<p><a href="https://peterattiamd.com/ama72/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=250616-pod-ama72&utm_content=250616-pod-ama72-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=250616-pod-ama72&utm_content=250616-pod-ama72-podfeed"> Become a Member to Receive Exclusive Content</a></p> <p><a href="https://peterattiamd.com/newsletter/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=250616-pod-ama72&utm_content=250616-pod-ama72-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></p> <p>In this "Ask Me Anything" (AMA) episode, Peter revisits the topic of fasting, sharing how his thinking has evolved over time. The episode explores fasting-related terminology and common types of fasting, as well as the various reasons individuals might choose to fast. Peter explores potential benefits including improvements in body composition, metabolic health, lifespan extension, cardiovascular disease, cancer prevention and treatment, neurodegenerative conditions such as Alzheimer's and Parkinson's, and autoimmune symptoms like arthritis. He also examines the risks and potential downsides of fasting and offers a practical framework to help assess when and how fasting may be most appropriately applied.</p> <p>If you're not a subscriber and are listening on a podcast player, you'll only be able to hear a preview of the AMA. If you're a subscriber, you can now listen to this full episode on your <a href="https://peterattiamd.com/members/private-podcast-feed/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=250616-pod-ama72&utm_content=250616-pod-ama72-podfeed">private RSS feed </a>or our website at the <a href="http://peterattiamd.com/ama72/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=250616-pod-ama72&utm_content=250616-pod-ama72-podfeed">AMA #72 show notes page</a>. If you are not a subscriber, you can learn more about the subscriber benefits <a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=250616-pod-ama72&utm_content=250616-pod-ama72-podfeed">here</a>.</p> <p><strong>We discuss:</strong></p> <ul type="disc"> <li>Why the topic of fasting is being revisited [1:45];</li> <li>The importance of being open to changing one's opinion in science and medicine as new evidence emerges [4:15];</li> <li>Defining fasting and how it fits in the framework of dietary restriction, time-restricted feeding, and calorie restriction [7:30];</li> <li>The most common types of fasting [11:45];</li> <li>Why someone might choose fasting over continuous caloric restriction [19:00];</li> <li>The biochemical effects of fasting: fuel partitioning, autophagy, and more [21:00];</li> <li>Autophagy: a cellular cleanup process stimulated by fasting and energy depletion [26:00];</li> <li>Comparing the physiological effects of a ketogenic diet to those of long-term fasting [27:45];</li> <li>How long fasting takes to induce ketosis and boost autophagy, and how autophagy is measured [29:45];</li> <li>At-home tests for ketones [33:45];</li> <li>Reducing senescent ("zombie") cells and inflammation through autophagy [35:00];</li> <li>Examining the evidence for the long-term health benefits of fasting beyond short-term metabolic effects [37:15];</li> <li>The common health claims associated with fasting across metabolic, neurological, oncological, autoimmune, and longevity domains [40:30];</li> <li>The impact of fasting on body weight and body composition [42:00];</li> <li>Weight regain and potential metabolic consequences of fasting [44:00];</li> <li>The risk of lean mass loss with fasting and how to mitigate it [47:15];</li> A practical framework for using fasting as a strategy to improve body composition [52:15]; <li>How extended fasting compares to caloric restriction in improving insulin sensitivity in people with insulin resistance or type 2 diabetes [54:00];</li> Is there any evidence that fasting can extend lifespan? [55:45]; <li>Examining whether fasting improves cardiovascular disease risk beyond the effects of weight loss and calorie reduction [58:15];</li> <li>Exploring whether prolonged fasting can reduce cancer risk [59:45];</li> <li>The potential benefits of fasting or fasting-mimicking diets during cancer treatment: emerging evidence and practical considerations [1:02:15];</li> <li>Fasting for protection against neurodegenerative diseases: early evidence of therapeutic benefit and open questions [1:10:45];</li> <li>Various fasting methods for autoimmune diseases: potential symptom relief with cautious application [1:14:00];</li> <li>Fasting and type 1 diabetes: risks, evidence, and careful dietary alternatives [1:16:45];</li> <li>Fasting and gut disorders: potential benefits outside of flare-ups [1:18:45];</li> <li>The primary risks and downsides associated with fasting [1:19:45];</li> <li>The essential vitamins and minerals to supplement during prolonged fasting [1:21:30];</li> <li>Who should avoid fasting and why [1:22:15];</li> <li>Fasting's role in health: where it shows promise and where it likely offers no distinct advantage over caloric restriction [1:23:45]; and</li> <li>More.</li> </ul> <p>Connect With Peter on <a href="https://twitter.com/PeterAttiaMD">Twitter</a>, <a href="https://www.instagram.com/peterattiamd/">Instagram</a>, <a href="https://www.facebook.com/peterattiamd/">Facebook</a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg">YouTube</a></p>
Actionable Insights
1. Prioritize Knowing What’s Right
Orient yourself towards knowing what is right, rather than being right, to ensure you constantly move in the correct direction and maintain a state of intellectual evolution.
2. Change Mind with New Facts
Be willing to change your mind or opinion when presented with new information, as this should be viewed as a feature, not a bug, especially in science and medicine where absolute certainty doesn’t exist.
3. Utilize DR, TR, CR Framework
To manage energy balance and metabolic health, generally implement at least one of these strategies: Dietary Restriction (DR), Time Restriction (TR), or Caloric Restriction (CR).
4. Maintain Energy Balance
Ensure your energy intake is balanced, as both consuming too much or too little energy can be detrimental to metabolic health.
5. Consume Adequate Protein
Prioritize consuming adequate amounts of protein to maintain lean muscle mass, as this is a consistent nutritional requirement regardless of other dietary choices.
6. Ensure Micronutrients, Avoid Toxins
Ensure your diet includes sufficient micronutrients and actively avoid toxins to support overall health.
7. Consciously Manage Eating
Recognize that maintaining energy balance typically requires conscious effort and attention to what, when, and how much you eat, rather than unrestrained consumption.
8. Implement Dietary Restriction (DR)
Deliberately restrict certain elements in your diet, such as specific macronutrients (carbohydrates, fat), animal products, or processed foods, choosing a method that is significant enough to produce desired health effects.
9. Practice Time Restriction (TR)
Restrict the daily period of time during which you eat, often referred to as intermittent fasting, as a narrower eating window can help reduce overall caloric intake.
10. Focus on Caloric Restriction (CR)
Minimize your total caloric intake throughout the day by consistently focusing on eating less, regardless of specific food types or eating windows.
11. Combine DR, TR, CR
You can choose to mix dietary restriction (DR), time restriction (TR), and caloric restriction (CR) strategies to achieve your health goals.
12. Aim for 16-18 Hour TRE
When practicing Time-Restricted Eating (TRE), aim for a daily fasting window of 16 to 18 hours, as less than 16 hours is considered less effective for true TRE.