The Insane Benefits of Water-Only Fasting: Dr. Alan Goldhamer | Rich Roll Podcast

hey everybody welcome to the podcast my guest today is dr alan goldhamer dr goldhamer is the founder of true north health center in santa rosa california he is the co-author of this book the pleasure trap and he's a pioneer in the plant-based nutrition space this conversation is about many things but there is a particular focus on fasting today and it is fascinating i think you're going to enjoy it if you enjoy my content in general please take a moment to hit that subscribe button and without further ado please enjoy my conversation with dr alan goldhamer right let's do it nice to see you thank you for coming out here to do this it's my pleasure it's been a long time in the coming um 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 and physiology and beneath all of that again which i appreciate is the fact that um there are some uncomfortable 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 um you know we're emotional beings and 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 tight rope 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 is really powerful well the reality is you know humans evolved in on a very different environment than when we the one we live in today we lived 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 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 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 two-thirds of people in industrialized societies are overweight or obese if you're not fat you're abnormal right and if you go to a physician and you 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 become an exercise program their differential diagnosis is uh oh this could be colon cancer eating disorder or drug addiction pathologize a healthy choice 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 yeah 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 i think in tandem with that there's also this pessimism from the typical general practitioner that any advice or 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 and you know maybe i'm gonna maybe i'll say that but there isn't a real expectation that that's gonna move the needle or that that person is going to be able to adhere to any kind of prescribed lifestyle change and and that's because we're dealing with people that are addicts yes and so talk about that expound upon expand expound upon that idea because i think it's really important you don't just say to an alcoholic oh you know how your life sucks yeah it's because you're a drunk uh stop drinking yeah and the alcoholic would say i've been told that oh it's the alcohol i had no idea thank you so much i won't drink again right 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 going to 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 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 it's it's the analog in addiction is you know quit the 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 and it's not real we know with alcohol the answer is don't drink that and the truth is for people that are suffering with obesity for people who 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 over consume 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 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 uh 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 and 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 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 is is well understood but when it comes to food that's a leap of faith for a lot of people it's 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 yeah well the reality is that the 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 in 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 it because people don't recognize it it's very difficult for them to take action uh 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 you have some alcohol and you say well i i can't because you know i have an alcohol problem most people at least will be tolerant of you because okay you got an issue you don't have to but if 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 mike you can have this that's great a little bit won't hurt 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 there's no question in fact the 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 yes of not participating and this is definitely true with food we've built so much of our social interaction around food that even even if you're looking to just modify the type of foods you eat it can be very upsetting for people and they can get really defensive about it 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 with doug lyle i've seen his ted talk i've seen him give his presentation many times on this subject and that really you know elucidates this dysfunctional relationship with food and and why it is from an evolutionary and psychological perspective well you know there's 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 insects 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 and so the higher caloric density foods are 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 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 yeah people have a hard time believing that you adapt there's this baked in assumption that you're you're you're you're just gonna you're looking you're staring down the pipeline of a lifetime of drab foods that are unappealing and you're just gonna have to tolerate it and we know there's a literature on this though with for example sodium uh people use on high sodium diet it takes about a month on a low sodium diet for the average person to neutral adapt to a lower salt diet you know with fat it takes almost three months wow 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 uh density foods so the the fruits the vegetables or grains of goons you will now feel satisfied whereas initially you don't because you're used to being satiated with these high fat uh this high fat intake and that that can take months and so it's a problem if you say to a person well look you're going to eat this new diet you're going to feel like crap and you're not going to like it and but it'll only be a few months right 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 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 in and you know with drugs and alcohol that's sort of the typical window that people say it takes you know it takes about that much time to kind of wean yourself off these cravings and reset your system a lot of people just wanna they wanna 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 you know what they once create like to get over the craving you have to deprive yourself and then you reboot and then those things that have held you hostage for so long suddenly hold less and less power over time and the fact that it can happen more quickly with fasting is really an interesting thing for example smokers you know 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 with right from cigarettes now some people say yeah they're so miserable fasting they don't even think about them you know 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 getting that behind you quickly really does enhance a person's ability to make the transition yeah to be drug-free i 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 why is it that salt is such a trigger for people 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 uh insulin levels to rise and then it drives your sugars lower and it follows the brain and now you 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 um salt is an essential nutrient that is sodium central nutrient without which you die 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 fractionated 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 you don't want any more 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 and you will systematically eat more on heavily salted foods when you're adapted to that than you will wow 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 pooling 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 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 pooling fertilizer in tea you want to make sure you're feeding them a healthy diet if 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 in silicon 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 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 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 right which which basically allows you to make anything taste good and you strip away those things and there's something completely unpalatable right and nutrition nutritionally deficient underneath it 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 cooked minimally processed grains beans nuts and seeds but you don't have the meat fish val 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 con infectious disease you know when you look at what are the vulnerabilities about why do some people get an influenza or a covid or an infectious disease and you know they recover they survive they have minimal consequences 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 disease the chronic diseases the heart disease the cancer the stroke it's the same metabolic syndrome in 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 so this is the the underlying premise uh that that drives uh true north which you founded what like 30 years ago at this point 35 in 1984 wow was when my wife dr moran and i started true north health 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 i mean potentially criminal right 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 wow what happened there um 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 um there was also uh every hospital today in this country will use versions of fasting for treating conditions like acute pancreatitis 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 and fontana and others that have published in major impact journals uh this idea that fasting or some modification of an intermittent fasting or modified fasting could be a helpful tool in fact it was interesting lanco did some research that i think really was pivotal he looked at cancer treatment 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 so 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 enhance 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 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 from the effects of chemotherapy and at that point people went particularly pharmaceutically-oriented people went oh so fast it could make the drugs work better oh well maybe it's not quackery 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 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 active 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 uh interest and including by the work that we're doing at the true north health center yeah you have this uh this study and this experience working with a patient who had stage three follicular lymphoma right where you had like this tremendous result um yeah we had a young woman with uh stage three follicular lymphoma that had been uh well documented excisional biopsy the whole bit and had progressed over a period of a couple years and uh 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 that diet had nothing to do with follicular lymphoma that she could eat whatever she wanted eating 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 is quite progressed in this case it progressed enough that he referred to the medical school talked to an oncologist an oncologist also reinforced the idea that diet was irrelevant to this condition uh that fasting was unproven uh and even with that advice she decided to come to the true north health center underwent 21 days of water only fasting during which time her tumors that were previously externally palpitated palpable disappeared so we fasted 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 um expressed some surprise uh she explained he said you know what did you do and she said well i went to the criminal quacks and i did the fasting and the tumors went away and he said well that's very impressive suggested he'd give me a call and talk to me about it um she asked to have the follow-up ct scan that we requested and we had warned her 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 uh order the studies and um he 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 months for white counts had normalized by a year she's doing great senator back got a whole uh 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 we submitted it to a british medical journal and after some back and forth they eventually did publish the paper they had asked us if we could get the oncologist to sign on and so we wrote him a letter and it you know thanked him so much for all the confidence he had shown in referring the patient to us for fasting and uh which he didn't okay well you know in spirit and uh so uh but unfortunately he hasn't gotten around to responding to us yet so we didn't how long how long ago was this uh well what happens we published that paper and then they asked us to do a follow-up because they said you know about 10 percent of lymphoma patients will go through periods of permissive state but sustaining it would be impressive so we followed this patient for three years and she continued she had lost a substantial weight she had maintained that weight loss for three years 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 police think she'd believe 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 um we submitted back to uh the british medical journal which had invited us to do the follow up they actually refused the the article the first time we 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 so 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 fall she continues to do well now since then and since the publication of that article we've managed to treat a 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 flickr lymphoma and ultimately we're hoping to publish enough case reports that we can um do a clinical trial that's amazing 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 what led you back in the 80s to [Music] to basically open this clinic that's premised upon fasting like what what was it about your education or your experience that you know that that you know you found this protocol and what led you to believe in it in its efficacy well yeah it was uh it was deep frustration um being constantly beaten by dr lyle in basketball i grew up with dr lawson's fourth grade and we played basketball and and he would beat me and i i've known him your whole life oh my god 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 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 be of course it failed miserably because he adopted the same kind of eating pattern he still beats me to this day here we are 61 years old playing basketball i still can't manage to beat you your whole life is basically a result of you trying to try to beat doctor okay yeah and it's and it's frustrating i picked the wrong guy i didn't even realize that you know the person i'm trying to be just you know this bookish stanford psychologist how hard could it be you know i thought finally i was getting desperate i thought well i 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 six 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 uh-huh he says okay you know he hasn't even played for a week well he he strikes me as a as a like a world-class sandbagger like the guy's always going to tell you that he's no good right he's always down playing right that's his whole strategy for all of this 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 course i'm telling him well what a joke if you can hit 99 why don't you just hit 100. i mean yeah so the point is it 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 love 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 going to die there's been a hundred 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 ability or 17 years in poor health that the average american is spending you know giving up compromise in the last decades of life that 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 attack stroke and other 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 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 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 or in autoimmune diseases oftentimes pain is significant inflammation is only people can't be active they can't dissipate their attention they aren't able to engage effectively and so when you get people out of pain it's like an epiphany experience and now the motivation goes up it's hard to be motivated to make diet 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 found the most effective patients or those are most motivated and motivations that are the most powerful is pain debility and fear of death yeah 100 the only problem is you know a lot of these people that 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 yeah the reality 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 in fairness though we have highly motivated self-selected people people are willing to get bad shape well they're motivated yeah it's it's one thing to talk about intermittent fasting or you know a fasting mimicking protocol it's another thing all together to talk about a 40-day water fast well that is a very extreme moses david elijah jesus and our patients right you know do fascinating it's interesting that fasting is you know shows up in all these various religious traditions isn't it interesting the jews the jeans 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 from healthful living but virtually every major religion has a tradition i mentioned not just about fasting but also about the value of a whole plant food diet you know these um traditions resonate throughout history and you know the reality is perhaps it's because that's what works how dare you all right so walk me through all right well first let me say this so in the in the decades that you've been doing this you and doug have taken and and your staff i mean i've had i've had you know chef aj in here explained 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 um but i've had i've had dr longo talking about fasting uh 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 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 so the first step is that they usually go to our website so they go to truenuthealth.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 you still do that right like still do they call up and you'll give them a free consult i still do that so i talked 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 call uh 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 they can look at their history objectively and give them advice um if there are appropriate candidates for fasting then i schedule them into the center for a stay i give them an idea about what we expect as 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 you know our facility has about 70 patients staying at it so they're interacting with those other people plus the the staff and the educators and so it's a pretty like immersion type of inexperience they go through fasting they go through re-feeding 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 because you know half our people are out of state 15 are four and they're not all living locally where they can pop in and right see our doctors or use our deli business or you know any of that kind of stuff what are what are the important vectors or variables that determine the appropriateness or you know for somebody to do one of these protocols like not everybody is suitable for this no the biggest one is that they have a condition that is appropriate for fasting so there's many uh 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 looking at diabetes looking at autoimmune diseases and the fact is we can in highly motivated patients generate safe and effective uh responses with fasting right 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 in art uh in response to this process so we've been able to show it is a safe process when it's done according 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 right i'm glad i'm glad you know your bias is intact here um if somebody has anorexia nervosa or if somebody is uh you know 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 you would have to wean them off of that i would presume on some level before they could undergo this yeah you know there's um 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 right because most medications are treating the diet 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 has 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 at home right 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 pres 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 impedance and premature death if the condition is actually normalized now the side problem is you have to keep on the healthy diet and lifestyle yeah because you're not curing anything you're just managing it but you've rebooted this operating system and wiped the slate clean so you can build a new foundation it's very much like treating a 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 right and it seems and we're trying to figure out exactly what those changes are that's occurring uh in fasting the i know the pharmaceutical injury is very interested in what's happening because they want to come up with what are called fasting mimicking drugs they want drugs that will do just what fasting does to you but without that nasty fasting that's something that they can sell in a pill yeah so a lot of the research 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 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 um you know uh physiologically that is causing this cascade of positive impacts like what would happen if you were eating a little bit i mean i know what longo has this fastic fasting mimicking um 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 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 you know 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 interesting we've done a study we have now uh recently acquired a hologix dexa scanner with the new software that allows you to do a whole body detail composition it looks not just a percent body fat but how much visceral fat there is and we have a paper that will 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 weak 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 re-feeding even though the scale weight obviously goes up as you rehydrate put some fiber back into right as long as you adopt as long as you continue to adopt the whole plant food healthy you know dietary style but the point that 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 we're re-feeding appropriately and so weight goes up but what the weight that goes up is re-elementing your glycogen stores and muscle stripes 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 immobilization of this very type of fat that we think is most compromising to health the fat the abdominal fat 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 have we're actually enrolling patients in the study starting in august looking specifically at body composition changes long term with follow-up so you know 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 natural resistance there's a selective mobilization elimination of excess sodium from the body and water fasting it happens right away it's very powerful more powerful than say taking hydrochlorothiazide or a diuretic 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 eliminate some of the arthritic symptoms and joint swelling and the non-healing wounds and this by 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 that's controversial 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 that 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 this idea of rapidly mobilizing toxins during fasting has been so uh well accepted by some that they say that's the reason not to fast because 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 we know that there are some studies looking at they've even done total body load measurements before and after fasting and showed that pcb levels would drop um clinically 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 but it's more than just what you would calculate through burning 2000 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 percent of your body weight you would assume that you'd probably lose 10 percent of your tumor weight but what happens in the 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 of the value of those tissues to the body right so it's getting the visceral fat which we think isn't probably healthful fat before it's mobilizing adipose fat and 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 saying when you're going on a healthy diet and lifestyle and that may be a way 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 uh glycogen storage 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 though that isn't induced with persistent exercise the same enzymatic production for glycogen for what balitic enzymes for a protein for gluconeogenesis enzyme systems is induced during fasting because you have to mobilize all your glycogen stores you're entering the chamber you're taking that battery and draining it all the way down and and it's 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 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 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 luigi fontana from washington university where they're looking at changes in microbiome changes in whole body composition changes in these 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 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 and rats that get their exercise lower and 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 and 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 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 can 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 the consequences of dietary excess when you exercise vigorously when you fast you're undoing the consequence of diatrixes i'm not surprised at all that fasting induces the same kind of bio changes that we see with exercise in fact for us it's saving a lot of time because we just look at all that fast exercise literature and start looking for the things they've discovered and seeing how much of it's mimicking mimicked with fasting um 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 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 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 will force sugar bond 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 um you can fast fasting has a profound effect on insulin resistance in fact as much as 80 percent 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 absolutely many diabetics that are able to make aggressive diet 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 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 ducks 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 his blood sugar taking off medication it's not part of the paradigm 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 you thought it would work knows the patient's not going to do it because people don't make diet lifestyle changes he's seen the literature 93 recidivism rate that that you know you is to ask people to make diet lifestyle changes very difficult 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 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 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 a 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 an hmo 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 ch chat about them why they've got to give up everything that they eat for that no 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 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 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 listen 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 this physician i was talking to never tells his patients well if you did radical and diet lifestyle changes you could get i'll give you an example my brother my brother's six years older so we're raised together he's slowly gaining weight his wife adopts our diet comes in and fast overcomes her own health issues he's on a vegan program 15 years later my brother's still eating chicken and doing stuff and getting fatter and he's got he can't play volleyball anymore his legs all swollen up i you know i'm poking him but he 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 hurt 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 ask the surgeon says if you do a bypass won't they plug up again and search yeah eventually but you know lasts longer than stenson he says what if i made radical diet and lifestyle change he said the surgeon laughed at him 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 past his stress test still has his vessels wow but my own brother it took yeah it's willing and ability 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 a 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 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 it looks great completely different person do you think he's going to like oh no it wasn't worth it you know no it's the best thing he's ever done fabulous so you you approach fasting from a perspective of of um weight management and also disease prevention and reversal but there's al also all this emerging science around longevity and anti-aging of course that's longo's you know specific lens on this but by dint of autophagy and all these other you know like sort of you know 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 i actually think the people that are going to turn out to get the most benefit from fasting this one in two week fast that we do with healthy people is healthy people healthy people that are looking to stay healthy too for example to avoid vulnerability of infectious disease to avoid the problems that you know not waiting like my brother did until 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 long ago 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 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 uh territory you know 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 your mouth and it goes down your esophagus and 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 the intestinal mucosa that enters the body and that intestinal mucosa acts like a screen keeping flies out 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 you know smoking it's obvious you see smoker's face cross-linked collagen tissues we know that's cross-linkaging from the free radicals from smoking it also affects the animal lining of the blood vessels it's my contention that cigarette smoking may protect people from getting lung cancer actually protects people well think about it eighty percent of smokers say that come on eighty percent of smokers never get lung cancer and twenty percent 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 okay now i understand well you know they say statistics don't lie that liars use statistics and the fact is you can look at these this data and twist it around in a way that sounds good even though it's completely ridiculous right smoking damages animal lining it damage 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 that 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 a little bit of powerful antioxidant from this grape skin is some justification for drinking alcohol they're trying to take 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 a clotting stroke maybe that's a justification you're a passionate man dr goldhammer why is it that uh why 40 days or 21 days like what is it about that extended period that's so important 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 the in fasting duration we don't go over 40 days generally because if you keep the fasts 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 fast 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 fast 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 i said oh i didn't know that patients had any more trouble sleeping on long-term fascicles oh no not the patients me he had sleep deprivation he was just worried too much yeah he'd worry too much about it so he 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 and there's no electrolyte supplementation or vitamin and mineral supplementation during this period you're looking at me like there's crazy water only fasting is the complete abstinence of all substances except pure water in an environment a particular kind of water we use fractionally steam 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 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 you see evidence in the literature of myocardial fibril 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 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 would 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 and so we're using a protocol that we've been able to test now it may be there's a better way to do it and that's why we do research and that's why we look at these things or maybe but until that's done i exercise caution because the fact is this is a 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 i would suspect also a psychologically delicate state walk me through the experience of this journey that you see with the typical patient i mean you're demanding a lot of them they're going through something they've never done before like what is the you know what it what is that like for that individual when they're on day three day 10 day 30 yeah so the first a few days of fasting are actually the most difficult because you're adapting off the uh alpha glucose metabolism into a fat metabolism so the brain is changing fuels from burning sugar to blurring 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 foul eggs dairy products processed foods all the host of chemicals 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 discharged they may get some vivid dreams they may have aches and pains and they may have difficulties with all kinds of adaptive process 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 of the 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 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 ten days into a fast you think oh my god you haven't eaten for 10 days no just enjoy being there that's not a problem um so then um depending on the patient sometimes they start getting relief they're 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 accurate 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 fun here for 40 days so my life completely craters on the outside but for many people this is an intense epiphanic 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 that they were told nothing could be done learn to live with it what do 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 you start you know looking at all aspects of their life 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 um 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 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 what do you eat when you fly 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's 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 important 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 they're fatigued they're not 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 they're doing is 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 and i think the same thing happens when people really get into a healthy lifestyle yeah they're really exhausted 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 time 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 and have the time to prepare and eat healthy food if there happens to be any time left well fine you go to work [Laughter] um let's talk about the uh the food part of all of this so uh 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 you'd be surprised by the time people come to the trunk 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 is referring to us to begin with yeah 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 the 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 fast or should would it even be appropriate so for those individuals maybe we just do a healthy eating regime 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 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 a 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 and they said they were that the patient was being held against their will by religious cultists and being starved to death to go to be with jesus [Laughter] and i thought i'd say like the person's not here involuntarily and you know i got into i said fine i'll let you interfere but first would you like a nice tall cup of kool-aid uh-huh right and dr lyle says that when a police officer puts relishing in your role as a cult leader he is not comfortable and i'm not to speak to authorities anymore but that's you know i'm thinking it's an obvious joke because kool-aid is full of sugar where would you serve that at the trump health center well i know it's funny the reality is that today it's not as much of an issue because now the idea of fasting doesn't yeah it's quite so much it's in the cream now it's not the jim jones kind of you know perception right so are you still the only medically supervised clinic that's doing this well you know i'm really excited because i just visited yesterday one of our doctors that trained with us nathan gerschfeldt is running a facility here in the los angeles area and he's it's beautiful i went to see his uh facility and it's absolutely beautiful and for anybody that uh you know and also we have another doctor uh dr ewan 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 residential training program and those schools i mentioned texas a m there's other medical schools the naturopathic professions uh graduates can come and spend a year as an as a resident doing a rotation at the triumph health center the chiropractors often come and spend three months as part of their training at the truman health center and those doctors were hoping to open up more facilities around the country and we make uh people that contact our website can get access to whoever the local right fasting supervisors are we're happy to provide that uh 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 uh that 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 yeah unless you can control a person's environment it's hard to really induce these kinds of profound changes it's got to be incredibly gratifying as a medical practitioner to see such dramatic results well i think that's one of the reasons we've been successful we have a dozen clinicians now with the truman thousand 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 just retired after nine years at triathlon we joke that we're like the firm you know once they start yeah and but it's because they like the low patient intensity in others 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 the center set up 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 a patient's specific needs and they like the idea that people get well 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 that it's enough gratification and enough benefit that those doctors really like working at treatment health and what that 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 well it's been a revolution actually it's been amazing change because when dr sultana 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 uh some of the hospitalists purchased their food through our outpatient deli so we have a good working relationship and now that they're seeing some of our referral uh patients that we're 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 right right 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 in a major journal we're hoping that we'll get positive uh publication of that here in the next couple weeks we've done a study with luigi fontana from washington university looking at biomarker changes in the gut microbiome before and after fasting right we have a couple other studies that we're enrolling in right now so now we're getting some affiliations with some of these major players like um 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 yeah his credibility and his pedigree i would imagine is very helpful oh he's done unbelievable just fabulous work and he's a wonderful guy yeah you know we're so fortunate that you know 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 uh with the most open uh mindedness from much of the medical profession 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 in what the health the documentary we all saw those individuals they're kind of before and after stories that were very dramatic um and hardly criticized and heavily yeah controversial for sure we have uh people telling us i see there's stuff on the internet that says those people were all paid actors you know reverse photoshop and i've seen some unbelievable kip and keegan just kind of grabbed them randomly right like how did that happen they they showed up and wanted to do the film so we did some interviews 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 whoever happened to be standing around yeah i wish we could have cherry-picked it and stuff because 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 is that type of experience is pretty routine yeah true north 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 um 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 oh they did and one of their six shows was filmed at the true north health center oh wow and it's on fasting who's behind that do you know um i can't i don't recall that yeah who the producer and what else but it's i know it's purchased by netflix it's a netflix original oh that's cool you know so i know it's gonna get pushed out i had john lewis in here a couple weeks ago um 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 i imagine it'll be very controversial and probably piss a lot of people off i'm really excited to see it keegan that's that's keegan's specialty yeah but all right so the food part um the the protocol that you're that you recommend and that you you 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 um somewhat controversial there's all these diet wars with the loaf 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 you can just speak to why you believe so strongly in a whole food plant-based diet well the exclusively whole plant food diet i think is has a lot of support whether it's john mcdougall or esselstyn or you mentioned one of my heroes um 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 and 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 so i want a whole i want whole plant food diet because a plant-based diet implies that yeah it's based on plants but it allows room for it allows flexibility interesting and so i think that dr mcdougall and dr campbell would argue that we want to have as broad a diet as possible to attract 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 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 add no i'm not arguing that i'm so grateful that people like dr campbell and dr esselstyn and dr mcdougall are out there educating the world i'm not that nice of a person i'm only interested in my patient and the and the maximizing the people that 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 you know i'm not a policeman i'm just trying to give you the best advice i can but i 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 1500 milligrams 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 and the staff that we have at the true north health foundation that are doing the same and so 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 by in 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 is going to prove we're right what do you say to the the low-carb proponent who tells you uh 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 what when you have to measure those two protocols against each other how do you well there's a number of protocols you're actually covering there yeah like for example these things get conflated in this conversation the uh the dead dr atkins diet the high protein high fat diets they'll argue what 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 antibiotic 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 which is maybe a higher fat low protein diet in 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 right they've been with you we've got wow you have people stay with you for a whole year sometimes longer than a year i've got people there now longer well sometimes we've had people checked in that we're being sent to the nursing home we came as the alternative and then they get well and go home and it was you know two thousand a month less staying with us then at the nursing home so you know for those individuals it was an economic benefit other people come in because they're gonna do long-term fasting long-term recovery they've got serious health problems sometimes it takes a couple 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 they want to live in a controlled setting until they really get it down so they feel comfortable going out there and 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 some people do 90 day programs some people you know have to do longer yeah 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 uh dr chili veras does a lot of phone coaching with people and so people would call upon me and we decide okay they need to come in and fast but it's a couple months before we have an opening so i say why don't you work with dr varess in the meantime and when you come in you won't have to be here so long you'll and then they go and get well and it's happening a lot i'm giving her a hard time you got him well before he could come here we couldn't even screw up our study or our documentation they're all well you know but it's okay how many how many beds do you have though you probably are at capacity most of the time yeah we have yeah we can handle about 70 people so we're right we're going to run about two months or so out you know it was interesting after the covet thing all of our foreign people had to cancel and that's 15 of our people we had 50 people who 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 they couldn't afford to miss work during the very time so they're working so some people are able to come in and do a fast but then they can during recovery they can go back to working remotely because we have excellent wi-fi 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 um 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 you know 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 yeah and if 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 input 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 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 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 permanent way you know we have a because we're a 501c3 nonprofit research driven organization our price pro is quite modest our rights are the same as they were 12 years ago 149 chef aj goes she's like it's cheaper for me to go to hotel 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 you know what i mean so you need to charge more well no the idea is or you need more beds or i don't know 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 insurance cover it the 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 to 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 in an inpatient basis 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 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 foul eggs dairy products oil salt sugar yeah and maybe consider fasting i mean that's a tough yeah yeah you know i have patients that their friends say well what do you go there too fast just come you can come to my garage i'll give you the hose you don't want to charge anything yeah that is true although you know i think when people are looking at that quadruple bypass you know other 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 gotta you know overhaul everything that you're doing is a difficult message it's it's a very undigestable message but at the same time like i know in my own experience and look you've done this 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 yeah it's it is a miraculous thing yeah and i think for the specific highly motivated self-selected people that we treat uh we have a really high satisfaction ratio and we're still here which is kind of a miracle in itself just the idea of it and you do have a really high rate of people that maintain these these practices you know we're interested how closely do you tabs do you keep on people we're doing uh a uh adherent 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 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 right 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 strict with the diet you can keep more people in i can't prove that yet because that data hasn't been done we did just recently though do a retrospective analysis of 1100 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 percent 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 because under conventional treatment weight loss is around 93 to 97 failure rate no matter what wow gastric 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 yeah it's not even worthwhile just let them be fat forget about it right um what is the study that you'd like to see done whether with respect to fasting or or eating a whole plant food diet like what what where's the gap right now 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 you know until they reach that that point uh 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 fine 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 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 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 know 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 i like that you got your mom on board well my mom and my father my father actually when he when i just started practice was having transient shaming attacks had 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 oh wow so you know he was cool he was really good to see how both my my mother and father uh you know got it started later in life because i didn't know you know yeah early enough but uh and both ended up doing uh uh doing really well so that was good and good lives and good deaths deaths in close proximity to the end of their life where that's what it's about i think it's an important issue it's oftentimes not really addressed that how valuable is this 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 health care 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 yeah and warehousing them through those later years where they're so uh 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 yeah 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 that where fasting can have the greatest good is in healthy people that use it preventatively to stay healthy in conjunction with a diet sleep and exercise regime that's health promoting are there other cultures overseas where fasting is more a part of the kind of mainstream well if you look in germany modified fasting at least the book entire 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 yeah 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 it's 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 human subjects communities can be approved by people that actually know stuff about um fasting in fact dr clapper is one of the uh professional members of the irb and um we have a research team dr meyers 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 years we have a great human subjects laboratory at the 200th health center we admit a thousand 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 to 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 we thank goodness in order to be able to fund our research because we can do it internally and 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 and you need to educate the next generation of medical practitioners which is exactly what dr clapper treasure to humanity is doing in this like third act of his career going around and lecturing to young medical students absolutely that's cool and that's what our internship in residency training is all about 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 just get in their car and drive up to northern california we'll share with you for foreign coaching service is really great they can go into our website and get access to a doctor right where they sit for under a hundred dollars they can do a phone consultation where all of their records have been reviewed and worked with a 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 mcdougall's excellent books star solutions the start solution is fabulous um 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 in it but in a way that people can understand and they're 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 have access to that kind of education and support 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 the first advice it's really important that history exam and lab they looked at just because the 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 uh 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 vulture longo's 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 simple things like we'll 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 the pharmaceutical preparations that you've been given inappropriately and what about um 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 well one thing i'd say is keep it to yourself don't become you know born again hygienist where you're trying to shove down your beliefs and other people's it 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 and trying to shove your belief systems and everybody else but support is also important right having some accountability to somebody seems to be effective yeah and that's why i always encourage people to 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 uh 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 uh broad you know all across the world this is you know automated systems are highly efficient 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 the you that struggle making those changes those are then you have to find the appropriate support that you need and if you can have even one friend that they don't even have to do it they could just be tolerate you doing it that does make a difference yeah so right now you i'm sure know the statistics better than i do but something like 70 percent of americans are obese or overweight childhood obesity rates are through the roof type 2 diabetes epidemic is what 30 of america whatever it is it's going to be more tomorrow right these these things are escalating astronomically and this really is you know covid pandemic aside like this is that this is a you know a health pandemic epidemic of a different nature that um 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 lifestyle changes that are rooted in evidence-based medicine and science that are proven to work i mean 20 000 patients over the years the 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 yeah we're having fun you know and uh you know it's interesting the uh the uh feedback from the pleasure trap has been interesting because that book came out uh more than that it's been a long time but actually the sales of the pleasure trap now are actually increasing so it's take that message is a message maybe you've been a little bit of ahead of its time but now it seems like it's resonating with a broader audience and that uh that's been really interesting to see we have a new book that we're working on right now on fasting that will be on or be done by the end of the year 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 is he in hawaii he's on a white right now he's on a writing sequestration in hawaii right now and he's not to come home until he finishes the book so i had dr greger in here the other day and i think there he is now out there they're all out there writing books together yeah so i'm really excited i've heard 20 of the chapters off dr last 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 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 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 cova 19 we need to make them less vulnerable so we have to start educating people up that health results from health 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 lifestyle my opinion is that is close to a whole plant food sos free diet with regular sleep and prioritized regular 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 job boning that's taking place right now powerful dr goldhamer thank you my pleasure thank you for having me yeah of course i appreciate it thank you uh for sharing your powerful testimony today um 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 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 fast and compendium website 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 [Music] you

Channel: Rich Roll

Views: 1,336,586

Rating: 4.8658376 out of 5

Keywords: rich roll, rich roll podcast, self-improvement podcasts, education podcasts, health podcasts, wellness podcasts, fitness podcasts, spirituality podcasts, mindfulness podcasts, mindset podcast, vegan podcasts, plant-based nutrition, 40 Day Water Fast, Dr. Alan Goldhamer, The Pleasure Trap, The Uncomfortable Truth About Our Food Choices, TrueNorth in ‘What the Health’ Documentary, Advice for Trying Out Fasting, Advice for Making a Change in Lifestyle

Id: yaWVflQolmM

Length: 113min 35sec (6815 seconds)

Published: Mon Aug 24 2020

Reddit Comments

[u/RadicalRudiger]

I can do without oil and sugar but if I go salt free, I feel absolutely awful. I don't go wild with the salt shaker but I add soy sauce to everything. I've never had a problem with my blood pressure, even when I was 365+ lbs, but I did have my first vegan blood test last month and my cholesterol was low, which I've read is not good in conjunction with high sodium intake. I try to keep it as low as I can but I ultimately don't worry about it that much. Feels like it's going to be a problem for me one way or another so meh.

[u/StarchRunner]

I use salt a bit differently. I tell clients (keep in mind I focus on helping the obese) to salt their veggies/greens/salads but not on the stuff that has calories.

The idea is to up their low calorie density intake and lower their overall calories. If I can get people to shove down 5 celery sticks without adding a single calorie, I'm all for it.

[u/OttawaDog]

on the other end of the scale. I need to gain weight, so I need to add salt to make food more palatable. I often start on big serving of rice and kale, without salt but sprinkle some on near the end to finish it.

[u/starchmuncher]

As always the pendulum swings both ways IMHO, here's a quote from Dr. McDougall:

Salt: The Scapegoat for the Western Diet

Sodium restriction is today the most widely publicized non-medication recommendation for heart disease and stroke prevention. Unfortunately, this advice has proven ineffective. Despite the vast amount of scientific research that has been published over the past seventy years, there is still little agreement as to the efficacy, safety, and acceptability of dietary salt reduction.1 In 2007, the authors of the Third National Health and Nutrition Examination Survey (The NHANES III study) representing nearly 100 million US adults reported that there is “ a robust, significant, and consistent significant inverse association between dietary sodium and cardiovascular mortality.”2 This means people who eat more salt have a lower risk of death from heart disease and stroke.

 

Here's a quote from the documentary film What the Health:

(15:27)

THE LEADING SOURCE OF SODIUM IN THE AMERICAN DIET FOR ADULTS IS CHICKEN

Drewnowski, Adam & Rehm, Colin D "Sodium Intakes of US Children and Adults from Foods and Beverages by Location of Origin and by Specific Food Source". Nutrients. 2013; 5(6): 1840-1855

"What are they pumping into your chicken?" Consumers Union

 

It doesn't hurt to quote Dr. Greger as well since this is like totally awesome stuff:

Why is the salt industry so powerful? They have their own PR and lobbying firms to play tobacco industry-style tactics to downplay the dangers. But salt is so cheap. How much money are they really making? It’s not the salt mine barons; it’s the processed food industry. Just like the sugar industry could care less if we buy a two-pound bag at the store, it’s the trillion-dollar processed food industry that uses the dirt-cheap added salt and sugar to sell us their junk. And, by hooking us on hyper-sweet and hyper-salty foods, our taste buds get so dampened down that natural foods taste like cardboard. The ripest fruit may not be as sweet as Fruit Loops; so, we just continue to buy more and more.

But, there are two other major reasons the food industry adds salt to food. “The other 2 reasons are entirely commercial and for most foods, are the real reason the food industry wants the intake of salt to remain high.” If you add salt to meat, it draws in water; so, you can increase the weight by like 20%. And, since it’s sold by the pound, that’s 20% more profits for very little cost. Salt also makes us thirsty.

Bars offer free salted peanuts for a reason. Soda companies own snack companies for a reason. It is not coincidence that Pepsi and Frito-Lay are the same company.

Would we shell out nine bucks for a drink at the movies after eating a bucket of unsalted popcorn? Would we supersize our soda if they didn’t salt our fries and Big Mac? But that’s not the only reason salt is added to meat. It solubilizes the muscle proteins to a gel for optimum meat texture. That’s one of the reasons the meat and fish industries like the so-called “meat glue” enzyme, transglutaminase. Meat glue can help gel the muscle protein without adding salt.

But some of these salt alternatives leave a bitter aftertaste in the meat, but this problem can be managed by also adding a bitter blocking chemical to the meat, which works by blocking the activating of our taste receptors, and preventing that information from ever reaching our brain.

The meat industry acknowledges that their products contribute a significant amount of dietary sodium, maligning their image. But, salt is just so cheap that using anything else would cost them money. However, if they are able to resolve this cost issue, if they can make it cost effective, then, one day, maybe, they could end up saving millions of lives, as well as dollars.

 

FWIW here are some relevant studies, just quoting from the last one and it should be dated 2 Sept 2020:

*A High Salt Diet Modulates the Gut Microbiota and Short Chain Fatty Acids Production in a Salt-Sensitive Hypertension Rat Model

 

The Gut Microbiome, Inflammation, and Salt-Sensitive Hypertension

 

Modest Sodium Reduction Increases Circulating Short-Chain Fatty Acids in Untreated Hypertensives

 

Impact of Gut Microbiome on Hypertensive Patients With Low-Salt Intake: Shika Study Results

These results suggested that consumption of a low-salt diet was ineffective in regulating hypertension in individuals with a specific gut bacteria composition.

 

Let's find out how we're rubbing salt into the wound, shall we?

In a press conference held last Wednesday (April 15), the Consumer Council said that 60% of salt products tested from supermarket shelves in Hong Kong contained heavy metals, with many containing microplastics and harmful additives as well. The prices of the pre-packaged salt products ranged from HK$2.6 (US$0.34) to HK$440 (US$57.80), and included sea salt, rock salt, table salt, iodised salt, lake salt and smoked salt varieties.

In particular, the most expensive Himalayan rock salt product priced at HK$440 per pack was found to contain lead content exceeding international food safety standards set by the United Nations. The body also warned that microplastics were found in samples of sea salt for the first time, and most salt products contained potentially harmful additives as well.

Four brands were detected to contain microplastic content from 114 micrograms per kilogram to as high as 17,200 micrograms per kilogram.

The chairwoman of the watchdog’s research and testing committee, Professor Nora Tam, said that the presence of microplastics in sea salt confirms the severity of marine plastic pollution caused by humans, which is now ending up back into our food chain.

Though the World Health Organisation (WHO) said that the health impact of consuming microplastics is still unknown, the body warned that more rigorous research and testing must take place to learn about potentially adverse effects. An alarming German study last year found over 97% of children showed plastic toxicity.

 

If you're spending quite a bit of time on Dr. McDougall's official forums, you should be able to recall that some WFPB doctors are sending their own patients to True North if they weren't able to solve the problems on their own:

I feel everything goes back to the digestive system and Pam Popper is right on it. She shared True North should name a building after her because she sends so many people there.

 

And then here's a quote from VegSource / Jeff Nelson:

Dr. Campbell had learned of a water only fasting center in Norther Caliifornia called True North, operated by Alan Goldhamer DC, Doug Lisle, PhD, and others. Encouraged to give water fasting a try, since modern medicine offered nothing hopeful, Dr. Campbell embarked on a medically supervised water fast at True North. Because he began to feel improvements, he went back again for two more extended water fasts.

The result of the fasting is that Dr. Campbell regained his health. A significant amount of the heavy dioxin load stored in his body fat apparently was released through the fasting, the paralysis reversed and Dr. Campbell recovered significantly.

Dr. Campbell subsequently helped the doctors at True North to document benefits of fasting in the scientific literature, such as that high blood pressure can be reversed through water fasting, and that it was effective in 82% of study subjects.

 

In other words, those patients might be considered relatively "hopeless" cases and they better adhered to SOS-Free in addition to WFPB. And then it's critically important to be compliant with a dire situation like this:

Water-only fasting and an exclusively plant foods diet in the management of stage IIIa, low-grade follicular lymphoma

 

British Medical Journal - Follow-up of water-only fasting and an exclusively plant food diet in the management of stage IIIa, low-grade follicular lymphoma

In other words, Alan Goldhamer, D.C. and his staff should have treated plenty of hypertensive patients over the decades and they better stay away from salt as if their lives depended on it.

 

How about the others with a more hopeful prognosis? As long as they're removing all kinda processed junk from the food diary, especially the salty champion called chicken as mentioned above, maybe it ain't such a big deal to follow what Dr. McDougall recommended:

In order to make these basic starches competitive with the creations engineered by the processed food industry, the McDougall Diet adds sensible amounts of salt, sugar, and spice (primarily to the surface of the foods at the dinner table). Dr. McDougall wants people to eat and enjoy their meals and will compromise a little to reach this necessary goal. The title of the song from Walt Disney’s 1964 movie Mary Poppins, “A Spoonful of Sugar Helps the Medicine Go Down,” encapsulates his philosophy. A half-teaspoon of sugar sprinkled over a bowl of oatmeal reaches the “bliss point” for sweetness. A little salt added to the rice and beans hooks people into a program that allows them to regain their lost health and appearance. (Rarely, people cannot tolerate small amounts of salt and sugar and these few must avoid them.)

Different strokes (no pun intended) for different folks, that's the motto.

[u/[deleted]]

People literally need some salt in their diet. This is easily researchable.