Take my friend, oh what name shall I invent to hide his identity, Ignatius. Iggy, let’s call him, has chronic stress in certain areas of his life, and is a lot more rotund than would be thought healthy. His diet is standard western, hence rubbish, he drinks ad lib (good name for a drink, you heard it here first) and wears trainers but rarely exercises. Not only do the stairs seem a lot steeper these days, he sometimes has little memory lapses.
Iggy doesn’t know it, but he has chronic inflammation in lots of his cells, including plaques, or neurofibrillary tangles, in his brain. But he doesn’t think there are any real problems because, despite his belly and breathlessness, he can get through his working day just fine, and that’s what counts, isn’t it?
So there’s this thing called apoptosis, or the scheduled dying-off of cells. Under conditions of chronic stress and chronic inflammation, cell death simply happens more quickly and more frequently.
And there’s this thing called autophagy, literally ‘self-eating’, a process by which dead and useless cells are re-absorbed and broken down to form new cells. Autophagy reduces apoptosis – it increases the cell’s stress threshold, basically, putting off the point at which cell death occurs. So if we could upregulate autophagy, we would downregulate apoptosis. Autophagy is an ongoing process, by the way, trundling along in our bodies day and night, but its rate can be increased. In the presence of hyperinsulaemia and insulin resistance, autophagy is suppressed, which is bad news for Iggy.
So as Iggy maintains his high-carb and exercise-free lifestyle, shuffling slowly towards metabolic syndrome and possibly type 2 diabetes, his cellular degeneration is disproportionately fast. And brain biopsies indicate that by the time you are experiencing slight memory loss, your brain probably has several years’ worth of neurofibrillary tangles – a kind of build-up of rubbish and sludge. Autophagy tidies away all these dead cells and repurposes them. Clever, eh? And as autophagy is stimulated, so production of growth hormone is increased, in order to help build new cells, which is extremely helpful for our overall health.
How can Iggy upregulate autophagy? By fasting.
Fasting exists in so many forms. One justification for fasting in the zero-carb/carnivore and Paleo communities is that our ancestors must have been obliged to spend long periods of time without food, and that we must therefore have evolved strategies to turn this to our advantage. One justification for fasting in the modern era is that it is a cleansing spiritual practice.
In Victorian and Edwardian times, fasting was even a sport, in that slightly bonkers Captain Matthew Webb-challenging-a-Newfoundland-retriever-to-a-floating-contest-in-the-Thames-and-winning way. One of the greatest ‘fasting artists was’ Giovanni Succi, who made a very nice living by travelling Europe in the 1880s and 90s, giving fasting exhibitions. In 1890 he came to London and fasted for 40 days (he did have a home-made ‘elixir’, whose contents are not known, but suspected to contain some kind of opiate, that he sipped) under close medical supervision, losing 34 lbs and winning £3,000, a veritable fortune.
We don’t want Iggy to fast for 40 days, elixir or no elixir.
How long does he need to fast before autophagy kicks in? Dr Annette Bosworth says that if you eat a standard, relatively high-carb western diet, it can take 72 hours. The guys down at Paleoleap, who eat a Paleo diet, say that autophagy begins at around 12-16 hours, which ties in with many types of intermittent fasting (IF), and applies if you eat a low-carb or zero-carb diet.
So it’s in Iggy’s interest first to move towards becoming carnivore/zero carb, and get rid of his hyperinsulaemia, then start simple 16-hour intermittent fasts to promote autophagy. Because he sure as hell doesn’t want to fast for 72 hours.
But hang on, what does the redoubtable Dr Zsofia Clemens of Paleomedicina say about fasting, especially intermittent fasting? Dr Clemens argues that people who are chronically sick and overweight have a paradoxical situation in which they eat too much, but don’t get enough nutrients. Makes sense.
Dr Clemens is also clear that an overcarbed Iggy would suffer miserably in his 72-hour fast because he simply doesn’t have the right mitochondria to deal with it without headaches, dizziness, sweats and more. Inducing a ketotic state, asserts Dr Clemens, is just as good as intermittent fasting, as long as Iggy eats freely of high-nutrient foods. Like meat. And more meat. And cuts out ALL the crap.
Many, many carnivores arrive instinctively and intuitively at an organic IF approach – the carnivore mantra of ‘eat when hungry, eat until full’ often means that they eat two meals a day, or one meal a day, or three meals every two days, and so on, eating when hunger strikes.
My conclusion here for Iggy is that an IF of 16-18 hours is probably fine (since you get diminishing returns after 24 hours of fasting), and that if you eat lots of meat and only meat, thus satisfying Dr Clemens’ position, you will most likely fall into a pattern of eating that both induces autophagy and fulfils your nutritional needs if you have chronic illness and are overweight.