#80 - Celebrity AMA #1: Fasting, rapamycin, performance vs. longevity, and more
Dr. Peter Attia, joined by Olympians Apolo Ohno and Sasha Cohen, discusses fasting protocols for women, the safety of adolescent fasting, and nutrition for learning. He shares insights on gradual fasting, hydration, and the importance of listening to your body.
Deep Dive Analysis
3 Topic Outline
Gender Differences and Challenges in Fasting for Women
Progressive Strategies for Individuals Struggling with Fasting
Considerations and Safety of Fasting in Adolescents
2 Key Concepts
Diuresis
During fasting, the body typically excretes sodium at a higher rate, which leads to increased water loss from the body, a process known as diuresis. This necessitates increased water intake to compensate.
Anabolic Mode (Adolescents)
Adolescents are in an 'anabolic mode' meaning their bodies are actively growing and building tissue. For this reason, doctors often aim for weight stability rather than weight loss in obese adolescents, allowing them to grow into their weight, focusing on fat mass versus muscle mass.
4 Questions Answered
There appears to be a gender difference in fasting tolerance, possibly related to evolutionary factors impacting fertility, though the exact reasons are not fully understood clinically.
It is crucial to stop and eat if a fast isn't feeling right, as 'failing' a fast is still a success, and one can always try again later.
Generally, fasting is not recommended as a regular practice for adolescents unless under strict medical supervision for metabolic conditions, due to concerns about growth, potential for eating disorders, and endocrine system imprinting.
When fasting, it's important to drink more water than usual to compensate for the water not obtained from food and the increased sodium excretion (diuresis) that occurs.
12 Actionable Insights
1. Prioritize Safety During Fasting
If you feel unwell or ’not right’ during a fast, it is important to stop and eat, as prioritizing safety and listening to your body is crucial for successful fasting.
2. Gradually Increase Fasting Duration
If you struggle with longer fasts, gradually work up to them by starting with longer stretches of time-restricted feeding. This allows your body to adapt over time.
3. Enter Ketosis Before Fasting
To make the transition into a fast easier, try going into ketosis the week before starting the fast.
4. Increase Water Intake While Fasting
When fasting, you must increase your water intake beyond your normal consumption to compensate for the water you would typically get from food.
5. Compensate for Sodium Loss
During fasting, your body excretes sodium at a higher rate, so it’s important to compensate for this increased loss to maintain proper hydration and function.
6. Monitor Urine Output for Hydration
To gauge adequate hydration during fasting, monitor your urine output; if you’re not urinating approximately every 90 minutes, you likely need to drink more water.
7. Maintain Caffeine During Fasting
If you are a regular caffeine drinker, consider continuing to consume black coffee or high-caffeine tea during a fast to avoid the combined stress of no food and caffeine withdrawal.
8. Progress Fasting to OMAD
After consistently maintaining an 18-hour time-restricted feeding window, progress your fasting by transitioning to one meal per day (OMAD).
9. Implement 36-Hour Fast
To further extend fasting, try a 36-hour fast by eating dinner on Monday, then fasting through Tuesday, and breaking the fast with lunch or breakfast on Wednesday.
10. Avoid Adolescent Fasting
Unless an individual is an adult, regular fasting should not be considered a routine part of their diet due to potential developmental and endocrine system impacts.
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3 Key Quotes
You can quote unquote fail at a fast 99 times and come back on the 100th and be successful. And in my mind, they're all successful.
Peter Attia
If I don't get up to pee about every 90 minutes, I'm not drinking enough.
Peter Attia
I do think it's important for people to not hammer through fasts no matter what.
Peter Attia
1 Protocols
Progressive Fasting Strategy (for those struggling with fasting)
Peter Attia- Consistently maintain 18 hours of not eating with a six-hour feeding window.
- Progress to eating one meal per day.
- Attempt a 36-hour fast (e.g., dinner Monday, no food Tuesday, breakfast Wednesday).