The Crazy Benefits of Water-Only Fasting With Dr. Alan Goldhamer

When you hear the word ‘addiction’, our attention typically turns to mind-altering substances -- illicit drugs, alcohol, and prescription medications. Typically overlooked in this conversation? Food. But food addiction isn't just real, it just might be our biggest problem. In fact, the hyper-industrialized western world is firmly entrenched in an epidemic of dysfunctional eating, fueled by an outsized appetite for an ever-increasing array of highly processed foods that are scientifically designed -- with just the right amount of sugar, salt and fat -- to hijack our nervous system. Enslave us to compulsive habits that lead to illness. And ultimately render us wards of the pharmaceutical industry. So how does one effectively transition to a healthy diet sustained over time? According to Dr. Alan Goldhamer, a great place to start is by fasting. I'm not talking about a couple days of drinking juice. I'm talking about nothing but water for upwards of 40 days. Even with strict medical supervision it sounds like scary quackery. But over the last few decades, Dr. Goldhamer has successfully supervised over 20,000 patient fasts. Along the way, he has seen lives transformed wholesale. Unhealthy eating habit addictions broken. Medications ditched. And countless illnesses overcome. An iconoclastic pioneer in his field, Dr. Goldhamer is the founder of True North Health Center, one of the first (and largest) facilities in the world that specializes in medically supervised water-only fasting, along with medical and chiropractic services, psychotherapy and counseling, and more. Today he joins the podcast to walk us through all things fasting, food addiction, and the power of a whole plant diet to prevent and reverse the many chronic lifestyle ailments that unnecessarily impair millions of people across the world. We explore all things water fasting, from it's origins dating back thousands of years across many cultures and religious traditions to the protocol Dr. Goldhamer administers today. We discuss how fasting can create the foundation to transition to a sustainable, healthy whole food plant diet. And we explore why he advocates an 'SOS' (very low salt oil and sugar) version of that diet. But more than anything, this is a powerful discourse on our uncomfortable relationship with food. How most of us don’t realize we are killing ourselves with our fork and knife. How our food, and our food culture, is making us fat, sick, and frankly miserable. And how almost all of us, despite weight and health, use food as an emotional crutch. I'm well aware that Dr. Goldhamer is controversial in certain circles. His approach represents a radical departure from our traditional western medical paradigm. But he also makes a lot of sense. And his results speak for themselves (I have several personal friends who have undergone his protocol). Final Note: Under no circumstances should anyone undertake a water fast of any length without the medical supervision of a trained professional. In other words, please do not try this at home. The visually inclined can watch it all go down on YouTube. And as always, the podcast streams wild and free on Apple Podcasts and Spotify. My hope is that Dr. Goldhamer will inspire you to think more deeply about the body's profound ability to heal itself when treated properly. That food freedom is possible. And that none of us need fall prey to chronic food-borne illness. Peace + Plants, Rich Learn more about your ad choices. Visit podcastchoices.com/adchoices

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

• 0:00Rich Roll?

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• 0:44Rich Roll?

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• 1:05Alan Goldhamer?

  We live in an environment of abundance, and it's responsible for the systematic overeating that people do that leads to the obesity, that leads to the metabolic syndrome, that leads to the vulnerability to infectious disease, and the chronic degenerative diseases, the cardiovascular disease, and many of the cancers. Two-thirds of people in industrialized societies are overweight or obese. If you're not fat, you're abnormal. If a person's overweight wants to lose weight, if a person has heart disease, diabetes, if they've got cancer, or if they're healthy and their goal is to live the maximum healthy life possible, I believe the evidence supports the idea of an exclusively whole-plant food diet that's free of SOS. SOS is the international symbol of danger, and it stands for salt, oil, and sugar.

• 1:48Alan Goldhamer?

  How long you're gonna live in life may be largely dependent on genetics and life, but how well you're gonna live in the time you have left may be dependent on what you put in your mouth and the diet and lifestyle choices that you make. Healthy life expectancy to me is even more important than life expectancy. An interesting life expectancy, for the first time, is actually starting to drop. Healthy life expectancy, the number of years you spend fully functional, that should be, I believe, the target, and that's what I believe where fasting can have the greatest good, is in healthy people that use it preventively to stay healthy in conjunction with a diet, sleep, and exercise regime that's health-promoting.

• 2:22Rich Roll?

  That's Dr. Alan Goldhamer, and this is the Rich Roll Podcast.

• 2:36Rich Roll?

  The Rich Roll Podcast.

• 2:40Rich Roll?

  Hey, what's up, people? How goes it? It is I, Rich Roll. Welcome. When you hear the word addiction, what typically comes to mind? I don't know about you, but when I think about that, I think about mind-altering substances, things like drugs, prescriptions, alcohol, sometimes behavior like gambling. But what's really not adequately embraced and discussed in this conversation around addiction is food. But the reality is, our hyper-industrialized culture is entrenched in an epidemic of food addiction. And it's something that I think is fueled by this ever-increasing array of highly-processed foods

• 3:23Rich Roll?

  that are scientifically designed with just the right amount of sugar, salt, and fat to hijack our nervous system, our hormonal response, to hook us, to enslave us, and ultimately, over time, make us sick and subsequently a ward of the pharmaceutical industry. Meanwhile, we've completely normalized this, so much so that, right now, in the United States, more than 2/3 of adults are overweight or obese, which is absolutely insane. It's bananas. And it's no question that dietary excess makes us vulnerable to a litany of diseases,

• 4:03Rich Roll?

  including COVID. And yet, for a variety of reasons, not the least of which is the highly addictive nature of these foods that are driving compulsivity, millions of people find it extremely difficult, if not downright impossible, to change their habits, to just stop.

• 4:24Rich Roll?

  So how do we do that? How do we stop? How do we transition to a healthy diet in a sustainable way? How do we modify behavior to eat only to satiation? Well, according to today's guest, a great place to start, perhaps the best way to start is with a fast. Now, I'm not talking about intermittent fasting. I'm not talking about Walter Longo's fasting mimicking diet. I'm talking about what I think everyone would agree would be classified as pretty hardcore fasting. A pioneer, as well as an iconoclast in his field, Dr. Alan Goldhamer is the founder of True North Health Center,

• 5:09Rich Roll?

  one of the first and largest facilities in the world that specializes in medically supervised, water-only fasting, among many other health services. And when I say fasting, again, I'm not talking about a day or a couple of days. I'm talking about nothing but water for 28 days and often upwards of 40 days. It sounds nuts, even with medical supervision. This is something that sounds like scary quackery. But here's the crazy thing. Over the last couple of decades, Dr. Goldhamer has successfully supervised the fast of thousands of patients, something like 20,000 people,

• 5:51Rich Roll?

  and has really helped them radically transform their lives from ditching medication to overcoming common diseases such as hypertension, diabetes, autoimmune diseases, and many others, not to mention breaking these addictions to unhealthy eating habits. This guy is a true paradigm breaker. This is a fascinating and also a challenging conversation that I think is going to leave you questioning and rethinking the power of the body to restore itself and the incredible power of healthy, whole-plant foods to heal. So if you're struggling with upping your game in this department, I would be. Remiss in not reminding you that we have created

• 6:35Rich Roll?

  an incredibly powerful digital platform to make your plant-forward food habits which convenient, affordable, and delicious. It's called the Plant Power Meal Planner, and it is a game changer. You get unlimited access to thousands of delicious, nutritious, easy-to-prepare, plant-based recipes. Everything's thoroughly customized based on your specific preferences, with access to our team of experienced nutrition coaches seven days a week. It also automatically creates simple grocery lists based on selected recipes, and it even integrates with grocery delivery in most urban areas. So basically, everything you need to eat the way you deserve magically arrives at your doorstep. So to learn more and sign up, visit meals.richroll.com or click Meal Planner on the top of any

• 7:20Rich Roll?

  page on my website, richroll.com, because, as you will soon hear with Dr. Goldhamer, who confirms this, one of the most important decisions we make every day is what we put in our mouths. Alrighty, Dr. Goldhamer. His work and studies have appeared in countless medical journals, including the International Journal of Disease Reversal and Prevention, and many more. You might have caught him in the documentary, What the Health? Some of his patients were depicted in that film, getting off their meds. Or maybe you stumbled across his book, The Pleasure Trap, which is a really great, powerful

• 8:03Rich Roll?

  primer on why unhealthy eating habits are so hard to break. He co-authored that book with Dr. Doug Lyle. I highly suggest checking that out if you haven't already. So today's conversation is, of course, about water fasting. Everything water fasting, specifically medically-supervised water fasting, and its mind-blowing, whole-body systemic benefits and the power it has to stop, reverse, and even prevent disease. We talk about the origins of fasting, a practice that dates back thousands of years across many cultures and religious traditions. We talk about how fasting can create a foundation, a tabla raza, to then make the transition to a sustainable, healthy, whole-food, plant diet, and why Dr.

• 8:48Rich Roll?

  Goldhamer advocates what he calls an SOS, or very low-salt, oil-and-sugar version of that diet. But more than anything, this is about our... Overall uncomfortable relationship with food. How most of us don't realize we're killing ourselves with our fork and our knife. How our food and our food culture is making us fat, sick, and frankly miserable. And how almost all of us, despite weight and health, use on some level food as a powerful emotional crutch. I understand full well that Dr. Goldhamer is controversial.

• 9:29Rich Roll?

  What he advocates is a radical departure from our traditional Western industrial medical paradigm. But he also makes a lot of sense and his patient results, I have several friends who have undergone his protocol, speak for themselves. Final note, please, please, people, do not attempt a water fast, or any fast for that matter, without medical supervision. That said, I give you Dr. Alan Goldhamer. Nice to see you. Thank you for coming out here to do this.

• 10:03Alan Goldhamer?

  It's my pleasure.

• 10:03Rich Roll?

  It's been a long time in the coming. I'm excited to talk to you. We're going to talk about fasting, we're going to talk about a whole food, plant-based diet, particularly your specific bent on it, the SOS version of a whole food, plant-based diet. But before we do that, I think what would be really interesting, and something about your work specifically that I find fascinating and that I appreciate, is that it's very much rooted in, as much in psychology as it is in nutrition science and physiology. And beneath all of that, again, which I appreciate, is the fact that there are some uncomfortable

• 10:41Rich Roll?

  truths about, about our relationship to food that is premised in this vernacular around addiction. And as somebody who is a long time in recovery, this is the lens that I kind of approach all of these things. And it's something that I think is under addressed in this conversation about not just a healthy diet, but how we transition to a healthy diet. Because people, you know, we're emotional beings and...

• 11:12Rich Roll?

  It's less about the information than it is about trying to help people figure out how to traverse that tricky, you know, sort of tightrope between old habits and new habits. And by, by kind of couching all of this in those uncomfortable truths about our addictive relationship with food, I think is really powerful.

• 11:34Alan Goldhamer?

  Well, the reality is, you know, humans evolved in a very different environment than the one, the one we live in today. We live in an environment of scarcity. So, most humans actually didn't live to reproduce. They didn't pass on their genes. They died from predation. They died from starvation. A few survived. Our ancestors. Our ancestors were the winners. They got enough to eat. They didn't get eaten. They lived long enough to reproduce. And our bodies and our minds were perfectly designed for that environment of scarcity. So, now, human beings, being the innovative creatures we are, we change everything. We change the environment we live in dramatically. And now, we don't live in that environment of scarcity. At least, most of us don't.

• 12:17Alan Goldhamer?

  We live in an environment of abundance. And although we're perfectly designed for that environment of scarcity, this environment of abundance can trip us up, and it does. And it's responsible for the systematic overeating that people do, that leads to the obesity, that leads to the metabolic syndrome, that leads to the vulnerability to infectious disease, and the chronic degenerative diseases, the cardiovascular disease, and many of the cancers. And so, that, that reality is why it's so difficult for people to adjust to the idea that they just can't eat as much of whatever they want and get away with it.

• 12:52Rich Roll?

  Yeah. It's almost as if, you know, if you're, if you're a heroin addict or an alcoholic, everywhere you go, everybody is a heroin addict or an alcoholic. There is no safe space, right? We've normalized our behavior and our respective relationships with food to such an extent that the radical notion is to step outside of that and do something different.

• 13:17Alan Goldhamer?

  Two-thirds of people in industrialized societies are overweight or obese. If you're not fat, you're abnormal.

• 13:24Rich Roll?

  Right.

• 13:25Alan Goldhamer?

  And if you go to a physician, and you've, say, you're significantly overweight, and you've lost a bunch of weight, the physician doesn't immediately think, "Oh, you must have adopted a whole-plant food diet and begun an exercise program." Their differential diagnosis is, uh-oh, this could be colon cancer, eating disorder, or drug addiction.

• 13:45Rich Roll?

  They pathologize a healthy choice.

• 13:46Alan Goldhamer?

  Well, the only experience they have of people losing weight and keeping it off is when they've got cancer, they've developed an eating disorder, or they're a drug addict. And so it's not even in their expectation that people are going to actually get well. You go to a physician with most of the diseases of dietary excess, the high blood pressure, the diabetes, and they're going to tell you, "Look, you're going to be on drugs the rest of your life. If you do what I tell you, I promise you, you'll never get well. You'll be sick forever." Because it's not in their expectation that people are going to actually recover their health. Because they're not addressing the actual reasons why they're developing the problem to begin with. They're not addressing the causes of the problem.

• 14:27Rich Roll?

  I think in tandem with that, there's also this pessimism from the typical general practitioner that any advice or kind of advised protocols about healthy lifestyle change fall on deaf ears. It's like, yeah, I could tell this person they should go to the gym or they should eat better, and maybe I'll say that. But there isn't a real expectation that that's going to move the needle, or that that person is going to be able to adhere to any kind of prescribed lifestyle change.

• 14:59Alan Goldhamer?

  And that's because we're dealing with people that are addicts.

• 15:02Rich Roll?

  Yes. So talk about that. Expound upon that idea, because I think it's really important.

• 15:08Alan Goldhamer?

  You don't just say to an alcoholic, "Oh, you know how your life sucks? It's because you're a drunk. Stop drinking."

• 15:15Rich Roll?

  Yeah.

• 15:16Alan Goldhamer?

  And the alcoholic would say-

• 15:17Rich Roll?

  I've been told that.

• 15:18Alan Goldhamer?

  "Oh, it's the alcohol? I had no idea. Thank you so much. I won't drink again."

• 15:24Rich Roll?

  Right.

• 15:25Alan Goldhamer?

  It doesn't quite work that way. We don't currently lie to alcoholics the same way we do lie to people, for example, that are overweight. We tell alcoholics, "Look, you have a particular vulnerability. You can't drink. You need to come up with a strategy each and every day that allows you to not drink. And if you can figure out how to do that, you win. But if you don't..." You're gonna be in trouble. So the same thing is actually true in many degrees to people that are overweight. But what we tell the overweight person is, oh, just put your food on a smaller plate. Here, cut your food with a knife and put your fork down between each bite and you won't be overweight anymore. You just need to learn to eat moderately and just eat a little bit less.

• 16:07Rich Roll?

  It's the analog in addiction is, you know, quit the whiskey and just drink beer or put your beer in a smaller or only binge on the weekends and maybe don't get behind the wheel of a car.

• 16:19Alan Goldhamer?

  And it's not real. We know with alcohol, the answer is don't drink. And the truth is, for people that are suffering with obesity, for people that are suffering with these diseases of dietary excess, it would be better to avoid the chemicals that are fooling your brain into allowing you to systematically overconsume than it would be to pretend that you can just have a little bit. If you could have just had a little bit, you would have just had a little bit and you would have had the thing under control. You can't, you don't. If you're an alcoholic, you're not the person that can have an occasional drink. Okay? And if you're the person that's suffering with these diseases, you may find it's easier to just adopt a strategy that eliminates these chemicals that fool the brain. We talk about this pleasure trap, the artificial stimulation of dopamine in the brain that results from chemicals that we put in our food that fool our brain.

• 17:03Alan Goldhamer?

  The chemicals we put in our food are things like salt, oil, and sugar. These are highly fractionated food byproducts, not food, and they stimulate the dopamine cascade in the brain, they make food taste better, they make food more interesting to us, and as a consequence, we will systematically overeat. Now, just like some people can occasionally have a drink and not become a drunk, some people can have bits of this without it becoming a health compromising problem. But if you're the overweight person, if you're the person with the heart disease, the cancer, the diabetes, it's not you. You're the person that would be better off saying, let me avoid those chemicals, I'll stop fooling my brain, I'll eliminate the systematic overeating, I'll reverse the disease

• 17:45Alan Goldhamer?

  in pathology, and I'll adapt a strategy that doesn't include continually beating myself up with these things that I'm not capable of regulating.

• 17:54Rich Roll?

  People have an easy time understanding that alcohol is a powerful drug, that heroin is something that is going to kill you. The addictive nature of these substances is well-understood. But when it comes to food, that's a leap of faith for a lot of people. It's a bridge too far to say, "I understand alcoholism and drug addiction, but when you start talking about food as addictive, you're starting to lose me."

• 18:22Alan Goldhamer?

  Yeah, well, the reality is that the neural cascade that's associated with addiction of any kind is very similar. Now, I'm not arguing that alcohol or cocaine or heroin might be even more potent than, say, the sugar, or the oil, or the salt, or the combination. But the net effect of salt, oil, and sugar in the diet is actually obvious and devastating around us. It's why you see obesity and the disease of dietary excess. That's what's making people fat. It is the hidden force that undermines health and happiness. It is a pleasure trap. And because people don't recognize it, it's very difficult for them to take action to eliminate it. At least with alcohol, most people know, "Oh, if you're an alcoholic, you probably shouldn't drink." If you go to a party and they say, "Oh, here, have some alcohol."

• 19:05Alan Goldhamer?

  And you say, "Well, I can't because I have an alcohol problem." Most people at least will be tolerant of you. Because, okay, you've got an issue, you don't have to drink. But if you go in and you say, "Oh, no, I don't want to eat," you're going to really upset people. "Oh, what's wrong with this?" "My doctor says this bit a little bit won't hurt."

• 19:21Rich Roll?

  Right. Yeah, so it's complicated. It's complicated in terms of the internal psychology in trying to reframe our relationship with food. But there's also all of these social constructs that create even additional complexity, that make it very difficult to modify behavior.

• 19:41Alan Goldhamer?

  There's no question. In fact, the social roadblocks to health are probably some of the limiting factors. I think that's probably true in all addiction, though. You know, one of the challenges for people with alcohol is oftentimes the social consequences of not participating. And this is definitely true with food. We've built so much of our social interaction around food that even if you're... Looking to just modify the type of food you eat, it can be very upsetting for people. And they can get really defensive about it.

• 20:08Rich Roll?

  Right, so let's talk a little bit more about the pleasure trap specifically, what that is. You co-authored this book, seminal work with Doug Lyle. I've seen his TED Talk, I've seen him give his presentation many times on this subject. And that really elucidates this dysfunctional relationship with food and why it is from an evolutionary and psychological perspective.

• 20:32Alan Goldhamer?

  Well, you know, this idea of dopamine is a neurochemical associated with pleasure. And there's two behaviors critical for human beings' survival, and that is food and sex. You have to get enough to eat in order to be able to sustain yourself. And you have to engage in enough sexual behavior so that you can pass on your genes and the whole process can start over again. So it's not surprising that food and sex are heavily reinforced. And the way the body, the brain reinforces the body's behavior is by rewarding us with dopamine, which is the neurochemical associated with pleasure. So the more dopamine, the more pleasure. The more dopamine, the better the food tastes. And so you react to food in response to largely caloric density. The higher the caloric density, the more valuable it is in this environment of scarcity in which we evolved.

• 21:17Alan Goldhamer?

  And so the higher caloric density foods tend to be more reinforced, more dopamine, better tasting. So what we've done as humans, we're innovative creatures. We said, oh, if a little good, a lot's better. Let's figure out a way to make the food taste even more special by increasing its caloric density. And we do that by adding things like oil and sugar to the food. And as a consequence, we like it better. And if that's what you get used to eating, that's all you like. And eventually, people get to the point, they really don't like the taste of simple, whole, natural foods anymore because this hyper-drug-like stimulating effect of the more concentrated foods is more appealing. So we literally become addicted. For example, if you want to neuro-adapt to a lower salt or lower fat diet, it actually takes time in order for the body to go through that adaptation.

• 22:02Alan Goldhamer?

  We can speed it up with fasting, but the bottom line is there is a period of adaptation where food doesn't taste good. If you eat whole foods and you're used to eating highly processed foods, it's not that appealing. Now, over time, you adapt, and then the body gets to the point where you like the simpler foods again.

• 22:18Rich Roll?

  Yeah, people have a hard time believing that you adapt. There's this baked-in assumption that... You're staring down the pipeline of a lifetime of drab foods that are unappealing, and you're just gonna have to tolerate it.

• 22:34Alan Goldhamer?

  We know there's a literature on this, though. With, for example, sodium, people use a high-sodium diet. It takes about a month on a low-sodium diet for the average person to neuro-adapt to a lower-salt diet. You know, with fat, it takes almost three months.

• 22:46Rich Roll?

  Wow.

• 22:47Alan Goldhamer?

  It takes three months on a lower-fat diet before that satiety mechanism that's used to being kicked in by the higher-caloric-density-fat begins to adapt, and you will feel satisfied on a lower-density food. So the fruits, the vegetables, the grains, the goons, you will now feel satisfied. Whereas initially, you don't, because you're used to being satiated with this high-fat intake, and that can take months. And so it's a problem. If you say to a person, "Well, look, you're gonna eat this new diet, you're gonna feel like crap, and you're not gonna like it, but it'll only be a few months."

• 23:20Rich Roll?

  Right.

• 23:21Alan Goldhamer?

  Adherence may be lagging. Whereas if you can make that process happen more quickly, the ability to get people to make dietary changes speeds up, and that's what we found with fasting. And sometimes that's a way of getting people to the point where good food tastes good more quickly.

• 23:34Rich Roll?

  Yeah. There does seem to be something about preparing people for that stage of acclimation, and there also seems to be something magical about the 90-day window. With drugs and alcohol, that's sort of the typical window that people say. It takes about that much time to kind of wean yourself off these cravings and reset your system. A lot of people, they're not willing to weather that period of discomfort, and perhaps there's a lack of belief that they'll reset and be able to reframe, so that what they want to create... To get over the craving, you have to deprive yourself, and then you reboot, and then those

• 24:19Rich Roll?

  things that have held you hostage for so long suddenly hold less and less power over time.

• 24:24Alan Goldhamer?

  And the fact that it can happen more quickly with fasting is really an interesting thing. For example, smokers. It's not easy to quit smoking once you're addicted to nicotine. But most smokers by somewhere between day two and day four of fasting no longer report withdrawal effects from cigarettes. Now, some people say, "Yeah, they're so miserable fasting, they don't even think about the cigarettes." But the reality is that that whole adaptive process just is sped up dramatically. Now, that doesn't mean you don't have psychological and social challenges afterwards that you still have to address in order to sustain good behavior patterns. But just getting rid of that first phase of a physical withdrawal and just feeling so crappy and feeling like, you know, you're wondering why you're putting the effort out,

• 25:07Alan Goldhamer?

  getting that behind you quickly really does enhance a person's ability to make the transition to being drug-free.

• 25:13Rich Roll?

  Yeah, yeah, yeah. I understand the, you know, when you were talking about caloric density, fat and sugar, these are things that are evolutionarily, you know, we're wired to seek out and to maximize. The salt thing, though, that's different. Like, why is it that salt is such a trigger for people?

• 25:31Alan Goldhamer?

  Yeah, this one is probably the most controversial recommendation that we make. People have come around, as you said, with oil. They realize a highly fractionated food product like oil, high caloric density, little satiety feedback, you know, they can understand that. Sugar, pretty well accepted, that refined carbohydrates, they cause your blood insulin levels to rise and then it drives your sugars lower and it fools the brain and now you've got cravings. And that's what a lot of the binging and craving and stuff comes around is because of physiological alterations of refined carbohydrates. But salt also is a really important part of this, and let's talk about a few reasons why that might be. Number one, salt is an essential nutrient, that is sodium, is an essential nutrient, without which you die.

• 26:14Alan Goldhamer?

  Fortunately, you get all of the sodium you need in a whole natural food diet, just like you get all the sugar you need and all the oil you need. You don't have to add a fraction of the concentrated food to get the amount of sodium, the milligrams of sodium that's needed to sustain optimum health. Salt also has a powerful effect on passive overeating. And you can do an experiment yourself. If you just sit down and figure out how much brown rice you'd eat until you feel satisfied, until you don't want anymore. And on a different day, everything else being equal, salt it up and see, you'll eat significantly more before you feel satisfied. Now, some people say, "Yeah, it tastes better." Well, what do you think tasting better means? It means it's stimulating more dopamine in the brain as a result of this artificial-type response.

• 26:56Alan Goldhamer?

  And you will systematically eat more on heavily salted foods when you're adapted to that than you will whole-natural foods. The other thing is, salt has a preservative effect, doesn't it? When they salt foods, it's to keep bugs from being able to affect it. Well, you have five pounds of bacteria living in your intestinal tract right now. A trillion creatures, a thousand strains. Very important to your immune system to protect you from infectious disease and other problems. And these thousand creatures are living, eating, and pooing inside you right now. So if you have five pounds of organisms pooing inside you, you might be concerned about what they're pooing in you. Because they might be pooing some nasty, toxic waste. Chemicals like TMA, which becomes TMAO and irritates the vessels and creates a problem if you're eating animal foods.

• 27:41Alan Goldhamer?

  If that's what you're feeding your bacteria. You're feeding your bacteria soluble fibers, you're getting fertilizer, you're getting vitamin K, you're getting a lot of other good stuff. So if you want your bacteria pooing fertilizer and to eat, you want to make sure you're feeding them a healthy diet. If salt is a powerful preservative, let's just imagine what happens when we put a high-sodium diet into this bacterial-rich environment. It can alter the gut microbiome. And so, sugar can affect it, oil can affect it, and so can salt. So it's been our experience that salt in the diet is an important part of obesity for many people, that it's an important part for causing fluid retention, which increases blood volume, which is associated with not just high blood pressure, but also the joint

• 28:23Alan Goldhamer?

  pain, the congestion, a lot of the aches and pains that people have oftentimes is because of this fluid that the body retains to protect itself from the consequences of salt. So it has many downstream effects, even though it doesn't have any calories, per se. It can still be an important part of the dietary excess profile. And by eliminating the sodium from the diet, you also eliminate a lot of the highly fractionated foods that you just can't eat without salt. Even products like bread and cookies and crackers and a lot of this stuff without the salt really doesn't taste that good because they've refined out most of the natural flavors of the food. And what they do is they take these federally subsidized grains like wheat and soy and then they, and corn, and they add oil, salt, and sugar to it, process it into various

• 29:08Alan Goldhamer?

  looking foods, and call that the diet. Go into a grocery store and walk around and you'll see a lot of those foods are really nothing more than one grain or the other with various concentrations of sugar, oil, and salt.

• 29:18Rich Roll?

  Right, which, which basically allows you to make anything taste good. And you strip away those things and there's something completely unpalatable and nutritionally deficient underneath it.

• 29:31Alan Goldhamer?

  And so what we're encouraging people to do is a really radical departure from what they're currently doing, but that's to adopt a whole plant food diet that's free of this added chemicals, free of the salt, oil, and sugar. And what you're left with is things like fruits and vegetables, raw or cooked, minimally processed grains, beans, nuts, and seeds. But you don't have the meat, fish, fowl, eggs, dairy products, oil, salt, sugar, and highly processed, fractionated foods that make up the majority of the people's diet in industrialized society. And it's that diet that makes them fat and sick and develop the disease of dietary excess. And that what makes you vulnerable to infectious disease. You know, when you look at what are the vulnerabilities about why does some people get an influenza or a COVID or an infectious disease?

• 30:14Alan Goldhamer?

  And, you know, they recover, they survive, they have minimal consequence. Other people, it's devastating or deadly. Well, if you look at the risk factors associated with what makes people vulnerable to these diseases as well as the diseases, the chronic diseases, the heart disease, the cancer, the stroke, it's the same metabolic syndrome and all of its associations. It's the same obesity and diabetes and high blood pressure and all the consequences of dietary excess. These are reversible and preventable conditions. People don't have to have these conditions. And even if they have them, they can largely reverse them by taking responsibility to control what they put in their mouth.

• 30:50Rich Roll?

  So this is the, the underlying premise that, that drives.

• 30:56Rich Roll?

  True North, which you founded, what, like 30 years ago at this point, 35?

• 31:01Alan Goldhamer?

  In 1984.

• 31:03Rich Roll?

  Wow.

• 31:04Alan Goldhamer?

  Was when my wife, Dr. Moreno, and I started True North Health.

• 31:08Rich Roll?

  I can't imagine what it must have been like to basically open the doors to this medically supervised water fasting clinic back in that time. I mean, now, it's all the rage. We have Walter Longo and all kinds of scientists studying the phenomenon of fasting deeply. It's part of the public awareness. Everybody's, it's very cool to be out there, you know, sort of experimenting with intermittent fasting. This was not the case back then. Like, I, I mean, potentially criminal, right?

• 31:42Alan Goldhamer?

  Well, at one point, the California Board of Medical Quality Assurance had rendered an opinion that recommending fasting to a patient constituted such a gross violation of the standard of medical practice that it rose to the level of criminal negligence. I was actually the first person in my family that required the services of a criminal defense attorney. My father was so proud.

• 32:02Rich Roll?

  Wow. What happened there?

• 32:04Alan Goldhamer?

  They ultimately decided that recommending fasting was not criminal negligence, that in fact, there was even a provision at that time in Medicare to pay for fasting, but as long as it was for rapid weight loss necessary for urgent surgery. If you got well, unfortunately, it wasn't a covered benefit. There was also, every hospital today in this country will use versions of fasting for treating conditions like acute pancreatitis. And we were able to demonstrate that this was not criminally negligent behavior, but was actually a rather innovative look at trying to help sick people get well. We've gone from being criminal quacks to cutting-edge researchers. As you said, there's been some wonderful people like Walter Longo and Matson and Fontana and others that have published in major impact

• 32:46Alan Goldhamer?

  journals, this idea that fasting or some modification of intermittent fasting or modified fasting could be a helpful tool. In fact, it was interesting, Longo did some research that I think really was pivotal. He looked at cancer treatment.

• 33:03Alan Goldhamer?

  And he took, you know, 30 rats with cancer and gave them enough chemotherapy to resolve all the cancer cells. You have to kind of kill all the cancer cells or they grow back. The problem is, all the rats died. So that wasn't a really good outcome. But he took the same rats with the same cancer and the same chemotherapy, but he used fasting before, during, and after the treatment. And not only did all 30 rats survive, but dramatically enhanced cancer-free survival. And so what he found was that there was these things like differential stress sensitization and differential stress resistance, that cancer cells were more vulnerable to the effects of chemotherapy in the fasting states, probably because of their higher metabolic rate, they don't adapt to the environment without glucose as well. There's lots of differences in

• 33:46Alan Goldhamer?

  cancer cells to healthy cells. And in the fasting states, the cancer cells were put at a selective disadvantage. And not only that, healthy cells appeared to be protected during the fasting state-

• 33:56Rich Roll?

  That's super interesting.

• 33:57Alan Goldhamer?

  -from the effects of chemotherapy. And at that point, people went, particularly pharmaceutically oriented, people went, "Oh, so fasting could make the drugs work better? Oh, well, maybe it's not quackery all after all." And so there was a lot better tolerance and acceptance of this idea that perhaps fasting may have a role in enhancing conventional treatment. And it was interesting to note, too, that many of the biomarkers that predict cancer and disease turn off whether you use chemotherapy or not. So the act of fasting itself puts the body in a selective environment that may be more conducive to healing. And so this type of research, of course, now is taking off, and there's been a lot more interest, including the work that we're doing at the True North Health Center.

• 34:37Rich Roll?

  Yeah, you have this, this study and this experience working with a patient who had stage III follicular lymphoma, right, where you had like this tremendous result.

• 34:47Alan Goldhamer?

  Yeah, we had a young woman with stage III follicular lymphoma that had been well documented, excisional biopsy, the whole bit, and had progressed over a period of a couple of years. And-

• 35:02Alan Goldhamer?

  She had asked her family physician along the way, was there anything she could do conservatively in terms of diet and lifestyle? He had assured her that diet had nothing to do with follicular lymphoma, that she could eat whatever she wanted to eat. And when she inquired about fasting, he informed her that fasting was criminal quackery. Nonetheless, she decided that she didn't want to undergo conventional chemotherapy because with this particular condition, it's not really effective. It doesn't affect all-cause mortality. There's a lot of side effects. And so often, it's not unusual for them to defer treatment until the condition has quite progressed. In this case, it had progressed enough that he referred her to the medical school, talked to an oncologist. Oncologist also reinforced the idea that diet was irrelevant to this condition, that fasting was unproven.

• 35:46Alan Goldhamer?

  And even with that advice, she decided to come to True North Health Center, underwent 21 days of water-only fasting, during which time her tumors that were previously externally palpable disappeared. So we fasted her for three weeks, fed her for 10 days, sent her back to the oncologist. And he examined her, couldn't find any evidence of the lesions, expressed some surprise. She explained, he said, you know, what did you do? And she said, well, I went to the criminal quack and I did the fasting and the tumors went away. And he said, well, that's very impressive. Suggested he give me a call and talk to me about it. She asked to have the follow-up CT scan that we requested.

• 36:30Alan Goldhamer?

  And we had wondered that they might be a little reluctant since she didn't have any obvious evidence of symptoms. And he said, well, she didn't really need a CT scan. But she said, well, she'd really like to objectify the changes that had occurred. He got a little nervous, but ultimately, he did admit, agree to order the studies. And he'd mentioned that because she was still a little bit neutropenic, maybe some gentle chemotherapy might still be a consideration. Nonetheless, she refused. After a couple of months, her white count had normalized. By a year, she's doing great. Sent her back, got a whole, you know, follow-up evaluations. And at that point, we decided that it was time to try to write up the report. So we wrote up this case report and we submitted it to a British Medical Journal.

• 37:14Alan Goldhamer?

  And after some back and forth, they eventually did publish the paper. They'd asked us if we could get the oncologist to sign on, and so we wrote him a letter and thanked him so much for all the confidence he had shown in referring the patient to us for fasting. Which he didn't. Well, you know, in spirit. And so, but unfortunately, he hasn't gotten around to responding to us yet. So how long ago was this? Well, what happened is we published that paper and then they asked us to do a follow up. Because they said, you know, about 10% of lymphoma patients will go through periods of remiss state, but sustaining it would be impressive. So we followed this patient for three years. And she continued, she had lost substantial weight, she had maintained that weight loss for three years.

• 37:58Alan Goldhamer?

  I think in part because I explained to her that, you know, she had to stick to the diet or it could be fatal, because I'd track her down and kill her. And I believe, think she believed me because she stuck to the diet. And at three years, we got a whole body CT follow-up with the oncologist and she's completely cancer-free. At that point, we submitted back to the British Medical Journal, which had invited us to do the follow-up. They actually refused the article the first time. We appealed and resubmitted and then they did decide to publish the follow-up. One of the reviewers felt like, well, maybe she just got lucky. But anyway, so she resolved her problem, she maintained it for three years. We now have a four-year and now we're working on a five-year follow-up. She continues to do well. Now, since then, and since the publication of that article, we've managed to treat a

• 38:42Alan Goldhamer?

  number of patients with various stages, including stage four lymphoma. And so far, the results look very promising. We have some follow-up data now. We're getting in the, we're in the process of submitting another case report with long-term follow-up on a stage four follicular lymphoma. And ultimately, we're hoping to publish enough case reports that we can do a clinical trial. That's amazing. And justify a clinical trial, because I think we're going to do very well with this condition in highly motivated, self-selected patients that are willing to do dangerous and radical things like eat well and exercise and go to bed on time. The results seem to be promising.

• 39:23Rich Roll?

  What led you back in the 80s to basically open this clinic that's premised upon fasting? Like, what was it about your education or your experience that you found this protocol? And what led you to believe in it, in its efficacy?

• 39:38Alan Goldhamer?

  Well, yeah, it was, it was deep frustration, being constantly beaten by Dr. Lyle in basketball. I grew up with Dr. Lyle since 4th grade, and we played basketball, and he would beat me.

• 39:49Rich Roll?

  Oh, you've known him your whole life?

• 39:50Alan Goldhamer?

  All my whole life.

• 39:51Rich Roll?

  Oh, I didn't know that, wow.

• 39:52Alan Goldhamer?

  And, you know, it was really frustrating, because he's really good. So, and he's just naturally got tremendous talent. So, I just thought, "Well, I've got to be able to beat him somehow." And so, I started reading some books. I came across a book by Herbert Shelton, and it made sense. The idea that, you know, health was a result of healthful living, and that diet played a role. So, I thought, "Well, I'll get an edge." And I adopted this diet vigorously, and lifestyle vigorously, thinking this was going to allow me to beat him. Of course, it failed miserably, because he adopted the same kind of beating pattern. He still beats me to this day. Here we are, 61-years-old, playing basketball, I still can't manage to beat him.

• 40:26Rich Roll?

  Your whole life is basically a result of you trying to beat Doug.

• 40:28Alan Goldhamer?

  Trying to beat Dr. Lyle.

• 40:29Rich Roll?

  Okay.

• 40:30Alan Goldhamer?

  And it's frustrating, I picked the wrong guy. I didn't even realize that, you know, the person I'm trying to beat, just, you know...

• 40:35Rich Roll?

  This bookish Stanford psychologist, how hard could it be?

• 40:38Alan Goldhamer?

  You know, I thought, finally, I was getting desperate. I thought, "Well, you know, he's too quick, he's got, I can't, but maybe I can beat him in a free throw shooting contest." Because I thought, you know, free throws is just practice, right? So, for 6 months, I go out, I'm shooting 500 free throws a day, really working on my form. And I just casually, one day, say, "Hey, Doug, why don't we do a free throw shooting contest?" And he says, "Okay." You know, he hasn't even played for a week.

• 41:00Rich Roll?

  Well, he, he strikes me as a, as a, like a world-class sandbagger. Like, the guy who's always going to tell you that he's no good, right? He's always downplaying, right? That's his whole strategy for all of this.

• 41:11Alan Goldhamer?

  I go out and hit 48 out of 50, and I'm thinking, "I got him." He hits 19, misses one, and then hits 80 in a row. 80 free throws in a row. In a row. 99 of them. Of course, I'm telling them, wow, what a joke. If you can hit 99, why don't you just hit 100? So, the point is, total failure, got involved trying to be a better basketball player. But what I would say is that we're both still playing. And so, you know, how good you can become in a sport may largely be dependent on genetics and luck. How long you're going to live in life may be largely dependent on genetics and luck. But how well you're going to live in the time you have left may be dependent on what you put in your mouth and the diet and lifestyle choices that you make. And so, what we're trying to explain to patients is you're not going to live forever, you're

• 41:56Alan Goldhamer?

  going to die. There's been 100, over 100 billion humans, modern humans born on the planet. There's 7.3 or 4 billion alive today, but there's only been five well-documented people that'll live past 117. So, the thing is, you're not going to live forever, but you don't have to spend the average 9.6 years of debility or 17 years in poor health that the average American is spending, you know, giving up, compromising the last decades of life, it could be your richest decades of life, because of chronic degenerative diseases, because we haven't taken control of our diet, sleep, and exercise patterns. And that's what we're trying to point is, you may not be able to live forever, but you can reduce dramatically the years of debility that you have, your vulnerability to infectious disease, your likelihood of developing heart attacks, stroke, and other

• 42:41Alan Goldhamer?

  debilitating conditions. That's where the big payoff is. Not living forever, but living well until you die, having a good life and then having a good death. All right, so how does the fasting come in, though, as a pathway towards that? So, fasting is interesting because you're dealing with people that are oftentimes addicted to the artificial stimulation of dopamine in their brain, whether it's to drugs or dietary issues. Fasting is a great way of breaking that cycle. It can be a very effective way of getting the person to the point where good foods taste good. It's a great way of lowering the blood pressure enough you can eliminate the medications, along with the chronic cough, fatigue, the impotence and premature death that's associated with them, normalizing the blood sugar levels, so your insulin levels normalize, so you don't have the cravings and the binging and all the other stuff that sometimes go along with it.

• 43:25Alan Goldhamer?

  Or in autoimmune diseases, oftentimes pain. Is significant inflammation, swelling. People can't be active. They can't dissipate their tension. They aren't able to engage effectively. And so when you get people out of pain, it's like an epiphany experience. And now motivation goes up. It's hard to be motivated to make diet and lifestyle changes when you feel like crap all the time. But when you get a taste of feeling good again, it's very motivating. And now oftentimes, that's enough motivation to help people overcome their addictions and their tendencies. The reality is, I've found the most effective patients are those are most motivated. And motivations that are the most powerful is pain, debility, and fear of death.

• 44:03Rich Roll?

  Yeah, 100%.

• 44:04Alan Goldhamer?

  The only problem is, you know, a lot of these people, they get out of pain, and they're not fearing death anymore. And then they might slip slide a little bit because they think, I'm better now. I don't have to work quite so hard. So, you know, there's, there's challenges on both sides, but.

• 44:15Rich Roll?

  Yeah. But you guys have had a tremendous success with getting, with keeping people on the path. Like, the recidivism rate for you is pretty low compared to other.

• 44:26Alan Goldhamer?

  In fairness, though, we have highly motivated, self-selected people.

• 44:30Rich Roll?

  People are coming to you in really bad shape.

• 44:32Alan Goldhamer?

  Well, they're motivated by.

• 44:33Rich Roll?

  Yeah, it's, it's one thing to talk about intermittent fasting, or, you know, a fasting-mimicking protocol. It's another thing altogether to talk about a 40-day water fasting. And that is a very extreme thing.

• 44:44Alan Goldhamer?

  Moses, David, Elijah, Jesus, and our patients, you know, do fasting.

• 44:50Rich Roll?

  It is interesting that fasting is, you know, shows up in all these various religious traditions.

• 44:55Alan Goldhamer?

  Isn't it interesting, the Jews, the Janes, the Hindus, the Muslims, the Buddhists, the Christians, all these religions that's diametrically opposed on so many things, that are killing each other in the street over disagreements, they have one thing in common, and that's a tradition about fasting. Because fasting changes how you feel about yourself and the world around you. You can't help it. And so, True North Health Center is not coming from a spiritual orientation. We're coming from a very much of a health orientation. We have different doctors with different backgrounds, and we don't try to impose our beliefs on anybody because we're not the experts in, you know, how you get into heaven or any of that stuff. Our focus is health and healthful living. But virtually every major religion has a tradition. I will mention, not just about fasting, but also about the value of a whole plant food diet.

• 45:38Alan Goldhamer?

  You know, these traditions resonate throughout history. And, you know, the reality is, perhaps, is because that's what works.

• 45:47Rich Roll?

  How dare you.

• 45:50Rich Roll?

  All right, so walk me through, all right, well, first, let me say this. So in the decades that you've been doing this, you and Doug have taken, and your staff, I mean, I've had, I've had, you know, Chef AJ in here explain to me her, you know, experience of being at, she goes to True North like for vacation when she wants to get out of town. I mean, she, she's got to be your most regular customer. But I've had, I've had Dr. Longo talking about fasting. Who else have I had in here? I've had, you know, True North comes up all the time on the podcast. So I've heard about it anecdotally. And over the years, you've taken, what, like 20,000 people through this fasting procedure,

• 46:35Rich Roll?

  you know, and had tremendous success. So I want to understand the, the process that is entailed here. Somebody comes to you, they're in bad shape, they're overweight, they have hypertension, diabetes, obese, cardiovascular disease, whatever, you know, this is the kind of person that's arriving in your doorstep.

• 46:52Alan Goldhamer?

  So the first step is that they usually go to our website. So they go to truenorthhealth.com and they fill out the registration forms, which gets us their medical history. And we get their previous laboratory work. That comes in and they get a free phone conversation with me. So we offer people free.

• 47:08Rich Roll?

  You still do that, right?

• 47:09Alan Goldhamer?

  I still do that.

• 47:10Rich Roll?

  Like people can call up and you'll give them a free consult.

• 47:12Alan Goldhamer?

  I still do that. So I talk to them as a screening about whether or not fasting might be appropriate, if anything that we do or we recommend might be helpful. For many people, they may not even need or be ready for fasting, but they may just need to talk to a doctor that's not a complete idiot. So we have a phone coaching service where our attendings are available. They go online through the website. We have all their medical records put together. They can schedule a formal phone consultation with one of our attending physicians. They can discuss, get a second opinion. They can do whatever they want to do, where they talk to a doctor that can look at their history objectively and give them advice. If they're appropriate candidates for fasting, then

• 47:52Alan Goldhamer?

  I schedule them into the center for a stay. I give them an idea about what we expect is a reasonable period of time. They come to the center. They go through with one of our attending physicians, a history exam, laboratory monitoring. We initiate them into a fasting protocol, if that's appropriate. And then after fasting, they go through a refeeding process. Now, while they're there fasting, they're seen twice a day by our staff doctors. We make sure it's done safely and effectively. They're monitored carefully. We have detailed educational classes, what I call "brainwashing," where they're able to go through all in detail. The process about what they're going to need to do, why they're going to need to do it. There's some social dynamics, because they're there with other people from around the world that are getting a chance to do this.

• 48:34Alan Goldhamer?

  You know, our facility has about 70 patients staying at it. So they're interacting with those other people, plus the staff and the educators. And so it's a pretty, like, immersion-type of an experience. They go through fasting, they go through refeeding. If they have specific health problems, we have chiropractors, naturopaths, body workers, all that kind of stuff, that they can get the kind of attention that they need. And then, when they're going home, they have very specific recommendations that we expect them to follow, and we try to provide follow-up support. And then, because of the phone coaching, they're able to continue to access these attending doctors affordably, without necessarily have... Because, you know, half our people are out of state, 15% are foreign, they're not all living locally where they can pop in and

• 49:16Rich Roll?

  Right.

• 49:16Alan Goldhamer?

  ...see our doctors, or use our deli business, or, you know, any of that kind of stuff.

• 49:19Rich Roll?

  What are the important vectors or variables that determine the appropriateness, you know, for somebody to do one of these protocols? Like, not everybody is suitable for this.

• 49:30Alan Goldhamer?

  No. The biggest one is that they have a condition that is appropriate for fasting. So there's many people that are not good candidates for fasting, and we can talk about that. There are some things that are particularly amenable to fasting. And for example, the conditions that are caused by dietary excess are particularly responsive to fasting. It makes sense. Obesity, cardiovascular disease, high blood pressure, type 2 diabetes, autoimmune diseases, certain forms of cancer. These conditions, we know are made much worse by poor dietary choices. So it's not shocking to find out that fasting, kind of the ultimate in undoing the consequence of excess, would facilitate the recovery of those patients. And it does, and we've been able to prove that. We've been publishing papers, looking at these conditions like high blood pressure,

• 50:15Alan Goldhamer?

  looking at diabetes, looking at autoimmune diseases. And the fact is, we can, in highly motivated patients, generate Safe and effective responses with fasting.

• 50:25Rich Roll?

  Right.

• 50:25Alan Goldhamer?

  In fact, we've actually published a fasting safety study, the first comprehensive look at long-term water-only fasting and what the risks are and aren't in response to this process. So we've been able to show it is a safe process when it's done according to protocol. In fact, Dr. Longo, who cautions people in his book about long-term water fasting and its safety, makes an exception, and that's if people fast at the True North Health Center. Because he's familiar with our safety. Now, I evaluate other scientists' intelligence based on how much they agree with me.

• 50:53Rich Roll?

  Right.

• 50:54Alan Goldhamer?

  So I consider him a genius.

• 50:55Rich Roll?

  I'm glad to know your bias is intact here. If somebody has anorexia nervosa, or if somebody is on the other side of chemotherapy where they're maintaining their weight is an issue, I would suspect that that's probably not a great candidate. What about somebody who's coming in and they're on a battery of medications? You would have to wean them off of that, I would presume, on some level before they can undergo this.

• 51:24Alan Goldhamer?

  Yeah, you know, there's... Most medications, you do not water fast while you're taking medications. Those have to be weaned down beforehand. But we have physicians that are experts at helping people unwind the consequences of their medical treatment. And most medications, interestingly enough, the day you change the diet, you have to begin changing the medication profile.

• 51:44Rich Roll?

  Right. Because the medications are treating the diet.

• 51:47Alan Goldhamer?

  Most people are being treated that is medicated for their diet. When you change their diet, the need for medication dramatically responds. You have to reduce the blood pressure medication. You start crashing these patients because they're not going to be hypertensive once you eliminate the reasons why they're hypertensive. And they're not going to be needing the same level of medication once you normalize their dietary intake as far as their diabetes, or getting them off their pain medication. Once they don't have the pain, they don't need to be on all that oxy because now the pain is being reduced because the inflammation's been reduced because of the dietary change, and then ultimately the fasting. So that's one of the reasons why fasting does need to be done in a controlled medically supervised setting. It's not the kind of thing that you do long-term fasting at home.

• 52:30Rich Roll?

  At home, right.

• 52:31Alan Goldhamer?

  You know, so you do that in a controlled setting where there's been a proper history, exam, lab, and daily monitoring. So we're seeing each of these patients twice a day, and that's how we're able to ensure that this is a safe and effective experience. So they may withdraw their medication with careful feeding, initiate the fasting, normalize the condition, and then after we're done, most of the time, there's no need for medication because their blood, you know, they've gone from 220 over 120 capped out on five meds to being 120 over 70 off medication. And so there's no reason for anybody to want to put them back on drugs that cause chronic cough, fatigue, impotence, and premature death if the condition's actually normalized. Now, the side problem is you have to keep on the healthy diet and lifestyle.

• 53:10Rich Roll?

  Yeah.

• 53:11Alan Goldhamer?

  Because you're not curing anything. You're just managing it.

• 53:13Rich Roll?

  But you've rebooted this operating system and wiped the slate clean so you can build a new foundation.

• 53:20Alan Goldhamer?

  It's very much like treating, you know, when your computer becomes corrupted and you don't know exactly what's wrong, but you turn the thing off, you turn it on, you can't explain, but now it's working.

• 53:28Rich Roll?

  Right.

• 53:29Alan Goldhamer?

  And it seems to be that way.

• 53:30Rich Roll?

  When in doubt, reboot.

• 53:31Alan Goldhamer?

  And we're trying to figure out exactly what those changes are that's occurring in fasting. I know the pharmaceutical industry is very interested in what's happening because they want to come up with what are called fasting-mimicking drugs. They want drugs that'll do just what fasting does to you, but without that nasty fasting. And something that they can sell in a pill.

• 53:48Rich Roll?

  Yeah.

• 53:49Alan Goldhamer?

  So a lot of the research that's of interest is trying to figure out what exactly is it that's happening in fasting that's allowing the body to get well so that we can try to reproduce that without having to go through the process.

• 53:58Rich Roll?

  Right, I mean, that's my next series of questions. Like, does it have to be water only? What is it about that deprivation protocol that is so special, you know, physiologically that is causing this cascade of positive impacts? Like, what would happen if you were eating a little bit? I mean, I know Longo has this fasting-mimicking protocol where he is allowing people to eat something like, I don't know, 600 calories a day, and he's able to reap some of the benefits of what you're experiencing without having to go on a complete water fast. But what is happening to the body when you're depriving it of food in such a, you know, comprehensive way?

• 54:40Alan Goldhamer?

  Yeah, the intermittent fasting protocols are just that fasting-mimicking diets or fasting-mimicking programs, trying to reproduce some of the changes that we know occur. With fasting, without the risk profile or the complications of long-term water-only fasting. And I think they can be very effective, as they've demonstrated. However, long-term water-only fasting has a much more profound impact on these mechanisms that are associated with fasting. For example, just the most obvious is weight loss. When you're water fasting, you're going to lose an average of a pound a day. Now, some people say, "Well, you lose weight, but then you gain it back afterwards." Now, interestingly, we've done a study. We have now recently acquired a Hologix DEXA scanner with the new software that allows

• 55:24Alan Goldhamer?

  you to do a whole-body detailed composition. It looks not just at percent body fat, but how much visceral fat there is. And we have a paper that'll be coming out that looks at the fact that, yes, you lose a bunch of weight fasting and you regain some weight after fasting. But it turns out the weight you regain after fasting, when you're eating a whole-plant food diet, is exclusively water, fiber, glycogen, and protein. There is no fat. In fact, the fat profile continues to drop during refeeding, even though the scale weight obviously goes up as you rehydrate, put some fiber back into the fat.

• 55:53Rich Roll?

  Right, as long as you adopt.

• 55:54Alan Goldhamer?

  As long as you continue to adopt the whole-plant food, healthy dietary style. But the point, the old wives' tale was, "Well, you lose fat and you just gain the fat right back." Well, that might be true if you go back to eating greasy, fatty, slimy, dead, decaying flesh processed foods, but that's not what's happening in these patients that were refeeding appropriately. And so, weight goes up, but the weight that goes up is re-alimenting your glycogen stores and muscle stores, which is really exciting. So preferentially, not just do you lose fat, but you preferentially lose visceral fat, that the ratio of visceral fat to adipose tissue loss is 3.0. In other words, there's a significant preferential mobilization of this very type of fat that we think is most compromising to health.

• 56:38Alan Goldhamer?

  The fat, the abdominal fat, the fat that stores around the organs. So now we have what may turn out to be an effective strategy of specifically mobilizing visceral fat. Now, we've done some preliminary work. We're actually enrolling patients in the study, starting in August, looking specifically at body composition changes long-term with follow-up. So we'll be able to speak more definitively about it by the end of the year. There's also a process that happens in water fasting that you don't see as profoundly influenced in juice diets or modified diets, and that's naturopathies. There's a selective mobilization, elimination of excess sodium from the body in water fasting that happens right away. It's very powerful, more powerful than, say, taking hydrochlorothiazide or a diuretic.

• 57:19Alan Goldhamer?

  And it's responsible for the big dump in fluids that happens initially on fasting that drops blood pressure so dramatically, gets rid of the congestive heart failure symptoms, that eliminates some of the arthritic symptoms and joint swelling and the non-healing wounds. And this body selectively getting rid of this excess sodium that's accumulated that the body's having to deal with because of the dietary choices. The traditional justification for fasting was the idea of detoxification. This idea that there's toxins in the body. And now we know that's true. They've actually been able to-

• 57:51Rich Roll?

  That's controversial.

• 57:52Alan Goldhamer?

  Well, it's actually not controversial in the sense that you can take a fat biopsy of a human and break it down, and you'll find there's hundreds of different chemicals there at various concentrations, PCB, dioxin, pesticide residues, mercury. And the only thing that's controversial is they say, "Oh, well, it doesn't matter." Well, it turns out it does matter. It just matters at different thresholds to different people. And so this idea of rapidly mobilizing toxins during fasting has been so well-accepted by some that they say that's the reason not to fast, is the body would rapidly mobilize these fat soluble nutrients too quickly, and your body wouldn't know what it's doing, and it would overload your system. Unless you take their proprietary products, then apparently it's okay. But what our experience has been, that there is a rapid detoxification.

• 58:34Alan Goldhamer?

  We know that there's some studies looking at, they've even done total body load measurements before and after fasting, and showed that PCB levels would drop clinically-

• 58:44Rich Roll?

  Well, you're not taking any chemicals into your body, and you're allowing the liver and the kidneys to just do what they do, right?

• 58:51Alan Goldhamer?

  But it's more than just what you would calculate through burning 2,000 calories of internal fluids. There's a selective and rapid mobilization. For example, with tumors. Let's say you have a breast tumor, and you lose 10% of your body weight. You would assume that you'd probably lose 10% of your tumor weight. But what happens in, for example, in lymphoma, you lose 100% of the tumor. So the body's preferentially mobilizing some nutrient stores versus others, and it seems to be able to do that in inverse proportion to the value of those tissues to the body.

• 59:22Rich Roll?

  Right.

• 59:22Alan Goldhamer?

  So it's getting the visceral fat, which we think isn't probably healthful fat, before it's mobilizing-

• 59:29Alan Goldhamer?

  adipose fat, or certainly before it's getting to critical nerve tissues and other things that are preserved, the body has an intelligence where it's unwinding itself. And what we're suggesting is, it appears that both endogenous and exogenous toxins are preferentially mobilized in water-only fasting at a much more powerful rate than they are when you're going on a healthy diet and lifestyle. And that may be a justification for trying to facilitate and speed this process. There's also the effect on enzymatic induction. Think about athletes. One of the things of being a trained athlete is you induce, for example, glycogenolytic enzyme systems. You get better at mobilizing glycogen stores. And you know, this whole business of carb loading and trying to increase glycogen storage

• 1:00:12Alan Goldhamer?

  so you have more to pull on so that you don't hit the wall so quickly when you're running that marathon or whatever, you get through that process. That is induced with persistent exercise. The same enzymatic production for glycogen, for lipolytic enzymes, for protein, for gluconeogenous enzyme systems, is induced during fasting. Because you have to mobilize all your glycogen stores. You're emptying the chamber, you're taking that battery and draining it all the way down. And it suggested that not only do you induce improved efficiency of enzyme systems, but they persist after fasting, which is just like you get better and better at exercising every time you do it, you get better and better at fasting every time you do it, which is perhaps one of the justifications for intermittent fasting.

• 1:00:53Alan Goldhamer?

  If you fast 16 hours every day, and you limit your feeding window to an eight-hour window, you may be inducing some changes in that, even that limited fast, that 16-hour fast, day after day after week after month cumulatively, that may have a very profound effect on body physiology. And that's one of the suggestions that's being made by those advocating intermittent fasting, or short periods of fasting, that cumulatively it may be. Well, when you do a long-term fast, this is a huge impact. And now, this is some of the stuff we're working with people, like Aluji Fontana from Washington University, where they're looking at changes in microbiome, changes in whole-body composition, changes in these various exotic biomarkers, and what happens in short-term and long-term fasting. Nobody knows yet, because we're really the only people doing and monitoring long-term

• 1:01:38Alan Goldhamer?

  water-only fasting and its physiological effects. So this is all virgin data and very exciting. But what we can see clinically is that When you induce changes with exercise, or you induce changes with fasting, they're often the same changes. If you look, for example, exercise, people that exercise, two rats in a cage, genetically identical. Give one rat an exercise wheel, and the other not. Everything else is equal. The rats with the exercise wheel, one, they'll use it, and number two, they don't get Alzheimer's disease and dementia. And they said, "Well, why? Why does exercise prevent, how does exercise prevent dementia?" And they look at those rats, and they find out that BDNF, brain-derived neurotrophic factor, is dramatically higher in rats that get their exercise,

• 1:02:23Alan Goldhamer?

  lower in those that don't. The ones that don't, much more vulnerable to Alzheimer's. Well, BDNF, it turns out, the precursor to that is beta-hydroxybutyric acid, which is the fatty acid that your brain is preferentially mobilizing during water-only fasting. BDNF goes up with water fasting, just like it does in exercise. Glycogen mobilizing enzymes go up in exercise, just like they do in fasting. In fact, all of the biomarkers that we've been able to look at that are improved with exercise, improve with fasting. Which is weird, because you think, "Well, wait a second. Exercise, you're up, vigorously running around, inducing all these changes. Fasting, you're sitting around, we don't even let you exercise much. You maybe could do a little yoga. How is it that they would do the same thing to the body?" But when you think about it, exercise and fasting are both reversing

• 1:03:07Alan Goldhamer?

  the consequences of dietary excess. When you exercise vigorously, when you fast, you're undoing the consequence of dietary excess. I'm not surprised at all that fasting induces the same kind of biochanges that we see with exercise. In fact, for us, it's saving a lot of time, because we just look at all that vast exercise literature, and start looking for the things they've discovered, and seeing how much of it's mimicked with fasting. I think that both of these processes, fasting and exercise, share a common biological benefit. And that's why we're seeing the biomarkers changing with both. That is crazy, wild. The other thing that happens is insulin. Insulin is the hormone that drives sugar from the bloodstream into the cells where it's needed to burn.

• 1:03:51Alan Goldhamer?

  So if you look at type 2 diabetics, you might assume mistakenly that they don't have enough insulin. They have plenty of insulin. They have more insulin. It doesn't work because there's insulin resistance. There's resistance to the insulin carrying out its function. So what drug can you take that reverses insulin resistance? There isn't any. There's drugs that'll force sugar on the cell and they have all kinds of side effects. What can you do to reduce insulin resistance? Well, you could exercise. You know, that helps. Weight loss, healthy diet. You can fast. Fasting has a profound effect on insulin resistance. In fact, as much as 80% of our type 2 diabetics can achieve normal blood sugar levels without medication. And if they're willing to continue to do the diet and the exercise, they can often sustain those results. Now, you might say, "Well, couldn't they do that with just diet and exercise?"

• 1:04:36Alan Goldhamer?

  Absolutely. Many diabetics that are able to make aggressive diet and lifestyle changes over enough time are successful at resolving and reversing their diabetes. But it's difficult. For people that aren't able to do it on their own, that's where we would use the next level of support and intervention, which is fasting. It can also be a little tricky unwinding the medications and all that kind of stuff. So, you know, doing whatever it is, whether it's feeding or fasting in conjunction with doctors that are able to be supportive and that have an expectation of you getting well is important. Now, think about it. If you go to a doctor and you've lost weight, does the doctor assume you've adopted a healthy diet? No. They assume you've got an eating disorder, you're a drug addict, or you're dying of cancer. You know, that's the differential.

• 1:05:19Alan Goldhamer?

  Colon cancer, eating disorder, drug addiction. Because many doctors have never had an experience of a diabetic getting well. I gave a lecture this year in Texas at a medical conference for physicians who specialize in diabetes. So there's 250 people there. What are they serving them? Pulled pork sandwiches, chocolate cake, you know? Most of them are overweight or obese. I do my presentation. I explain our results. Afterwards, one of the docs comes up, he's about maybe 70, 80 pounds overweight. He says, "You know, I've been in practice 25 years treating diabetics. I've never seen one get well." He's never had the experience of a single patient recovering, stabilizing a blood sugar you get off medication. It's not part of the paradigm.

• 1:06:04Alan Goldhamer?

  Well, how likely is he going to give meaningful diet and lifestyle advice to a patient when he doesn't do it himself, doesn't believe, doesn't even know that it would work? Or even if he thought it would work, knows the patient's not going to do it because people don't make diet and lifestyle changes. He's seen the literature, 93% recidivism rate. That, you know, you ask people to make diet and lifestyle changes, very difficult.

• 1:06:23Rich Roll?

  So when you get up and you give a presentation like that to that type of audience, what is the receptivity to what you're saying?

• 1:06:31Alan Goldhamer?

  Well, in the past, it was aggressively negative. Now, it's actually becoming where at least a percentage of the audience is actually interested. The way that we made that contact was, one of the doctors that runs the residency training program came in, had his own experience, wanted it for his students, and now those second and third year residents can rotate as part of their training at the True North Health Center. So they can get the experience of actually doing something that some of them have never done before, which is see these patients get well. Because under conventional treatment, you don't get to do that. And it turns out, there's some doctors, that rings their bell. They like the idea of patients getting well. And so they're willing to put the extra time and energy and effort in. But if you're in a traditional system, if you're in an HMO

• 1:07:15Alan Goldhamer?

  system, and you're a physician, and you have to see 26 patient contacts a day, do you think you have time to review their history, do an exam, write the prescriptions, and then sit and chit chat about them, why they've got to give up everything that they eat?

• 1:07:26Rich Roll?

  The system isn't set up for that.

• 1:07:27Alan Goldhamer?

  No.

• 1:07:28Rich Roll?

  It's not set up for that. It's not set up for the accountability that's required to get somebody to maintain any kind of lifestyle change protocol, anyway.

• 1:07:36Alan Goldhamer?

  And I'm not sure many of them even realize that it's actually worth their time, because they've never actually seen it happen before. So, you know, and of course, the criticism is, well, yeah, but you're working with special patients. Well, that's true. We're working with the people that are highly motivated, self-selected, willing to make diet and lifestyle changes. It is a self... I'm not saying you can take our advice, give it to everybody, and everybody's just going to go, "Oh, great, whole plant food diet, just what I wanted." That's not the reality. But for people that are willing and interested, they should at least have the right. Somebody should at least say, "Well, you could go on this diet and lifestyle, you know, but it's a lot of work. Or you can just take these pills and you'll be sick forever. What do you want to do?" You know? But they don't even know that. It's not... I can guarantee you, this physician I was

• 1:08:20Alan Goldhamer?

  talking to never tells his patients, "Well, if you did radical in diet and lifestyle changes, you could get well." I'll give you an example. My brother. My brother's six years older. So, we're raised together.

• 1:08:31Alan Goldhamer?

  He's slowly gaining weight. His wife adopts our diet, comes in and fast overcomes her own health issues, is on a vegan program. Fifteen years later, my brother's still eating chicken and doing stuff and getting fatter and he's got, can't play volleyball anymore, his legs all swollen up. I, you know, I'm poking him, but he won't do anything. Finally, he calls me from the hospital. He says, Alan, I'm in the hospital. I had a heart attack. I said, that's great. He goes, no, no, no, you don't hear, I had a heart attack. I said, I heard you. Best thing that could have happened. So he said, oh, they want to do a quadruple bypass. And I said, well, talk to your surgeon. I asked the surgeon, he says, if you do a bypass, won't they plug up again?

• 1:09:14Alan Goldhamer?

  And the surgeon, yeah, eventually, but you know, lasts longer than stents. And he says, what if I made radical diet and lifestyle change? He said, the surgeon laughed at it. He said, Mark, you're not gonna make diet and lifestyle changes, come on. Checked himself out, got on a whole plant food SOS free diet, lost the 50 pounds, back to playing volleyball, passed his stress test, still has his vessels. But my own brother, it took

• 1:09:39Rich Roll?

  Yeah, it's willingness.

• 1:09:40Alan Goldhamer?

  Pain, ability and fear of death.

• 1:09:41Rich Roll?

  It's just like in 12 step, it's like, it's all about willingness and pain is, is the fulcrum for that, right? When people are in a desperate state or they've suffered, you know, a severe medical, you know, trauma like that, then they're ready to actually implement those kinds of changes. Short of that, it's very difficult. And I think that speaks to the pessimism that most practitioners have about the, you know, the viability of advising somebody to change their lifestyle habits.

• 1:10:12Alan Goldhamer?

  Absolutely. I completely understand. This is amongst the most difficult thing you can ask a patient to do. Adopt a health promoting diet in a world designed to make you fat, sick and miserable? Not an easy task, certainly not for sissies. And in my brother's case, you know, he had the advantage, his wife, my sister-in-law, already doing the work of providing support to the family with healthy food and stuff, but still difficult. Now, I just saw him a few days ago, looks great. Completely different person. Do you think he's gonna like, oh, no, it wasn't worth it? No, no, it's the best thing he's ever done. Fabulous.

• 1:10:52Rich Roll?

  So you approach fasting from a perspective of weight management and also disease prevention and reversal. But there's also all this emerging science around longevity and anti-aging. Of course, that's Longo's specific lens on this. But by dint of autophagy and all these other biomechanical systems that are affected by fasting, there's now this whole world of research opening up around prolonging life as a result of this.

• 1:11:22Alan Goldhamer?

  I actually think the people that are going to turn out to get the most benefit from fasting, this one- and two-week fast that we do with healthy people, is healthy people. Healthy people that are looking to stay healthy. For example, to avoid vulnerability of infectious disease, to avoid the problems that, not waiting like my brother did till he has a heart attack, but the people that are willing to use it to prevent the problems from beginning. And interestingly enough, I've been communicating with Walter Longo recently about doing a joint study where we're going to use his expertise and access and our facility to do some look not just at intermittent fasting, but long-term fasting and compare and contrast and see what the very best bang for the buck, so to speak, of is in terms of taking healthy people and helping them stay that way.

• 1:12:04Alan Goldhamer?

  We've got a study that's planned for next year looking specifically exotic biomarker changes with these dietary changes with fasting and then trying to differentiate how much fasting, how frequently, what's the right combination. That's all relatively new territory. There's other impacts of fasting that are not as well-recognized. For example, the gut. You have a tunnel through your body that starts at your mouth and it goes down your esophagus and then your stomach and your intestinal tract and gets to the rectum. You've got a hole at one end and another hole at the other end. And digestion is essentially shoving things in one hole, trying to push it out the other hole. But it's only the stuff that gets absorbed through the intestinal mucosa that enters the body. And that intestinal mucosa acts like a screen, keeping flies out.

• 1:12:47Alan Goldhamer?

  If the screen becomes inflamed, things can leak through. That's essentially what gut leakage is. And the things that cause inflammation of the gut, we believe, are free radicals that come from not just smoking or drinking alcohol. Smoking, it's obvious, you see smokers' face, cross-link collagen tissues. We know that's cross-linkaging from the free radicals from smoking. It also affects the enamel lining of the blood vessels. It's my contention that cigarette smoking may protect people from getting lung cancer. Actually protects people.

• 1:13:16Rich Roll?

  That's a radical statement.

• 1:13:17Alan Goldhamer?

  Well, think about it. Eighty percent of smokers.

• 1:13:18Rich Roll?

  How can you say that? Come on.

• 1:13:20Alan Goldhamer?

  Eighty percent of smokers never get lung cancer. And 20% of smokers get cancer. And I believe it's because smoking kills people from heart attacks before they live long enough to grow their tumors. Because of the damage to the animal lining of vessels, cardiovascular disease may occur slightly quicker than the inevitable lung cancer would have. And so if you could make smoking more dangerous and kill everybody from heart disease, perhaps they could advertise it as cancer safe.

• 1:13:44Rich Roll?

  Okay. Now I understand.

• 1:13:47Alan Goldhamer?

  Well, you know, they say statistics don't lie, but liars use statistics. And the fact is, you can look at this data and twist it around in a way that sounds good, even though it's completely ridiculous.

• 1:13:59Rich Roll?

  Right.

• 1:14:00Alan Goldhamer?

  Smoking damages animal lining, it causes lung cancer. Alcohol, peroxidation of alcohol, leads to cirrhosis of the liver. Why do you think people that drink a lot of alcohol get fatty liver? It's a scar tissue that comes from the detoxifying effect of the nasty alcohol. But today, they're trying to tell you that alcohol is health food. If you don't drink, you should start. That resveratrol, the little bit of powerful antioxidant from this great skin, is some justification for drinking alcohol. They're trying to tell, oh, it thins the blood, like aspirin does. So if you're on a greasy, fatty, slimy, dead, decaying flesh diet and risk of clotting stroke, that thinning effect is going to reduce your risk of dying from a clotting stroke, which might be true, but you're going to increase your risk from a hemorrhagic stroke. You're not going to reduce your all-cause mortality. So the only reason to drink alcohol is if you'd rather die of a bleeding stroke than

• 1:14:43Alan Goldhamer?

  a clotting stroke, maybe that's a justification.

• 1:14:46Rich Roll?

  You're a passionate man, Dr. Goldhamer. Why is it that, why 40 days or 21 days? Like, what is it about that extended period that's so important?

• 1:14:57Alan Goldhamer?

  Well, what we do is, we want to fast as short as possible, but long enough to get the problem resolved. And so it's not like we're setting out to try to beat Jesus in fasting duration. We don't go over 40 days generally, because if you keep the fast under 40 days, there's few metabolic complications. As you start getting into the really long fasts, the 60 days, the 80 days, the longer fasts that were done in the past, it's a much more delicate balance in terms of electrolyte balance and other things. And so, the guy that I trained with Alec Burton in Australia, used to do fasts as long as 100 days or longer. And I asked him, by the time I got there, that was 36 years ago, he was no longer doing over 40 days as a routine, just very occasionally. And I said, why? And he said, well, because of the sleep deprivation.

• 1:15:41Alan Goldhamer?

  I said, "Oh, I didn't know that patients had any more trouble sleeping on long-term fasts." He goes, "Oh, no, not the patients, me." He had sleep deprivation. He was just worried too much. Yeah, he worried too much about it. So, he decided to keep it to 40 days because we knew from experience that that was the period of time you could go without getting into more of the complications.

• 1:16:01Rich Roll?

  And there's no electrolyte supplementation or vitamin and mineral supplementation during this period? You're looking at me like I'm crazy.

• 1:16:08Alan Goldhamer?

  Water-only fasting is the complete absence of all substances except pure water in an environment of complete rest.

• 1:16:15Rich Roll?

  Is there a particular kind of water?

• 1:16:16Alan Goldhamer?

  We use fractionally steamed distilled water just because it's pure water. Patients that are fasting get really sensitive. They won't tolerate municipal contamination and other stuff. They just want pure water. It's H2O. It's just what rainwater would be if the environment wasn't polluted. And so, anytime you start supplementing, like, for example, there were some long-term fasts done by medical authorities that killed people. And the reason why is because they supplemented. What they would do is they would supplement potassium if potassium got low. But if you don't allow something to be the rate-limiting nutrient, and you're not measuring, obviously, everything that's possible to be measured, you can get into depletion of something else, and they did. And you see evidence in the literature of myocardial fibrill breakdown or other problems that you'll not see if you don't let the rate-limiting nutrients be rate-limiting. For example, potassium is pretty sensitive.

• 1:17:00Alan Goldhamer?

  If you don't supplement potassium and you use potassium as a rate-limiting mineral, all the downstream things that you might not necessarily know to measure are not likely to become an issue. So, we use 3.0 potassium as an arbitrary termination. If it gets below that, then we modify the protocol. Now, it's not necessary to do that. You could push people further. But if you use that as a protocol, we've proven you can do it safely and effectively over 20,000 consecutive times. The reason why we've been able to do this so consistently is we have strict protocols that we follow that are time-tested and proven. And supplementation of electrolytes, although you might think, "Well, potassium's low, we'll just give them some potassium." But that's an example of letting arrogance exceed your ignorance because you don't know what the downturn consequences of that is.

• 1:17:44Alan Goldhamer?

  And so, we're using a protocol that we've been able to test. Now, maybe there's a better way to do it, and that's why we do research, and that's why we look at these things. There may be. But until that's done, I exercise caution.

• 1:17:56Alan Goldhamer?

  Because the fact is, you're in a physiologically vulnerable state, particularly in a person that's coming off medications and has a health history. And you want to make sure that everybody that walks in walks out. And that's why we use the protocol we do.

• 1:18:09Rich Roll?

  I would suspect also a psychologically delicate state. Walk me through the experience of this journey that you see with a typical patient. I mean, you're demanding a lot of them. They're going through something they've never done before. Like, what is that like for that individual when they're on day three, day 10, day 30?

• 1:18:32Alan Goldhamer?

  Yeah, so the first few days of fasting are actually the most difficult because you're adapting off a glucose metabolism into a fat metabolism. So the brain is changing fuels from burning sugar to burning largely beta-hydroxybutyric acid, which comes from the ketone bodies from the fat breakdown. So there's an adjustment there. You're detoxing oftentimes a lot, although we've learned to minimize the effect of detoxification by getting people to eat a fruit-vegetable-only diet for a few days before we start fasting. That's made a huge difference. So they're not coming off caffeine addiction at the same moment that they're trying to adapt to the fast. They've already gotten that stuff out of their system. And that's actually the most difficult stuff, getting the cigarettes, the caffeine, the alcohol, all the meat, fish, fowl, eggs, dairy plex, processed foods, all the host of chemicals

• 1:19:17Alan Goldhamer?

  that people are putting into their body with over-the-counter prescription medications. So we've gone through a wean-down process, and then we start fasting. And their mouth may coat up and taste like something crawled in there and died. And they may have some skin rashes or elimination. They may get mucus discharge. They may get some vivid dreams. They may have aches and pains, and they may have difficulties with all kinds of adaptive processes, but they go away. And then something else comes along, and then it goes away. And then it becomes very empowering because they realize that they're able to get through this process, that just because they had a headache doesn't mean they have to rush out and try to suppress those symptoms with a pill. It goes away. The body's able to heal itself. And then, once you get into four or five days of fasting, the body's pretty well acclimated to the fasting. At this point, there's no hunger.

• 1:20:03Alan Goldhamer?

  People are going to cooking demonstrations. They're coming to lectures. They're going to the dining room to socialize with people. They're five days, 10 days into a fast. You think, "Oh, my God, how you haven't eaten for 10 days?" No, I just enjoy being there.

• 1:20:13Rich Roll?

  That's crazy.

• 1:20:14Alan Goldhamer?

  Not a problem. So then... Depending on the patient, sometimes they start getting relief. Their pain, maybe for the first time in years, the pain that they've been suffering with is going away. And they may find that, you know, some people have these chronic debilitating problems. Start resolving, things start falling off, tumors start shrinking. They start getting excited like, oh, maybe there's something to this idea of the body healing itself. And, you know, we're monitoring these patients to go through the process. And then at some point, you get to the point where there's a limiting factor. Maybe their electrolytes start to drop a little bit, or their energy is not acceptable. They're not able to maintain adequate ambulation. Or maybe they've just, that's how much time they've got. Because, you know, some people have jobs and lives and responsibilities. So we only have so much time to work with.

• 1:20:59Rich Roll?

  Been here for 40 days. While my life completely craters on the outside.

• 1:21:03Alan Goldhamer?

  But for many people, this is an intense, epiphonic experience. Because they've got this intense education that they're really open to. They've seen these other people, sometimes what looks to them like miracles going on. Because they're seeing people that they have no expectation that that could get well. Getting well, they're experiencing themselves sometimes for the first time. You know, a sense of empowerment, because they're able to actually reverse these processes. They were told nothing could be done, learn to live with it. What did they expect at their age? That's just how it is. And now they're thinking, wow, if they were wrong about that, maybe they're wrong about other things too. And they start, you know, looking at all aspects of their life.

• 1:21:36Rich Roll?

  The empowerment aspect of it has got to be huge. Like, even if you set aside all of these, you know, physical benefits that are a result of this. Simply the fact that they did something that seems impossible, very, very difficult, and get to the other side of it, has to, you know, sort of make them feel like, okay, now, nothing is impossible. Like, I just did this thing that almost nobody does. Now, now what's the next challenge that I can tackle?

• 1:22:07Alan Goldhamer?

  You know, the idea is that many people think that if you fast, you die. They believe if they got on a plane in New York, and they were to fly all the way to California, they would die over Colorado, except they ate the peanuts. You know, that the pretzels saved their life.

• 1:22:21Rich Roll?

  What do you eat when you fly?

• 1:22:22Alan Goldhamer?

  And somehow, if you fasted for 10 days or 20 days, sometimes the idea that you might have to skip a meal, because there was nothing healthy to eat, doesn't seem quite so overwhelming. There is definitely empowerment. And I think that the other thing that happens is when you start feeling what it feels like to be you, instead of what you'd become, that's very empowering. I think the same thing happens to athletes. You know, when people first start exercising at first, it's not pleasant. They got aches, they got pains, they're fatigued, they're not getting the success, they can't do what they want. But as they do it, they get to the point where not only do they tolerate, they're not just doing it because they want to, you know, maintain the weight or get the figure or whatever it is. They're doing it as they start realizing they're getting real intrinsic benefit from engaging in this consistent activity. And now they don't want to give it up.

• 1:23:07Alan Goldhamer?

  And I think the same thing happens when people really get into a healthy lifestyle.

• 1:23:11Rich Roll?

  Yeah, they're invested.

• 1:23:11Alan Goldhamer?

  They don't want to go give it up and feel like everybody else feels because of some greasy, slimy, convenient food. They're willing to pay the price of trying to do the planning and do what it takes to try to ensure that they can get their needs met. Just like I think people that get into a regular exercise regime, realize that now this is so beneficial, they will literally structure their schedules around making sure that that's an important part of their activity. And the same thing happens with sleep. When you realize how important sleep is to health and maintenance and energy, you start prioritizing that. And you don't compromise your sleep, you don't compromise your exercise, and hopefully you don't, you learn to not compromise your diet and lifestyle. I tell people, here's what you need to do. First, get enough sleep, because it's your most critical activity. Then engage in regular exercise, so you can dissipate the tension, you can build fitness,

• 1:23:57Alan Goldhamer?

  and have the time to prepare and eat healthy food. If there happens to be any time left, well, fine, you go to work.

• 1:24:05Rich Roll?

  Let's talk about the food part of all of this. So, well, first of all, does anybody freak out in the middle of this and flee? Like, I can't handle it? Like, there has to be some people that just psychologically can't handle it.

• 1:24:23Alan Goldhamer?

  You'd be surprised. By the time people come to the True North Health Center, they're pretty well vetted. They've gone through some screening. We've evaluated their history. They're usually pretty motivated. Most of the time, the only way they find out about us is some doctor or somebody they know has referred them to us to begin with. And you know, it's like you're not going to refer somebody that if you know what's going on there, that's not going to be a good candidate. So there's a lot of filtration that goes on. And so the exceptions that I've seen, I've had some patients that are coming off drugs like cocaine and other stuff that don't last 12 hours, you know, because they're just, they're not really ready to make the change. But as far as fleeing because of diet, no, because the True North Health Center is set up to meet people where they're at. Not everybody's ready to do vigorous water-only fasting, or should, would it even be appropriate? So for those individuals, maybe we just do a healthy eating regime.

• 1:25:06Alan Goldhamer?

  And just eating the diet, doing the classes, doing the yoga, the meditation is enough to induce significant changes. Sometimes after they've been a while, they might say, well, you know, maybe I'll try a little intermittent fasting, or maybe I'll try a little bit of a fast and see how I do with that. And that's fine. So it's not like everybody comes in and we lock them up and that's it. In fact, you know, I tell the story, when we first moved to the new facility, one day a really large police officer showed up at the door and he said he wanted to interview one of my patients. And I asked him, what did they do? And they said, well, you know, I don't need to know. And I said, well, if you want me to tell you if they're here or not, I need to know, you know, what the issue is. And he said, okay, we got a complaint. And the complaint was from this patient's relatives.

• 1:25:48Alan Goldhamer?

  And they said that the patient was being held against their will by religious cultists and being starved to death to go to be with Jesus.

• 1:25:57Alan Goldhamer?

  And I thought, I'm saying, look, the person's not here involuntarily. And you've got to interview, I said, fine, I'll let you interview. But first, would you like a nice tall cup of Kool-Aid? Uh huh, right. And Dr. Lyles says that when a police officer puts his hand Like relishing your role as a cult leader. He is not comfortable, and I'm not to speak to authorities anymore, but. You know, I'm thinking it's an obvious joke because Kool-Aid's full of sugar. Why wouldn't you serve that at the TruNorth Health Center?

• 1:26:21Rich Roll?

  Well, I know, it's funny.

• 1:26:22Alan Goldhamer?

  The reality is that today, it's not as much of an issue because now the idea of fasting doesn't seem quite so extreme. It's not the Jim Jones kind of, you know, perception.

• 1:26:32Rich Roll?

  Right. Are you still the only medically supervised clinic that's doing this?

• 1:26:37Alan Goldhamer?

  Well, you know, I'm really excited because I just visited yesterday, one of our doctors that trained with us, Nathan Gershfeld, is running a facility here in the Los Angeles area. And it's beautiful. I went to see his facility and it's absolutely beautiful. And for anybody that, you know, and also we have another doctor, Dr. Ewen in Ohio, that's opened up a small facility, is doing really well. I've gotten excellent feedback from people. We have other doctors that we train. We have an intern resident training program. And those schools, I mentioned Texas A&M, there's other medical schools, the naturopathic professions graduates can come and spend a year as a resident doing a rotation at the TruNorth Health Center. The chiropractors often come and spend three months as part of their training at the TruNorth Health Center.

• 1:27:22Alan Goldhamer?

  And those doctors, we're hoping to open up more facilities around the country. And we make, people that contact our website can get access to whoever the local fasting supervisors are, and we're happy to provide that information. And it's really exciting to see these guys, not only learning how to do it, but actually figuring out how to get these places open and offer affordable care to people. And, you know, the thing, it's always gratifying to see the clinical results that they're seeing because it's really a hard thing to do in an outpatient practice. Unless you can control a person's environment, it's hard to really induce these kinds of profound changes.

• 1:27:58Rich Roll?

  It's gotta be incredibly gratifying as a medical practitioner to see such dramatic results.

• 1:28:04Alan Goldhamer?

  Well, I think that's one of the reasons we've been successful. We have a dozen clinicians now at the TruNorth Health Center. We have Five medical doctors. We've got osteopathy, chiropractic, naturopathy, all represented. And these doctors, once they come, they often are with us their entire career. In fact, Dr. Clapper, who just retired after nine years at TruNo Health, we joke that we're like the firm, you know, once they start.

• 1:28:25Rich Roll?

  Yeah.

• 1:28:26Alan Goldhamer?

  But it's because they like the low patient intensity. In other words, they're not having to see high volumes of patients. So they're spending a lot of time with a few people instead of a little time with a lot. They like the center setup where the doctor's able actually to get all that intense education done without it coming out of the visit time, that they can spend the visit time really working with the patient's specific needs. And they like the idea that people get well.

• 1:28:48Rich Roll?

  Mm-hmm.

• 1:28:49Alan Goldhamer?

  And so the combination of that allows us to keep the doctors, even though they probably work harder for less with us than they would if they went off and worked for the local HMO or whatever it is. It's enough gratification, enough benefit, that those doctors really like working at TruNo Health.

• 1:29:03Rich Roll?

  What is the, what is the kind of current relationship that you have with the conventional, you know, medical establishment? Like, how are they perceiving what you're doing now?

• 1:29:13Alan Goldhamer?

  Well, it's been a revolution, actually. It's been amazing change because when Dr. Soltana, who's been with us now about 20 years, came, the first thing we did is we got him to take a job with the local hospital as an urgent care doctor. And so he became known to the medical staff there and the nurses, and he's such a wonderful doctor. They loved him. And so that allowed us to have a good relationship with the immediate, we have a trauma center, you know, just a mile away. And so some of their nurses or patients of ours, we provide chiropractic support to the nurses at that hospital. The, some of the hospitalists purchase their food through our outpatient deli. So we have a good working relationship. And now that they're seeing some of our referral patients that we're

• 1:29:57Alan Goldhamer?

  doing for diagnostic workups and people getting well, that's really helped too, because they're not used to seeing people actually recover. And so today, it's completely different than it was 20 years ago, where we were seen as some kind of, you know, crazy people. Now, I think they see it as a little bit odd and different, but at least for people that have, whatever it is they see, get well, acceptable.

• 1:30:19Rich Roll?

  Right, right.

• 1:30:20Alan Goldhamer?

  And they know we're well-intentioned. The other thing that's made a big difference is we've published a number of papers in peer-reviewed medical literature, including on the safety of fasting, the effect of fasting on high blood pressure. We've recently finished a study with the Mayo Clinic, looking at primary prevention of stroke. That's in review right now at a major journal. We're hoping that we'll get positive publication of that here in the next couple of weeks. We've done a study with Luigi Fontana from Washington University, looking at biomarker changes in the gut microbiome before and after fasting.

• 1:30:50Rich Roll?

  Right.

• 1:30:50Alan Goldhamer?

  We have a couple of other studies that we're enrolling in right now. So now we're getting some affiliations with some of these major players like Walter Longo, which is going to allow us to get into journals that we might not otherwise have been able to access because of the power that these guys bring.

• 1:31:05Rich Roll?

  Yeah, his credibility and his pedigree, I would imagine, is very helpful.

• 1:31:09Alan Goldhamer?

  Oh, he's done unbelievable, just fabulous work. And he's a wonderful guy.

• 1:31:13Rich Roll?

  Yeah.

• 1:31:13Alan Goldhamer?

  You know, we're so fortunate that we've got these kind of people out there trailblazing into the scientific and medical literature. Because as clinicians, and particularly alternative health clinicians, we're not always viewed with the most open-mindedness from much of the medical profession.

• 1:31:27Rich Roll?

  Yeah. Well, the other big piece here is the diet and nutrition piece. I would suspect that a lot of people come to True North because they saw you and they saw those case studies portrayed in What the Health?, the documentary. We all saw those individuals, their kind of before and after stories that were very dramatic. And a big part of that-

• 1:31:49Alan Goldhamer?

  And heavily criticized.

• 1:31:50Rich Roll?

  And heavily, yeah, controversial, for sure.

• 1:31:53Alan Goldhamer?

  We have people telling us, I see there's stuff on the internet that says those people were all paid actors.

• 1:31:57Rich Roll?

  Oh, really?

• 1:31:58Alan Goldhamer?

  It was all, you know, reverse Photoshop. And I've seen some unbelievable-

• 1:32:01Rich Roll?

  I think Kip and Keegan just kind of grabbed them randomly, right? Like, how did that happen?

• 1:32:06Alan Goldhamer?

  They showed up and wanted to do the films. We did some interviewing. Then they came back and they said, well, they've decided they wanted a little more- Can we just interview some of your patients? And they went out to the courtyard.

• 1:32:15Rich Roll?

  Whoever happened to be standing around.

• 1:32:17Alan Goldhamer?

  Yeah, I wish we could have cherry picked it and stuff.

• 1:32:19Rich Roll?

  Well, there was that one guy, he had all his pills. You know, he went through all of his medications and all that kind of stuff.

• 1:32:24Alan Goldhamer?

  The point is, that type of experience is pretty routine.

• 1:32:26Rich Roll?

  Yeah.

• 1:32:27Alan Goldhamer?

  True or tough, we see what looks like miracles. It's not miracles at all. It's just getting rid of the crappy diet, instituting a whole plant food SOS free diet and using fasting effectively. You know, that's the reality. And I know they've got a new movie coming out and I know they've done a bit of filming with us as well. Also, I'm very excited that I think it's September, Netflix decided to do a special on wellness.

• 1:32:47Rich Roll?

  Oh, they did?

• 1:32:47Alan Goldhamer?

  And one of their six shows was filmed at the True North Health Center.

• 1:32:51Rich Roll?

  Oh, wow.

• 1:32:51Alan Goldhamer?

  And it's on fasting.

• 1:32:53Rich Roll?

  Who's behind that, do you know?

• 1:32:54Alan Goldhamer?

  I can't, I don't recall who the producer and what else, but it's, I know it's purchased by Netflix. It's a Netflix original.

• 1:33:03Rich Roll?

  Oh, that's cool.

• 1:33:04Alan Goldhamer?

  You know, so I know it's going to get pushed out.

• 1:33:06Rich Roll?

  I had John Lewis in here a couple of weeks ago, who's working with, with Keegan on The Hungry for Justice project. And so I've been behind the scenes, kind of looking at what they're doing. That's going to be a really big one.

• 1:33:18Alan Goldhamer?

  I imagine it'll be very controversial and probably piss a lot of people off. I'm really excited to see it.

• 1:33:23Rich Roll?

  Keegan, that's, that's Keegan's specialty.

• 1:33:25Alan Goldhamer?

  Yeah.

• 1:33:26Rich Roll?

  But, all right, so the food part. The, the protocol that you're, that you recommend and that you, you know, apply with your patients is, you know, owes its debt of legacy to Caldwell Esselstyn and, you know, a whole legion of those pioneering doctors who have put the whole food plant-based diet onto the forefront of public awareness. We've seen it grow in adoption and recognition and we're seeing the benefits of that. I think it's still, you know, somewhat controversial. There's all these diet wars with the low, the low carb people and now ketosis and all of that. So that's kind of all kind of going on in the background here, but maybe, you know,

• 1:34:11Rich Roll?

  you can just speak to why you believe so strongly in a whole food plant-based diet?

• 1:34:16Alan Goldhamer?

  Well, the exclusively whole plant food diet, I think is, has a lot of support, whether it's John McDougal or Esselstyn, or you mentioned one of my heroes. T. Colin Campbell, you know, just a brilliant guy. So, they all make a very compelling case that people should eat a whole plant food diet.

• 1:34:33Rich Roll?

  Essentially, you call it a whole plant food diet. I notice that you always do that, instead of calling it a whole food, plant-based diet. What's the reason for that?

• 1:34:39Alan Goldhamer?

  So, I want a whole, I want whole plant food diet because a plant-based diet implies that, you know, it's based on plants, but it allows room, it allows flexibility.

• 1:34:48Rich Roll?

  Interesting.

• 1:34:48Alan Goldhamer?

  And so, I think that Dr. McDougal and Dr. Campbell would argue that we want to have as broad a diet as possible to intract as many people as possible. Because, remember, most people in the vegan vegetarian movement are not just interested only in health, but actually dominantly in animal rights, moral, ethical, and spiritual reasons, environmental impact. And so, their argument is, well, maybe it doesn't have to be Mr. Perfect, you know, diet. If it encompasses a broader range of people, we'll get more people doing it, we'll save the planet, we'll save the animals, we'll go to heaven, whatever it is. And I don't disagree with any of that. That's, that's great. But when it comes to maximizing health, if a person's overweight, wants to lose weight, if a person has heart disease, diabetes, if they've got cancer, or if they're healthy

• 1:35:31Alan Goldhamer?

  and their goal is to live the maximum healthy life possible, I believe the evidence supports the idea of an exclusively whole-plant food diet that's free of SOS. SOS is the international symbol of danger, and it stands for salt, oil, and sugar. Now, can you have a little salt and still be healthy? Yes, just like sometimes people can have a beer and not be a drunk. But for my patient population, which is either sick people that want to get well, or the healthy people that really want to maximize their health, a whole-plant food SOS-free diet, I believe, will prove to be the most health-promoting diet out there. Now, is it the best diet for society to advocate? No, I'm not arguing that. I'm so grateful that people like Dr. Campbell and Dr. Esselstyn and Dr. McDougal are out there educating the world. I'm not that nice of a person.

• 1:36:13Alan Goldhamer?

  I'm only interested in my patient and the, and the maximizing the people that's in front of me. And the people that I see are often sick or healthy and want to stay that way. And so, I believe that is the best advice for them. Now, does that mean somebody can't have a more flexible diet and still be healthy? Of course they can. And if it's working for you, that's great. I'm not going to argue with it. But if you're struggling, don't pretend that there's not another level of compliance that's possible. And I suggest people try it this way, because they might find out, you know, they don't miss all that salty, sugary stuff anyway. And they may be just as happy. And if not, that's fine. If you can modify the diet, maintain the numbers, not screw up our outcome data... I'm not a policeman. I'm just trying to give you the best advice I can.

• 1:36:57Alan Goldhamer?

  But I do believe I'm right. Now, if it turns out I'm wrong, and the evidence supports that you're better off having more than 1,500mg of sodium a day, because that's an important reason for some reason, then I'll change my recommendation. Okay, I'm recommending what I'm recommending based on the combination of 36 years of clinical experience watching people get well, and my ability to interpret the scientific literature, and the staff that we have at the True North Health Foundation that are doing the same. And up till now, a lot of the stuff that we used to advocate was criticized heavily. Most of the stuff that we've been advocating, if you go back for 36 years, has been accepted as reasonable. The two things that we do that are still controversial is recommend a lower sodium intake than some of our colleagues.

• 1:37:38Alan Goldhamer?

  And this type of diet ends up having about a gram of sodium in it, naturally. And water-only fasting. And I believe in both cases, the data's gonna prove, we're right.

• 1:37:51Rich Roll?

  What do you say to the low-carb proponent who tells you, "Listen, you know, we need some of these oils in our diet. You know, healthy olive oil has its place. We've seen that in the Mediterranean diet. We've had tremendous results with people losing weight and maintaining their weight, and reversing a whole litany of conditions. So, you know, why not just go that route?" Like, when you have to measure those two protocols against each other, how do you think about that?

• 1:38:19Alan Goldhamer?

  Well, there's a number of protocols you're actually covering there. Like, for example...

• 1:38:22Rich Roll?

  But these things get conflated in this conversation that's going on.

• 1:38:25Alan Goldhamer?

  The dead Dr. Atkins diet, the high-protein, high-fat diets, they'll argue, "Well, we got weight loss." I don't disagree. And a lot of times, what's really good for short-term benefit isn't necessarily the same thing that's good for long-term outcome. Same thing in athletics. You can inject anabolic steroids, and you can get some pretty powerful short-term effects. But then you get the testicular atrophy, and you get cancer and die, and it's not so good in the long run. So, what's good for short-term weight loss isn't necessarily the same thing as what's good for long-term health support. And I don't disagree that a lot of these programs are effective for weight loss. Heck, you can cut the hip off at the leg and lose 40 pounds overnight. Now, it may not be, you know, a net benefit to you, but just because you want instant weight loss, there's lots of things you can do. As far as the other alternatives,

• 1:39:06Alan Goldhamer?

  which is maybe a higher-fat, low-protein diet inducing a ketogenic state, that may very well have some short-term benefits. It may even have some long-term benefits. But when you compare the results that we see clinically in the conditions that we treat... There's nothing I've seen that's worked better than exclusively whole plant food SOS free diet. And I have the luxury of having patients living with me, sometimes for a period of a year or more. So we're able to really test the diet and see what it takes for them to actually recover their health. That's one of the downsides of living with your patients, because if they don't get well, who can you blame?

• 1:39:39Rich Roll?

  Right. They've been with you for a year. Wow, you have people stay with you for a whole year?

• 1:39:43Alan Goldhamer?

  Sometimes longer than a year. I've got people there now, longer. Well, sometimes we've had people checked in that were being sent to the nursing home. We came as the alternative, and then they get well and go home. And it was, you know, 2,000 a month less staying with us than at the nursing home. So, you know, for those individuals, it was an economic benefit. Other people come in because they're going to do long-term fasting, long-term recovery, they've got serious health problems. Sometimes it takes a couple of months just to get people off all their drugs. Some people come in because they don't feel comfortable living freely, because they've got some issues with food and eating, and they want to live in a controlled setting until they really get it down, so they feel comfortable going out there. And the same thing true with alcoholics. Some people, you say, quit drinking, and they quit. Some people go to outpatient treatment, they do great. Some people do 30-day programs.

• 1:40:25Alan Goldhamer?

  Some people do 90-day programs. Some people, you know, have to do longer.

• 1:40:29Rich Roll?

  Yeah.

• 1:40:29Alan Goldhamer?

  So you have to make it to meet the patient's need. So I'll tell you a funny thing. We have this phone coaching thing I told you about. And so one of our doctors, Dr. Chilla Verast, does a lot of phone coaching with people. And so people will call up on me, and we decide, okay, they need to come in and fast, but it's a couple of months before we have an opening. So I say, why don't you work with Dr. Verast in the meantime? And when you come in, you won't have to be here so long, and then they go and get well. And it's happening a lot. I'm giving her a hard time. I say, you got them well before we could come here. We screwed up our study, our documentation, they're all well. But it's okay.

• 1:41:00Rich Roll?

  How many beds do you have, though? You probably are at capacity most of the time.

• 1:41:04Alan Goldhamer?

  Yeah, we can handle about 70 people. So we're going to run about two months or so out. You know, it was interesting, after the COVID thing, all of our foreign people had to cancel. And that's 15% of our people. We had 50 people that couldn't get in. But we had so many more local people, because now people can work from home. So some people that wanted to come in, but they, you know, couldn't... Afford to miss work during the full time.

• 1:41:28Rich Roll?

  So they're working while they're.

• 1:41:30Alan Goldhamer?

  Some people are able to come in, do a fast, but then they can, during recovery, they can go back to working remotely because we have excellent wifi bandwidth and all that stuff. So, you know, those patients are able to actually function, you know, in a controlled setting, but not necessarily miss work. Sometimes we have situations where they've got kids. Well, now we have like suites that people book family units. So they may come into fast, but they can have their family there. And so the family learns to eat good food and there's no cooking. And so there's lots of different ways to adapt to people's needs, depending on what it is they're really wanting to accomplish. Our limiting factor is we have to have highly motivated people that really want to pay the price to get well.

• 1:42:08Rich Roll?

  That's the determining factor in success. I mean, it's so similar to the recovery community. I mean, you have outpatient, you know, situations, you have inpatient. I mean, I did inpatient for 100 days and, you know, now I think I should have stayed longer. Like it was, it was, it had such a dramatic, I mean, it saved my life and it gave me a new life, but I needed that much time. And then, you know, a lot of people from that experience, and I work with people today who are in halfway houses or, you know, sober living facilities. There are all of these transitionary scenarios that are available to people to help them not just create these new habits and, and, and, you know, build a new foundation for

• 1:42:49Rich Roll?

  their life, but you need that support system in place in order for it to really lock in so that they can carry it out in the world in a, in a permanent way.

• 1:42:58Alan Goldhamer?

  You know, we have a, because we're a 501(c)(3) nonprofit research driven organization, our price point is quite modest. Our prices are the same as they were 12 years ago.

• 1:43:06Rich Roll?

  That's why Chef AJ goes through, she's like, it's cheaper for me to go to your north than go to hotel.

• 1:43:11Alan Goldhamer?

  We actually have businessmen, sometimes they'll choose to stay with us when they're on the road because they get their meals and it's cheaper than the DoubleTree.

• 1:43:17Rich Roll?

  You need to charge more.

• 1:43:19Alan Goldhamer?

  Well, no, the idea is.

• 1:43:20Rich Roll?

  Or you need more beds or I don't know what you need.

• 1:43:22Alan Goldhamer?

  We want to keep the price point as low as possible. There's a reason we haven't raised rates in the last 12 years is because people need to stay long enough to get well. They need to be able to come back if they need support. And by keeping as low rate as possible, it broadens the number of people that can actually afford to do share.

• 1:43:36Rich Roll?

  Insurance cover it?

• 1:43:37Alan Goldhamer?

  Insurance will cover their medical exam, the, all the traditional medical management things, not the part where you get well. That of course wouldn't be part of health insurance. The daily rate at the center, the 149, but if, seeing the medical doctor, getting any scan or lab, that would be treated just like it would any insurance. What is interesting though, people that have medical savings accounts. That covers the state at the center fully because you are temporarily disabled. You are under direct medical supervision. You are being treated on an inpatient basis.

• 1:44:03Rich Roll?

  It seems like with the explosion in the rates of obesity and diabetes and all of these, you know, chronic lifestyle ailments that are debilitating millions of people every year and escalating at a shocking rate, that there would be clinics like this in every city available to people because it really is an opportunity for you to reboot and reframe your relationship to the habits and the foods that you're eating that are creating these problems in the first place. Otherwise, you just become a ward of the pharmaceutical industry.

• 1:44:38Alan Goldhamer?

  Well, I hope you're correct. I hope you're predicting just exactly what we're starting to see, new facilities opening. But you also have to remember, any place that makes you give up coffee, alcohol, tobacco, meat, fish, fowl, eggs, dairy products, oil, salt, sugar, and maybe consider fasting.

• 1:44:55Rich Roll?

  It's a tough shell.

• 1:44:56Alan Goldhamer?

  I mean, that's a tough, yeah. You know, I have patients that their friends say, "Well, what do you go there to fast? Just come, you can come to my garage, I'll give you the hose, you don't, I won't charge you anything."

• 1:45:04Rich Roll?

  Yeah, that is true. Although, you know, I think when people are looking at that quadruple bypass, you know, those options don't seem so onerous anymore. And I think the thing is, we've, we've arrived at this cultural moment where anything uncomfortable is seen as, you know, optional in our lives, right? We're so disconnected from challenge and stepping outside of our comfort zones. And to tell somebody, "Look, you've got to, you know, overhaul everything that you're doing," is a difficult message. It's a, it's a very undigestible message. But at the same time, like, I know in my own experience, and look, you've done this

• 1:45:45Rich Roll?

  with 20,000 people, to get those people through those uncomfortable weeks and have them arrive on the other side where, you know, you can pull the curtains open and the sun shines in, and suddenly those foods they thought were unpalatable actually taste good, their cravings have changed, they actually look forward to their meals with these, you know, plant foods. I mean, that's a miraculous thing that I just wish more people could discover in their lives.

• 1:46:15Alan Goldhamer?

  Yeah, it is a miraculous thing. And I think for the specific, highly motivated, self-selected people that we treat, we have a really high satisfaction ratio and we're still here, which is kind of a miracle in itself, just the idea that...

• 1:46:29Rich Roll?

  And then you do have a really high rate of people that maintain these practices.

• 1:46:34Alan Goldhamer?

  You know, what's interesting...

• 1:46:35Rich Roll?

  How closely do you, tabs do you keep on people?

• 1:46:37Alan Goldhamer?

  We're doing an adherence study, starting in January of next year, which is designed to do long-term tracking of, very carefully, in terms of patient actual dietary compliance. It's actually difficult research to do, in terms of monitoring specifically what people are consuming and not consuming. But we've actually designed a study that's going to let us do some really long-term tracking of people. Because what we're trying to find out is, how strict do you have to be to get the best ratio of return? Do you have to be as strict as we say? Or could you be more flexible, like many of our colleagues recommend programs?

• 1:47:08Rich Roll?

  Right.

• 1:47:09Alan Goldhamer?

  The problem we have with them is their recidivism rates. Their theory is that by being more flexible with the diet, you'll get more people in. Our theory is, by being stricter with the diet, you can keep more people in. But I can't prove that yet, because that data hasn't been done. We did just recently, though, do a retrospective analysis of 1,100 people that had been to the center and that had experienced 10% or more of weight loss, looking at what people had sustained that magnitude of weight loss over a period of a year. And it was over 30%. And so, although that means a lot of people didn't maintain the full magnitude of weight loss, that doesn't mean that they haven't improved their overall health. But just the fact that people can do that and sustain that, and as much as a third of those people apparently are able to, that's, to me, very encouraging.

• 1:47:52Alan Goldhamer?

  Because under a conventional treatment, weight loss is around 93% to 97% failure rate, no matter what.

• 1:47:59Rich Roll?

  Wow.

• 1:48:00Alan Goldhamer?

  Gastroenteric bypass, when you look at who sustains long-term weight loss, what kind of health benefits, very poor. It's so poor that most physicians say, "Ah, it's not even worth worrying about, just let them be fat, forget about it."

• 1:48:07Rich Roll?

  Right. What is the study that you'd like to see done, whether with respect to fasting or eating a whole plant food diet? Like, where's the gap right now?

• 1:48:19Alan Goldhamer?

  Well, the real gap is looking at what effect on healthy people does healthy living have? And what effect on healthy people does periodic fasting have in terms of preventing them from ultimately getting debility? And that's why we're doing what we call this navigator study, where we're going to enroll a large number of people and track them the rest of their life. And so the goal is to be able to demonstrate. Now, it'll take us a while until they reach that point. And it's particularly a problem because once people adopt this diet and lifestyle habits, they tend to live a lot longer. My mother, when she turned 92 years old, she used to get all kinds of trouble from her friends because her son's crazy diet that she's following. But at 92, she realized she had outlived all 52 of her lifelong friends. They were all dead. And she said she realized, here she was, 92 years old,

• 1:49:04Alan Goldhamer?

  everybody was gone. And she said, Alan, you need to warn your patients. If they're going to eat this kind of diet, make younger friends. Much younger. Because she had said even the people 10 years younger didn't want to play bridge and do stuff. They were too busy suffering with their consequences. So the bottom line is that it's likely that if you avoid the causes of premature death, you're still going to die. You're going to reach your genetic potential someday. But the period of debility may be dramatically reduced. So you have to be prepared to live a fully functional life up until you reach your genetic potential and not count on vegetating in some nursing home waiting for people to change your diaper for the last 10 years of your life.

• 1:49:43Rich Roll?

  I like that you got your mom on board.

• 1:49:46Alan Goldhamer?

  Well, my mom and my father. My father, actually, when I just started practice, was having transient ischemic attacks, had to retire from teaching because of cognitive decline. And he was really suffering. He came in and was probably one of my most diligent patients, did the fasting, recovered his health. And 20 years later, he helped edit the pleasure trap.

• 1:50:06Alan Goldhamer?

  So, you know, he was, he was really good to see. Both my, my mother and father, you know, got it started later in life because I didn't know, you know, early enough, but, and both ended up doing, doing really well. So that was good. And good lives and good deaths, deaths in close proximity to the end of their life, where they didn't go through.

• 1:50:26Rich Roll?

  That's what it's about.

• 1:50:27Alan Goldhamer?

  Yeah, I think it's an important issue. It's oftentimes not really addressed, that how valuable is, is to spend the last eight years of your life, however long that's going to be, fully functional, capable of taking care of yourself. And what percentage of healthcare do we expend on treating people where we don't affect their all-cause mortality? And we may not even be improving the quality of their life, but we're basically just fostering the consequences of poor dietary choices. And oftentimes because people don't even realize that what they're doing is killing themselves with their fork and knife.

• 1:50:54Rich Roll?

  Yeah, and warehousing them through those later years where they're so debilitated that the quality of life is de minimis at that point. So, we talk a lot about longevity, how, how, how many years are you going to live? But it's really about the quality of those years.

• 1:51:10Alan Goldhamer?

  Yeah, healthy life expectancy to me is even more important than life expectancy. And interesting, life expectancy for the first time is actually starting to drop. Healthy life expectancy, the number of years you spend fully functional, that should be, I believe, the target. And that's what I believe that where fasting can have the greatest good is in healthy people that use it preventively to stay healthy in conjunction with a diet, sleep, and exercise regime that's health promoting.

• 1:51:34Rich Roll?

  Are there other cultures overseas where fasting is more a part of the kind of mainstream?

• 1:51:41Alan Goldhamer?

  Well, if you look in Germany, modified fasting at least, the Buchenwald Clinic and others are covered by the system. And I think there's a little bit more acceptance of it. Water-only fasting is still pretty extreme.

• 1:51:51Rich Roll?

  Yeah.

• 1:51:52Alan Goldhamer?

  And I think it's up to us to actually demonstrate that what we're doing is not only safe, which we've done, but is effective. And, and I can't say that that's been done. There's not enough research done. But that's why the True North Health Foundation is excited. We have a laboratory now, we have an affiliated IRB, so a human subjects committee can be approved by people that actually know stuff about. Fasting effect, Dr. Klapper is one of the professional members of the IRB. And we have a research team, Dr. Myers, our director of research, and others that we've now hired to be able to actually conduct these trials. We've got these affiliations with researchers around the world, some of these big impact researchers like Walter Longo. So hopefully, we'll be able to do some meaningful research in the next couple of years. We have a great human subjects laboratory at the True North Health Center.

• 1:52:35Alan Goldhamer?

  We admit 1,000 people a year for fasting already. We already have all the mechanisms in place to conduct the trial, to collect the data. You know, it's happening. And so for me, it's 36 years waiting to get to this point where we can actually start doing meaningful prospective studies. We're there now, and we're ready to do it. And the proceeds from the True North Health Center fund the True North Health Foundation. And so we're not dependent on exogenous grants in order to be, we thank goodness, in order to be able to fund our research, because we can do it internally. And that's perhaps one of our greatest successes, is really pulling that off. That's why you don't see, I don't think, a lot of clinical research being done by other than university-based facilities with all their politics. We're really a freestanding, independent research facility that isn't dependent or beholden to anybody.

• 1:53:20Rich Roll?

  And you need to educate the next generation of medical practitioners, which is exactly what Dr. Klapper, treasure to humanity, is doing in this, like, third act of his career, going around and lecturing to young medical students.

• 1:53:34Alan Goldhamer?

  Absolutely. And that's what our internship and residency training is all about.

• 1:53:38Rich Roll?

  Yeah. So you only have 70 some odd beds, right? Not everybody can go to True North. So what is the recommendation? Like, how do you talk to the person who's listening to this or watching this, who's looking to make some lifestyle changes, but isn't ready to, you know, get in their car and drive up to Northern California and stay with you for 40 days?

• 1:53:59Alan Goldhamer?

  The True North phone coaching service is really great. They can go onto our website and get access to a doctor right where they sit. For under $100, they can do a phone consultation where all of their records have been reviewed and work with the doctor in detail on an ongoing basis. They can talk to me for free. They can call, and I'll help at least point them in the right direction, send them to a place that's closest to them, hook them up with the appropriate doctor, whatever it is they need to do. Or they can read the books now. Get Dr. Campbell's whole book and read it, or China's study. Look at Dr. McDougal's excellent books.

• 1:54:28Rich Roll?

  Starch Solution.

• 1:54:29Alan Goldhamer?

  Look, and The Starch Solution is fabulous. Dr. Esselstyn's book. Wonderful. I mean, we've got so many great resources now from people that are out there doing a really good job representing the scientific literature accurately, but in a way that people can understand and that are meaningful and useful. Our website, everything we do is freely available on our website at TrueNorthHealth.com. So they can go on there, there's video. In fact, we're just about to launch our own Roku channel where all of our content is going to be available, including our lecture program, our live lecture program at the center. So people will have access to that kind of education and support.

• 1:55:04Rich Roll?

  Obviously, you know, nobody should do a water-only fast without medical supervision. But if somebody does want to start experimenting with some intermittent fasting, or some things that they could do at home, like how do you, what's the kind of advice that you give to that person?

• 1:55:21Alan Goldhamer?

  The first advice, it's really important that history exam and lab, they looked at just because medications particularly can really be complicated, even with intermittent fasting, unless you take care of the medication complications, you know, you can get yourself into a little bit of trouble. So whoever's prescribing that medication, at least needs to be discussed with, a lot of times, they don't know anything about diet. They don't even know how to get people off drugs. And so that's why I would suggest find a local plant-based doctor, or use one of our phone coaches to at least make sure, am I a good candidate for this? And then they can tell you, look, you'd be a good candidate, you might want to do Walter Longos programming, you might want to do, here's something you can do on your own. These are things that are reasonable. The problem is people are so screwed up from long-term dietary abuse and medication complications, that even

• 1:56:04Alan Goldhamer?

  simple things like, well, just eat a good diet. Yes, that's great. Anybody can do that. But you still may need to keep into account that you might have to modify the pharmaceutical preparations that you've been given inappropriately.

• 1:56:15Rich Roll?

  And what about people that are, that are moving in the direction of eating a more whole-plant-based diet? What are some of the sort of psychological tools that they can rely on that would be helpful in making them? Successful in that switch.

• 1:56:35Alan Goldhamer?

  Well, one thing I'd say is keep it to yourself. Don't become a born again hygienist where you're trying to shove down your beliefs in other people's because it doesn't work very well. You're just going to antagonize everybody around you and make a lot of stress. So you can set a good example, but my advice is only answer questions that are asked directly. Don't be going around and trying to shove your belief systems in everybody else's face.

• 1:56:54Rich Roll?

  But support is also important, right? Having some accountability to somebody seems to be effective.

• 1:57:00Alan Goldhamer?

  Yeah, and that's why I always encourage people to take advantage of, you know, around the country now, there are doctors that aren't complete idiots that are trying to encourage and advocate support, the plant-based physicians, et cetera. So there are resources available. That's one of the reasons I'm excited about this phone coaching business because we can expand that broad, you know, all across the world. This is, you know, automated systems are highly efficient and we're adding more doctors to the list as the demand increases so that there will be people and resources available to people that are serious about making these diet lifestyle changes. Honestly, for relatively healthy people, all they got to do is start eating a whole plant food diet and stop the rest of it. For those of you that struggle making those changes, then you have to find the appropriate support that you need.

• 1:57:45Alan Goldhamer?

  And if you can have even one friend that they don't even have to do it, they could just tolerate you doing it, that does make a difference.

• 1:57:51Rich Roll?

  Yeah. So right now, you, I'm sure, know the statistics better than I do, but something like 70% of Americans are obese or overweight, childhood obesity rates are through the roof, type 2 diabetes epidemic is, what, 30% of Americans?

• 1:58:10Alan Goldhamer?

  Well, whatever it is, it's going to be more tomorrow.

• 1:58:12Rich Roll?

  Right. These things are escalating astronomically. And this really is, you know, COVID pandemic aside, like this is, you know, a health pandemic epidemic of a different nature that needs to be addressed in new and different ways. What we're doing right now certainly is not working. And the path forward and what you have so beautifully demonstrated through a lifetime of work is to show that agency plays a huge part here and that we can take better control of our health by making some pretty basic, simple

• 1:58:52Rich Roll?

  Lifestyle changes that are rooted in evidence-based medicine and science that are proven to work, I mean, 20,000 patients over the years, a level of success that you've experienced, the long-term success of these patients speaks for itself. And it's powerful, man. And so for somebody who's listening or watching, who feels stuck, who feels like they can't make that change, who is mired in the vicious cycle of The Pleasure Trap, to be able to give people a lifeline and say, it doesn't have to be this way, that there is hope and there is a way out, I think is, you know, that's God's work that you're doing.

• 1:59:30Alan Goldhamer?

  Yeah, we're having fun. You know, and, you know, it's interesting, the feedback from The Pleasure Trap has been interesting, because that book came out more than a decade ago.

• 1:59:38Rich Roll?

  For a long time.

• 1:59:39Alan Goldhamer?

  But actually, the sales of The Pleasure Trap now are actually increasing. So it's taking, that message is a message, maybe been a little bit of ahead of its time, but now it seems like it's resonating with a broader audience. And that, that's been really interesting to see. We have a new book that we're working on right now on fasting that'll be on, or be done by the end of the year.

• 1:59:59Rich Roll?

  Oh, cool.

• 1:59:59Alan Goldhamer?

  So we're excited about that. Actually, Dr. Lyle is finally coming towards the end of his book that he's been working on for a number of years.

• 2:00:07Rich Roll?

  Is he in Hawaii, right?

• 2:00:08Alan Goldhamer?

  He's on a writing, he's on a writing sequestration in Hawaii right now, and he's not to come home until he finishes the book, so.

• 2:00:15Rich Roll?

  I had Dr. Gregor in here the other day, and I think that he is now out there, they're all out there writing books together.

• 2:00:22Alan Goldhamer?

  Yeah. Well, I'm really excited. I've heard 20 of the chapters off Dr. Lyle's book, and it's brilliant. And it's, I'm really excited to have him put that out there, because I think that's going to be a whole nother, you know, message and another angle that's going to be really necessary and very useful.

• 2:00:36Rich Roll?

  Cool. Final question that I ask all of my medical professional guests. If you were suddenly in the position of being the surgeon general, In charge of making policy decisions and regulatory decisions about health in America, where do you start?

• 2:00:53Alan Goldhamer?

  Well, what I would say right now, the most important thing is recognizing that we need to make our people less vulnerable to the various diseases, whether it's chronic diseases like heart disease and diabetes, or the acute diseases like COVID-19. We need to make them less vulnerable, so we have to start educating people that health results from healthful living. So we need to fight to improve the diet and lifestyle habits of people, because honestly, you're not going to completely avoid exposure to every infectious agent that comes along. And we're not going to be able to escape heart disease, cancer, and diabetes unless we adopt healthful habits. So we should be incentivizing, encouraging, intimidating, whatever it takes people to adopt a health-promoting diet and lifestyle.

• 2:01:37Alan Goldhamer?

  My opinion is that is close to a whole-plant-food SOS-free diet with regular sleep and prioritized exercise and prioritized sleep as you can get, that that's what's going to result in healthy living. Diet, sleep, exercise. You do that, you'll do more than all the other jaw-boning that's taking place right now.

• 2:01:57Rich Roll?

  Powerful Dr. Goldhamer. Thank you.

• 2:02:00Alan Goldhamer?

  My pleasure. Thank you for having me.

• 2:02:02Rich Roll?

  Yeah, of course. I appreciate it. Thank you for sharing your powerful testimony today. If you want to learn more about Dr. Goldhamer and his works, pick up the Pleasure Trap book that he co-wrote with Doug Lyle. And where is the best place to direct people online to learn more about what you're doing?

• 2:02:19Alan Goldhamer?

  Well, if you go to www.truenorthhealth.com, you'll get access to everything you need. If you want to learn specifically about fasting, there's a website called fasting.org, which is a fasting compendium website.

• 2:02:30Rich Roll?

  Cool. And I'll link all that up in the show notes, and your phone's going to start ringing. All right. Come back and talk to me again. Peace.

• 2:02:40Alan Goldhamer?

  Platts.

• 2:02:43Rich Roll?

  Okay, mind officially blown, right? I don't know how this one landed for you, but that was quite a bit to take in. Again, don't feel like I have to say this, but I should, and I kind of have to say it. Please do not try a water fast at home. If you're interested, please seek out medical guidance and supervision under somebody specifically trained in this kind of thing. Dr. G isn't much for social media, but if you want to learn more about him and his work, go to the True North website at healthpromoting.com. Check out his book, The Pleasure Trap, which expands on much of what we talked about today and will not disappoint. Finally, check out the episode page at ritual.com where we have tons of show notes where you

• 2:03:26Rich Roll?

  can dig deeper into everything that we talked about today. If you'd like to support the work we do here on the show, subscribe, rate, and comment on it on Apple Podcasts and Spotify. Hit that subscribe button on YouTube and also hit that little notification bell so you're always apprised when a new video hits. This one is on video, you're going to want to see it. Go to youtube.com/ritual to check that out. You can share the show or your favorite episodes with friends on social media. We create all these beautiful assets and quote images and video clips that seem to percolate across the internet. I love seeing that stuff show up. And you can support us on Patreon at ritual.com/donate. I appreciate my team who works very hard to help me put on the show every week.

• 2:04:09Rich Roll?

  Jason Camiello for audio engineering, production, show notes, and interstitial music. Blake Curtis and Margot Lubin for videoing today's show. Jessica Miranda for graphics. Ally Rogers for today's portraits. DK for advertiser relationships. And theme music by my boys Tyler, Trapper, and Hari. I appreciate you guys. I love you. You guys give me the gift of being able to do this and share this information with you. I don't take it for granted, so thank you for tuning in today, and we will be back here. Soon with another cool episode, TBD. Until then, treat your bodies right, be kind, be compassionate. Talk soon. Peace, plats, namaste.