What Six Months of Soup Can Teach Me

Part 2 – The Fed Versus Fasting State

A word of caution is needed here.  There are some health problems that may be helped by this intermittent modified fasting dietary pattern but it should only be done with the agreement of your doctor and with some professional monitoring during the process.  More severe diabetes controlled with medication is an example.  Reducing medication levels under supervision may be needed.  While this is an objective of the dietary pattern it must be done carefully with supervision.  Kidney disease may be another precaution.  So any doubt, coordinate any large dietary change with your treating physician.

So, how am I doing at this?  I am a couple of days into the 5:2 dietary pattern and no body parts have fallen off yet.  I didn’t expect any to but thought I should reassure everyone about that. 

This dietary plan uses a modified fasting pattern of 2 days per week to “reboot” a more normalized metabolic pattern.  On the two days of the modified fasting, 1-1.5 cups of soup is consumed twice at 12-hour intervals.  Tea or black coffee can be consumed as well as water.  The idea is to switch our metabolism from the fed state to one of fasting.  But just “what does that do?” seems to be the question.

As I have a higher genetic risk pattern (I will explain that in a later post), and I tend to do things “the best they can be done”, I am actually doing the 3:4 version which is 4 days of modified fasting and 3 normal dietary days.  Dr. Mosley’s 5:2 version works, but I am doing it a little more aggressively – an affliction I have!

In the fed state dietary energy (calories) is used to provide immediate energy to cells.  All excess is then sent to the liver for conversion to a storage fat, triglyceride.  If fed state occupies too much of our day, we are in a fat production and storage mode increasing all of the diseases that are associated with it.  Carbohydrates especially accelerate the production of triglycerides, thus the high protein/low carb content or Paleo-esque nature of the soup.  The increase in carbohydrate in the western diet over the past 200-300 years from 30% to about 55% of energy has been particularly contributory to the overweight and obesity epidemic as well as its associated chronic disease epidemic.

An additional problem from the constant fed state that upregulates triglyceride production is that some persons have difficulty transporting all of the triglyceride out of the liver to fat storage.  This causes these fats to build up in the liver itself creating non-alcoholic fatty liver disease (NAFLD).  A recent study reported that the number of male teens with NAFLD doubled over the past several decades with 1 in 10 affected by the disease and 1 of every 2 obese teens affected.

In contrast when we are in the fasted state, triglyceride is pulled out of fat storage and burned for energy directly as triglyceride and as ketones which are made in the liver from triglyceride.  The reason the liver turns some of the triglyceride into ketones is that the brain can only burn glucose and ketones but not fat.  We can exploit that in some individuals with cognitive decline or mild dementia using a modified fasting to improve brain function, but more about that in another post.

There are many other positive benefits to spending some time in the fasting state.  It lowers blood sugar and insulin levels which lowers diabetes risk and the risks of many other associated diseases such as arterial disease (heart, stroke, etc), dementia/Alzhiemer’s disease, kidney disease, neuropathy and others.

The metabolic changes during the fasting state were thought to impart an advantage to the success of finding subsequent food either through hunting of gathering.  It appears this fasting state increases mental alertness that would be needed pursuing wild game.  This interesting video is about how mice who have an increased genetic pattern towards developing memory impairment and dementia can greatly reduce this tendency with periodic fasting.

One of the other convincing pieces of evidence for periodic fasting comes from studies about the effect of caloric restriction on healthy longevity.  It seems restricting overall energy consumption in mammals results in important increases in healthy longevity.  This is defined as not simply living longer but being free of chronic disease for a greater portion of this longevity as well, which I think is an objective of almost all of us.

The picture shows the measured effects of caloric restriction in laboratory animals.  The RER is resting energy reserves or stored fat, while WAT is white adipose tissue, the belly fat most associated with disease risk.  Notice the survival age with caloric restriction increases about 15-20% over the ad libitum, or free eating group.

The difficulty with caloric restriction is that it requires constant reductions in caloric intake of 60% for several decades, an ongoing lifestyle few would undertake.  Intermittent fasting, however, can induce a disproportionate amount of the benefit of ongoing caloric restriction but in a much more tolerated way for most persons. 

I guess the other alternative is to live in the wilderness and only eat what you catch or find as did our ancient ancestors who were the origins of our genetic machinery.  This is a trait I learned from parenting.  If they don’t like option “A”, make it look better by giving them a less appealing option “B”!

Not everyone has the same urgency for avoiding the constant fed state and not everyone requires such strict adherence to the Paleo dietary pattern of only 35% of energy from carbohydrate, very low grain, no added sugars.  We are not all genetically wired the same.  There appears to be 2 dominant genetic patterns that most humans have which govern the urgency/intensity of dietary behavior.  I will discuss these 2 patterns in the next post, how they appeared to have originated and how to tell which you may have.  In the meantime, I continue to explore what six months of soup can teach me.  The first few days have been easier than I expected.