E172 - Dr. Alan Goldhammer: The Science of Fasting: How to Heal the Body and Rewire the Mind

Dr. Alan Goldhammer, co-founder of TrueNorth Health Center, joins us to reveal the science and psychology of water fasting, detoxification, and healing the body through nature’s intelligence. Drawing from 40 years of clinical experience with over 20,000 supervised fasts, he explains why many chronic illnesses—hypertension, autoimmune conditions, metabolic disease, and even depression—respond when the body is given a chance to reset. BONCHARGE Holiday Sale - Up to 25% off the best red light therapy products https://www.boncharge.com/knowthyself [Code: KNOWTHYSELF] MUDWTR Black Friday Sale - Up to 50% off sitewide https://www.mudwtr.com/knowthyself [Code: KNOWTHYSELF] Andrés Book Recs: https://www.knowthyselfpodcast.com/book-list ___________ 00:00 Intro 04:25 The Body’s Innate Ability to Heal 08:45 TrueNorth: How Water Fasting Is Done Safely 13:10 Dopamine, Pleasure, and Modern Addiction 17:40 The Food Environment That Makes Us Sick 22:00 The Problem With Hyper-Processed Eating 25:47 Ad: Boncharge 26:20 What Happens to the Body During a Fast 30:55 Detoxification and the Healing Crisis 35:10 Who Should and Shouldn’t Fast 36:16 Ad: Mudwtr 39:30 Refeeding: The Most Important Phase 44:00 Case Studies: Reversing Chronic Disease 48:25 Weight Loss vs. Health Restoration 52:40 Why Most Diet Advice Fails 56:55 The Discipline of “Nothing” 1:01:15 The Psychology of Cravings 1:05:40 How Environment Shapes Behavior 1:10:05 Living in Alignment With Natural Law 1:14:20 How Much Is “Enough” for a Healthy Life? 1:18:40 The Simplicity of Whole Plant Foods 1:22:00 Conclusion ___________ Episode Resources: https://www.healthpromoting.com/ https://www.instagram.com/truenorthhealthfoundation/ https://www.instagram.com/andreduqum/ https://www.instagram.com/knowthyself/ https://www.youtube.com/@knowthyselfpodcast https://www.knowthyselfpodcast.com

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Speaker 00

  Isn't it interesting that the Jews and the Jain, the Hindus, the Muslims, the Buddhists, the Christians, don't all agree on everything? But they all have a deep respect and longstanding tradition regarding fasting. It turns out, we're able to do something with diet and fasting that's not traditionally done in medicine, and that's helped people get well. Today, we're in a situation where it's so common to be overweight, to have these diseases of excess, that we think it's normal. It's really a difficult challenge to teach people how to get healthy in a world designed to make them fat, sick, and miserable. Fasting's like rebooting a computer. You know how your computer doesn't work, and then you get frustrated, you turn it off, and you don't know why, but when you turn it back on, it's working again.

• 0:44Speaker 00

  I think there's three things that are really important. The idea is to fast as short as possible, but long enough to resolve the problem or achieve the goal. And then, perhaps, the most critical part of fasting is actually, as beneficial as fasting is in sick people, it's even more helpful in healthy people.

• 1:06André Duqum?

  Alan Goldhammer, thanks for being here.

• 1:08Speaker 00

  My pleasure.

• 1:10André Duqum?

  For over four decades, you've been helping people heal through fasting and lifestyle intervention. What originally led you down this path and has made you so committed to it for all these years?

• 1:22Speaker 00

  Well, you know, I was a kid on the spectrum and was interested in playing basketball, and wasn't that good. And I wanted to be better. And so I started reading some books, trying to see if there was maybe I could get an edge. And one of the books I read was a guy by Herbert Shelton, who said that health had causes, just like disease has causes. So if you wanted to be healthy, if you wanted to function at your best, you had to do the things that resulted in that outcome. And he talked about diet, and sleep, and exercise. And he also talked about fasting as a way of kind of undoing the consequences of dietary excess. And that, just for some reason, really struck me as interesting.

• 2:05Speaker 00

  And so I just got very, very interested in that, and I began to pursue that. It didn't do much for me in terms of my athletic prowess, but it did kind of lead me down a path, which I continue to follow. In fact, I remember I was about 16. I was a teenager. And I had decided that I wanted to pursue this whole idea of causing health as a career. I had an uncle who was a medical doctor who was vehemently opposed to anything to do with alternative medicine. And I remember he, it was actually my birthday party my parents had for me. I told the family I had decided to pursue kind of alternative medicine as a career.

• 2:49Speaker 00

  And he said, no, I wasn't going to do that, that nobody in our family would go to a doctor like that, let alone become a doctor like that. He said that better I should be a communist spy. He was really upset. And I remember my father took me aside and he didn't say too much usually. He was a pretty serious guy. And he said, son, I don't know anything about this alternative medicine, but anything that makes him that angry and mad, it can't be bad. So you stick to your guns and good luck to you. And really, my whole life, now I'm 67, so it's been, you know, been doing this since I've been a kid, has been about trying to figure out how to cause health in patients and how to use fasting in an effective way.

• 3:33Speaker 00

  And it's been very satisfying because it turns out we're able to do something with diet and fasting that's not traditionally done in medicine. And that's helped people get well. Because getting well isn't part of the paradigm under conventional medical care. You're on drugs the rest of your life. If you go to a physician with high blood pressure, they won't say, well, this is what we have to do to get you well. What they'll say is, oh, well, you'll take these drugs and you'll be on these drugs forever. And they may cause side effects like chronic cough, fatigue, impotence, and even premature death, but that's how we deal with it. Because getting well isn't really even considered. The same thing's true with diabetes, with autoimmune diseases, and some forms of cancer like lymphoma.

• 4:16Speaker 00

  Getting well isn't the focus. And in our practice, getting well is the focus. The problem is, it takes highly motivated people because they have to do really radical things like eat well and exercise and go to bed on time. And they might even have to go through a period of fasting to help give the body a facilitation. And that's considered really extreme in our society.

• 4:44André Duqum?

  It's so funny how it is. Like. When we look anthropologically back through how humans have evolved up into this point and what has constituted our natural way of being, which creates an atmosphere and environment of health and wellbeing, now living in modern society where we have all of these things where it becomes an uphill battle to just live in a natural holistic way. How, what key insights do you glean from looking back about how we've evolved in terms of how we eat and fasted?

• 5:15Speaker 00

  Well, when you think about human evolution, we evolved in an environment of scarcity. So it was really hard to get enough to eat and not get eaten. In fact, most modern humans probably didn't live long enough to reproduce and pass on their genes, which drive the whole scheme. And as a consequence, we evolved specific skillsets to allow us to get enough to eat and not get eaten. Our brain became huge. I mean, the human brain is our biggest burner of glucose. It's two and a half times that of our nearest relatives, chimps. And, you know, it's very valuable. It's allowed us to do a lot of things, not the least of which is dominate the environment which we live in.

• 5:58Speaker 00

  But it also creates huge demands, not the least of which for glucose. And so humans, for example, if they wandered away from the tropics, the first time spring came late, they'd be vulnerable to death. And that was one of the reasons why we evolved the mechanism of fasting. Fasting is essentially changing your brain fuel from burning sugar to burning fat. So taking our biggest burner of glucose, shifting the fuel so we can use stores, means that an average 70 kilogram male can go, instead of surviving maybe a week without eating, to surviving 70 days. So a huge evolutionary benefit.

• 6:41Speaker 00

  But in that environment of scarcity, there was no dietary excess consistently. So it was always about struggling, trying to get enough to eat. So fasting didn't necessarily, wasn't used originally the way we're using it today, which is to overcome the consequences of diet. Diary excess. The diseases people have today that are so common used to be called the diseases of kings. It was the wealthy elite kings that could develop the gout and the heart disease and the diabetes, the cancer. And today, even people that are of relatively limited income still eat like only kings used to eat before. As a consequence, 70% of the population is overweight or obese. And for every pound of fat that you have that's excess of, about 10% of it on average

• 7:26Speaker 00

  is visceral fat. And visceral fat is a tissue that's hypertrophic, it's hyper metabolic, it acts like a tumor. It gives off inflammatory products that are associated with heart disease, diabetes, autoimmune disease, cancer. And what's interesting is those diseases are treated as if they're independent. You have to go to a different kind of doctor to be diagnosed, let alone treated. And yet, they all have a common contributing factor, which is inflammation associated with excess visceral fat. And so today, we're in a situation where it's so common to be overweight, to have these diseases of excess, that we think it's normal.

• 8:06Speaker 00

  And it doesn't even dawn on people to think that, you know, for 200,000 years, we lived on whole foods. And only 200 years have we been beginning to shift over to ultra-processed foods. 70% of calories today now come from ultra-processed foods for the average person. And so the idea is, maybe what we ought to do is go back to doing what we did for 200,000 years, which is living on a whole food diet and not the diet that's creating the dietary excess, that creates the fat, that creates the visceral fat, that produces the inflammation that leads to the diseases that we're suffering from today. The problem is our brain drives our body.

• 8:49Speaker 00

  And our brain drives our body to engage in behaviors that it perceives will increase survival reproduction. And it does that with a neurochemical called dopamine. And dopamine is a neurochemical associated with pleasure. So when the brain rewards the body for engaging in behaviors that favor survival and reproduction, it does it with dopamine. And the more dopamine, the more we like it, the more reinforcing it is. And there's only two behaviors that naturally stimulate dopamine production. As you can imagine, the two things we need to survive and reproduce, eating and sex. So food and sex are the normal, natural stimulants. We got clever, figured out how to hack the system and artificially stimulate dopamine production in our brains. We do it with drugs, and it can lead to addiction.

• 9:34Speaker 00

  We do it with chemicals that we put into the food. And the chemicals that we put in the food that artificially stimulate dopamine in the brain that results in more pleasure are salt, oil, and sugar. Salt, oil, and sugar aren't food. They're hyper-concentrated food components put back into food to make food taste better, because that's what tasting better means. It means whatever you're putting in your mouth stimulates more dopamine in your brain, reinforces the behavior, and it does it so effectively that 70% of people are overweight or obese.

• 10:06Speaker 02

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• 10:36André Duqum?

  I'm really looking forward to going through the whole physiological process of what happens when you fast. You opened up a whole can of worms with all the different things that are happening within the food industries and pharmaceutical companies. But before we do that, it's interesting that... Big theme, I think, here on this podcast we like to explore is the blossoming of a human being. How does one realize their true nature, their full potential? And in an age of indulgence, in an age where there's so much excess, oftentimes we find so much growth by removing things instead of adding more things. When it comes to fasting, this is a very real aspect of how we relate to food and substances and different liquids

• 11:20André Duqum?

  every single day. And it's quite astounding how we don't really examine the relationship we have emotionally, spiritually, and psychologically to food and how connected they all are. So as we dive in deeper here, I would just love to actually get your quick thoughts on the spiritual component of how fasting for millennia has been leveraged by various spiritual traditions to, for one's spiritual maturation in the process. And so now that we've kind of talked about the ancestral lens and how we've evolved biologically, I'm just curious your thoughts on that component.

• 12:00Speaker 00

  Well, isn't it interesting that the Jews and the Jain, the Hindus, the Muslims, the Buddhists, the Christians, don't all agree on everything, but they all have a deep respect and longstanding tradition regarding fasting. Because the bottom line is that fasting profoundly affects the way you feel about yourself and the world around you. Can't help it. Happens automatically as a consequence of going through that process. And, you know, we don't come to this from a spiritual viewpoint. We come to it from a health viewpoint, but you can't help but see the impact that doing nothing intelligently has on people. And, you know, it obviously affects on many levels. The physiological levels, your brain itself, which is what you're using to basically perceive reality,

• 12:44Speaker 00

  changes fuels. It changes fuels. And when the brain is burning beta hydroxybutyric acid, things feel, look, and are perceived differently than when they're burning your normal fuel, glucose. When people are resting, it is a different experience than when they're Sleep deprived and overstimulated and not getting rest. When they're in a controlled and supportive environment like at True North Health Center, where people are taking care of you, you're in a safe and supportive setting. People's experience of that is different. And just being around other people that are trying to do the same thing for a prolonged period of time, because remember, people are there sometimes for a few days, but many times for weeks or even months.

• 13:25Speaker 00

  And so that experience itself can be rather intense and can have a powerful effect on people's perceptions of themselves and the world around them.

• 13:36André Duqum?

  Before we go into the immediate and I guess more directly observable health benefits that are all derived from fasting, as somebody who's been helping create space that's really conducive for someone's, like an environment for fasting, what have you noticed in terms of people's peace of mind, their levels of joy, happiness, clarity? When you've personally fasted and supported other people, what are those more like hidden things that come along the ride with the health benefits as well?

• 14:03Speaker 00

  Well, there's a certain amount of empowerment that happens when people go through a fasting process. I mean, let's face it, most people are terrified of not eating. They are, if they think if they got on a plane in New York and they were to fly to California, they'd die over Colorado from starvation, except the pretzels, you know, that saved their life probably. So, you know, and it's natural because your biological imperative is get enough to eat and try not to get eaten. That's essentially what your brain's trying to get you to do. And so the idea of purposely and consciously withholding access to food is a very disturbing,

• 14:45Speaker 00

  counterintuitive and challenging, you know, kind of intervention. And when people can overcome that and not just skip a meal or skip food for a day, but for a week or two weeks or as much as 40 days as we do at True North Health, after that, they come away with a certain amount of empowerment. Now they're not as fearful if they had to skip a meal or they might experience this sensation of hunger or they, you know. Worry that their body's not capable of adapting to a lack of food for a period of time. I think that in itself has a profound effect on people, just getting rid of the fear associated with it.

• 15:30Speaker 00

  The other thing is that most people are driven to fasting by pain, debility, and fear of death. So what motivates people is they get so desperate that they can get out of pain, or that they don't die prematurely, that they're willing to do anything, even eat well, or exercise, or go to bed on time, or undergo fasting. And we get highly motivated people. When you think about our operation, we see about, admit about 1,500 people a year. We've had 25,000 people undergo fasting in the last 40 years. And most of them were heavily motivated. Now, an increasing percentage of people are coming in motivated not to overcome debilitating

• 16:14Speaker 00

  disease, but because they understand that as beneficial as fasting is in sick people, it's even more healthy, helpful in healthy people. The people biologically get the most proportional benefit from fasting are actually healthy people doing briefer periods of fasting in order to prevent disease, rather than wait until they get sick and then try to undo the consequence. That's one of the fundamental mistakes, I believe, that's been made by modern medicine, is everything's geared towards wait till people get sick, and then try to do heroic intervention, which often doesn't work very well, in order to undo the consequences of disease. So we treat the leading causes of death, which are heart disease, cancer, and diabetes, instead of the actual causes of death.

• 16:57Speaker 00

  The reason people get high blood pressure, and diabetes, and cancer, which is smoking, drinking alcohol, including organic red wine, and eating a diet that's based on animal foods and ultra-processed refined carbohydrates. If we were to refocus our attention on dealing with the reason people got sick, instead of waiting and trying to deal with them after they got sick, would save a lot of money and get a lot better outcomes, in my opinion.

• 17:24Speaker 02

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• 17:56André Duqum?

  I love your passion for all of this. Can you walk us through what's happening physically, mentally, emotionally, as someone goes on a process of fasting? And how that deepens and difference, is there's a difference there between a one day, three day, five, seven, 30 and beyond day water fast?

• 18:15Speaker 00

  Yeah, it really starts with people's motivation. And so, again, most of the time, people are driven by a specific problem. They have too much weight and they're having trouble losing it, or they're, they're having trouble controlling what they put in their mouth in terms of refined carbohydrates or alcohol or tobacco or something. They've decided they want to break that cycle. And for whatever reason, they've come to believe that fasting may be a tool in helping them to achieve that. So, even the first thing we have to really do is determine, is this really a reasonable approach for that person? Are they a good candidate? Not everybody would be a good candidate, for example, for water only fasting. And the way you really do that is you kind of review the medical history, do a physical

• 18:56Speaker 00

  exam, get some lab work done, and you can then accurately predict who would be a good candidate. In terms of fasting duration, the idea is to fast as short as possible, but long enough to resolve the problem or achieve the goal. And that's why typically in healthier people, where their goals may be able to be achieved more quickly, fasting might be a few days or a couple of weeks. Whereas a person that has a very significant health challenge may be fasting in many weeks or may do multiple fasts in order to achieve their goal. Once they're decided to fast and it's determined they're a good candidate for fasting, the next thing is to remember that fasting is a really intense process and it needs to be done in an environment of rest.

• 19:39Speaker 00

  If people are too active, and too active means even like driving cars around or going to work, doing what would be considered relatively mild activity, that can put the body under physiological stress. If you're too active, you'll burn more glucose. The only way you can get that glucose after the first 48 hours when you've burned your glycogen reserves is through breaking down lean tissue through gluconeogenesis. And we don't really want to break down our lean tissue, we want to preserve it. And that's one of the reasons fasting is so critical, resting is so critical in fasting, is to preserve the lean tissue. If people are more active, for example, they'll lose more weight, but it won't be more fat. It'll be lean tissue. What we want to do in fasting is maximize fat, particularly visceral fat mobilization.

• 20:24Speaker 00

  And what's interesting is it does that. When we did a study using a DEXA scanner, it analyzed body composition. A male, for example, that fasted two weeks would on average lose about 10% of their entire body weight, but 20% of all the fat on their body and 40% of their visceral fat. So this pro-inflammatory visceral fat is preferentially mobilized in fasting, much like tumors are. For example, if you go on a fast and lose 10% of your body weight, you don't necessarily lose 10% of your breast gym. You may lose 20, or 40, or 50, or all of the tumor, because the body has its own method of mobilizing tissues in inverse proportion to their need in the body. So now you have motivated people, they're fasting, they're resting, they're hydrating.

• 21:09Speaker 00

  One of the big concerns in fasting, there's a physiological dehydration that occurs that's part of the hormetic effect. That is how the body is stimulating a healing response. Dehydration is a part of that. But if that becomes too severe, your kidneys could shut down, it could become a very serious problem. So we're monitoring fluid balance. And the other thing is electrolyte balance. So potassium and sodium, these things, you have a limited capacity. You can recycle them to some extent, but we need to make sure that they don't get too low, because that could interfere with your heart's ability to function or your body's ability to be able to maintain. Itself during fasting. So that's why monitoring during fasting is important. We monitor patients twice a day. We're using appropriately physical exam, lab testing,

• 21:54Speaker 00

  et cetera. And then perhaps the most critical part of fasting is actually refeeding after fasting. And too rapid a recovery to or return to feeding after fasting can result in post fasting edema, where you get swelling or even refeeding syndrome, where electrolyte imbalance could result in serious problems or even death. And so we're able to completely avoid those complications by using a progressive refeeding pattern. And so it takes about half the length of a fast to properly realiment after the fast, where you start with fresh fruit and vegetable juices and you go to raw fruit and vegetables and then steamed vegetables and more concentrated food within the body's capacity.

• 22:36Speaker 00

  A lot of the materials that are mobilized during fasting are actually eliminated as you're coming off the fast. So too rapid a return to refeeding could interfere with the ultimate long term healing benefits that one can derive from fasting. So there's lots of ways to screw it up. You could try to fast a person that's not a good candidate. That could be a disaster. You could fast an appropriate candidate, but not let them rest and hydrate and do it properly. That could be a problem. Or you could do everything right and then really screw it up by returning too rapidly to feeding, particularly inappropriate refeeding. And then the final issue is fasting is not a cure. It's a management strategy.

• 23:20Speaker 00

  You can't cure obesity. You can lose the weight. You might keep it off the rest of your life. But if you go back to eating greasy fatty processed junk, you're going to get fat again. You can't cure hypertension. We take people 220 over 120 capped out on meds, normalize their pressure at 100 over 60 off meds. But if you go back to the salty processed foods, it's going to come back. You're not curing it. You're managing it and you're managing it with diet and lifestyle instead of pills and potions. Now, the good news is, it works really well. Like, for example, with high blood pressure, one of the leading contributing causes of death and disability, we did a study with 174 consecutive patients. 174 people achieved normal pressure without medication.

• 24:00Speaker 00

  We've got a study we did recently that was 27 subjects fasted, and 26 of which were able to achieve normal pressure without any intervention. One required half-dose medication. But what was interesting is we followed those people at a year. And in a year, 76% of those people had maintained their weight loss, and the majority were still normal blood pressure without medication. And so it shows that highly motivated patients are capable of making radical diet and lifestyle changes. That's not accepted to be the fact. Most physicians would tell you, people can't make diet and lifestyle changes. And the data would support them in that misassumption.

• 24:43Speaker 00

  Because if you look at the statistics on weight loss, for example, using any of the traditional weight loss techniques, about 95% of people will have their weight back within a year. There's only about a 5% success rate, which actually isn't even as good as heroin addiction or alcoholism. So, a physician actually has a better chance of getting a heroin addict off heroin than they do of getting somebody to lose weight and keep it off. Because with drug addicts, we lie to them. Or, excuse me, with drug addicts, we don't lie to them. We tell them the truth. We tell them, if you're an alcoholic, for example, you have to stop drinking completely. We don't tell them to just have beer and wine. We don't tell them it's okay to, you know, we don't tell them to put their alcohol in a smaller cup, and they won't be a drunk anymore.

• 25:27Speaker 00

  We say, you have to completely stop, because you don't handle that chemical well. But with overweight people, we lie to them. And we tell them, well, just change the color of your meat from red to white, and you'll be fine. Or, you know, put your food on a smaller plate, and put your fork down between each bite, and you won't overeat anymore. And the fact is, that doesn't work. What works is getting rid of the chemicals in the food that fool the brain into overeating. And those chemicals are salt, oil, and sugar. Problem is, very hard to eat highly processed foods without salt, oil, and sugar because highly processed foods are used as carrier agents to carry the salt, oil, and sugar to your palate. We even have professionals called chefs,

• 26:08Speaker 00

  which are trained to deliver salt, oil, and sugar to the palate using various foodstuffs as carrier agents. If you take foods, for example, like bread, and you remove the salt, oil, the sugar, the yeast, you get a product called matzah. Matzah is punishment on Passover. Nobody's overeating on matzah. It's the salt, oil, and sugar that's being used with this carrier agent. If you take beef and boil it and then try to gnaw on it, you're not going to like it. It's being used as a carrier agent for the salt, the sauces. So, we're basically kind of delusional when it comes to what we're actually doing. And we're basically poisoning ourselves with chemicals and we don't even recognize it.

• 26:51André Duqum?

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• 27:34André Duqum?

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• 27:59André Duqum?

  Do you make a direct connection between the food companies that have been making society sick and the pharmaceutical medical industry, which profits off of treating them?

• 28:10Speaker 00

  Well, if you actually track down ownership, you start finding there's a whole lot of overlap. And they're both incredibly successful at, you know, getting their products sold. The pharmaceutical company particularly loves drugs that you don't just take short term, but that you have to take for the rest of your life. That's the, that's the ultimate. And the food companies are really great at selling lots of food. In fact, when they've supersized the people, then they can take even more of their product in. So I think the pharmaceutical and the food industry are largely much of the same conglomeration. And I think they're doing a fabulous job of making money, but maybe not necessarily helping people achieve their optimum health or happiness.

• 28:52André Duqum?

  Safe to say, yeah. So let's walk through what's happening in the body on a one day to three day to five day to seven day and beyond fast. What's shifting as you, as you stay longer and longer on the fast?

• 29:05Speaker 00

  Well, in the first 48 hours, you're still burning glucose, more or less, depending on the person and their activity. You have glucose reserves in the form of glycogen and glycogen will be mobilized. But at some point, you will deplete your glycogen stores. Marathon runners find out that happens around 20 miles. And then, you know, they have to go into this whole enzymatic conversion. It's called hitting the wall. Once you've depleted your glycogen stores, your body is now going to break down lean tissue in order to get glucose as the body shifts to burning fat. And then you'll be ultimately by the end of the second week of fasting, you're burning predominantly fat.

• 29:49Speaker 00

  So there's this really complex physiological adaptation that's occurring that's designed essentially to allow humans with our large brains to survive when spring comes late. And as a consequence of that adaptation,

• 30:05Speaker 00

  Huge changes are taking place physiologically. They have been pretty well studied. Actually, the government studied this very intensely in the Minnesota experiments. There was actually a two-volume textbook written because they were studying the effect of starvation on soldiers. They wanted to know how long people could consistently be able to still kill people without having to carry heavy food burdens and all this kind of thing. And so they really made a detailed study of the physiological adaptations that occur in fasting. And they're complex and they're varied, but the bottom line is to give the body preservation time until, you know, spring or till food becomes, you know, available once again.

• 30:48Speaker 00

  When people are fasting, their experience, though, is very stereotypical. The first thing that often happens is your mouth may coat up and taste like something crawled in there and died. You can get all kinds of detoxification symptoms through the skin and other limited organs. We call it or called fasting rashes. You may pass all kinds of discharge. You may develop some foul odors. You may not even want to be in the same room with yourself, depending on what how well you've prepared before fasting.

• 31:13André Duqum?

  Or how sick the system is.

• 31:15Speaker 00

  Depending how sick the system, how good the limited systems are. And also, different people have different adaptive capacities to fasting, depending on the age of the person and their their internal mechanisms. So individual have very different experiences of fasting. But interestingly enough, the same individual can have a very different experience from one fast to another. But here's the general observation. The more people fast, the better they get at it. They kick in these enzyme systems and it turns out those enzyme systems are involved in macronutrient mobilization and detoxification. Like, have you ever wondered if you, how does fat get burned? It has to be through a process called lipolysis, which is enzymatically driven. How do you get glycogen out?

• 32:00Speaker 00

  It's enzymatically driven through gluconeogenesis or glycogenogenesis. How do you break down protein through gluconeogenesis? All these enzymatically induced systems, those enzyme systems are induced during fasting and they persist, just like an athlete. Every time a person works out, they get better at glycogenylysis. Well, every time you fast, whether it's 12 hours on a daily intermittent fast, or it's a week or two on a yearly preventative fast, or it's a longer fast, for whatever reason, those enzyme systems get better and better. So the people you see that fast every year, it gets easier and easier to adapt. They get more and more efficient, just like becoming a trained athlete. And that may be one of the mechanisms by which the popular intermittent fasting,

• 32:45Speaker 00

  the shorter periods of fasting people are doing, day after day, week after week, may be inducing beneficial adaptations that allow people to get into this process and benefit from it more efficiently.

• 32:57André Duqum?

  So what is specifically autophagy and the systemic uptick in stem cells? And what's happening where the body is really going through and cleaning up and do these processes?

• 33:08Speaker 00

  Well, the Yoshinori Asumi won the Nobel Prize in 2016 for his work on autophagy. So it's relatively recently that this has been recognized as a critically important part of how the body gets rid of senescent cells. As cells age, autophagy is involved in breaking down and recycling those components, and also in getting rid of things like cancer cells or aberrant cells. So the higher your intensity of autophagy, the better chance your body has of getting rid of cancer cells faster than they're accumulating. For example, the theory is that everybody's having some of these aging cells and senescent cells every day. And if they accumulate faster than you can get rid of them, you grow tumors and you get into problems. But if you can get rid of them as fast as they're being formed,

• 33:52Speaker 00

  you can slow down the aging process. And for example, in rodents, where they can test this relatively easily, if you allow rats to, for example, eat ad libitum, they live to a certain amount of time. But if you then restrict their cleric intake to 60% of what they would eat ad libitum, or periodically fast them, you can dramatically increase how long they live, as much as double their lifespan. And part of the thinking is that that allows autophagy to do its job at helping slow down this aging process. In fairness, though, a lot of this research is pretty new. And particularly when we start talking about stem cells in terms of specific mechanisms, we know that stem cell production is thought to increase during fasting. We know that

• 34:35Speaker 00

  it's thought to be a helpful component in slowing the aging process. But in terms of qualitative and quantitative measurements and being able to really be specific about it, I don't think that's ready for mainstream yet.

• 34:48André Duqum?

  What about sleep? Especially as the resting heart rate decreases as you start to prolong your fasts, all the different benefits that come from that?

• 34:59Speaker 00

  Well, one thing we really want to recognize is one of the most important things we do is sleep. And sleep deprivation is associated with immune suppression, so it makes people more vulnerable to illness. But also, it's thought to be very significant when it comes to brain health and vulnerabilities to Alzheimer's disease and dementia. The theory is that when you sleep, there's kind of a flushing effect, a washing effect that takes place. If you don't get enough sleep, particularly non-REM, deep sleep, the brain isn't able to get rid of the chemicals associated with oxidative damage and that that oxidative damage leads to scarring and blacking and other things that may be associated with brain aging. Well, one of the things that happens is a consequence of fasting is that

• 35:44Speaker 00

  sometimes profound improvement in sleep quality. A lot of times, people are waking up because they have to urinate frequently because they have benign press psych hypertrophy, or they have all kinds of bladder irritation. And there's things you can do to reverse that pathology. One thing you can do is not eat three to four hours before you go to bed so that you can empty your bladder and bowels before you go to sleep, so you're not waking there. You can not overstimulate yourself with highly addictive nervous system drugs like caffeine or poisons like alcohol. And you can make sure that you're getting the activity and the stress modulation that you need in order to avoid the consequences of excess stress. It turns out, too much stress is not a good thing. It has profound

• 36:29Speaker 00

  effect on our hormones and other factors, not the least of which is brain health. So It's interesting how it all ties together. If you want a healthy brain, you gotta get enough sleep. You gotta get enough exercise. It turns out people that exercise regularly are able to get to and sleep more efficiently. You can use fasting to undo the consequences that are interfering with it. And you can control what you put in your mouth, particularly in terms of getting a whole plant food diet that's avoiding some of the dietary antigens. And it's going to be true with all of the different common diseases that we look at. It's all going to come back to diet, sleep, exercise, and potentially fasting. Because the mechanisms are the same. It's the same kind of inflammation, the same kind of toxicity, the same kind of living

• 37:13Speaker 00

  beyond our capacities and outside the realm of the way we're designed.

• 37:18André Duqum?

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• 37:57André Duqum?

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• 38:29André Duqum?

  What is the specific mechanism behind why when I fasted in the past, I feel high after a couple of days? Why is there like a just like feel good and surge of like feel good chemicals when someone's fasting?

• 38:42Speaker 00

  Well, some of it is like, you know, you're seeing these profound changes in brain fuel. But also I think that a lot of times it's you're getting to feel like you would normally feel all the time if you weren't suppressing your normal, healthy response with, you know, too much stress, not enough sleep, too much dietary antigens and not getting the raw materials that are ideal. When people, think about when you go camping and you go to bed early and you get lots of sleep because it's dark and there's no artificial stimulation and you're not watching all the worst things that could happen to any human being anywhere in living color on the news and you're, you know, getting physical activity and you're away from all the, you feel fabulous.

• 39:27Speaker 00

  Well, I think that's how people are designed to feel and it's just we suppress that. And so it's just really going back to feeling the way you're supposed to be feeling all the time.

• 39:36André Duqum?

  Yeah. One thing you mentioned this really earlier because I would love to just go through a bit of a protocol for people, of course, with all the medical supervision and all the things that you need to say. I'm curious because you mentioned how we can actually lose lean mass if we're really active and not properly resting when we're fasting. What is the maximum kind of threshold that you've seen in your practice is like viable to like still move, but like not switch from burning fat to burning muscle?

• 40:05Speaker 00

  Well, as long as you're talking about the 12 to 16 hour daily intermittent fasting, you don't have to worry about it. Because you still have glycogen stores, you don't have to call on your lean tissue in order to maintain necessary glucose need. So that's why we recommend everybody fast every day for 12 hours, which means don't eat three to four hours before you go to bed. And if you're trying to lose weight, you might even extend that to delaying breakfast if you've had a chance to do exercise and the theory is to preferentially mobilize fat. And so now you might feed within an eight hour window. So for people that aren't Trying to lose weight or that have no trouble maintaining weight. An eight hour feeding window may help prevent overeating. It avoids late night eating and it gives you an opportunity to induce some of those benefits

• 40:49Speaker 00

  without getting into depletion. Once you get beyond your glycogen stores, though, that's where we're going to recommend that people are resting. So if people are going to go beyond that 16 hour daily fast, then we would recommend that they would do that in a resting state, not be, you know, doing two and three day fast while they're working and carrying on. Because if you think that puts the body under more physiological stress, there's vulnerability. I also should mention, though, that for people that are on medications, you have to really take into consideration the effect that those chemicals are having on your body and how fasting may potentiate those drugs and other things. You really want to talk to the person that's prescribing those medications before you especially get beyond a 16 hour period.

• 41:29Speaker 00

  For most people, they can do a 16 hour a day fast without modifying their normal routines in terms of medications and it's going to work fine. But again, if you're on drugs, you know, the goal is to help get healthy enough so you can get off the drugs. But in the meantime, in that transition, you want to be really respectful because medications are extremely powerful.

• 41:50André Duqum?

  I have been really enjoying for the past many years typically having like a one to three hour eating window every day. If you were to like take a human being, and of course, there's going to be variants depending on everyone's physiological makeup, but does more equal better in terms of daily fasting window? At what point do the benefits start to weigh in?

• 42:12Speaker 00

  Well, we have, there's very good evidence that 12 hours of fasting every day has beneficial effects. And Walter Longo and others talk a lot about that. There's some suggestion that, as I said, for people trying to actively lose weight, extending that to 16 hours has utility and benefit as well. Beyond that, there's a couple of challenges when you try to go to a single meal, you know, regime. And that's that if you're eating the kind of diet that we think is best, not just for short term benefit, but long term health.

• 42:39André Duqum?

  Hard to get the calories?

• 42:40Speaker 00

  It's hard to get the caloric density because most of these foods are lower caloric density, very high nutrient density foods. So the human being, for example, Stomach holds around five to 700 calories of things like potatoes and stuff like that. If you're not using concentrated calories like oil and stuff. So that means you have to fill the feeding bag up at least a couple of times a day just to get enough in. Unless you're eating a lot of more concentrated food or you're in a calorie deficit. Which when people are losing weight might be fine. But long term, if you keep doing that, of course, then you're going to get progressively thinner and could eventually become depleted. So we don't recommend routinely, everybody try to eat all, you know, always eat on a one meal a day program.

• 43:20Speaker 00

  You know, if somebody is, does that on occasion or because they lack of appetite, they're trying, you know, different issue. But on a routine, it takes most people two and sometimes three meals within that eight hour window in order to get enough calories to meet their needs. Now, remember, caloric needs can vary as much as 100%. You know, a 93 year old passive female might have different needs than a 23 year old male who's working as a roofer. So, you know, you've got to take into account that depending on your caloric needs will depend on the amount of more concentrated foods that will be necessary to get enough to eat. Within, within any given window. But we recommend routinely 12 hours for everybody.

• 44:01Speaker 00

  But a 12 hour feeding window is adequate time to get as many meals as you need in order to meet your caloric density, even of these relatively low density foods.

• 44:11André Duqum?

  And then even for regularly healthy folks, do you recommend either a longer three day fast every month or a week long fast every year?

• 44:19Speaker 00

  Well, what we're doing right now is really investigating that, that question. What we're doing in practice is having people that are healthy fast one week a year, diagnostically and preventively.

• 44:29André Duqum?

  Once for once under this.

• 44:30Speaker 00

  End of that week, if they are symptomatic, we continue until the problem or issues are resolved. And now this is for normal weight people that are, have normal blood pressure and normal vitals. And, and we believe that a week is enough to be able to unleash any healing crisis that might be necessary. If they're stable at a week, we're done. For sick people, it's a little different because we're going to fast however long it takes to get them healthy enough that when they eat properly, they'll continue to get well faster than they're getting sick. So if you have high blood pressure, we want to fast you down to healthy blood pressure, which might be 100 over 60, rather than the 200 over 100 that you are on the meds. So that might take two or three or four weeks to fast. In some cases, they can't fast long enough because the reserves aren't adequate.

• 45:14Speaker 00

  So they might do a two-week fast, then six months, we do another two-week fast, until we get everything normalized and eliminate the need for medication. So there's a little bit of individual variation, and you never know exactly till you see how they respond to fasting, because fasting is both

• 45:30Speaker 02

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• 45:59Speaker 00

  Gnostic, as well as therapeutic.

• 46:02André Duqum?

  So if somebody's listening right now, and they're generally a healthy person, but they're curious about the preventative effects and all the positive effects that come from doing a three or a five-day water fast, you recommend distilled water, monitoring electrolytes, doing nothing else in terms of what you're taking in, and being at a state of rest, so not being heavy, active, or working out, and then having a really guarded refeeding window after.

• 46:31Speaker 00

  I do, about half the length of the fast recovery. So a five-day fast, take about seven days of where you're kind of taking time off to do that. And if you're going to fast, for example, on your own, you want to do it with the same protocols that we use at TrueNorth Health Center. So you consult with your doc to make sure you're a good candidate, you rest, you hydrate, you get appropriate baseline lab, and to have somebody available in case there's any issues that come up. Now, what's interesting is, we traditionally have done that at the TrueNorth Health Center, where it's very convenient, it's set up to do that. We examine people twice a day, it's great. We've also begun providing remote support to doctors that want to be able to fast their patients at home, and as long as the fasts are under two weeks in duration and the person is Appropriately supported by their physician in terms of medical complications. We found that there are people that are good candidates for that.

• 47:14Speaker 00

  And we'll provide daily remote coaching to answer their questions and make sure they don't, you know, muck it up. We also get, though, a lot of people calling us in trouble because they've, well intentioned, undertaken a fast, but, you know, they've either were too active, they've gotten dehydrated, they've tried to go to work, they've, you know, they've done some foolish things by taking drugs or substances in conjunction with fasting that's created some problems. And that can get really stressful. And it really makes fasting look kind of bad. So we really want people, if they're gonna fast, do it safely, do it appropriately. If you're gonna do it at home, make sure you, you work with your local health provider and make sure that you're, establish you're a good candidate, do it properly, re-feed appropriately.

• 47:58Speaker 00

  And honestly, most people, particularly the first time they fast, are better off going into an inpatient setting where they can be supported and controlled. If they don't want to do that, though, there's a modified version of this that you can do safely at home without the level of medical supervision. And that's these modified fasting regimes where people continue to take, say, fruit or vegetable juices, or limited chloric intake, they maintain hydration, and they don't get the same intense hormetic effect that water fasting does. So it's slower, you have to be patient. But for people that don't have significant health problems, that might be enough to kind of get the job done. For example, sometimes people will just go on things like watermelon for a day. And it's enough to clear the palate and kind of reboot their system. It doesn't disrupt their ability to maintain their normal medication profile.

• 48:43Speaker 00

  And, you know, there's a lot of suggestions that can be done at home safely, short of water-only fasting. If you're gonna do water fasting, my advice is do it right or don't do it. And we wrote a book, it's called Can Fasting Save Your Life? And it was written not only to help people understand what research is available on fasting supporting this idea, but to convince physicians that might otherwise be skeptical that there really is science behind it and that their patient isn't crazy for thinking that that might be a good thing. And it does that really well. Physicians that read Can Fasting Save Your Life come away feeling like, oh, there's more evidence and support than I thought, it makes some sense. Oftentimes, they become even pro advocates.

• 49:23Speaker 00

  And for patients, it gives them the, there's a lot of detailed information that would guide them through doing fasting safely and effectively.

• 49:35André Duqum?

  Yeah, I found water fasts at different periods of my life very beneficial. I'm doing a liquid cleanse right now for like a four day liquid cleanse. And for the proper refeeding, because you mentioned that it needs to be about half the duration, so do a five day water fast, two and a half days roughly. And what in terms of caloric intake, in terms of what would be, yeah, what do we eat after?

• 50:02Speaker 00

  So with water fasts, there's some general rules of thumb. And again, sometimes you have to vary this because the person has a particular condition that you wouldn't want to say, maybe they have ulcerative colitis, you wouldn't want to put a bunch of raw vegetables into them right away or something. But generally, we use a day of juices for every week of fasting. So if a person had a three week water fast, they might do two or three days of fruit or vegetable juices, generally more vegetable juices and broth and stuff, but enough fruit to be able to get to about 600 calories. And without fiber and 600 calories, it gives the body a chance to gear back out of fasting mode, back into the feeding mode. And if there's any difficulties initially without the fiber, it passes very quickly.

• 50:44Speaker 00

  And then, once they're settled down with that, then we introduce raw fruits and vegetables. And we'll do one day of that for every week of fasting, more or less. And it's seven to 10 days, depending on the person and their history. And then we'll introduce steamed and starchy vegetables. And once that's settled down, we'll introduce non-glutenous grains or beans and finally some nuts or seeds or more concentrated foods. So that, you know, a person that had a two week fast would spend about a week progressively going through that. And those are all laid out in our book or on our website. You can see the actual refeeding schedule, depending on the duration. It is proven, it's tried and true, we've done it with 25,000 patients. When the protocol is followed, it works. Okay? The tendency is for people to want to speed that up.

• 51:29Speaker 00

  And they're feeling so good oftentimes after fasting, they don't realize how vulnerable they really still are because the body's rapidly and intensely detoxifying even in the days off of fasting. In fact, those are some of the most productive days if they're done right. Rather than having stuff resorbed, you're able to process and eliminate those accumulated intermediary products of metabolism that have been mobilized during fasting.

• 51:54André Duqum?

  Are there main differences between men and women fasting, either daily intermittent or longer ones that people should be mindful of?

• 52:01Speaker 00

  Well, in general, you know, women are a lot tougher than men. So I think they're a lot easier to work with. Our tolerances as males, I think, are somewhat less to certain types of discomfort. But women also have a completely different physiology. When you think about it, healthy women will maintain 25% more fat than men would on average. Women have significant numbers of complicated systems that men don't, you know, have to deal with. Weight loss for women is slower than males. Women are full of estrogen, which is a fat storage hormone. And men are full of testosterone, which is a fat-burring hormone. So you definitely have differences between men and women.

• 52:41Speaker 00

  And most of it's quicker and faster and easier in males than it is in females. It seems like women always have to work harder at pretty much everything to get the same kind of results. So we tell them to get used to it because, you know, there's nothing we can do to change that. I think that it was really necessary for women. When you think about women of any species, including humans, they're essentially energy-conserving fat storage devices. They had to be able to store fat in order to survive a period of biological vulnerability called pregnancy, which, by the way, men don't even have any relationship to biologically.

• 53:22Speaker 00

  And so that necessity makes them more efficient at storing fat. So that when it comes to losing fat, the female brain is not saying, "Oh, good on you, girl. Let's get rid of this fat." No, it's saying the opposite. You store as much fat as you can for as long as you can, because then if you get pregnant, you have a better chance of survival. Your body's designed to conserve energy and to store fat. And essentially, biologically, women that stored fat well were the winners. The people that could eat whatever they wanted and never gain weight, they weren't the winners. The winners were the ones that took that long boat ride and they survived. They probably ate everybody else for all we know. But the bottom line is, if you store fat easily, that's not a bad thing.

• 54:07Speaker 00

  That's a good thing biologically. And in a natural setting, you and your ancestors were the survivors. In the modern world, you're screwed. Because with ultra-processed food, the question is only, how fat are you gonna get? Because if you're eating those foods and your body has good plumbing, which by definition, if you gain fat easily, you got good plumbing, you're gonna get proportionally more fat. But you need to not see gaining fat easily as a bad thing. It's not, it's a good thing. It just means you have to change your environment.

• 54:37André Duqum?

  Why is having fat not great physiologically?

• 54:40Speaker 00

  Well, having fat is critical and necessary.

• 54:42André Duqum?

  Yeah, yeah.

• 54:42Speaker 00

  Having too much fat is a problem. And what happens is, you know, getting fat is so valuable that healthy people will store fat to survive the inevitable scarcity that would naturally be present. But storing too much fat leads to a formation of a type of tissue called visceral fat. Visceral fat is pro-inflammatory. It's hyper-metabolic. It acts, as I said, like a tumor.

• 55:05André Duqum?

  And so the fat around the organs.

• 55:06Speaker 00

  It generally accumulates around the organs in the belly. That fat there functions differently than your normal adipose tissue.

• 55:12André Duqum?

  How so?

• 55:13Speaker 00

  Because it produces inflammatory products. Now, why does it do that? Probably because it shouldn't be there. This is aberrant tissue. The body was not designed for an environment where dietary access would be routine. It almost never, like, for example, even if you go back to when we were kids, or at least when I was kids, typical classroom, you had one or two overweight children. Sometimes they were made fun of. Now, there's one or two kids that are not overweight. Okay? We've gone through this big change. In fact, 1986, I always think of significant things. We introduced high fructose corn syrup. And then we started subsidizing it, making it cheap, and the soda pop. And you think about, it used to be like a nine-ounce Coke was a special treat, right?

• 55:57Speaker 00

  And now you got the Big Gulp with free refills. And you know, it's like, we've completely turned ourselves On end. And as a consequence, we're getting excess tissue and that excess fat just happened to have this inflammatory process and it leads to diabetes, heart disease, autoimmune disease, cancer, which is what we're suffering from. And if you look at the fatter people are, the higher their risk of dying from those diseases. If you go to countries where percentage of body fat is lower, the disease rate is much lower until they get more wealthy and begin to adopt our dietary habits. And then the disease rate escalates. And now we're seeing it worldwide. What we're seeing in China, you see in India, you see in all the places that begin to adopt our hyper-processed foods, get our

• 56:42Speaker 02

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• 57:12Speaker 00

  Consequence of hyper-processed foods, diseases.

• 57:15André Duqum?

  So could you expand on what is the unique link between visceral fat and certain types of cancer and how fasting is an efficacious intervention for those?

• 57:24Speaker 00

  Well, visceral fat is associated with an inflammatory response. It's associated with cancer. It may not be the only factor, but I'll give you an example, like even during the pandemic where we had the highest death rates around, which it's kind of curious if you think medical care is going to help protect you. The reason is that we also have the highest percent body fat. And the fatter you are, the higher your risk of dying from infections, including COVID-19 infections and all the rest of it. Now, you didn't hear much of that because that would be blaming the victim and it's not politically correct to acknowledge that being overweight might actually have some health consequences. But it does. Not the least of which is being vulnerable to dying from infectious diseases

• 58:04Speaker 00

  as well as these other diseases that we've been discussing. And fasting, much like it does with other types of tumors, preferentially breaks them down. And so you'll see lots of masses and growth that go down with fasting disproportionate to the amount, percentage of body fat that's lost. So in my mind, visceral fat is like any other tumor in the body and fasting happens to be good at giving the body a chance to get rid of the things that ails it.

• 58:32André Duqum?

  So fasting is an incredible intervention for these more chronic illnesses and diseases. I'm curious, how much do you feel like, or potentially all of chronic disease could be tracked back to what we put in our mouth and how much of it?

• 58:45Speaker 00

  Well, I think there's three things that are really important. Number one is diet. Number two is sleep. And number three is exercise and activity. You know, our ancestors that couldn't just sit around and, you know, get fat because they got hot, they got cold, they got thirsty, hungry, and they didn't want to get eaten. And people that didn't move didn't make it. Okay, now, in the modern world, post-industrial world, we can sit around, in fact, men in our society, or I understand, don't even exercise anymore. They hire other people to do it for them. It's called the NFL. So they sit around in overstuffed chairs, drinking high-caloric beverages, watching other people engage in mock warfare, pretending to be part of the winning coalition.

• 59:30André Duqum?

  Yeah, yeah. So it seems, it's funny, and I know how you opened up with it being a radical act to actually care about your sleep, diet, and exercise, and the healthy lifestyle that you can create. When it comes to the hyper-palatable foods and the excess of salt, oil, and sugar that hijack our system and make us feel like we need more food than we actually nutritionally do need, yeah, talk about the importance of examining that and how we can guard ourselves from not praying, you know, prey.

• 1:00:08Speaker 00

  Well, it's not-

• 1:00:09André Duqum?

  Sorry, not falling prey to those.

• 1:00:12Speaker 00

  It's not fundamentally different than any addiction. You know, some people can drink alcohol and not become a drunk, but if you're a drunk, it's not you. And some people can eat bits of this and that without becoming overweight, but if you're overweight, it's not you. It's not like you haven't tried to regulate it. You can't regulate it. And so the answer is, don't take the chemicals that fool your brain. And so, you know, it's ideally, if you're eating exclusively whole plant food diet, right? So it's fruits, vegetables, grains, legumes, nuts and seeds, and you're not eating animal foods, the meat, fish, fowl, eggs, dairy products, oil, salt and sugar. We know what happens because we've got thousands of patients that we've worked with.

• 1:00:53Speaker 00

  If you're a male, you can expect to lose about three pounds a week with moderate activity down to optimum weight. If you're a female, only about two pounds a week down to optimum weight. So women will lose about 50% less weight, everything else being equal, just because of the differences between men and women. The problems that are associated with diureticus begin to reverse. Now, they don't reverse quite as quickly as they do in fasting. You know, things that may take a couple of weeks of fasting, it might take you weeks or months of feeding, but the process continues and it continues to unwind. One of the benefits of fasting is we can get people sometimes out of pain so they can get back to being active and they can, you know, they're not depressed anymore. So now they're willing to take action. But the fundamental healing is diet, sleep, exercise.

• 1:01:38Speaker 00

  That's why not only is it necessary to heal, but in order to maintain it, you have to maintain it. Radicus means radical root or cause, right? Radicus. So you have to deal with the root or cause of the problem. And that's not what medicine is doing. Medicine is helping alleviate the pain without actually forcing you to actually deal with the issue. And that's why it doesn't work very well for so many of these chronic degenerative things.

• 1:02:04André Duqum?

  Carl Jung has this interesting quote where he says, "Pleasure is tension reduction." And when it comes to the emotional drivers behind our food choices, I'm curious, because when I've gone on a water fast, after a couple of days, I'm not even actually hungry, but like the emotional, if there's any emotional dysregulation or like the comfort that food provides for us emotionally, I'm just curious, how important do you think it is to examine the relationship between those emotional drivers and the choices we make food-wise?

• 1:02:30Speaker 00

  Well, the reason hunger goes away is there's a hunger blunting effect of ketosis. In other words, fasting blunts hunger. And it's probably an adaptive mechanism. If there's nothing to eat, it doesn't do a lot of good to have your attention focused on how hungry you are. And, you know, after a couple of days, people water fasting, for example, they'll go to cooking classes, they'll go, they'll socialize over dinner without eating. And, you know, you think, oh, that would be so impossible, but it's not because of this. And now a lot of people are trying to mimic fasting effect with fasting mimicking diets or fasting mimicking substances to try to induce that response that happens when carbohydrates are eliminated and the body goes into a ketotic state where your brain is bringing primarily

• 1:03:12Speaker 00

  beta-hydroxybutyric acid. That hunger blunting will go on all the way, actually, until you get into depletion. And, and, once you, if you fast long enough, you enter a different phase, it's called starvation. And then you get depleted and die. And so we really meticulously avoid doing starvation. We only do the fasting part. That usually comes at what, like day 60 and beyond? It depends on the, the, the reserves of the individual. For some people, it could come much earlier if they're, you know, depleted, or it might, they may not run out of caloric fuel, but they may run out of electrolyte balance or other issues. And particularly now, we're seeing problems with fasting that we didn't used to see before

• 1:03:55Speaker 00

  because people are taking these new diabetes drugs that are being used for weight loss. Ozempic? Which is simply essentially make people nauseous and disrupt gastric motility, make them sick, basically, so that they don't eat as much of their highly processed foods or even their drugs. They, they find a reduction in craving. If you make people sick enough, they don't crave as much of that food. And the attraction is, one, you have to take the drugs the rest of your life because as soon as you stop, it's over. Second of all, you don't have to change your diet under those programs. You can keep eating all that health compromising food, but because you're sick, you won't feel as much hunger, you won't eat as much, and it is successful at weight loss.

• 1:04:38Speaker 00

  And here's the thing, even though it's not a good long-term strategy, in my opinion, because of the compromise to health that happens, being overweight is so dangerous that even losing weight by making you sick may have some net short-term benefits. Yeah. But if you look at how long do people keep taking the drugs, you find it's not unusual at three months, four months, people will discontinue it because they don't like. Losing weight from being sick and they don't like the side effects. You can induce those same chemicals, though, with diet and exercise. It's just, it's a lot more work.

• 1:05:07André Duqum?

  Yeah. So when it comes to Ozempic or these GLP ones, and there is, I believe, with Trump's like, like, recent initiative of like, making these way more widely affordable or accessible. You just hinted at the, obviously, there's benefit to losing fat and your means to getting there. But it sounds like otherwise, you're just not a big fan of what it's doing physiologically.

• 1:05:29Speaker 00

  No, I'm not. And including in diabetes, it may be an effective way of regulating blood sugar levels. But what's better is diet, sleep, and exercise and fasting. And, you know, most of our type 2 diabetics were able to achieve normal blood sugar without medication. But again, it comes back to, you know, you have to be prepared to do the diet and lifestyle changes in order to sustain the results. For people that are really wanting to get healthy, though, not only does it work short term, it works long term. And, you know, I have a lot of patients, and I've been doing this 40 years. So I'm tracking these people that were in their 40s and now they're in their 80s. And what's interesting is you keep hearing the same story over and over again. Everybody they know is dead, including, in some cases, their kids,

• 1:06:12Speaker 00

  who are having heart attacks in their 60s and whatnot. And, you know, I was, it's my mom is, was a good example. 92 years old, she outlived all 50 of her lifelong friends. And she said it was getting harder and harder to make new friends. Because even people 10 or 15 years younger than her were still too sick and involved with all the doctors and whatnot to do the things that she wanted to do. And she said, Alan, you have to warn your patients. If they're going to live like this, make younger friends. Or have a couple of friends that are health conscious. Because, you know, that's a big problem for people when they don't have social network. And that's one of the biggest challenges to people that go on this kind of diet and lifestyle approach. They lose the weight, you think it'd be all good. No.

• 1:06:55Speaker 00

  First of all, they can become a social outcast. And a lot of people get really upset with you. Especially women find, you know, they can run all kinds of problems. I have women that say they'll like, wear baggy clothes to work because all the other women get upset with them because they've lost weight and whatever. They're not supportive at all. They're often frankly antagonistic. And they'll actually try to undermine their success. It's very much like-

• 1:07:18Speaker 02

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• 1:07:47Speaker 00

  Like alcoholics find, sometimes they have to make new friends.

• 1:07:51André Duqum?

  When it comes to the psychosomatic element, if somebody has, maybe they have an excess of body fat, they do have some physiological stuff. It's not easy nor fair to ever separate the mind and the body, right? They're intimately intertwined. But what have you observed, even if it isn't the primary objective, for people that are suffering various mental ailments, psychological issues, without any guarantees or promises, what have you seen as a byproduct that fasting can provide for people mentally?

• 1:08:21Speaker 00

  Well, remember that most of the serotonin and dopamine that was normally thought to having an effect on brain is produced in the gut. And so it's not shocking that when you go on a fast and you reboot the gut microbiome, which is a profound effect of fasting, and you have a trillion creatures living in your gut, swimming around right now.

• 1:08:41André Duqum?

  Quite the visual.

• 1:08:42Speaker 00

  Five pounds of organisms, bacteria, protozoa, and they're eating, drinking, and defecating in you right now. And what they poo in you depends on what you feed them. If you feed them a high

• 1:08:53André Duqum?

  I tried telling this to my last date, by the way, and she just, it wasn't working.

• 1:08:58Speaker 00

  If you feed them ultra-processed foods and animal food, you have different organisms, a thousand different strain of organisms than people that say are on a plant-based diet. And their poo is different. If you, if you feed, for example, people that eat large amounts of animal food have high levels of TMA, which is trimethuminoxidase, which produces, associated with heart disease and all kinds of problems. People that are on plant-rich diets tend to make a lot of vitamin K and fertilizer. So depending on if you want fertilizer or toxic weight, depends on what you shove in the In the feeding hole. And that, you know, that's on a fundamental level, that may be an important part of also psychological health because dopamine production, serotonin production profoundly affected by this balance in the gut.

• 1:09:42Speaker 00

  You also have, interesting in women, for example, women have problems men don't even know anything about, but fibrocystic breast disease, dysmenorrhea, menorrhage, polycystic ovarian syndrome, uterine fibroid tumors. There's like a whole industry of diseases that women get. And there is one thing that seems to be kind of associated with all of them. And that's that if estradiol, the active estrogen hormone, doesn't get broken down to esterol and excreted in the urine, the estradiol builds up and it seems to be associated with a lot of these problems. Well, what breaks estradiol down to esterol is the bacteria that live in the gut and the liver function. So it may be the reason women get so much benefit after fasting with their fibrocystic breasts and the dysmenorrhea and all this stuff, maybe because of the effect on the

• 1:10:26Speaker 00

  hormone balance that's occurring because of their relationship with these organisms. And fasting is like rebooting a computer. You know how your computer doesn't work and then you get frustrated, you turn it off and you don't know why, but when you turn it back on, it's working again because you flash the memory, whatever it is that is going on. It's the analogy is it's similar in people. When you shut it down with fasting and you turn it back on, not only does it feel sometimes better even during fasting, like you experienced as your serotonin and dopamine levels are modulated, but the entire system of balance seems to be rebooted. And that may be why even a short fast, like a few days or even a week, can sometimes have a profound effect on especially relatively healthy people that, you know, don't have

• 1:11:10Speaker 00

  to have a wholesale renovation, but just need a little bit of fine tuning.

• 1:11:13André Duqum?

  Hmm. When it comes to resetting our system physiologically. How have you seen that can directly affect addictions, both to substances and

• 1:11:23Speaker 00

  Yeah.

• 1:11:24André Duqum?

  various food, which are also substances? Yeah.

• 1:11:27Speaker 00

  What's interesting, by the second day of fasting, or maybe the third day, depending on the person, most cigarette smokers report no physical cravings for cigarettes, which is a lot faster than it is when you try to quit. And most cigarette smokers will tell you, "Oh, that was the easiest transition I had. It was so hard for me, and that was much easier." Now, they say, some people say, "Yeah, they're so miserable fasting, they don't think about the cigarettes." And that's not true, though. It, it, yes, they are miserable fasting, but it goes, just that whole process goes through quicker. Alcoholics also find sometimes when they stop drinking while in conjunction with fasting, that whole process tends to be facilitated. And for people that are addicted to sugar, and also, to some extent, salt and fats,

• 1:12:11Speaker 00

  that transition to healthy eating is much quicker. For example, even after a week of fasting, people will eat, say, Swiss chard, and they'll say, "Oh, my God, it's so salty." Well, it's the same salt it's ever been naturally in the chart, but you couldn't taste it because your tastes have been neuro-adapted from being addicted to artificially concentrated substances. Fasting reboots the pot. We actually did a study showing that the actual sensitivity to sodium and sugar changes with fasting, that you need less stimulation or to feel satiated after fasting. And so now, whole foods start to taste good, whereas they're disgusting, tasteless. Well, to many people, they're addicted to sugar. Once you get free of that addiction, now you can actually like the taste of healthy foods,

• 1:12:54Speaker 00

  which improves our adherence and compliance. Because if you don't like food, it's very hard to get people to stick to a healthy diet. If you like it, and it gets better and better as time goes on, our adherence goes up. And then, once we get people eating enough food, there's not as much room for all the processed crap. Then they're able to start losing weight. Then they get higher self-esteem. They feel more confident. They realize it is possible to beat the problem. And then they stop blaming themselves. Because, you know, people that are, for example, having trouble with weight, it's not because they're damaged goods or psychologically impaired. It's because they're a little bit more sensitive to the effects of these Particular chemicals and that's genetic. That's not a personality deficit. If you look at people that gain fat easily,

• 1:13:36Speaker 00

  they're not any more messed up psychologically than people that don't. But people that don't may be a little bit more satiety sensitive. And so they're not going to tend to eat as much before their inhibitors kick in. So these are biological differences, not psychological differences in my experience.

• 1:13:53André Duqum?

  Hmm. I love the, just the importance of the reflection on how our sensitivity increases. And we can start to enjoy the foods that are healthy for us. And it just seems like that is a thing across the board. Like the more that a person is fulfilled within themselves and has that level of sensitivity, you need less stimulation. You need less of the hyper palatable foods to feel like fulfilled. And that goes from food. It also goes to relationship dynamics and how we're not moving from a place of desperation of, you know, because we're lacking something and we need this whole filled within us. And it seems like fasting is one of those areas which at first, maybe unsuspectingly, actually has so many far reaching benefits on all of these different dynamics.

• 1:14:38Speaker 00

  Well, and they're not just fasting from food. For example, we ask them not to be watching the news and all this stuff. You know, people don't understand how powerful this constant stream of hyperstimulation is, especially involving things you can't do anything about. So, you know, I advise patients that, you know, they need to stop spending so much of their energy worrying about things they can't have any influence on. They can't do anything about it. And nothing they're worrying about it isn't going to change it. Focus on the things you can actually have some effect on. And it doesn't mean there's no stress in your life. There's going to be stress, but we don't have to artificially stimulate the stress by watching news broadcasts that are designed to do exactly that.

• 1:15:22Speaker 00

  And, you know, I think some of the social media stuff and the clickbait and all the other stuff that's going on is designed to kind of engage your nervous system. Just like they train the gambling machines to kind of bang on your nervous system. You know, we've just got to become a little bit more aware that we are vulnerable. To some of these influences and we can consciously, volitionally override that. And we might feel a whole lot better because of it. So some of the benefit we see may not just be because they're getting off the food, but they're also getting away from dealing with what I call energy vampires. People that do what they do best, and that's make other people as sick and miserable as they are. So by comparison, they don't have to feel so bad. And we need to kick those people to the curb and focus on people that at least will be neutral, if not supportive.

• 1:16:05Speaker 00

  You just, you just can't have that much room for too many energy vampires because it will definitely bring you down.

• 1:16:12André Duqum?

  Have you ever been in a room where, let's say, the air conditioning unit or the fridge was running and then it turned off? Or maybe the power went out in your house? And there's this shift from this noise that was humming in the background you didn't realize was there to the contrast of stillness, of peace, of, of less noise. And you feel your nervous system relax and exhale.

• 1:16:33Speaker 00

  Yeah, I find, for example, just flying on a plane where there's inherently large, and if you put earplugs on the plane, you'll get there more rested and relaxed than you would if you listened to that 80 decibel, you know, background noise constantly. And also, it's not just the quantity of noise, it's the quality of noise. It's like the words people are saying sometimes is a problem. You could listen to somebody saying pleasant things in the background, but caustic, you know, hateful and things have, I think, a bigger impact on our nervous system than other things. And some people are much more sensitive to these influences. And that's the one thing people don't always recognize. For example, if you happen to be like me and you're far enough on the spectrum, you don't worry as much about what other people think.

• 1:17:16Speaker 00

  And as a consequence, them feeling bad isn't as much of a problem. If you happen to be one of those loving, caring, kind, gentle people, and I'm not being critical, I know you can't help it, it's, you know, it's your genetics. You're going to be more vulnerable to making diet and lifestyle changes because you will be, you'll be concerned about other people being upset with your success. And so for some of us, it's a lot easier because we don't care. And for people that do care, you just have to recognize that, you know, that makes you a little bit more vulnerable and you have to put that much more effort into kind of managing the people in your environment.

• 1:17:52André Duqum?

  There's something so profound about the shift where you actually, you have the experience of what it's like to be in a body and a nervous system that isn't so dysregulated, where like the power turns off at the house or the noise, you know, the fridge turns off and you're like, oh, okay, you exhale. And I feel the same shift when, you know, a couple of days into a fast, for example, where there's just less of this background mental chatter that is consuming consciousness. And how like liberating that feels and you're, you pointed to many times throughout this conversation, that's our natural state, you know, we can actually be there throughout the day, all of our life or most of our life.

• 1:18:30Speaker 00

  Yeah. And, you know, the, the question is, how can you try to maintain that without necessarily removing yourself from the world like the yogis do? So, you know, so, and I think there are practices, I'm not an expert in those practices, but there are practices that people engage in, in various types of meditation, et cetera, that try to help people keep grounded. I find it actually through basketball. I play 10 hours a week of basketball. And I find that, you know, there's certain routines I go through, like free throw shooting and other things that are very meditative in, in practice and in nature, and they have a profound effect on how I feel and function. And I noticed like a couple of weeks ago, I broke my thumb in basketball. And so I haven't been able to engage. I absolutely

• 1:19:15Speaker 00

  feel profound difference, just not engaging in those, those activities on a, on a consistent basis. And I'm sure it's very similar to what people find with their music practices and their meditation practices and their, you know, all the different things that people, people do. For me, I just like basketball, so.

• 1:19:37André Duqum?

  I love it. I'm sure you're, you're a killer on the court.

• 1:19:40Speaker 00

  Well, I'm, you know, I, I've been playing a long time and. Doug Lyle and I, we're buddies. He's our psychologist. And we finally got to, they have these senior basketball tournaments. We went to Florida and we played in the national senior tournament. And it's 65 and to 70 range. So we got to be the young guys again, which was great because we're in much better shape than most of them. But the problem is they're still six foot six.

• 1:20:06André Duqum?

  Yeah.

• 1:20:08Speaker 00

  So he still kicked our butt. But it was nice to be able to, you know, because I'm used to playing with people 25, 30 years younger. And sometimes that can be a little bit dispiriting because they have a level of athleticism that you're not going to maintain necessarily in your 60s and 70s. But it's something I enjoy. I've never been particularly good at it, but I, I, I'm good at playing it, you know? So I enjoy playing it and it's, for me, that's great. And I think lots of people have different places that they can put that kind of energy into, and it's productive and effective. And we certainly encourage our patients to, you know, find the niche that works well for them.

• 1:20:43André Duqum?

  Yeah.

• 1:20:44Speaker 00

  Preferably one that's a little bit less dangerous.

• 1:20:46André Duqum?

  Yeah. Alan, you know, one of the beautiful things I get to do on this podcast is meet individuals who have devoted their life to a field of study. For whatever reason, they've just felt so called to. And I can see the passion and the aliveness that, that happens when you get to talk about all the things we did in this conversation today. And I'm just curious for you, what do you feel like is really the essence of why you're so lit up by everything we talked about?

• 1:21:12Speaker 00

  Well, I think I get to do something that most doctors never get a chance to do, and that's consistently see people get well. And also, most physicians are limited to, you know, they have to work the best they can with whoever walks in the door that lives within, you know? Whereas our practice, I do all the screening of all of our patients. So when people go on our website, for example, and fill out the questionnaire, I do a free phone conversation with them to kind of make sure they're a good candidate, point them in the right direction. And I find it incredibly rewarding because we can pick out the people that are likely to have really good results. They come in, they have the result, and then we get to follow them for years or decades. So it's inherently satisfying. I think it's the work that most people go to medical school to do, but never get to

• 1:21:57Speaker 00

  do. And so I think that's really where the enthusiasm comes. Although my wife says the entire operation is just so I'll have a place to eat lunch.

• 1:22:07Speaker 00

  The other, I've also been accused that what I really get passion from is proving that we're right and everybody else is wrong. And that may be why we're doing the research that we're doing and trying to publish the papers and, you know, trying to get into that, into the heads of the mainstream. And it's a great challenge. It's really a difficult challenge to teach people how to get healthy in a world designed to make them fat, sick, and miserable. And I think it's the hardest thing you can ask a patient to do is to make these diet and lifestyle changes. It's the most rewarding, but it's also the most challenging because it challenges not just their own addictions, but also the whole social environment that they live in. And so it takes tremendous amount of effort and it takes tremendous amount of consistency in order for people to be successful.

• 1:22:52Speaker 00

  It's not for everybody.

• 1:22:53André Duqum?

  What do you think it would take to live in a society one day where we didn't have to constantly fight all these uphill battles?

• 1:22:59Speaker 00

  Well, I think the first thing we ought to do is let's start electing people that can read. I think that might be a novel story.

• 1:23:05André Duqum?

  Might be a good start. What are, do you want to mention anything with those studies that you have done and are doing right now?

• 1:23:12Speaker 00

  Well, we've done a number of studies. The first one was looking at safety studies. So we did the first long-term study showing that fasting when using this protocol can be done safely. And then we looked at effectiveness. We took, for example, the study I mentioned with hypertension with 174 people and then later a prospective study with 27 subjects and showed that the majority of these people could achieve normal blood pressure, get rid of the medication. About 80% of our type 2 diabetics can achieve normal blood pressure without medication. We treat autoimmune diseases where the body's attacking itself, which when you think about it is the opposite of cancer. In cancer, the immune system's not vigorous enough to keep down the formation of mutated cells.

• 1:23:55Speaker 00

  In autoimmune disease, the immune system's overly reactive and is attacking itself. And often when you treat cancer by turning down, or turning up the immune system, you end up with autoimmune disease, even if it's effective at dealing with the cancer. If you treat autoimmune disease by turning down the immune system, you become more vulnerable to cancer. So I'm suggesting- That these are basically opposite sides of the same coin. So the trick is, how can we normalize the immune system without overstimulating the immune system, which is associated with the side effects when they're using, say, immunotherapy and some of these things. And for some patients, fasting and diet lifestyle change does that. It will help calm the nervous system down and autoimmune disease.

• 1:24:37Speaker 00

  It'll stimulate it for for some forms of cancer. And so we're helping to see some balance there that you wouldn't otherwise be able to do with conventional conventional practice. And even for people, for example, that are using, say, for example, chemotherapy for cancer treatment, if you fast those people before and after chemotherapy, you can dramatically affect the success of chemotherapy. Because some cells, differential stress sensitization, for example, cancer cells have a high metabolic needs. They don't do well in a ketogenic environment. But normal human cells are adapted to that because fasting is a biological adaptation. So when you put the body in a fasting state, chemotherapy works better. And there's less side effects.

• 1:25:21Speaker 00

  And once Walter Longo published those studies showing that, for example, 30 rats with cancer, if you give them enough chemotherapy, they all die from the effects of excess. But the same rats with the same cancer, fasted before and after, dramatically increased survival. So once pharmaceutical companies realized, oh, something's happening in fasting that's making cancer cells more vulnerable and helping protect healthy cells, they got excited and fasting went from being criminal quackery to cutting edge research because they said, oh, all we need to do is come up with fasting mimicking drugs. And if we can get a drug that'll do to the body what fasting does, but without that nasty fasting, they'll have a product they can sell and make lots of money on.

• 1:26:05André Duqum?

  Undefeated and making a profit. What, having context of our whole conversation today, is there anything that you feel like we missed that would fill in any gaps that would be helpful for our audience?

• 1:26:15Speaker 00

  Well, we talked, we didn't talk about the motivation. Like, why do doctors, are they so intent on pushing, for example, chemotherapy or immunotherapy drugs or steroids and whatnot? And one of the things you might want to look into is that, you know, a while ago, they kind of separated pharmacology from physicians' practice because they felt there was an inherent conflict if the doctors were selling drugs. But if you look into

• 1:26:43Speaker 00

  How drugs are administered now for cancer and autoimmune disease, you'll find out that it's actually doctors that are owning the centers that are distributing the drugs. So the more they distribute, the more money they make. And I'm not suggesting that money could ever have an influencing effect on people's behavior. But in the case of drug prescriptions, you know, that's really a big profit center right now. And I believe that profit is a major factor in driving the behavior when it comes to what we recommend, particularly when it comes to chemotherapy and immunotherapy and treatment for autoimmune disease.

• 1:27:24André Duqum?

  I know it can be quite baffling and aggravating at times to see the incentives that are driving so much of the chronic disease that are this pervasive throughout society. But I really appreciate how individuals like yourself are being a pioneer in creating institutions and places where people can come and return to the natural way our body has the intelligence to heal and go through these processes. So, thank you for the work that you're doing. And if people want to stay more connected with that world and True North and whatnot, we'll leave links down in the description where people can stay connected. Is there anything you want to point people towards?

• 1:27:57Speaker 00

  Well, if they want to go to our website at TrueNorthHealth.com, if they fill out the registration forms, we offer them a free phone conversation. I'm happy to do that. If they really want to go into a deep dive, they can read our book, Confess and Save Your Life. It's a good book. It's well done. They'll enjoy it.

• 1:28:13André Duqum?

  Amazing. If you could leave our audience and everybody who's listening to this conversation with one thought about reclaiming their health and life, what would you share?

• 1:28:24Speaker 00

  Health results from healthful living. And healthful living involves diet, sleep, and exercise. So if you want to be healthy, you got to pay the price and do what it takes to get healthy.

• 1:28:33André Duqum?

  Alan, thank you so much. I thoroughly enjoyed this conversation.

• 1:28:37Speaker 00

  My pleasure.

• 1:28:38André Duqum?

  Yeah, I appreciate you. All right, everybody. Thank you for tuning into this episode of the Know Yourself Podcast. I'll catch you on the next one.