mTOR. We view mTOR as a sensor for insulin, amino acids, oxygen, and energy levels. Thus, as we eat carbohydrates or proteins, the mTOR detects that the body is processing food. Thus, the presence of mTOR signals the cells that the body has a supply of nutrients coming because the body breaks down carbohydrates into glucose that in turn triggers insulin secretion. Meanwhile, the digestive system breaks proteins down into amino acids and, thus, trigger the mTOR sensor. The presence of mTOR turns off autophagy because the body uses the nutrients to build structures.

When a person fasts, insulin levels drop [15, 42, 43] while glucagon rises [15, 43]. Insulin and glucagon are adversaries. Glucagon signals the muscles to release their glycogen or stored sugar. Since the body has no incoming nutrients, mTOR goes dormant and switches on autophagy. Glucagon may also help switch on autophagy by depleting the amino acids [35]. Consequently, the body goes into recycling mode.

The body is incredibly complex, and other conditions can switch on autophagy. For example, when nutrients become scarce, the protein, AMPK (adenosine mono-phosphate-activated protein kinase), rises and turns on autophagy directly [36, 39, 41]. AMPK also switches off mTOR [36, 41, 44].

How many hours does a person need to fast for autophagy to turn on? Depending on whom we ask, the answers vary from 8 hours to three days. However, we know liver glycogen and insulin drop to low levels after 12 hours into a fast while glucagon peaks after 13 hours [45]. Our digestive systems would also have processed and assimilated all the protein within this time, so the mTOR should turn off while AMP should switch on, thus activating autophagy. Of course, each person differs in how his or her hormones behave during a fast. Furthermore, obese people and diabetics may experience less autophagy [36]. Mostly, likely, they suffer from elevated and persistently high insulin levels that stop their bodies from turning off the mTOR and, thus, switching on autophagy.

We also have no way to measure autophagy since the process occurs within the cells [46]. Some fasters measure their insulin and glucagon levels, or the ratio of insulin to glucagon [47]. Other fasters use ketone strips to measure the level of ketones in their blood or urine. If the body burns ketones for fuel, then the body should have switched on autophagy. Furthermore, autophagy reacts to stress on a cell, and other pathways switch on autophagy, such as dehydration as in a dry fast, exposure to an extremely hot or cold environment, or hypoxia, i.e., oxygen deprivation. Of course, I do not recommend fasters to deprive themselves of oxygen.

The mTOR pathway is sensitive and just 3 grams of leucine, an amino acid, can halt autophagy [10]. Intense exercise also causes mTOR to go dormant and switch on autophagy. In a study of mice, 30 minutes of running on a treadmill switched on AMPK and turned off mTOR [48]. Therefore, exercise and autophagy go together like soda and popcorn at the cinema. That's why we fasters must be careful what we drink during a fast. A splash of milk in our coffee may halt autophagy momentarily.

Christian de Duve discovered the process of autophagy and won the Nobel Prize in Physiology and Medicine in 1974. Autophagy depends on lysosomes, a part within every cell. A lysosome acts like a stomach inside a cell and contains digestive enzymes. Subsequently, autophagy causes a lysosome to release the enzymes that digest old, broken down cell parts including engulfed bacteria and viruses [36]. Then the cell recycles the parts to build new cell structures [34].

Autophagy comes in three forms.

  * **Macroautophagy:** Cells create an autophagosome within a cell. It resembles a little Pac-Man that goes around the cell eating the debris, invading organisms, and damaged cell structures. The autophagosome engulfs an organelle (or "little organ"), damaged proteins, fats (or lipids), or bacteria in a damaged cell [34, 35, 37, 38, 40, 49-51], and then the autophagosome fuses with the lysosome [36-38, 40, 49-52]. The digestive juices of the lysosome break down the damaged organelle into proteins, fatty acids, and raw materials, so that the body can recycle the components [35, 37]. Furthermore, the cells create autophagosomes during nutrient deficiency or cell stress [38], and autophagosomes are crucial for a person's longevity [39].

Short bouts of fasting can increase the size and number of autophagosomes within cells. In a study of well-fed, male mice, scientists detected few and small autophagosomes inside neuron cells or brain cells [53]. After 24 hours of fasting, the autophagosomes multiplied and expanded in size [53]. After 48 hours of fasting, the autophagosomes became larger and became 3 to 4 times as numerous compared to the well-fed state [53].

Mitophagy and lipophagy are two common forms of macroautophagy. Mitophagy recycles a cell's mitochondria [49, 54]. The mitochondria provide heat and energy to a cell, the cell's energy furnace. Meanwhile, lipophagy targets autophagy to lipids, i.e., fat.

  * **Microautophagy:** The lysosome attaches itself directly on the cytoplasm within a cell [38]. The cytoplasm consists of all material in the cell except the nucleus and includes the mitochondria and lipids. Microautophagy does not depend on nutrient deficiency [38]. It's just part of routine maintenance.

  * **Chaperone-mediated autophagy:** A unique protein selects and binds with a material and fuses the material to the lysosome directly [38, 55]. The specific protein scavenges for proteins one by one within a cell. A nutrient deficiency can trigger this selective autophagy [38, 55], which may be critical in a person's longevity [39].

Now, we see why exercise and fasting are essential. Autophagy slows the negative impact of aging and age-related diseases by recycling old parts within a cell [33, 34, 38, 39]. Hence, we take our old, dependable car to a mechanic for a tune-up and some repairs, and that engine purrs like a happy kitten.

We know fasting promotes and stimulates autophagy. Researchers believe the rise of ketones, particularly beta-hydroxybutyrate message the body's cells to switch on autophagy [55-57]. We can implement several methods to strengthen autophagy and strengthen the state of ketosis during a fast.

  1. We exercise during a fast to strengthen autophagy. Both aerobic and resistant training encourage autophagy.

  2. We should drink coffee during a fast. Researchers found both regular and decaffeinated coffee encourage autophagy in heart, liver, and muscle cells in mice by raising AMPK and lowering mTOR [50].

  3. During a fast, we can drink green tea, which contains a polyphenol, epigallocatechin gallate (EGCG). In mice, the EGCG turns on AMPK and autophagy in the liver cells [58].

  4. Sweating in saunas and shivering in ice baths could spur autophagy because autophagy strengthens the body's cells against external stress. The Russians are on to something as they sit in a hot sauna and then run and jump into an icy lake during winter.

We can also include several methods to enhance autophagy during our feasting cycle. The ketogenic diet, coconut oil (or medium-chain triglycerides), and the supplements such as berberine and resveratrol help promote autophagy by activating AMPK [56].

## Cancer

Cancer occurs when a person's cells mutate and divide uncontrollably. Researchers believe chronic inflammation triggers cancer [59]. Cancer forms abnormal tissues or tumors. The tumors serve no purpose in the human body as they rob the body of nutrients and harm nearby healthy tissues and organs. Cancer can also form from any cell or organ in the body. Unfortunately, the cancerous cells can metastasize and spread to other parts of the body. For example, skin cancer, which doctors can easily treat, can spread the cancer to the brain and other vital organs if left unchecked.

Normal, healthy cells switch energy sources between glucose and ketones. Our digestive system creates glucose from carbohydrates during our feasting cycle and ketones from fat during our fasting cycle. On the other hand, cancer and tumor cells have a defect or mutation in their energy source. They remain stuck in using glucose as their primary energy and cannot switch to ketones. Scientists call this phenomenon the Warburg Effect after the German biochemist, Otto Warburg, who discovered this phenomenon in the 1920s [60]. The cancer cells love sugar the way children devour their large bulging bags of trick-or-treat candy on Halloween. Thus, we utilize fasting to starve and kill the cancer cells.

We should not be surprised that insulin and insulin growth factor encourage the growth of cancer [61-63]. Insulin sends a signal to the cells in the body to utilize sugar or glucose, especially cancer cells. Furthermore, the liver produces insulin growth factor that acts like insulin and informs the cells in the body to grow. Insulin growth factor can also prevent apoptosis, or programmed cell death. Apoptosis removes the poorly functioning cells that cannot be repaired. In mice, suppressing the insulin growth factor leads to the body creating new cells upon refeeding [64]. Consequently, people afflicted from obesity or Type 2 diabetes or both have a greater chance of dying from cancer [61, 63].

We can see the importance of fasting. Normal cells switch to ketones while cancerous cells starve during fasting. For example, a study showed intermittent fasting stifled tumor formation in rats [65] and mice [32, 66, 67]. Furthermore, researchers breed specific genetic lines of rodents. Studies on fasting, unfortunately, can give conflicting results. Most studies indicate that insulin growth factor stays the same or increases in fasted mice and rats [68, 69] while two studies showed a decrease in insulin growth factor in both mice and rats [62, 70]. For all the rat and mice studies, the fasted rodents experienced the largest drop in blood glucose and insulin [68, 69, 71] and the highest increase in ketones such as beta-hydroxybutyrate [68, 69]. The fasted mice and rats had lower sugar and insulin levels that would slow the growth of cancers despite the higher insulin growth factor.

Some fasters claimed a complete remission and recovery from cancer [3, 8, 13, 65]. The remission rate of cancer varies with the faster. The body's absorption of a tumor depends on the faster's age and condition, the tumor type, and whether the faster has a hard or soft tumor [3]. Fasters allowing the tumors to grow too large require several extended fasts of two weeks or more [3].

Dr. Joel Fuhrman believes fasting cannot dissolve the tumors for obese people [8]. During a fast, the body devours the most accessible tissues first for energy, which would be the fat stores in obese people. However, we can use one argument to counteract this. Intermittent fasting coupled with a diet and exercise can help an overweight person lose weight. Once the person slims down, the fasting helps the body devour the cancer. Intermittent fasting is like cleaning a messy garage. As we clean the garage once or twice a week, and we do not add to much garbage in the garage between cleanings, we will open the door one day to a spotless, clean garage. That's the power of intermittent fasting.

Fasting provides another benefit for chemotherapy. Medical doctors use chemotherapy as one of the primary treatments of cancer. The doctors inject a poisonous substance into the body that kills the cancer cells. However, the substance harms and kills healthy cells, tissues, and organs as well. Consequently, a patient can reduce the negative side effect of chemotherapy by fasting [32, 33, 66]. Fasting switches the cell's energy source to ketones, which minimize the impact of chemotherapy. One study of mice shows how fasting protects healthy cells and organs but allows the poisonous chemotherapy to target and kill cancer cells [32, 66, 72].

We believe the body uses a process, called autolysis, to remove cancer, unneeded tissues, and cells. Autolysis resembles autophagy except the cell releases the digestive enzymes from the lysosomes that dissolve the whole cell while autophagy controls the digestive juices to destroy specific structures within the cell and retain other cell parts. Autolysis originates from Greek and means self-loosing [3, 13].

Many life forms exhibit autolysis. What happens if we leave a potato, yam, or onion in a sunny area? Life prevails. A stem and roots sprout and grow as the plant consumes the bulb or tuber without external nutrients. [3]. For another example, the rapid growth of a tadpole comes from the tadpole assimilating its tail and using the recycled cells to grow legs [3].

Some fasters reported moles, bumps, and scars disappearing after regular bouts of intermittent fasting. I witnessed a dozen bumps and scars disappear after six months of intermittent fasting – some of these bumps I had for ten years or more. Just imagine what fasting does to the inside of our bodies.

We must add a note of caution. Autophagy may weaken the benefits of autolysis. Scientists believe cancer cells utilize autophagy to prolong their life [37, 73, 74]. However, scientists have not unraveled all the mysteries of autophagy in the body [37]. Perhaps we know the reason why the Soviet doctors would not allow cancer patients to fast [24]. From one study, one day of fasting, twice per week, did not heal the mice of prostate cancer [75].

## The Digestive System

Each time we eat food, we not only supply the body with energy and nutrients, but we also expose our bodies to additives, artificial coloring, bacteria, and toxins [8]. The body must sort through the food and absorb the nutrients and dispose of the wastes. The body expends about 25% of its energy to break down and process food into energy making it energy intensive. The immune system also places most of its defenses along the digestive system since it serves as a major entry point for bacteria and viruses.

Fasting gives the digestive system a rest. The intestines, liver, pancreas, and stomach stop processing food and take a break during a fast. Then the organs heal themselves. For example, a fast improves and repairs the liver. People suffering from alcoholic liver injury, fatty liver, and drug-induced liver damage improve their livers from fasting [8].

Fasting impacts stem cells. Stem cells are blank cells that can turn into any cell in the body. Stem cells can create new stem cells as needed. The body fashions stem cells to replace broken and damaged cells in the body. Stem cells come as different types such as stem cells in embryos and adult stem cells. Adult stem cells are scattered across all tissues in the body and are not entirely blank. For example, adult stem cells in bone marrow can form both bone and heart muscle cells [76, 77]. Meanwhile, embryotic stem cells are more versatile.

The intestines require frequent repairs as the food processing damages the cells that line the intestines. Thus, stem cells are always repairing the intestines. As mice age, their stem cells do not function and metabolize fatty acids well [78, 79]. However, researchers found a 24-hour fast improved the functioning of intestinal stem cells in both young and old mice [78, 79]. The intestines of fasting mice healed faster because stem cells improved their functioning during fasts [78, 79]. Stem cells prefer to burn fatty acids as their fuel source [78, 79]. Thus, a bout of fasting awakens stem cells and gets them repairing the body as the feasting cycle starts. Fast of 48 hours led to liver cell regeneration in mice [64]. Researchers need to conduct further studies whether fasting improves the performance of all stem cells in the body.

Some claim fasting heals the following ailments.

  * **Inflammatory Bowel Disease** [8, 30]: Inflammatory bowel disease is chronic inflammation of the gut and comes as ulcerative colitis and Crohn's disease. Ulcerative colitis affects the large intestines or colon while Crohn's disease impacts any tissues between the mouth and anus.

  * **Duodenal Ulcers** [30]: Duodenal ulcers, i.e., sores form on the upper part of the small intestines.

  * **Intestinal Parasites** [30]: Parasitic worms and one cell organisms like protozoans live in the digestive system and usually prefer the intestines. The protozoans feed on the gut bacteria while many intestinal worms prefer sugar as their food. The sources of parasites include contaminated water, undercooked meats, and unwashed fruits and vegetables.

  * **Neurogenic Bladder** [30]: People suffer nerve damage to the bladder. They have trouble urinating, urinate frequently, or experience leakage.

  * **Acute Glomerulonephritis** [30]: Inflammation damages the kidneys.

  * **Pancreatitis** [30]: Inflammation damages the pancreas.

I suffered from severe digestion problems that worsened in March 2018. I attended a conference in Bangladesh, and the conference organizers took good care of me as they fed me five square meals a day. Bangladeshi food is filled with exotic spices and flavors and the spiciness stings like a mouthful of angry bees. Although the food tasted great, my stomach hurt constantly, and I felt bloated and suffered from constant diarrhea. Since 2017, I gobbled down the Imodium like M&Ms. I took three or more tablets per week, sometimes daily. Also, my weight peaked at 220 pounds (100 kgs) with a body mass index of 32%. Thus, I was obese, and, boy, I was in the worse shape in my life.

After returning home, I went on a calorie restriction diet. On some days I felt good, and my stomach didn't hurt. Other days, my stomach hurt a little but not like the pain in Bangladesh. Then I started intermittent fasting in April 2018. After six months of fasting, the problems of my digestion system went away. Now, I take Imodium about one time per month. Sometimes, I even become constipated which is a new sensation for me. In the past, every time I ate food, my body always pushed the food out after three hours, sometimes partially digested.

## Heart Health

Fasting imparts many health benefits on the heart and blood. For example, fasting reduces blood pressure [8, 10, 13, 15, 27, 32, 43, 80] and slows heartbeats allowing the heart to rest [3, 15, 32, 80]. For example, if fasting reduces a person's heartbeat from 80 to 60 times per minute, then the heart gains more rest. (An athlete's heart beats at 60 times per minute). Of course, the rest accumulates over time. At 80 beats per minute, a person's heart beats 115,000 times in one day. If fasting lowers the heart rate to 60 beats per minute, then that same person's heart beats 86,500 per day – a savings of 28,800 beats. Therefore, the heart can rest and repair damaged structures [3].

Fasting improves the blood quality, and the blood feeds the heart and other organs, tissues, and cells in the body [3]. For example, medical doctors view low-density lipoprotein (LDL) as the bad cholesterol and high-density lipoprotein (HDL) as the good cholesterol. Since fats and watery substances like blood do not mix, a lipoprotein carries the cholesterol in the blood. LDL transports the cholesterol to the cells while HDL returns the cholesterol to the liver for disposal [81].

High levels of LDL are associated with a higher risk of cardiovascular disease [10]. Furthermore, medical doctors believe a high ratio of LDL to HDL increases the chance of a cardiac event because the blood has too much bad cholesterol relative to the good cholesterol. Finally, the liver manufactures excess glucose in the bloodstream into triglycerides [10]. Triglyceride is a fat. High triglyceride levels may lead to an increased risk of heart disease [10]. Then the liver converts high triglycerides into LDL cholesterol [10].

The high LDL cholesterol causes atherosclerosis, which, in turn, leads to heart disease. Atherosclerosis, where cholesterol and fatty deposits buildup on the walls of the arteries, is a problem of our modern society. Children and teenagers show the onset of atherosclerosis at a young age. Atherosclerosis leads to heart attacks when the deposits block an artery that feeds the heart while blockages of the arteries in the brain cause a stroke. Thus, heart and brain tissues die from the lack of blood and the nutrients that the blood carries.

We start with the animal studies to show the power of fasting. In two rodent studies, the doctors deliberately induced heart damage in rats. The rats that fasted every other day had a greater survival rate than the control group [82, 83]. Thus, the stress of fasting strengthens and protects the heart from damage, or at least in rats.

The studies on blood chemistry yield different results because of the different genetic lines of rodents that scientists use. LDL cholesterol either stays the same or decreases [68, 84] while the HDL cholesterol either stays the same or increases [68]. Doctors view the ratio of LDL to HDL as more important. Consequently, the LDL to HDL either stayed the same in fasting mice [68, 84] or became smaller [68], which indicates an improvement as HDL becomes larger relative to LDL.

In most rodent studies, the rats and mice either lost or maintained weight from intermittent fasting. However, in two studies, the fasted mice gained more weight than the control group [67, 84]. This study suggests that fasting places stress on a body. Hence, the fasting mice became heavier as their bodies compensate for the stress of fasting. They also ate twice as much food on their feasting day. In addition, fasted rabbits also gained 50% more weight [13].

Another study demonstrated the curing power of fasting on the body. In a 10-week trial, 16 obese people fasted every other day. On fasting days, they ate 25% of their regular caloric intake, so they did not do a complete fast. The subjects lost an average of 12.3 pounds (or 5.6 kg) and lost 2.3% from their body mass index [80, 85]. Their LDL cholesterol fell by 25% while blood triglycerides dropped by 32% [80, 85]. Their HDL cholesterol did not change [80, 85]. In other studies, subjects lost weight and body fat with both total cholesterol and triglycerides falling as well [27, 86, 87] but LDL cholesterol increased in one study [87] and fell in another [27]. In another study of overweight women, the control, fasting, and diet restriction groups witnessed declines in HDL, LDL, and triglycerides with the fasting group experiencing the greatest declines in all three measures [88].

Fasting, in theory, reverses atherosclerosis because fasting lessens inflammation while the cholesterol deposits soften [8, 43]. Some believe that inflammation triggers atherosclerosis [43, 89, 90]. Fasting forces the body into scavenging mode as the body searches for non-vital tissues and materials for fuel. As the deposits and plagues are removed, the greater blood flow nourishes all the organs, tissues, and cells of the body [8, 13]. We are not sure which mechanism clears plagues from the arteries, but some surmise the white blood cells, macrophages, mop up the plaque and utilize autophagy to break down the cholesterol [40, 49]. These white blood cells turn into foam cells because they look like foam under a microscope. (Some researchers blame chronic inflammation causes the foam cells to create the deposits on the artery walls).

Some claim fasting cures the following heart problems.

  * **Angina** [8]: Angina is a severe pain that starts in the chest and spreads across to the arms, neck, and shoulders when the heart does not get enough blood. Angina, although not life-threatening, serves as a warning sign for future heart attacks and strokes.

  * **Congestive Heart Failure** [30]: Narrowing arteries and high blood pressure weaken the heart. The heart has trouble pumping blood until it becomes too weak and fails.

  * **Thrombophlebitis** [30]: A blood clot inflames a vein and usually occurs in the legs. Thrombus is another name for blood clot while phlebitis refers to inflammation.

  * **Varicose Ulcers** [30]: Varicose ulcers, i.e., sores usually form on the legs from poor circulation.

I regularly perform a health check once per year. Every time I have taken a blood test, I always scored high cholesterol. Then I always hear the doctor's speech about taking care of myself and the need for statins to reduce my high cholesterol levels. Table 2 shows my cholesterol tests before intermittent fasting. The health measure shows what the maximum for a person to be healthy. My LDL and total cholesterol were high and exceeded the health measure while my triglycerides were little above the threshold.

I took a health check on 7 June 2018 after intermittent fasting for two months. At that time, I fasted 18 hours twice per week. I also fasted 18 hours before the medical tests. I wanted to check whether the tests registered any abnormalities from the fast. Both the urine and blood tests failed to detect abnormalities except that my LDL cholesterol and triglycerides became higher while my HDL cholesterol fell. The ratio between total cholesterol and HDL become higher signaling a cardiac event in my future. The remaining tests were normal.

Dr. Joel Fuhrman observed that fasting patients with atherosclerosis showed a surge in cholesterol levels [8]. Doctors in the Soviet Union also noticed surges in cholesterol at the beginning of a fast [24]. The cholesterol could remain elevated for months because the fasting reduces inflammation while the body removes atheromas from the blood vessels. Atheromas are cholesterol deposits in the arteries. Meat eaters usually show the surge in cholesterol while vegetarians do not [8]. Some claim that vegetarians can fast easily while heavy meat eaters experience difficulties abstaining from food for extended periods.

I took another blood test after intermittent fasting for 10 months when I fast a minimum of 24 hours twice per week. I even fasted 36 hours before taking the urine and blood tests. The urine tests were normal. My HDL increased while triglycerides fell almost to the normal range. Unfortunately, my LDL and total cholesterol worsen. Consequently, I showed mixed improvement.

My doctor did not give me the speech about statins because I showed some improvement in my blood cholesterol tests. Of course, I refuse to take statins because every cell in the body needs cholesterol as the body uses cholesterol to manufacture hormones and repair cell walls [10, 81]. Furthermore, not only do statins lower a patient's cholesterol, but statins also lower Vitamin D production and co-enzyme Q10. Our bodies produce Vitamin D from cholesterol as the sunlight warms our skin [81]. Meanwhile, co-enzyme Q10, a powerful antioxidant, helps provide energy for our cells and aids in heart health [91].

The 2019 blood and urine tests detected one abnormality – high uric acid. The uric acid is a waste byproduct as the body breaks down purine. The purine forms a building block of deoxyribonucleic acid (DNA), the life's blueprint and contained in every cell. High uric acid causes gout, an inflammatory disease that causes arthritis as crystals form in the joints. Both a high protein diet and fasting raise uric acid in the blood.

I explained to the doctor that I had fasted for 36 hours before taking the blood and urine tests. She looked at me as if I were a raving lunatic. My doctor is Malay, Muslim, and a female doctor, so I informed her I also do 24-hour dry fasts with no liquids nor food for 24-hour stretches. She became even more shocked as if I had plopped a dead rat onto the center of her desk. By the way, she recommends intermittent fasting with 6-hour eating windows. She thinks fasting beyond 24 hours is too extreme. Good thing she is not a psychiatrist. She would have committed me into the nearest loony bin. At last, I also told her I wrote a book about fasting. She wasn't impressed. That's the way it goes. So, I'm her crazy American patient.

I also added the blood glucose in Table 2. Although I haven't eaten in 36 hours, the body maintains the blood glucose around 100. In the next section, we discuss the importance of blood glucose and insulin.

## Insulin and Diabetes

Diabetes, a silent killer, robs a person of their health and eyesight [8, 10] while their bodies feel like a tightly wound yarn ball of aches and pains. Some people with diabetes may lose a leg and suffer from atherosclerosis, heart disease, kidney failure, and stroke [8, 10, 92].

The hormone associated with diabetes is insulin. We cannot call insulin a culprit because it isn't. We possess a flexible fuel system. For our bodies to utilize sugar, i.e., glucose, insulin allows glucose from the blood to enter the cells [10, 11]. The problem with insulin is the hormone helps the body store glucose as fat.

Some people believe eating copious quantities of sugar is bad for their health. Instead, many people eat a variety of carbohydrates such as bread, pastries, potatoes, and pasta. For the body to utilize the starch in carbohydrates, the digestive system breaks down starches into sugars. Starches are long connected chains of sugar. The ole Italian saying contains a kernel of truth – to fatten up a skinny kid, just feed them large plates of pasta. Some starches like bread spike a person's insulin levels more than gulping down pure table sugar [11].

Diabetes, one of the most insidious diseases, originates from utilizing sugar as energy. Diabetes comes in two forms: Type I and Type II. For Type I, a person's immune system mistakenly destroys his or her pancreas, the organ that manufactures insulin [8, 10, 11]. Type I diabetics look skinny and malnourished because their bodies cannot utilize glucose for energy or store glucose as fat. Before insulin injections became widely available, Type I diabetics usually died within months after their disease was identified.

The pancreas, on the other hand, functions in Type II diabetics and still manufactures insulin [8, 11, 92]. Type II diabetics tend to be overweight or obese [10] and suffer from a range of health problems that doctors refer to collectively as metabolic syndrome, such as insulin resistance, high blood pressure, cardiovascular disease, and diabetes. The diabetic's blood glucose rises to high levels that require the person to take additional insulin to lower blood glucose levels. Type 2 diabetics become resistant to insulin while insulin levels remain persistently high [10, 11]. That high insulin level stops the body from utilizing fat as energy.

A diagnosis of diabetes is a sloppy wet kiss of death. People with diabetes show a gradual deterioration of their health as the disease progresses. At the beginning of the disease, diabetics start taking metformin orally, the most widely prescribed medication in the world [8]. As the disease advances, diabetics begin injecting insulin directly into their bodies. Over time, the diabetics require higher and higher doses of insulin to reduce their glucose levels [11]. Meanwhile, their health worsens over time while other health problems appear.

Over time, diabetics' insulin levels remain persistently high, and the cells become insensitive to insulin [11]. Then blood glucose levels rise. People begin putting on the weight and become obese with most of the fat stored around the abdomen. Then people with diabetes suffer from a wide spectrum of problems such as high blood pressure, high cholesterol, and heart disease. Eventually, diabetics take half a dozen pills daily to alleviate the multiple symptoms of their diseases. Dr. Fung has acknowledged the fallacy in doctor's treatment [10]. The medications treat the symptoms of the disease and rarely cure the patient.

Dr. Frederick Allen connected the relationship between diabetes and diet in 1915 [93, 94]. He recommended a high-fat, low carbohydrate diet to treat Type I diabetes [93, 94]. Dr. Allen also recognized that calorie restriction did not reduce blood sugar levels. Only fasting reduced blood sugar levels in diabetics [94]. He also discovered how sugar and starches contributed to diabetes.

Dr. Frederick Allen treated diabetics at his hospital by following a fast with a calorie restricted diet [94]. His patients wasted away, which he called inanition. He recommended a shot of brandy or whiskey per day to prevent acidosis. Out of 42 patients, seven patients died. Another study placed a death rate of 78% [94]. We do not know why Dr. Allen did not raise the fat in meals to stop the patients from wasting away during their feasting cycle. Thus, calorie restriction and fasting play poorly with each other because patients will eventually deplete their fat stores and enter starvation.

Dr. Allen would not survive in today's hostile legal climate, where anyone with money in his or her pockets has a legal bull's eye painted on their back. However, this was the best treatment available until the availability of insulin in 1922. Before 1922, people with Type I diabetes died within months of a prognosis.

We move forward to current times when doctors routinely admonish obese patients to exercise more and follow a calorie restricted diet to help patients lose weight. The doctors believe the weight loss will correct the person's health problems. As Dr. Fung explained brilliantly, diabetes and insulin resistance originate from a hormonal imbalance and not from weight [10, 11]. If a patient loses a massive amount of weight, the weight loss does not correct the hormonal imbalance. We all know what happens. The weight returns with a vengeance and brings along a few extra pounds for good measure. That way, the dieter is punished for trying to lose weight.

Dr. Fung's observation explains the paradox of the popular TV show – The Biggest Loser. We all cheered for our favorite contestants as the fierce Jillian and holistic Bob pushed their teams to lose the most weight. The contestants ate healthy, reduced calorie meals and exercised five hours or more per day. The contestants lost an incredible amount of weight of a 100 pounds or more (or 45.5 kg or more).

What happened when the contestants returned to their old lives? The weight returned with a vengeance. The exercise and restricted calorie diet did not restore the balance of hormones. In one research study, dieters lost weight on calorie restriction [95]. Although their insulin sensitivity had improved, the blood glucose levels remained the same [95]. Eventually, they regained their weight after they had quit their diets.

Fasting helps correct hormonal imbalances. Fasting returns glucose to normal levels, reduces the insulin level in the blood, and makes the body's cells more sensitive to insulin [10, 17, 32, 92, 95-97]. Fasting acts like a reset switch. For instance, we must switch off an electrical gadget for several seconds to reset the device. Alas, the body requires a longer reset time. In my case, I need between 24 hours and 36 hours to reset my body's hormones and gain the benefits of fasting. However, each person is different and requires different reset times. (In one study, fasting overweight women became less sensitive to insulin because the body reserves the scarce glucose for the brain and nerve cells [88]).

One study illustrates the power of fasting to alleviate the symptoms of Type 2 diabetes. Three patients who injected insulin medication between 10 and 25 years [98]. They also suffered from high blood pressure and high blood lipids [98]. They fasted three times per week for 24 hours [98]. One patient came off insulin in five days while the other two took 13 and 18 days to come off medication [98]. They all lost weight and slimmed down [98].

Intermittent fasting, of course, is a key to long-term weight loss. We fast once or twice a week for the rest of our lives. Hence, the periodically fasting stabilizes our weight. If we stop fasting, then, of course, we will gain weight again. Remember – fasting and feasting are the heads and tails of the coin of life. We practice both to ensure a long life.

## Brain Function

Intermittent fasting impacts brain function and brain structure profoundly. Both exercise and fasting boost a protein called brain-derived neurotrophic factor (BDNF) [10, 32, 87, 99, 100]. (Please note that one study of asthma sufferers showed a decrease in BDNF [18]). BDNF helps the brain's neurons survive injuries and diseases and encourages the growth of new neurons and synapses and, thus, becomes the brain's super food [32, 100]. A neuron, a brain or nerve cell, communicates information through electrical impulses while a synapse forms a junction between two brain cells. The synapse either passes or blocks an electrical signal. Therefore, BDNF increases brain health and influences higher thinking, learning, and long-term memory.

As people age, their brains degrade and deteriorate over time. For instance, people usually the elderly suffer from Alzheimer's Disease. In the beginning stages of the disease, the victims become forgetful or have trouble thinking [101]. As the disease progresses, the sufferers lose the ability to perform simple tasks [101]. A characteristic of Alzheimer's is the abnormal accumulation of amyloid beta proteins [16, 99, 102]. We view these proteins as toxic garbage and plaques that disrupt the synapses and hamper the communication between neurons in the brain [10, 101, 102]. Researchers believe that autophagy stops working or slows down in Alzheimer's patients [101, 103]. Then the amyloid beta proteins accumulate and hamper the electrical signals within the brain.

For the good news, fasting helps people with Alzheimer's because autophagy creates autophagosomes that absorb the amyloid beta proteins and recycle the proteins [10, 101]. A cell under stress creates autophagosome that gobble the amyloid beta proteins and fuse with a lysosome. The lysosome releases the digestive enzymes that break down the toxic proteins into raw building blocks, amino acids. Furthermore, ketones protect the neurons from death as the cells utilize ketones for fuel [16, 56, 99].

Fasting aids in two additional degenerative brain diseases: Huntington's and Parkinson's. Parents pass Huntington's disease to offspring through their genes. Huntington's disease kills the brain cells over time. The disease starts with mood and thinking problems and progresses to the inability to walk and talk. Similar to Alzheimer's disease, scientists believe autophagy stop working in the neuron cells because the mTOR becomes defective [103]. In addition, some people inherit Parkinson's disease. The sufferers tend to shake and jerk when they move as the disease affects motor functions. They also have trouble walking. Accordingly, intermittent fasting lessens the symptoms and conditions of both Huntington's and Parkinson's diseases [10, 99].

We revert to the mice and rat studies because they age rapidly, and the scientists can dissect and examine the rodent's brains under a microscope. In one study, researchers discovered that intermittent fasting boosted memory and learning in rodents [68, 84]. Furthermore, the mice's brains showed less oxidative stress than the control group [32, 84]. Oxidative comes from the word oxygen. When oxygen reacts with another chemical, the reaction exchanges electrons. Electrons are negatively charged particles that make electronic devices function. Oxidation is also the chemical reaction of a fire consuming wood and paper as the fire creates heat and light. The exchange of electrons causes stress and damage within the cells and tissues. Although our bodies need oxidation to live, oxidation also damages our bodies simultaneously.

In one study, researchers induced strokes in the brains of young, middle age, and elderly mice. After intermittent fasting, the young mice had the highest levels of BDNF while the oldest had the lowest [104]. The youngest and middle-aged mice survived an artificially induced stroke while the elderly mice were more likely to die from the stroke [104]. The elderly mice had greater concentrations of chemical markers that indicated chronic inflammation [104]. The mice allowed to eat freely with similar age groups resembled the elderly mice that fasted [104]. Consequently, the effects of fasting weaken over time as we age. Otherwise, animals and humans could live forever.

Fasting affects the neurons in the brain. For example, elderly mice genetically prone to Alzheimer's disease exhibited little mental decline for the calorie restricted and intermittently fasting groups while the control group that ate freely showed signs of Alzheimer's disease [102]. Ironically, the calorie restricted group exhibited less buildup of the amyloid beta proteins in their brains [102]. Although the intermittently fasting and the control groups showed the same level of buildup of the amyloid beta proteins, the intermittently fasting strengthened the mice's neurons and made the neurons more resistant to stresses [102]. We have to remember these mice were genetically prone to the abnormal protein buildup. Scientists would need to use normal mice to determine whether intermittent fasting removes the protein garbage and plaques from the brain. In another study, fasting mice genetically prone to Huntington's disease show boosts in BDNF and lived longer with better motor skills than the control group [71].

In another study, rats that fasted intermittently showed boosts in learning, memory, and BDNF [32, 68, 105]. The rats also produced new neurons in the hippocampus [32, 105]. Scientists believe the hippocampus aids in memory storage, motivation, and emotions. In another experiment, fasting rats with spinal injuries recovered quicker than rats that ate freely or were on a calorie restricted diet [106]. Yes, the scientists deliberately injured the rats' spinal cord as part of the experiment.

## Human Growth Hormone

The pituitary gland, located at the base of the brain, manufactures the human growth hormone (HGH) [107]. HGH helps the body burn fat for energy, build lean muscle mass, and strengthen bone density [10, 15, 107-109]. Other HGH claims include boosts of testosterone, hastens healing, and improves sleeping quality [108]. Furthermore, children require HGH to mature into adults. HGH peaks around puberty and continues declining over a person's life [10].

HGH and insulin are adversaries because when insulin levels rise, HGH levels fall, and vice versa [10, 110]. Furthermore, obese people produce little HGH because some characteristic of obesity inhibits the production of HGH [107]. HGH varies during the day and peaks during the night as sleepers approach their waking time [10]. It is also the same time when the sleeper has not eaten anything since their last meal unless they sleepwalk to the fridge for a midnight snack.

As a fountain of youth, some males inject HGH into their veins. The HGH makes the men look younger and muscular because HGH builds muscle and reduces fat. Vanity comes with a price. Males pay between $1,000 and $5,000 per month for HGH injections from a reputable company [108]. Men could take low-cost HGH tablets, but they are not as effective as the injections [108].

In one study, researchers found middle-aged men in their 50s showed strength gains when taking HGH [111]. However, the men's weight and waist size both increased after six months [111]. Of course, HGH injections are not as effective as naturally produced HGH. For this study, the researchers used a small sample size. Small samples are a blessing because researchers can collect and measure a variety of biological markers. However, my statistics professor once said, statisticians expand their data sets to find statistical differences. If the experimental and control groups differ in a measure, then a large sample size will likely find a statistical difference. The relationship must be strong in small samples to find variables statistically significant.

We fasters can save our money. Fasting costs zilch, zero, nada! Intermittent fasting at least 24 hours boosts HGH production significantly [10, 17, 33, 110]. The HGH is 100% natural, produced within our own bodies. The study indicates that we should enter a fasting state before we go to bed because HGH production peaks around 2 A.M. when we are sound asleep [110]. We don't need that pesky insulin messing with our vanity.

## Psychological Problems

We have already seen the benefits of fasting on the brain as fasting improves the mental powers. The fasters' memory, reasoning, and attention span improve [2, 3]. In addition, all senses of the faster become more acute and sensitive. Thus, some fasters feel more spiritual and a greater connection to religion.

Fasting also treats or alleviates the following psychological symptoms and problems.

  * **Addictions** such as alcohol, caffeine, cocaine, and nicotine [8, 24]: We shouldn't be surprised since religion warns us of these vices.

  * **Anxiety** [8, 30]: A person suffers from panic attacks, compulsive behavior, or constantly worries. A related condition called neurocirculatory asthenia causes fatigue, heart palpitations, rapid heartbeat, and shortness of breath. In the old days, we call this an anxiety attack or panic attack.

  * **Depression** [8, 30]: A person enters a state of pessimism, feels wholly inadequate, or views oneself as a failure. Sometimes, a depressed person thinks about suicide.

  * **Neurosis** [8, 30]: A person has a mild personality disturbance. Neurosis includes phobias when a person has an intense fear of something like spiders, heights, or enclosed spaces.

  * **Psychosomatic Disease** [30]: Some neurotics believe they are sick when, in fact, they are not.

  * **Schizophrenia** [3, 24, 30]: A person with schizophrenia perceives distortions of reality and thought, and the person withdraws from social relationships.

  * **Insomnia** [30] **:** Fasters experience better and more restful sleep.

  * **Epilepsy and Seizures:** Fasters prone to seizures experience a reduction in frequency or a complete absence of seizures during a fast [3, 13, 16]. Sometimes, seizures return once the faster resumes eating [3].

Some fasters claim enhanced psychic abilities, such as telepathy and clairvoyance [3, 13]. No evidence supports this claim. Dr. Herbert Shelton supervised over 30,000 fasts and failed to witness one case of heightened psychic abilities [3]. If intermittent fasting enhanced my psychic abilities, then this author would have won the lottery at least two or three times. Of course, winning the lottery four times or more is way too greedy.

## Other Health Benefits

The ailments do not fit neatly into the previous categories. Fasters claim that fasting cures the following ailments and illnesses.

  * **Rosacea** [30]: Victims suffer from extreme redness around the cheeks and nose [8].

  * **Chronic Neck and Back Pain** [8, 30]:

  * **Osteoarthritis** [30]: The cartilage, the soft cushion between the joints, stops bones from grinding against each other. During osteoarthritis, the cartilage breaks down and allows the bone to rub against another bone. Fasting reduces the symptoms of osteoarthritis.

  * **Fibromyalgia** [8, 29, 30]: The sufferers experience aches and stiffness in the muscles.

  * **Gout** [13, 30]: The sufferer experiences a buildup of uric acid in the body that accumulates and inflames the joints.

  * **Impotence and Infertility** [3, 13]: After extended fasts, men lose their impotence while women unable to conceive become expectant mothers [3, 13]. Ironically, women experience morning sickness after conception, which forces the women to fast as the morning sickness prepares the body for the pregnancy.

  * **Uterine Fibroids** [30]: The muscle tissues of the uterus have non-cancerous growths.

  * **Venereal Diseases** such as ‎gonorrhea and syphilis [3, 13].

We do not have a summary of Dr. Shelton's patients to calculate fasting's effectiveness to cure diseases. However, we have the statistics from Dr. James McEachen, who treated 715 patients in a sanatorium near Escondido, California [13]. He treated his patients with fasting between 1952 and 1958, and 294 patients recovered completely or made substantial improvements [13]. Another 360 patients showed modest improvement [13]. Finally, 61 patients showed no improvement [13]. Consequently, fasting healed at least to some degree 91.5% of the patients including tuberculosis infections.

In 2019, researchers conducted a large study of prolong fasting on healthy people that ranged between 4 and 21 days [27]. The study permitted the fasters to consume between 200 and 250 calories per day [27]. From the study, 404 participants reported a health problem, and 84.4% of them claimed an improvement in their health [27]. Furthermore, only two suffered medical problems during the fast from a total of 1,422 subjects [27]. Thus, prolong fasting is safe and effective for healthy people.

We have read the amazing health benefits from fasting. Exercise, diet, or medicine does not even come close to imparting the same health benefits of fasting. Fasting smokes all the other alternatives. If you have not started fasting, what is stopping you? I'm ready to fast some more.

# 3. Fasting and Longevity

"He who eats until he is sick must fast until he is well."

– English Proverb

In this chapter, we outline the connection between fasting and longevity. Even with our scientific knowledge and progress in technology, we do not know why we age. Consequently, we discuss the human's lifespan, the current theories of aging, and how fasting influences aging and longevity. Finally, we discuss the Soviet Union because it is the only modern nation to dedicate resources in the study of fasting.

## Human's Lifespan

The American society made giant strides and leaps in sanitation, refrigeration, and medicine that raised the life expectancy in the United States. For example, men lived on average to 46.3 years, and women lived 48.3 years in 1900 [112]. The life expectancy has dramatically increased with men born in 2015 living until 76.3 years while women living to 81.1 years [113]. However, some claim that the American obesity epidemic will erase our progress in longevity as people around the globe become sicker and experience more medical complications.

One problem of aging is we do not know the life span of humans. However, the Holy Bible provides the answer. Let's return to Genesis when God created Adam and Eve as the first humans. God forbid Adam and Eve to eat the forbidden fruit from the Tree of Knowledge. Then God banished Adam and Eve from the Garden of Eden before they could eat the fruit from the Tree of Life and attain everlasting life (Genesis 3 [5]). The Bible clearly stated Adam lived 930 years while his son Seth lived 807 years. Unfortunately, the Bible neglects Eve and her lifespan. The Bible is also vague whom Seth married since Eve appears to be the only human female around.

Once we reach Noah, 10 generations later, Noah's father, lived 595 years while Noah lived 950 (Genesis 9 [5]). Here's the thing. God grew tired of man's wickedness and flooded the earth to purge the land of humans. Then God reseeded the earth with Noah's family and set the age of man to 120 years (Genesis 6:3 [5]). Although Noah and his sons lived a long life, the life expectancy began dropping with each new generation after Noah.

We may view the Bible as making a mistake on ages. However, archaeologists found Sumerian clay tablets near the city of Mosel, Iraq. The city is located near the covered ruins of Nineveh, an ancient Assyrian city. The Bible mentions Nineveh several times. One set of clay tablets lists the kings before the great flood with reigns lasting 30,000 years. Interesting huh?

God probably thought humans couldn't be so destructive on the world if he vastly shortened our lifespans. I guess, we showed God. It just took us a little longer to turn the world into a festering, overflowing trashcan.

We should not be surprised that the 120-year lifespan is accurate. For example, Jeanne Louise Calment (1875-1997), the longest living person, lived to the ripe old age of 122 years [114]. As a child, she saw the construction of the Eiffel Tower and sold canvases to Vincent Van Gogh in her father's shop [114]. She even smoked cigarettes [114]. She complained about the bland food in the retirement home. She wanted fried and spicy food and ate over a kilogram of chocolate per week. (So, we have one good reason to eat junk food.) It does not appear that she fasted, but life is good with a little chocolate, fried, spicy food, and possibly a cigarette.

We are also not sure of the long-term effects on fasting. Nevertheless, we know the lifespans of four fasters born in the 19th century. They were born at a time with an average lifespan less than 50 years. Mahatma Gandhi (1869-1948) lived for 78 years until he was assassinated. Both Upton Beall Sinclair, Jr. (1878-1968) and Dr. Herbert Shelton (1895-1985) lived until 90 years old. At last, Dr. Edward Dewey (1837-1904) lived 67 years.

Sinclair wrote over 100 books, mostly fiction and wrote the popular Fasting Cure in 1911. He also wrote several popular newspaper stories on fasting. Ironically, Upton Sinclair did not believe in intermittent fasting [1]. He believed people needed to change their lifestyle and practice extended fasts.

Dr. Edward Dewey grew tired of medications and tonics that failed to cure diseases [2]. In his age, medical doctors supplemented medications with whiskey [2]. Dr. Dewey stumbled on intermittent fasting and recommended his patients skip breakfast daily and eat lunch at 1 PM, which equates to an 18-hour fast [2]. He wrote the No Breakfast Plan and the Fasting-Cure in 1900, which chronicled patients' stories and how intermittent fasting cured their ailments [2].

Dr. Herbert Shelton started a fasting clinic in Texas. Although he helped cure over 30,000 patients with a variety of medical conditions, one faster died at his school in 1978. The wife of the deceased won her negligence lawsuit against Dr. Shelton and bankrupted him [115]. At this time, Dr. Shelton had Parkinson's disease and was disabled [115].

The dead faster illustrates the case when a patient is beyond repair. Previous doctors cut out parts of his large intestine and cut into his stomach. The patient wore a sack to collect fecal matter [115]. Even though fasting provides a multitude of benefits for the body, fasting has limitations and cannot perform miracles. If a faster needs a miracle, he or she must appeal to a higher power.

The point of this section is the 120-year lifespan appears accurate although historical texts indicate humans before the great flood lived much longer. Unfortunately, scientists and doctors do not know why we age. In theory, we humans should live a long time because our bodies possess remarkable systems to repair damaged cells and tissues.

## Theories of Aging

Scientists don't know why we age. They devised many theories to explain aging. Many of these theories relate to each other with the truth lying somewhere in between.

  * **The Cellular-Congestion Theory:** The cell accumulates wastes over time, and it the most popular theory [8, 116-118]. Eventually, the waste overloads and damages the cells [8]. The wastes come from toxins or free radicals [8]. Autophagy plays a vital role to clean up and repair cells.

  * **The Free-Radical Theory:** A free radical, i.e., a charged molecule, damages cell parts. The natural process of breaking down food into energy creates free radicals. Pollution, toxins, and smoking also produce free radicals. Insulin can also lead to the production of free radicals [119]. People with elevated insulin levels may produce more free radicals that harm the body's cells. Now, we see the importance of antioxidant vitamins because antioxidants neutralize the charged molecules and prevent cell damage [120].

  * **The Telomere Theory:** Deoxyribonucleic acid (DNA) contains the genetic information to create life or, in other words, the blueprint of life. The cell's nucleus contains DNA. Some cells like red blood cells, hair, nails, and skin, lack a nucleus with DNA. In addition, DNA resembles two chains coiling together to form a double helix. The ends of the DNA chains are telomeres that tie the DNA together like a cap or aglet at the end of the shoestring. As a cell divides, the telomeres shorten. Like the fraying of a shoestring missing the cap, cells cannot divide once the telomeres become too short. Many cells divide a maximum between 40 and 60 times, called the Hayflick Limit [116-118]. Once aging cells reach the upper limit, they stop dividing and become senescent cells.

The telomere ensures the integrity of the DNA since cell replication causes mistakes in DNA [77, 121-124]. As too many cells with shortened telomeres accumulate in one area could lead to problems with the immune system, organ failure, or cancer [121]. Furthermore, cancer and tumor cells become defective and violate the Hayflick Limit [117, 123, 125]. These cells can divide indefinitely, which makes these cells dangerous to the body because cancerous cells produce telomerase, an enzyme that rebuilds the telomeres at the end of the DNA [125]. Scientists believe by suppressing the telomerase, the cancer cells will reach the end of their life and die by apoptosis [125].

The Telomere Theory is a beautiful theory. For example, women show a slower erosion of their telomere length than men although both are born with the same telomere length [126, 127]. Then women usually outlive men. In addition, people with shorter telomeres and over the age of 60 tend to die sooner from age-related diseases than people with longer telomeres [127].

As always in science, telomeres fail to account for one critical fact. We would expect telomere shortening to cause problems in high turnover cells in skin, intestines, and blood cells. The body always produces and replicates these cells continuously as living life always damages these cells. Nevertheless, telomere shortening shows up in low turnover cells in the heart, liver, and brain cells [123, 128]. Something external to the cells is purposely shortening the telomeres over time.

  * **Senescent Cell Theory:** Cells losing their ability to replicate become senescence because of the Hayflick Limit, DNA damage, or oxidative stress [38, 77, 122, 129]. The senescent cells produce chemicals that contaminate the nearby healthy cells [122, 124], and some refer to senescent cells as zombie cells. Hence, a body is a perfectly green lush grass lawn in the spring, and a senescent cell corresponds to a sprouted dandelion. By fall, the yard looks like hell with a field of dandelions. This theory explains why a person gets one gray hair; the gray hair grows into a gray patch. The body begins aging as the body accumulates too many senescent cells.

The senescent cells sending off toxic garbage may provide signals to the body to kill them off via apoptosis, also called programmed cell death. A cell goes through a sequence to kill itself like the heroes activating the self-destruct mechanism in a starship. The white blood cells in the immune system gobble and eliminate the zombie cells to remove them from the body. As we age, senescent cells accumulate rapidly, and the immune system becomes overwhelmed and cannot eliminate them [122, 130]. The immune system becomes inefficient over time. Some believe senescent cells cause chronic inflammation [38, 122, 124, 130] that leads to many diseases that we outlined in Chapter 2.

Scientists discovered one species, called hydra that does not experience senescence [131]. We are not referring to the mythical creature with five heads. The hydra is a simple lifeform living in fresh water and has an elongated body with tentacles coming off one end. In theory, the hydra does not age as the cells can completely regenerate themselves.

  * **Intercellular Communication Theory:** Cells communicate to each other using protein messengers, called cytokines. We already discussed senescent cells, where they send out chemical messages that turn neighboring cells into senescent zombie cells [122, 124]. Furthermore, a tissue suffering from inflammation send out inflammatory cytokines that could harm healthy tissues around it [124]. In a Japanese study including 684 centenarians, the researchers checked a variety of factors such as kidney and liver function, glucose and lipid metabolism, and immune cell senescence [28]. They concluded that low levels of inflammation caused the long life span [28]. The centenarians also possessed longer telomeres [28].

  * **The Cross-Linkage Theory:** As we age, body tissues such as collagen develop cross-links between cells [8]. The tissues lose their elasticity and start functioning abnormally [8]. A body's metabolism creates energy and substances to sustain a cell's life. However, metabolism produces incomplete substances that become wastes in the cell and forms cross-links with other cells [8, 77]. Excessive protein intake helps contribute to cross-links [8].

Dr. Joel Fuhrman warned people about consuming high-protein diets, such as a diet with too many eggs and meat [8]. The body uses protein to build structures and, thus, the protein promotes rapid growth [8]. People and animals that mature quickly also reach death sooner [8]. For example, children reaching puberty at a younger age will tend to die at a younger age.

  * **Genetic-Code-Error Theory:** A cell's DNA becomes damaged from free radicals or cellular congestion [8, 124]. Too many cell divisions cause errors in the DNA. The damage and errors in DNA prevent the cell from splitting itself to create new cells [116, 124]. Even though the cells contain enzymes, telomerase, to repair the DNA and extend the telomeres, the severe damage from free radicals and cellular congestion could prevent repairs [8, 124].

  * **Mitochondria Dysfunction:** The mitochondria serve as the cell's energy furnace as they create energy for the cell. As a person ages, his or her mitochondria become less efficient at utilizing energy that slows metabolism and cellular function [124, 132]. Dysfunctional mitochondria leak toxic compounds and free radicals that damage the components within a cell [36, 77, 120, 122, 124, 128]. In addition, telomere shortening can also lead to poorly functioning mitochondria [128].

  * **Stem Cell Theory:** A stem cell is a blank cell. The body can fashion a stem cell into any cell in the body such as a blood cell or nerve cell. The body utilizes stem cells to repair damaged cells. As we age, our bodies produce fewer stem cells [77, 124]. Meanwhile, the telomeres also shorten as stem cells divide, which causes the stem cells to function poorly over time [77].

  * **Suppression of Autophagy Theory:** We already discussed the importance of autophagy and how the body uses autophagy to rejuvenate and recycle parts within our cells. Autophagy slows down aging because the body recycles a poorly functioning cell and makes it healthy again. Thus, the body does not need to kill and replace the cell. Then the body avoids the Hayflick Limit by preventing the creation of a new cell.

Reduced autophagy leads to accelerated aging in living tissues [36, 124]. Scientists found in worms, flies, and mice that as they age, their bodies accumulate more Rubicon, a protein [34]. The protein suppresses and inhibits the autophagy process [34]. Thus, aging causes autophagy to weaken over time. Unfortunately, we do not know if we could increase our longevity by boosting autophagy or artificially eliminating the Rubicons.

  * **An Internal Clock:** I present my theory of aging. We have a biological clock buried deep within our bodies. This clock sends out a chemical signal to all cells in the body to inform the cells of their age. Although the shortening of the telomeres does tick like a molecular clock, I believe another process causes the shortening telomeres since it strikes both high and low turnover cells.

The origin of my theory is simple. Researchers observed as they subjected muscle and liver cells from old mice to a serum made from the cells of young mice, both the muscle and liver cells acted more like young cells [133]. The researchers took the experiment further and performed blood transfusions between the equivalent of 20-year mice and 80-year mice. The old mice's blood harmed the younger mice because the young mice acted decrepit and old [134]. However, the young mice's blood had little impact on the old mice. Of course, a company, Ambrosia, jumped ahead to offer older people blood transfusions from the young for $8,000. Perhaps technology has created the rise of modern vampires as the elderly affluent prey on the young.

For the good news, fasting slows down aging in the following ways.

  * Fasting helps rid the body of wastes and toxins. Fasting forces the body into scavenging mode as the body searches for nonvital cells and materials, and recycle their proteins and components via autophagy and autolysis.

  * Fasting reduces inflammation [27]. Thus, inflamed cells and tissues stop sending inflammatory messages to nearby healthy cells and tissues.

  * Fasting encourages the mitochondria to improve its energy efficiency and improve cellular function [132]. Furthermore, ketones produce fewer free radicals as the mitochondria convert ketones into energy [16, 56]. Researchers observed adverse changes to the mitochondria in healthy men after a 24-hour fast [12].

  * Autophagy allows the body to restore and recover poorly functioning cells and thus avoid the creation of new cells. Autophagy slows a cell's steadily advancement towards the Hayflick Limit and could limit senescent cells and apoptosis. At last, fasting may strengthen the cells to external stresses and protect the DNA within the cell [32].

  * Scientists are vague about the mechanisms that trigger apoptosis and the connection between apoptosis and autophagy. They are not sure if apoptosis and autophagy share some of the same mechanisms or whether the presences of autophagy stops apoptosis [51]. For some cells, the body prefers to keep senescent cells while quickly killing off other cells via apoptosis [38]. For example, the body does not use apoptosis to kill off cells in the heart and liver. Also, cells using ketones for fuel become protected and less likely to die via apoptosis [16, 56]. Of course, the presence of ketones may provide the starvation message to the cells to switch on autophagy [55, 57]. Consequently, we need more research to understand the role between apoptosis and autophagy.

  * Stem cell activity goes into overdrive when a faster resume eating after a fast [78, 79]. The stem cells rapidly divide and replace damaged cells [78, 79].

Some patients pay enormous sums of money for stem cell treatment because stem cell therapy repairs tissue or reverses age-related degenerative diseases, such as diabetes, heart disease, Parkinson's disease, and stroke [77], For example, Mel Gibson's father received stem cell treatment in Panama [135] because the procedure is not approved in the United States. The doctors harvest the stem cells from the tissues of the umbilical cord [135]. The father showed an improvement of cognition and eyesight and a reduction in inflammation [135]. For the treatment to be effective, a patient requires multiple stem cell treatments. However, we fasters just need to fast 24 hours or more, and it does not cost us anything for stem cell treatment.

Researchers have conducted few longevity studies of fasting on humans because we live a long time. The researchers would need to track humans throughout their lives and record how many times they fasted. A good study would require following people for several years to extrapolate trends. Thus, we must revert to the animal studies.

We examine several animal studies with short lifespans on longevity. Although we humans share similar biological processes with animals, the human body responds differently than animals. The following studies are on mice, rats, and worms since they have relatively short lifespans.

  * In one study, a 24-hour fast triggered a three-time increase in apoptosis in intestine cells in old rats [136]. Thus, the rat's bodies eliminated the senescent cells or zombie cells. In another study, fasting delayed the aging effects of mice with a genetic defect. The defect caused the mice's bodies to produce higher amounts of senescent cells [137]. Although it appears fasting causes apoptosis, we require human studies to determine whether fasting has the same effect. In addition, rodents have a higher metabolism than humans, so they may be more sensitive to a day of fasting than humans.

  * Fasting mice lived 33.6% longer than fully-fed mice [138]. Depending on the species, mice starting fasting at a young age live longer while mice starting at an older age die quicker than non-fasting mice [139]. It is possible in these strains of mice that old mice cannot adapt to the stress of fasting. Furthermore, fasting also helped mice with a predisposition for autoimmune diseases live longer [138]. In addition, calorie restriction boosts longevity in mice [140], rats, rhesus monkeys, fish, flies, worms, and yeast [141]. Ironically, the fasted mice gained 10% more body weight [138]. Perhaps the mice's bodies adapted to the stress of fasting, or their digestive system became more efficient at processing food for nutrients [13]. Similarly, fasted rabbits also gained weight [13].

  * Researchers compared a group of rats that fasted every other day to a control group that ate freely. The fasted rats lived longer [142, 143], weighed less than the control group [70, 142, 143] while both aging and diabetic rats maintained kidney function [144, 145]. Ironically, voluntary exercise had little effect on longevity and weight [70, 142].

  * Researchers studied the ketone, beta-hydroxybutyrate, on mice's vascular cells that line the arteries [146]. The ketone prevents senescence in vascular cells, where senescent cells cannot replicate, or stress has induced premature senescence [146]. People who practice calorie restriction, ketogenic diet, or fasting produce this ketone as their bodies break fat down. Then the ketone rejuvenates the senescent cells. Consequently, the body can transform those zombie cells back into healthy cells. For this to happen, the cells should be producing telomerase to lengthen telomeres at the end of the DNA strands.

  * A study showed that intermittent fasting extended the life of worms, i.e., C. elegans, by at least 40% [147]. Yes, we are talking about worms. Nevertheless, the study's importance lies that the researchers identify the gene, RHEB-1, that regulates a cell's growth and cell cycle. Animals and humans share the same gene that is responsible for the mTOR and insulin pathways. The mTOR pathway senses nutrients and serves as the switch for autophagy.

  * Researchers found that dietary restriction and intermittent fasting extended the life of worms [148]. The absence of food switches on AMPK that preserves mitochondria [148]. The cells also needed flexibility to fuse or break apart mitochondria as needed to extend life [148]. Again, the study is important because humans also have AMPK that switches on autophagy.

  * Scientists show that as we age, the protein, Rubicon, accumulates in the bodies of worms, flies, and mice and weakens the process of autophagy [34]. By knocking out the Rubicon, the scientists extended the lives of their subjects [34]. In addition, mice on a calorie-restricted diet also showed less buildup of Rubicon as they aged [34]. Logically, fasting should accomplish the same reductions in Rubicon as calorie restriction since fasting leads to reduction in total calories.

  * Scientists found that as mice age, an inflammatory protein called vascular cell adhesion molecule 1 (VCAM1) accumulate in the blood's plasma [149]. The protein leads to cognitive decline and activity in the brain. By blocking the protein in old mice, the mice acted young again [149].

  * Researchers bred mice with a genetic disposition for rapid telomere shortening [128]. Of course, the bred mice exhibited signs of rapid aging while their mitochondria began functioning poorly [128]. The mice also had trouble maintaining stable blood glucose levels during a fast [128]. Thus, the mice experienced trouble while fasting.

At this time, I found no studies where fasting lengthened the telomeres via telomerase nor repaired the damaged DNA. Nevertheless, lack of exercise, inflammation, obesity, pollution, smoking, stress, and an unhealthy diet could lead to premature telomere shortening [123, 150]. Yes, stress can lead to premature telomere shortening. Thus, we have a connection between a mental state and the health and longevity of a person. Unfortunately, some people are prone to rapid telomere shortening, which causes premature gray hair, cancer, vulnerability to infections, and shorter life span in adults [123].

At this time, we have no studies linking fasting to telomere shortening. We get around this problem because fasting rejuvenates and restores damaged cells via autophagy and kick-starts the production of stem cells that replace unrepairable, damaged cells. Finally, no studies link fasting to the internal biological clock. Unfortunately, scientists and doctors have only begun to unravel the mysteries of the human body. The proteins, Rubicon and VCAM1, come close to a clock since they accumulate and buildup in the body over time.

## Prolonging Life

We already established that fasting imparts many health benefits and reduces numerous diseases and health problems. A natural question is whether fasting can prolong a human's life. The 120-year life is programmed into our bodies. Most likely, fasting cannot extend our lives beyond 120 years. However, if Americans live on average to 80, and fasting extends the age to 120, then we get a 50% increase in our lifespan, which corresponds to the previously mentioned studies of rodents and worms in the last section. That begs the question of whether scientists and researchers can untangle why we age and discover substances that either extends our age or makes old bodies young again.

We have this notion that we must drink a special elixir, potion, or medicine or eat a particular fruit to extend life. For example, the bible mentions the tree of life in the Garden of Eden, and how God shorten our lifespan from 900 years to 120. For another example, the Epic of Gilgamesh is an old tale about the fifth and famous king who ruled Uruk in 2,500 BC. Thus, we are talking about a 4,500-year-old story.

The story began with Gilgamesh being 2/3 god and 1/3 human [151]. He went on a quest to search for everlasting life because the gods made him mortal [151]. The 2/3 god is an interesting ratio. In gene splicing, scientists use three parents to overcome genetic flaws and deficiencies when tampering with life.

After several trials and tribulations, Gilgamesh met Utnapishtim, the name of Noah in Akkadian [151]. The Akkadian empire rose after Sumer. Archeologists believe Sumer was man's first civilization.

Utnapishtim guided Gilgamesh to harvest a plant (or flower) growing under the water with thorns [151]. The plant will make a man young again. Gilgamesh plunged into the sea with weights tied to ankles and successfully harvested the plant [151]. As Gilgamesh returned home, he bathed in a well with cool water [151]. A serpent, attracted to the flower's sweet scent, came and ate the flower [151]. It shed its skin and returned to the well [151]. (That damn serpent keeps popping up and causing trouble again. He already tricked Eve into eating the forbidden fruit in the Garden of Eden.)

Perhaps the Epic of Gilgamesh provides a lesson. We're not supposed to become young again. Similar in Genesis, God kicked Adam and Eve out of the garden before they could eat the fruit from the tree of everlasting life. Thus, we have this inherent desire to search for substances to cure our health and make us live longer.

In our modern world, the goal to make money also encourages scientists and researchers to search for drugs and medicines to extend life. They file a patent with the U.S. Trademark and Patent Office that grants the patent holder 20 years as the exclusive producer. That way, the company charges high prices and squeezes customers for everything they have for a lifesaving drug.

For example, researchers identified several substances to extend life.

  * **Metformin:** The popular diabetic drug may reduce the zombie cell's nasty secretions and prolong longevity [130]. Metformin may also turn on the AMPK pathway that switches on autophagy [49, 56, 140]. I do not recommend readers to take this drug without a doctor's prescription. The pharmaceutical industry makes metformin from the French lilac or Goat's Rue.

  * **Rapamycin:** Doctors use the drug to suppress a patient's immune system during transplants. The drug prevents the immune system from attacking the transplanted organ or tissue [130]. Rapamycin also inhibits the mTOR pathway and, thus, switches on autophagy [35, 36, 41, 49, 140]. The drug also helps remove the senescent, zombie cells [130]. They refer to these drugs as senolytics, and they are experimental.

  * **Curcumin:** This substance is a polyphenol and comes from the spice, turmeric. Although scientists have not identified curcumin as a life extender per se, they study its potential to kill cancer cells [152]. Curcumin switches off mTOR [152], similarly to fasting that, in turn, would switch on autophagy. Scientists implicate mTOR as another factor that encourages the growth of cancer cells. When we are always eating, we activate mTOR that encourages cell growth.

  * **NAD+:** The chemical, nicotinamide adenine dinucleotide (NAD+), plays a crucial role in helping the mitochondria produce energy in the cell [153, 154]. As we age, NAD+ levels drop over time [153, 154]. The mitochondria in old mice function like mitochondria in young mice when given NAD+ [153]. The NAD+ supplements boost both DNA repair and autophagy (i.e. mitophagy) and prolong life in worms and mice [155]. As we would expect, fasting and the ketogenic diet raises blood ketones and, in turn, encourage the cells to produce more NAD+ [56]. Normally, the cells make NAD+ from vitamin B3, niacin, or nicotinamide. Scientists are searching for NAD+ boosters to extend life and reduce metabolic diseases such as diabetes and obesity [154].

  * **Resveratrol:** Many believe resveratrol lengthens and repairs the telomeres on the DNA. In several research studies, resveratrol enhances autophagy [36, 39, 56, 120]. Resveratrol is a polyphenol, i.e. an antioxidant. Sources include blueberries, cranberries, cocoa, dark chocolate, grapes, peanuts, pistachios, and red wine.

This chapter would not be complete without mentioning my three favorite antiaging herbal supplements:

  * **Hyaluronic Acid:** A simple compound helps the body retain water and keeps the skin, eyes, and cells hydrated [156]. It also is a powerful antioxidant [156]. In a Japanese village, the residents eat a purple sweet potato that helps their bodies produce high levels of hyaluronic acid. The villagers often die in their 90s while always looking half their age.

  * **Astaxanthin:** Astaxanthin, one of the strongest antioxidants, comes from the alga, Haematococcus pluvialis. Lobster, shrimp, and salmon get their reddish orange color from eating this alga. Manufacturers stress the alga to switch on the plant cell's survival mechanism, which creates astaxanthin. Then they crack and extract the astaxanthin. Capelli and Cysewski (2013) wrote a good book on astaxanthin called The Worlds' Best Kept Health Secret – Natural Astaxanthin [157].

  * **Lingzhi:** The fungus, lingzhi, grows on dead trees. The fungus has been part of Chinese herbal medicines for two thousand years. The Chinese refer to lingzhi as the "divine plant" and "auspicious plant" because it symbolizes good fortune, happiness, longevity, and wealth. The fungus strengthens the immune system and departs some anti-cancer properties. The Japanese call it reishi.

We probably don't want to run to the nearest Chinese herbal shop to buy some lingzhi. Simmering the dried fungus in water for a half hour creates one foul tasting tea. Let's just say if drinking a cup of lingzhi per day extended one's life by twenty years, I couldn't do it. On the other hand, the herbal stores offer a pill supplement made from the cracked, fungus spores, which I find more palatable. The herbalists claim the fungus spores are much more potent than the fungus. Of course, I loved it whenever I would ask for lingzhi at the herbal store; the Chinese clerk would ask me if I have cancer.

Researchers and corporations may neglect fasting since the corporation cannot patent the fasting process. Patents cover devices or chemicals and not processes. Thus, fasting provides little financial awards in studying it.

Some researchers study fasting, but we cannot predict how much future research they will conduct. I'm also a researcher in finance and renewable energy. Our academic careers depend on publishing papers in good journals and obtaining research grants. Researchers studying fasting may have trouble getting grants since corporations offer grants for future products and patents. Often, governments mirror the corporations and provide grants for tangible results. Consequently, researchers pursue research to boost careers, reputations, and salaries, but not necessarily to further human knowledge.

We, of course, must be careful of research funded by a grant. A research grant could bias experiments and research. Remember that old idiom – don't bite the hand that feeds you.

Times could change. Iranian academics established, _The Journal of Nutrition, Fasting and Health_ in 2013. The journal, published in English, covers all aspects of fasting, and anyone can download articles for free. Unfortunately, the hostile relations between Iran and the United States could prevent the academics in the west to stay away from the Iranian journal. Believe it or not, only one country in modern history had studied fasting on a large scale. That country was the Soviet Union.

## The Soviet Union

It seems odd to discuss the Soviet Union in a fasting book. The Soviet Union was a murderous state where millions disappeared under Stalin when the infamous secret police knocked on troubler makers' doors at midnight. Furthermore, Stalin starved millions of people in the USSR when the state confiscated the livestock and restructured all industries in the Soviet Union.

The Soviet Union created two privileged classes. For the first class, the members of the communist party drove cars, lived in the best apartments, and shopped at their exclusive stores with fully stocked shelves. We shouldn't be surprised. The communist party members were the politicians. Of course, they lived well compared to the people they ruled over. Then the scientists and professors filled the second privileged class. Consequently, the Soviet Union excelled in mathematics and physical sciences. The Soviet Union put the first man, Yuri Gagarin, into outer space, which sparked the space race between the United States and the Soviet Union.

The scientists in the Soviet Union studied fasting as a medical cure. Dr. Uri Nickolayev discovered fasting as a cure for schizophrenia accidentally [24]. The story began with a schizophrenic patient refusing to eat. Instead of forcing the patient to eat food, Dr. Nickolayev let him be. Surprise, the symptoms of schizophrenia disappeared after two weeks of not eating food. That piqued the doctor's curiosity. Then Dr. Nickolayev started conducting water fasts in the Moscow Psychiatric Institute to cure patients [24].

The patients water fasted from 20 to 30 days [158]. They must drink a minimum of one liter of water per day and exercise three hours per day including outdoor walks [24]. The patients breathed fresh air while the sunlight hit their skin. They also practiced breathing exercises, afternoon naps, massages, showers, and cleansing enemas [24]. Ironically, fasting resorts follow the same guidelines and include yoga and tai chi but charge premium prices.

The fasting treatment cured 64% of the schizophrenics, and 47% of patients maintained their improvement over six years [24]. When the hospital discharged patients, doctors conducted periodic home checks on the patients for 10 years [24]. People with schizophrenia usually have abnormal buildups of protein in the brain. The patients would periodically fast for short periods at home to remove the protein buildup [24]. Alzheimer's is another disease with abnormal accumulation of proteins in the brain that fasting may help alleviate.

Dr. Nickolayev expanded fasting to manic-depressives [24], overweight teenagers [159], people suffering from cardiovascular diseases [159], and alcoholics [24]. If the alcoholics continue to drink after the fast, they greatly reduce their consumption [24] because their bodies become more sensitive to alcohol. Ironically, the doctors would not treat cancer patients with fasting [24], even though we already learned in this book that fasting reduces or eliminates some cancers.

Dr. Nickolayev notified the Soviet Academy of Sciences. Although the academy was skeptical at first, the academy dedicated resources, doctors, and scientists to study water fasts. The intellectuals of the Soviet Union took the study of fasting seriously.

With the breakup of the Soviet Union, fasting lost its popularity in Russia because doctors recommend medical supervision of fasters. Most Russians cannot afford to pay for medical supervision. In places like Siberia, the medical doctors still practice fasting. On the other hand, Russian fasting resorts attract health tourists. Several resorts are located in the Russian wilderness and cost half as much than the fasting resorts in Europe [159].

The Soviet Union had many smart people running the system, so why did the system fail? We have a simple answer. The bureaucrats made all economic decisions. They decided how much the factories would charge, how much to produce, how much labor to use, etc. A person needed permission from the government for every tiny thing. For example, a person living in a village needed a special document to relocate and work in a city. Sometimes, a village guy would marry a city girl to get that document. Yes, the bureaucracies were that anal. When I lived there in the mid-1990s, the bureaucracies were a headache to deal with unless one tucked a couple of Benjamins inside the documents. (I visited places where Americans were not viewed highly, but I never had trouble buying with American dollars.)

The Soviet Union grew phenomenally during the 1960s, but severe shortages and degradation set in the 1980s. The bureaucrats also froze technology, and the Soviet Union fell behind the western nations. Then the system collapsed in 1991.

# 4. After Effects of Fasting

"The best of all medicines is resting and fasting."

– Benjamin Franklin, Founding Father of the United States

We examined the health benefits of fasting and how fasting not only extends the faster's life but also improves the quality of life. Furthermore, fasting imparts additional effects that last well into the feasting cycle. Finally, we cover the rare side effect that makes fasting dangerous – death.

## Allergies and Skin Rashes

Fasting influences allergies. An allergen is an airborne substance such as pollen, dust mites, or mold that forces the body's immune system into overdrive as the immune system neutralizes the substance. Insect bites and particular foods could also trigger an allergic reaction. Consequently, fasting could reduce the following allergies over time.

  * **Allergies** [8, 30]: The immune system becomes super sensitive to harmless substances in the environment. Allergies manifest in a variety of symptoms. The immune system produces histamines to combat the offending substance.

  * **Bronchial Asthma** [13, 18, 30]: The bronchial tubes, where the airway divides into two branches and supplies air to the lungs become inflamed. A person coughs, wheezes, and experiences shortness of breath and tightness of the chest.

  * **Eczema** [8, 13, 30]: Pollen may trigger eczema where patches of skin become cracked, inflamed, itchy, and red.

  * **Hay Fever** [13, 30]: A person sneezes and has a runny nose and red, itchy eyes.

  * **Hives or Urticaria** [30]: A person experiences an outbreak of swollen, red bumps on the skin.

A faster may also experience bouts of skin rashes. The rashes resemble an allergic reaction, but we are not sure. The body tucks toxins and harmful substances into the fat tissues as a temporary remedy during a person's feasting cycle. During a fast, the body burns the fat and releases the toxins and harmful substances into the body again. Dr. Shelton and Dr. Fuhrman believe skin rashes are a means to remove toxins through the skin [3, 8].

***

In my case, I'm allergic to tree pollen. In the United States, I suffered from severe allergies for two weeks when the trees awakened after lying dormant during a cold winter. In some years, the allergies were terrible, when I wanted to take a spoon and gouge my eyes out.

My allergies were not severe in Malaysia before 2017. I live in a tropical country where plant life never goes dormant because Malaysia has two seasons: Hot and rainy, and hot with little rain. I would experience a mild hay fever every several months as a specific tree started pollinating.

Then my allergies worsened in 2017 and 2018. Incidentally, I was also sick many times during this period. (My best friend also suffered from allergies and sickness more often than I in 2017.) I chewed the antihistamine tablets like breath mints, taking at least two or three times per week.

I started fasting in April 2018, and my allergies went dormant after eight hours into a fast. My sense of smell sharpened and became more intense. It seemed I wore a garland of tree buds around my neck from the strong smell of tree pollen in the air around me. Unfortunately, my allergies returned within 30 minutes after eating food.

I continued intermittent fasting twice a week. After six months of intermittent fasting, my allergies improved. Although I'm not cured, the symptoms lessened, and my allergies clear quickly when I start fasting. Subsequently, I take antihistamines two or three times per month. Finally, after twelve months of intermittent fasting, my allergies rarely disturb me. I don't remember the last time I have taken an antihistamine.

During my fasting journey, I experienced three bouts of skin rashes. The first outbreak occurred after my first month of intermittent fasting. Little, itchy red bumps formed on my arms, legs chest, and abdomen. The bumps resembled hives. Then a six-inch red rash developed on the left side spanning across the lower torso and upper abdomen where my stomach is located. I showed my doctor the rashes, and she was stumped. She took pictures and sent them to a dermatologist. They didn't know what it was, but the outbreak cleared after two weeks.

I experienced the second and third outbreaks after the sixth and eighth month of intermittent fasting. The rashes seemed to occur when I bust through a weight plateau. The second happened when I lost 26.4 pounds (or 12 kgs) and the third at 28.6 pounds (or 13 kgs). The second outbreak was a handful of red bumps while the third was severe with many red bumps covering my body that resembled chicken pox. However, both incidences cleared after two weeks. Perhaps Dr. Shelton and Dr. Fuhrman are correct [3, 8]. The body cleanses and detoxifies itself of toxins during a fast. Thus, the skin rashes come from the body ridding itself of the toxins through the skin.

## Eating and Satiation

Fasting changes a person's relationship with food. When I fasted for 18 hours twice a week, I could exert control over my appetite during the feasting cycle. I usually add a treat like a candy bar or ice cream to my regular meal when I break a fast. I actually eat more junk food and sweets, and drink more sodas since I started fasting. However, I eliminated snacking between meals.

When I started fasting between 24 and 36 hours twice per week, my eating habits veered out of control. I would cycle between periods when I wasn't hungry, and when I was ravenous and couldn't stop eating.

We are creatures of habit. I reestablished my old eating habits when I always eat breakfast at 6 AM, lunch around 12, and dinner at 5 PM. I reverted to my old habits to control overeating. Otherwise, I would be caught in these vicious cycles of extreme hunger and no hunger when fasting beyond 24 hours. That leads to another tip.

  * **Tip #5:** If we experience difficulties with eating during the feasting cycle, we revert to our normal eating habits regardless of whether we are hungry or not.

I watched testimonies on YouTube, where bloggers claimed that they ate well after a fast, and the weight melted away from their bodies. I followed their recommendation. I'm 51 years old and, sometimes, I eat like a starving teenager, but I continue to shed weight while becoming slimmer.

The hunger makes perfect sense after a fast. Autophagy causes the cells to recycle parts within the cell; autolysis eliminates cells while the body kills senescent, zombie cells. Hence, the body scavenges for energy and devours any substance not deemed vital. During the feasting cycle, we must rebuild those lost structures. Similar to a growing teenager, the fasters eat and not gain an ounce of fat.

Many health gurus and medical doctors recommend fasters control their eating and also eat healthier during their feasting cycle [8-10]. This recommendation is easier said than done. Eating habits depend on the person. I believe Dr. Fung is correct that a hormonal imbalance causes obesity [10, 11]. Thus, we utilize fasting to correct the hormonal imbalance, which corrects our hunger and satiation signals. When the hormones are in balance, the body gives the correct hunger signals for food. Thus, we eat until we are satiated.

I'm suspicious of the doctors' and experts' opinion to eat healthier. Is healthy food really healthy? Since the dawn of civilization, man used selective breeding to alter the food supply over the centuries. Recently, we humans accelerated the process and played with the genes in plants and animals directly through genetic engineering.

Let's take a look at meats. Farmers and herders have bred animals selectively over the centuries. They also altered the diet of animals. For example, cattle eat grains even though their natural diet is grass. Farm raised fish eat protein pellets instead of algae and small organisms. Unfortunately, the changes in diet alter the composition of meat such as:

  * Farmed raised cattle, animals, and fish are usually fatter than wild animals. The nutrient content also differs. For instance, grass-fed cattle build up five times more omega 3 fatty acids than grain-fed cattle [160]. Omega 3 fatty acid reduces the risk of heart disease. Of course, the nutrients in the meat depend on what the farmer feeds the animals and fish. Unfortunately, a competitive industry causes producers to reduce costs as much as possible such as using the cheapest feeds.

  * Farmers inject cattle and animals with a smorgasbord of antibiotics and growth hormones [160].

  * Farmers restrict the movement of animals and fish because exercise toughens the meat and makes the meat leaner. Farmers sell meat by the pound (or kilogram), so they lose money if the animals lose weight from exercising.

The animals are, in essence, of what they eat. Farmers feeding the animals and fish low-quality feeds yield low-quality meat. Then we eat the animals and fish and assimilate what they have eaten. Of course, the farmers choose grains like corn to fatten the animals, which are carbohydrates.

Some doctors recommend people should eat mostly fruits and vegetables and eat meat sparingly [8]. Unfortunately, farmers have altered the genetics of fruits and vegetables through selective breeding. Farmers breed crops to yield bigger and sweeter fruits as they boost harvests from the trees. Several examples show how humankind has altered the following fruit and vegetables:

  * **Carrots:** Carrots were gnarly roots and came as either white, yellow, or purple. Today, carrots grow as a tapered root and come as orange and red.

  * **Strawberries:** Wild strawberries grow to the size of blueberries. Farm strawberries approach the size of apples and oranges.

  * **Bananas:** We eat the sweet, Cavendish bananas with soft seeds. The original banana had a starchier texture and packed with hard seeds. (I tried bananas on Borneo with the crunchy seeds. Definitely, an unusual eating experience.)

Fruits and vegetables contain thousands of chemicals. They pack many nutrients, antioxidants, phytochemicals, vitamins, and minerals. Are all these chemicals safe to the human body? Researchers estimate we eat 1.5 grams of natural pesticide per day, which exceeds the synthetic pesticides by 10,000 times [161].

We only hear about the synthetic pesticides and not the natural ones. We should not be surprise. That is the meaning of life – to grow, create offspring, and die. Plants do not like to be eaten since it prematurely ends their existence. A damaged or stressed plant produces natural pesticides to protect itself [161]. In large quantities, researchers have proved these natural pesticides cause cancer in rodents [161].

Several chemicals that are bad for the human body include:

  * **Potato:** A potato exposed to sunlight grows a green skin. A chemical, solanine, causes the green skin and could make a person ill or sick if he or she overeats green skinned potatoes.

  * **Nightshade Family:** Eggplant, peppers, tomatoes, and white potatoes belong to the nightshade family. Researchers identified 27 natural pesticides in these vegetables [161].

  * **Cancer Prevention:** In a large study between 1992 and 2000, researchers recruited 521,448 men and women across Europe from diverse backgrounds [162]. The researchers found eating fruits and vegetables had a weak influence of preventing cancer [162].

  * **Wheat and Celiac Disease:** We adapted the dwarf-wheat variety in the 1950s for higher yields [11, 163]. Modern wheat contains fewer nutrients than older varieties, and some people are sensitive to the wheat gluten in the dwarf varieties [163]. Their immune system identifies the gluten incorrectly as a foreign invader. Then the immune system attacks the digestive system causing leaky gut syndrome and chronic inflammation [163]. Some people improve their health just by avoiding gluten.

  * **Coffee:** It breaks my heart to write this. Roasted coffee contains chlorogenic acid, neochlorogenic acid, caffeic acid, and caffeine, which are toxins to the body [161].

  * **Fiddlehead Fern:** A popular delicacy on the Island of Borneo. The fiddlehead is the curled, new leaf of a fern. The fern contains a toxic, carcinogenic substance.

I tried the fiddlehead fern. It's delicious, similar to French-cut green beans. However, I broke out in severe hives and had severe diarrhea for two days. The diarrhea was so severe that I could not venture too far away from a bathroom. Also, I couldn't eat anything and drank kefir, similar to yogurt, for two days.

Perhaps fast food is toxic crap to the body and potentially causes health problems down the line, like a poorly running car engine from burning dirty gasoline for years. However, we humans have severely manipulated all our food including fruits and vegetables. Although apples and oranges may be better than a juicy Big Mac, apples and oranges could cause problems in the body albeit at a much lower level. How do I know? All foods elicit an insulin response except pure fats [11]. Of course, nobody eats pure fat. However, both carbohydrates and proteins spike insulin levels [11]. Although not replicated here, dieters can refer to the insulin index that measures a body's insulin response to food. The insulin index is similar to the glycemic index, that measures a person's response to glucose.

The results of the insulin index may shock you. The researchers compute an insulin score for subjects eating 250 calories of a specific food [164] and measure the insulin response during two hours [164]. For example, white bread scores a 100 on the insulin index while yogurt, which many consider healthy, scores 115 [164]. Baked beans come in at 120 [164]. Fruits such as apples, bananas, oranges, and grapes range between 59 and 82 [164]. Finally, eggs and cheese score 31 and 45, respectively [164].

For another example, many report the health benefits of a juice fast, but the juice fast is weaker than a water fast. Thus, the process of the digestion system breaking down food inflicts problems on the body. However, we need the nutrients and energy to sustain life even though fruits and vegetables contain natural pesticides and may not prevent cancer.

Don't get me wrong; we should eat fruits and vegetables to ensure we get plenty of vitamins and minerals. However, eating fast food once in a while is not the end of life. For example, Blake Horton, a health guru, demonstrates the power of fasting and shows his extreme eating on YouTube when he eats his mountain of food from a large platter with a layer of French fries covered with melted cheese, and small pools of glistening oil. His meals clock between 4,000 and 5,000 calories. Although he cooks his meals and controls the ingredients he puts in his food, he demonstrates the power of fasting. His eating window spans one hour while he fasts for the other 23 hours in the day. He's in shape and athletic looking although he shocks viewers with his eating regimen.

That's why I do not worry about indulging in sweets and junk food. We transform our indulgence into a reward. If our weakness is a slice of chocolate cake with a scoop of ice cream, a candy bar, or a cream-filled doughnut, we reward ourselves for fasting. Then we sit down and savor that weakness as we break a fast. The taste buds are sensitive from taking 16 hours or more break from food, and that first bite is a taste of heaven.

  * **Tip #6:** Diets do not work because they punish the dieter. We make fasting work by turning a food weakness into a reward. When we fast for 16 hours or more, we deserve a treat. A candy bar, ice cream, or a can of soda tastes fantastic after a fast. That way we have something to look forward to when we begin our feasting cycle. Please note, the indulgence is not a tub of ice cream, a box of doughnuts, or liters of soda. We revert to our old eating habits and toss in a treat as a reward.

Because of fasting, I recovered my teenager metabolism when I can eat anything and not gain weight. I violate all the rules that the medical profession advises against. Although I'm a rebel by nature, I save the bacon grease. I eat one or two fried eggs per day cooked in said bacon grease. I drink the salty brine leftover from my Ramen noodles to ensure I get plenty of salt. I drink cream milk for breakfast. I love the chicken skin, which is the best part of the chicken. Finally, I sometimes say yes to the whipped cream on my Starbuck's Frappuccino.

I have been fasting for over 16 months. Fasting has become second nature. Most times, I feel no difference between a fast or feast. However, I sometimes end fasts with a Big Mac and fries or a bag of Doritos with a Snickers. For my second meal after breaking a fast, I revert to my regular eating patterns. Don't worry, I admit I have an atrocious diet, but I fast and exercise, so two out of three isn't bad.

I'm gradually improving. I do eat some healthy food, and I give the readers some of my favorite salad recipes in Chapter 9. I also eat more fruit such as apples, oranges, bananas, dragon fruit, and rambutans, and made my New Year Eve's resolution to eat healthier in 2019. However, all food contains toxins and both natural and synthetic pesticides that could harm our health. The best piece of advice is to eat a variety of foods especially nutrient dense foods packed with vitamins and minerals.

## Metabolism and Weight Loss

A person usually loses about a pound (or 0.45 kg) of fat for a full day of fasting [3, 8, 13]. The weight loss can drop to ½ pound (or 0.23 kg) per day [3, 8]. However, weight loss varies with the person. Both obese and athletic people lose more than a pound (or 0.45 kg) per day [3]. For example, fasting obese people can lose between 1.5 and 5 pounds per day [19]. In one study, fasters lost up to 9% of their body weight with significant decreases in body fat within five months [20]. Dr. Shelton claimed a person losing a lot of weight during a fast indicates a sick body while little weight loss means a healthy body [1, 3]. We covered the health benefits of fasting in Chapter 2.

A faster could lose more than a pound per day as the body rids itself of excess water during a fast [3, 8, 10, 15]. When we burn our glycogen, our bodies release water [12]. In addition, the lower insulin levels allow the body to rid itself of excess salt and water via urination [10, 15, 165]. When we step on the scales, we smile because we think we have lost a lot of weight. However, we will regain the water weight once we start our feasting cycle again. That leads to another good tip.

  * **Tip #7:** We only weigh ourselves towards the end of a fast. That way, we do not feel depressed if we had gained several pounds (or kilograms) from water weight. We also should use the scale to determine when we end the fast. Please note; we could gain weight during a fast by drinking too many fluids. The one measure that never lies is the tightness of a belt.

We do not know at this time whether an obese person losing massive amounts of weight rapidly from fasting will suffer from excess skin. For obese people, losing weight is the double whammy. An obese person loses tons of weight but then suffers from skin that drapes from his or her body like curtains. Usually loose skin comes from a 50-pound (or 22.7 kgs) or more weight loss. In theory, fasting should cause the body to recycle the excess skin but more research is needed.

Intermittent fasting boosts metabolism and burns more energy, allowing fasters to lose more weight. Fasting boosts metabolism in the following ways:

  * Fasting increases adrenaline, i.e., the neurotransmitter norepinephrine that stimulates metabolism [10, 11, 20]. A neurotransmitter is a chemical that allows a brain neuron to communicate with another neuron. Adrenaline is part of the fight versus flight response as it constricts blood vessels and raises the heartbeat. Consequently, adrenaline prepares the person for action, i.e. search for food because the body's cells are hungry.

  * Fasting causes the liver to produce glucose from amino acids, called gluconeogenesis. The chemical conversion requires energy which boosts a faster's metabolism [20].

  * Fasting boosts human growth hormone (HGH), lowers the insulin in the blood, and helps the body burn fat for energy [9, 10]. Fasting boosts metabolism by 3% [9, 10].

  * The metabolism revs up after the faster resumes eating. The body must rebuild the tissues and cells it had lost during the fast from autophagy, autolysis, and apoptosis, the death of old cells. The stem cells go into overdrive to replace the dead cells.

Another reason for the boost in metabolism is the body has access to the fat stores during fasting. For example, I weighed 220 pounds (or 100 kgs) at the worst time in my life in 2018. My body mass index (BMI) peaked at 32.7. That means I was obese with my body comprising about 32.7% of fat. I walked around with 71.9 pounds (or 32.7 kgs) of fat with enough fat stores to last at least 71 days. How could my body be hungry for energy as fasting makes 71 days of energy available?

A person's metabolism relates to his or her mitochondria, the energy furnaces of the cells. One theory of aging suggests the mitochondria become inefficient at utilizing energy over time, which is why we feel colder and eat less as we age. Fasting improves the functioning of mitochondria and revs up the energy consumption within the cells [16].

A person consuming a diet rich in carbohydrates overloads their system with sugar because the digestive system breaks carbohydrates like starch into glucose. Consequently, the mitochondria become accustomed to always burning glucose for fuel instead of fat. If we always snack every two hours especially carbohydrates, our mitochondria are stuck burning glucose for fuel.

Fasting switches a person's body from a sugar burner to a fat burner. A sugar-burner only lasts two hours before they need another snack or sweet drink. Meanwhile, a fat burner can go hours until the next meal. Thus, fasting makes the mitochondria more flexible in fuel sources as a faster switches back and forth between fasting and feasting.

We see the problem of modern-day society. Doctors advocate eating or snacking every two hours while awake. Some people even wake up during the night and snack. Hence, most people rarely enter the fasting state, or if they do, they awaken and eat to re-kick the feasting cycle again. Thus, the pancreas always produces insulin so the body's cell's turn the glucose into both energy and fat. Then people trap themselves in the fat storage mode and encourage their mitochondria always to burn glucose for fuel.

***

I tried the Adkin's Diet and caloric restriction several times. I have always been good about working out in the gym. I jog two or three times per week on the elliptical trainer and resistant training twice per week. I jokingly called it my natural health insurance. Of course, my health insurance is much better than the health insurance plan that President Obama and Congress had pushed onto Americans in 2010.

I didn't know it at the time, but I ate nothing between 6 PM and 6 AM the next day. Thus, I fasted 12 hours daily. My largest weight loss was 11 pounds (or 5 kgs). That's it. That was in 2016. Then I became fatter in 2017 as I regained all my weight plus a couple of extra pounds as punishment for trying to lose weight. In 2017, I couldn't lose weight on caloric restriction while my weight remained stuck at 220 pounds (or 100 kgs).

I rarely dieted because I knew one critical fact – dieters lose weight in the beginning and then regain the weight plus several extra pounds for good measure. I tried the calorie restriction and frequent small meals. The calorie restriction left me hungry all the time. I also tried to eat small meals every two or three hours, a trick bodybuilders use to build muscle and shed fat. That failed too. The frequent small meals keep the body in sugar burning mode.

Then I saw the videos on YouTube – calorie restriction versus fasting. Later, I learned how fasting switches on autophagy. Thus, I gave fasting a try. At first, I tried 18-hour fasts once per week. For the first several times, I thought I would die. I became dizzy when I stood up, and I suffered hunger pangs. Each time I fasted, the process became easier and easier. Then I expanded fasting to twice per week and gradually increased the duration.

The weight loss is miraculous, and I still eat three square meals per day during my feasting cycle while expanding my portion size. I lost 11 pounds (or 5 kgs) within a month. The next month, I lost another 4.4 pounds (or 2 kgs). Then fasting became interesting. I modified my exercise regime to include fasting. I jog twice per week, resistant training twice per week, and fasting twice per week with one day of rest.

The weight loss slowed each month as I kept hitting weight plateaus. After 7 months of fasting, I lost 28.6 pounds (or 13 kgs) with little effort. Currently, I weigh 191.4 pounds (or 87 kgs) while my waist shrank from 38 to 33. Wow! I wore a 33 in high school and never dreamed I would wear 33 again. My body mass index (BMI) dropped from 32.7 (obese) to 28.4 (overweight). That blew my mind away. Hence, I had to write a book about it. Of course, I'm more than happy to be overweight than obese by the government's standards, but damn, I can fit into 33-inch jeans again.

I almost returned to my college weight of 185 pounds (or 84 kgs), of course, the lean years and not the chubby years. I gained the freshmen 10 during my first year in college like the other freshmen. (The 10 stands for 10 pounds (or 4.5 kgs) of weight gain). That was during the 1990s; now they call it the freshman 15. The university cafeterias feed the students like cattle ranchers fattening the calves at meal time.

I have no desire to do extended fasts. I incorporated a lifestyle change, and I plan to maintain my weight loss. Thus, I maintain two fasts ranging between 24 and 48 hours during the week unless I gain a pound or two from my atrocious eating habits. Then I may add an extra fast during the week to correct my weight. I also add at least two bouts of dry fasting to my fasting regime per month to maximize the benefits to my health.

That is what blows the mind about fasting. We go through life and put on a little weight with an expanding waist size. We think a gradual weight gain is part of the aging process. We know now that we do not have to age like this. We can use the power of intermittent fasting to improve our health and maintain a healthy weight as we age gracefully.

## An Accidental Athlete

Fasting enhances the functioning of cells, tissues, and organs. It causes the body to become better adapted to build muscles and recovers quickly from workouts [33]. Consequently, fasting improves athletic performance as it transforms anyone into an athlete. Then we use our better bodies to play and participate in sports. Thus, all fasters should workout. Fasters should add resistance training to combat muscle loss during fasts [86] and exercise aerobically to strengthen their cardiovascular systems.

Once we become adjusted to intermittent fasting, we can exercise while fasting. Upton Sinclair, the American writer, walked four miles every morning and worked out in the gymnasium while fasting [1]. He also hiked and rode his horse more often [1]. During the outdoor walks and hikes, he exposed his skin to the sunlight allowing his body to produce vitamin D while breathing the fresh country air.

I never considered myself an athlete even though I jogged and lifted weights in the gym since college. I figure that exercise is my personal healthcare plan. Then I began intermittent fasting and witnessed the shocking side effects.

I, for example, run on an elliptical trainer in the gym since 2017 because jogging causes too much pain in my legs. I weighed 220 pounds (or 100 kgs), and my heavy weight was flattening and crushing my feet. Then I ran on the elliptical trainer for 45 minutes three times per week. Unfortunately, my gut would jiggle as I ran on the machine. Sometimes, after the run, I was wiped out. I would return home and lights out as my head hit the pillow.

I participate in charity runs at least six times per year ranging between 1.9 and 7.5 miles (or 3 km and 12 km). I had nothing but trouble with the 10 km. I needed to take a break and walk for 10 minutes several times for me to cross the finish line. The 12 km was worse. I had only 2 km to go, but I couldn't even run anymore. I had to crawl to the finish line. After the races, I felt terrible. Every muscle in my body hurt; muscles that I even didn't know I had hurt like I smashed them with a sledge hammer. Then I suffered for days in pain and agony as I gobbled down the aspirin.

Then I started intermittent fasting twice per week. I run only twice per week; sometimes I run during a fast. The 45 minutes on the elliptical trainer is nothing. My gut stopped jiggling. After taking a shower, I feel like I didn't even work out. In 2018, I ran my first 10k run with no walking breaks. Meanwhile, I walked once for ten minutes in the 7.5-mile (or 12 k) run but completed the race with a good time. I also recover much quicker after the race with a fraction of the pain. Now, I skip the aspirin for minor aches and pain.

I have a long way to go before I can run the marathon, but you should have seen the sour look on the students' faces as I passed them in the charity race at the university. They never expected uncle, who is twice their age, to smoke them during a run. The Asians reserve uncle to describe older men while auntie stands for older women. I like the term uncle much better than grandpa.

Fasting improves athletic performance in other areas. For example, I also lift weights in the gym twice per week. Since I started fasting, I lift more weight with more repetitions. Moreover, I'm more focus and have better control over my buoyancy when I scuba dive. Buoyancy is one of the essential skills in scuba diving. The diver adjusts the air in the BCD that allows him or her to hover above the coral. Improper buoyancy means the diver would bump and scrape against the coral and possibly damage life forms or float to the surface too quickly and cause nitrogen to bubble in the blood.

## Become Younger

Autophagy recycles cell parts while autolysis removes unwanted tissues and cells. Then fasting eliminates the senescent, i.e., zombie cells and recycles the components. Intermittent fasting once or twice a week is like working on a classic car. Fix a part here, replace another part there. And bam! Six months later, we are driving around the town in a completely restored 1969 Ford Mustang. As we drive by, the engine roars while the exhaust rumbles. Hence, we become young again.

It's no coincidence. Fasters look younger. People claimed Mahatma Gandhi looked 25 years younger after a fast [3, 13] because the body rejuvenates the skin while the skin blood circulation improves [3]. Blemishes, blotches, and pimples also clear [3, 13] while wrinkles and fine lines smooth and disappear [3, 13]. Thus, we fasters look good, young, and sexy.

I'm shocked by the transformation. People tell me I look 15 years younger. However, the reader can be the judge. In Figure 1, I present three pictures, when I was 40, 50, and 51. The middle picture represents the worst health of my life. The third picture shows the impact of 10 months of intermittent fasting.

I'm not only shocked from looking younger, but I had a dozen red bumps scattered across my body. All the bumps had disappeared. I even had one bump on the back of my right leg for 15 years. One day, I used a band-aid to press a cotton ball saturated with iodine against the abscess to burn it off. It burned for several hours, but the abscess reappeared after the scar had healed. After six months of intermittent fasting, all the bumps and abscesses are gone – dissolved and recycled.

One aspect of aging is the senses become dull. However, fasting improves the eyesight and hearing [2, 3, 8]. I cannot vouch for hearing. Although I have been turning the volume down on my Walkman while listening to classic rock music, it is a far cry from being scientific. However, I worry about the deterioration of my eyesight, which I keep track.

I'm farsighted, which means I can see objects far away but not close. Therefore, I wear glasses when I read and, of course, I wear the thick, Coke-bottle glasses. At least if I get lost in the forest, I can always use my glasses to start a campfire. The thick lenses would concentrate the sunlight into a laser beam to start a fire.

I provide three eyesight measurements in Table 3. The first is when I was a young man. The second measurement shows my worsening eyesight in 2017. The third shows my vision after 10 months of intermittent fasting.

Spherical power refers to the lens power to restore my eyesight to 20/20 vision. The plus means farsighted while negative means nearsighted. As we can see, I had terrible eyesight in 1995 with a spherical power of 3 and 3.25. By age 49, my vision deteriorated especially my left eye. Since my eyesight is quite bad, the lenses do not correct my eyesight to 20/20 vision. Otherwise, they would be too thick. Consequently, intermittent fasting has improved my vision since the spherical power has fallen.

I also have astigmatism, which means the eyeballs are not perfectly spherical. Astigmatism causes blurry vision because the lens focuses the light improperly on the retina. The cylinder measures the degree of astigmatism. Thus, as Table 3 shows, intermittent fasting has reduced the astigmatism in my right eye while no change in the left eye.

The last aspect of aging is gray hair. I had little gray patches around the sideburn, salt and pepper beard, and white hair on the upper chest. After intermittent fasting, I noticed fewer gray hairs, especially on my beard.

Senescent cells could be responsible for gray hair. Senescent cell means the cell cannot divide as it has reached the end of its life. Unfortunately, the senescent cell does not die quietly. It must create proteins and garbage that contaminate the nearby healthy cells like an elderly person creating a ruckus at the nursing home. That is why we notice a gray strand here and there. Then several months later, the single gray hair grows into a patch of grayness. Hence, fasting helps us look young by triggering the death of senescent cells, which scientists call apoptosis.

Fasting, unfortunately, has little impact on baldness. A person can easily lose a 100 strands of hair per day, and fasting slows hair loss [3]. I wish I could say I have found the cure for baldness. Nevertheless, I don't know whether fasting has slowed my hair loss, but I can say my baldness has not reversed. I could be sad about the hair loss, but I consider myself lucky since I started going bald in my late 40s. Unfortunately, baldness strikes some men in their 20s as life takes jabs at a young man's virility at the prime of their life.

Fasting has a powerful effect on the body but little impact on dihydrotestosterone (DHT), the hormone responsible for baldness. Scientists believe DHT causes the hair follicles to shrink on a man's head that chokes the growing hair [166]. Over time, a man's hair recedes in the front while a bald spot grows on the top of the head. Scientists believe men inherited baldness through their genes [166]. Balding men are more susceptible to an enlarged prostate, diabetes, heart disease, high blood pressure, and obesity [166].

## Drug Testing

Fasting may have one negative side effect. We are fasting and improving our lives. Then the next thing we know, our history comes back to haunt us. What am I talking about? Drug testing.

Fasting allows the body to consume the fat and remove toxins and wastes from the cells. A faster with a previous history of drug use can release those toxins and wastes into the body again. Table 4 shows the testing windows for standard drugs. One pattern emerges; the body metabolizes and expels most drugs relatively quickly within a week for the urine test with alcohol being eliminated the quickest. However, the body can take up to a month to remove the metabolites of marijuana. As we can see, the urine drug test is biased towards marijuana use.

The problem with marijuana is the fatty tissues absorb the metabolites of marijuana [167]. Consequently, the more the user smokes, the more substances and chemicals of marijuana get stored in the fat tissues, like charging a battery. I heard a story of an obese, heavy user of marijuana testing positive up to six months after going clean.

We, unfortunately, cannot control when we take the tests. As Table 4 shows, some drugs have short testing windows, so employers have an incentive for random drug tests, unless we are a new employee. Although I live in Malaysia, a new employer required me to take my very first urine drug test in March 2019. (No big deal – I don't use drugs).

The urine tests are relatively cheap and the most common tests [167]. On the other hand, hair tests have testing windows up to 90 days depending on the length of the hair specimen [167]. Even though employers would prefer the longer testing windows of the hair test, the test may not detect new or infrequent drug use. In addition, blood drug tests are not so common. They rise during medical treatments and surgeries, or a person was arrested and facing criminal charges. The blood test can determine exactly which drug the person took and the dosage. Finally, saliva tests are becoming popular. For example, we are walking through immigration in a foreign country, and the next thing we know; an immigration officer sticks a cotton swab in our mouth and takes a generous specimen of spit. Fortunately, saliva drug tests have short windows up to 48 hours for all drugs [167]. Marijuana's test window is only 24 hours [167].

The moral of the story is we do not use drugs. If we have used drugs in the past, we use fasting to clean and detox our bodies and fashion ourselves into better people. However, a faster with a previous history of heavy marijuana use has every right to feel nervous about an impending urine drug test.

## Repel Sickness

Fasting rejuvenates and restores the body and immune system as it clears the body of old, poorly working cells and improves the faster's health. A faster decreases their chances of sickness and quickens recovery if a faster has become sick. Furthermore, fasting helps the body rid itself of bacteria and viruses [37]. Thus, a person suffering from a cold or upper respiratory infection should fast to hasten recovery [24].

I've witnessed an improvement in my health. In 2017, I experienced my worst year. I was scuba diving frequently and just had passed my rescue diver certification in July 2017. Like clockwork, I would get an ear infection every two months in my right ear, and the virus would take a week or two to go away. My doctor prescribed an ear ointment, but the medicine did nothing. The first several times I fasted for 18 hours, the ear infection returned for a day and disappeared rapidly. Now, the ear infection has become a fading memory. Dr. Moser called this retracing as a faster relives a past infection [25]. I refer to it as a ghost infection. Of course, some fasters experience a ghost pain as they re-live pain and discomfort from old injuries during a fast.

In November 2017, I caught this nasty respiratory illness with a sore throat, phlegmy rough cough, and fever. Several times, I almost passed out from a coughing fit that lasted a minute. The sickness took two weeks to go away. Then I started my divemaster training in December 2017 in Kota Kinabalu, Malaysia, and the illness returned with a vengeance. I had to sit out for five days to rest and recover from the illness. I finished my divemaster training, but the illness returned when I returned home. When I visited a college friend in Bangkok in January 2018, the sickness returned for the fourth time. I just couldn't shake this illness. It was like walking through a field of prickers while hundreds of prickers clinging to my clothes that I couldn't shake off. When I was young, I rarely got sick or, if I did, I recovered in a day or two.

I started intermittent fasting in April 2018, and that illness returned in August and again in December. However, this time was different. I shrugged the virus off like a dog shaking off a flea. I was slightly ill for two days as my body squashed the infection quickly. That leads to a good tip on fasting.

  * **Tip #8:** We should start a fast when we feel the onset of a cold, flu, or other illness. Fasting switches the body into repair mode and speeds recovery as the body searches for viruses and bacteria to break down and recycle.

## Extreme Fasting and Enlightenment

Followers of Christianity and Islam use fasting as a means to commune with God. On the other hand, Buddhists utilize fasting to achieve enlightenment and higher levels of consciousness. Buddhism was founded by Gautama Buddha, who renounced his life as a prince and sought the path to enlightenment. He studied various altered states of consciousness such as meditation, sensory deprivation, mind control, breathing techniques, and extreme fasting. When he fasted, he ate a cup of vegetable soup consisting about 25 calories daily [168]. He pushed fasting into starvation with massive losses of body fat and muscles [168]. He also suffered from diarrhea, hair loss, stomach atrophy, and vitamin deficiencies [168].

On the verge of death, Gautama decided to give up fasting [168]. A pedestrian offered Gautama a bowl of rice pudding made from milk, rice, and sugar [168]. After consuming the meal, Gautama entered into an intense spiritual state that lasted nine hours [168]. He lived past lives, experienced rebirths in various forms with different moral traits, and passed through heaven and hell [168].

Researchers believe extreme fasting altered Gautama's brain chemistry. As he ate the rice pudding, a meal rich in carbohydrates and milk, both the carbs and tryptophan from the milk overstimulated the serotonin in his brain [168]. Serotonin has a powerful effect on mental states. For example, a deficiency of tryptophan reduces serotonin in the brain leading to anxiety, depression, and poor cognition in patients. On the other hand, overstimulation of serotonin leads to hallucinations. The psychedelic drug, lysergic acid diethylamide (LSD), overstimulates serotonin that leads to hallucinations and vivid sensory experiences. Consequently, extreme fasting combined with refeeding caused Gautama Buddha to experience higher levels of consciousness and spiritual enlightenment, or gave him one hell of a natural psychedelic trip.

Another form of extreme fasting comes from Lord Mahavira, the "Great Hero," who founded the Jain religion roughly the same time as Buddhism in the 4th century BC in northern India [6]. The Jain religion shares many similarities with Buddhism. The followers deny themselves of earthly pleasures to achieve spiritual purification and enlightenment [6]. The Jain monks and nuns spend most of their time praying, confessing, meditating, and engaging in other rituals [6]. They also fast regularly [6].

The Jain followers respect all living forms and will go out of their way to avoid harming or injuring any life forms including insects [6]. They view any harm or injury to a living thing as a form of violence [6]. They will even inspect their clothing periodically to remove any insects [6]. That is why they are vegetarians because meat comes from the killing and slaughter of animals.

The followers believe a vegetarian diet is healthier than an omnivorous diet [6]. They avoid stimulating and flavorful food because delicious food is addictive, dissipates energy, and dulls the senses [6]. In addition, a restricted diet helps the Jains clean, purify, and strengthen their body and help purify the soul [6]. They also slim down while their body becomes harder and stronger [6]. At last, they are less prone to sickness, require less sleep, have weaker sexual urges, and less desire for food [6].

As the Jains fast, they believe their desires and volitions wither away [6]. Consequently, the fast helps the followers remove the karma from the soul [6] because karma reflects cause and effect. When we do bad things in this life, these bad acts follow us into the next life. Of course, we could choose to do good deeds and actions that lead to better karma in the next life. From the Jains' perspective, they believe the removal of the karma allows the soul to become free and omniscient [6].

Here is where fasting becomes extreme. The Jains believe they will attain enlightenment if they die during meditation [6]. They call this practice samadhi-maran – death while in meditation [6]. The follower sits and meditates quietly as he or she waits for death [6]. For example, Amarcand-ji was an old man who fasted until his death [6]. For his last fast, he fasted for 36 days with the last 24 days being a dry fast [6]. Amarcand-ji was talking, sitting, and praying on his last day. Then he blurted, "Now, I will die. [6]"

At his death, people claimed there was a rain of saffron while his skull cracked open as a wound appeared on his head [6]. Normally, a son cracks his deceased father's head to liberate the soul from the body [6]. Amarcand-ji performed his own funeral rites as he had liberated his own soul [6].

Although I am intrigued with fasting and enlightenment, I think I will try other ways to attain enlightenment. Come on. We only have one shot at life. No do overs!

## Complications and Death

Fasting could endanger a person's health and possibly result in the faster's death. The fasting itself does not cause the death unless the faster has starved himself or herself. Otherwise, the process of starting the feeding cycle causes problems, or the faster suffers from severe medical issues that fasting cannot heal and cure.

For the first complication, some fasters experience Refeeding Syndrome after prolong fasts between 7 and 10 days [21]. This is one of the reasons why I advise against extended fasts beyond two days unless under medical supervision.

The body requires a variety of minerals such as calcium, chloride, magnesium, phosphorus, potassium, and sodium to support living tissues [10, 21]. The minerals form electrolytes when dissolved in water such as in the blood and water of the body's cells. The water allows the suspended minerals to create charged particles. That is why pure, distilled water does not conduct electricity. However, if you dissolved a pinch of salt, i.e., sodium chloride, into the water, the salty water conducts electricity. Many processes in the body require electrolytes to fulfill chemical reactions to sustain life.

The body balances the electrolytes strictly in the body during feeding and fasting states [10]. However, a faster can experience Refeeding Syndrome as they start the feasting cycle. Refeeding Syndrome comes from the digestive system lacking the minerals to break down the food as the digestive system steals minerals away from the blood and cells. A lack of minerals causes electrolyte imbalances. The imbalances cause heart arrhythmias, cardiac arrest, respiratory failure, seizures, or a host of other complications and problems [15, 21]. Symptoms take up to a week to manifest themselves [21].

People with anorexia, alcoholism, diabetes, cancer, or bowel disease are susceptible to refeeding syndrome [10]. These people are usually malnourished and underweight [10], and the fasting creates a great shock to their bodies.

For the second complication, the faster pushes the fasting into starvation. As the body finishes using the fat reserves and has assimilated the noncritical tissues, the faster's hunger returns. A faster choosing to abstain further enters the starvation state. Then the body begins to digest tissues and cells from vital organs [3]. Meanwhile, the body's core temperature drops as the body scrambles to save energy [3, 13].

For the third complication, Dr. Shelton noted in a handful of cases when the faster couldn't eat food again [3]. After eating, the faster became sick and vomited the food. The inability to eat may stem from the refeeding syndrome. Subsequently, these fasters enter into the starvation state if they cannot kick-start the feasting cycle again.

The fourth complication comes from eating improper foods as the feasting cycle begins. Fasters who have fasted three days or more should transition to food by drinking juice and eating broths, fruits, or light soups. After extended fasts, the stomach lacks the enzymes to break down food. One YouTuber reported kidney failure after he ate a regular meal after a 20-day fast. Unfortunately, people show little symptoms of kidney or liver problems until 75% or more of the organ is destroyed and begins malfunctioning.

For the last complication, the faster suffers from an incurable disease, or the disease progressed to an advanced stage beyond fasting's curing range. Unfortunately, sick people resort to fasting as the last measure and not the first. If a disease such as cancer grows too large and spreads throughout the body, fasting will not heal the disease. In addition, patients taking harmful drugs and medicines for years also damage their bodies severely [8]. Unfortunately, fasting has its limits.

Fasting deaths, at last, occur rarely, but the deaths make front page news. Even in the days of Dr. Shelton and Upton Sinclair, the newspapers widely reported fasting deaths [1, 3]. Dr. Shelton and Sinclair lamented that the authorities should conduct autopsies to thoroughly identify the correct cause of death because fasting unlikely caused the deaths. Most likely, another complication caused death. However, the reporters sensationalize fasting deaths to sell newspapers or capture a larger TV viewing audience.

The most notorious case of fasting comes from Linda Hazzard, known at the starvation doctor. She operated a fasting clinic in the early 1900s and, at least, 15 people had died at her fasting clinic. She was convicted of manslaughter in 1912 of the death of a wealthy British woman who weighed less than 50 pounds (or 22.7 kgs) at the time of her death. Linda forged her signature on the British women's will and stole her valuables. The governor of the state of Washington pardoned her in 1916. Linda Hazzard (1908, 1927) also wrote two books on fasting, called _Fasting for the Cure of Disease_ and _Scientific Fasting: The Ancient and Modern Key to Health_ [169, 170].

# 5. Types of Fasting

"A little starvation can really do more for the average sick man than can the best medicines and the best doctors."

– Mark Twain

Fasting is not for everyone. Fasting depends on the person and the balance of a person's hormones. Some people have a slight imbalance of their hormones. Just by reducing their sugar intake or removing gluten from their diets, for the gluten sensitive people, may be enough to restore their hormone balance. Then their health problems correct themselves. Accordingly, people should experiment to find what works well with them. What works for me will not work for everyone.

Exercise and diets are additional methods to correct hormonal imbalances. They inflict stress on the body; the stress could balance some people's hormones again. Voila, they do not need fasting. Some people require a bigger shock to their bodies. People should turn to fasting as the next level when exercise and diet restriction fail.

I compare fasting to the Richter scale. Reducing your sugar intake shakes the body a little like an earth tremor. Diet restriction and exercise are small earthquakes. They both place stress on the body. A juice fast is a moderate earthquake while intermittent fasting shakes the body like a major earthquake and rocks the body to its core. At last, a dry fast is a major earthquake and hurricane pummeling the body at the same time. The dry fast places the most stress on the body.

Before we jump into the types of fasts, we need to discuss people who shouldn't fast. Fasting could lead to health problems and death if the wrong people begin fasting.

## Who Should Avoid Fasting

Fasting has a profound effect on the body such as lowering both blood glucose and blood pressure [15, 27, 43]. A person taking insulin or high blood pressure medication can jeopardize his or her life. The insulin and high blood pressure medications could drop the blood sugar level and blood pressure to lethal levels. Thus, we listen to our bodies. If our blood sugar levels drop too much, we could become irritable and hungry, feel nervous and nauseous, and experience shaking and sweating [10], These symptoms indicate hypoglycemia or low blood sugar. Type II diabetics keep a candy bar, a bottle of juice, or a sugary soda at hand in case their blood sugar level drops too much. Failure to raise blood sugar levels could cause death [10].

The following people should not fast, or they should fast under medical supervision.

  * **People Afflicted with Severe Diseases** [30]: Fasting has a profound, powerful impact on the body. Fasting could complicate people with serious illnesses.

  * **Pregnant Women** [8, 10, 13, 30]: A pregnant woman requires abundant nutrients, vitamins, and minerals to support the healthy growth of her baby [9, 10]. A fast during a pregnancy could harm the baby [10].

  * **Breastfeeding Mothers** [10, 13]: The reason is identical to pregnant women. Women need abundant vitamins and minerals to produce nutrient enriched breast milk to support the baby's growth [9, 10]. Also, a fast halts milk secretion [13].

  * **Infants, Children, and Teenagers** [10, 30]: The bodies of infants, children, and teenagers grow rapidly. They need abundant nutrients, vitamins, and minerals to support the rapid growth. In some cases, doctors have fasted infants and young children to overcome a serious viral infection or medical ailments [2, 3, 13]. For example, a two-year old overcame polio by fasting for 47 days as his weight dropped from 32 pounds (or 14.5 kgs) to 15 pounds (or 6.8 kgs) [13].

  * **Type 1 Diabetics** [8-10, 30]: Diabetics must monitor their glucose blood levels during a fast. They may have trouble maintaining normal glucose levels.

  * **Kidney Problems** [8, 30]: Fasting stresses the kidneys as the kidneys filter the blood.

  * **Liver Disease** [8]: Fasting stresses the liver.

  * **People Suffering from Gastroesophageal Reflux Disease** [10]: For gastroesophageal reflux disease (GERD), the stomach acid flows upward into the esophagus. Then the acid burns and damages the esophagus [10]. Overweight or obese people can suffer from GERD because the abdominal fat constricts the stomach and pushed the stomach acids into the esophagus [10].

  * **People Lacking MCAD:** Although rare, some people lack an enzyme called medium-chain acyl-CoA dehydrogenase (MCAD) [8]. The body needs this enzyme to oxidize fatty acids [8]. Thus, fasting would be fatal to these people.

  * **Severe Anemia** [8]: Anemia is a person has a deficiency in red blood cells. Fasting amplifies the effects of anemia.

  * **Advance Stages of Cancer** [8]: It means the cancer has spread to different areas and organs of the body. The cancer patient has lost weight, stopped eating, and could be dehydrated. A fast could worsen these problems.

  * **Acquired Immune Deficiency Syndrome (AIDS)** [8]: The HIV virus has demolished a person's immune system. The stress from fasting may be too great with a weakened immune system.

  * **People with Toxic Levels of DDT Stored in Their Body Fat** [30]: This one is unusual. The body tends to dump toxins into fat tissue during the feeding cycle. When a faster starts burning fat from his or her body, he or she releases the toxins into the body again.

People afflicted with the following conditions can fast, but they require medical supervision. These medical conditions are less severe than the previous list.

  * **People taking medications** [10]: Fasting lowers both insulin levels and blood pressure [8, 10, 11, 27, 32, 43]. A person taking insulin during a fast can reduce blood sugar levels to lethal levels [10, 11]. Taking high blood pressure medication during a fast can drop blood pressure to dangerous levels. Low blood pressure causes light-headedness [10]. Also, fasting strengthens the potency and sensitivity of some medications [3, 13]. Please consult a medical doctor to adjust medications for fasting.

  * **Gout:** The body retains excess uric acid in the blood instead of excreting the uric acid in the bladder. The uric acid forms crystals in the joints causing arthritis and joint pain [10]. Fasting leads to a build of uric acid [10, 11, 15, 27]. Fasters without gout can easily handle the increase in uric acid, but gout suffers may not. Several medical doctors say most people afflicted with gout experience no troubles in fasting [8, 10, 96]. For example, in a study of prolong fasting between 4 and 21 days, only one subject experienced gout out of 1,422 healthy participants [27].

  * **Malnourished and Underweight People** [8-10]: At the turn of the 20th century, some people suffered from malnutrition because their digestive system could not process food efficiently. They fasted for a week or two, so their bodies repaired their digestive system [1-3, 8]. Then the malnourished people gained healthy weight as their bodies absorbed the nutrients from the food during the feasting cycle [1-3, 8]. The worry is the fine line between fasting and starvation since malnourished people lack the fat reserves to endure a fast.

I discuss fasting in the order that the fasting stresses the body. People must start at the lowest levels before proceeding to the more advanced forms. The juice fast is the easiest. Then intermittent fasting comes next. Finally, the extended fast is third while the dry fast is the hardest and strongest.

## The Juice Fast

The juice fast is technically not a fast because the person does not abstain from drinking juice. Instead, the faster drinks the juice to replace food. The juice fast includes eating fresh fruits and vegetables.

The Christians call the juice fast the Daniel fast from one of the books in the Old Testament (Daniel 1 [5]). King Nebuchadnezzar of Babylon captured Daniel and three other children from Judah. Daniel and his friends refused to eat meat and drink wine from the king's table (Daniel 1 [5]). Instead, they ate pulse, which translates as beans, lentils, and peas. The Daniel diet or fast includes all-natural foods except for meat and wine.

Some claim three days of juice fasting equates to one day of water fasting. This is a popular saying that we cannot back up with scientific evidence. Which measure would we use to substantiate this claim?

The juice fast poses three problems:

  * **Problem #1:** Juicing fruit extracts the sugar and removes the fiber. A faster's body quickly absorbs the sugar and spikes the insulin level [8, 171]. Then the faster becomes hungry when the sugar level plummets. The fiber in fruit slows the sugar absorption [171].

  * **Problem #2:** Drinking juice contains sugar and spikes insulin [8, 171]. The high insulin prevents the faster from switching to ketones for fuel. Remember the nutrient sensors, mTOR and AMPK, are sensitive to insulin and amino acids.

  * **Problem #3:** The juice fast prevents the faster from entering the protein sparing state. Consequently, a fasting person loses more muscle mass and less fat than a water faster [8].

The juice fast became popular with celebrities in 2012 and had since withered. We should not be surprised that the juice diet causes people to be always hungry especially if they drink the sugar from the fruit [172]. Even Upton Sinclair complained the fruit diet made him ravenously hungry and weaker [1].

In the Book of Daniel, Daniel and his friends became fairer and fatter in the flesh (Daniel 1 [5]). Remember, in those days, being chubby was a sign of health and living well. Readers wanting more information on the Daniel Fast should visit: https://ultimatedanielfast.com/.

Some people live by the health benefits of a juice fast. Juices are easy on the stomach and provide the body with loads of vitamins and minerals. Accordingly, the juice fast probably imparts some health benefits. In Asia, health retreats and resorts offer the juice fast to clients, but the resorts charge prices that compete with five-star hotels.

We do not need to juice fast to enjoy the rich mixture of vitamins, minerals, and antioxidants from freshly squeezed juices. We can enjoy fresh juices during our feasting cycles especially if we eat atrocious diets. In Malaysia, many stores, restaurants, and cafeterias sell fresh juice. My favorites include lime juice and three sour. Three sour is a juice drink made from lime, lemon, and sour plum. Other excellent juices include carrot, orange, pineapple, and apple.

  * **Tip #9:** It may be wise to invest in a juice machine. Fresh juice contains many vitamins, minerals, and antioxidants. Even if we do not juice fast, we can enjoy fresh juices during our feasting cycles.

## Intermittent Fasting

Intermittent fasting, one of the most popular fasting methods, is easy to implement. First, we write down our reasons to fast. We must stay focus when fasting starts changing our lives. For example, we see massive weight loss, or the opposite sex begins showing an interest in us; we are tempted to keep pushing that fasting duration for the wrong reasons. Compulsive, impulsive personalities could take fasting out of control. Therefore, we need to be clear why we fast, and when we will start our feeding cycle again.

  * **Tip #10:** Be clear why we want to fast. We need to define our goals and what we hope to achieve.

Fasting can be a dangerous activity. Once we jump over the hunger hurdle, we lose the desire to eat. We have no problems continuing a fast for days or weeks. Consequently, we must be clear when to end a fast.

I started fasting to improve my health, i.e., autophagy. My goal was never about losing weight or becoming an athlete. Those are the frosting and chocolate sprinkles on the doughnut. I ended many fasts when I felt great and could keep going. I would walk next door to the gym to weigh myself. If I had gained no weight from my atrocious diet, I ended my fast after 24 or 36 hours. My goal is not to push the fasting duration but to keep my body in the best health.

The next decision is to choose how long we should fast and how frequent. Like exercise, we start slowly. The first thing I did was to implement a simple rule – no food or drink between 6 P.M. and 6 A.M. the next day. We may drink water, tea, or coffee with no sugar, no honey, or no milk.

  * **Tip #11:** We should implement a 12-hour feeding window and 12-hour fasting window every day.

We don't follow strict rules. If we meet friends for a Saturday night dinner or invited to a party, by all means, we go and enjoy ourselves. Fasting is about living and enjoying life's little pleasures. Violating the rule once a week will not hurt. I won't hesitate to end a fast prematurely if I am offered good food. I know I will fast twice per week for the rest of my life. A day here and there of ending a fast early will matter little.

For the next step in fasting, we must convert our bodies into fat burning machines called fat adaptation. Many of us spent our lives being sugar burners. That means our bodies haven't adapted to burning fat, which the body needs to enter a fasting state. It may be a good idea to start a high protein, low carbohydrate diet such as the Adkins, South Beach, Zone, Protein Power, Sugar Busters, or Stillman Diet. The Ketogenic Diet is also gaining popularity, which is a high fat, moderate protein, and low carbohydrate diet.

We use a diet temporarily to help our bodies transition towards burning fat for fuel.

  * **Tip #12:** We should start a low carbohydrate diet two weeks before our first fast to help our bodies transition into a fat burner.

Once our bodies become accustomed to burning fat, and we have no trouble with a with a 12-hour fasting window, we just extend the fasting window. If we want to fast 15 hours, delay eating breakfast by an additional three hours one day per week [9] or eat dinner three hours earlier once per week. It's that simple! Now we are fasting 15 hours once per week.

We utilize another trick to improve the fasting experience. We avoid foods high in sugar. If I eat cookies, ice cream, or doughnuts, I am ravenous again after two hours. We can save the cookies, ice cream, and doughnuts as a treat when we break the fast. Protein and fat fill people and make them feel satiated.

  * **Tip #13:** Our last meal before the fast should be low in carbohydrates. The body burns carbohydrates quickly causing insulin levels to peak and then crash. The crash awakens hunger pangs.

When I first started fasting, I started with the 18-hour fast once a week. The first couple of times, I thought I would die. Fasting is both physiological and psychological. The low carbohydrate diet helps with the physiological part. Once the fast becomes routine, then we must learn to jump over the mental hurdle.

The psychological hurdle is difficult. Sometimes, I felt hungry during a fast. I learned to persist and not eat. When I started the 24-hour fasts, the 20-hour mark became dangerous. I would walk around the mall like a zombie smelling the freshly baked cookies and the cheese sizzling on a baking pizza. I just wanted to eat even when I wasn't hungry. We conditioned ourselves to eat at least three times a day since birth. Thus, we must rewire our brains to get away from the desires to eat food.

The first several fasts are difficult. We may need a crutch when we start fasting. It feels weird to go an extended time without eating. The first several fasts, I ate a couple of hard-boiled eggs with hot sauce. Technically, I violated the fast and introduced protein in my body. If the crutch turns into a meal, we don't worry about it. We enjoy our meal. We can start a fast on another day.

  * **Tip #14:** We need a crutch to help us endure the fast in the beginning. We eat a low-carbohydrate snack. The Keto Diet recommends many good, low carbohydrate snacks, such as chicken, cheese, nuts, or berries. Once fasting becomes second nature, we drop the crutch and eliminate all snacks.

We continue fasting until it becomes routine. When we think we need to expand the fast, we start fasting twice per week. We need to spread our fasts over the week between two full days of feeding. It felt so natural to fast; I started fasting twice per week without even thinking about it. After two days of feasting, I just did not feel hungry again on the third day.

I accidentally came across a good rule. I maintain a ratio of 1 to 2 for fasting and feasting cycles. For example, if I fast for one full day, then I feed for the next two days. The first day of feeding sometimes throws my body out of equilibrium. Then everything turns to normal for the second feeding day. We also must ensure we eat enough food to provide our bodies with the necessary nutrients.

  * **Tip #15:** Maintain a ratio of 1 to 2 for fasting and feasting cycles. If we fast for three days, then we should feed for six days before starting the next fast. We must ensure our bodies obtain the minimum nutritional requirements.

After several weeks, we can extend our fasting duration if we believe we need to. However, we need to check ourselves and question why we're fasting. If we want to hasten the pace of our weight loss, it may be a bad idea to extend the fast. For me, it took thirty years to pack on 35 pounds (or 15.9 kgs) of fat. I'm more than happy that fasting removed this fat within a year. My goal is not to lose this weight in one month. My fasting goal is to improve my health and fast intermittently for the rest of my life. We use fasting to make our bodies healthy. Then our body determines how much fat we should carry.

We can boost our fasting duration by 3- or 6-hour increments. I started with 18-hour fasts once per week. Then I started fasting twice per week. Then I started the 24-hour fasts and then 30-hour fasts. Now, I am going for the weekly super cleanse, a 48-hour fast once per week. I fast beyond 24 hours because I feel and see the health benefits and believe I am prolonging my life.

We must drink plenty of fluids during a fast because fasting dehydrates the body [8]. Also, food contains water. Since we stop eating food, we need to drink extra fluids to make up for the shortfall. Chapter 6 discusses the permitted drinks during a fast.

  * **Tip #16:** Drink plenty of water [1, 8, 9]: Since fasters stop eating food, they must drink more water to make up for the shortfall of water. We can burn additional calories by drinking cold water since our bodies must warm the water to body temperature [173].

Fasting subjects the body to stress. When we have just started fasting, we should take it easy. We should rest, relax, and not exercise. If the fasting euphoria makes us a little spacey, we should avoid driving a vehicle or operating power tools. Once we become accustomed to fasting, we can resume our usual activities.

  * **Tip #17:** When we start fasting, we should take it easy the first several times. Once our bodies have adapted to fasting, we can exercise [93].

Sometimes we should fast back to back to avoid weight gains during celebrations, or when we become sick. For example, Malaysians celebrate Christmas, Chinese New Year, the feasting celebrations after Ramadan, and Gawai, the harvest celebration of the Borneo tribes. This is a perfect time to eat delicious, ethnic food. Remember, fasting is about living and enjoying life, and I love eating. I didn't become obese because I hated food.

For Gawai in 2018, I ate and drank all day long as we visited a half dozen houses on Friday. The hosts offered a well-stocked buffet of various delicious foods, such as curry chicken, beef rendang, prawn crackers with peanuts and anchovies, and sliced tropical fruits. The Borneo natives believe in drinking copious amounts of homemade rice wine and whiskeys of questionable grades and qualities.

Afterward, I fasted for 18 hours and then had lunch at both Pizza Hut and KFC. Then I fasted another 18 hours. I neither gained nor lost weight. Thus, I was not nervous when I headed to the gym and stepped on the weight scales.

  * **Tip #18:** We employ two back-to-back fasts to prevent weight gains from celebrations and holidays. These are special occasions that we should enjoy and cherish. Accordingly, we apply back-to-back fasts once in a while for weight maintenance.

It sounds like I contradicted myself. As I already stated, I do not fast for weight loss. However, I do alter my fasting schedule to prevent weight gains.

Fasting has a psychological part. We conditioned ourselves to eat food at least three times per day since birth. Breaking this habit is difficult. Often, we may feel hungry during a fast, but the hunger pangs come in waves. We learn to endure the hunger waves and keep fasting. Each time we fast, it becomes easier and easier to push the fasting duration.

  * **Tip #19:** We learn to endure the hunger pangs. One trick we use is to stay busy and keep our minds focused on non-food activities. We can also join fasting groups on social media such as Facebook to find mutual support and fasting buddies.

Fasting has another benefit. We can utilize fasting to identify food allergies. For instance, we suspect we are allergic or sensitive to gluten. If we have fasted at least 15 hours, we have cleared the food from our digestive system. Subsequently, we can eat a slice of bread or pastry and note how we react to it. However, this technique only works for fasts of two days or less because extended fasts require a transition period to adjust to food again.

  * **Tip #20:** We can utilize short fasts between 15 and 48 hours to identify food allergies.

If we feel nauseous, dizzy, fatigue, or lethargic, and the symptoms do not go away, we end the fast [10]. Our health is more important than the time we spend in a fast. Thus, we live another day to fast in the future.

  * **Tip #21:** We end the fast if we feel ill, dizzy, fatigue, or lethargic, and these side effects do not subside. We can live another day to start another fast.

Intermittent fasting is flexible and easily fits into anyone's lifestyle. We can adjust the fasting schedule to fit into our busy lives. I prefer to fast on Mondays and Thursdays on my workdays and leave my weekends open for food and friends. I also fast by the clock. For example, I eat breakfast after 6 AM, lunch before 12, and dinner before 6 PM. I have no trouble keeping track of my fast since I go by 6-hour increments.

  * **Tip #22:** We can easily track our fasts if we eat at 6 AM, noon, and 6 PM. Then we work with either 3- or 6-hour increments. We can also download free fasting trackers for our smartphones. The trackers also store a log of our fasts.

When we fast, we should avoid people. Fasters become more sensitive to other people's emotions. I do not know why but I lose patience and become irritable and grumpy. That is definitely not a good time to interact with people. I refused to believe I was a grumpy person but my best friend could tell when I was fasting.

  * **Tip #23:** We should avoid people when we are fasting because we become hypersensitive to other people's emotions [25]. Furthermore, prolong fasts tend to make people angry [174].

Fasters should be warned about one potential drawback to fasting. A faster may experience a ghost infection, when a past chronic infection returns during a fast. Dr. Moser called this retracing [25]. I suffered from a chronic ear infection that periodically returned. During my first several fasts, the ear infection returned and disappeared quickly. Nevertheless, I never suffered an ear infection since. Other fasters have reported ghost injuries where previous, old injuries started to hurt again.

  * **Tip #24:** Fasters may relive a ghost infection or a ghost pain if they suffered from a chronic, reoccurring infection or an old injury in the past. Just keep warm and drink plenty of fluids.

Fasting brings other benefits as well. I travel often and balk at the high prices at the international airports. The food is overpriced and guaranteed to give traveler's diarrhea. One time, I felt like I was robbed at the Guangzhou Baiyun International Airport in China when I paid $30 for a $2 bowl of Ramen noodles. Embarking on a long trip is a good time to start a fast, which leads to the next tip.

  * **Tip #25:** When we start a long trip, that is the perfect time to start a fast. Thus, we avoid expensive, substandard food that gives us the traveler's diarrhea and digestion problems.

After six months of intermittent fasting, I experimented and tried different things. For example, I started a fast with a bag of Oreo cookies with a dipping milk and a sweet coffee for lunch. That was a terrible idea. I had one incredible sugar buzz for the first three hours of the fast. Then I felt queasy and a little dizzy until the fifth hour. After the fifth hour, it was smooth sailing, and I ended the fast 30 hours later. I become so well adapted to intermittent fasting. A crazy sugary meal couldn't stop me from fasting. It has become second nature.

I tried to get my Malaysian Chinese girlfriend, Alice, to fast. I bribed her with 100 Malaysian ringgits (or $25) to fast one weekend for 18 hours. One hundred ringgits is more like $50 because of the low Malaysian prices. For instance, I can get an awesome lunch of two pieces of curry chicken, rice, and herbal tea for 12 ringgits (or $3) at a Chinese cafe. Alice did all right and made it to 16 hours. Unfortunately, she found a bag of Skittles under the car seat and gorged herself and, thus, broke the fast. I tried to get her to fast on other occasions and upped the bribe to 200 ringgits (or $50). No luck! She refuses to fast.

The significance of this case is the importance of money in Chinese culture. For example, I had several dates with Chinese women that felt more like job interviews. On one date, I received three hours of financial advice and tips. My date even estimated the cash flows and profits at the restaurant where we dined. Of course, the date was a bargain since a three-hour consultation with a financial advisor would cost some serious money. (These were okay dates, but I had some crazy dates in Asia.) Hence, Alice turning down the money for a simple task means she loves eating food too much.

I tried to get Alice to fast for two reasons. First, I wanted her to experience the health benefits, and perhaps she would start fasting on her own. She usually goes on diets to lose weight, which has a high failure rate. Second, I wanted to get information about women fasting because a female blogger on YouTube suggested some women have trouble fasting. The female blogger claimed women who can skip meals with no difficulties can easily fast while other women experience troubles. For example, in one study, healthy men became more sensitive to insulin after a 36-hour fast than women [26]. In another study, overweight women who fasted became less sensitive to insulin compared to the diet restricted and control groups [88]. Thus, fasting impacts men and women differently.

I am also curious whether Alice could fast since she is a sugar addict. On several occasions, I sipped her Starbucks drink and winced over the extreme sweetness. I'm not sure if I'm more surprised that a barista can pack a ton of sugar molecules into a dense liquid, or that Alice can easily drink her overly sweet concoction.

## The Prolonged Fast

Any fasts extending beyond 24 hours are prolonged fasts because the fast stretches two or more days. The 24 hours is an artificial construction, but researchers have noted "adverse" changes in healthy men's mitochondria, the cells' energy furnace, after a 24-hour fast [12]. In addition, I believe fasts beyond 24 hours helps to prolong longevity, but no studies back this in humans. Rodent studies back prolong fasts for extending lifespans. However, a 24-hour fast shocks the rodent's bodies greatly because of their greater metabolism.

Fasting beyond two days forces the faster to enter into dangerous territory. My longest fast lasted 50 hours. When I broke my fast, I experienced no hunger, no discomfort, and no medical complications. I could have easily fasted for another day if I had wanted to. Nevertheless, my purpose and goal of fasting are to get the health benefits via autophagy, autolysis, and apoptosis of senescent cells.

Some people must fast beyond 24 hours because they need a shock to their bodies. Some people, including me, have insulin resistance. Not only does the body produce too much insulin, but the insulin levels also remain persistently high even when the digestive system ceases the processing of food [11]. Consequently, the persistently high insulin levels keep the body in fat storage mode and prevent our bodies from burning fat reserves [11].

Fasting, accordingly, helps reset insulin and other hormones such as ghrelin. Ghrelin sends a satiated signal that we should stop eating [11, 109, 175]. When our bodies screw up this hormone, we can be extremely overweight and always feel that we are starving. When I was obese, I always felt hungry and wanted to snack every two hours.

Researchers argue that ghrelin does not provide a satiation signal [175]. Instead, the hormone prepares the digestive system in the anticipation of food [175]. Scientists and doctors have identified many other hormones involved in satiety and hunger signals. They are searching for the magic pill that would help dieters lose weight without the hunger pangs.

Fasting restores the satiety and hunger signals by shocking and stressing the body. For example, some electronic gadgets like a computer start malfunctioning. We must turn off the device to reset it. Some devices need to remain off for several minutes. Fasting does the same to our hormones. We turn off the digestive system for a while that brings the persistently high insulin levels down and resets the sensitivity of our hormones such as ghrelin [32].

Of course, I don't fast beyond 48 hours because I reap all the health benefits of fasting. For example, if autophagy switches on after 16 hours of abstaining from food and I fast twice a week for 24 hours, then in one year I had fasted a total of 104 days. However, each fast has 16 hours without autophagy. If I deduct the 16 hours from each fast, then I fasted for 34.7 days with autophagy. Fantastic! I spent over one month in autophagy per year! (Please note many researchers and bloggers debate when autophagy kicks in, but the mTOR sensor and AMPK are mechanisms to control autophagy that we discussed in Chapter 2).

For people wanting to practice prolonged fasts, we should not fast beyond 48 hours. I list several reasons why we should end the fast within two days.

  * **Stabilize Weight:** In the old days, people would fast 21 days or more. They would lose 21 pounds (or 9.5 kgs). Then they continued their same lifestyle after the fast and regained the weight. In one study, 50% of the fasters regained their weight on a 14-day fast while 24% of the subjects continued to lose weight [96]. On the other hand, 43% of fasters who were obese could maintain a lower weight for fasting intermittently while 17% continued losing weight [19]. That success rate of fasting squashes the one percent success rate of calorie restriction.

Medical doctors warn of the dangers when we yo-yo diet, where a person loses a lot of weight and then regains it. Thus, we should fast intermittently every week to stabilize our weight and smooth the fluctuations.

  * **Metabolism:** Fasting beyond two days reduces a faster's metabolism [20]. That's the trick. We fast one day or two days. Then we eat well during our feasting cycle to keep that metabolism roaring and devouring energy. Short fasts do not slow metabolism [42] and may even boost metabolism by 3% [20].

  * **Refeeding Syndrome:** Extended fasts between 7 and 10 days may result in refeeding syndrome [21].

Re-feeding syndrome occurs when the faster or starving person starts eating food again, and the food throws the person's electrolytes out of balance. Electrolytes are salts such as magnesium, phosphate, potassium, and sodium dissolved in water and are critical to chemical reactions to sustain life [10, 21]. Severe electrolyte imbalances cause heart arrhythmia, respiratory failure, dementia, seizures, and a host of other symptoms and problems [21]. Two-day fasts or less reduces the complications of refeeding syndrome.

  * **Maximize Fat Burning:** Fasts between 18 and 24 hours are sufficient for the body to break down fats and triglycerides [86]. Thus, fasters are burning some of their fat stores.

  * **Effective Weight Loss:** In one study, healthy subjects increased their caloric intake by 30% for the first meal after a 36-hour fast with a preference for more fatty foods [176]. After the first meal, they resumed their normal eating patterns [176]. Thus, subjects still lost weight because they fail to make up for the deficient calories they missed while on a fast. (In this regard, fasting corresponds to calorie restriction because fasters are reducing their total calories).

Some people fast for three days because they believe the body renews the immune system. In a study of mice, a prolonged fast of at least three days caused the mice's bodies to remove the poorly functioning, old white cells [177]. (The study used the fasting mimicking diet that permits limited food consumption during the fast [177]). Unfortunately, our bodies are complex, and white blood cells come as two broad classes: Lymphocytes and phagocytes. Lymphocytes adapt to new threats and include T cells, B cells, and natural killer cells. The T cells cause apoptosis of virus-infected cells like a tack popping a balloon; B cells produce antibodies to destroy foreign invaders while natural killer cells obliterate cancerous cells. On the other hand, phagocytes resemble Pac-Man and gobble foreign invaders, dead cells, and cell debris. During the feasting cycle, our bodies quickly regenerate the white blood cells [177]. Thus, prolonged fasters have new, efficient immune systems to defend their bodies against foreign invaders.

People who fast three days or more should eat light food to re-introduce food into their digestive system slowly. The stomach lacks the enzymes to break the food down. Fasters should drink freshly squeezed juice or bone broth for their first meal and add steamed vegetables for the next meal [1, 8, 24, 178]. Dr. Shelton recommended fasters drink fresh fruit juice every two hours on the first meal day and three meals of fruit the next day [3]. The Soviet doctors and Upton Sinclair added dairy products to the diet [1, 24]. However, Upton Sinclair (1911) admitted that he had trouble taking dairy products after an extended fast. In addition, some people doing extended water fasts follow the fast with the juice fast or Daniel diet. Fasters should avoid salt, pepper, and spices until their stomachs can handle them [8]. At last, the Soviet doctors advised patients to avoid meat for some time [24]. Meanwhile, Dr. Shelton recommended eating plenty of protein to allow the body to rebuild structures lost from autophagy and cell death (apoptosis) [3].

As fasters start their feasting cycle, they may experience a bout of diarrhea. Thus, we fasters must be careful when passing gas after our first meal or carry some clean underwear with us. I occasionally experienced diarrhea after completing fasts beyond 24 hours. Of course, I wait to see if the problem corrects itself before taking Imodium. Most of the time, the problem corrects itself before the next meal. I could not find the reason why the diarrhea occurs, but I have a theory why this diarrhea is so foul. Our liver keeps filtering the blood during a fast and removes debris and old blood cells. Then the liver passes the debris through the gallbladder and then into the small intestines. Then the body can purge itself of this foulness via from the small intestines into the colon and out of the body. Now, we see why the hygienists performed regular enemas at the fasting clinics.

Even though I do not recommend fasts beyond two days, some people require prolonged fasts. For example, fasting to reduce the size of tumors requires two weeks or more [3, 8]. Dr. Shelton fasted patients between three days and two months [3]. He supervised six fasts beyond 60 days with his longest fast of 90 days.

People with medical conditions must fast under a doctor's supervision at a fasting clinic. The staff at the clinic can monitor blood pressure, glucose blood level, and electrolytes while the doctors adjust medications as needed [8]. Then the doctors will terminate a fast to prevent endangering a patient's health and life.

## The Dry Fast

The dry fast also called the absolute fast is the strongest fast. The faster abstains from all food and drink for a time period. Some claim that one day of dry fasting equates to three days of a water fast. This claim is more of a statement because which measure could we use to support this claim? The dry fast, also called the virus killer, induces three times the autophagy of a water fast. Again, no research validates these claims.

I, nevertheless, found a weight loss ratio of 1 to 3 between water and dry fasts. For example, research subjects lost 3 pounds (or 1.39 kgs) per day on a dry fast [3, 178]. Meanwhile, a person loses about a pound (or 0.45 kg) per day on a water fast [3, 8, 13], which gives a one to three ratio. The researchers do not answer whether the higher weight loss comes from water loss. Otherwise, the fasters would quickly regain the water weight once they started eating again.

The dry fast comes as soft and hard dry fasts. For the soft dry fast, fasters can brush their teeth, take showers, and wash their hands after using the bathroom. Meanwhile, fasters cannot even touch water during a hard dry fast because their bodies absorb water through the skin during showers and brushing teeth. Of course, we can use the dry fast to get out of some house chores like washing the car or washing the dishes.

The dry fast places more the stress on the body than a water fast. The faster could become dehydrated quickly. The faster should not exercise or stand outside on a hot day since the body loses a great deal of water from sweating.

When deprived of water, the body produces small quantities of water. For instance, the body produces 107 grams of water from 100 grams of fat [179], which equals about 0.34 liter for a full 24 hours of dry fasting. (The calculation assumes a person burns 2,500 calories of fat during one day). Some estimates claim the body produces about one quart (or liter) of water per day, which is triple of the previous estimate. Of course, the body also conserves water as water becomes scarce.

Some fasters claim the dry fast is the easiest to practice. The process of drinking fluids awakens a hunger in some people during a water fast. People who want to experiment with the dry fast must adhere to the following rules.

  * **Rule 1:** The faster is clear why he or she uses a dry fast. If we dry fast, we should take it easy and stay in bed, cover ourselves with a blanket, and relax. This is the perfect time to catch up on our favorite TV shows or read a good book. Fresh air, rest, and sunshine are also good for the body.

  * **Rule 2:** The person is an experienced faster. Fasting resembles exercise. The more a person fasts, the easier fasting gets. The body quickly adapts to frequent fasts. Thus, fasters have completed many water fasts before trying the dry fast.

  * **Rule 3:** The dry fast is not an extended fast. We should ignore the YouTubers who dry fast for three days or longer. They always post a disclaimer at the beginning of their videos as entertainment purposes only. The dry fast dehydrates the body and jeopardizes a faster's health and life. In a study, healthy subjects experienced no health problems of a five-day, dry fast [178]. Of course, I dry fast at least twice a month for 24 hours. The body quickly adapts, and the dry fast becomes easy.

  * **Rule 4:** We should not exercise or be outside in hot weather. The dry fast dehydrates the body, which jeopardizes health in hot weather. Athletic performance also declines during a dry fast [180], so dry fasting may be the wrong time to train for competitions. The lower athletic performance comes from either the dehydration, poor sleep as Muslims awaken early to eat breakfast before dawn, or raising fat and lowering carbohydrates consumption [180]. Thus, the muscles store less glycogen from the carbs that the muscles utilize for energy.

  * **Rule 5:** Heavy coffee and tea drinkers should be careful during a dry fast. They may experience headaches and mood swings since they suffer from caffeine withdrawal symptoms during a fast [179]. Fasters may need to abstain from coffee and tea for several days to ease withdrawal symptoms [179].

  * **Rule 6:** People afflicted with eye diseases should avoid a dry fast [179]. A dry fast exacerbates the symptoms of cataracts, dry eye syndrome, or glaucoma [179].

Dehydrated fasters experience increased thirst, dark or more yellow urine than usual, headache, sleepiness, or dizziness, or a combination of two or more symptoms [181]. Fasters must end the dry fast and drink fluids when fasting becomes uncomfortable.

The Muslims practice dry fasting. During the month of Ramadan, Muslims cannot eat or drink anything from sunrise to sunset nor partake in the carnal pleasures as the faster communes with God. Islam exempts people who are vulnerable to dry fasting such as children, elderly, pregnant women, breastfeeding women, women during their menstrual cycle, and severely sick people.

Muslims limit the duration of a dry fast from sunrise to sunset. If Ramadan falls in June, the longest day occurs during the summer solstice, around June 20 in the northern hemisphere. The day lasts 17 hours. Consequently, Muslims fast between 11 and 22 hours depending where they live on the earth [87]. Therefore, Muslims would never dry fast beyond 24 hours unless they live at the North Pole with the midnight sun.

I live in Malaysia and talk to the Muslims about fasting. The Muslims are surprised when I tell them I fast intermittently. They concede the dry fast imparts many health benefits, but the benefits aren't enough to voluntarily fast every Monday and Thursday per week. Remember, Islamic law requires all eligible Muslims to fast during Ramadan, but Muslims can volunteer whether to intermittent fast twice per week. Again, when people feel obligated or forced into fasting, they never want to fast voluntarily.

We do not have enough evidence whether a 12-hour fast is long enough despite the dry fast being a stronger fast than the water fast. Both sexes experienced drops in LDL cholesterol, blood glucose level, and inflammation markers [87]. Meanwhile, women exhibited increases in HDL cholesterol while the men lost weight and lowered triglycerides. I talked to one Muslim woman who is overweight and suffers from gout. Doctors treated her with chemotherapy for a brain tumor. She fasts regularly between sunrise and sunset and concedes that she feels much better when fasting, but she has lost no weight. She fasts about 12 hours regularly, which may not be enough. That leads to our next tip.

  * **Tip #26:** Muslims may extend a dry fast or switch to a water fast after sunset to boost the health benefits of fasting. Fasters can also embed a dry fast into a water fast by dry fasting for 24 hours and then switch to a water fast for 12 hours.

People should fast at least 16 hours to attain the maximum benefits of fasting [109]. Depending on the person, fasting causes significant physiological changes between 12 and 16 hours into a fast. Both glycogen and insulin drop to new, lower plateaus after 12 hours after the last meal while blood glucose sets to a lower level after 13 hours [45]. Glucagon, the opposing hormone of insulin, peaks 13 hours into a fast [45]. The pancreas produces glucagon to message the muscles to release all glycogen and increases the fatty acids in the blood. Finally, the body begins breaking down fat into free fatty acids while the liver converts the free fatty acids into ketones. Thus, people must fast at least 16 hours to switch their bodies from a sugar-burning mode into fat-burning mode.

I tried the 24-hour dry fast. I used this as a perfect opportunity to catch up on Supernatural and the Winchester boys. The faster's euphoria returned after 8 hours into the fast, which I haven't experienced the euphoria in months on a water fast. I must usually water fast beyond 30 hours to get some remnants of a euphoria.

During the dry fast, I alternated between shivering and being cold, and sweating and being hot. I felt little pinpricks at different places on my body. I would feel a light pinprick on the right wrist, then on my ankle, later on, my left chest, and other places on the body.

I used a soft dry fast, so I still took a shower, brushed my teeth, and washed my hands after using the bathroom – no need to make others suffer my stench and germs during a dry fast. I still urinated five times during the fast. However, I peed less frequently as the fast progressed while the urine turned a darker yellow. Finally, I was surprised my mouth still produced saliva, and I felt good.

I experienced insomnia as I slept for four hours. I woke up at 2 AM and could not return to sleep. I didn't feel refreshed entirely, but I didn't feel terrible either. Nevertheless, I slept better on my next dry fasts. Now, the dry fasts have become routine.

I measured my weight during my first dry fast and lost 4.4 pounds (or 2 kgs). Of course, I lost mostly water because 4.4 pounds of fat would translate into 15,500 calories. No way did I lose that much body fat within 24 hours! That is easily five days of food for me.

I ended the fast after 23 hours by drinking an unsweetened strawberry tea. Then I followed the tea with homemade cinnamon oatmeal bread with real butter a half hour later. Perhaps it wasn't smart to make homemade bread and fill the house with a wonderful cinnamon, baking bread smell after not eating nor drinking for 22 hours. The next night, I slept nine hours and woke up refreshed and ready to go.

I, consequently, incorporated at least two soft, dry fasts into my monthly intermittent fasting regimen. The dry fast is a stronger fast, so hopefully, the dry fast imparts more health benefits on the body. Only time will tell. However, my body quickly adapted to dry fasting as the dry fast became just as easy as a water fast. Now, I almost feel no difference between feasting and a dry fast. The dry fast has become routine and monotonous except after exercising. One time, I tried to start a 24-hour dry fast after running for 45 minutes. I became severely dehydrated and had to drink unsweetened tea 18 hours into the fast.

## Hormesis

We view hormesis as a body's response to a chemical or condition. The human body is a beautiful machine that adapts quickly to the environment, so a mild stress strengthens the body while a severe stress damages it. For example, fasting inflicts stress on the body. A short fast strengthens the body and imparts many health benefits. However, if we keep extending the duration of the fast, then the fast may place too much stress on the body and thus weaken it.

The key is to find that level of stress that strengthens the body the most. We witness hormesis on a regular basis.

  * All drugs and medicines have a hormetic effect on the body. At low doses, the substances benefit the body, but the substances become lethal at high does. For example, a cup of coffee contains about 100 milligrams (or 0.1 grams) of caffeine. However, 20 grams of caffeine becomes lethal. That's about 100 cups of coffee. Nevertheless, people develop a tolerance to caffeine as they drink coffee regularly. Thus, they need higher doses of caffeine to get the same effect.

  * Running is excellent exercise for the body. The stress of running strengthens the lungs and circulatory system as the muscles demand oxygen to do work. However, have you observed marathon runners? Some look sickly thin and emaciated because they imposed too much stress on the body. Ironically, no body discusses the origin of the marathon. The Greek soldier, Pheidippides, ran 26 miles (42 kilometers) to Athens to report the victory of the Battle of Marathon. Then he collapsed and died from exhaustion.

  * Animals and plants do not want to be eaten, so they developed defenses against predators. Animals can run or fight, whereas plants produce natural pesticides to sicken the predator from toxic chemicals [161]. We already discussed natural pesticides in fruits and vegetables in Chapter 4. We eat a variety of foods to strengthen the body, but eating the same foods regularly may cause health problems as we constantly expose our body to the same poisons.

The key point to hormesis is the body adapts to the stress. Siim Land provides a good rule: We should always cycle through different regimes and conditions to strengthen the body [47]. Several examples include:

  * We should alter the durations of our fasts. For instance, we water fast for 30 hours. Then our next fast lasts 18 hours. Subsequently, the next fast is 25 hours. Perhaps we dry fast one time and then water fast the next. That way, we are always changing the stressor and its impact on the body.

  * We know the body's cells prefer glucose, i.e. sugar to fats. However, most cells in the body can utilize ketones and fatty acids for fuel. (Remember the liver, red blood, and 25% of the brain cells still need glucose). Some people fast and follow the ketogenic diet to remain in ketosis, whereas their bodies are always burning fat for fuel. The body may benefit by cycling between a standard diet and the ketogenic diet as we always change the cells' energy source [56].

Of course, we know the converse is true – it's not always good to be eating and burning carbohydrates for energy all the time. Hence, periodically abstaining from food can do wonders for the body.

# 6. Fasting Friendly Drinks and Supplements

"In anything, there has to be that moment of fasting, really, in order to enjoy the feast."

– Stephen Hough

In this chapter, we discuss drinks and supplements a faster can enjoy without breaking his or her fast. For a true fast, a person abstains from both food and drinks except water. However, the faster has many options for non-caloric beverages. The beverages must be free from sugar since sugar triggers an insulin response and forces the body out of the fasting state. Sugar comes in many disguises.

  * Sugar includes table sugar, honey, and agave nectar [10].

  * Sugar has many scientific names depending on the source: Fruits and honey (fructose), milk and dairy products (galactose and lactose), barley (maltose), and wood and straw (xylose).

  * The food industry manufactures high fructose corn syrup from cornstarch. Technically, fructose may elicit a small insulin response since the liver must convert it into fat.

The faster should avoid sugar substitutes such as aspartame, saccharin, and sucralose. The chemical industry manufactures the sugar substitutes from artificial chemicals. We fasters should avoid the artificial sugars since they can awaken hunger, which would cause us to end the fast prematurely. Furthermore, we do not know whether artificial sweeteners illicit an insulin response because of many conflicting studies [11]. On the other hand, stevia comes naturally from the plant, _Stevia rebaudiana_. However, we do not know if stevia elicits an insulin response.

Dieters drinking zero calorie drinks do not reduce their calories and provide little benefit in weight loss. In one study, 30 healthy males consumed a sugary strawberry flavored beverage spiked either with table sugar, aspartame, stevia, or monk fruit [182]. Monk fruit is a natural zero calorie sweetener. The participants showed no difference in calories consumed, blood sugar, and insulin spikes after eating [182]. Thus, we may want to avoid consuming drinks with artificial sugars since we would make up for the zero calories by eating more food.

Fasters can drink broth, coffee, flavored water, tea, soda water, and minerals and not violate their fast. Although these drinks have a touch of calories, the calories are not enough to kick the faster out of the fasting state. It is like a speeder slowing down to go over a speed bump to protect a car's suspension. Once the speeder crosses the speed bump, he or she returns to violating all the traffic laws again in full force again.

## Broth

Some fasters drink bone broth made from beef, pork, chicken, or fish bones. Bone broth contains traces of protein, fat, and carbohydrates [183]. People fasting less than 24 hours may want to avoid bone broth since the protein and carbohydrates can halt the fasting state. A 0.42 cup (or 100 milliliters) of bone broth has 51 calories with trace elements and minerals such as calcium, magnesium, phosphorus, potassium, and sodium [10, 183]. Since the faster has eaten some food, they can endure longer fasts [10]. The bone broth provides the body with essential electrolytes that help the faster avoid refeeding syndrome when they kick-start the feeding cycle again [10].

  * **Tip #27 – Bone Broth:** Clean half pound (or ¼ kg) of your favorite bones, such as beef, chicken, lamb, and pork. Simmer bones in a covered pot of water or crock pot with 2 bay leaves for a minimum of four hours. During the last hour, add sea or Himalayan salt and pepper for taste. Sea and Himalayan salt contain trace elements and minerals. Add water as necessary to make at least four mugs of broth. Refrigerate and reheat as needed.

Some recipes add vegetables to the broth. The vegetables not only add vitamins and minerals to the broth but also carbohydrates as well. Thus, fasters beware.

Some medical experts recommend that fasters avoid bouillon cubes because they contain artificial flavors, colors, and monosodium glutamate [10]. However, they are convenient. Just drop a bouillon cube into a mug of hot water and enjoy.

My favorite bouillon, Tom Yam, is a spicy, sour Thai soup. The soup base comes from chicken or seafood stock, lemongrass, lime leaves, lime juice, fresh ginger, spicy chilies, fish sauce, brown sugar, and red curry paste. It packs a spicy punch.

The salt has the potential to dehydrate the faster. The body must muster extra water to expel excess salt in the urine. That is why we fasters should always drink plenty of fluids during a fast.

## Coffee

Fasters who love their morning cup of joe can still enjoy their coffee as long as they add no sugar, cream, nor milk. In large quantities, sugar, cream, or milk could halt the fasting state. In addition, dairy products contain lactose, which serves as both a sugar and protein.

Black coffee is great when we get used to the taste. I live in a tropical climate, so coffee on the rocks adds a nice touch to my mornings. One teaspoon of instant coffee contains 4 calories with trace levels of minerals such as calcium, magnesium, phosphorus, and potassium and a smidgeon of niacin [183]. The coffee's nutrients depend on the coffee bean's origin, type, roasting, and manufacturer.

  * **Tip #28 – Cold Brew Coffee:** Some coffees have a bitter taste. If you enjoy iced black coffee, add 3 tablespoons of ground coffee to a small bottle of water. Shake and refrigerate for several days. Then filter the coffee, add ice, and enjoy. The cold brew weakens the bitterness of strong coffees.

The antioxidants in coffee impart many health benefits such as the following:

  * Both decaffeinated and regular coffee initiate autophagy, which causes the body to rejuvenate its poorly performing cells [50].

  * Regular coffee drinking reduces the risks of heart disease, Type II diabetes, and several cancers such as liver, colorectal, and melanoma [184, 185].

  * Coffee drinkers experience a lower risk of Alzheimer's disease, Parkinson's, and multiple sclerosis [184].

  * Coffee lowers mTOR and raises AMPK that switch on autophagy [50]. Thus, coffee encourages the body to rejuvenate and repair the body's cells.

Coffee or the caffeine in coffee acts as a mild diuretic causing the coffee drinker to urinate frequently. Fasters should drink beverages with no caffeine to replenish the water in the body.

Bulletproof coffee has become popular with fasters. Nevertheless, bulletproof coffee may not be a good choice for intermittent fasting with fasting periods less than 24 hours because the faster essentially drinks a liquid meal.

Bulletproof coffee clocks in the calories. The typical recipe is one cup of brewed coffee blended with two tablespoons of unsalted butter, two tablespoons of coconut oil (medium chain triglycerides), and two tablespoons of heavy cream. Thus, the coffee has close to six tablespoons of fat and packs 648 calories. The calorie count depends on the recipe and which ingredients the person blends with the coffee. Some fasters substitute a strong tea for coffee to make bulletproof tea.

We can estimate the calories content of bullet coffee or tea. One teaspoon of fat equals 4 grams. A tablespoon equals 3 teaspoons, and thus 12 grams of fat. Then a gram of fat holds 9 calories of energy. Hence, one tablespoon of fat yields 108 calories. Then we can ignore the calories in the coffee or tea since it adds 4 calories or less compared to the fat.

A person fasting beyond 24 hours or a person following the ketogenic diet may find benefits in drinking bulletproof coffee. The coffee should keep the person in a state of ketosis, but the person burns fat from the coffee and not the fat stores from his or her body.

I have tried bulletproof coffee. It tastes similar to a rich cup of cappuccino since the blender froths the cream. However, we are drinking a liquid meal.

## Exogenous Ketones

I am always searching for ways to strengthen the state of ketosis without having to fast beyond two days. Unfortunately, the body quickly adapts to fasting. In one study, healthy women experienced a drop in a blood ketone, beta-hydroxybutyrate during their second fast [186]. This study presents trouble because ketones may provide the signal to cells to switch on autophagy [56]. Furthermore, ketones may rejuvenate senescent cells and activate the stem cells when the feasting cycle starts again. Then the liver can create glucose from both proteins and glycerol because the body's cells prefer sugar as its primary energy source. Thus, the body does its best to overcome the stress of fasting.

I accidentally came across exogenous ketones as a means to strengthen the state of ketosis. Exogenous ketones are salts of beta-hydroxybutyrate. The salts also supply the body with minerals such as calcium, magnesium, and sodium. That leads to our next tip.

  * **Tip #29:** In theory, a faster can take exogenous ketones to strengthen the state of ketosis since many of the health benefits of fasting are associated with the level of ketones in the blood.

Unfortunately, I cannot buy exogenous ketones in Malaysia and have not experimented with them. I get many crazy looks from pharmacists when I ask about exogenous ketones and explain what they are used for. Of course, they have heard of the ketogenic diet, but this diet has not taken root in Malaysia.

In theory, I would fast for 12 hours before taking exogenous ketones. The 12 hours of fasting help the body burn the excess sugar because the body's cells prefer glucose first before consuming ketones for energy.

That is probably why some people rate exogenous ketones poorly as they overload their diet with carbohydrates. Subsequently, the exogenous ketones have little impact on their bodies since most cells in the body consume glucose first as its primary fuel.

## Flavored Water

Fasters can drink flavored water. The faster squeezes fresh juice from either lemons and limes and adds to the water. One lemon contains about 24 calories while one lime contains around 20 calories. Both include Vitamin C with the minerals – calcium, magnesium, phosphorus, and potassium. Many purport health benefits of consuming fresh lemon or lime juice every day.

Fasters can use other fruits and vegetables to make flavored water. We can submerge berries, cucumber slices, or orange slices in water to infuse the water with flavor. Cucumbers are a good choice since they contain minuscule traces of sugar while berries and oranges contain sugar. The sugar could kick the faster out of ketosis. Thus, we should be careful which fruits we add when making the flavored water.

The food industry offers vitamin and fiber water. Depending on the brand, we should avoid these. Many brands contain as much sugar as sodas and juices. Furthermore, the food industry offers zero calorie vitamin and fiber waters, but they sweeten the water with artificial sugars or stevia. We do not know the long-term effects of artificial sugars on health and whether artificial sugars raise insulin levels in humans [187].

## Soda Water

Although I am not enthusiastic fan of sodas, I accidentally came across soda water. As an American, sometimes I forget that some names do not translate well outside the United States. For example, I was visiting a friend in New Zealand and asked for a soda at a restaurant. Imagine the surprise when I sipped the water, and it had no flavor or sweetness. It was just carbonated water. Duh! Outside the United States, a soda is just carbonated water and not a carbonated sugary drink. However, I actually enjoy drinking soda water during a fast, which leads to our next tip.

  * Tip #30: For people who love drinking their sugary carbonated drinks, soda water is refreshing and effervescent. It contains zero calories, and some companies add traces of minerals. Soda water is also called club soda, seltzer, and sparkling water.

## Tea

Tea drinkers enjoy tea in a variety of flavors. What we call tea is a drink made from the leaves of the plant, _Camellia Sinensis_. However, tea companies process the same leaf in a multitude of ways that changes the character, flavor, and cost of the tea. For example, tea companies mass produce teas cheaply by using a special hedger that removes the top leaves from the tea bush. Meanwhile, laborers handpick expensive, quality teas. The pickers remove the top three young leaves and buds of new growth.

Tea also differs in processing and include the following:

  * **White Tea** : Producers use young shoots from the tea bush, and they do not allow the tea to oxidize, which is the least processed tea [188]. Oxidize means that some chemicals in the tea react with the oxygen in the air. Oxidation darkens the tea leaves.

  * **Green Tea:** Producers quickly dry the tea leaves to stop oxidation [188]. Green tea is slightly oxidized.

  * **Oolong Tea** : Oolong tea lies between green and black and is partially oxidized [188].

  * **Black Tea:** Producers completely oxidize the tea leaves and is the most commonly drank tea in the Western world [188].

  * **Matcha Tea:** Growers cover the tea bush for three weeks before harvest. Then producers pulverize the whole green tea leaf into a fine powder. Tea drinkers drink the entire leaf.

Fasters can enjoy tea during fasts with no worries as long as they add no sugar or dairy product. Tea has zero or close to zero calories with trace minerals and vitamins [183]. Tea contains traces of calcium, magnesium, phosphorus, potassium, sodium, and zinc [183], but the nutrients depend on tea type, variety, and growing conditions.

I could write another book on the health benefits of tea in all its varieties and forms. For instance, all tea from the _Camellia Sinensis_ contain polyphenols, which are catechins, flavonoids, and theaflavins. These substances are antioxidants that depart many health benefits. Antioxidants neutralize free radicals in the body. Free radicals are charged molecules that float around the body and harm and damage cells and tissues. Cigarette smoke, radiation, and the cells making energy produce free radicals.

  * **Tip #31 – Sun Tea** : Place between 4 and 8 tea bags in a clear glass pitcher of water. Cover the pitcher to keep bugs out and let the pitcher get at least four hours of direct sunlight. Sun tea has a milder taste than brewed tea and works well for inexpensive, bitter black teas. Then we drink it as an iced tea.

Fasters and health conscious people focus on green tea because the catechins suppress appetite, boost metabolism, and help in weight loss [10]. Green tea also contains epigallocatechin gallate (EGCG) that triggers autophagy, or at least in the livers of mice [58]. Steeping tea leaves in hot water dissolves some of the antioxidants.

Matcha tea becomes another good choice. It started in Japan where the Japanese pulverize the whole green, tea leaf into a fine powder. That way, the tea drinker consumes all the nutrients and antioxidants from the tea leaf. All the popular coffee shops make a matcha smoothie. Please note, that matcha tea contains up to 25 calories per cup because the producers add sugar to the mixture. Sometimes, I get a little buzz from drinking matcha tea, so the tea contains something. Matcha tea can be difficult to make, which comes to my next tip.

  * **Tip #32 – Matcha Tea:** The tea mixes poorly with water. The tea drinker places the matcha tea in a cup and adds a little hot water. Then the person uses a flat, small spoon to thoroughly dissolve the powder into the water before filling the cup with hot water. The tea clumps if not completely dissolved. The tip – place the matcha tea in a capsule for the espresso machines like Nescafe Dulce Gusto and Keurig. The machine does the work dissolving the tea powder into the water using hot water and pressure.

Herbal tea excludes tea from the _Camellia Sinensis_ and includes a mixture of herbs such as chamomile, jasmine, ginger, dried fruit, mint, lavender, hibiscus, or licorice. Many of these herbs impart health benefits in and of themselves. Many of these herbs are also blended with tea from _Camellia Sinensis_. Of course, I prefer black tea with strawberry or tropical flavors, but fasters have many choices.

Tea is also a great drink when sick, which leads to my next tip.

  * **Tip #33 – Ginger Tea:** Clean and thinly slice a fresh ginger root. Place five slices of ginger with a black tea bag and steep in a cup of hot water. I learned this trick in Malaysia when I suffered from a persistent sore throat because ginger has antifungal, antibacterial, and antiviral properties. After two days of drinking this tea twice per day, good riddance sore throat.

## Vitamins and Minerals

Calcium, magnesium, phosphorus, and potassium levels stay remarkably stable in the body during a fast [15] along with proteins and vitamins [8]. However, the levels of zinc rise in the blood, which results from the body catabolizing and breaking down tissues within the body [15]. In addition, the body loses sodium rapidly during a fast [15, 19, 27], which explains why the body sheds excess water with rapid weight loss [15, 19].

Some fasters take multivitamin and mineral supplements during their fast. However, Dr. Joel Fuhrman believes the faster should avoid vitamin and mineral supplements during a fast to allow the complete rest of the digestive system [8]. Salt, i.e. sodium chloride, should be the only exception. Some fasters believe salt would violate their fast while others do not. When my fast extends beyond 24 hours, I add a ½ teaspoon of Himalayan salt to my hot water, drink bone broth, or drop a bouillon cube into hot water.

We all heard the dangers of high salt and high fats in our diets. The loss of salt during a fast shows that we fasters should not restrict our diets during our feasting cycles. Diet restriction could compound mineral and vitamin deficiencies over time. For example, we fast and lose some sodium. Then we feast but limit our salt intake. As we continue to fast and feast over months, we continually lose sodium until the sodium deficiency endangers our health. Furthermore, we should also not restrict our oil and fat intake either because the oils help our digestive system absorb vitamins A, D, E and K. (Don't forget to eat your bananas because raising salt intake may lead to a loss of potassium).

We should take vitamins and minerals during our feasting cycles to ensure we have plenty of nutrients. One of my favorite supplements is Spirulina. Spirulina, a blue-green alga, grows in salty water in oceans and salty lakes in subtropical climates. Several celebrities call spirulina the superfood because it contains significant amounts of amino acids, calcium, iron, magnesium, potassium, magnesium, and B vitamins [189]. Amino acids are the building blocks of proteins [189]. Proponents claim that spirulina cures a variety of health conditions because it also contains beta-carotene (related to Vitamin A), phycocyanin (blue pigment), and tocopherols (related to Vitamin E) [189]. However, I do not offer any health claims for spirulina. I take spirulina because I call it God's natural multivitamin. It comes from nature.

Yeast extract, an alternative to spirulina, contains vitamin Bs, minerals, and protein. Yeast, a fungus, decomposes sugar into ethanol and carbon dioxide and forms the backbone of the beer and wine industry. Furthermore, yeast undergoes autolysis where the yeast cells break down into simpler components that we call yeast extract when the yeast dies.

Yeast extract contains proteins called glutamates. The food industry uses monosodium glutamate (MSG) as a flavor enhancer and extracts MSG from the yeast extract. Some blame MSG for headaches, allergies, and infant obesity. The food industry uses MSG and yeast extract interchangeably. We usually find MSG in bouillon cubes. Thus, I enjoy a bouillon cube in a mug of hot water once in a while during a fast.

We should do our research to determine which supplements we think are best for us. Supplements are expensive, and people should avoid taking a whole assortment of them. Other supplements for anti-aging include acetyl-L-carnitine arginate, CoQ10, green tea extract, pycnogenol (French pine bark), and resveratrol (from grape skins). Just be careful. In rare cases, people taking green tea extract suffered from liver and kidney issues and problems. That leads to the next tip.

  * **Tip #34:** We should take vitamin and mineral supplements on our feasting days to ensure our bodies have plenty of nutrients for our fasting days. My favorites include fish oil, a multivitamin, and spirulina.

The health food industry creates vitamin and mineral supplements from chemical processes. Some people debate whether the human body can utilize artificial chemicals. For example, beta-carotene, a precursor to Vitamin A, imparts many health benefits to the human body. However, beta-carotene in pill forms does not provide the same benefits as natural beta-carotene from carrots and orange vegetables. If given a choice, we should always choose natural sources for our nutritional needs.

## Vaping and Smoking

I included a section on vaping and smoking because several young people asked me whether smoking cigarettes or vaping breaks a fast. Technically, a person does not eat tobacco, so the digestive system does not process the chemicals in tobacco. It also doesn't appear to spike insulin. Therefore, the tobacco does not break a fast. However, consuming tobacco products breaks the "spirit" of the fast because a person fasts to remove the toxins and poisons from the body. Consuming a tobacco product introduces new toxins and poisons into the body during a fast. For instance, the primary chemical, nicotine, stimulates the body at low dosages but turns into a poison at high dosages. In addition, cigarette smoke contains about 4,000 toxins, which creates free radicals in the body [54]. Then the free radicals damage cells.

Two studies highlight the dangers of nicotine. First, nicotine could lead to insulin resistance and hinders the action of insulin in the body for both smoking and nicotine gum [190]. (We can assume vaping would impart the same effect on the body). We already know that insulin allows the cells to utilize glucose for energy and also encourages the body to store glucose as fat. Nevertheless, insulin resistance leads to metabolic syndrome – high blood pressure, diabetes, heart disease, and obesity. Second, the free radicals in second hand, cigarette smoke damage the mitochondria in the cells [54]. The mitochondria are the energy furnaces inside the cells. Although this is another study of mice, the damaged mitochondria switch on autophagy as the cells break down the damaged mitochondria and produce new ones [54]. Thus, we have a dilemma. If a person did not smoke that cigarette, his or her body could be repairing other cells in the body instead of the recently damaged cells from the cigarette smoke.

Don't get me wrong. I'm not an anti-smoking crusader. Sometimes, I enjoy a cigar while drinking with friends. I had also vaped when it was cool in 2014. The key is moderation; I enjoy about four cigars per year but not every day.

# 7. Fasting Diets

"When the stomach is full, it is easy to talk of fasting."

– St. Jerome

The key to fasting is sustainability and attitude. We fast regularly to cleanse and repair the body. The body, just like our house, needs periodically cleaning. The fasting also helps nullify most of the negative effects of aging. However, a person's attitude determines whether that person will fast or not. For example, my best friend is a brilliant researcher and professor at a university in New Zealand. Unfortunately, he is encountering many health problems in his 40s – chronic infections, severe allergies, and digestion system problems including a sensitivity to wheat gluten. He sees how fasting has made me healthy, but he refuses to fast. Unfortunately, he was forced to fast as part of his religious duties as a child, and he detests fasting. This is quite common. People forced to do something turns them off from doing something voluntarily. On the other hand, I look forward to a fast. I have two whole days in a week where I do not prepare any meals or wash any dishes. I also know I'm getting the health benefits that were already outlined in this book. Thus, I enjoy my fasts.

In this chapter, fasters have a range of options to incorporate fasting into their lifestyle. Fasters must experiment to find which regimen works well for them. For example, some fasters swear by the one meal a day (OMAD), and how this diet has transformed their lives. I love food, so I cannot do this fasting regimen. Instead, I fast between 24 and 48 hours and then feast for a whole two days. Then I eat like a condemned man eating his last meal before his execution during feasting days.

Accordingly, this chapter gives the fasters ideas how best to incorporate fasting into their lives. This chapter also summarizes the ketogenic and fasting mimicking diets since they complement fasting. The ketogenic diet turns on the same pathways as fasting [57].

## The Ketogenic Diet

Medical doctors started the ketogenic diet in the 1920s to treat epilepsy in children. The name ketogenic comes from the word ketone. The diet became popular in the 1920s and 1930s and has recently resurged in popularity. Celebrities go on the keto diet and show off their toned, chiseled bodies.

The ketogenic diet is not fasting since the dieter still eats food. Thus, the ketogenic diet is weaker than a water fast because all food elicits an insulin response except pure fats [11]. Nobody eats pure fat. However, the Keto diet puts the dieter into a perpetual state of ketosis and resembles the process of fasting, when the body burns fat for energy. The dieter either burns fat from his or her body or the fat from the food.

Some believe the ketogenic diet is not strong enough to reverse insulin resistant [10]. Some people need a fast to reset their insulin levels. Furthermore, some people combine the ketogenic diet and intermittent fasting to multiply the health benefits from both regimens.

The U.S. Departments of Agriculture and Health and Human Services recommend people consume between 20 and 35% fat, between 10 and 35% from protein, and the remaining calories from carbohydrates. The keto diet recommends around 70% of fat, 25% protein, and 5% carbohydrate Women require 2,000 calories per day and would restrict their carbohydrates to 100 calories or lower. Meanwhile, men consume on average 2,500 calories per day and would limit their carbs to 150 calories or lower. In practice, dieters often restrict carbs to 50 calories or lower.

The ketogenic diet restricts carbohydrates extremely. Table 5 shows how much carbs a dieter can eat in one day. Dieters are limited to one small fruit per day or a 1/3 cup of cooked brown rice. Starbuck lovers can have a caffe latte with nonfat milk or two cold brew coffees with almond milk, but the other Starbucks drinks and cakes are forbidden. Once dieters consume their tiny carb portion, they are left with proteins and fat for the remainder of the day. In addition, the dieters must control their protein intake since the liver can manufacture glucose from protein.

We can see the Keto diet is extreme when it comes to carbohydrate restriction. Some people experience the Keto flu as the body adapts to burning fat as energy. The symptoms resemble the flu and include diarrhea, dizziness, headache, nausea, vomiting, and weakness [191]. The symptoms can last a week [191]. Technically, the dieters experience sugar withdrawal symptoms as the dieter experiences extreme cravings for sugar. Other Keto complications include the Keto crotch, where the crotch emits some strong smells down there.

Many nutritionists and doctors debate the long-term health problems of a keto diet. In a mouse study, a high-fat diet raised LDL cholesterol and increased ratios of cholesterol/HDL and LDL/HDL [84]. Hence, the researchers are setting up the little critters for future heart attacks. In another study of rats, scientists show the ketogenic diet switches off mTOR in liver and brain cells [44]. The mTOR pathway must turn off to promote autophagy. Although we share similar biological processes with mice, research studies often do not transfer to humans.

In a human study, researchers studied the keto diet on 15 military personnel with 14 people in the control group. The control group showed no change during the study. On the other hand, the keto group lost 16.9 pounds (or 7.7 kg), lost visceral fat, and experienced an improvement of insulin sensitivity [193]. The study lasted 12 weeks, and both groups ate until they were satisfied [193]. The keto group showed the same athletic performance as the control group in squats, bench press, sprints, and other exercises [193]. The study confirmed that the keto group entered into ketosis after three days [193]. Although they are not fasting, we see the three days again. Finally, the study has one flaw – the participants chose which group to join [193]. Thus, we have a selection bias with the keto group having more chubby members.

In another human study, the cholesterol, LDL, and HDL levels were similar on high-fat and low-fat diets [194]. The high-fat diet consisted of 39% of fat while the low-fat consisted of 22%. The high-fat diet is not the ketogenic diet. However, the subjects on a low-fat diet exhibited higher triglyceride levels [194], indicating their bodies converted the excess sugar into triglycerides.

We must remember table sugar is half glucose and half fructose. The liver manufactures triglycerides from excess fructose in the body. Dr. George Bray believes a diet high in fructose increases triglycerides because the liver turns fructose into fat [195]. That's why we should avoid sodas and drinks brimming with high fructose corn syrup.

News reporters, of course, love reporting sensational news that the keto diet will harm the dieters and their health. We must be careful when we cite and read research papers. That is why I added the mouse study. Perhaps researchers saw an increase in cholesterol in mice. Let's say they stopped the study and dissected the mice before they developed heart disease. Then in the conclusion, they cite a paper that connects high cholesterol levels to heart disease in mice. Bam, high-fat diets cause heart disease in mice. The news reporters get a hold of this research paper and write a news story about how the ketogenic diet leads to heart disease in humans.

Research is not dishonest per se. We play a game because research is like hitting a home run. We are triumphant if we get our article into a top-notch journal. Our employers, the universities, love us and shower their top researchers with promotions, reduced teaching hours, and other benefits. If we despise our employer, the top researchers have no problems relocating to another university. Unfortunately, professors who are excellent teachers but poor researchers may have trouble finding new employment opportunities.

Research presents another problem. The research literature contains several conflicting studies. We can easily find another research study on mice that show a high-fat diet does not affect cholesterol. This is not dishonest. Perhaps one group of researchers used mice that were prone to high cholesterol levels while the second group of mice was not. When we write that brilliant research article, we emphasize research papers that support our ideas and de-emphasize papers that weaken our ideas. It does not matter if only one person reads our research paper. We still hit a home run. Then we show our employer and earn our rewards.

Grant money may complicate research and lead to biased research reports. Our employers expect us to go out and obtain research funding. They give it a cute name – monetizing research. Universities are just as hungry and greedy for money as the corporations, but we posit altruistic reasons why we need the money. Therefore, when we receive a research grant, we must substantiate the claim that the granter wants. Otherwise, that benefactor will never grant us a research grant again.

A large corporation, for example, bestows a multimillion grant to study the health effects of one of its products, high fructose corn syrup (HFCS). Some claim that HFCS causes fatty liver, insulin resistance, and high triglyceride levels [11, 195] and, in addition, increases the risk of obesity, diabetes, and heart disease [195]. Researchers must find ways to amplify the positive benefits of HFCS and de-emphasize its negative qualities. Otherwise, the corporation will never fund the researchers again. Thus, we must be careful when reading and citing research papers. Perhaps this is why numerous conflicting studies and reports fill the research literature.

We, unfortunately, see the problems of the keto diet. The U.S. Department and the food industry has demonized fats for five decades. The food industry offers a large variety of high-carb, low-fat snacks. Now, the keto diet has come along and threatens to shake up the food industry. Then we read and listen to the many conflicting research news of how the keto diet ruins (improves) our health and quickens (slows) our destination to our final resting spot.

Sometimes I may eat one or two meals that are extremely low in carbohydrates and high in fats before starting a fast. I can tell it strengthens a fast. Consequently, we can use go on the ketogenic diet one or two days before the start of the fast, which leads to the next tip.

  * **Tip #35:** Fasters can go on the ketogenic diet before starting a fast. The keto diet puts the person into ketosis before the fast, which strengthens short term fasts.

Because of the keto diet, I boosted the fats in my diet. However, the diet has a large impact on training. For example, I love carbohydrates and usually train on a high carb diet. One time, I ate several low carbohydrate meals a day before a 10-kilometer run. I felt great. I experienced no pain. Once I reached the 7-kilometer mark, I lost all my energy and had to walk the remaining distance. The problem is I don't train on the ketogenic diet. I'm used to the sugar fuel for the initial energy during a run. Consequently, athletes going on the ketogenic diet must train while on the diet to maintain their performance.

## The Fasting Mimicking Diet

Valter Longo, the director of the Longevity Institute at the University of Southern California, created the fasting-mimicking diet [196]. The diet allows people to gain the benefits of fasting without completely abstaining from food [197].

The diet lasts five days and uses the following protocol:

  * On the first day, the dieter consumes 1,090 calories. The meals consist of 56% fat, 34% carbohydrates, and 10% protein [197, 198].

  * On remaining days, the dieter eats 725 calories per day. The meals consist of 44% fat, 47% carbohydrates, and 9% protein [197, 198].

Day 1 serves as a transition day, but it is interesting that Day 1 has the highest calories from fat while the remaining days have the highest calories from carbs. The carbohydrates would kick the faster out of the fasting state, but the diet makes up for the carbohydrates by fasting five days. Of course, a dieter could modify the diet to make it more ketogenic friendly.

The company, L-Nutra, sells the ProLon meal kits to help people implement the fasting mimicking diet [196]. The meal kits sell between $250 and $300 depending on how many kits a consumer purchases [196]. Over 52,000 people have purchased the meal kits [196]. That means, the company has grossed at least $13 million. Not bad. Hence, one company found a way to make money from fasting.

People may find the diet useful. For me, I do not trust the Malaysian postal service to deliver an expensive package to my door. Sometimes I receive my mail; sometimes I don't. I remember one time it took the postal service four months to deliver an urgent bank letter.

  * **Tip #36:** Some fasters require a crutch to help them transition to fasting. A meal kit comes in handy. The faster doesn't need to measure his or her food or count the grams of fat, carbohydrates, and proteins. Thus, the meal kit makes fasting easier and more convenient.

Professor Valter Longo conducts much needed research into fasting using his fasting mimicking diet. I read several of his team's papers, and their papers are good and published in top journals. However, the research benefits the L-Nutra company indirectly, the company he founded. He donates 60% of his profits to Create Cures Foundation, a non-profit organization to apply science to the treatment of diseases. Professor Longo is also the founder. The good news – his research team studies fasting at the cellular level.

In one study, for example, researchers showed that mice on a fasting mimicking diet experienced a boost in the number of stem and progenitor cells upon refeeding [197]. Stem cells are blank cells that the body uses to repair damaged cells in tissues and organs. Progenitor cells are similar to stem cells except they are more limited in which cells they transform into.

In studies of mice, researchers found that a two-day fast or a three-day fast mimicking diet cleans and clears the blood of senescent white blood cells [64, 177]. Then the immune system quickly regenerates white blood cells upon refeeding [177]. The stem cell regeneration comes with a drawback. If a faster exposes him- or herself to carcinogenic substances during refeeding, he or she may transform those new cells into cancerous cells [32, 66].

## Popular Fasting Diets

Several diets gained popularity. The diets are not true diets where the dieter restricts his or her food choices. The diets use a combination of feeding and fasting windows. The diets are ranked from the easiest to the most difficult as either the fasting window increases or the number of fasts per week increases.

  * **LeanGains or 16:8:** Marin Berkhan popularized this regimen where the dieter eats all his daily food during an eight-hour window and fasts for the remaining 16 hours [199]. The dieter is flexible and determines his or her eating window such as joining the family for supper. The 18:6 regimen is also popular with a 6-hour eating window and 18-hour fast.

  * **Eat Stop Eat or 5:2:** A person fasts for two days out of the week and freely eats during the remaining five days [9, 199]. Michael Mosley, a British journalist, popularized a version of the diet by allowing the dieter to eat up to 500 calories per day for a woman and 600 calories for a man on the fasting day [9]. The dieter either spreads the calories over the day or consumes all at one meal.

  * **The Warrior Diet or 20:4:** A faster eats all his daily meals within a four-hour window and fasts for the remaining 20 hours [199]. Ori Hofmekler based his regimen on the eating habits of warriors who battled during the day and returned to the camp at night to feast [199].

  * **Alternate Day Fasting:** Dr. James Johnson popularized this eating protocol where a person fasts for a whole day and then feasts the next day [199]. Then the faster repeats.

  * **The Snake Diet:** A person eats like a snake. The snake gulps down a rodent and lets its digestive system devour the rodent over a day or week. Thus, a person eats all meals within a one- or two-hour feeding window and fasts for the remaining time [200]. Cole Robinson, the diet's creator, recommends the faster drink snake juice – a concoction of water and minerals [200].

  * **One Meal a Day (OMAD):** The diet resembles the snake diet but omits the snake juice. The dieter eats all calories in a one-hour eating window and fasts the remaining 23 hours in the day [201]. Blake Horton offers a similar diet as the OMAD [202]. He shocks the viewers on YouTube as Blake gorges on a mountain of food within an hour. He demonstrates the power of intermittent fasting.

  * **The Autophagy Fast:** The person eats regularly on his or her feasting day until 6 PM. The second day, the person fasts for the whole day. Then the person resumes eating breakfast at 6 AM the third day, granting the faster a 36-hour fast. Of course, we may adjust the time to conform to our schedules.

  * **The Weekly Super Cleanse:** The faster drinks only water between 42 and 60 hours per week. I developed this fast because I regularly fast for at least 24 hours, twice per week. Instead of spacing out the two fasts, I joined them together. That way, a 48-hour fast imparts more benefits than two 24-hour fast because a person stays in autophagy for a longer duration. The digestion system processes and clears the food out once during a 48-hour fast rather than clearing the digestive system twice for two 24-hour fasts. Furthermore, the feasting and fasting days maintain a ratio of two to one, so a person eats well during his or her feasting cycle to prevent nutritional deficiencies.

The key is to find a fasting regimen that fits well with our lifestyle. I gravitate towards the Autophagy Fast and Weekly Super Cleanse because I'm interested in extending my life with minimum health problems. What's the point of living forever if we are always sick and ill. That's why the ancient Greeks believed longevity and youth go together.

# 8. Alternatives to Fasting

"To starve is to die; to fast is to live."

– Dr. Herbert Shelton

In this chapter, we examine the obesity epidemic in the United States and identify the possible causes. Then we look at the traditional methods the healthcare industry uses to combat obesity, such as caloric restriction, exercise, and bariatric surgery.

## The Obesity Epidemic

The obesity epidemic has exploded in the United States in the last fifty years. Obese people usually build layers of visceral fat around their organs in the abdomen. Visceral fat increases the person's chance of developing diabetes, hypertension, high cholesterol, hyperlipidemia (excess blood fat), liver problems, and heart disease [95, 203, 204]. Obese people could also suffer from gallbladder disease, osteoarthritis, gout, breathing problems, and sleep apnea [203], when a sleeper's breathing stops.

Some researchers blame obesity for health problems while others suggest obesity is a symptom. For example, one theory states that obesity leads to chronic inflammation because the large amount of fatty deposits send out hormones and chemical proteins called cytokines, which lead to chronic inflammation [89, 90]. Cytokines allow cells to communicate to each other. Many of the diseases and illnesses in Chapter 2 originate from chronic inflammation.

How do we define obesity? Healthcare providers define obesity using the body mass index (BMI). The BMI equals a person's weight in kilograms divided by the person's height in meters, squared [11, 205]. For example, before I discovered fasting, I weighed 220 pounds (or 100 kgs) with a height of 5 ft 9 in (or 1.75 m). As calculated in Equation (1), my BMI equaled 32.7. Therefore, I was obese. This simple measure estimates I was 32.7% of fat. After six months of intermittent fasting, my BMI dropped to 28.4. Hurray, I'm overweight.

The formula in (2) converts the measurements to a height in inches and weight in pounds.

The health professionals and doctors use Table 6 to classify their patients' BMI. The BMI assumes a person with a specific height carries a healthy body weight. A person with a BMI exceeding 35 has a 100-fold increase in the risk of diabetes [95]. Nevertheless, the BMI is not always accurate. The BMI incorrectly identifies bodybuilders and muscular men and women as overweight or obese even though they have a lean body mass.

We use the BMI to estimate the obesity in the United States in Figure 2. The graph defines the percentage of Americans age 20 and older who are overweight, obese, or severely obese. The percentage removes the effect of a growing U.S. population. Ironically, the proportion of overweight people has remained constant since the 1960s. Not many writers and researchers comment on this. However, obesity has skyrocketed over the same time as well as severe obesity.

Obesity does not strike all states, ethnic groups, and educational level equally. The map in Figure 3 shows California and Colorado have the lowest incidence of obesity while the Southern United States has the highest. Usually, obesity strikes the poorest people while educated people exhibit lower levels of obesity. Obesity also differs by ethnic groups.

Scientists and doctors do not know why obesity is exploding so rapidly in the world. The United State is the obesity capital of the world while the United Kingdom is the obesity capital in Europe. Meanwhile, I reside in Malaysia that has become the obesity capital in Asia.

The scientists and doctors posit several reasons to explain the explosion of obesity:

  * The U.S. Department of Agriculture released its dietary guidelines in 1977 that encouraged a high carbohydrate and low-fat diet [10, 11]. Many nations followed the United States, such as the food labeling law. The food labels in Malaysia resemble the United States. We have known for some time a diet high in carbohydrates makes people overweight. Two centuries ago, Jean Anthelme Brillat-Savarin (1755–1826) wrote that a diet high in floury and starchy substances leads to obesity [208].

Ironically, a British medical doctor, Dr. John Yudkin, warned the public of high sugar consumption in his book, _Pure, White, and Deadly_ in 1972, and how high sugar consumption leads to diabetes and heart disease [209]. The public and medical field ignored his research and book for 30 years. However, Yudkin's book is witnessing a resurgence while his words are turning into prophecy.

  * The American society has witnessed the explosion of the snack food industry. Snack foods contain various types of sugar and refined carbohydrates. Even the low-fat snacks make up the taste by adding sugar. In addition, the processing removes fiber, healthy vitamins and minerals. Many of the U.S. snack foods are available everywhere in the world.

  * Farmers have grown fruits and vegetables on the same land for decades. Some theorize that soils have become depleted in minerals. Thus, we eat more fruits and vegetables to make up for the deficient nutrients [11].

  * Families ate three meals, breakfast, lunch, and dinner in 1977. By 2003, families snack between meals, so on average, a person eats up to six meals per day [10, 11]. The constant snacking leads to persistently high levels of insulin [11]. Then the person becomes insulin resistant over time as he or she converts their bodies into sugar burners.

We assume modern families eat more calories from the snacking because the evidence suggests meal frequency does not influence obesity [210, 211]. As long as a person eats the same calories, it makes no difference if that person snacks seven small meals throughout the day or gorges on two [210, 211]. (It would be interesting to compare gorging one meal per day versus snacking since the one meal would put a person into the fasting state).

  * U.S. food manufacturers started manufacturing high fructose corn syrup (HFCS) since the 1960s, which we find in many products at the supermarket. Some claim that HFCS damages health and leads to fatty liver and insulin resistance, and elevated triglycerides [11, 195]. Only the liver metabolizes the fructose and converts it into fat [11, 195]. On the other hand, almost every cell in the body uses glucose for energy [11]. We rarely find HFCS outside the United States because the U.S. imposes high tariffs on imported sugar. The exception is soda because the United States exports sodas with Coca-Cola and Pepsi being available anywhere in the world. Non-U.S. food manufacturers use real table sugar because sugar is cheaper relative to HFCS. (Please note that table sugar is 50% glucose and 50% fructose, and fruit also contains fructose along with fiber, vitamins, and minerals.)

  * When I grew up in the 1970s, we treated eating out as a luxury. We ate out once in a while. Not only do families eat out more often, but they also eat more fast food [11]. Fast food contains more fat, sugar, and salt.

  * When I grew up in the 1970s, my friends and I always played outside. We constructed forts and tree houses, played baseball and basketball, and rode our bicycles everywhere. In modern times, many children, teenagers, and young people stay indoors watching TV or playing games on the computer. Adults are more sedentary as they sit behind their desks inside the cubicle punching numbers into spreadsheets on a computer.

  * The stress level in our society has risen several notches. Employment, relationships, and friendships have become temporary and fleeting. Stress constantly bombards us as we worry about being unemployed, or our mate has run off with someone else. Our bodies release cortisol from physical and psychological stress. The constant stress and cortisol raise both blood glucose and insulin, and cause weight gain [10, 11].

  * Some people sleep poorly. Sleep deprivation increases cortisol levels and, hence, people gain weight [11].

  * A new theory links gut microbes to allergies, gastric cancer, inflammation, Type 2 diabetes, cardiovascular disease, and metabolic syndrome [212, 213]. Obese people could have a different composition of microbes in their gut that makes their intestines more permeability [212]. Thus, food and bacteria can easily pass through the intestines that lead to chronic inflammation and metabolic syndrome [212].

Once we put on the weight, it becomes virtually impossible to take the weight off. In one study, researchers tracked 76,704 males and 99,791 females in the United Kingdom [205]. They concluded that an obese man has a one chance out of 210 of attaining a normal body weight [205]. Meanwhile, females fared better with a 1 out of 124 [205]. Furthermore, a man has a ½ percent chance of attaining a normal weight while a woman has close to a 1% chance. Unfortunately, the odds worsen for severely obese. A morbidly obese man has a 1 out of a 362 chance achieving normal weight while a woman has a 1 out of 608 [205]. Thus, we have better odds of winning the jackpot in Las Vegas than losing weight. Finally, the study highlighted the problem of people losing weight; at least half will regain the weight.

The problem is we are not sure why obesity is rising and what causes obesity. Once a person becomes obese, he or she will likely remain obese. Nobody wakes up in the morning and says I want to be obese. Trust me. I hit many hours in the gym and restricted my caloric intake, but I spent the last 30 years of my life being obese and trying to fight it. I didn't conquer obesity until I started intermittent fasting. Wouldn't it be ironic that fasting regularly could solve the obesity epidemic and help people maintain a healthy weight?

## Calorie Restriction

A person practices calorie restriction when he or she purposely reduces their caloric intake. People watching their weight eat smaller portions and avoid the sweets pastries and desserts. Calorie restriction imparts health benefits and helps reduce cancer [33, 214]. Although not emphasized in this book, calorie restriction achieves many of the health benefits of fasting. (Of course, fasting resembles calorie restriction if the fasting leads to a lower food consumption. They differ because fasting causes a rise in blood ketones that activate the stem cells and rejuvenate the senescent cells.) Both fasting and calorie restriction could achieve identical weight loss [214] or the fasting group may experience greater weight loss [88]. However, people who fast tend to lose less muscle than people on calorie restricted diets [214].

Diet restriction causes other problems. We are limited on what we can restrict. We have three macronutrients to juggle – carbohydrates, proteins, and oils/fat. Thus, it is incredible the number of diets we have. Nathan Pritikin started the first diet craze in America in 1979 with the publication of his bestseller - Pritikin Program for Diet and Exercise. The book advised dieters to eat a high carbohydrate, high fiber, and low-fat diet. The diet has one problem – the body burns sugar and carbohydrates quickly. Consequently, the dieter feels hungry again after one or two hours after eating.

Then Dr. Adkin came along and advocated a high protein diet and started the next diet craze with the Adkin's diet. The dieter eats copious amounts of protein and curtails carbohydrates [11]. Filling up on protein gives a person the feeling of satiety and fullness [11, 215].

Protein is one of those macronutrients we need because the body breaks the protein down into amino acids to build cells and tissues. We need about 0.36 grams per pound of body weight (or 0.8 grams per kg) [215]. That means, I weigh 191.4 pounds (or 87 kgs) and require a minimum of 68.9 grams of protein daily. On the other hand, bodybuilders and athletes need more protein to build and repair muscles.

Now, we are left with fats. The U.S. Department of Agriculture and the medical establishment demonize fats because fats pack twice the calories of both proteins and carbohydrates. Each gram of fat provides 9 calories of energy while carbohydrates and proteins supply 4 calories each. They also assume the fat tissues in the body immediately absorb the fats from the diet. The establishment blamed fats for the increased body's production of cholesterol that leads to heart disease and clogged arteries [11]. Similar to proteins, fats make the person feel full longer, which is why the Ketogenic diet works.

The diets are further complicated because the macronutrients differ in quality. For example, an apple provides more nutrients than an apple pie. The fruits and vegetables lose vitamins and minerals from processing and cooking. Some health experts claim that vegetable oils like soybean, corn, and sunflower are inflammatory because they comprise mainly of omega six fatty acids [11]. Meanwhile, olive oil contains and balances both omega three and omega six fatty acids and considered healthier. Thus, olive oil is healthy for the heart [11]. Unfortunately, we are inundated with a large variety of diets and health tips.

Dr. Joel Fuhrman raises an excellent point on consuming high levels of animal proteins [8]. The fatty tissues of farm animals and fish concentrate pesticides, toxic chemicals, antibiotics, and growth hormones. Some doctors advise against high protein diets and claim a high protein diet leads to a large variety of diseases and health problems such as cancer and atherosclerosis [8]. Thus, Dr. Fuhrman recommends people obtain most their proteins from fruits and vegetables [8].

One argument against the modern diet come from Dr. Dewey, Dr. Shelton, and Mr. Sinclair. They noticed many people suffered from health problems from consuming the food at the turn of the 20th century [1-3]. People still became sick eating a diet absent of all the chemicals, hormones, and toxins that exist in modern food. In addition, they rarely lived beyond 50 years. Dr. Dewey noticed people were overeating and believed this overeating sparked many diseases [2].

Some claim the vitamin and mineral supplements in pill form are not as effective as vitamins and minerals from plant sources. For example, fruits, vegetables, coffee, and tea contain phytochemicals, which act as antioxidants. Furthermore, some phytochemicals prevent cancer [8]. Therefore, Dr. Fuhrman recommends people get their vitamins and minerals from plant sources [8].

All diets must ensure every dieter gets his or her daily recommended vitamins and minerals. Deficiency in any vitamin or mineral causes health problems and diseases. Tables 7 and 8 show the minimum vitamins and mineral requirements for a man and women age between 31 and 50 years old.

All diets suffer from the same problem. A diet restricts a person's food choices. For example, a person on a high protein diet may crave carbohydrates such as ice cream and chocolate. A dieter on the Pritikin diet may tremble and shake for a hamburger with French fries. Thus, all diets are not sustainable and lead to a 99% failure rate [8, 10].

All diets have the following flaws:

  * The degree of calorie restriction affects whether a person can follow a diet for a time [217]. For example, a person restricting daily calories by 10% is more likely to follow a diet than a person who restricts calories by 20%.

  * Dieters lose weight in the beginning, reach a plateau, and then regain all the weight. They usually gain additional weight as a punishment [10, 11, 165].

  * Both the fasting and calorie restricted groups loss weight. However, fasters experience greater weight loss in one study [88], identical weight loss in another [214], and less weight loss in another [95]. The calorie restriction group showed no change in blood sugar level [95] or a decrease in blood sugar [88]. Meanwhile, the fasting groups showed declines in blood sugar [88, 95]. Ironically, the fasters and dieters showed an increase in insulin sensitivity [95] except in one study with overweight women [88]. The researchers believe fasting women became less sensitive to insulin because the body reserves the scarce sugar for the brain and nervous system [88].

  * Dieters experience a slowing metabolism [8, 10, 11, 204]. If a dieter restricts their consumption of calories by 10%, then that dieter's metabolism slows by 10% [11]. Furthermore, the diet restriction keeps the metabolism persistently slow [11, 165].

  * Dieters feel miserable and always hungry while their stomachs always growl and grumble. Dieters become cold easily and have trouble concentrating while their blood pressure and heartbeat slow, as the body conserves energy [11].

Diets fail because they always restrict people's choices for food. We want to eat the tasty, decadent, and rich food. How many people do we see at the all-you-can-eat buffet reach for a steamed vegetable?

The famous TV show – The Biggest Loser illustrates the problems of calorie restricted diets and excessive exercise. The show pits two teams of dieters against each other to determine who loses the most weight. The last contestant wins and becomes the biggest loser.

The contestants exercised several hours every day as they ate healthy food with small portions. They lost an incredible amount of weight with an average of 127 pounds (or 57.7 kgs) of body weight [10] while their BMI dropped from 49% to 28% [10]. However, the weight loss was temporary! Kai Hibbard who won the third season said, "It was the biggest mistake of my life." Suzanne Mendonca, from the second season, said, "There is never a reunion show because we're all fat again."

Researchers reviewed 14 contestants after 6 years after appearing on the Biggest Loser [165]. The contestants lost an average of 128.3 pounds (or 58.3 kgs) and regained 90.2 pounds (or 41.0 kgs) in six years [165]. Although the contestants lost some weight, their metabolism slowed to 704 calories per day [165]. That's a substantial decrease because a typical man requires about 2,500 calories while a woman needs 2,000. Unfortunately, restricting calories slows down metabolism persistently.

That is why fasting works for some people. Intermittent fasting does not restrict food choices. It limits the feasting cycle for a brief time. Then fasters resume eating the foods they love and not worry about their metabolism slowing down. We can also convert that decadent, high-calorie treat into an award and not a punishment.

## Exercising

Many people exercise to lose weight. Exercise comes as aerobic and anaerobic. Aerobic means "with oxygen" while anaerobic means "without oxygen." Both types build and strengthen the body.

People perform aerobic exercise when they are continually moving their bodies for a time period. Running is the most intense aerobic exercise, but walking, swimming, cycling, or playing sports are also good for the body. Aerobic exercise strengthens the lungs, heart, and blood circulation because the exercise places stress on the body. Consequently, the body becomes more efficient at transporting oxygen to the cells in the body as the body burns energy to keep the constant motion.

Anaerobic exercise, on the other hand, is the exerciser performs short bursts of energy with the most common form being resistant training or weight lifting. The burst of energy causes the muscles to produce lactic acid from the glucose. The buildup of lactic acid in the muscles gives the exerciser the burn or fatigue feeling. Anaerobic exercise helps a person develop speed, power, and strength while bodybuilders pack on the bulging muscles on their frames.

Medical doctors always advise their patients to exercise to lose weight. However, the exercise in and of itself causes little weight loss. For example, I run on an elliptical trainer and burn 500 calories for 45 minutes twice per week. I also lift weights twice a week. At most, I burn 150 calories for a 30-minute workout.

I burned 52,000 calories in a year from the running and 15,600 calories from weight lifting. In theory, I should lose 14.9 pounds (or 6.8 kgs) from running and 4.5 pounds (or 2.0 kgs) from weight lifting in one year. During 2017, my weight stayed at 220 pounds (or 100 kgs) for the whole year. I lost no weight even though I exercised regularly during the year. A study confirms that exercise provides little weight loss. A study had three groups of women: A diet only, a diet with endurance exercise, and a diet with resistant exercise. All groups exhibited identical weight losses [217].

The body is an efficient, highly regulated machine. Although I was obese in 2017, my body maintained my weight. What happened in 2017? I ate more to satisfy my hunger. Thus, I lost no weight. Furthermore, my hormones were out of balance, and the stress of the exercise could not correct the imbalance. The exercise also creates another effect. If we exercise in the gym for an hour, we reduce physical movement for other activities during the day. For example, if I run for 45 minutes on the elliptical trainer, then I stay at home and watch a movie instead of strolling around in the mall.

I'm not providing a reason for people to avoid exercise. Aerobic and anaerobic exercises impart many health benefits on the body. For example, running for 30 minutes switches the body from burning carbohydrates to burning fat for fuel. Frequent running imparts some of the health benefits of fasting. In addition, anaerobic exercise keeps muscles and bones strong. Strong, healthy muscles also burn more energy than the equivalent weight of fat. A good tip is a person should combine both an aerobic and anaerobic exercise regimen for optimal health.

  * **Tip #37:** An excellent exercise program incorporates both aerobic and anaerobic exercises.

Vanity comes with exercise. Being single in today's society is a challenge. It's not just the United States. The relationship crisis has hit many men and women around the world. I had women tell me that they cannot find a good man. Then men say the same about finding a good woman. Thus, we have a serious mismatch problem as people stay single. Subsequently, many countries expect a declining population from the low birth rates.

Being athletic is a plus in today's society. I'm not resurrecting the cavemen hypothesis that athletic men are better adept at catching prey to feed his woman and children while obese guys are dinosaur bait.

We humans desire something that we cannot have. It is similar to the diamond-water paradox that economists argued in the 19th century. Diamonds are expensive and not essential for life. Meanwhile, water is cheap and essential for life. Hence, the paradox. Of course, economists provide a simple answer. Water is abundant while diamonds are scarce. An equal demand for both diamonds and water causes the market price for diamonds to exceed water greatly.

That is the same in dating. I live in Malaysia, the obesity capital of Asia. Most people are chubby and want a skinny, athletic person for a mate. In the Middle Ages, most people were poor, malnourished serfs. Everybody was chubby chasers because chubby males meant they ate and lived well while chubby females indicated that the women would bear strong, healthy children. Thus, people are attracted to something rare and scarce, which today's modern society defines as a skinny, athletic person in the world drowning with plenty of food.

Exercise programs are easy to start. We just need to invest in a good pair of sneakers, dress appropriately, and drink plenty of fluids for aerobic exercise. We can walk around the block for 30 minutes, toss a Frisbee with some friends, or play basketball or baseball with the kids. Some tips of starting an exercise regimen:

  * **Tip #38:** We consult a physician before beginning an exercise program if taking medications or suffering from a medical condition.

  * **Tip #39:** We gradually ease into an exercise program. We do not run 10 kilometers on the first attempt. We start walking for 20 minutes and keep building up strength and endurance over time.

  * **Tip #40:** We must work out consistently at least two or three times per week. Exercising becomes easier over time. Unfortunately, we lose most of the aerobic benefits of exercise in little as a month of no exercise.

  * **Tip #41:** We exercise with a buddy to overcome boredom.

  * **Tip #42:** We drink plenty of fluids to stay hydrated.

  * **Tip #43:** We exercise outside because the sun and fresh air also impart health benefits on the body.

  * **Tip #44:** We don't exercise outside at noon when the summer sun scorches everything. During the summer, we exercise outside at dawn or dusk during cooler temperatures.

Many communities offer charity runs ranging between 3.1 miles (or 5 km) and full marathon (26.2 miles or 42.2 km). The charity runs work well for people with a competitive nature. For example, I'm extremely competitive. I sign up for a charity run every two months usually between 3.1 miles (or 5 km) and 7.5 miles (or 12 km).

The charity run provides several benefits. First, the run motivates me to work out in the gym regularly. I want to ensure I am ready for the race. Second, I feed off the camaraderie and energy from the crowd of young, healthy people. I also love the stunned look my students give me as I pass by them during a race. Uncle smoked them. Third, the races usually start at 6.15 AM in the morning, and the island of Borneo has some amazing vibrant sunrises. Then the runner's high kicks in while the sun rises. Finally, everybody gets a medal after crossing the finish line. I proudly display my runner's bib and medal on my office wall. The runner's bib is the sweat-resistant number that runners pin to their shirt.

People should complement aerobic exercise with resistant training to strengthen muscles and bones. Some tips when starting a weight training regimen include:

  * **Tip #45:** Start a specific exercise with two repetitions with light weights. Over time, increase to at least three repetitions with heavier weights.

  * **Tip #46:** People should warm up their muscles by running in place for five minutes or something similar.

  * **Tip #47:** People should start working the largest muscles. The leg muscles are the largest muscles in the body. The horizontal seat leg press hits the whole leg including the calves, quads, glutes, and hamstrings. People can work up to the barbell squats for more intense workouts.

When we work out, we must remember to work symmetric opposing muscles. For example, the chest is the second largest group of muscles. The symmetric opposing muscles are the back muscles.

  * **Tip #48:** Both the chest press and barbell bench press work the chest, biceps, and triceps. Then the lateral pull-down works the large back muscles called the latissimus dorsi. Strengthening the latissimus dorsi gives athletes the triangular athletic look.

Other excellent exercises include:

  1. Barbell shrugs exercise the trapezius, the top muscles that connect the shoulders to the neck. A person holds a heavy barbell in each hand and shrugs upward to exercise the trapezius.

  2. The dip exercises the muscles of the chest, front shoulders, and triceps. The dip is a more advanced exercise. A person holds his body weight by grabbing onto the bars with both hands. Then the person plunges down and up vertically, similar to a pushup. (The pull-ups work the opposite muscles of the dip).

  3. The shoulder press works the shoulders, trapezius, and triceps. A person sits in the machine and pushes the bar upward with his or her hands.

  4. The bicep curl works the bicep muscles. A person holds a dumbbell in each hand and curls the barbell inward to work the muscle. We need the bicep curl to balance the tricep exercises in exercises (2) and (3) because biceps and triceps are opposing muscles.

  5. Leg raises or sit-ups work the abdominal muscles. Of course, we should not neglect the lower back muscles.

People should switch machines or techniques every couple of months to work the muscles differently. For example, the inclined press or butterfly press works different parts of the chest muscles than the chest press. That way, the person exercises different muscles over time.

We also have a choice in how we work out. If we're going to build muscle, so we can take on the incredible hulk, we exercise with low repetitions and heavy weights. If we want to improve our endurance and tone our muscles, we exercise with light weights and high repetitions. We define high repetitions as exceeding 12 repetitions.

Bodybuilders develop specialized programs. The bodybuilders lift five or six times per week, and they dedicate each workout to one or two muscle groups. For example, one workout focuses on the chest. Thus, they do five different types of chest exercises with a minimum of three repetitions each. Then they exercise the back on the next day while the legs on the third. Of course, the bodybuilders rarely engage in aerobic exercise since aerobic exercise consumes some of the muscles for energy.

The critical point of this chapter – both aerobic and anaerobic exercises are great for a person's health but they may not help a person lose weight. Furthermore, exercise may not prevent health problems. For example, the health guru, James Fuller Fixx, jumped start the fitness revolution in America with writing the bestseller – _The Complete Book of Running_. Unfortunately, he died of a heart attack at 52 while jogging from blocked arteries feeding his heart. He had severe atherosclerosis, fatty deposits in the arteries. Atherosclerosis restricts blood flow through the arteries and in severe cases will block the blood flow. (It seems heart disease strikes many men around age 50 [218].) Therefore, exercise and fasting complement each other. Exercise strengthens the body while fasting helps repair the body and keeps it in top shape.

## Bariatric Surgery

Some obese people go for bariatric surgery when all other weight loss measures fail. Bariatric refers to the branch of medicine that deals with obesity while bariatric surgery involves a variety of operations performed on the stomach. The overweight and obese choose which surgery they want. For the least invasive surgery, surgeons place a silicon balloon in the patient's stomach and fill it with a sterile liquid. The balloon occupies volume and reduces the amount of food that the stomach can hold. Other techniques involve a surgeon wrapping a lap band around the upper portion of the stomach to shrink it. Finally, the morbidly obese with a BMI exceeding 40% can opt for gastric bypass surgery, which is the most invasive surgery. A surgeon staples the stomach to make it smaller and then reroutes and shortens the small intestines.

Bariatric surgery shrinks the patients' stomachs and, thus, forces the patients to reduce their caloric intake. The patients will become nauseous or will vomit if they overeat [10].

The patients, of course, lose massive amounts of weight after bariatric surgery. The lap band group lost 20.0% of their body weight after two years and experienced a drop in their triglycerides and blood glucose level [219]. Their HDL cholesterol also increased compared to the control group [219]. Finally, 43% of the patients witnessed a remission of type 2 diabetes [219].

The gastric bypass surgery is the most invasive surgery and causes the most weight loss of 38% [158]. Patients lost 8.69 pounds (or 3.95 kgs) and shaved 1.68 from their BMI in ten days [220]. Finally, 83% of the patients with diabetes went into remission [220]. Thus, bariatric surgery cured the patients of diabetes from the severe restriction of their eating.

Bariatric surgery works because it restores the hormonal balance in the patients. Patients with Type 2 diabetes improve before the weight comes off [10, 220]. Thus, it provides evidence that the hormonal imbalance causes obesity and not vice versa. The surgery also does not slow down the patients' metabolism, which curses dieters restricting their caloric intake [10]. The patients also feel satiated since tiny quantities of food fill the stomach [220].

Bariatric surgery is not cheap. The lap band surgery costs as low as $15,000 while stomach stapling costs around $25,000 [221]. The cost depends on the hospital and surgery type. The gastric bypass surgery permanently modifies the body while banding and gastric balloon are easily reversed. For the balloon, the surgeon pops the balloon and removes it from the stomach. Hence, the surgery does not modify the body.

Some Americans visit Mexico for bariatric surgery and pay bargain prices between $3,500 and $10,000. (Ironically, bariatric surgery costs the same in Malaysia). As we say here in Malaysia, a Chinese iPhone is a Chinese iPhone. We think we found a bargain. Then we have nothing but problems with the phone. Several victims of the Mexican butcher doctors posted videos on YouTube about their horror stories of their bargain surgeries. Typically, the consumer gets what he or she pays for. Buyer beware!

Some patients experience complications from bariatric surgery and require additional surgery. Furthermore, a patient may need an adjustment to his or her band, or the patient's esophagus narrows. Then the patient has trouble eating. The surgeon must install a large tube to expand the esophagus [10].

Ironically, fasting does not cost a penny, does not modify the body, and shares many health benefits of bariatric surgery. Of course, fasting is probably the last thing the patients would consider doing even though fasting should be at the top of the list.

We should note that fasting and bariatric surgery are not compatible. During the feasting cycle, the patient must eat plenty of food to ensure the body has the minimum required nutrients. However, the bariatric surgery limits the food intake. Unfortunately, mixing fasting and bariatric surgery could lead to a gradual starvation over time.

# 9. The Backlash against Fasting

"Are you nuts?"

– My best friend

The quote, "Are you nuts?", comes from my best friend of 40 years. I informed him that I intermittent fast twice a week and I had just finished a 30-hour fast. In addition, a bodybuilder told me I was crazy to fast 30 hours, although he fasts intermittently for 18 hours once per week. Thus, everyone holds strong views against fasting.

I receive daily compliments from my colleagues, co-workers, and students. They see the transformation. The change transcends the weight loss. People compliment how good my skin looks and how much younger and healthier I look. They see me gorge at the gatherings. For example, one day we gathered together to celebrate a colleague's birthday. I ate five slices of pizza, drank four cups of soda, and ate a large slice of chocolate cake. I even scooped up and ate the extra frosting and cake crumbs from the cake platter. I noticed everyone else avoided the soda and ate a small slice of cake. They acted like the chocolate cake hid black scorpions ready to sting them.

People always want to know my secret to my weight loss and transformation. Some of them also struggle to lose weight. Then I tell them my secret – I fast twice a week for at least 24 hours. I get the blank stares as if I were passing out Bibles at an Ozzy Osbourne concert. I even tell them I can eat anything I want during my feasting days. Nope. No conversions. Just blank stares like I just ripped a thunderous fart, and everyone pretends to not smell it.

My Malaysian Chinese girlfriend, Alice, has witnessed the transformation and weight loss. She knows I fast and worries I will leave her for another woman. Several times, I tried to convince her to fast with me. However, she says she needs the energy to do work. One time, I explained to her that the body stores fat, and that fat provides energy. Wow; that conversation didn't go well. For the good news, she didn't make me walk home. Boy, that would have been a long walk home. However, I have convinced Alice to fast 16 hours several times. She just needs a little more persuasion.

Fasting freaks people out. Thus, in this chapter, we look at fasting from the viewpoint of the medical establishment, the food industry, and the government. Finally, we debunk most of the fasting myths.

## The Medical Establishment

In the United States, medical doctors are hostile towards fasting. They act like a person will go into a diabetic coma if he or she does not eat something every two hours.

We visit the doctors and expect them to be masters of human health. For chubby patients, doctors give the same advice to lose weight – exercise more and eat more fruits and vegetables and avoid fats. I heard this speech numerous times, ad nauseam. Then Dr. Fung once wrote that medical doctors receive little training in nutrition [10]. For instance, Dr. Fung says he had about four hours of lecture on nutrition out of his nine years of medical education and training [10].

The top medical schools in the United States include Harvard University, John Hopkins, and the Mayo Clinic. Medical students study human anatomy, science, substance abuse, and end of life care but no class in nutrition. Hence, nutrition would fall as a sub-topic in one of the courses. However, I face the same problem when I teach my students finance. I have three years to teach them, and I wonder if I'm preparing them for the real business world.

The hostility of medical doctors is nothing new and existed in the early 1900s. Upton Sinclair wrote about the doctors' attitude in his book. In Sinclair's time, doctors created their ointments, potions, and concoctions in their backroom labs and sold them to the patients directly [1]. In addition, Dr. Edward Dewey wrote how intermittent fasting had cured a variety of ailments and illness and wrote a popular book - The No Breakfast Plan and the Fasting-Cure [2]. The _British Medical Journal_ scoffed at his evidence and call it a "foolish delusion." We still possess this mentality today, but the pharmaceutical industry creates the new concoctions. Then the doctors prescribe the medicines to their patients.

The healthcare industry holds the view that a sick person must take a pill to make the person well again or the sick person needs surgery where the doctors cut into the body to remove or modify the tissues. Medicines and surgery are incredibly expensive in the United States. On the other side of the accounting equation, the doctors, medical establishments, and pharmaceutical companies reap enormous profits.

Let's say we are savvy business people with a sliver of conscience and want to make money. How could we extract the most money from the customers? First, if we make a one-time sale, we want to provide a product or service that will cost substantial money. We want to sell the customer a decked-out Cadillac Escalade with gold plated rims and smooth leather interior. Let's not forget the sound system that will rattle and shake all the windows in the neighborhood as we drive by in style. The second way to drain the customers is the customer returns every month to keep buying that product or service. That's precisely what the health care industry does to enrich itself.

Hospitals make their big money from surgery. For example, heart bypass surgery is a common surgery where doctors take a blood vessel from one part of the body and reroute a blocked artery that feeds the heart. Americans are willing to pay a high price for this service because heart disease is America's number killer. Unfortunately, 635,260 Americans died from heart disease in 2016.

Bypass surgery costs between $70,000 and $200,000 depending on the hospital and whether the patient suffered additional complications [222]. Some patients require physical therapy and medications for additional costs. Dr. Fuhrman says heart bypass surgery rarely extends life [8]. However, it does not stop the patients from cashing in all their assets to get one. I would not hesitate to cash in all my assets for surgery if a doctor convinced me that I needed one. God only gave us one life in this world, and we cannot take the assets with us.

The pharmaceutical industry fulfills the second criteria to make money by selling medicine every month to patients. And business is good. The pharmaceutical industry patents their concoctions. A patent grants the company the exclusive right to produce its concoction for 20 years in the United States. Another company cannot produce that product unless it receives permission from the patent holder. Otherwise, the patent holder can sue for patent infringement.

A patent grants monopoly power. Monopolies charge the highest price and sell the lowest quantity compared to all market structures. On the other hand, a competitive market sells for the lowest price and sells the highest quantity. Don't get me wrong. I'm not against patents because companies must invest billions of dollars to finance research and development. Furthermore, the patent allows companies to recoup their research and development costs, but sometimes the companies go overboard on the prescription drug prices.

Prescriptions, even the cheap ones, are profitable. For example, people in the early stages of diabetes take Metformin, the 7th most prescribed drug in the United States in 2017 [223]. The Centers for Disease Control and Prevention estimates 30.3 million Americans have diabetes [224]. Hence, if diabetics pay $8 per one-month supply of Metformin [223], and 10 million diabetics take Metformin every year, that means the pharmaceutical industry earns $960 million per year (or $8x12x10 million) in revenue. That is just a tad under a billion per year.

We see the paradox of modern medicine. The medicine treats the symptoms but never cures the patients. As Dr. Fuhrman learned in medical school, all medications and drugs are toxic to the body [8]. The medicines and drugs do not provide nutrients nor energy. Instead, they interfere with the body's natural processes [8]. Thus, the medications help alleviate the symptoms but ensure the medicines never cure us. That way, we keep buying the medicines every month for the rest of our lives. Hence, we have a paradox.

We, hence, identified a problem with fasting. Companies cannot patent fasting while fasting requires no medicines nor potions. In addition, medical doctors advise against fasting. For example, we go to a doctor, and the doctor recommends that we water fast for two days. Then the miraculous healing power of fasting cures us. Next time when we get sick, we stay home and fast and don't bother to see the doctor again. The next thing we know, the doctor is knocking on our door and is begging us to buy a $2,000 vacuum cleaner. Consequently, fasting on a large scale has the potential to severely contract the medical industry.

## The Food Industry

We expect the food industry to oppose fasting. If we don't eat, then the food industry doesn't make money. For example, a person fasts twice a week for 24 hours, which means the person fasts from one dinner to the next dinner the following day or from breakfast to breakfast, or lunch to lunch. Thus, that person misses two meals for one fast and four meals per week for two fasts. If that person spends $10 on a meal and fasts intermittently the whole year, he or she saves $2,080 per year. That means the food companies see a decline of $2,080. Now imagine the financial hardship that fasting would cost if millions of people started intermittent fasting.

The dynamics are a little complicated. Some fasters alter their buying behavior when see they save money. They could purchase better quality food. For example, when I go shopping, I buy more expensive food because I know I save some money from fasting when not eating. The high-quality food has an upside. I love the taste of food when I break a fast. Thus, I want the good stuff. Also, fasters tend to overeat for their first meal after breaking the fast.

Another dynamic is a faster's lifespan. A faster could live longer, so he or she eats for a longer lifetime. Using the same numbers, fasting twice a week yields 17 meals per week. We assume the person eats three meals per day except for the fasting period. That person would eat about $8,840 per year. If that faster lives an additional 10 years, the food industry will make $88,400. Unfortunately, many companies in the United States are geared to earn short run profits.

The food industry would not benefit in the short run if large masses of people began fasting. The food industry is one of the most competitive industries in the United States with a small profit margin. Consequently, a slight decrease in food demand in the short run would bankrupt companies. Thus, we would expect the food industry to oppose fasting.

## The Government

I wouldn't expect the U.S. government or state governments to jump on board and advocate fasting. The answer is simple. Retirees stop working and stop contributing tax revenue to the government. Instead, the retirees receive money from Social Security and begin cashing in their retirement plans. Americans could start collecting Social Security benefits as early as 62 years of age. Although the government reduces the benefits for retiring early, retirees can receive full benefits for retiring between 67 and 70 years of age depending on when they were born [225].

Men, on average, live until 76.3 years while women to 81.1 years in 2015 [113]. Men and women could collect 10 years of Social Security before they die. What would happen if many retired Americans adapt intermittent fasting and start living healthy until 120 years of age? Now the government would pay 50 years in social security benefits. The Social Security Administration would bankrupt faster than rain falling from the heavens. Technically, a federal agency cannot bankrupt, but a cash flow crisis would cripple operations. Then the crisis spreads to the pensioners dependent on their monthly social security checks.

The society would need to restructure if people start living until 120 years. That means a person could work for one employer for 100 years. Only the devil can devise such a 100-year servitude.

Fasting on a large scale would evoke another problem. Many Americans suffer from medical problems and take a large variety of medicines. The immense demand for healthcare has inflated the industry to $3 trillion per year [226]. That is a large chunk of the U.S. economy, at least 15%. What if a large portion of Americans started fasting and became healthy? The healthcare industry would crumble and start shedding jobs.

The healthcare industry employs doctors and nurses who spent a lifetime learning their skills. Medical doctors must complete a bachelor's degree, four years of medical school, and between 3 and 7 years of residency to apply for a medical license. Furthermore, nurses require at least a four-year degree. However, many nurses complete a masters and additional training with additional training equating to higher salaries. Thus, fasting on a large scale could lead to massive job losses of highly educated people who had earned lucrative salaries.

We expect the politicians would hear the doctors' and nurses' plight. The politicians need to be re-elected to continue their jobs. The politicians pay millions in campaign costs to work a job that pays a fraction of campaign costs. For example, Congressmen and Senators earn $174,000 per year in Congress in 2017 while election costs exceed $3 million. It would be foolish for Congressmen to pay campaign costs out of their pocket. Thus, other people pay that campaign costs, which explains why politicians always cave into public demands and bend over backwards to their financial contributors.

The hospitals, insurance companies, pharmaceutical companies, and the food industry are large contributors to political campaigns. Yes, the companies buy votes. The politicians know if they vote against a financial backer, that financial backer will contribute to the opposition in the next election. That is why we get the politicians who talk on both sides of their mouth at all levels of government. The healthcare and food industries would be hostile towards fasting, so that the politicians would be hostile towards fasting also.

We would expect the government to use its authority and power to go after the people who advocated fasting if fasting were to become popular. For instance, the state arrested and charged Dr. Shelton along with many associates several times for practicing medicine without a license [115]. Dr. Shelton never prescribed medications nor performed surgical operations. He opened several medical clinics and supervised thousands of fasters. However, state governments viewed him as a criminal and ordered the police to arrest him.

## Myths of Fasting

In this section, we debunk several myths of fasting.

  * **Myth #1** – Breakfast is the most important meal of the day [109].

We heard this saying since birth. As soon as we rise, we must eat to keep that metabolism burning energy like shoveling coal into a steam locomotive to keep the train going. Schools insist every student must have breakfast to perform well academically. In one study of healthy adults, the participants did not suffer from mental decline after two days of severe calorie deprivation [227]. Of course, it makes sense. If missing a couple of meals caused severe mental decline, we would have never survived as a species in the wild.

For many people including me, breakfast is the smallest meal of the day and the easiest meal to miss even though people have not eaten since yesterday's dinner. How can the smallest and easiest meal to miss be the most important?

Dr. Edward Dewey wrote a popular book in 1900, when he recommended his patients and sick people to refrain from breakfast every day [2]. The fasters could still enjoy their coffee or tea in the morning [2]. He described the numerous ailments and sickness intermittent fasting had cured. If our bodies need breakfast, shouldn't our bodies become weaker while our ailments and sickness strengthen?

The myth has even spread to Malaysia. I heard one commercial on a popular radio station with the young people espouse the importance of eating breakfast in the morning.

  * **Myth #2** – East small, frequent meals or snacks to boost metabolism and stabilize blood sugar [11, 109].

The American society has changed eating habits as we have turned into a nation of snackers. Every day, Americans eat five or six times per day [10, 11]. We have a false notion that man and woman must always eat. Thus, six small meals are always better than three large ones. However, the evidence suggests no difference between gorging and nibbling on the human body if we eat the same calories through the day [210, 211]. Please note that the studies omit fasting and the potential to gorge on one massive meal per day.

I remember growing up in the 1970s in Michigan. At school and home, we ate three meals with no snacks in between. I was lucky to get a glass of milk in the afternoon before supper, but the snacking lifestyle crept in college. I gorged at the university's cafeterias and snacked on chips, soda, and candy between meals. Thus, snacking caused me to eat more calories during the day. Then I gained the freshmen 10 during my first semester.

I turned into a snacker. For example, I copied the eating habits of the bodybuilders at my gym, where the bodybuilders eat six small meals per day. I reduced my caloric intake by eating frequently, and the frequent eating would ward off the hunger pangs. However, this notion is wrong. Since I always consumed carbohydrates, I kept my insulin levels high throughout the day while my digestive system only rested briefly at night. The frequent eating turned my body into a carbohydrate burning machine and not a fat burning one.

When I started 30-hour fasts twice per week, I stopped snacking. I can easily go six hours without eating on my feasting days. Eating is psychological. If I can go 30 hours without eating on a fasting day, then six hours between meals is nothing. I also eat until I feel satiated.

I go out of my way to prevent snacking. For instance, I drink my cappuccino or latte within an hour of eating either breakfast and lunch. That way, I include the coffee as a meal and not a snack. Then I drink tea without sugar and cream between meals.

  * **Myth #3** – The body consumes muscle and not fat during fasts [10]

This myth may be true. The body ramps up production of the human growth hormone, and this hormone helps spare the breakdown of muscle tissue. However, the bodybuilders at my gym and the scientific literature supports the view that fasters lose some muscle mass. Dr. Shelton reported that skeletal muscles lose up to 40% of their weight during a fast [3]. A person does not lose muscle cells per se. Instead, the muscle cells become smaller as the person loses fat and glycogen stored in the muscles [3]. In addition, several studies indicated loss of muscle mass because the liver manufactures glucose from amino acids with muscles being a source [8, 15, 20, 21]. The red blood cells and liver require glucose for energy while the brain needs at least 25% glucose.

The body's attack on muscles depends on the person. As people's bodies ramp up the consumption of ketones for fuel, their bodies spare protein. Women and lean individuals switch to burning ketones at a faster rate than men and the obese [15]. Thus, women and lean individuals could lose less muscle than their counter parts, which is quite unfair.

I talked to the bodybuilders at my gym. The bodybuilders appreciate fasting and believe fasting provides many health benefits. However, they avoid fasting before competitions because they claim they lost 22 pounds (or 10 kgs), which is a fantastic weight loss. However, they believe they lost between 13.2 and 15.4 pounds (or 6 and 7 kgs) of fat and between 6.6 and 8.8 pounds (or 3 and 4 kgs) of muscle.

Perhaps fasters do lose some muscle tissue from the fast because fasting restores balance to the human body. For instance, bodybuilders overly develop their massive physiques and large muscles, which become abnormal. Large bulky muscles could pose a detriment in the long run, especially if the person no longer needs the large muscles. Thus, the body consumes the nonvital tissues first because the body can easily rebuild these tissues during a feasting cycle. Perhaps a little muscle loss during fasting is beneficial to help the body shed unneeded muscles and rebuild them when needed.

I don't think the muscle loss is a big deal. Exercise helps compliment the benefits of fasting. We use resistance and weight training to strengthen and build muscles and aerobic exercise to strengthen our cardiovascular system. Hence, we have an incentive to renew our gym membership.

  * **Myth #4** – Fasting slows metabolism.

For us to be healthy, functioning humans, we must burn energy to support the life processes. Our lungs need energy to breathe. The brain consumes energy to think, and send and receive signals from all parts of our body. The heart consumes energy to pump blood to and from all cells within our body. The liver and digestive system require energy to break down food into energy, minerals, and vitamins. We refer to this collective energy consumption to support life our metabolism, which we also call the basal metabolic rate.

Metabolism is our body's thermostat. When we were teenagers, we could trek outside in the snow in a t-shirt and shorts and not shiver. Our metabolism was high, and we could eat anything and everything and not gain an ounce of fat. As we become older, we shiver in a breeze on a warm spring day. Our metabolism slows, and we begin eating less. Then it is like we glance at food, and our bodies start piling on the weight.

We have known since the last century that restricting food consumption reduces metabolism [8, 10, 11, 204]. For example, we reduce our food by 10%, our body gradually lowers the thermostat, causing the metabolism to slow about 10% [11]. Thus, people lose weight on a calorie restricted diet, but the weight loss slows and eventually reaches a plateau. Eventually, the dieter resumes normal eating patterns because he or she always feels hungry, cold, and lethargic. Then the dieter regains the weight rapidly.

Fasting, on the other hand, boosts metabolism by 3% [9-11]. As long as the faster starts the feasting cycle within two days and resumes normal eating patterns, the metabolism remains high.

  * **Myth #5** – Fasting leads to low blood sugar or hypoglycemia [10].

Symptoms of low blood sugar include feeling shaky, nervous, sweating, clamminess, and chills. Diabetics know the signs well as they quickly drink a glass of orange juice or eat a sugary snack to counteract low sugar level. Death results if the blood sugar level drops too low.

People worry that fasting will cause low blood sugar. However, the body regulates blood sugar well. During a fast, most cells switch to burning ketones for fuel. Although the red blood cells, liver, and 25% of the brain's energy require glucose, the liver can produce glucose from amino acids from the muscles. The liver can also make glucose from glycerol, which comes from the breakdown of triglycerides, i.e., fat [3, 10, 15].

People with diabetes must be careful during fasts because they experience wide swings in their blood sugar levels. Consequently, a medical doctor should supervise a diabetic during a fast to ensure blood sugar level varies little.

  * **Myth #6** – Fasting starves the person [10].

We discussed this issue in the first chapter. A person performs a fast correctly if the body uses nonvital tissues and cells as fuel. During a fast, the body utilizes the body's fat stores, possibly some protein from the muscles, and the recycled proteins and substances from autophagy, autolysis, and apoptosis. The body causes a cell to kill itself via apoptosis if the cell is damaged or old, i.e., senescent.

A faster enters starvation by prolonging the fast too long or is extremely malnourished. A person will not likely starve on a two-day fast. For instance, a person weighing 200 pounds (or 90.9 kgs) with 20% body fat has 40 pounds (or 18.2 kgs) of fat. The fat reserves easily power the body for 40 days or more.

The fasting duration depends on a person's fat reserves. The longest known fast comes from a Scottish man, Angus Barbieri [228]. He started his fast weighing 455.4 pounds (or 207 kgs) and fasted for one year and 17 days in 1965 [228, 229]. He lost 275 pounds (or 125 kgs) [228], which equaled 0.72 pounds (or 0.33 kgs) per day. He drank black coffee, black tea, and water, and took a multivitamin, potassium, sodium, and yeast supplements daily [228, 229]. Yeast resembles spirulina and contains the nine essential amino acids and the vitamin B complexes. The body uses vitamin Bs in cell metabolism, energy burning, and brain function. A doctor monitored Angus's fast and recorded no medical complications [228, 229].

As long as the faster has plenty of fat reserves, he or she will not starve during a fast.

  * **Myth #7** – Fasting causes overeating [10, 11].

This myth does contain a kernel of truth. People doing intermittent fasting for two days or less tend to overeat during their first meal [11]. However, the fasters do not replace all the calories they had missed during a fast. They usually eat 30% more calories during the first meal [176]. Then normal eating patterns resume.

People doing prolonged fasts of three days or more must transition to eating food again. Their first meals are juices, broths, soups, fruits, and vegetables. Consequently, the fasters aren't likely to overeat during their first meals because they will experience extreme discomfort. The digestive system requires a transition time to begin processing food again.

  * **Myth #8** – Fasting starves the body of nutrients [10, 11].

We know this myth is false. People usually fasted for two weeks or more. They look younger and have more energy while their health problems disappear, and muscles become stronger. If fasters are deprived of nutrients, then the fasters would see and feel the deprivation. They would look sick after a fast if the fast had caused deficiencies in nutrients. For example, vitamin C deficiency causes scurvy while vitamin D and calcium deficiencies cause problems with the bones.

As a marvelous machine, the body reduces waste to a minimum during a fast [3]. The body conserves its minerals like calcium, sodium, potassium, and magnesium, and stores vitamins [3, 11]. We must remember; the fast utilizes resources that we had eaten in the past. All we are doing is rummaging in the back of the cupboard to use the old cans of soups and vegetables. The fast helps us use the old cans of food that our body has stored long ago.

  * **Myth #9** – Fasting collapses the heart within six days [3].

This myth is funny and comes from the beginning of the 20th century. Doctors warned potential fasters that their hearts would collapse within six days of fasting [3]. Furthermore, Upton Sinclair (1911) conversed with a well-known, respected physician who refused to believe a man or woman could survive beyond five days without nourishment [1].

We know this myth is false. Angus Barbieri fasted one year and 17 days. In addition, a healthy, normal weighing man or woman can easily fast for a month and still have plenty of fat reserves leftover. The doctors perpetuated a false myth to scare patients from fasting.

#  10. Tips and Recipes to Promote Healthy Eating

"Fasting is the greatest remedy, the physician within."

– Paracelsus

I struggle with healthy eating. Although I eat plenty of fast food along with decadent iced coffees, ice cream, and chocolate, I eat some fresh fruit and vegetables. Thus, I give the reader tips and recipes that maximize healthy eating because we need nutritious meals to ensure our bodies have all the necessary nutrients, such as vitamins, and minerals to endure a fast.

My favorite salads are raw, delicious, and filled with garlic and onions. Not only do I eat my salads on a regular basis, I even drink the leftover sour brine.

## Tips on Healthy Eating

We should cook most of our meals at home. Restaurants and grocery stores compete in a competitive market and earn profit margins between 3 and 5%. Therefore, every penny counts. When they prepare food, they gravitate towards the cheapest ingredients. At home, we control what we put on our food.

  * **Tip #49:** Always add fresh vegetables and fruits to dishes instead of things that come from a can. Just read the nutritional information on the side of the can or box. Canned fruits and vegetables are nutritionally dead because the processing and cooking destroy many of the vitamins and antioxidants. Thus, we take the extra 15 minutes to dice some fresh fruits and vegetables. We can also add frozen fruits and vegetables because the freezing helps retain their nutrients.

From my experience in the kitchen, seasonings and meat are the two most essential ingredients that we cannot skimp on. A cheap seasoning has a bland, dull taste and adds a minuscule of flavor to the dish. Cheap meats are tough, dry hockey pucks while cheap ground beef breaks down into an oily, gelatinous gristle that ruins the meal. That leads to our next tip.

  * **Tip #50:** Buy better ingredients. I always go for the omega-three enriched eggs at the supermarket. Of course, I place trust in the farmers that they have indeed fed the chickens flax seeds.

Fresh herbs and seasonings add flavor to a dish. For example, when I make spaghetti sauce, I simmer freshly diced tomatoes, onions, garlic, and seasonings. I add tomato paste to thicken the sauce. Many people comment on my spaghetti sauce especially when I add fresh oregano, basil, and thyme. I can even freeze the sauce in plastic containers for future meals.

My church has a potluck lunch after service. The church members usually devour my dish. Adding fresh herbs to a dish enhances the flavor and the next tip.

  * **Tip #51:** Many herbs can grow in containers or grow like weeds in the garden such as basil, oregano, and thyme. Not only do fresh herbs add flavor to a dish, but they also impart many health benefits.

Home remedies often include garlic and onions because they have potent medicinal properties. Of course, the Asian home remedies also add ginger to the mix. I think eating copious amounts of garlic and onions help prolong life. For instance, my grandmother made it to 85 although she suffered from diabetes, heart disease, obesity, and high blood pressure for 40 years. She always ate garlic and onions, raw or cooked, with everything. She was also a stubborn woman. I also believed she lived a long time just to anger her doctors.

Many people avoid the garlic and onions because the odor of garlic and onions emanate from our sweat pores and breath. However, the health and longevity benefits far exceed the attractiveness to the opposite sex. That is why we have mouthwash, breath mints, cologne, and perfume.

I always stock my kitchen with garlic, onions, and shallots that I can quickly dice within minutes and sprinkle into any meal.

  * **Tip #52:** When a recipe calls for garlic or onions, at least double or triple the garlic and onions. Chef Emeril is onto something when kicking up the garlic another notch.

Another good ingredient to use is extra virgin and light oil olive oil in cooking and salads. Light olive oil means the producers removed polyphenols and impurities giving the olive oil a lighter appearance. I use both oils to sauté food or eggs at the lowest stove heat because olive oil has a low smoke point. Hence, cooking meat at medium or high heat levels burns the oil and ruins the dish with a burnt oil smell. We need to switch oils if we want to sear meat or cook at medium heat or higher.

  * **Tip #53:** We should substitute light olive oil in place of vegetable oils. Many claim olive oil is healthier than vegetable oils and better for the heart because olive oil contains omega-3 fatty acids. Meanwhile vegetable oils are saturated with omega-6 fatty acids [11]. Although our bodies need both fatty acids, too much omega-6 causes inflammation [11]. Almost all processed foods use the cheap vegetable oils filled with omega-6 fatty acids to reduce costs.

Olive oil is an expensive oil. The producers harvest the olives and use a press to extract the olive oil from the crushed olives. Some shifty producers use heat and chemicals to remove every minuscule drop of olive oil and may even add vegetable oil and green coloring and sell the olive oil as pure extra virgin olive oil. When I make one of my cold salads with olive oil, pure olive oil congeals in the refrigerator. On the other hand, olive oils adulterated with vegetable oils do not solidify in the fridge.

Another culprit in the declining health of Americans is the high sugar consumption. The sugar spikes the insulin level causing the cells to utilize glucose for energy. The high insulin level causes our bodies to store more fat.

The taste buds dull when always eating high levels of sugar. On several occasions, I reduced my sugar consumption as much as possible, hoping to lose some weight. With the absence of sugar, my taste buds became super sensitive; I could even taste the sugar in white bread. Don't get me wrong, I still eat sugar but cut back on consumption.

The key is moderation. For example, when I bake cookies and cake for the church, I reduce the sugar about 30%. The cakes and cookies still taste great, but we can savor the other ingredients as well. I also use real butter and brown sugar, and the church members scarf down my cookies and cake as if they have not eaten in weeks.

  * **Tip #54:** Reduce sugar consumption. The key is moderation.

We should avoid high-fructose corn syrup (HFCS). Some researchers and doctors claim consuming too much fructose causes fatty liver, insulin resistance, and elevated triglycerides [11, 195]. A diet high in fructose could increase the risk of obesity, diabetes, and heart disease [195].

We should not eliminate all fructose. Fruits contain fructose along with fiber, vitamins, and minerals. Furthermore, table sugar contains 50% fructose and 50% glucose. Every cell in the body can utilize glucose while only the liver can process fructose [11, 195]. Again, we have returned to reducing sugar consumption again.

The bad news is the food industry puts HFCS into almost all processed food. We can avoid HFCS by cooking more homemade meals.

  * **Tip #55:** Avoid HFCS. Corn contains trace amounts of sugar. Food companies manufacture HFCS from cornstarch.

We should avoid trans-fat that we find in margarine, shortening, and hydrogenated vegetable oils. The food industry artificially produces trans-fat from vegetable oils. For example, vegetable oils are unsaturated which means the oil shares chemical bonds. The problem is unsaturated oil breaks down and degrades over time [11]. However, the food industry discovered that by passing hydrogen through the vegetable oil, they could saturate all the chemical bonds making the oil chemically stable. Thus, each free bond would have a hydrogen atom. Consequently, the food industry fries food in oil or incorporates trans-fat into processed food for extended shelf life. That's the problem. Trans-fat does not exist in nature. Trans-fat raises LDL cholesterol, i.e., the bad cholesterol and lowers HDL cholesterol, i.e., the good cholesterol.

  * **Tip #56:** Avoid trans-fat that we would find in shortening, margarine, and hydrogenated vegetable oils [11].

I live on the Island of Borneo on the Malaysia side with year-round tropical weather. I must keep the kitchen spotless and take the garbage out regularly. If I dice fresh vegetables or fruits, I must put them into Tupperware or the refrigerator immediately. If I leave the fruit and vegetables on the counter, tiny bugs will cover the cutting board and freshly cooked foods within 15 minutes. Those little critters even like freshly baked bread. Thus, I must keep an eye on freshly cooked bread as it cools. Those little bugs are ravenous.

Here's the thing. If I leave a heavily processed item on the table or counter like fast food or something made from a box like hamburger helper or macaroni and cheese, those little critters will not touch it. The exception is table sugar, which I keep in the freezer. The little bugs must know something that we don't, or we purposely choose to ignore.

I give the readers some good recipes to help them eat more nutritious meals.

## Beans

Beans are rich in plant protein, minerals, B vitamins, and soluble fiber. Soluble fiber absorbs water in the stomach, slows the absorption of food and sugar, and gives a feeling of fullness. In theory, fiber slows the absorption of glucose and, thus, would weaken the insulin response.

The problem is beans do not taste good especially from a can. However, the recipe made from dried beans tastes great. I often start my day with a bowl of homemade beans for breakfast. The recipe comes from my grandmother who knew how to cook good Southern food. In the Southern United States, homemade cornbread and beans go together. In Malaysia, I top the beans with a fried egg with a soft golden yolk. Figure 4 shows the recipe for black eye peas.

Ingredients

  * 1 pound (or 1/2 kilogram) of your favorite beans

  * 1/2 pound (1/4 kilogram) beef or pork bones

  * 2 bay leaves

  * 1 onion, diced

  * 2 tablespoons olive oil or butter

  * 1 teaspoon sea salt

  * 1 teaspoon pepper

Directions

  1. Clean and cover beans with water overnight.

  2. Simmer beans with bones and bay leaves between 2 and 4 hours on low heat and covered. Pinto and black eye peas soften quickly while other beans such as kidney beans take longer.

  3. Add the remaining ingredients in the last half hour of cooking.

The key to good beans is the bones and oil. These two ingredients make the beans delicious. We feel free to add additional seasonings to our liking.

## Bone Broth

We already discussed bone broth and how people should drink a mug of a bone broth for prolonged fasts beyond 24 hours. Figure 5 shows a picture of bone broth.

Ingredients

  * 1/2 pound (1/4 kilogram) beef, chicken, fish, or pork bones

  * 2 bay leaves

  * 1 teaspoon sea salt

  * 1 teaspoon pepper

Directions

  1. Simmer bones and bay leaves at least 3 hours on low heat, covered.

  2. Add the salt and pepper in the last half hour of cooking.

## Carrot and Cucumber Salad

Carrot-cucumber salad is a favorite in Malaysia at the Indian and Muslim restaurants and shown in Figure 6. I always take a heaping of this salad with fried chicken, curry sauce, and rice.

Ingredients

  * 1 carrot

  * 1 large cucumber

  * 2 tablespoons rice or white vinegar

  * 2 tablespoons honey

  * 1 teaspoon sea salt

  * 1 teaspoon pepper

Directions

  1. Clean both the carrot and cucumber. Slice the cucumber lengthwise and use a spoon to remove the seed core. Julienne both the carrots and cucumbers. We may adjust the number of carrots and cucumbers to get a ratio of one to one.

  2. Julienne, a special shredder from the Asian stores, shreds vegetables into long shoestrings.

  3. Mix all ingredients together.

Malaysians offer variations of this dish. Sometimes, they dice and add pineapple or diced spicy chilies.

## Carrot Salad

Carrot salad is one of my favorite salads, and I eat it several times each month. I discovered this dish in Central Asia in the Republic of Kazakhstan in the mid-1990s. Kazakhstan was a state of the Soviet Union. I would trek to the open market even during winter in freezing temperatures to pick up this salad. Figure 7 shows the carrot salad.

Ingredients

  * 3 carrots

  * 1/4 cup white vinegar or apple cider vinegar

  * 1/4 cup water

  * 2 tablespoons honey

  * 1/2 teaspoon sea salt

  * 1/2 teaspoon black or white pepper

  * 3 cloves, finely diced garlic

  * 3 shallots finely diced or 1/2 red onion finely diced

Directions

  1. Mix the vinegar, water, honey, salt, pepper, shallots, and garlic together. Allow the sauce to absorb the flavors.

  2. Julienne the carrots. Julienne is a special shredder, usually at Asian stores, that shreds vegetables into long shoestrings.

  3. Bring a pot of water to boil. Add the carrots and blanch for 10 seconds. Yes, 10 seconds. Strain carrots and rinse with cold water. Blanch softens the carrots a touch.

  4. Drizzle olive oil and sauce and refrigerate for an hour to allow carrots to absorb the flavors.

The sellers make a spicy version of this salad. Just mix in a little chili sauce or diced chili pepper for a touch of heat.

## Green Papaya Salad (Som Tom)

Som Tom is my absolute favorite Thai dish. We can easily find this dish at any food cart on any street in Thailand. Street vendors offer two versions: Green papaya or mango. Thai women claim they stay skinny by eating this dish.

Street vendors tone down the spiciness of this dish when selling to foreigners. The vendors are surprised when I ask for regular spiciness. The sweat would pour from my red face when eating this dish. During eating, I must pause several times to breath in and out to dissipate the heat blast in my mouth. Of course, I loved watching the British tourists as they winced and suffered as they ate this spicy salad. Figure 8 shows my homemade version of som tom.

Ingredients

  * 2 bowls green raw papaya, julienne

  * 10 green beans, cut diagonally into small pieces

  * 5 garlic cloves, finely diced

  * 4 Roma or cherry tomatoes, chopped in half and sliced

  * 6 red, small chili peppers (spicy)

  * 2 tablespoons palm sugar, or 1 tablespoon table sugar

  * 1/4 cup freshly squeezed lime juice

  * 1/2 cup Thai fish sauce

  * 1/2 cup unsalted peanuts, roasted

  * 1/2 cup dried, miniature prawns (optional)

  * 1 small raw crab (optional)

Directions

  1. Ripe papaya has a yellow skin with orange flesh. Meanwhile, green papaya has a green skin with a light green (or pinkish) flesh. I prefer to Julienne the papaya for thick shoestrings similar to linguine.

  2. I mix the garlic, chilis, sugar, lime juice, and Thai fish sauce together. I let the sauce sit for a while to absorb all the flavors. The street vendors always use a mortar and pestle to blend the ingredients.

  3. Mix the remaining ingredients and add the sauce.

  4. American peanuts are salty Rinse the salty peanuts in water and bake on a cookie sheet for 10 minutes at 300 0F (or 150 0C) to re-roast. Thai fish sauce contains plenty of salt, so adding salty peanuts adds too much salt.

Notes:

  * Thai fish sauce is a hallmark of Thai cooking. Producers age the sauce by fermenting anchovies in brine.

  * I always ask to omit the raw crab. Otherwise, we are asking for trouble with raw seafood stored on a street cart all day in tropical temperature.

  * I can never find the dried, miniature prawns in Malaysian stores and omit this ingredient too.

## Homemade Salsa

Once we taste homemade salsa, we can never return to the jar. I add fresh salsa on top of omelets, Mexican food, or just a dip for my tortilla chips, which Figure 9 shows.

Ingredients

  * 5 red tomatoes, diced

  * 1 red or yellow onion, diced

  * 2 green onions, diced

  * 8 cloves garlic, finely diced

  * 4 limes, freshly squeezed lime juice, or 2 tablespoons vinegar

  * 4 jalapeno peppers, finely diced

  * 1 teaspoon red chili powder

  * 1/2 teaspoon cumin

  * 1 teaspoon salt

  * 1 teaspoon black pepper

  * 1/4 cup minced cilantro (optional)

Directions

  1. Mix all ingredients. Refrigerate. We cannot get more straightforward than that. Some recipes simmer the sauce over low heat. However, I want all my vegetables and seasonings raw and uncooked to maintain the vitamins and minerals.

**Note** : Fresh pineapple or mango chunks go well with salsa.

## Lime Juice

In Malaysia, many cafes and restaurants offer fresh lime juice as a drink. Thus, I drink lime juice on a regular basis, which Figure 10 depicts. The lime juice serves as an excellent mixer for tequila and whiskey.

Ingredients

  * 5 tablespoons sugar

  * 5 cups water

  * 10 small limes

  * Ice

Directions

  1. Slice limes in half. Place all ingredients in a bowl or container. Add 5 cups boiling water. The hot water also removes some of the oils from the skin.

  2. Allow mixture to cool and pass the mixture through a wire mesh to remove all limes and seeds. I also squeeze the limes to extract all juice.

  3. Pour into a glass filled with ice. Garnish with lime halves. Refrigerate the remainder.

## Lime Soda

Pharmacies sold sodas as health tonics and energy drinks in the late 19th century. For example, Dr. Pepper, the first soda, was invented as an energy drink and brain tonic [230]. Meanwhile, the original 7-up contained a mood stabilizer called lithium citrate [230]. Finally, drinking a Coca-Cola would rejuvenate health, strength, and vitality [230].

I, thus, resurrect the original purpose of a soda as a health drink using 100% natural juices as shown in Figure 11.

Ingredients

  * 1 cup sugar

  * 1 cup water

  * 1 tablespoon fresh lime zest

  * 2/3 cup freshly squeezed lime juice

  * Carbonated water

  * Ice

Directions

  1. Use a grater to get a tablespoon of lime zest if the grater makes slivers. If the zest is a fine powder, reduce the zest to a teaspoon.

  2. Add zest, water, and sugar to a saucepan and stir over low heat. Once all the sugar dissolves, remove the heat and allow to cool.

  3. Add the freshly squeezed lime juice and refrigerate. Also, chill the carbonated water. The coldness keeps the carbon dioxide dissolved in the water.

  4. To make the soda, add 1/3 syrup and 2/3 carbonated water, mix, and add ice.

We can adjust the recipe for other flavors.

Lemon soda

  * Replace the lime zest with lemon zest.

  * Replace lime juice with freshly squeezed lemon juice.

Orange soda

  * Replace the lime zest with orange zest.

  * Replace lime juice with freshly squeezed orange juice.

Cream soda

  * Replace the lime zest with tablespoon vanilla.

  * Add two tablespoons of fresh lemon or lime juice. The name of the cream soda may come from cream of tartar, another sour agent used in cream soda. Please do not mix dairy cream in with the soda since the cream is alkaline and carbonated water is slightly acidic.

**Note:** My friends and I were surprised over the deliciousness of these homemade sodas.

## Soursop (Guyabano) Smoothie

I fell in love with the soursop smoothie when I first tried it in Brunei at the mall. Some people eat soursop for its health and anti-cancer properties. However, no scientific evidence supports the power of soursop to combat cancer. I show a picture of soursop in Figure 12 with the soursop smoothie. Please do not confuse soursop with durian. Durian, another favorite fruit in Asia, emits a strong, reeking, dead body smell. Trust me, I can smell the decaying durian a block away.

Ingredients

  * 3 chunks soursop

  * 1 cup vanilla or plain yogurt

  * Honey

  * Ice cubes

Directions

  1. Slice soursop in half and carefully peel the skin with a knife. Slice flesh into small one-inch (or 2.5 cm) cubes. We must remove the seeds from the cubes, which is why we cut them small.

  2. Add yogurt, a cup of soursop chunks, and several ice cubes. Drizzle a little honey and blend. Add additional honey and ice to get desired sweetness and consistency.

  3. We freeze the leftover soursop if we plan to use it for future smoothies.

## Three Sour

I discovered three sour in the Chinese cafes in Malaysia, and it has become one of my favorite drinks. The three sour comes from lemon, lime, and sour plum and is shown in Figure 13.

I also drink an alternative of three sour on my fasting day. I omit the sugar and add a ½ teaspoon of Himalayan salt instead.

Ingredients

  * 10 small limes

  * 10 lemon slices

  * 5 sour or salty plums

  * 5 tablespoons table sugar

  * 5 cups boiling water

  * Ice

Directions

  1. Slice limes in half and place all ingredients into a container or bowl.

  2. Add boiling water, stir to dissolve the sugar, and allow mixture to cool.

  3. Strain mixture through a wire mesh to remove seeds. I also squeeze all the juice from the limes and lemons.

  4. Pour into a glass with ice. Add freshly sliced lime and lemon and one plum as a garnish.

I prefer the dried sour plum, but the Asian stores sell sour plums in a brine. Although the salty plum is a good choice, I find the salt neutralizes the sourness of the drink.

# 11. The Conclusion

"Fifty is the new thirty, via intermittent fasting."

– Ken Szulczyk

I added my quote to express the quintessential impact of fasting on my life. I'm in better shape at 51 than I was in 30. Heck, I'm in better shape than when I was 20.

When I started fasting, I didn't think much about it except I would get the benefits of autophagy. However, the weight melted off my body while my waist size shrank from a 38 to a 33 with little effort. The 33-waist has even become loose. I couldn't squeeze into a 33 since high school. Thus, I knew fasting held something special. Come on; we all know. The greatest prophets, Jesus, Muhammad, and Buddha all fasted. So, fasting was never secret knowledge. I read the Bible several times, and I skipped over the passages of fasting with no thought nor interest. It was just by chance I heard someone mention intermittent fasting, and it piqued my curiosity. Then I watched the YouTube videos.

After starting intermittent fasting, I witnessed performance improvements in the gym. I exercise with heavier weights with greater repetitions. Then I started running 6.21 miles (or 10 km) nonstop. I couldn't run that distance nonstop as a young man. Fasting has transformed me into an athlete.

In the past, I researched many herbs and supplements searching for the fountain of youth in a bottle. Out all the medicines, medical technology, and herbs that we have access to, fasting blows all other alternatives out of the water. Nothing comes a close second. Don't get me wrong. Exercise, diet restriction, and several supplements are great for the body, but they don't compete with fasting. Fasting switches on the body's repair mechanisms via autophagy, autolysis, and removal or regeneration of the senescent cells.

After fasting for a year and a half, fasting has become easier. Also, I don't get the white, coated tongue anymore; the euphoria has weakened considerably. Many times, I feel no difference between fasting or feasting even though I have not eaten for 30 hours. Thus, I ask myself several questions.

Am I abusing intermittent fasting? Am I fasting too frequently causing fasting to lose its effectiveness? A good research question is whether the power of fasting weakens each time we use it. Another question on fasting is the long-term effects on the body. I don't know the answer to these questions. However, exercise and calorie restriction place stress on the body. The lungs, heart, and blood become more efficient at transporting oxygen to the body during aerobic exercise while anaerobic exercise strengthens the muscles and bones. Then the body lowers metabolism for calorie restriction to conserve energy. Therefore, the body as an ingenious machine ensures we survive in an environment filled with stress. Thus, the body adapts to stress.

We know fasting places more stress on the body than exercise and calorie restriction. Hence, the body adapts and tries to minimize this stress. For example, Dr. Shelton noticed patients lost less weight on second and third fasts because the body becomes efficient at conserving its resources [3]. Animal studies also highlight the impact of fasting. The fasted mice gained 10% more body weight than the control group [67, 138], while another study on fasted rabbits showed a 50% gain in weight [13]. Therefore, the mice's and rabbits' bodies had adapted to the stress of fasting, or their digestive system processed food more efficiently [13].

Another question I have is each time we fast, do our bodies become more efficient in entering the fasting state? Then autophagy and the repairing processes become more efficient, or must we fast for longer and longer periods to attain the same benefits of fasting? Unfortunately, the research has just started to unravel the mysteries of fasting.

I have another question. Will fasting extend my lifespan? I think I have to say yes because old age started to catch up with me at 50 as I suffered from chronic allergies, recurring infections and colds, and constant digestive issues with persistent diarrhea. I gobbled down the antihistamines and Imodium three or more times per week. My knee joints were stiff, and I started to put on the weight. I was in the worse shape of my life.

Then I tried intermittent fasting. Poof! All my ailments have disappeared. The weight melted off; my BMI dropped 4%, and the joint stiffness went away. If I can delay the effects of aging another 20 years, then I will have no problem reaching 100 years old. It appears fasting gives us the means to age gracefully like a fine wine. We get better with age. Unfortunately, I don't think we will live to the same age as Adam, over 900 years old. We need an act of God or some magic concoction to live that long.

My last question is whether the efficacy of fasting depends on age. For example, if a 25-year old, 50-year old, and 75-year old fasted for 24 hours, is the fasting process identical for all people? When we age, our hormone levels decline while our cells fill with garbage. Our bodies brim with senescent zombie cells. Do the repair processes of fasting also become efficient over time? We would expect the 75-year old would need more bouts of fasting since he or she is more likely to have health problems, but does the aging process also reduce the effectiveness of fasting? Unfortunately, we already know the answer to this one. Several studies indicate autophagy weakens as we become older. It appears we should fast for longer durations and more frequently to offset weakening autophagy.

I hope the readers have enjoyed this book. If we must take away one thing, we use fasting to enjoy life and to keep our bodies in the healthiest state. We're on this planet for a short time. We are all passengers on a bullet train as we watch the scenes of life fly by the window. We can use intermittent fasting to make the train ride more enjoyable and perhaps delay the final destination a little longer.

Let's make the planet a better place to live while living life to the fullest. We all can age gracefully by utilizing the power of fasting.

# 12. References

[1] Sinclair U. _The Fasting Cure._ Chet Day's Health and Beyond Online; 1911.

[2] Dewey EH. _The No Breakfast Plan and the Fasting-Cure._ Project Gutenberg: Edward Hooker Dewey; 1900.

[3] Shelton HM. _The Science and Fine Art of Fasting._ 5th ed: Dr. Shelton's Health School; 1978.

[4] U.S. Geological Survey. The Water in You. _U.S. Department of the Interior_ 2018.

[5] The New King James Version. _The Holy Bible._

[6] Laidlaw J. A Life Worth Leaving: Fasting to Death as Telos of a Jain Religious Life. _Economy and Society._ 2005; 34:178-99.

[7] Buddha Dharma Education Association. A Monk's Dream Comes to Life. 2012.

[8] Fuhrman J. _Fasting and Eating for Health._ St. Martin's Press; 1995.

[9] Thompson C. Art of Intermittent Fasting \- How to Lose Weight, Shed Fat, and Live a Healthier Life. 2018.

[10] Fung J, Moore J. _The Complete Guide to Fasting: Heal Your Body Through Intermittent, Alternate-Day, and Extended Fasting._ Victory Belt Publishing; 2016.

[11] Fung J. _The Obesity Code: Unlocking the Secrets of Weight Loss._ 2016.

[12] Awad S, Stephenson MC, Placidi E, Marciani L, Constantin-Teodosiu D, Gowland PA, et al. The Effects of Fasting and Refeeding with a 'Metabolic Preconditioning'Drink on Substrate Reserves and Mononuclear Cell Mitochondrial Function. _Clinical Nutrition._ 2010; 29:538-44.

[13] Devries A. _Therapeutic Fasting._ Chandler Book Co.; 1963.

[14] Pet MD. Fatty Liver Disease in Cats. 2018.

[15] Kerndt PR, Naughton JL, Driscoll CE, Loxterkamp DA. Fasting: the History, Pathophysiology and Complications. _Western Journal of Medicine._ 1982; 137:379.

[16] Veech RL, Chance B, Kashiwaya Y, Lardy HA, Cahill Jr GF. Ketone Bodies, Potential Therapeutic Uses. _IUBMB Life._ 2001; 51:241-7.

[17] Owen OE, Felig P, Morgan AP, Wahren J, Cahill GF. Liver and Kidney Metabolism During Prolonged Starvation. _The Journal of Clinical Investigation._ 1969; 48:574-83.

[18] Johnson JB, Summer W, Cutler RG, Martin B, Hyun D-H, Dixit VD, et al. Alternate Day Calorie Restriction Improves Clinical Findings and Reduces Markers of Oxidative Stress and Inflammation in Overweight Adults with Moderate Asthma. _Free Radical Biology and Medicine._ 2007; 42:665-74.

[19] Duncan GG. Intermittent Fasts in the Correction and Control of Intractable Obesity. _Transactions of the American Clinical and Climatological Association._ 1963; 74:121.

[20] Zauner C, Schneeweiss B, Kranz A, Madl C, Ratheiser K, Kramer L, et al. Resting Energy Expenditure in Short-term Starvation Is Increased As a Result of an Increase in Serum Norepinephrine. _The American Journal of Clinical Nutrition._ 2000; 71:1511-5.

[21] Crook M, Hally V, Panteli J. The Importance of the Refeeding Syndrome. _Nutrition._ 2001; 17:632-7.

[22] Biden TJ, Taylor KW. Effects of Ketone Bodies on Insulin Release and Islet-cell Metabolism in the Rat. _Biochemical Journal._ 1983; 212:371-7.

[23] Madison LL, Mebane D, Unger RH, Lochner A. The Hypoglycemic Action of Ketones. II. Evidence for a Stimulatory Feedback of Ketones on the Pancreatic Beta Cells. _The Journal of Clinical Investigation._ 1964; 43:408-15.

[24] Cott A. Controlled Fasting Treatment of Schizophrenia in USSR. _Schizophrenia._ 1971; 3:2-10.

[25] Moser I. _How and When to be Your Own Doctor._ Prabhat Prakashan; 1997.

[26] Heilbronn LK, Civitarese AE, Bogacka I, Smith SR, Hulver M, Ravussin E. Glucose Tolerance and Skeletal Muscle Gene Expression in Response to Alternate Day Fasting. _Obesity Research._ 2005; 13:574-81.

[27] de Toledo FW, Grundler F, Bergouignan A, Drinda S, Michalsen A. Safety, Health Improvement and Well-being during a 4 to 21-day Fasting Period in an Observational Study Including 1422 Subjects. _PloS One._ 2019; 14:1-23.

[28] Arai Y, Martin-Ruiz CM, Takayama M, Abe Y, Takebayashi T, Koyasu S, et al. Inflammation, but not Telomere Length, Predicts Successful Ageing at Extreme Old Age: A Longitudinal Study of Semi-supercentenarians. _EBioMedicine._ 2015; 2:1549-58.

[29] Fuhrman J, Sarter B. Brief case reports of medically supervised, water-only fasting associated with remission of autoimmune disease. _Alternative Therapies in Health and Medicine._ 2002.

[30] Buhner SH. The Health Benefits of Water Fasting. _The Foundation for Gaian Studies_ ; 2003.

[31] Choi IY, Lee C, Longo VD. Nutrition and Fasting Mimicking Diets in the Prevention and Treatment of Autoimmune Diseases and Immunosenescence. _Molecular and Cellular Endocrinology._ 2017; 455:4-12.

[32] Longo VD, Mattson MP. Fasting: Molecular Mechanisms and Clinical Applications. _Cell Metabolism._ 2014; 19:181-92.

[33] Sisson M. The Myriad Benefits of Intermittent Fasting. _Mark's Daily Apple_ ; 2011.

[34] Nakamura S, Oba M, Suzuki M, Takahashi A, Yamamuro T, Fujiwara M, et al. Suppression of Autophagic Activity by Rubicon is a Signature of Aging. _Nature Communications._ 2019; 10:847.

[35] Sachdeva UM, Thompson CB. Diurnal Rhythms of Autophagy: Implications for Cell Biology and Human Disease. _Autophagy._ 2008; 4:581-9.

[36] Rubinsztein DC, Mariño G, Kroemer G. Autophagy and Aging. _Cell._ 2011; 146:682-95.

[37] Hippert MM, O'Toole PS, Thorburn A. Autophagy in Cancer: Good, Bad, or Both? _Cancer Research._ 2006; 66:9349-51.

[38] Vicencio JM, Galluzzi L, Tajeddine N, Ortiz C, Criollo A, Tasdemir E, et al. Senescence, Apoptosis or Autophagy? _Gerontology._ 2008; 54:92-9.

[39] Vellai T, Takács-Vellai K, Sass M, Klionsky DJ. The Regulation of Aging: Does Autophagy Underlie Longevity? _Trends in Cell Biology._ 2009; 19:487-94.

[40] Ouimet M, Franklin V, Mak E, Liao X, Tabas I, Marcel YL. Autophagy Regulates Cholesterol Efflux from Macrophage Foam Cells Via Lysosomal Acid Lipase. _Cell Metabolism._ 2011; 13:655-67.

[41] Hay N, Sonenberg N. Upstream and Downstream of mTOR. _Genes and Development._ 2004; 18:1926-45.

[42] Heilbronn LK, Smith SR, Martin CK, Anton SD, Ravussin E. Alternate-day Fasting in Nonobese Subjects: Effects on Body Weight, Body Composition, and Energy Metabolism. _The American Journal of Clinical Nutrition._ 2005; 81:69-73.

[43] Malinowski B, Zalewska K, Węsierska A, Sokołowska MM, Socha M, Liczner G, et al. Intermittent Fasting in Cardiovascular Disorders—An Overview. _Nutrients._ 2019; 11:673.

[44] McDaniel SS, Rensing NR, Thio LL, Yamada KA, Wong M. The Ketogenic Diet Inhibits the Mammalian Target of Rapamycin (mTOR) Pathway. _Epilepsia._ 2011; 52:e7-e11.

[45] Zyrowski N. Best Hours For Intermittent Fasting | The Golden Hours. _Youtube_ ; 2018.

[46] Yoshii SR, Mizushima N. Monitoring and Measuring Autophagy. _International Journal of Molecular Sciences._ 2017; 18:1865.

[47] Land S. _Metabolic Autophagy: Practice Intermittent Fasting and Resistance Training to Build Muscle and Promote Longevity (Metabolic Autophagy Diet Book 1)_ Amazon Digital Services LLC 2019.

[48] Williamson DL, Kubica N, Kimball SR, Jefferson LS. Exercise‐induced Alterations in Extracellular Signal‐regulated Kinase 1/2 and Mammalian Target of Rapamycin (mTOR) Signalling to Regulatory Mechanisms of mRNA Translation in Mouse Muscle. _The Journal of Physiology._ 2006; 573:497-510.

[49] Vindis C. Autophagy: An Emerging Therapeutic Target in Vascular Diseases. _British Journal of Pharmacology._ 2015; 172:2167-78.

[50] Pietrocola F, Malik SA, Mariño G, Vacchelli E, Senovilla L, Chaba K, et al. Coffee Induces Autophagy in Vivo. _Cell Cycle._ 2014; 13:1987-94.

[51] Gump JM, Thorburn A. Autophagy and Apoptosis: What is the Connection? _Trends in Cell Biology._ 2011; 21:387-92.

[52] Klionsky DJ, Cuervo AM, Seglen PO. Methods for Monitoring Autophagy from Yeast to Human. _Autophagy._ 2007; 3:181-206.

[53] Alirezaei M, Kemball CC, Flynn CT, Wood MR, Whitton JL, Kiosses WB. Short-term Fasting Induces Profound Neuronal Autophagy. _Autophagy._ 2010; 6:702-10.

[54] Gannon AM, Stämpfli MR, Foster WG. Cigarette Smoke Exposure Elicits Increased Autophagy and Dysregulation of Mitochondrial Dynamics in Murine Granulosa Cells. _Biology of Reproduction._ 2013; 88:63, 1-11.

[55] Finn PF, Dice JF. Ketone Bodies Stimulate Chaperone-Mediated Autophagy. _Journal of Biological Chemistry._ 2005; 280:25864-70.

[56] McCarty MF, DiNicolantonio JJ, O'Keefe JH. Ketosis May Promote Brain Macroautophagy by Activating Sirt1 and Hypoxia-inducible Factor-1. _Medical Hypotheses._ 2015; 85:631-9.

[57] Newman JC, Verdin E. Ketone Bodies as Signaling Metabolites. _Trends in Endocrinology & Metabolism._ 2014; 25:42-52.

[58] Zhou J, Farah BL, Sinha RA, Wu Y, Singh BK, Bay B-H, et al. Epigallocatechin-3-gallate (EGCG), a Green Tea Polyphenol, Stimulates Hepatic Autophagy and Lipid Clearance. _PloS One._ 2014; 9:e87161.

[59] Hunter P. The Inflammation Theory of Disease: The Growing Realization That Chronic Inflammation Is Crucial in Many Diseases Opens New Avenues for Treatment. _EMBO Reports._ 2012; 13:968-70.

[60] Trafton A. How Cancer Cells Fuel Their Growth. MIT News,: _Massachusetts Institute of Technology_ ; 2016.

[61] Gallagher EJ, LeRoith D. Minireview: IGF, Insulin, and Cancer. _Endocrinology._ 2011; 152:2546-51.

[62] Varady KA, Roohk D, Hellerstein MK. Dose Effects of Modified Alternate-day Fasting Regimens on In Vivo Cell Proliferation and Plasma Insulin-like Growth Factor-1 in Mice. _Journal of Applied Physiology._ 2007; 103:547-51.

[63] Bianchini F, Kaaks R, Vainio H. Overweight, Obesity, and Cancer Risk. _The Lancet Oncology._ 2002; 3:565-74.

[64] Cheng C-W, Adams GB, Perin L, Wei M, Zhou X, Lam BS, et al. Prolonged Fasting Reduces IGF-1/PKA to Promote Hematopoietic-stem-cell-based Regeneration and Reverse Immunosuppression. _Cell Stem Cell._ 2014; 14:810-23.

[65] Rocha NS, Barbisan LF, de Oliveira MLC, de Camargo JLV. Effects of Fasting and Intermittent Fasting on Rat Hepatocarcinogenesis Induced by Diethylnitrosamine. _Teratogenesis, Carcinogenesis, and Mutagenesis._ 2002; 22:129-38.

[66] Lee C, Raffaghello L, Brandhorst S, Safdie FM, Bianchi G, Martin-Montalvo A, et al. Fasting Cycles Retard Growth of Tumors and Sensitize a Range of Cancer Cell Types to Chemotherapy. _Science Translational Medicine._ 2012; 4:124ra27-ra27.

[67] Descamps O, Riondel J, Ducros V, Roussel A-M. Mitochondrial Production of Reactive Oxygen Species and Incidence of Age-associated Lymphoma in OF1 Mice: Effect of Alternate-day Fasting. _Mechanisms of Ageing and Development._ 2005; 126:1185-91.

[68] Mattson MP. Energy Intake, Meal Frequency, and Health: A Neurobiological Perspective. _Annual Review of Nutrition._ 2005; 25:237-60.

[69] Anson RM, Guo Z, De Cabo R, Iyun T, Rios M, Hagepanos A, et al. Intermittent Fasting Dissociates Beneficial Effects of Dietary Restriction on Glucose Metabolism and Neuronal Resistance to Injury from Calorie Intake. _Proceedings of the National Academy of Sciences._ 2003; 100:6216-20.

[70] Wan R, Camandola S, Mattson MP. Intermittent Fasting and Dietary Supplementation with 2-deoxy-D-glucose Improve Functional and Metabolic Cardiovascular Risk Factors in Rats. _The FASEB Journal._ 2003; 17:1133-4.

[71] Duan W, Guo Z, Jiang H, Ware M, Li X-J, Mattson MP. Dietary Restriction Normalizes Glucose Metabolism and BDNF Levels, Slows Disease Progression, and Increases Survival in Huntingtin Mutant Mice. _Proceedings of the National Academy of Sciences._ 2003; 100:2911-6.

[72] Raffaghello L, Lee C, Safdie FM, Wei M, Madia F, Bianchi G, et al. Starvation-dependent Differential Stress Resistance Protects Normal But Not Cancer Cells against High-dose Chemotherapy. _Proceedings of the National Academy of Sciences._ 2008; 105:8215-20.

[73] Hu Y-L, DeLay M, Jahangiri A, Molinaro AM, Rose SD, Carbonell WS, et al. Hypoxia-induced Autophagy Promotes Tumor Cell Survival and Adaptation to Antiangiogenic Treatment in Glioblastoma. _Cancer Research._ 2012; 72:1773-83.

[74] Kenific CM, Thorburn A, Debnath J. Autophagy and Metastasis: Another Double-edged Sword. _Current Opinion in Cell Biology._ 2010; 22:241-5.

[75] Thomas II J, Antonelli J, Lloyd J, Masko E, Poulton S, Phillips T, et al. Effect of Intermittent Fasting on Prostate Cancer Tumor Growth in a Mouse Model. _Prostate Cancer and Prostatic Diseases._ 2010; 13:350.

[76] Mayo Clinic. Stem Cells: What They Are and What They Do. _Mayo Clinic_ ; 2018.

[77] Ho AD, Wagner W, Mahlknecht U. Stem Cells and Ageing: The Potential of Stem Cells to Overcome Age‐related Deteriorations of the Body in Regenerative Medicine. _EMBO Reports._ 2005; 6:S35-S8.

[78] Jarreau PB. Eating (Or rather, Fasting) Our Way to Rejuvenated Stem Cells? : _Medium.com_ ; 2018.

[79] Mihaylova MM, Cheng C-W, Cao AQ, Tripathi S, Mana MD, Bauer-Rowe KE, et al. Fasting Activates Fatty Acid Oxidation to Enhance Intestinal Stem Cell Function during Homeostasis and Aging. _Cell Stem Cell._ 2018; 22:769-78.

[80] Varady KA, Bhutani S, Church EC, Klempel MC. Short-term Modified Alternate-day Fasting: A Novel Dietary Strategy for Weight Loss and Cardioprotection in Obese Adults. _The American Journal of Clinical Nutrition._ 2009; 90:1138-43.

[81] Luo EK. Everything You Need to Know About High Cholesterol. _Healthline_ ; 2018.

[82] Ahmet I, Wan R, Mattson MP, Lakatta EG, Talan M. Cardioprotection by Intermittent Fasting in Rats. _Circulation._ 2005; 112:3115-21.

[83] Wan R, Ahmet I, Brown M, Cheng A, Kamimura N, Talan M, et al. Cardioprotective Effect of Intermittent Fasting is Associated with an Elevation of Adiponectin Levels in Rats. _The Journal of Nutritional Biochemistry._ 2010; 21:413-7.

[84] Li L, Wang Z, Zuo Z. Chronic Intermittent Fasting Improves Cognitive Functions and Brain Structures in Mice. _PloS One._ 2013; 8:e66069.

[85] Bhutani S, Klempel MC, Berger RA, Varady KA. Improvements in Coronary Heart Disease Risk Indicators by Alternate‐day Fasting Involve Adipose Tissue Modulations. _Obesity._ 2010; 18:2152-9.

[86] Tinsley GM, La Bounty PM. Effects of Intermittent Fasting on Body Composition and Clinical Health Markers in Humans. _Nutrition Reviews._ 2015; 73:661-74.

[87] Patterson RE, Sears DD. Metabolic Effects of Intermittent Fasting. _Annual Review of Nutrition._ 2017; 37.

[88] Hutchison AT, Liu B, Wood RE, Vincent AD, Thompson CH, O'Callaghan NJ, et al. Effects of Intermittent Versus Continuous Energy Intakes on Insulin Sensitivity and Metabolic Risk in Women with Overweight. _Obesity._ 2019; 27:50-8.

[89] Ye J, Keller JN. Regulation of Energy Metabolism by Inflammation: A Feedback Response in Obesity and Calorie Restriction. _Aging._ 2010; 2:361.

[90] Gandhi H, Upaganlawar A, Balaraman R. Adipocytokines: The Pied Pipers. _Journal of Pharmacology & Pharmacotherapeutics._ 2010; 1:9.

[91] Hein D. CoQ10 and Statins: What You Need to Know. _Healthline_ ; 2016.

[92] Arnason TG, Bowen MW, Mansell KD. Effects of Intermittent Fasting on Health Markers in Those with Type 2 Diabetes: A Pilot Study. _World Journal of Diabetes._ 2017; 8:154.

[93] Allen FM. Prolonged Fasting in Diabetes. _Journal of Experimental Medicine._ 1915.

[94] Mazur A. Why Were "Starvation Diets" Promoted for Diabetes in the Pre-insulin Period? _Nutrition Journal._ 2011; 10:23.

[95] Barnosky AR, Hoddy KK, Unterman TG, Varady KA. Intermittent Fasting vs Daily Calorie Restriction for Type 2 Diabetes Prevention: A Review of Human Findings. _Translational Research._ 2014; 164:302-11.

[96] Gilliland I. Total Fasting in the Treatment of Obesity. _Postgraduate Medical Journal._ 1968; 44:58.

[97] Halberg N, Henriksen M, Soderhamn N, Stallknecht B, Ploug T, Schjerling P, et al. Effect of Intermittent Fasting and Refeeding on Insulin Action in Healthy Men. _Journal of Applied Physiology._ 2005; 99:2128-36.

[98] Furmli S, Elmasry R, Ramos M, Fung J. Therapeutic Use of Intermittent Fasting for People with Type 2 Diabetes as an Alternative to Insulin. _Case Reports._ 2018; 2018:1-5.

[99] Martin B, Mattson MP, Maudsley S. Caloric Restriction and Intermittent Fasting: Two Potential Diets for Successful Brain Aging. _Ageing Research Reviews._ 2006; 5:332-53.

[100] Duan W, Guo Z, Mattson MP. Brain‐derived Neurotrophic Factor Mediates an Excitoprotective Effect of Dietary Restriction in Mice. _Journal of Neurochemistry._ 2001; 76:619-26.

[101] Nilsson P, Loganathan K, Sekiguchi M, Matsuba Y, Hui K, Tsubuki S, et al. Aβ Secretion and Plaque Formation Depend on Autophagy. _Cell Reports._ 2013; 5:61-9.

[102] Halagappa VKM, Guo Z, Pearson M, Matsuoka Y, Cutler RG, LaFerla FM, et al. Intermittent Fasting and Caloric Restriction Ameliorate Age-related Behavioral Deficits in the Triple-transgenic Mouse Model of Alzheimer's Disease. _Neurobiology of Disease._ 2007; 26:212-20.

[103] Hoeffer CA, Klann E. mTOR Signaling: At the Crossroads of Plasticity, Memory and Disease. _Trends in Neurosciences._ 2010; 33:67-75.

[104] Arumugam TV, Phillips TM, Cheng A, Morrell CH, Mattson MP, Wan R. Age and Energy Intake Interact to Modify Cell Stress Pathways and Stroke Outcome. _Annals of Neurology._ 2010; 67:41-52.

[105] Lee J, Duan W, Long JM, Ingram DK, Mattson MP. Dietary Restriction Increases the Number of Newly Generated Neural Cells, and Induces BDNF Expression, in the Dentate Gyrus of Rats. _Journal of Molecular Neuroscience._ 2000; 15:99-108.

[106] Jeong M-a, Plunet W, Streijger F, Lee JH, Plemel JR, Park S, et al. Intermittent Fasting Improves Functional Recovery after Rat Thoracic Contusion Spinal Cord Injury. _Journal of Neurotrauma._ 2011; 28:479-92.

[107] Rasmussen MH. Obesity, Growth Hormone and Weight Loss. _Molecular and Cellular Endocrinology._ 2010; 316:147-53.

[108] The Aesthetic Medicine and Anti-aging Clinics of Lousinana. How Much Does HGH Therapy Cost? : _Crystal Clear Digital Marketing_ ; 2018.

[109] Paulson P. _Intermittent Fasting 101: A Simple Guide to Losing Fat, Building Muscle and Becoming an Alpha Male._ Create Space; 2014.

[110] Salgin B, Marcovecchio M, Hill N, Dunger D, Frystyk J. The Effect of Prolonged Fasting on Levels of Growth Hormone-binding Protein and Free Growth Hormone. _Growth Hormone & IGF Research._ 2012; 22:76-81.

[111] Tavares ABW, Micmacher E, Biesek S, Assumpção R, Redorat R, Veloso U, et al. Effects of Growth Hormone Administration on Muscle Strength in Men over 50 Years Old. _International Journal of Endocrinology._ 2003.

[112] Arias E. United States Life Tables. In: Statistics DoV, editor.: _Centers for Disease Control and Prevention_ ; 2003.

[113] National Center for Health Statistics. Table 14. Life Expectancy at Birth and at Age 65, by Sex: Organisation for Economic Co-operation and Development (OECD) Countries, Selected Years 1980–2015. In: Prevention CfDCa, editor.2017.

[114] Guinness World Records. Oldest Person Ever. _Guinness World Records Limited 2018_ ; 2018.

[115] Bidwell V. Timeline For The Life of Dr. Herbert M. Shelton.

[116] Hayflick L. The Limited in Vitro Lifetime of Human Diploid Cell Strains. _Experimental Cell Research._ 1965; 37:614-36.

[117] Hayflick L, Moorhead PS. The Serial Cultivation of Human Diploid Cell Strains. _Experimental Cell Research._ 1961; 25:585-621.

[118] Schmucker DL, Sanchez H. Liver Regeneration and Aging: A Current Perspective. _Current Gerontology and Geriatrics Research._ 2011; 2011.

[119] Ceolotto G, Bevilacqua M, Papparella I, Baritono E, Franco L, Corvaja C, et al. Insulin Generates Free Radicals by an NAD (P) H, Phosphatidylinositol 3′-kinase-Dependent Mechanism in Human Skin Fibroblasts Ex Vivo. _Diabetes._ 2004; 53:1344-51.

[120] Ramis MR, Esteban S, Miralles A, Tan D-X, Reiter RJ. Caloric Restriction, Resveratrol and Melatonin: Role of SIRT1 and Implications for Aging and Related-diseases. _Mechanisms of Ageing and Development._ 2015; 146:28-41.

[121] Armanios M. Telomeres and Age-related Disease: How Telomere Biology Informs Clinical Paradigms. _The Journal of Clinical Investigation._ 2013; 123:996-1002.

[122] Van Deursen JM. The Role of Senescent Cells in Ageing. _Nature._ 2014; 509:439.

[123] Shammas MA. Telomeres, Lifestyle, Cancer, and Aging. _Current Opinion in Clinical Nutrition and Metabolic Care._ 2011; 14:28.

[124] López-Otín C, Blasco MA, Partridge L, Serrano M, Kroemer G. The Hallmarks of Aging. _Cell._ 2013; 153:1194-217.

[125] Zhang X, Mar V, Zhou W, Harrington L, Robinson MO. Telomere Shortening and Apoptosis in Telomerase-inhibited Human Tumor Cells. _Genes and Development._ 1999; 13:2388-99.

[126] Okuda K, Bardeguez A, Gardner JP, Rodriguez P, Ganesh V, Kimura M, et al. Telomere Length in the Newborn. _Pediatric Research._ 2002; 52:377-81.

[127] Cawthon RM, Smith KR, O'Brien E, Sivatchenko A, Kerber RA. Association Between Telomere Length in Blood and Mortality in People Aged 60 Years or Older. _The Lancet._ 2003; 361:393-5.

[128] Sahin E, Colla S, Liesa M, Moslehi J, Müller FL, Guo M, et al. Telomere Dysfunction Induces Metabolic and Mitochondrial Compromise. _Nature._ 2011; 470:359.

[129] Weindruch R, Sohal RS. Caloric Intake and Aging. _New England Journal of Medicine._ 1997; 337:986-94.

[130] Corbyn Z. Want to Live for Ever? Flush Out Your Zombie Cells The Guardian2018.

[131] Martı́nez DE. Mortality Patterns Suggest Lack of Senescence in Hydra. _Experimental Gerontology._ 1998; 33:217-25.

[132] Feldscher K. In Pursuit of Healthy Aging. _The Harvard Gazette_ ; 2017.

[133] Conboy IM, Conboy MJ, Wagers AJ, Girma ER, Weissman IL, Rando TA. Rejuvenation of Aged Progenitor Cells by Exposure to a Young Systemic Environment. _Nature._ 2005; 433:760.

[134] Regalado A. Blood from Old Mice Makes Young Mice Decrepit. _MIT Technology Review_ ; 2016.

[135] WideCells. How Umbilical Cord Tissue Stem Cell Treatment Helped Mel Gibson's Father Regain a New 'Lease of Life' at 92. _WideCells._ 2018.

[136] Iwakiri R, Gotoh Y, Noda T, Sugihara H, Fujimoto K, Fuseler J, et al. Programmed Cell Death in Rat Intestine: Effect of Feeding and Fasting. _Scandinavian Journal of Gastroenterology._ 2001; 36:39-47.

[137] Tajes M, Gutierrez-Cuesta J, Folch J, Ortuño-Sahagun D, Verdaguer E, Jiménez A, et al. Neuroprotective Role of Intermittent Fasting in Senescence-accelerated Mice P8 (SAMP8). _Experimental Gerontology._ 2010; 45:702-10.

[138] Sogawa H, Kubo C. Influence of Short-term Repeated Fasting on the Longevity of Female (NZB× NZW) F1 Mice. _Mechanisms of Ageing and Development._ 2000; 115:61-71.

[139] Goodrick C, Ingram D, Reynolds M, Freeman J, Cider N. Effects of Intermittent Feeding upon Body Weight and Lifespan in Inbred Mice: Interaction of Genotype and Age. _Mechanisms of Ageing and Development._ 1990; 55:69-87.

[140] Azzu V, Valencak TG. Energy Metabolism and Ageing in the Mouse: A Mini-review. _Gerontology._ 2017; 63:327-36.

[141] Fontana L, Partridge L, Longo VD. Dietary Restriction, Growth Factors and Aging: From Yeast to Humans. _Science._ 2010; 328:321-6.

[142] Goodrick CL, Ingram DK, Reynolds MA, Freeman JR, Cider NL. Differential Effects of Intermittent Feeding and Voluntary Exercise on Body Weight and Lifespan in Adult Rats. _Journal of Gerontology._ 1983; 38:36-45.

[143] McCay CM, Crowell MF, Maynard LA. The Effect of Retarded Growth upon the Length of Life Span and upon the Ultimate Body Size: One Figure. _The Journal of Nutrition._ 1935; 10:63-79.

[144] Gehrig Jr JJ, Ross J, Jamison RL. Effect of Long-term, Alternate Day Feeding on Renal Function in Aging Conscious Rats. _Kidney International._ 1988; 34:620-30.

[145] Tikoo K, Tripathi DN, Kabra DG, Sharma V, Gaikwad AB. Intermittent Fasting Prevents the Progression of Type I Diabetic Nephropathy in Rats and Changes the Expression of Sir2 and P53. _FEBS Letters._ 2007; 581:1071-8.

[146] Han Y-m, Bedarida T, Ding Y, Somba BK, Lu Q, Wang Q, et al. β-Hydroxybutyrate Prevents Vascular Senescence through hnRNP A1-Mediated Upregulation of Oct4. _Molecular Cell._ 2018; 71:1064-78. e5.

[147] Honjoh S, Yamamoto T, Uno M, Nishida E. Signalling through RHEB-1 Mediates Intermittent Fasting-induced Longevity in C. Elegans. _Nature._ 2009; 457:726.

[148] Weir HJ, Yao P, Huynh FK, Escoubas CC, Goncalves RL, Burkewitz K, et al. Dietary Restriction and AMPK Increase Lifespan Via Mitochondrial Network and Peroxisome Remodeling. _Cell Metabolism._ 2017; 26:884-96. e5.

[149] Yousef H, Czupalla CJ, Lee D, Chen MB, Burke AN, Zera KA, et al. Aged Blood Impairs Hippocampal Neural Precursor Activity and Activates Microglia via Brain Endothelial Cell VCAM1. _Nature Medicine._ 2019:1.

[150] Shin D, Shin J, Lee KW. Effects of Inflammation and Depression on Telomere Length in Young Adults in the United States. _Journal of Clinical Medicine._ 2019; 8:711.

[151] Sanders NK. The Epic Of Gilgamesh. _Assyrian International News Agency_.

[152] Beevers CS, Li F, Liu L, Huang S. Curcumin Inhibits the Mammalian Target of Rapamycin‐mediated Signaling Pathways in Cancer Cells. _International Journal of Cancer._ 2006; 119:757-64.

[153] Gomes AP, Price NL, Ling AJ, Moslehi JJ, Montgomery MK, Rajman L, et al. Declining NAD+ Induces a Pseudohypoxic State Disrupting Nuclear-mitochondrial Communication during Aging. _Cell._ 2013; 155:1624-38.

[154] Houtkooper RH, Auwerx J. Exploring the Therapeutic Space around NAD+. _Journal of Cell Biology_ ; 2012. p. 205-9.

[155] Fang EF, Kassahun H, Croteau DL, Scheibye-Knudsen M, Marosi K, Lu H, et al. NAD+ Replenishment Improves Lifespan and Healthspan in Ataxia Telangiectasia Models via Mitophagy and DNA Repair. _Cell Metabolism._ 2016; 24:566-81.

[156] Manasa M, Sridevi V, Chandana Lakshmi M, Dedeepya J. A Review on Hyaluronic Acid. _International Journal of Research in Chemistry and Environment._ 2012; 2.

[157] Capelli G, Cysewski G. _The Worlds' Best Kept Health Secret Natural Astaxanthin._ Kailua-Kona, HI: Cyanotech Corporation; 2013.

[158] Das SK, Roberts SB, McCrory MA, Hsu LG, Shikora SA, Kehayias JJ, et al. Long-term Changes in Energy Expenditure and Body Composition after Massive Weight Loss Induced by Gastric Bypass Surgery. _The American Journal of Clinical Nutrition._ 2003; 78:22-30.

[159] O'Callaghan T. Why are Foreigners Coming to Russia to Starve Themselves? : _Russia Beyond_.

[160] Gunnars K. Grass-Fed vs. Grain-Fed Beef - What's the Difference? : _Healthline_ ; 2018.

[161] Ames BN, Profet M, Gold LS. Dietary Pesticides (99.99% All Natural). _Proceedings of the National Academy of Sciences._ 1990; 87:7777-81.

[162] Boffetta P, Couto E, Wichmann J, Ferrari P, Trichopoulos D, Bueno-de-Mesquita HB, et al. Fruit and Vegetable Intake and Overall Cancer Risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). _Journal of the National Cancer Institute._ 2010; 102:529-37.

[163] Gunnars K. Why Modern Wheat Is Worse Than Older Wheat. _Healthline_ ; 2014.

[164] Holt S, Miller J, Petocz P. An Insulin Index of Foods: The Insulin Demand Generated by 1000-kJ Portions of Common Foods. _The American Journal of Clinical Nutrition._ 1997; 66:1264-76.

[165] Fothergill E, Guo J, Howard L, Kerns JC, Knuth ND, Brychta R, et al. Persistent Metabolic Adaptation 6 Years After "The Biggest Loser" Competition. _Obesity._ 2016; 24:1612-9.

[166] Smith MW. Why Am I Losing My Hair? : _WebMD_ ; 2017.

[167] Hadland SE, Levy S. Objective Testing: Urine and Other Drug Tests. _Child and Adolescent Psychiatric Clinics._ 2016; 25:549-65.

[168] Joseph PG. Serotonergic and Tryptaminergic Overstimulation on Refeeding Implicated in "Enlightenment" Experiences. _Medical Hypotheses._ 2012; 79:598-601.

[169] Hazzard L. _Fasting for the cure of disease._ New York City: Physical Culture Publishing Company; 1908.

[170] Hazzard L. _Scientific Fasting: The Ancient and Modern Key to Health_ New York City: Grant Publications Inc; 1927.

[171] Shea M. Why No One Does Juice Cleanses Anymore. _New York Post_ ; 2018.

[172] Donatelli J. The 5 Stages of a Juice Fast. _Livestrong.com_ ; 2017.

[173] Boschmann M, Steiniger J, Hille U, Tank J, Adams F, Sharma AM, et al. Water-induced Thermogenesis. _The Journal of Clinical Endocrinology & Metabolism._ 2003; 88:6015-9.

[174] Solianik R, Sujeta A, Terentjevienė A, Skurvydas A. Effect of 48h Fasting on Autonomic Function, Brain Activity, Cognition, and Mood in Amateur Weight Lifters. _BioMed Research International._ 2016; 2016:1-8.

[175] Frecka JM, Mattes RD. Possible Entrainment of Ghrelin to Habitual Meal Patterns in Humans. _American Journal of Physiology-Gastrointestinal and Liver Physiology._ 2008; 294:G699-G707.

[176] Johnstone A, Faber P, Gibney E, Elia M, Horgan G, Golden B, et al. Effect of an Acute Fast on Energy Compensation and Feeding Behaviour in Lean Men and Women. _International Journal of Obesity._ 2002; 26:1623.

[177] Choi IY, Piccio L, Childress P, Bollman B, Ghosh A, Brandhorst S, et al. A Diet Mimicking Fasting Promotes Regeneration and Reduces Autoimmunity and Multiple Sclerosis Symptoms. _Cell Reports._ 2016; 15:2136-46.

[178] Papagiannopoulos IA, Sideris VI, Boschmann M, Koutsoni OS, Dotsika EN. Anthropometric, Hemodynamic, Metabolic, and Renal Responses during 5 Days of Food and Water Deprivation. _Complementary Medicine Research._ 2013; 20:427-33.

[179] Gustin A. Dry Fasting: The Truth About This New Health Industry Trend. _Perfect Keto_ ; 2018.

[180] Meckel Y, Ismaeel A, Eliakim A. The Effect of the Ramadan Fast on Physical Performance and Dietary Habits in Adolescent Soccer Players. _European Journal of Applied Physiology._ 2008; 102:651-7.

[181] Davis CP. Dehydration (Adults). _WebMD_ ; 2018.

[182] Tey S, Salleh N, Henry J, Forde C. Effects of Aspartame-, Monk Fruit-, Stevia-and Sucrose-sweetened Beverages on Postprandial Glucose, Insulin and Energy Intake. _International Journal of Obesity._ 2017; 41:450.

[183] Agricultural Research Service. USDA Food Composition Databases In: United States Department of Agriculture, editor.2018.

[184] Caffeine Informer. 20+ Good Health Reasons To Drink Coffee. 2018.

[185] Van Dam RM, Feskens EJ. Coffee Consumption and Risk of Type 2 Diabetes Mellitus. _The Lancet._ 2002; 360:1477-8.

[186] Cerniuc C, Fischer T, Baumeister A, Bordewick-Dell U. Impact of Intermittent Fasting (5: 2) on Ketone Body Production in Healthy Female Subjects. _Ernahrungs Umschau._ 2019; 66:2-9.

[187] West H. How Artificial Sweeteners Affect Blood Sugar and Insulin. _Healthline_ ; 2017.

[188] Tea People. Types of Tea. _Tea People Limited_ ; 2013.

[189] Cox L. Spirulina: Nutrition Facts & Health Benefits. _Live Science_ ; 2018.

[190] Targher G, Alberiche M, Zenere MB, Bonadonna RC, Muggeo M, Bonora E. Cigarette Smoking and Insulin Resistance in Patients with Noninsulin-dependent Diabetes Mellitus. _The Journal of Clinical Endocrinology & Metabolism._ 1997; 82:3619-24.

[191] Kubala J. The Keto Flu: Symptoms and How to Get Rid of It. _Healthline_ ; 2018.

[192] Calorie King. Food Search. _Calorie King Wellness Solutions_ ; 2018.

[193] LaFountain RA, Miller VJ, Barnhart EC, Hyde PN, Crabtree CD, McSwiney FT, et al. Extended Ketogenic Diet and Physical Training Intervention in Military Personnel. _Military Medicine._ 2019.

[194] Nelson GJ, Schmidt PC, Kelley DS. Low-fat Diets Do Not Lower Plasma Cholesterol Levels in Healthy Men Compared to High-fat Diets with Similar Fatty Acid Composition at Constant Caloric Intake. _Lipids._ 1995; 30:969-76.

[195] Bray GA. Fructose: Pure, White, and Deadly? Fructose, by Any Other Name, Is a Health Hazard. _Journal of Diabetes Science and Technology._ 2010; 4:1003-7.

[196] Loria K. A Strange Diet Is Designed to Slow Aging by Mimicking Fasting - Here's How It Works and What People Eat. _Business Insider Malaysia_ ; 2018.

[197] Brandhorst S, Choi IY, Wei M, Cheng CW, Sedrakyan S, Navarrete G, et al. A Periodic Diet That Mimics Fasting Promotes Multi-system Regeneration, Enhanced Cognitive Performance, and Healthspan. _Cell Metabolism._ 2015; 22:86-99.

[198] Mowll B. What Is The Fasting Mimicking Diet? : _Drmowll.com_ ; 2018.

[199] Kim J. Intermittent Fasting: The Complete Guide. _Hack Your Fitness_ ; 2016.

[200] Robinson C. Getting Started. _The Snake Diet_.

[201] Biswas C. The One Meal A Day Diet (OMAD Diet) – How It Works, Health Benefits, And Safety. _Stylecraze_ ; 2018.

[202] Horton B. Intermittent Fasting Made Easy. _The Blake Diet_ ; 2018.

[203] Bray GA. Medical Consequences of Obesity. _The Journal of Clinical Endocrinology & Metabolism._ 2004; 89:2583-9.

[204] Redman LM, Ravussin E. Caloric Restriction in Humans: Impact on Physiological, Psychological, and Behavioral Outcomes. _Antioxidants & Redox Signaling._ 2011; 14:275-87.

[205] Fildes A, Charlton J, Rudisill C, Littlejohns P, Prevost AT, Gulliford MC. Probability of an Obese Person Attaining Normal Body Weight: Cohort Study Using Electronic Health Records. _American Journal of Public Health._ 2015; 105:e54-e9.

[206] National Center for Health Statistics. Prevalence of Overweight, Obesity, and Severe Obesity Among Adults Aged 20 and Over: United States, 1960–1962 Through 2015–2016. _Centers for Disease Control and Prevention,_ ; 2018.

[207] Centers for Disease Control and Prevention. Nutrition, Physical Activity, and Obesity: Data, Trends and Maps 2018.

[208] Brillat-Savarin JA. The Physiology of Taste: Or Meditations on Transcendental Gastronomy, trans. _MFK Fisher, New York, Everyman's Library._ 1825.

[209] Yudkin J. _Pure, White and Deadly._ Penguin Random House UK; 1986.

[210] Bellisle F, McDevitt R, Prentice AM. Meal Frequency and Energy Balance. _British Journal of Nutrition._ 1997; 77:S57-S70.

[211] Verboeket-Van De Venne WP, Westerterp KR, Kester AD. Effect of the Pattern of Food Intake on Human Energy Metabolism. _British Journal of Nutrition._ 1993; 70:103-15.

[212] Tremaroli V, Bäckhed F. Functional Interactions between the Gut Mcrobiota and Hst Mtabolism. _Nature._ 2012; 489:242.

[213] Clemente JC, Ursell LK, Parfrey LW, Knight R. The Impact of the Gut Microbiota on Human Health: An Integrative View. _Cell._ 2012; 148:1258-70.

[214] Varady K. Intermittent Versus Daily Calorie Restriction: Which Diet Regimen is More Effective for Weight Loss? _Obesity Reviews._ 2011; 12:e593-e601.

[215] Gunnars K. Protein Intake – How Much Protein Should You Eat Per Day? : _Healthline_ ; 2018.

[216] Harvard Health Publishing. Listing of Vitamins. In: School HM, editor.2009.

[217] Del Corral P, Chandler-Laney PC, Casazza K, Gower BA, Hunter GR. Effect of Dietary Adherence with or without Exercise on Weight Loss: A Mechanistic Approach to a Global Problem. _The Journal of Clinical Endocrinology & Metabolism._ 2009; 94:1602-7.

[218] Segal B. Heart Attacks at 50 Years Old. _Focus for Health_ ; 2016.

[219] Dixon JB, O'Brien PE, Playfair J, Chapman L, Schachter LM, Skinner S, et al. Adjustable Gastric Banding and Conventional Therapy for Type 2 Diabetes: A Randomized Controlled Trial. _Jama._ 2008; 299:316-23.

[220] Lingvay I, Guth E, Islam A, Livingston E. Rapid Improvement of Diabetes after Gastric Bypass Surgery: Is It the Diet or Surgery? _Diabetes Care._ 2013:DC_122316.

[221] Web MD. Paying for Weight Loss Surgery. 2018.

[222] CostHelper. Heart Bypass Surgery Cost. _CostHelper Inc_ ; 2018.

[223] Bean M. 10 Most Popular Prescription Drugs for 2017. _Becker's Hospital Review_ ; 2017.

[224] Media Relations. New CDC Report: More Than 100 Million Americans Have Diabetes or Prediabetes. _Centers for Disease Control and Prevention_ 2017.

[225] Konish L. You May Want to Rethink This Strategy for Claiming Social Security Early. _CNBC_ ; 2018.

[226] Munro D. U.S. Healthcare Hits $3 Trillion. _Forbes_ ; 2012.

[227] Lieberman HR, Caruso CM, Niro PJ, Adam GE, Kellogg MD, Nindl BC, et al. A Double-blind, Placebo-controlled Test of 2 D of Calorie Deprivation: Effects on Cognition, Activity, Sleep, and Interstitial Glucose Concentrations. _The American Journal of Clinical Nutrition._ 2008; 88:667-76.

[228] Woodfield J. The Story of Angus Barbieri, Who Went 382 Days Without Eating. _Diabetes.co.uk_ ; 2018.

[229] Stewart W, Fleming LW. Features of a Successful Therapeutic Fast of 382 Days' Duration. _Postgraduate Medical Journal._ 1973; 49:203-9.

[230] Medical Bag. The Origins of Soda. _Medical Bag_ ; 2014.

