Fasting – is that what you’re really doing?


Run a search on the word “fasting” and you will undoubtedly get back hundreds of results, most of which will lead you to websites loaded with a mix of information ranging from half truths to excursions into the absurd.  So, what’s the deal with fasting?  Is it good, bad, or somewhere in between?

The fasting state

Abstinence from food for 18 to 48 hours is called the “fasting state” (1). During the fasting state, glycogen (stored carbohydrate) is depleted and amino acids from muscle protein break down to provide fuel for gluconeogenesis (production of glucose by the liver in the absence of carbohydrate intake) and the body enters a state of ketosis.  (If you thought only low carb diets promoted ketosis, you may want to look at fasting and starvation as something a bit more extreme than low-carb, in that they are both “no-carb”.) Large amounts of nitrogen are lost through urine to keep up with the body’s high rate of muscle protein breakdown and glucose synthesis by the liver (1).

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The starvation state

Abstinence from food for more than 48 hours is called the “starvation state” (1).  While a 24 hour fast is generally a good idea every now and then, starving oneself is not.  So, to be clear:  if you’re abstaining from food for more than 48 hours you are not fasting – you are starving your body of important nutrients.

When fasting turns into starvation, fat stores become the main suppliers of energy as the body tries to hang on to important proteins (enzymes, antibodies, hemoglobin).  Fatty acid levels in the blood increase sharply and the brain and skeletal muscles adapt to using ketones for energy.  The more fat deposits a person has, the longer s/he can survive – in theory.  In practice, the detrimental effects of starvation on the immune system leave people susceptible to infections which, in the absence of protein in the diet, can lead to death.

Purposeful starvation

Most people undertaking a fast, do so for more than 48 hours, which means they are actually engaging in starvation.  On purpose.  I don’t know how long such people keep up this feat, but I suspect most do not run out of fat stores by the time they start eating again.  Thus, they are in no danger of starving to death.  However, there are side effects to starving oneself.

Fasting and starvation rob the body of essential amino acids (EAA), essential fatty acids (EFA), and essential vitamins and minerals (1).  They’re called “essential” for a reason.  We can not produce them ourselves, so, we must get them from food.  If you think you can overcome this problem by juicing while you’re abstaining from food, I hope to relieve you of such fantasies in the next sections.

Juicing

Juicing entails the removal of pulp and nutrient rich skins from fruits and vegetables. As a result, some essential vitamins and minerals, as well as most of the fibre are lost.  This is no big deal if you enjoy the products of juicing as part of an adequate diet, but if you are relying on juice to get you all the nutrients your body needs as you forego solid foods, you are far from reaching your goal.

Protein intake is significantly limited, meaning you’re very likely to experience the side effects of continuously robbing your body of essential amino acids.  I use the word “likely” because, in theory, if you consume enough juice, you will eventually meet your EAA needs.  In practice, this is virtually impossible, since the amount of juice needed would be of astronomical proportions.  Limiting amino acids, particularly lysine, methionine and tryptophan would keep your body from producing adequate amounts of proteins (antibodies, enzymes, hormones, etc.).  The longer you keep it up, the longer your body has to make do with robbing muscles of their proteins to compensate for self-imposed limitations.

Leptin

Our stomachs and adipose cells under the skin secrete a hormone called leptin.  Its job is to keep track of how much fat we store and to suppress appetite after eating by stimulating the release of melanocyte stimulating hormone (MHS) (1).  In addition, leptin alters immune system function.  Fasting decreases basal leptin levels in the body.  Since inducing starvation in human subjects is considered unethical, we can only extrapolate what happens to starving people based on animal models and the study of malnourished persons or those suffering from eating disorders such as anorexia nervosa (2,3).  The effects of leptin imbalances during fasting and starvation are visible in as little as two days in animal models, with immune system suppression occurring at just 48 hours (4).  It should come as no surprise if, during a bout of starvation (water “fasts”) or adhering to a liquid diet yielding inadequate essential nutrients (particularly protein), people succumb to viral, bacterial or fungal infections, among other things.  All it takes is to be in the right place at the right time (in other words, exposure).

Other stuff

In a surprising turn of events, researchers in Israel found that some of their initially obese test subjects, who had no prior diabetic symptoms, developed diabetes after a course of very low calorie dieting (5).  This may have been the result of insulin resistance which usually occurs during early stages of starvation.  The subjects were not starving, but the low caloric intake may have mimicked starvation enough to lead to insulin resistance.

One day fasts and alternate day fasting

This I can support.  There is a fair amount of evidence that one day fasts and alternate day fasting have a number of benefits ranging from weight loss and maintenance to decreased risk of some cancers and cardiovascular disease (see my post on caloric restriction).  Although the most likely to be beneficial, alternate day fasting is the toughest of the two in terms of adherence.  Most people get tired of it within a week or two, many much sooner.  Alternate day fasting results in lowered caloric intake which, as I mentioned in a previous post, has been linked to higher quality of life and possibly longevity.

Finally…

If you’re abstaining from food for more than two days, you are not fasting. You are starving.  I suggest you stop.  If you are engaging in one day fasts or alternate day fasts, more power to you.  If you think juicing while fasting or starving is enough to keep all bodily functions operating properly, you are kidding yourself.  Juicing is the equivalent of a very low calorie diet which is to say, you’re not getting essential nutrients and you’re setting yourself up for infections, weight re-gain after the regimen is over and possibly other issues not readily visible.

I did not touch on the claim that fasts of any kind or starvation of any length act as a way to detoxify the body or liver because I already covered it here.

References

  1. Gropper SS, Smith JL, Groff JL.  Advanced Nutrition and Human Metabolism, 5th Ed. CA: Wadsworth; 2009.
  2. Marcos A, Varela P, Toro O, Lopez I, Nova E, Madruga D, Casas J, Morande G.  Interactions between nutrition and immunity in anorexia nervosa: a 1 year follow-up study.  Am J Clin Nutr, 1997;66(2):485S-490S.
  3. Lord GM, Matarese G, Howard JK, Baker RJ, Bloom SR, Lechler RI. Leptin modulates the T-cell immune response and reverses starvation-induced immunosuppression. Nature 1998;394:897–901.
  4. Faggioni R, Moser A, Feingold KR, Grunfeld C. Reduced leptin levels in starvation increase susceptibility to endotoxic shock. Am J Pathol, 2000;156(5): 1781-1787.
  5. Koffler M, Kisch ES.  Starvation diet and very low calorie diets may induce insulin resistance and overt diabetes mellitus. J Diabetes Complications, 1996;10(2):109-12.
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To spit or not to spit…


Candida albicans is a fungus which, along with thousands of other species of fungi and bacteria, lives symbiotically within the human body (1).  Proper Th1 (a type of lymphocyte) response of the immune system keeps its numbers in check as it goes about its daily business rendering it virtually incapable of producing infection or disease in the healthy host (1).  In immune suppressed persons, such as HIV patients or persons taking immunosuppressant medications, invasive growth may occur.

Candidal infections usually take over warm and moist areas of the body such as underarms, oral and genital areas.  Itching and irritation accompanied by rashes, blisters or painful cracks in the corners of the mouth (in the case of oral thrush), as well as discharge that resembles cottage cheese (in the case of vaginal infection) are the most common signs (2).  In rare cases, usually as a result of significantly depressed immune system function, the infection may spread to other areas of the body, and can affect the organs and blood (2). In such cases, symptoms are more severe, usually painful, with or without fever, and, if the infection is in the blood and spreads to the brain it can cause significant disruptions in mental function. Infections of this magnitude are usually life threatening (2).

Candidiasis affecting the skin, oral and/or genital cavities is treated with over the counter or prescription medications for a few days or a couple of weeks, whereas, infections affecting organs and the blood require hospitalization and intravenous medications as they can be fatal.

Infections affecting organs and the blood (aka “systemic infections”) occur primarily in hospital settings among patients undergoing immune system suppression (usually in the wake of transplant surgery or auto-immune disease/disorder treatment) (3).  The infection tends to recur several times during the first six months following surgery or immune system suppression treatment (4).  Its signs and symptoms are generally severe and require aggressive interventions.   Even so, death occurs in more than 1 out of 2 infected patients (3).  The good news is that infection rates hover around 2.9 per 100,000 people in Canada and anywhere between 6 and 10 per 100,000 people in the USA (depending on geographical region studied), making systemic candidiasis infections relatively rare (3).

ALTERNATIVE MEDICINE TAKE ON THIS

A surprising number of websites and their authors (who often also publish books on the subject or sell their own brands of remedies) may tell you that C. albicans is the leading cause of afflictions too many to list here, ranging from general fatigue and brain fog to asthma and obesity.  It takes over the body, organs, and blood, they claim, but keeps its population in check somehow, thus, remaining undetected by conventional methods, because, they say, physicians do not, or pretend to not, have the necessary technology.  However, they tell us that if we spit in a glass of water and watch what the saliva does over the course of 20 minutes, we can detect the infection ourselves. Of course, everyone’s saliva is going to do something similar (or exactly the same) to what is described in this so-called “test”, rendering it less than useless.

Whatever your symptoms, C. albicans is generally considered to be the main culprit and changing your diet (which almost always includes taking whatever supplement the website author is peddling) is the remedy of choice.  Science based medicine is often seen as having an agenda that keeps it from diagnosing and treating the infection.  Assuming the diagnosis and treatment would involve trading money for services / tests / medications rendered, this agenda must involve something far more valuable than mere dollars.  Whatever it is, its value exceeds the potential windfall that treating nearly 90% of the population (the number of people afflicted by C. albicans systemic infection, according to the “treatment” promoting websites – a far cry from the less than 0.0003% actually documented by the Canadian Journal of Infectious Diseases) would provide (3).

REALITY CHECK

C. albicans, in the absence of a normal immune system response, will do what any pathogen will do:  it will spread relatively quickly until something stops it.  That something is usually medical intervention that restores immune system function and/or attacks the fungus itself.  When no intervention takes place, infection spreads unchecked and death soon occurs.  This process does not take years- or decades-worth of suffering from nebulous afflictions.  An out of control infection acts relatively quickly, its signs and symptoms don’t beat around the bush, and even with the best of care and prompt intervention, odds of survival are not good.

REFERENCES

  1. Kosonen J, Rantala A, Little CH, Lintu P, Harjamaki PR, Georgiou GM, Cone RE, Savolainen J.  Increased levels of Candida albicans Mannan-specific T-cell-derived antigen binding molecules in patients with invasive candidiasis. Clinical and Vaccine Immunology, 2006;13(4):467-474.
  2. Molero G, Diez-Orejas R, Navarro-Garcia F, Monteoliva L, Pla J, Gil C, Sanchez-Perez M, Nombela C.  Candida albicans: genetics, dimorphism and pathoginicity. Internatl Microbiol,  1998;1:95-106.
  3. Bow EJ, Evans G, Fuller J, et al.  Canadian clinical practice guidelines for invasive candidiasis in adults. Can J Infect Dis Med Microbiol, 2010;21(4):e122-e150.
  4. Danovich GM, Handbook of Kidney Transplantation, Philadelphia, PA: Lippincott Williams & Wilkins; 2010:269.

Do detox plans work?


Short answer? No.

“But I feel better after a detox!” you might say.

Of course you do. You’ve avoided junk food and other unhealthy foods for several days or weeks. Your body is thrilled. This does not mean you’ve rid yourself of unwanted substances.

Detox claims

Various so-called “detox” products and diets claim to accomplish many different things (sometimes all at once), the most common of which tend to revolve around boosting the immune system, increasing energy, and/or promoting weight loss. The one claim they all have in common, as evidenced by the presence of the words “detox” and/or “cleanse” in their selected names, is that such diets or products will rid your body of some (or all) toxins that have accumulated in various tissues over the years.

The product being touted, be it a pill, shake, drink, diet, skin pad, or electronic contraption, is supposed to locate the silent killers in your body and escort them out via urine, faeces, or sweat. Together, these products and services amount to a multibillion dollar industry worldwide that dupes people into spending money that would be better spent on learning how to eat healthy, well rounded diets and engaging in more physical activities on a regular basis.

Dosage

We inhale, ingest, and absorb (through the skin) hundreds of different chemicals every day. Whether or not these chemicals are toxic to us depends on dosage, either at the time of exposure, or after years of accumulation in the body. I can’t stress this point enough: dosage is everything and any chemical, natural or man made, from ascorbic acid to zinc, can be toxic if enough of it is absorbed or accumulated. Heck, water can kill you if you drink too much at once.

It is very unlikely that any food item purchased in industrialized nations such as the US and Canada contains toxic doses of any chemical given that our food supply is fairly well controlled. Sure, there may be a mishap now and then, but this is the exception, not the rule. Thus, it is the slow accumulation of small amounts of unwanted chemicals in the body that detox and cleansing programs usually target, but fail to actually remove.

What happens to all the unwanted stuff we take in?

Except in cases of overdose (poisoning), harmful chemicals are usually blocked from harming the body by natural barriers such as the gastrointestinal (GI) system, lungs, and skin (1). Those which sometimes break through these barriers are excreted with the help of the liver, kidneys, and lymphatic system (more than half the tissue of which surrounds the digestive tract)(1). These systems work together to eliminate threats to the body and do a great job of it in the absence of disease – if cirrhosis is present, for example, the liver will have a hard time doing its job. Thus, unless you have been diagnosed with something which directly involves these systems, most substances that pose a threat to your health will be eliminated with or without any added help (1).

Although some of the chemicals commonly used to control pests in our food supply stick around the body for a while, they generally do so in insignificant doses, or for less time than it is necessary for them to cause significant harm. There are some exceptions, of course, such as persistent organic pollutants (POPs). You may have heard of POPs as the “dirty dozen”. These include DDT and other chemicals that were predominantly used in manufacturing of various items, as well as in food production (particularly as pesticides), a few decades ago when we didn’t know any better. Their use has been outlawed in most countries, with some limited use (such as the use of DDT to fight malaria) still allowed in certain circumstances. Although they are no longer in use today, they are still around in our environment, left over from their heyday. If present in your body, no diet, shake, pill, foot pad, foot bath, colon irrigation, or any other means of so-called “detoxification” method is going to help you rid yourself of them. You simply have to wait them out and hope they aren’t doing too much damage while they’re camping out in your body. Most will, eventually, surpass their respective points of half-life and begin to slowly disappear on their own before you do.

If you are concerned about the presence of pesticides, herbicides, fungicides, fumigants, hormonal growth promoters, anthelmintics (used to control internal parasites in farm animals), and antibiotics in your food, then, a change in mind-set is needed: rather than looking for ways to “cleanse” yourself of these things, look, instead, for ways to avoid exposure to them in the first place. If you smoke and agree that smoking is bad for your health, do you look for things that can help your lungs cope with your habit, or do you concentrate instead on ways to help yourself quit smoking?

Which foods contain the most unwanted substances?

Animal foods. If you’re veg*an, you have very little to worry about since the amount of unwanted chemicals you ingest by consuming non-organic, conventional plant foods pales in comparison to what you would be ingesting if you were eating animals.

Animals are higher on the food chain than plants and their products. The higher up the food chain we go, the higher the concentrations of unwanted substances we find. For instance, predatory fish (i.e. tuna, salmon, sword fish) have higher concentrations of mercury in their flesh than plant eaters (i.e. sardines). Such harmful substances accumulate primarily in muscle tissue and organs (some set up camp in fatty tissues). The less animals you eat, the less likely it is you will ingest and accumulate questionable chemicals in meaningful amounts. Of course, regardless of dietary choices, we must still breathe and live surrounded by plastics and other man made materials, so, resistance to exposure is… well… futile.

What about the sludge sticking to the inside of my intestines? Will diet or colonic irrigation get rid of that?

There is no sludge. I will happily state otherwise (and eat my husband’s hat) if anyone can show me footage from a colonoscopy that shows this sludge hanging out inside the colon or anywhere else in the GI tract for that matter.

How can I boost or stimulate my liver, kidneys, lymphatic system?

You can’t. You can avoid taxing them unnecessarily (for instance, don’t drink alcohol to excess), but you can’t “boost” them into performing beyond their limitations. If their performance is diminished, medical intervention is very likely needed, since this implies something is wrong (kidney disease, liver disease).

Bottom line

Don’t waste your money and don’t torture yourself with bad tasting concoctions or invasive and uncomfortable procedures. Your body “detoxes” itself just fine and the stuff it can’t get rid of on its own is not going to be removed by special diets, products, or visits to the local colonic irrigation shop. Avoid exposure within reason, eat less, or no animal products, and save the stress for things that truly are worth worrying about… like healthcare reform.

References

  1. Mahan LK, Escott-Stump S. Krause’s Food and Nutrition Therapy. MO: Saunders-Elsevier; 2008.
  2. Lasky T, Sun W, Kadry A, Hoffman MK. Mean total arsenic concentrations in chicken 1989 – 2000 and estimated exposures for consumers of chicken. Environmental Health Perspectives, 2004:112(1):18-21.
  3. Leeman WR, Van Den Berg KJ, Houben GF. Transfer of chemicals from feed to animal products: the use of transfer factors in risk assessment. Food Additives and Contaminants, 2007:24(1):1-13.