Intermittent fasting (5/2 diet) and anti-inflammatory effects: likely benefits for ME?

[Sasha]

I've just been reminded, by an article in my TV guide, of a BBC documentary shown a few months ago by Dr Michael Mosley on intermittent fasting. Dr Mosley had high levels of visceral fat (he looked thin on the outside but had a lot of fat around his organs) and was borderline diabetic with high cholesterol and a family history of premature death through heart disease, hence his interest. He has done some interesting TV documentaries on scientific evidence-based weight loss.

However, he reckons that studies indicate that intermittent fasting has health benefits quite separate from weight loss and its consequences.

He defines intermittent fasting as eating normally on most days but having some days where you just have a quarter of your normal calories, and through trial and error came up with a routine where he'd eat normally for five days in the week and would have two non-consecutive days on the reduced calories. Once he'd got to his desired weight he switched to a six-one maintenance schedule.

He says that high levels of Insulin-like Growth Factor 1 (IGF-1) are associated with accelerated ageing and cancer and that fasting lowers levels of IGF-1. Also, fasting appears to switch on 'repair genes' which start doing cellular repairs. Also, mice who had had the same food as a control group but had been forced to eat it within and 8-hour period and so fast for 16 hours for 100 days had lower levels of chronic inflammation, suggesting lower risk for cancer, stroke, heart disease and Alzheimer's.

Here's what it says on his website about inflammation (interesting to read the comments that people have made there):

http://thefastdiet.co.uk/help-with-inflammation/

He has warnings that the chronically ill or anyone on any kind of medication shouldn't try the diet without consulting their doctors, BTW, and that Type 1 diabetics, those with eating disorders, children, and pregnant or trying-to-be pregnant women, or already lean people shouldn't do it.

Is it likely that PWME could benefit from intermittent fasting of this type, given that chronic inflammation seems to play a role in our disease?

If that's a possibility, what do we need to watch out for? A lot of us, me included, go a bit wobbly if we go without food for long (hypoglaecemia, presumably).

There have been a couple of interesting threads on more traditional fasting (i.e. for days at a time with no food) and it seems that for that kind of fasting at least, PWME should be very careful:

http://forums.phoenixrising.me/index.php?threads/has-anyone-tried-fasting.9522/

http://forums.phoenixrising.me/index.php?threads/2-enlightening-fasting-experiences.6745/

 

[Mij]

I think this one is coming up here soon too. I'll be looking out for it on t.v. Inflammation is a huge issue.

I just watched one of his other documentaries last week, The Truth About Exercise was one I found very interesting, especially for those of us who can't do too much. He had genetic testing to determine how some of us respond to exercise and how a lot of us only need very little to get the full benefits.

 

[Sasha]

I think this one is coming up here soon too. I'll be looking out for it on t.v. Inflammation is a huge issue.

I just watched one of his other documentaries last week, The Truth About Exercise was one I found very interesting, especially for those of us who can't do too much. He had genetic testing to determine how some of us respond to exercise and how a lot of us only need very little to get the full benefits.

Yes, I saw that one - fascinating, and very surprising.

 

[justy]

Hi Sasha - i saw the documentary when it first came out and there was a small flurry of interest on the forum, which soon fizzled out. i tried it for a while, along with some friends (who dont have M.E) and my husband. I very much enjoyed the diet - rather than over eating on the non fast days, i did infact moderate my intake. For me though it wasnt long term sustainable - i found out a the time i had severe anemia - also had severe gastritis and was generally feeling very ill with the M.E. 500 calories on the fasting day was just not enough for me - after a few weeks i was feeling quite weak from doing this twice a week. My husband gave up after a month as it made him exceptionally grumpy and he devloped insomnia. My friend is still going and has lost weight and is happy and feeling good 9she doesnt have any health problems) needless to say i didnt lose ANY weight, despite needing to and not overeating on off days.

As i already have poor nutritional status (not absorbing?) it seemed a crazy thing for me to do - shame tho, i would have liked to have continued.
Justy.

 

[Sasha]

As i already have poor nutritional status (not absorbing?) it seemed a crazy thing for me to do - shame tho, i would have liked to have continued.
Justy.

Hi Justy - I'm sorry it didn't work out for you. I wonder if this is going to be another subgroups issue! Or maybe, if we all have a problem with inflammation at some level, it could not be a subgroups thing so much as that those of us with certain conditions such as anaemia or malabsorption or hypoglaecemia won't be able to handle the diet.

I have to take iron supplements in order to fend off anaemia, and my latest ferritin levels were OK. I'm worried about hypoglaecemia and maybe just some weird unintended consequence of the diet on PWME that wouldn't affect a healthy person.

I'm tempted to have a go, if I can do it safely. I like the idea of a diet that is actually less effort than the other dietary changes I've tried in the past to help my ME such as the Wahls diet. Less effort than a normal diet, in fact, because on the fast days you're eating so little!

I'm getting over a bug now so won't be trying it until that's well and truly behind me, at least.

I'm hoping some of the biochemically brainy people on the forum might have some views on the anti-inflammatory aspects of the diet!

 

[Sasha]

Interesting that the NHS has seen the need to comment on the 5:2 diet:

http://www.nhs.uk/news/2013/01January/Pages/Does-the-5-2-intermittent-fasting-diet-work.aspx

They're basically saying that there isn't much definitive evidence in humans either way because RCTs haven't been done - absence of evidence rather than evidence of absence, in other words. A lot of the work has been done on mice and rats and it's unclear to what extent it would translate to humans.

Interesting that they have something on their site about it, though - must be an indication of its popularity and the 5:2 diet specifically seems to have been around only a few months (since the Horizon documentary).

 

[justy]

Hi Sasha, since the programme a lot of people (non M.E) have been trying it. Anecdotally there are now a lot of stories around of people having blood results completely changing to those of a much younger healthier person. My friend who i discussed earlier is on a forum with a lot of people doing it. Many are seeing changes in blood cholesterol, sugar etc - BUT i dont know if this is correlating with people feeling fantastic on the diet.

I did it because i already have very high oxidative stress, high cell free DNA, hypoglycaemia etc etc and felt if i could 'rest' my body in this way it would help with the symptoms and perhaps if it didnt help with symptoms could reduce my chances of disease progression - cancer etc especially in the future. Unfortunalety the diet made me feel weak. I wasmnt able to do much at all on the fast days and then was struggling to get energy back up after.

I have mito dysfucntion - shown on Acumen labs test and i find that eating also helps my energy levels. If i am struggling after being out i will eat something to he;lp get me home. This has resulted in me overeating a ttimes - especially with sugar - instant energy fix!

It seemed that the diet was aggravating my hypoglycaemia and i started to look paler and iller - have been on iron tablets now for 2 years consistently and my ferritin i still only at 10 (up from 6 - but down from my high of 11) so pretty rubbish. I now also have a calcium deficiency. I found that 500 cals a day was not enough - for men it is 600 - that made me feel a bit better - at 700 i would probably be ok - but this probably defeats the point.

I'm jut letting you know my experience. I think if anyone feels like it, its worth a try - you can always stop if its not working for you - and i cant see it doing any long term damage at all.

Take care, Justy.

 

[Sasha]

Hi Justy - I know how frustrating it is to try something that other people are benefitting from and find that it just makes you worse. Our illness is so complex and our biochemistry so screwed up that all we can do is try it and see, as long as it's not dangerous.

Thanks for giving the detail on your situation and what it was like for you. It's very helpful to know what kind of experiences PWME can have with this - knowing this helps tthe rest of us to be prepared.

I've ordered Michael Mosley's book, which several reviewers said didn't add much that wasn't in the TV programme but it's only £3.85:

http://www.amazon.co.uk/The-Fast-Di...1676/ref=sr_1_1?ie=UTF8&qid=1358940949&sr=8-1

and I've just downloaded this one by a journalist to my Kindle for £1.09 (no typo! bargain!) because it apparently includes a lot of accounts of people's experiences, as well as going over the science, which I think will be helpful:

http://www.amazon.co.uk/The-Feast-Weight-Transform-Health/dp/1481235966/ref=pd_bxgy_b_img_z

I'm feeling quite thwarted that I have a bug at the moment because I'd like to just try a single day of this to see how (whether) my body copes.

 

[peggy-sue]

I was really delighted to see this programme and it's sensible approach - because this is the only way I can ever loose weight.

After all, given we evolved to cope with a hunter-gatherer lifestyle, we are perfectly capable of coping with feast and famine conditions, if we have "low blood sugar" glucose is released from stored energy.

(I think all this nonsense about having to "eat regularly" to keep "blood sugar stable" must have it's roots in sugary snack industries... same as "drink 8 glasses of water a day" is part of the bottled water industry hype.)

Kids don't get "sugar rushes", they're a fallacy. Kids just get "rushes" - it's just part of being a kid.

I've managed to loose 30 lbs over the last couple of years, just by occassionally going without for a few days here and there.
It helps a lot if I'm stressed - I go right off my food then, I just give in to it for a short while. Never more than 3 days.

However, my eating habits are perhaps unusual - I only eat one big meal a day, in the late evening.
It's what suits me.
I did try, for 5 months, to eat 3 meals a day, in case my late dinner-ing was causing any of my ME problems,

but the 3 meals a day knocked me out - I get low after eating, and the earlier I ate, the hungrier and hungrier I got so I ate more and more each meal.. an utterly useless and counterproductive strategy for me!

Obviously, folk with diabetes and other health conditions might not find this at all suitable.

 

[Sasha]

Hi peggy-sue - that's good you've found an eating pattern that's good for you.

A lot of PWME have problems with not eating for a while - I used to get weak and shaky if I went without food for more than a few hours and it would get worse until I ate something. Whether that's actually hypoglaemia or not I don't know. I wasn't eating sugary snacks. I saw a dietician who advised me not to go for more than five hours without eating and always to have at least some protein and a smaller amount of carbohydrate by volume.

I'm interested in trying this diet partly because I want to see if I've still got that problem and if it's possible to push through it (which in my current state would consist of lying down until it's over).

 

[peggy-sue]

I use coffee when I get that weak feeling.
Coffee gets me going in the morning, I have another in the mid-afternoon.
It "jump starts" your metabolism to get it releasing stored glucose to give you energy.

However, I did have alcoholic anorexia many years ago.
Food interferes with getting the maximum effect from alcohol; it also uses up a lot of those "green drinking vouchers". I couldn't afford both!
I also lived on nothing but porridge for 4 weeks once, because of being broke.

I don't tend to ever notice being hungry or thirsty.
I do wonder if this inability of mine to recognise these bodily states has anything to do with my addictive tendencies.

I don't see why you should have to do a 2/5 routine.

Even the odd day here and there seems to have done the trick for me.

I am careful inbetween times - I don't ever use butter when having "a something" on bread, I do cut out those sorts of little things on a daily basis.

One time I lost a whole load of weight without trying was when I decided to boycott Nestle, having discovered their dirty little secrets about flogging baby food known to cause developmental brain damage to the babies of mothers in India.
The mothers needed the baby food so thay could go out to work, and the legislation in India hadn't caught up with this - so while the stuff couldn't be sold to the rest of the world, and Nestle knew of this, they carried on selling it in India.
So I stopped putting coffee mate in my coffee. (I drank a lot of coffee then, and I like it creamy.)
I lost a stone in 6 months.


If you eat just one extra spoonful of sugar than you need in a day (50 calories) you will put on a stone in a year.

If you eat 50 calories less than you need every day, you will loose a stone in a year.

So if you can find a wee something you can cut out every day, it might help?

 

[Sasha]

I use coffee when I get that weak feeling.
Coffee gets me going in the morning, I have another in the mid-afternoon.
It "jump starts" your metabolism to get it releasing stored glucose to give you energy.

However, I did have alcoholic anorexia many years ago.
Food interferes with getting the maximum effect from alcohol; it also uses up a lot of those "green alcohol vouchers". I couldn't afford both!
I also lived on nothing but porridge for 4 weeks once, because of being broke.

I don't tend to ever notice being hungry or thirsty.
I do wonder if this inability of mine to recognise these bodily states has anything to do with my addictive tendencies.

Coffee used to make me weak! We seem to have opposite metabolisms.

Wow, four weeks of porridge... glad you're over the alcoholic anorexia, that must be a great burden removed.

 

[peggy-sue]

Thank-you, Sasha!
Yes, it is wonderful being free from the booze!

My porridge for 4 weeks wasn't as bad as my friend - who ended up on nothing but dog biscuits for a similar period.
When there's no money for food, you have to make do with what you can get your mitts on.
We were young then.

 

[Sasha]

My porridge for 4 weeks wasn't as bad as my friend - who ended up on nothing but dog biscuits for a similar period.

 

[peggy-sue]

We were young!
It was the time between school finishing and trying to find a job for the summer, before going on to further education, leaving home for the first time...
I think they were good quality dog biscuits, if that helps.
It was a time to do daft things.

 

[Little Bluestem]

When I was trying to lose weight, I was surprised at how little I could eat and not become hypoglycemic (or lose weight) as long as I spread the food throughout the day in several small meals. I wasn't counting calories, but I doubt that I got as low as 500. You could start with a higher number of calories on your fast days and every few fast days reduced the calories until you reached 500 or the lowest number that worked for you, whichever came first.

He does warn that the chronically ill or anyone on any kind of medication shouldn’t try the diet without consulting their doctors.

Quite a few years ago I was interested in traditional fasting. Even fasts that included broth and juice said that a person with hypoglycemia should only try it under a doctor’s supervision. I was having more trouble with my hypoglycemia then and could not afford a doctor’s supervision, so I didn’t fast.

 

[alex3619]

My old CFS doc in about 1993 used to use intermittent fasting for patients all the time, depending on patient subgroups. Some kinds of patients respond, some don't apparently. I wind up regularly doing fasts or partial fasts all the time though, when I am too stuffed to cook.

Intermittent fasting is not just about calories. Its about changing metabolism and hormones. There is an old diet trick that has you eat more and more fat, day by day, until you are pigging out. Then you switch to a very low calorie diet. The metabolism is geared to burn fat, you lose a lot of fat really fast (but risk hypoglycaemia, acidosis etc) and this effect slowly wears off. When you no longer lose more weight, you start pigging out again.

I think intermittent fasting is safer than the high/low calorie idea. Its also much better if you are thin. I wonder if you have too low a weight you might respond by overeating for five days, then substantially under eating for two.

 

[Sasha]

My old CFS doc in about 1993 used to use intermittent fasting for patients all the time, depending on patient subgroups. Some kinds of patients respond, some don't apparently. I wind up regularly doing fasts or partial fasts all the time though, when I am too stuffed to cook.

Intermittent fasting is not just about calories. Its about changing metabolism and hormones. There is an old diet trick that has you eat more and more fat, day by day, until you are pigging out. Then you switch to a very low calorie diet. The metabolism is geared to burn fat, you lose a lot of fat really fast (but risk hypoglycaemia, acidosis etc) and this effect slowly wears off. When you no longer lose more weight, you start pigging out again.

I think intermittent fasting is safer than the high/low calorie idea. Its also much better if you are thin. I wonder if you have too low a weight you might respond by overeating for five days, then substantially under eating for two.

That's interesting - which kind of patient did your old doc think benefitted from this?

Although a lot of people will use it for the weight loss, I'm interesting in it for the alleged anti-inflammation properties and increased autophage activity and I think that might be to do with not just the low calories eaten one day but not eating them little & often - e.g. having just two meals on the fasting day spaced 12 hours apart.

Interesting question what you do if you're too low weight. I'm not there yet!

 

[peggy-sue]

It can be far harder for naturally very thin folk to put weight on, than it is for fat folk to loose it.

The way to try (I believe) is to add something both nutritious and calorific to the daily diet. But making it something nutritious is important. Not just a load of extra cream cakes.

I have wondered if adding a daily drink of something like complan (250 calories and basically nutrituous) instead of an ordinary cup of tea, coffee or juice every day would help.


I agree that the intermittent fasting will be playing tricks on metabolism, keeping it on its toes, as it were, rather than allowing the body to accustomise itself to a lower daily intake.

A big advantage of managing to keep your weight in the right sort of range is that you do not have to carry all your excess weight around with you all the time.

It really helps your energy levels not to have to do that.

I'm sorry I can't add anything at all about it helping in any way with inflammation.

 

[alex3619]

That's interesting - which kind of patient did your old doc think benefitted from this?

Alas Sasha, I don't know who this benefits the most. This was from 20 years ago and I don't recall, or recall if I ever knew the answer. If something occurs to me I hope to update this post. My best guess though would be something else that doc used to say: nobody knows, the only way is to suck it to see what it is. That of course led to my lemon rule:

Rule 22. Most treatments for ME are lemons, they don't suit everyone - but you often wont know if it suits you until you suck it and see. If you see a soured look on my face you will know why. http://forums.phoenixrising.me/index.php?entries/28-rules-of-thumb.941/