Why This Cardiologist Recommends Fasting with Dr Pradip Jamnadas #236
Dr. Pradip Jamnadas, a cardiologist, discusses the profound benefits of therapeutic fasting for reversing diabetes, lowering blood pressure, and improving metabolic health. He shares a gradual protocol for adopting fasting, highlighting its physical and psychological empowerment.
Deep Dive Analysis
18 Topic Outline
Introduction to Fasting and Its Benefits
Why Fasting is Not Widely Adopted by Medical Professionals
Fasting as Self-Imposed Scarcity and Broader Applications
Biochemistry of Fasting: Insulin, Glucose, and Ketones
The Role of High Insulin in Heart Disease and Metabolic Dysfunction
Fasting's Impact on Mood, Energy, and Inflammation
Activating the Body's Natural Reparative Processes Through Fasting
Practical, Gradual Protocol for Introducing Fasting
Understanding Atherosclerosis, Ischemic Heart Disease, and Stress Tests
Using Coronary Calcium Scores to Motivate Patients
Metabolic Syndrome and Its Connection to Insulin Resistance
Addressing Challenges and Compromises in Dietary Changes
Fasting Considerations for Women and Specific Populations
Navigating Potential Extremes and Eating Disorders with Fasting
Fasting as a Unifying Approach Across Diverse Diets
Mental and Emotional Benefits of Fasting: Freedom and Self-Confidence
The Importance of Stress Management and Meditation in Health
Top Tips for Feeling Better and Living More
8 Key Concepts
Insulin Resistance
This occurs when the body's cells become less responsive to insulin, requiring the pancreas to produce increasingly higher amounts of the hormone to manage blood sugar. It often results from frequent eating and consistently elevated insulin levels, keeping the body in a 'storage mode' and contributing to various metabolic issues.
Ketogenesis / Ketones
Ketogenesis is the metabolic process where the body, after depleting its glucose and glycogen stores, begins to burn fat for energy, producing molecules called ketones. Utilizing ketones as an energy source can lead to feelings of euphoria, improved mental clarity, and enhanced physical performance.
Atherosclerosis
Atherosclerosis is the buildup of plaque, often containing calcium, within the walls of arteries throughout the body. This plaque accumulation can narrow the arteries, restricting blood flow and leading to conditions such as ischemic heart disease.
Ischemic Heart Disease
This condition results from a lack of adequate blood flow (ischemia) to the heart muscle, typically caused by narrowed coronary arteries due to atherosclerosis. Patients may experience symptoms like chest pain (angina), especially during physical exertion, as the heart muscle is deprived of oxygen.
Coronary Calcium Score
A non-invasive CT scan that quantifies the amount of calcium buildup in the coronary arteries, serving as a direct indicator of existing atherosclerosis. This score is a powerful predictor of future heart attacks, coronary events, stroke, and overall mortality, often more accurately than traditional blood tests.
Metabolic Syndrome
A cluster of conditions including being overweight (BMI > 25) with increased abdominal girth, low HDL cholesterol, high triglycerides, and borderline high blood pressure. This syndrome is primarily driven by high insulin levels and insulin resistance, leading to inflammatory fat deposition in organs like the liver and pancreas.
Autophagy
Autophagy is a fundamental cellular process where cells break down and recycle their own damaged or unnecessary components to become more efficient and functional. This crucial reparative mechanism is significantly activated and enhanced during a fasting state, contributing to cellular rejuvenation and longevity.
BDNF (Brain-Derived Neurotrophic Factor)
BDNF is a protein that plays a vital role in the survival, growth, and differentiation of neurons in the brain, essentially helping to grow new brain cells. Its production increases during fasting, contributing to improved brain alertness, mental clarity, and overall neuroplasticity.
10 Questions Answered
Fasting leads to weight loss, decreased blood pressure, reversal of diabetes, reduced progression of coronary artery disease, improved heart muscle function, better mental well-being, stronger muscles, fewer falls, and reduced re-hospitalizations for heart attacks.
Promoting fasting is challenging because it requires a significant lifestyle change and a deeper, time-consuming engagement with a patient's entire outlook on life, which many busy doctors focused on treating disease rather than prevention find difficult to implement.
Fasting allows the body to deplete glucose and glycogen stores, then switch to burning fat for energy, producing ketones. This process lowers insulin levels, which often stay high due to frequent eating, and activates reparative processes like autophagy and stem cell mobilization.
Chronically high insulin levels, often due to frequent eating, keep the body in storage mode, leading to increased fat stores and insulin resistance. High insulin also acts as a vasoconstrictor, reducing nitric oxide and increasing blood pressure, contributing to hardening of the arteries.
'Essential hypertension' is a medical term for high blood pressure with no known cause. Dr. Jamnadas suggests it's often linked to high insulin levels, which reduce nitric oxide production and cause blood vessels to constrict, leading to elevated blood pressure.
Fasting can lead to improved mood, better sleep, and increased energy due to the production of substances like BDNF (brain-derived neurotrophic factor), which makes the brain more alert, and the reduction of systemic inflammation throughout the body.
Fasting activates reparative processes such as autophagy (cellular recycling), mitophagy (mitochondrial recycling), and stem cell mobilization. These mechanisms help clean up and repair damaged cells, strengthen the body, and improve immunity.
While some data suggests women may not benefit as much as men, Dr. Jamnadas's clinical experience indicates women, including South Asian women who have a higher incidence of coronary artery disease, benefit significantly from fasting, though individual hormonal situations should be considered.
Yes, fasting can potentially be overdone or become problematic for individuals with eating disorders or addictive behaviors. It's crucial to recognize these issues and seek specialized psychological help when necessary, as addiction to food can be linked to other addictive patterns.
Fasting can be integrated with various diets (e.g., meat-eater, vegan, low-carb) as long as the focus is on whole, natural foods and avoiding processed items. It helps the body become more metabolically flexible, and the insulin response to food after a fast is different.
20 Actionable Insights
1. Consult Healthcare Professional for Fasting
If you are on medications (especially insulin or blood pressure drugs) or have an eating disorder, consult a healthcare professional before starting any fasting regimen. This is crucial to avoid hypoglycemia, manage blood pressure, and ensure the fasting protocol is suitable for your individual health conditions.
2. Clean Up Your Diet First
Before starting any fasting, eliminate all artificial foods, sugar, and processed foods for approximately two to three weeks. This helps reduce potential withdrawal symptoms and prepares your body for fasting by adapting to whole, natural foods.
3. Eat Whole, Natural Foods
Consume foods in their natural, whole form, ensuring you can recognize what’s on your plate. This includes grass-finished meats, organic chicken/eggs, fish, and plenty of vegetables for gut health, while avoiding anything processed, packaged, or made into flour.
4. Eat Infrequently, Only When Hungry
Shift your eating pattern to only consume food when truly hungry, rather than eating out of routine or at specific times. This helps break addictive eating patterns and empowers you to regain control over your habits.
5. Prioritize 7+ Hours of Sleep
Ensure you get at least seven hours of sleep daily. Adequate sleep is crucial for maintaining energy, mental clarity, and willpower, which are essential for adhering to dietary changes and fasting protocols.
6. Find Pleasure and Happiness
Actively seek pleasure and happiness in your life and daily activities. This helps prevent the body from metabolizing negative physiology stemming from bad habits and contributes significantly to overall well-being.
7. Start Fasting by Skipping Meals
Begin your fasting journey by randomly skipping meals when you are not hungry, such as breakfast or lunch, for about two weeks. This gradual approach helps your body adapt and builds confidence without immediately committing to longer fasts.
8. Practice 18-Hour Daily Fasting
After adapting to skipping meals, aim for two meals within a 6-hour eating window daily (Monday-Friday), creating an 18-hour fasting period. During the fasting window, consume only water, black tea, or black coffee, ensuring no caloric intake.
9. Implement One Meal A Day (OMAD)
Progress to eating only one meal a day on specific weekdays (e.g., Monday, Wednesday, and Friday), while maintaining two meals on other weekdays. This further extends your fasting period and deepens metabolic adaptation.
10. Incorporate Weekly 36-Hour Fasts
Once comfortable with one meal a day, introduce a 36-hour fast once a week for two consecutive weeks. This typically involves skipping an evening meal and not eating until breakfast the day after next, helping to induce ketogenesis.
11. Consider 3-Day Water Fasting
For deeper metabolic benefits or to break weight loss plateaus, consider a three-day water fast, but only after gradually adapting through shorter fasts. This prolonged fast can significantly enhance autophagy, growth hormone production, and fat mobilization.
12. Manage Hunger Cravings
When hunger strikes, recognize that ghrelin levels (hunger hormone) typically peak for about an hour before subsiding. Drink a glass of water and keep your mind busy with chores or activities to overcome the craving.
13. Address Deeper Addictions
Recognize that food addiction, especially to sugar and processed foods, can be linked to other addictive behaviors like digital media, alcohol, or gambling. A holistic approach addressing all forms of instant gratification is often necessary for sustainable change.
14. Embrace Fasting Beyond Food
Extend the concept of fasting beyond just food to include social media fasts, alcohol fasts, or caffeine fasts. This broadens the practice of self-imposed scarcity and control over various dependencies in your life.
15. Monitor Blood Pressure
If you are on blood pressure medication, monitor your blood pressure twice daily during fasting periods. Any adjustments to medication should only be made by a healthcare professional based on your readings.
16. Monitor Blood Sugar & Insulin
If on oral blood sugar agents, continue them during 18-24 hour fasts while monitoring blood sugars. If on insulin, reduce dosage by half for 24-hour fasts and discontinue completely for fasts longer than 24 hours, under strict medical supervision, to prevent hypoglycemia.
17. Supplement Electrolytes During Fasting
If experiencing cramps during longer fasts, add a pinch of salt to a glass of water and drink it. This helps replenish electrolytes and alleviate symptoms, especially during extended periods without food.
18. Practice Simple Meditation for Stress
To manage stress during fasting or in daily life, practice simple meditation by closing your eyes and focusing on your breath. Let thoughts pass without engagement, returning to your breath, to find inner awareness and reduce stress.
19. Cultivate Self-Empowerment
Realize that you are more than your hunger, cravings, or habits; you are in charge of your choices and can change your behavior. This realization fosters self-confidence and can positively impact all areas of your life, from work to relationships.
20. Consider Holistic Health Factors
Understand that health outcomes are significantly influenced by social determinants such as relationships, social support, and self-perception. Addressing these broader life aspects can profoundly impact your physical and mental well-being.
8 Key Quotes
You are not your habits. You are not even your body. You are something that can change everything.
Dr. Pradip Jamnadas
Your body was made to do this. It was not made to just pile on, pile on, pile on all the time, because that results in increased fat stores, which you'll never break down.
Dr. Pradip Jamnadas
Insulin, bottom line for all your listeners, insulin just is a storage molecule, puts everything in storage. So when the insulin levels come down, the storage padlocks are taken off.
Dr. Pradip Jamnadas
It's not really a weight loss program. It's a metabolic program in which one of the side effects is that your weight comes back down to the way it's supposed to be.
Dr. Pradip Jamnadas
You are as old as your arteries.
Dr. Pradip Jamnadas
Fasting forgives you. Fasting, in a sense, forgives you for certain foods that you may then consume.
Dr. Pradip Jamnadas
It's freedom from a dependency on food, addicted to food, processed food, sugar.
Dr. Rangan Chatterjee
You basically metabolize your psychosocial being. You metabolize it into your body. So be careful about your thoughts, about who you are and how you're interacting with the world and everything that's going around you because in an instantaneous moment, you're actually metabolizing it into physiology in your body.
Dr. Pradip Jamnadas
1 Protocols
Gradual Fasting Protocol (Dr. Jamnadas's Approach)
Dr. Pradip Jamnadas- **Dietary Cleanup (2-3 weeks)**: Eliminate all artificial sugars, processed foods (anything made in a factory, with a barcode, pulverized, or powdered). Eat only natural, whole foods (e.g., grass-finished meat, organic chicken/eggs, natural vegetables). Eat as much as desired of the right foods, no fasting yet.
- **Random Meal Skipping (2 weeks)**: Learn to skip individual meals randomly (e.g., skip breakfast one day, lunch another). Drink plenty of water during skipped meal times to manage hunger.
- **18-Hour Fasting / Two Meals a Day (2 weeks)**: Five days a week, consume only two meals within a six-hour eating window, resulting in 18 hours of no food intake. Only water, black tea, or black coffee are allowed during the fasting window. On weekends, have three meals but no snacks.
- **24-Hour Fasting / One Meal a Day (Multiple weeks)**: On Monday, Wednesday, and Friday, consume only one meal (a 24-hour fast). On other weekdays, continue with two meals. On weekends, continue with three meals.
- **36-Hour Fasting (2 weeks)**: Once a week, extend the single-meal fast by skipping that meal and having breakfast the next day, resulting in a 36-hour fast. This helps prepare the body for longer fasts and ensures ketogenesis.
- **Three-Day Water Fast**: For highly motivated patients, especially those who are significantly overweight or have reached a weight loss plateau, undertake a three-day water fast. (Note: Patients on insulin will have insulin discontinued for fasts over 24 hours, with close blood sugar monitoring. Blood pressure medications are adjusted based on readings).