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  #1   ^
Old Mon, Nov-21-16, 09:40
Nancy LC's Avatar
Nancy LC Nancy LC is offline
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Default Magical thinking and fasting

I get eating one meal a day, no qualms from me on that. But long-term fasting? You do know that your body has to get protein from somewhere to repair itself. Also, that small amount of glucose you need to power parts of your brain comes from protein, so it will tear down muscle mass to get it.

I like much of what J. Fung says, but I think he is out-to-lunch, dangerously so, on fasting.

http://www.theatlantic.com/health/a...ut-food/508220/

Also, remember "The Biggest Loser" effect? Extreme calorie deprivation/exercise led to severe and permanent reductions in metabolism. I'm just curious why you wouldn't think this would lead to the same situation.

I'm thinking that people need to try to think critically about what he is saying and do some research. Don't just guzzle down the koolaid just because you like Dr. Fung.
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  #2   ^
Old Mon, Nov-21-16, 09:45
MickiSue MickiSue is offline
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Nancy, I am not a long term faster. But my understanding of the phenomenon is that FASTING VS severe calorie reduction, gives a different result, metabolically.

That, and, of course, no one with a life can keep up the level of activity that participants in the Biggest Loser sustain during the course of the taping of the show.
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Old Mon, Nov-21-16, 09:49
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thud123 thud123 is offline
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I'm beginning a 72 hour fast today. I will force my body to take it's protein requirements from the extra skin I grew when I blew up in size. And if I feel unwell at anytime I will eat some food and the fast will be over.

blew up, blowed up, this is the war zone

Thanks for bringing the topic up Nancy!

Last edited by thud123 : Mon, Nov-21-16 at 09:55.
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  #4   ^
Old Mon, Nov-21-16, 10:17
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Nancy LC Nancy LC is offline
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See, that's where I think the logic breaks down. Fasting is no different than severe calorie restriction except it is more extreme.

"Reducing food intake for weeks causes metabolism to slow, so that a person who once needed 2,000 calories per day to function might now need only 1,800. After the fast is over, it’s not clear whether the metabolism will bounce back. A recent study of contestants on The Biggest Loser, who cut their calorie intakes dramatically for the show, found the participants must now eat hundreds fewer calories each day than people of a similar size in order to maintain their reduced weights."

So, I guess I'd want to see some studies that proved it wasn't the same. And I'd want to see these same studies replicated. Getting your metabolism slowed down by 15-30% permanently isn't fun. I'm not sure but if you do this over and over again, does it slow more each time?

Quote:
I will force my body to take it's protein requirements from the extra skin I grew when I blew up in size.

Oh dear... I have no idea where your body is going to get it's protein requirements. It could be your heart, your liver, your left big toe. What on earth makes you believe it will be your extra skin?
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  #5   ^
Old Mon, Nov-21-16, 10:20
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JEY100 JEY100 is online now
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Dr Fung's own explanation of the difference is the subject of his most recent post on November 10.

https://intensivedietarymanagement....ing-fasting-27/ Though it is also helpful to read the previous 26 posts, Many charts and graphs did not copy below.

The difference between calorie restriction and fasting – Fasting 27

Quote:
Perhaps one of the most common questions we get is what the difference is between calorie restriction and fasting. Many calorie enthusiasts say that fasting works, but only because it restricts calories. In essence, they are saying that only the average matters, not the frequency. But, of course, the truth is nothing of its kind. So, let’s deal with this thorny problem. deathvalley

The weather in Death Valley, California should be perfect with a yearly average temperature is 25 Celsius. Yet, most residents would hardly call the temperature idyllic. Summers are scorching hot, and winters are uncomfortably cold.

You can easily drown crossing a river that, on average, is only 2 feet deep. If most of the river is 1 foot deep and one section is 10 feet deep, then you will not safely cross. Jumping off a 1 foot wall 1000 times is far different than jumping off a 1000-foot wall once.intermittentvscontinuous

In a week’s weather, there is a huge difference between having 7 grey, drizzling days with 1 inch of rain each and having 6 sunny, gorgeous days with 1 day of heavy thundershowers.

It’s obvious in all these examples that overall averages only tell one part of the tale, and often, understanding frequency is paramount. So why would we assume that reducing 300 calories per day over 1 week is the same as reducing 2100 calories over a single day? The difference between the two is the knife-edge between success and failure.

The portion control strategy of constant caloric reduction is the most common dietary approach recommended by nutritional authorities for both weight loss and type 2 diabetes. Advocates suggest that reducing daily caloric consumption by 500 calories will trigger weight loss of approximately one pound of fat per week.

The American Diabetes Association’s main dietary recommendation suggests to “focus on diet, physical activity, and behavioral strategies to achieve a 500–750 kcal/day energy deficit.” The ‘portion control’ advice to reduce calories has been fairly standard since the 1970s. This reduction is average calories should be spread consistently throughout the day, rather than all at once. Dieticians often counsel patients to eat four, five or six times a day. There are calorie labels on restaurant meals, packaged food, and beverages. There are charts for calorie counting, calorie counting apps, and hundreds of calorie counting books. Even with all this, success is as rare as humility in a grizzly bear.

After all, who hasn’t tried to portion control strategy of weight loss. Does it work? Just about never. Data from the United Kingdom indicate that conventional advice succeeds in 1 in 210 obese men and 1 in 124 obese women (4). That is a failure rate of 99.5%, and that number is even worse for morbid obesity. So, whatever else you may believe, constant caloric reduction does NOT work. This is an empirically proven fact. Worse, it has also been proven in the bitter tears of a million believers.

But why doesn’t it work? For the same reason the contestants of The Biggest Loser could not keep their weight off – metabolic slowdown.

Starvation Mode

The Biggest Loser is a long running American TV reality show that pits obese contestants against one another in a bid to lose the most weight. The weight loss regimen is a calorie-restricted diet calculated to be approximately 70% of their energy requirements, typically 1200-1500 calories per day. This is combined with an intensive exercise regimen typically far in excess of two hours daily.

This is the classic ‘Eat Less, Move More’ approach endorsed by all the nutritional authorities, which is why The Biggest Loser diet scores third on the 2015 USA Today’s ranking of best weight loss diets. And, it does work, in the short term. The average weight loss that season was 127 pounds over 6 months. Does it work long-term? Season two’s contestant Suzanne Mendonca said it best when she stated that there is never a reunion show because “We’re all fat again”.

Their Resting Metabolic Rates (RMR), the energy needed to keep the heart pumping, the lungs breathing, your brain thinking, your kidneys detoxing etc., drops like a piano out of a 20 story building. Over six months, their basal metabolism dropped by an average of 789 calories. Simply stated, they burning 789 calories less per day every day.

As metabolism drops, weight loss plateaus. Caloric reduction has forced the body has shut down in order to match the lowered caloric intake. Once expenditure drops below intake, you start the even more familiar weight regain. Ba Bam! Weight is regained despite dietary compliance with the caloric restriction and even as your friends and family silently accuse you of cheating on your diet. Goodbye reunion show. Even after six years, the metabolic rate does not recover .

All of this is completely predictable. This metabolic slowdown has been scientifically proven for over 50 years. In the 1950s Dr. Ancel Key’s famous Minnesota Starvation Study placed volunteers on a ‘semi-starvation’ diet of 1500 calories per day. This represented a 30% caloric reduction from their previous diet. In response, their basal metabolic rate dropped about 30%. They felt cold, tired, and hungry. When they resumed their typical diet, all their weight came right back.

Caloric restriction diets only work in the short-term, before basal metabolism falls in response. This is sometimes called ‘starvation mode’. Daily calorie restriction fails because it unerringly put you into metabolic slowdown. It’s a guarantee. Reversing type 2 diabetes relies upon burning off the body’s excess glucose, so the daily calorie-restricted diet will not work.

The secret to long-term weight loss is to maintain your basal metabolism. What doesn’t put you into starvation mode? Actual starvation! Or at least the controlled version, intermittent fasting.

Fasting triggers numerous hormonal adaptations that do NOT happen with simple caloric reduction. Insulin drops precipitously, helping prevent insulin resistance. Noradrenalin rises, keeping metabolism high. Growth hormone rises, maintaining lean mass.

Over four days of continuous fasting, basal metabolism does not drop. Instead, it increased by 12%. Neither did exercise capacity, as measured by the VO2, decrease, but is instead maintained. In another study, twenty-two days of alternate daily fasting also does not result in any decrease in RMR.

Why does this happen? Imagine we are cavemen. It’s winter and food is scarce. If our bodies go into ‘starvation mode’, then we would become lethargic, with no energy to go out and find food. Each day the situation gets worse and eventually we die. Nice. The human species would have become extinct long ago if our bodies slow down each time we didn’t eat for a few hours.

No, instead, during fasting, the body opens up its ample supply of stored food – body fat! Yeah! Basal metabolism stays high, and instead we change fuel sources from food, to stored food (or body fat). Now we have enough energy to go out and hunt some woolly mammoth.

During fasting, we first burn glycogen stored in the liver. When that is finished, we use body fat. Oh, hey, good news – there’s plenty of fat stored here. Burn, baby burn. Since there is plenty of fuel, there is no reason for basal metabolism to drop. And that’s the difference between long-term weight loss, and a lifetime of despair. That’s the knife edge between success and failure.

Fasting is effective where simple caloric reduction is not. What is the difference? Obesity is a hormonal, not a caloric imbalance. Fasting provides beneficial hormonal changes that happen during fasting are entirely prevented by the constant intake of food. It is the intermittency of the fasting that makes it so much more effective.

Intermittent Fasting vs Calorie Restriction

The beneficial hormonal adaptations that occur during fasting are completely different from simple calorie restriction. The reduction of insulin and insulin resistance in intermittent fasting plays a key role.

The phenomenon of resistance depends not only upon hyperinsulinemia, but also upon the persistence of those elevated levels. The intermittent nature of fasting helps to prevent the development of insulin resistance. Keeping insulin levels low for extended periods of time prevents the resistance.

Studies have directly compared daily caloric restriction with intermittent fasting, while keeping weekly calorie intake similar. A 30% fat, Mediterranean style diet with constant daily caloric restriction was compared to the same diet with severe restriction of calories on two days of the week.

Over six months, weight and body fat loss did not differ. But there were important hormonal differences between the two strategies. Insulin levels, the key driver of insulin resistance and obesity in the longer term, was initially reduced on a calorie restriction but soon plateaued. However, during intermittent fasting, insulin levels continued to drop significantly. This leads to improved insulin sensitivity with fasting only, despite similar total caloric intake. Since type 2 diabetes is a disease of hyperinsulinemia and insulin resistance, the intermittent fasting strategy will succeed where caloric restriction will not. It is the intermittency of the diet that makes it effective.

Recently, a second trial directly compared zero-calorie alternate-day fasting and daily caloric restriction in obese adults. The Caloric Reduction as Primary (CRaP) strategy was designed to subtract 400 calories per day from the estimated energy requirements of participants. The ADF group ate normally on eating days, but ate zero calories every other day. The study lasted 24 weeks.

What were the conclusions? First, the most important conclusion was that this was a safe and effective therapy that anybody could reasonably follow. In terms of weight lost, fasting did better, but only marginally. This is consistent with most studies, where, in the short term, any decent diet produces weight loss. However, the devil is in the details. The truncal fat loss, which reflects the more dangerous visceral fat,was almost twice as good with fasting as opposed to CRaP. In fat mass %, there is almost 6 times (!) the amount of loss of fat using fasting

The other big concern is that fasting will ‘burn muscle’. Some opponents claim (without any evidence) that you lost 1/4 pound of muscle for every single day of fasting you do. Considering I fast at least 2 days a week, and have done so for years, I estimate my muscle percentage should be just about 0%, and I shouldn’t even have enough muscle to type these words. Funny how that didn’t happen. But anyway, what happened in that study? The CRaP group lost statistically significant amounts of lean mass, but not the IF group. Yes, there is LESS lean muscle loss. Maybe it has to do with all the growth hormone and nor adrenalin being pumped out.

Lean mass % increased by 2.2% with fasting and only 0.5% with CRaP. In other words, fasting is 4 times better at preserving lean mass. So much of that old ‘fasting burns the muscle’.

What happens to basal metabolism? that’s what determines long term success. If you look at the change in Resting Metabolic Rate (RMR). Using CRaP, basal metabolism dropped by 76 calories per day. Using fasting, it only dropped 29 calories per day (which is not statistically significant compared to baseline). In other words, daily caloric reduction causes almost 2 1/2 times as much metabolic slowdown as fasting! So much for that old ‘Fasting puts you into starvation mode’.

Fasting has been used throughout human history as a tremendously effective method of controlling obesity. By contrast, the portion control strategy of daily caloric restriction has only been recommended for the last 50 years with stunning failure. Yet, conventional advice to reduce a few calories every day persists and fasting is continually belittled as an outdated, dangerous practice akin to blood-letting and voodoo. The study reports that “Importantly, ADF was not associated with an increased risk for weight regain”. Holy S***. That’s the Holy Grail, Man! The whole problem is obesity and The Biggest Loser is WEIGHT REGAIN, not initial weight loss.

Weight regain differed during fasting vs CRaP. The fasting group tended to regain lean mass and continue to lose fat, while CRaP group gained both fat and lean mass. Part of the issue was that the fasting group reported that they often continued to fast even after the study was done. Of course! It is easier than they though, with better results. Only an idiot would stop. One of the very fascinating things is that ghrelin (the hunger hormone) goes up with CRaP but does NOT during fasting. We’ve known forever that dieting makes you hungrier. It’s not a matter of willpower – it’s a hormonal fact of life – the ghrelin goes up and you are hungrier. However, fasting does not increase hunger. Fascinating. No wonder it’s easier to keep the weight off! You’re less hungry.

Calorie restriction diets ignore the biological principle of homeostasis – the body’s ability to adapt to changing environments. Your eyes adjust whether you are in a dark room or bright sunlight. Your ears adjust if you are in a loud airport or a quiet house.

The same applies to weight loss. Your body adapts to a constant diet by slowing metabolism. Successful dieting requires an intermittent strategy, not a constant one. Restricting some foods all the time (portion control) differs from restricting all foods some of the time (intermittent fasting). This is the crucial difference between failure and success.

So here’s your choices:

Caloric Reduction as Primary: less weight loss (bad), more lean mass loss (bad), less visceral fat loss (bad), harder to keep weight off (bad), hungrier (bad), higher insulin (bad), more insulin resistance (bad), perfect track record over 50 years unblemished by success (bad)
Intermittent Fasting: More weight loss, more lean mass gain, more visceral fat loss, less hunger, been used throughout human history, lower insulin, less insulin resistance.
Almost every medical society, doctor, dietician and mainstream media will tell you to use choice #1. I prefer to tell people to take choice #2.


One point he probably does not repeat enough, and not in The Atlantic, is that his patient population for the most part are obese, very sick if they already have diabetic nephrology, and fast weight reduction is way better than dying on a dialysis machine. People who would like to lose ten pounds..or even thirty, should probably not consider extended fasts. Two days a week or the 16:8 day is more than adequate. Fasting for cancer treatment and other metabolic therapies is another reason fasting is making a comeback, but yet again, a very specific use for a sick population...not to lose a few pounds before the holidays.

Last edited by JEY100 : Mon, Nov-21-16 at 10:36.
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  #6   ^
Old Mon, Nov-21-16, 10:25
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Nancy LC Nancy LC is offline
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Man, I hope like hell he has valid citations for these claims. I also notice he mentions he does 2-day fasts, but yet he's advocating much, much longer fasts. Like I said, I think your body is probably okay for short fasts used for IF. At least you're getting some protein in for repairing it.
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Old Mon, Nov-21-16, 10:32
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phoenix31 phoenix31 is offline
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I wish there was a "like" button on posts, Janet...that was incredibly informative.
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Old Mon, Nov-21-16, 10:39
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Nancy LC Nancy LC is offline
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You don't have to look to far to understand the effects long-term fasting has on the body. It has been studied endlessly in hunger-strikers.

http://www.livescience.com/28984-hunger-strike.html

"After the third day of a hunger strike, the body starts to use muscle protein to make glucose, a sugar that's needed for cell metabolism. Levels of important electrolytes, such as potassium, fall to dangerous levels. The body also loses fat and muscle mass."

So, you're probably fine up until 3-days in. Remember how we talk about the various problems with LC flu and electrolytes? Well, it is also going to be an issue with fasting. Your body will have to tear down bone to get potassium and probably muscle to get other electrolytes.

"Low levels of thiamine (vitamin B1) become a real risk after two or three weeks and can result in severe neurological problems, including cognitive impairment, vision loss and lack of motor skills."
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Old Mon, Nov-21-16, 10:40
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JEY100 JEY100 is online now
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I added something to the post after the copy, repeating here since you were typing at same time:

One point he probably does not repeat enough, and not in The Atlantic, is that his patient population for the most part are obese, very sick if they already have diabetic nephrology, and fast weight reduction is way better than dying on a dialysis machine. People who would like to lose ten pounds..or even thirty, should probably not consider extended fasts. Two days a week or the 16:8 day is more than adequate. Fasting for cancer treatment and other metabolic therapies is another reason fasting is making a comeback, but again, a very specific use for a sick population...not to lose a few pounds before the holidays.

The Obesity Code book has extensive citations for each chapter, I assume the new book does as well.

Steve Phinney disagrees with him on the whole protein issue...says they use different studies to bolster their claims...but they both do have studies.
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Old Mon, Nov-21-16, 11:14
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Ambulo Ambulo is offline
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From my reading of the book, Fung does not advocate extended water fasting for the general public. Bullet proof coffee and bone broths are a different animal.
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Old Mon, Nov-21-16, 11:29
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thud123 thud123 is offline
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Quote:
Originally Posted by Nancy LC
Oh dear... I have no idea where your body is going to get it's protein requirements. It could be your heart, your liver, your left big toe. What on earth makes you believe it will be your extra skin?

That was kind of tongue and cheek (both excellent protein sources by the way) I trust that my body will recycle protein from places that are non critical first. Also, it has been my experience that It's fairly easy to build muscle. The amount of total protein "loss" over the course of a few days is minute and probably good for you.

These are just my uninformed opinions.

However, I do agree, if you have no adequate fat supplies to support extended fasting than you probably shouldn't do it. I would consider extended fasting a length exceeding 3-5 days.

More opinion, take it for what it's worth. I'm willing to admit I could be exactly WRONG and am willing to change if required.
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Old Mon, Nov-21-16, 12:44
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Fung also advises supplementing with a multivitamin/mineral if going beyond 2 or 3 days.
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Old Mon, Nov-21-16, 13:47
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Those "hunger strikers" weren't fasting because they were being force-fed. Ancel Keys' Minnesota "starvation" studies students also weren't fasting, they were on low calorie diets. None of these people were allowed to become fat adapted, where one can actually make glucose from fat. http://chrismasterjohnphd.com/2012/...ose-from-fatty/
If you get force-fed through the nose or are fed 500-1000 calories of SAD in a ward study, you will never become fat adapted, so you will use up all your blood glucose, then glycogen, then use protein to make glucose.

From some of the cited articles in Fung's books, true fasting with zero or close to zero carbs, kicks in other body-saving pathways like increasing human growth hormone production on day 2-3 and reducing insulin resistance. This amps up autophagy where the body breaks down decrepit cells but conserves and reuses pieces to build new protein molecules (moreso than when you are eating protein so the body doesn't bother to conserve it). Fasters who have been closely monitored don't lose muscle until they get below 4% body fat. In fact, some gained a pound or two of lean body mass during 30-90 day fasts.

Last edited by deirdra : Mon, Nov-21-16 at 14:00.
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Old Mon, Nov-21-16, 13:58
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Nancy LC Nancy LC is offline
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No, not all hunger strikers are force-fed. Force-feeding is very controversial. If they were force-fed, they wouldn't be showing the effects of starvation. The article I linked was specifically about hunger-strikers that were allowed to starve and what happens to them during the course of their hunger strike.

Specifically the article I cited says:
Quote:
Hunger strikes and medical ethics

The medical ethics of forced feeding are also a subject of controversy. "The situation at Guantanamo Bay is unique and has been characterized as a 'legal black hole,'" according to a commentary in the Journal of the American Medical Association.

Because "restraints reportedly have been and continue to be used to immobilize competent prisoners … force-feeding at Guantanamo Bay violates the Geneva Conventions, international human rights law and medical ethics," the authors wrote.
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Old Mon, Nov-21-16, 14:04
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GRB5111 GRB5111 is offline
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I'm comfortable with longer fasts and have done very well with them. In this case, I'm talking up to 96-hour fasts (4 days) where I've consumed only water, tea, salt. I felt great and could have gone longer. For fuel for the brain, very little glucose is required, and one's fat reserves provide the ingredients for the necessary fuel the body requires. There are still camps arguing energetically regarding how the body derives fuel from lean mass or fat mass, and my readings of the science indicates that the body is very protective when exogenous food sources are completely eliminated by compensating with HGH and ketone bodies. Don't forget that the glycerol backbone of fat contributes to the production of the small amount of glucose the body needs via gluconeogenesis. Yes, energy can come from fat or protein. For me, I don't believe I've ever been that low on body fat where fasting would require my metabolism to get glucose from lean mass protein.

Here's a very good Ted talk from Mark Mattson explaining the benefits of fasting. If the root of the argument here is the danger of long fasts, I believe that a lot remains to be learned here, and we really need a definition of "long fasts."

https://www.youtube.com/watch?v=4Uk...eature=youtu.be

Good dialog and discussion on this thread!
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