THE POWER OF FASTING TO OPTIMIZE MITOCHONDRIAL HEALTH
In previous sections of this book I have thoroughly covered how foods can optimally support your mitochondria and dramatically improve your health. But eating even the best health-promoting foods is only half the equation when it comes to taking care of your health in general and your mitochondria in particular.
By focusing too much on what foods to eat, we forget that eating has a natural and powerful counterbalance, which is not eating.
Everything in nature has two sides: darkness and light, activity and rest, hot and cold. Fasting is the flip side of eating—as Dr. Jason Fung, the co-author of The Complete Guide to Fasting and The Obesity Code calls it—and fasting plays a vitally important role in allowing your body to function at its best.
Why? Because your body simply isn’t designed to run optimally when it is continuously fed.
If regularly going without food were detrimental to human health, we certainly wouldn’t have survived, let alone flourished as a species. Humans have evolved to not only withstand extended periods where food isn’t available, but to thrive because they didn’t have continuous access to food as many of us now do in the 21st century.
Yet this isn’t what we’ve been led to believe. The media, conventional medicine, and the food industry have drilled it into us that we need to eat all day long. These statements have been repeated so often that we’ve come to believe that they’re true: breakfast is the most important meal of the day; you need to eat three square meals plus snacks to keep your metabolism high; eating a snack before bedtime helps you sleep.
But we haven’t always lived with food available 24/7. As Fung describes fasting in The Complete Guide to Fasting, “Fasting is the oldest dietary intervention in the world. It is not just the latest and greatest, but the tried and true.”
WATER OR FAT FASTING
At the present time more than two out of three adults in our population are overweight or obese,1 and that number is steadily climbing. This tragedy is also ravaging the health of our children. It makes perfect sense for those who are overweight to consider an extended fast. Periods of fasting can range from a few days to a few weeks. Not only will this simplify the program for most people, but it will also rapidly accelerate the transition to fat burning and immediately begin to improve metabolic pathways that address the fundamental causes of many health challenges. Hunger pangs and cravings can be a challenge on days two and three, but after that the cravings tend to dramatically decrease.
Being adapted to burning fat before even starting a well-designed nutritional ketosis plan may even improve your implementation because by the time you start, you’ll have passed the point where hunger and cravings can undermine your efforts. An interesting alternative that may make the process even easier is to consume healthy fats while keeping carbs and protein under 5 grams of each per day. Since carbs and protein are really the only macronutrients that activate mTOR, insulin, leptin, and IGF-1, by virtually eliminating them you can obtain most of the benefits of water fasting yet not experience the typical loss of energy. Examples of fats you can use are healthy pastured butter, coconut oil, and MCT oil in a hot beverage of tea or coffee. You can add naturally processed stevia to make the drink more palatable, although most people following this type of diet no longer crave sweet. Most find this a much easier alternative to water fasting.
Whatever type of fast you choose, water or fat, once you have completed it you will need to transition to foods with low net carbs, low protein, and high-quality fats. This transition is typically much easier in those who have achieved fat burning and nutritional ketosis using these fasts.
If you are interested in implementing this approach or even just intrigued enough to learn more, I strongly encourage you to obtain a copy of The Complete Guide to Fasting. It is a comprehensive guide that will serve as a valuable resource for anyone considering this approach.
Fasting is a ritual that is an integral part of nearly every major religious tradition—Jesus, Buddha, and Muhammad all observed fasts that played a large role in their spiritual transformations. Hippocrates was the father of medicine, and he recommended that overweight people eat only once a day. Benjamin Franklin wrote, “The best of all medicines is resting and fasting.” And even Mark Twain was a fasting proponent, having written, “A little starvation can really do more for the average sick man than can the best medicines and the best doctors.”
It’s only recently that we’ve lost touch with the power of fasting to heal, in large part because it was only within the last century that humans learned to manipulate the food supply through agriculture and long-distance transportation to the point that food became available in abundance 24/7 and all year long. Although there clearly are exceptions, it appears a large part of humanity regularly went through some periods of starvation or famine.
Research reveals that a vast majority of Americans eat all day long2—with as many as 15.5 separate eating events in a typical day. Most also consume a majority of their daily calories late in the evening, which is exactly when your body requires the least amount of energy as calories from food. That’s why I recommend you avoid eating for at least three hours before bedtime—and that includes everyone, no matter what kind of diet you follow or don’t follow. This continuous access to food prevents your body from undergoing the repair and rejuvenation processes that occur during fasting.
THE SURPRISING BENEFITS OF FASTING
Fasting, much like exercise, is a biological stressor that initiates metabolic processes that promote overall health. By reintroducing periods of time without food into your daily life and mimicking the eating habits of your ancestors who did not have access to food around the clock, you can restore your body to a more natural state that allows a whole host of biochemical benefits to occur.
Physiologically, the benefits of fasting include:
A small pilot study evaluated the efficacy of intermittent fasting in reducing weight in humans. In this study, the only dietary change made was restricting eating to a 10- to 12-hour window each day. For the remaining 12 to 14 hours, participants fasted. After four months, those who had fasted daily had lost an average of more than seven pounds. And, while they were not specifically instructed to cut calories, they ended up reducing their daily calories by an average of 20 percent anyway.5
Elevated IGF-1 levels are associated with many cancers, including breast and prostate cancers. Cancer cells have more receptors for this hormone than normal cells, and reducing levels of IGF-1 is associated with reduced cell proliferation in many cancers. Fasting also reduces levels of pro-inflammatory cytokines, small proteins that also have a role in promoting cancer.
Fasting also inhibits the mammalian target of rapamycin (mTOR) pathway, which you may recall from Chapter 3 is an ancient cellular signaling pathway that orchestrates insulin, leptin, and IGF-1 and is ultimately responsible for either growth or repair, depending on whether it is stimulated or inhibited. Inhibiting mTOR is precisely your goal if your intention is to up-regulate maintenance and repair, boost longevity, and reduce your risk for cancer. This means it is a good idea for nearly everyone except bodybuilders or competitive athletes.
Without any intervention, the mice develop dementia in half that time or around 1 year, equivalent to the age of 40 or 50 in humans. And when Mattson put them on a junk food diet, they developed Alzheimer’s disease at around 9 months!
Mattson’s research suggests that alternate-day fasting can boost a protein known as brain-derived neurotrophic factor (BDNF) by anywhere from 50 to 400 percent, depending on the brain region. BDNF activates brain stem cells to convert into new neurons. It also triggers other chemicals that promote neural health and has been shown to protect brain cells from adverse changes associated with Alzheimer’s disease and Parkinson’s disease.7
| A Quick Overview of What Happens in Your Body in a Fed versus a Fasted State | |
|---|---|
| What Happens in the Body When You Eat | What Happens in the Body When You Fast |
| Energy (aka fat) is stored | Energy (aka fat) is burned |
| Insulin rises | Insulin falls |
| Human growth hormone is suppressed | Human growth hormone is released |
| Free radical production is increased | Free radical production goes down |
The only other strategy that has so many research-backed benefits for longevity is long-term calorie restriction, which requires a significant long-term reduction in the amount of food you eat so that you are essentially living on the brink of starvation. As you probably know, compliance with calorie-restricted diets is abysmal. The good news is that there are many ways to fast, and there is likely a form of fasting out there that you will be able to tolerate and incorporate into your life without undue hardship. I’ll cover these options in just a moment. It’s important for you to remember that fasting can provide nearly identical benefits without the pain, suffering, and compliance challenges of calorie restriction.
Instead of regulating how much food you eat, as with long-term calorie restriction, you only need to modify when you eat—and of course wisely choose the foods you do eat. Simply cycling between periods of eating and fasting on a daily, weekly, or monthly schedule has been shown to provide many of the same benefits as long-term calorie restriction. Choosing when to eat and when to fast in this way is known as “intermittent fasting.” As my colleague and fasting advocate Dr. Dan Pompa notes, “Don’t eat less—eat less often.”
A TOUR OF THE DIFFERENT TYPES OF INTERMITTENT FASTING
Intermittent fasting is rapidly gaining in popularity for the simple reason that it works. It does so whether you’re trying to lose excess body fat or improve biomarkers for optimal health. As a general rule, intermittent fasting involves cutting calories, in whole or in part, either a couple of days a month or a week, every other day, or even daily, as in the case of the Peak Fasting regimen, the form of scheduled eating I prefer to use myself.
There are many ways to fast, from consuming nothing but water for two to three days each month to eating a normal amount of calories every day but during a restricted window of time so you still get a good long stretch without food intake during each 24-hour period.
The “right” fast for you is the one you will actually comply with. Here’s a tour through the different options:
For most healthy people I am not an advocate of going without food for any period longer than about 18 hours. However, if you are overweight and have serious health challenges, a medically supervised water fast may be appropriate.
A water fast is just what it sounds like. You consume nothing but water and some minerals for a finite period of time. This type of fast can give you a shorter transition into fat burning because you will rapidly burn through your glycogen stores and push your body to start using fat for energy.
This may be appropriate for you if you have just received a very serious diagnosis, such as brain cancer. But if you are limited by any of the following conditions, consult with your health care team before embarking on this type of fast:
5-Day Fast
This is the approach proposed by Dr. Michael Mosley, author of The Fast Diet. He recommends that you spend five consecutive days of each month on a modified fast. You do not abstain from food entirely during these days. On the first day, you eat about 1,000 to 1,100 calories, followed by 725 calories on the remaining four days. As with all fasting options, the foods you do eat should be low in net carbohydrates and protein, and high in healthy fats.
In one 2015 experiment,8 people who fasted five consecutive days once a month for three consecutive months saw improvements in biomarkers for cell regeneration. Risk factors for diabetes, cancer, cardiovascular disease, and aging also declined.
Beware that it can be quite challenging to go for a full five days with very little food, especially if you’ve never fasted before, so you may want to work your way up slowly to this type of a fast.
1-Day Fast
In this case you skip eating for one day of every week, consuming only water on that day. Your fast should be broken with a regular-sized meal (i.e., avoid eating a meal that is more than 20 percent larger than your typical meal when coming off your fast), and you can maintain your regular exercise program without any special diet recommendations for workout days.
Fasting for 24 hours can be tough for some people, but eating a high-fat, low-carb diet can make a 24-hour fast easier, as a higher-fat diet will tend to normalize your hunger hormones and provide improved satiety for longer periods of time. You can also fast from dinner to dinner, skipping a full 24 hours of eating while still eating each day.
Alternate-Day Fasting
This program is exactly as it sounds: one day off, one day on. On fasting days you restrict your eating to one meal of about 500 calories. On nonfasting days, you can eat normally.
When you include sleeping time, your fast can end up being as long as 32 to 36 hours. According to Krista Varady, Ph.D., author of The Every-Other-Day Diet, alternate-day fasting can help you lose up to two pounds of body fat per week.
Another benefit to alternate-day fasting is that your body tends to adapt to the regularity of the program, whereas the randomness of the 5:2 plan can be more difficult to adjust to.9 In clinical trials, about 90 percent of participants were able to stick to alternate-day fasting, whereas the other 10 percent dropped out within the first two weeks.
I should note that I am not a fan of this type of fasting. I believe there are far better approaches with higher compliance rates. Alternate-day fasting may also diminish diastolic reserve in the heart, as one rodent study10 found to occur in those animals that were kept on this type of fasting long term.
5:2 Fasts
Another fasting plan espoused by Dr. Michael Mosley in his book The Fast Diet is the 5:2 plan, where you cut your food down to one-fourth of your normal daily calories—about 600 calories for men and about 500 for women—on two days of your choice each week. On the other five days of the week you eat normally.
One thing to be aware of is that there is some evidence that the irregularity of the 5:2 plan may disrupt the circadian rhythm of your body. These automatic rhythms orchestrate your sleep/wake cycle and various functions of your hormonal system.
Peak Fasting—My Preferred Form of Intermittent Fasting
As a general rule I recommend a specific type of intermittent fasting that I call Peak Fasting. This is my hands-down favorite form of fasting and the one I personally use. It is by far the easiest to maintain once your body has shifted over from burning sugar to burning fat as its primary fuel, and it also appears to support steady circadian rhythms.
Peak Fasting is done every day rather than a few days per week or month. However, you can certainly cycle in off days to suit your schedule or social commitments—this flexibility is another major benefit of Peak Fasting. If circumstances allow, I recommend doing this type of fasting about five days a week. The process is quite simple.
The crux of Peak Fasting is to restrict your eating each day to a 6- to 11-hour window. As a result you will avoid eating for 13 to 18 hours of every day. The simplest way to implement Peak Fasting is to stop eating at least three hours before bed and then delay your first meal of the following day until at least 13 hours have passed since you last ate. A powerful illustration of its value is a recent study showing that women who fast for 13 or more hours after the evening meal may reduce the risk of early-stage breast cancer coming back.11 It is important to note that you if you have trained your body to burn fat as your primary fuel, you have greater access to this type of benefit with an intermittent fast of only 13 hours. If you are still burning carbs as your primary fuel, it will take closer to 18 hours of fasting to achieve this benefit.
This may seem like an awfully long time to go without eating on a daily basis, but once you have transitioned to burning fat as your primary source of fuel, you won’t experience those frequent hunger pangs. Another benefit of Peak Fasting is that you will be able to go for hours without a dip in energy because fat provides a continuous source of fuel. This is in contrast to glucose, which triggers glucose/insulin spikes, frequent hunger pangs, and energy crashes as cues to consume more high-carb foods.
Transition Tip: If it’s difficult for you to go 13 or more hours without eating, try adding a teaspoon or two of coconut or MCT oil to a cup of coffee or tea. The fat will help ward off hunger without causing a rise in blood sugar. It essentially allows you to extend your fast while minimizing your hunger.
THE BENEFITS OF AVOIDING EATING HOURS BEFORE YOU GO TO BED
No matter which fasting program you choose, or even if you choose not to adopt any formal type of fasting, you’ll want to stop eating at least three hours before you go to bed. I have recently become much more aware of how important this simple change is in helping to optimize your mitochondrial function and prevent cellular damage. Many factors influence why you will reap health benefits if you develop the habit of not eating within three hours of bedtime:
A review paper published in 201112 provides much of the experimental work supporting the advice to refrain from eating too close to bedtime. The take-home message is clear: since your body uses the least amount of calories when sleeping, you’ll want to avoid eating close to bedtime because adding excess fuel at this time will generate excessive free radicals that will damage your tissues, accelerate aging, and contribute to chronic disease.
For this reason, I believe one of the best strategies for reducing mitochondrial free radical production is to limit the amount of fuel you feed your body when it requires the least amount, which is when you are sleeping. That’s why I stop eating four to six hours before I go to bed, although a three-hour window is also beneficial and probably more doable for most people.
Although I believe intermittent fasting, particularly Peak Fasting, is a powerful way to improve your physiological function all the way down to the mitochondrial level, it is not for everyone. Individuals taking medications, especially diabetics, need medical supervision; otherwise there is a risk of hypoglycemia.
If you have serious adrenal challenges or chronic renal disease, are living with chronic stress (adrenal fatigue), or have cortisol dysregulation, you would likely need to resolve these issues before implementing intermittent fasting. Also, if you have a disease called porphyria, you should not fast.
If your goal is to build large muscles or engage in competitive sports such as sprinting that require glucose for anaerobic fast twitch muscle fibers, intermittent fasting is not likely to be your best strategy.
Pregnant women and nursing mothers should not practice intermittent fasting, as the baby needs a wider range of nutrients during and after birth, and there’s no research supporting the safety of fasting during this important time.
Children under 18 should also not fast for extended periods. And anyone of any age with concerns about malnutrition, or who is underweight (with a body mass index, or BMI, of less than 18.5), or who has an eating disorder such as anorexia nervosa should avoid fasting.
When implementing intermittent fasting, keep your eye on any signs of hypoglycemia, or low blood sugar, which include:
If you suspect that your blood sugar is low, make sure to eat something that will not impact your blood glucose levels, such as coconut oil in black coffee or tea.
Paradoxically, Peak Fasting is part of the solution for normalizing adrenal function, but you may require professional guidance to help you navigate that course if you struggle with this problem.
TIPS FOR ADAPTING TO A REGULAR FASTING SCHEDULE
The toughest part of any intermittent fasting plan is getting through the initial transition, which can take anywhere from a week to two months. In some people this transition may take even longer, depending on how insulin resistant they are and other factors such as weight, blood pressure, and how consistent they are with their fasting regimen.
About 10 percent of people report headaches as a side effect when they first start fasting, but the biggest complaint is hunger. This is why it is so important to keep hydrated, especially while adding extra magnesium. It may also be helpful to remember that one reason you’re craving food is because your body has not yet made the switch from burning sugar to burning fat as its primary fuel. As long as you’re running on sugar, frequent hunger pangs will be the norm. Fat is far more satisfying, as it’s a much slower-burning fuel.
Another factor that can trip you up during the transition period is purely psychological. If you’re used to grazing in the evenings, it may take some time to break the habit. One trick to make it easier to go longer periods of time without eating is to drink more water. Oftentimes people mistake thirst for hunger.
It typically takes a few days to work up to 13 hours, but once you start activating your fat-burning system you will easily achieve this. The most effective way is to keep to your fat-burning plan by limiting your net carbs to under 40 grams per day and not exceeding more than 1 gram of protein per kilogram of lean body mass.
Once you achieve the ability to burn fat as your primary fuel, you will want to add some variety to this regimen, as I discuss in the feast-famine cycling section below.
USE FEAST-FAMINE CYCLING TO REAP THE BENEFITS OF FAT BURNING OVER THE LONG HAUL WITHOUT FEELING DEPRIVED
As I have shown in this book, switching to burning fat as your primary fuel is a very powerful intervention that can improve the health of your mitochondria, which in turn improves your overall health. But you may be wondering, How long should I keep to this eating plan?
Many aspects of MMT are important parts of a lifelong commitment to better health, such as choosing high-quality fats, avoiding GMO foods, and eating local, organic produce whenever possible. You may believe that this is a way of eating that you could embrace for a lifetime, and for some that might be optimal. But my best guess is that is not the case for nearly everyone.
After implementing this plan for over six months, I learned that some of the metabolic changes it creates may not be beneficial over the course of a lifetime. This is mostly related to the hormone insulin and the way insulin works.
Most health professionals have been taught that insulin works by driving glucose into the cell. It turns out this is not the primary mechanism of insulin—it actually drives glucose out of the cell.
How can it be then that when you inject someone with insulin, especially someone who has never received insulin injections, their blood sugar will drop?13
It turns out the way insulin really works is to suppress gluconeogenesis—the process your liver uses to produce glucose. The reason this is not widely appreciated is that very few people actually have insulin levels low enough to stop the liver’s production of glucose. About the only times this happens is during prolonged fasting and nutritional ketosis with low-net-carb intakes.
When your insulin levels are very low, your blood sugar will start to rise because your liver starts making glucose. What is really astonishing is that when you are in this state and you eat a small amount of carbs, your blood sugar will actually drop! This is because the liver is making more glucose than you are consuming and the carbohydrate you ate was enough to raise insulin levels, which then stopped the gluconeogenesis process.
I have worn a continuous glucose monitor for six months as of this writing. I have learned that when I eat a low-net-carb diet and my blood sugar starts to rise 10 to 30 points for no obvious reason, it is related to low insulin levels and it is time for me to eat more carbs. When I do that my blood sugar starts to drop quite dramatically.
Why does this happen?
One of the reasons, as we have seen, is that while your brain can run primarily on ketones and fats, it requires a certain amount of glucose to function properly. If you aren’t providing glucose directly via your diet, your body cues the liver to produce it.
An alternate explanation is simply that your body is constantly adapting to ensure that you stay alive. During a long fast or extended periods of ketosis, your body is simply seeking to preserve its fat fuel. Remember that your cells can only use glucose or fat for fuel. When you are in a state of ketosis, the majority of your cellular energy is being derived from fat. When your body senses that food is scarce, your body is programmed to ensure that you have plenty of glucose to fuel functions.
As a result, your metabolism will adjust and slow down fat burning and increase gluconeogenesis by burning muscle instead of fat. Your body wants to hang on to your precious fat stores so you’ll have access to them in the future. It’s like hanging on to your longest-burning wood before a hard winter, especially when you don’t know how cold it’s going to get or when it will end.
Many of the clinicians I interviewed for this book who employ ketosis as a therapeutic strategy find that many of their patients lose muscle and gain fat after an extended time in ketosis. The amount of time is different for everyone, but genetics and mitochondrial differences seem to be the main determining factors. Those with hormonal challenges such as hypothyroidism can fall victim to this natural adaptation sooner than most. Common complaints during this phenomenon are lack of energy and weight gain that is difficult to lose.
VARIETY MAY BE THE KEY TO LIFE (NOT JUST THE SPICE)
I strongly believe that variety is an important biological principle. Using one form of exercise or diet exclusively for long periods of time is likely to cause unintended negative consequences no matter how useful the diet or exercise is. So after you have regained your ability to burn fat as your primary fuel, it is wise to integrate variety into your food plan.
So how long should you remain in nutritional ketosis?
The details of what types and amounts of dietary variety will work best are clearly individual and depend on how severely impaired your metabolism was prior to regaining fat-burning capability. My best advice is to continue the fat-burning protocol described in this book for as long as it takes your body to adapt to burning fat as your primary fuel. After that, you can maintain your benefits over the long term by using what I call feast-famine cycling, which I describe in detail below.
If you are battling cancer, consult with your clinician before making any dietary changes, but it may make sense to continue in fat-burning mode until that issue is resolved.
Before I outline feast-famine cycling, there are a few basic premises behind this theory that you should know:
HOW TO USE FEAST-FAMINE CYCLING
Once you have captured the ability to burn fat as your primary fuel, it is time to listen to your body and increase the flexibility in your diet. If done prudently, this will not impair your body’s ability to burn fat.
The way I recommend doing this is through feast-famine cycling, which approximates the eating pattern of many of our ancient ancestors.
To the best of my knowledge there are no controlled studies that have examined the details of this strategy, although many in the bodybuilding community have used variations of this theme to optimize their performance.
One intriguing and very structured approach is one that Dr. Dan Pompa is using with his group of trained physicians who implement nutritional ketosis in their patients. They start with four or five days a week of Peak Fasting, one or two days a week of water fasting, and one or two days a week of feasting. If you do this you will need to carefully listen to your body and ideally follow your biometrics, such as your body fat percentage, weight, and ketone and glucose levels, to determine the best strategy for you.
A more holistic way of approaching this is to make seasonal shifts in your dietary intake, much like our ancestors were forced to do in response to environmental stressors, scarcity of food supply, or seasonal growing patterns. You could achieve this by spending your winters following MMT and maintaining a fat-burning state, implementing a four- to seven-day fast in the spring (consuming only water or bone broth), and then enjoying more veggies, berries, and lighter meats and fish during the summer.
Some do well switching between strict MMT and a more lenient, yet still whole foods–based, diet every three or four months because it offers more change and seems to reignite weight loss and reinvigorate motivation every time they shift their diet.
No matter which strategy you choose, I have found that regular variation in diet helps encourage long-term compliance to a healthy lifestyle because the change helps ward off feelings of frustration, deprivation, and even boredom with continually eating the same foods.
CONDITIONS THAT SUGGEST YOU NEED TO IMPLEMENT DIET VARIETY
GENERAL PRINCIPLES TO CONSIDER WHEN IMPLEMENTING
It makes sense to not restrict yourself to a rigid schedule, such as fasting every Friday. Remember: variety is key. So while you can use the 5-1-1 (Peak Fasting for five days, water fasting for one day, and feasting for one day) or the 4-2-1 approximate weekly ratio that Dr. Pompa recommends, you could mix those days up throughout the month. The purpose of the feast days is to remind your body it’s not starving, stop the breakdown of muscle, and reignite fat burning. The fast days boost your fat-burning efficiency.
During feasting you decrease the amount of fat you are consuming and increase healthy carbs and protein. Feasting does not give you permission to eat junk food! (Although small amounts on an irregular basis will likely not contribute to serious metabolic challenges, they also will not promote health.) Seek to increase your net-carb intake to 100 to 150 grams of healthy carbs like sweet potatoes, yams, berries, beets, or other root veggies. You may even tolerate small amounts of healthy grains, such as brown rice and quinoa.
You can also increase your protein intake, but it would be wise to synchronize this with the days you are strength training so you can take advantage of the anabolic boost that is provided by activating the mTOR pathway with additional protein. It would likely be wise to limit the increase to double your normal protein intake, but you can play around with increasing it up to three times.
It is important to remember that in no case should you have more than 25 grams of protein in one meal as that will likely exceed your body’s ability to effectively use these amino acids and simply put an extra burden on your kidneys. So be careful to space your protein throughout the day.
During feast days it would still be best to follow the strategy of not eating for at least a few hours before bed, and if you do eat, have a light meal to optimize your mitochondrial function.
Treating Sleep Issues, Migraines, and Chronic Fatigue with Feast-Famine Cycling
Gina, one of my treasured home and garden assistants, is 48 years old. Although she has always led a healthy lifestyle and had loads of energy, she has had some health problems. When she was in her mid-30s, her lifelong sleep disorders—severe jaw clenching and night terrors—were taking a heavy toll on her health.
She went to a sleep disorder center, and the doctor who saw her prescribed Clonazepam (also known as Klonopin). When the medication didn’t relieve her symptoms, the doctor increased her dosage and promised the cure was just on the horizon. Instead of a cure, Gina developed a toxic reaction.
Her symptoms were brutal and widespread, leading to years of misdiagnoses, including fibromyalgia, anxiety, depression, hypermania, post-traumatic stress disorder, dissociative stress disorder, severe adrenal insufficiency, adrenaline dominance, parasitic infection, blood infection, chronic fatigue syndrome, lupus, rheumatoid arthritis, and Lyme disease.
After years of struggling with swelling, chronic hives, migraines, excessive weight gain, heavy brain fog, insomnia, thick blood, extensive nerve issues, loss of taste and smell, and extreme exhaustion, she was frustrated, overweight, and tired.
I had her track her nutritional intake for a week and reviewed it with her. At that point we decided to implement the high-fat, low-carb, adequate-protein diet. The first two weeks were difficult, but after that she found that following the program became both very easy and very satisfying. “Being in a fat-burning state provided a fantastic rush of clarity and energy,” Gina recalls. In addition, her weight dropped and some symptoms eased up a bit.
After about a year of eating this way, Gina plateaued. Though better than when she started, she still had many issues and her weight was still excessive, especially considering that she had an active, nonsedentary lifestyle. At that point, we revisited her diet. I had her log everything she ate on Cronometer to be aware of what she was eating and in what portions. We then implemented a hardcore strategy to reset her system.
She did a four-day water fast and then followed an extreme low-carb and low-protein diet—limiting herself to 5 grams of carbs and 5 grams of protein with unlimited good fats—for 23 more days. Gina shared that it was very difficult to stick with the plan, but she worked through it.
At that point, we moved her to 20 grams of carbs and 20 grams of protein, still with unlimited fats, for another 21 days. Needless to say, she found this easier and experienced further weight loss and a slow but consistent easing of her symptoms. Then she hit another plateau. At that point we implemented feast-famine cycling with four days of high fat (unlimited), low to moderate protein (20 grams) and low carbs (20 grams); one day of water fasting; and two days of higher carbs (100 to 150 grams), higher protein (50 grams), and not so much fat. I instructed her to play with the number of days, the frequency, and the order to find her sweet spot of both physical and mental health.
In the last three months Gina has lost 20 pounds. She states that she is feeling better than she has felt in the last decade. Her sleep is significantly better, her energy level is rising, the excessive swelling in her hands is dissipating, her migraines have dropped by 90 percent, her muscles no longer constantly burn in pain, she grinds her teeth less, her night terrors have decreased markedly in both intensity and number of occurrences, and her brain fog is lifting. She is a work in progress but is finally optimistic that she can take control and regain her health, her energy, her mental capacity, and her healthy weight goals.