Ep.74: Fasting for Longevity with Valter Longo
Dr. Valter Longo is coming to us from across the pond. He’s internationally recognized as a leader in the field of aging studies and related diseases. Today, we’re going to talk about the benefits and risks of fasting and what role it plays in our longevity.
Dr. Longo’s discoveries include some of the major genetic pathways that regulate aging and life-threatening diseases. He’s identified genetic mutations that protect human beings from several common sicknesses. He’s director of the Longevity Institution at the School of Gerontology at the University of Southern California in Los Angeles, which is devoted to research on aging. He also works part of the time in Milan, Italy. He’s also director of the Oncology Laboratory and Longevity at the Institute of Molecular Oncology. Enjoy the episode!
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Robyn: Hey, everyone. It’s Robyn Openshaw, and welcome back to Vibe. I’m bringing you someone today who I’ve been very excited to interview. I recently read his book. It’s called The Longevity Diet. I’ve heard him on a few other shows that friends of mine run who have really great health and wellness podcasts. Dr. Valter Longo, Professor Longo, is coming to us from across the pond. He’s internationally recognized as a leader in the field of aging studies and related diseases.
Today specifically, we’re going to talk about fasting, and how you can fas,t and how you can get the benefits of fasting without completely going without food. We’re doing this just a few days before I head to an ashram in Texas to water fast for nine days. It’s my fourth trip there in the last two years. I don’t recommend you get on a plane and go to this ashram and water fast, and we’ll share with you why.
Dr. Longo’s discoveries include some of the major genetic pathways that regulate aging and life-threatening diseases. He’s identified genetic mutations that protect human beings from several common diseases. He’s a professor of gerontology and biological science. He’s director of the Longevity Institution at the School of Gerontology at the University of Southern California in Los Angeles, which is devoted to teaching and research on aging. He also works part of the time in Milan. He’s director of the Oncology Laboratory and Longevity at the Institute of Molecular Oncology. I could go on for another five minutes about his amazing academic accomplishments, but let’s get right to it. Thanks for being on the show, Professor Longo.
Valter: Well, thanks for having me.
Robyn: I’m really excited to talk about fasting, partly because of my own personal experience with fasting. I was raised in a religious tradition that fasted once a month for a full day. From the time I was eight years old, I would go without food for 24 hours once a month. My parents were very, very strict about it.
I was not actually provided any food, but it wasn’t for health reasons. It was for spiritual reasons, and I think that’s been most people who fast, throughout history, it’s been more for those kinds of reasons. Will you tell us a little bit about why fasting is such an incredible health reboot, and why it’s so disease preventative?
Valter: Yeah, so you’re absolutely right. People think that most religions have been imposing fasting for thousands of years because of health reasons, but that’s not really true. It’s been really about sacrifice more than health. Now, it is possible that there’s some who had the health in mind and made some observations about health and fasting, but that’s not really the main reason.
Why is fasting good? First of all, fasting is good and bad. Now we know, for example, something called calorie restriction that we’ve been studying for a hundred years, and we were all convinced it was so good for everybody. It turns out, after we did monkey studies and human studies and mouse studies, that it’s great for diseases, it reduces diabetes. Almost 100% of the monkeys that were calorie restricted are protected from diabetes, protected from cancer, and protected from cardiovascular disease. Then they probably become weaker, frailer, and then they die of other causes, so fasting is the same way. It can be great, very powerful, but it can also hurt you.
How can it be powerful? Well, the main thing that we find in the lab, both in mice and human studies, is it seems to be able to get rid of junk, essentially damaged cells, damaged cellular components, and, essentially, replace them with ones that are working very well.
Why can it be dangerous? For many, many different reasons. It can be dangerous because, particularly with water-only fasting, is causes hypoglycemia. It can cause hypotension. It can, of course, interact with a number of drugs and medicines in a negative way. For example, a number of people have died by injecting insulin in combination with fasting. I had several patients that wrote to me and got very close to dying because they did some improvise longterm fasting and they didn’t know it cannot be combined with insulin.
In Italy, for example, I always talk about a lady that had multiple sclerosis and, under doctor supervision but the doctor wasn’t very careful, did three weeks of water-only fasting at home, with multiple sclerosis, and she ended up also dying.
These are just some of the stories, but I think there are many, many more of these stories that people don’t see. This is why we, a long time ago, made the decision to standardize this, and make sure that it is clinically tested and it’s tested in animal studies, and then clinical testing so that we can remove the danger out of the fasting.
Robyn: Before we did this interview, I mentioned to you that I was going to do a nine-day water fast and the first thing you said was, “Hey, who’s supervising that?” How do you feel about that, for a healthy person who’s done it several times and doesn’t have any disease states and isn’t overweight or on any kind of medications?
Do you feel like three days would be safe, or have your loved ones keep an eye on you, or a week is safe, or two weeks? You probably can’t say because you don’t want any liability, and I am the same. I don’t want any liability. What, at least, general comments do you have? I want people to feel like they can fast. I want people to feel like they can fast.
Valter: Look at it this way. Sometimes we look at the government as the bad actor and all that. Really, institutions like the Food and Drug Administration are there to protect us, right? If you look at the way the FDA rules, this is really based on experience. Why? Because they say a drug may seem very innocuous. You think oh, how could this possibly hurt me? Then when you look at 10,000 people, it did hurt a lot of people, so there is a percentage of people, and it could be any combination of things.
It’s hard to know, until you do the clinical studies, and until you do something that’s called face forward where you actually monitor tens of thousands of people and continue to ask the question, what happens if you do this together with a variety of situations?
This hasn’t really been done for this improvised water-only or semi-water-only fasting, so probably, the majority of people are going to be fine, or certainly are going to be fine, in any given fasting moment, meaning that they might do it five times and they’re fine. Then they can do it the sixth time and they get in trouble. They could get in trouble maybe because they have a cold, or maybe they have some bacterial infection, or they may have some other issue, medical or maybe taking a certain drug.
Now, all of a sudden, the fasting and re-feeding moments really revolutionize the metabolism in the human body. When that happens, let’s say, for example, I give you an easy one, metformin. This is one of the most-taken drugs in the United States. Metformin: lots of people take it even when they’re prediabetic or certainly in the early stages of diabetes, and others are suggesting that people should take it all the time, even if they’re not diabetic. This hasn’t been tested.
Now, metformin blocks something called gluconeogenesis. This is where your liver basically makes glucose to feed your brain and the rest of the body. Now, fasting requires gluconeogenesis, so now you combine something that blocks gluconeogenesis with something that requires gluconeogenesis and the result could be disaster, including death.
Something so innocuous, and I talk to technicians and they’re not aware of the mechanism, even the endocrinologists that are very well-trained in handling diabetes patients, they don’t know this. They’re very surprised when I say, “Well, did you know that one, fasting requires gluconeogenesis and the other one, metformin, blocks gluconeogenesis.
Robyn: Interesting. Let’s back up because we started to talk about fasting and I said tell us about the health benefits of it and we kind of bunny trailed off into the risks for a minority of people. Can you go a little deeper? When you talked about burning up the junk, getting rid of the junk, can you talk a little bit about what the health benefits are of fasting? We could talk later about what fasting safely looks like for different people, and your fasting-mimicking diet. I want to dive into that, but let’s talk more about the health benefits.
Valter: Yes. First of all, we used to think that, and this is where I make the distinction now, we used to think that the fasting-mimicking diet was just a way to get fasting plus the ability to eat, right? Now we’re finding out it’s not just that. There is more about what the food, the fasting-mimicking food, contains that is activating and triggering protective mechanisms. Let’s say, just for the sake of me keeping it simple now, we can talk about it later, but we’ll talk about the effects of fasting or fasting-mimicking diets.
Essentially, I use the analogy of a wood-burning train. Imagine now you have a wood-burning train, an old one that cannot make it, does not have enough wood to make it, to the next train station. Then the engineer starts going around the train looking for damaged chairs that are made of wood, damaged walls of the train that are made of wood and burns those first. Then eventually, goes to maybe some of the ones that are not damaged and burns those.
Now what happens is the train becomes lighter, and the train is using itself, essentially, to make it to the next station. That’s exactly what the human body does. If you don’t have any food coming in, then the body, after a few days, starts breaking down its components, both inside of each cell and also at the organ and system level, so for example, white blood cells, liver cells, muscle cells, everything starts slowly breaking down. It’s also making the body lighter. If you break down a white blood cell in the immune system, you don’t need to feed it anymore, so that white blood cell now becomes food for the other cells. At the same time, now you remove something that consumes energy.
Now when you re-feed, the body now has a very sophisticated program, as we found out in many papers that we publish, to start rebuilding. For example, an extraordinary example, you damage the pancreas of a mouse and then you start with the cycles of the fasting-mimicking diet, and you can regenerate. You damage the pancreas to the point that it’s not making insulin anymore, and then you start the fasting-mimicking diet and re-feeding cycle. After you do four or five of them, the pancreas now starts making insulin again.
So you’re essentially regenerating functional pancreatic cells. We’ve shown the same is true in a multiple sclerosis model where autoimmunity damages the myelin in the spinal cord, and now the cycle of fasting-mimicking diet and re-feeding can regenerate that.
By the way, in the multiple sclerosis system, the body seems able to go first after the autoimmune cells, as I was saying, the damaged components of the train versus the good ones. First, it seems like the body knows what’s damaged and what’s not. Whether it’s a precancerous cell or cancer cell or autoimmune cell, they seem to be able to kill those first, or certainly kill those at a high level. Now, on one side, you have the killing of damaged cells, and on the other side, you have the rebuilding, and you see how this can really be effective in the prevention and treatment of many diseases.
Robyn: Okay. This is fascinating because, in the beginning of our interview, when you were talking about how there’s a very few who might have a terrible reaction to fasting, especially if they’re doing a long period of time, you mentioned a patient you know with diabetes who actually died trying to do a longer fast, and a patient with multiple sclerosis who died even being supervised. I want to point out that you also just were talking about the benefits of breaking down, rebuilding possibly, myelin sheaths.
That’s your multiple sclerosis right there, and you just talked about regenerating the pancreas as being a potential benefit demonstrated in animal studies. I read about both of those in your book, which is why a diabetic patient would be interested in fasting. So I think it’s unbelievably exciting in this age where we feel like we’re breaking down in midlife at unprecedented rates, probably because of our crap diet and all the toxicity everywhere in our environments that our body can, if we give it a break from metabolism, can actually break down those broken parts.
I loved your wood-burning train metaphor. The body can actually break down broken parts of myelin sheath and pancreas and you come out of it with a pancreas like a baby’s, at least in animal studies, yes?
Valter: Right. I wouldn’t say like a baby, but certainly in the animals, we show that we go from a pancreas that no longer makes insulin to a pancreas that makes normal insulin. I don’t know if you define that as one working like a baby or not, but certainly, a tremendous difference as in the ability to make insulin. Also, we showed this in both the human type 1 and normal pancreatic cells that the fasting is able to turn back on insulin production, or increase insulin production. The potential is there.
We are now starting clinical trials on both type 1 and type 2 diabetes, and metabolic syndrome, that is going to be three different trials, actually, handling each one of those diseases. We have a trial that we’re going to start on multiple sclerosis, one that we’re going to start on Crohn’s colitis, so yeah, we’re going after all of these.
I don’t know. I hope it’s successful for everything, but I think if we were successful in a third of these, it would be really extraordinary. So we are optimistic, but we don’t want to be overoptimistic.
Robyn: I think you’re very, very scientific in your approach. You don’t make a lot of claims. The thing I was excited to talk to you about is that you’re a researcher, not a marketer, so I’m really interested to see what rolls out and what plays out as you test fasting against these specific diagnoses.
I want to talk a little bit about autophagy because when you talk about it, you mentioned re-feeding, and that was something I learned from your book. People talk about fasting like it’s the breaking down process and autophagy in the body going after the broken parts, broken cells, rebuilding from inside the cell, but it’s not just the breaking down. There’s what happens after your period of fasting.
Can you talk a little bit about the re-feeding? That seems to suggest, to me, if we’re breaking down the broken chairs on the wood-burning train, if we’re not going to make it to the station and then we get to the station, the rest of your metaphor is that we rebuild the chairs when we get to the station. This makes it very, very important that we eat a very, very healthy diet after our period of fasting or of the fasting-mimicking diet. Can you talk about that a little bit?
Valter: Yes, absolutely. The re-feeding and the nourishment becomes as important as the breaking down, so at a certain point, when you get to the train station, then you have to rebuild it. And if nobody’s dared to rebuild it well, then you’re going to have a broken train. The body is the same way. For example, proteins. I eat a mostly vegan diet, but I eat fish a couple times a week. Of course, you can get enough protein by a vegan diet, so this is not a criticism for the vegan diet.
It’s a warning because a lot of people that are vegan don’t realize how much, let’s say chickpeas, you need to have 40 grams of protein. Now, of course, the great majority of Americans and Europeans are eating too much proteins, but then you may have the vegans that eat too little proteins. This may explain why vegans sometimes in some studies are not performing as well as you would expect against the carnivores.
I think the proteins, for example, is a very important part of the rebuilding. Again, it’s not about excess protein. It’s about sufficient levels of protein. For example, if you’re a 120 pound person, you’re looking at maybe 45 grams of protein per day being the minimum, and 45 grams of protein means about 400 grams, so one pound of chickpeas or beans. That’s a lot, so most people don’t have that much. This is very important to look at.
Another one is omega-3 fatty acid. Well, you may not have that in your diet unless you eat fish, and so that’s something that is probably very important in the rebuilding process. B12 is also very important in the rebuilding process. A lot of vegans, if they don’t take a supplement, they’re not going to have B12. These are the things to pay attention to. I don’t think that too many people are aware of this.
Now, I should mention one thing as I mention all these trials that are coming up. You were going to ask me maybe, but we did finish a trial. 100 people, a randomized clinical trial, and we finished mouse studies, but the human clinical trial showed powerful effects, particularly in people that had high cholesterol, high blood pressure, high triglycerides, high fasting glucose, and high systemic inflammation as measured by CRP, and also, high risk factors for cancer. In all cases, these were reduced or greatly reduced by the three cycles of the fasting-mimicking diet. I just wanted to make sure that we get that in there because I didn’t want people to think that it’s all about future studies.
The prevention and the effects on risk factors [is apparent]; for example, a lot of the prediabetic patients move back to the normal state. A lot of the people that had the systemic inflammation and that were at risk for cardiovascular disease, they also moved back to the low risk range, so 60% of the effects of the fasting-mimicking diet were long lived.
So the patient did three cycles of the FMD, one month apart, for five days. Then after three months, we measured that again, and 60% of the changes were still there. Meaning that they’re going away after three months slowly, but the majority of the effects are still there and are probably lasting four, five, six months. It probably takes four, five, six months before all the effects go away.
Robyn: Well, that is beyond exciting that you can spend this brief period of time fasting and then have long-term disease prevention and risk decrease because of that. One of the things I really like about your work, Professor Longo, is that you’re very rigorous about assessing anything that somebody might make claims about.
For instance, (I don’t want to go sideways just yet on the ketogenic diet that’s so popular here in the US right now, I want to talk about that in a minute) there’s people out there claiming that [the ketogenic diet] is preventative of cancer, or that it’s a good diet for a cancer patient and they cherry pick – this is my opinion, you can totally disagree, agree, whatever – but they cherry pick the data, and a few people out there are repeating cherry-picked data about how the ketogenic diet, which is tons of bacon and butter and stuff like that, is somehow good for cancer.
You say no, no, no. Rather than cherry pick the data, there’s five pillars that we need to look at before we’re going to make any claims about whether something contributes to longevity or not. Will you talk about that, because I believe you are becoming one of the world’s leading authorities on what actually creates longevity in human beings.
We’re all hanging on your every word, and I’m super excited to continue to follow the arc of your career because everybody wants to know about this, and you’re out there doing these trials and comparing it to other longitudinal studies. Talk about the five pillars [you should know] before you’re going to put any real weight on some practice, some dietary practice, whatever. You’ve honed in on fasting because it’s so powerful, but what are these five pillars that you look at before you’re going go out there and make claims like the ketogenic diet people are making?
Valter: First of all, in the book, I talk about “pick who you listen to.” Obviously, I’ve been doing this for 30 years now, and with some of the best groups in the world and some of the top universities in the world.
This really is important. It doesn’t mean that you have to take my track. There are people that are trained other ways, but certainly, it’s very important to pick the right people you listen to. Whenever you need surgery, most people don’t just say oh, anybody can do surgery. They look at the surgeon, the hospital, the success rate, but somehow, when it gets to eating, people underestimate the power of it and they just grab anything that they can find on the internet. Imagine if somebody did that for surgery. That would be crazy, right? Yet, the way you eat can really make an incredible impact on whether you live to 100 or to 50.
Of course, then I had to come up with a system. It was important even for me, to not say “Oh, because I’ve spent 30 years on this, now I can say whatever I want.” Doesn’t work like that. I still have to show that this works using multiple pillars of science and medicine. The pillars are epidemiology; so what if you’re talking about high meat, high protein, high fat, animal fat diet and you look at large populations. Is this high animal fat, animal protein diet and low sugar the successful one?
I’ll just give you an example. Large study by Harvard looking at low carb, high protein, high fat diet and showing very clearly an increase in overall mortality, increase in cardiovascular mortality, increase in mortality from cancer. Epidemiology studies a large population, very important.
The other one is clinical studies. What if you take a group and you feed it high animal protein, high fat, and you take another group and you feed it a control diet. How do they do? For example, you’ll see that the ones that eat a high protein diet will have a high level of IGF-1. IGF-1 is a risk factor, or a marker, for cancer and also aging, etc. In the clinical level, there’s not much data about this, but certainly, it’s a very important pillar.
For example, another one that I talk about all the time and I talk about in the book is a large study done in Spain by the Astro Group. Basically, they took thousands of people and put them on a low fat diet and then thousands of other people and they put them on a high olive oil and/or nut diet, different type of nuts.
This was trying to address this argument out there, that are in books out there, that talk about how you need to have zero fat in your diet to be protected against cardiovascular disease. At the end of the five years, they had to stop the study because the people that were on the olive oil and/or nuts were doing so much better than the controls. These were people that were at high risk for cardiovascular disease. They were so much better on olive oil and nuts that they had to stop it and let everybody take advantage of this. That’s the second pillar, the clinical studies.
The third pillar is basic research focused on longevity. You need to look at, say, mice and other organisms that have been tested, what if they’re fed a high protein diet, for example, versus a low protein diet? Do they do better? Well, it turns out that not surprisingly, if they’re fed a low protein diet, they live longer, healthier. That’s the third pillar, fundamental research, basic research that focus on longevity.
Why is it important to focus on longevity? Well, because you can say to somebody, “This causes cancer. Don’t eat it.” I can come back and say, “Well, it doesn’t matter, because these prevent Alzheimer’s and cardiovascular disease and diabetes.” Now you have to put it in the context of what impact is it going to have on your overall health? Not necessarily, is it increasing your chance of developing colon cancer by 22%? Because it might decrease your chance for developing cardiovascular disease by 50%. Now, there are not very many examples of this. I’m just making it up, but certainly that’s important to look at that.
The fourth pillar is centenarians in populations around the world that have record longevity, a very important pillar. Why is that?
Well, because you could do some studies and you could, by mistake and coincidence, get a lot of opinions about something that has been based on a short study, and maybe even multiple pillars will support it. Then if you go look at the Okinawans, the people in Loma Linda, California, the people in Sardinia, Calabria, Icaria, Greece, the ones that have regular longevity, and you ask the question “Did they have a high protein diet?” for example, well, none of them do.
Then you have to think hmm, that’s interesting. When you go look at the ones that are very successful, none of them adopt a high protein diet. Well, actually, the other pillar supports a low protein diet, so we don’t have a problem there. Everything in these four pillars now is supporting, let’s say, a low protein, mostly vegan, maybe some fish, plus some fish diet, but also a high nourishment diet being the most protective.
The fifth pillar is complex systems. What if you look at cars and planes, or the train that I was just telling you about? This allows us to simplify things, and look at examples of things that we build, like the train. It’s very easy to understand something like the train, because we built it. That way, we can take it apart and sort of reason about the consequences of what I told you earlier, like let’s say burning the wood to get fuel to get to the next station.
Robyn: I love it. Very good overview of the five pillars. I’m going to repeat them back in bullet point form here, but I’m going to put number three as number five because I’m going to ask a follow-up question about it.
Professor Longo tells us that he wants to look the five different pillars before he’s going to make a recommendation about diet, or fasting, or anything related to our longevity based on: number one, epidemiological large studies. Number two, large clinical studies. Number four (I’m skipping one) is centenarians, looking at what the blue zones actually eat, the people who live to be over 100 at 20 to 30 times the rate that Americans do. Number five, comparisons to other complex systems.
Then back to number three: basic longevity research. You mentioned, you touched on this, and I want to go a little deeper, is comparing, over the course of a lifetime, how people do on a high fat, low carb diet, for instance. You talk about this in your book and it completely defies what the current trend is.
It’s really important to me that people get very aware of what they’re being taught out there, with this new ketogenic diet fad and, actually, all of the low carb fads of the last 15 years. All these fad diets that have made billions of dollars at the expense of Americans’ health, in my opinion.
I’m totally betraying my own prejudice here. We are being told to avoid carbs, and carbs are being vilified, and we’re being told that carbohydrates are bad foods, but what do we know from looking at people who live a long time regarding how much fat they eat, and how much carbs they eat?
Valter: We know a lot. Not just the centenarians, but all the pillars. If you look every single one of the pillars, the carbohydrates come on top, every single one. Now, the problem is that people confuse sugars, starches, and carbohydrate. Most people, I would say, don’t even know the difference.
Sugars are the simple form of the carbohydrate, like what you will have in a Coke. That’s a sugar. Now, starches are complex, and they are what we get from the pasta, the bread, the rice, etc. Sugars, you probably want to keep very, very low, as low possible, and also not eating a lot of fruit. You can eat fruit, but not a lot of fruit. Why? Because it contains lots of sugar. Now, it’s okay to have one apple a day or whatever is perfectly fine, no problem, and, in fact, may help you, but not lots of fruit.
Starches, now, they’re good and bad. Why are they good? Well, they’re good because they taste good and people love it. That’s another thing I learned the hard way. You just can’t come up with things everybody hates because they’ll drop it. If you go too extreme, then people will do it for six months. We see this over and over and over. They’ll do it for six months, and then they’ll drop it.
I learned that, and in the book I talk about don’t get rid of pasta if you’re Italian, or whatever, or rice or bread, but get rid of lots of it. Keep 50 grams in your dish of pasta. That’s what I do every day. I love to have that because it pleases me. It makes me happy. Then I put 350 grams of chickpeas, and another 100 grams of vegetable. So 50 grams of pasta, that’s a very healthy dish.
What you see all over the world, the dish in every restaurant that you go to, is you see this dish covered with pasta, or rice, and then 30 grams of garbanzo beans and two vegetables. That’s very unhealthy. That’s the problem in the demonization. We’re attacking carbohydrate, not really understanding that what we really mean to do is attack sugars and limit starches, and say have a ton of carbohydrates unless you have a particular inflammatory disease that affects you.
Some people may be allergic or intolerant to tomatoes, so you cannot have a ton of tomatoes. If you don’t have that, then having most of your carbohydrate come from the legumes and come from the vegetables is a very healthy way to do it. In the book I talk about how 60% of your calories should come from carbohydrates, not a big portion of it should come from starches. Try to limit that because that’s empty carbs, and they eventually are going to contribute to obesity, and that’s going to contribute to all kinds of disease.
So 60, 30, 10: 60% good carbs, mostly, 30% fats, and 10% protein. That is a good distribution. Keep in mind that with 30% fat, fats contain a lot more calories per gram than carbs and proteins.
Robyn: That’s almost the opposite of what people have been eating who have been following the paleo diet. The research I’ve seen is that 40 to 80% of calories [is protein]. Most people find the paleo diet is protein, and you’re saying 10% protein is ideal. I think that’s totally born out by all the same meta studies. All the metanalysis out there shows us that eating carbohydrates is our main fuel source.
Valter: Well, not only that, but if you look at the high animal fat, high protein [diet studies], I just mentioned a large study by Harvard, but if you look at the animal studies, if you give them a high protein diet, they lose weight. That’s where people are confused, and that’s why you need the experts. You lose weight. Then you might even see an improvement in some markers. Then you’re going to have more metabolic problems and a shorter lifespan.
Now, let’s say that there was a form, a very special form, of a paleo diet that works. We cannot rule it out. But there are much healthier ways to lose weight than that. It’s good, for example, to keep, as I just mentioned, the starches low. Keep the sugars low. Keep the carbohydrate high.
A lot of times, I don’t think they realize that there’s difference. That’s why they talk about a low carb diet because they don’t even understand the difference and, of course, if you keep the starches low and the sugar low, you’re going to lose weight the same way. Now you’re going to do it in a healthy way, rather than having lots of meat and hamburgers and other fats, animal fats and proteins that do mostly bad.
Robyn: I almost feel like the word carbohydrate is a meaningless, useless word because yeah, a bagel is going to be bad for you, but legumes also qualify as a carbohydrate, and there’s just no comparison between those two foods.
Valter: Yeah, absolutely. Not just carbohydrates, but also protein and fats. In the book I talk about how they’re all good and bad. These ideas from the past that fat is bad or good is a bad idea, same thing for proteins. In fats, in olive oil, the fat from salmon, the fat from nuts, these are excellent sources of fat. It’s good to have about 30% of your diet contain those, as you see in southern Italy, as you see in Greece and other parts of the world. The Okinawans have less fat consumption.
Of course, it’s very bad to have lots of butter, lots of fat from milk-based products and dairy products and red meat, etc. Those have been over and over and over associated with problems, and shortening the lifespan and not lengthen. Same thing for proteins. Proteins from vegetables are perfectly good and protein from fish, within limits, are also good. A ton of proteins, as everybody is doing from these artificial drinks or from red meat or from most meats (not just red meat, also white meat), are associated with problems. So you either get rid of it or certainly limit it as much as possible.
Robyn: You’ve described your diet as being vegan with a little bit of fish. That’s John Robbins’ diet, who I have interviewed on this show, whose work, Diet for a New America and The Food Revolution, influenced my life tremendously 25 years ago. It’s my diet, too, although I don’t eat fish a couple times a week. I probably eat it a couple times a month. I’m really doing it to hedge my bets because I don’t think vegan describes a diet very well, because you can eat a lot of different things within a vegan diet.
I want you to talk about one other thing just because I hear so much vilification or demonization of legumes and as you talk about your diet and you’re, of course, from Italy and the most researched positive outcome diet is the Mediterranean diet.
You’ve had your own experience being a rock musician and eating the crap diet when you came to the US in Chicago. I read your story, but as you talk about your diet now, you always bring up legumes and when you talk about the blue zones, you bring up legumes.
What’s interesting, Professor Longo, is that we have several of the fad diets that are being heavily promoted here in the US, and I’m going to mention a few, paleo, keto, and AIP, totally demonize legumes. You talked about eating a pound a day of chickpeas as an example of how you can get plenty of protein from legumes. I feel like people have been eating legumes for thousands of years and I feel like the healthiest populations on earth eat split peas and lentils and beans of all kind, but right now, in the US, people are being told not to eat them and instead, to get their protein from animal sources. What do you think?
Valter: Well, I think this is again where the pescatarian diet comes in. I think that, in fact, I know that, there are people that have inflammatory diseases. And if you have an autoimmunity in the gastrointestinal system, it may be this has been initiated by antibiotics or it been initiated by something else, maybe a viral infection. So there are situations where the gut flora, the microbiota, is so affected by something that happened to you, as I just mentioned, that your gut becomes leaky. And now there are lectins and other components that are in legumes (and this also depends how you cook them) that some people who develop inflammatory diseases are negatively affected by certain legumes or even vegetables.
I mentioned tomatoes. Tomatoes are a pro-inflammatory fruit. If you have that, then you have to find out what it is and you have to stay away from it until your microbiota goes back to normal. Certainly, the fasting-mimicking diet [helps].
Now we’re testing this for Crohn’s and colitis. It has a positive effect on the gut microbiota. In fact, in the clinical trial that we’re going to run here at USC, we’re going to combine the fasting-mimicking diet with the lack of pro-inflammatory vegetables and legumes. We’re going to eliminate them from the diet of these patients until they’re healthy.
Absolutely, in some cases, that’s again where the five pillars come in. In some cases, the legumes and even vegetables can be detrimental, and fruits can be detrimental. In those cases, you have to avoid them, and this could make a tremendous difference in your life.
Now, is it well-understood? Not yet. I think we’re still learning about pro-inflammatory vegetables and legumes, and how maybe cooking could completely change these inflammatory properties. Also, we’re learning about, is inflammation at a low level necessarily bad?
Why do I say that? It’s possible that, for example, you can give somebody a tomato. And if somebody never had the tomato, that is pro-inflammatory, but it’s also possible and likely that if you give somebody a tomato long enough, they’re going to develop bacteria that can process the tomato in a way that is in symbiosis with your organism, and now it doesn’t affect you anymore.
This is probably happening when you mention people have been eating tomatoes for hundreds of years and legumes for thousands of years. This is probably why they were fine because they always had this in their gut bacteria, and microorganisms were really set up to deal with tomatoes or garbanzo beans and other legumes. That’s why they don’t have problem, but yeah, absolutely, you could have somebody that always ate meat and now, all of a sudden, they take a tomato, and this could be a negative food for them.
Robyn: Interesting. Yeah. I laughed in the book where you talk about how a woman was talking to you about her diet, and you were saying we’re taking our cues on what to eat from the wrong people. This woman was explaining to you why she eats the way she does, and then she said this phrase that people say to me all the time, and it’s so frustrating. She was like, “Well, all things in moderation.”
I laugh because I feel like people say that [all the time]. It’s like no, you really should not eat arsenic in moderation. I feel like that saying was meant for we should eat all things that are good for us in moderation. What do you think about that?
Valter: Well, yeah, moderation is one of those worthless words. Not only worthless, it’s kind of like the word intermittent fast: it doesn’t mean anything. Now, moderation is the same thing. It doesn’t mean anything because what is moderation?
If you ask 10 people, they’re going to give you 10 versions of what moderation is. This is why I talk about a bagel in the book. If you ask people how many calories is in the bagel, a lot of them will say 100, 150, and by the time you put some cream cheese on it, you may have 600 calories in a bagel. Is that moderation?
We need to stop using words like moderation because it’s just an excuse for people to eat whatever it is that they want to eat. That includes, like you say, arsenic, for example. It includes foods that maybe historically we viewed as good for us, let’s say rice or certain whole grain, certain types of rice, but they contain lots of arsenic and now, particularly if you’re allergic to that, and I guess it’s a toxin so almost everybody in some ways is allergic to it, now you have a problem.
There’s even some good foods that may contain ingredients, at least nowadays, that are toxic, so we need to figure this out. Now, people shouldn’t get worried, because I think that if you’re eating something (and this is why I talk about going back to your grandparents to figure out the good foods), which ones did your grandparents also consume? Because it’s more likely that if you do it the same way they did it and they were fine, most likely you’re going to be fine, too.
Robyn: You mentioned how intermittent fasting is a word that gets thrown around a lot these days and how it’s sort of meaningless. I think it’s super funny that people are calling not eating from 7 p.m. until 7 a.m. intermittent fasting. I think that could literally only happen in 2018 America, that that is somehow a weird thing to not eat from 7 p.m. to 7 a.m., because that’s not even fasting. That’s just the distance between dinner and breakfast.
Valter: That’s called eating, actually, right, 7 p.m. to 7 a.m. It’s called eating.
Of course, people have always done that. I just emailed Satchin Panda and I was like, “Satchin, how is it possible now people are using your studies to mention that going for 12 hours without food is fasting?” Of course, it’s just the normal eating. Let’s stop calling it fasting. Even 16 hours of fasting shouldn’t be called fasting. It should be called time-restricted eating because the body doesn’t even enter an initial fasting mode.
I think it’s good to start qualifying what it is that we mean by different things, and particularly when you go from a few hours to a few months. What does that mean? That’s like calling anything you eat food, call it eating. Yeah, of course you can do that. It’s okay. Even if you go two hours without food, that’s fasting; but for the purpose of what people understand when you say intermittent fasting, we should certainly eliminate these. For sure the 12 hours, but probably also the 16 hours.
Robyn: Yeah. I want to talk a little bit about your fasting-mimicking diet. You can learn about it in Professor Longo’s book, The Longevity Diet. Then we’ll talk about where else they can find you.
I think it’s super interesting that you don’t accept any profit from your book, your products, teaching people how to do the fasting-mimicking diet. It’s just really incredible that the benefits here go to cancer patients who want to step outside of standard of care, which is a big passion of mine, too. That’s why I’m going to try and talk you into coming to Switzerland and meeting my friends there who treat cancer with biological medicine, not far from where you are in Milan, if I can talk you into it.
I’ll work on you later on that, but let’s talk about the fasting-mimicking diet because you don’t think somebody should just jump into a two week or three week water fast like I’ve done a number of times in my life. You don’t recommend that. I don’t blame you. Nobody wants the liability of that, but you’ve discovered some ways that we can achieve many of the same benefits.
Valter: Yes. Not, I think, just many of the same benefits. We now have evidence that adding benefits to the fasting, to the water only fasting, so there are things about the fasting-mimicking diet. The fasting-mimicking diet, it doesn’t have a particular length, but the one we tested on healthy, or relatively healthy, subjects was five days long, with low protein, low sugar, low starches, relatively high good carbohydrates, mostly from vegetables, and high fat – but good fats. Really, this is a summary of why we shouldn’t demonize any particular component because they’re all good and they’re all bad.
The purpose of the fasting-mimicking diet is exploiting our many years of connecting, for example, proteins with something that we call growth hormone IGF-1, a pathway in tyrosine kinase pathways. We spent decades really understanding the link between components of the food like proteins and aging pathways, the pathways that control aging. They control protection, but they also control regeneration both inside of a cell and cellularly that I mentioned earlier.
On the other side is sugars. Sugar control is also pro-aging and they control something called protein kinase A. So together, proteins and sugar push the system to age faster, and also to not regenerate. The fasting-mimicking diet exploits this, and much more than this, to allow people to undergo five days of fasting in a safe way, but also activate all these different pathways. Then it has a number of ingredients that make sure that the patients are relatively full. They’re not going to be full, of course, completely full, but relatively, meaning that they can handle it. They don’t feel like they’re being completely deprived.
I’ve done water-only fasting and you’ve done it, but to me, it was very, very tough. It may be because I’m Italian, but certainly, it was difficult. It can be done, but it’s difficult on people, so the purpose of the fasting-mimicking diet is also to keep people eating, almost normally, breakfast, lunch, and dinner. Plus a snack, and to also nourish people because some people may be deficient in B12, may be deficient in iron, may be deficient in all kinds of minerals and vitamins before they begin the fasting and the fasting could exacerbate this.
Let’s say somebody was severely protein deficient for two months. Now they come and do five, six, seven days of water-only fasting. This could push them over the edge. It may be, for example, suppress the immune system to a point that they get pneumonia. Not very common, for example, among the people that have very restricted diets. The immune system is very sensitive to nourishment and if you push it to the limit, you can now have a problem.
Again, the fasting-mimicking diet: we test it clinically on 100 patients and the results are very positive. If you go to prolongfmd.com, prolong is pro-longevity, FMD, fasting-mimicking diet dot com, then you can read all about it, can see the clinical results.
Now, I should say that all my shares of the company will be assigned to the Create Cures Foundation. As you mentioned, my book royalties, all the royalties are already assigned to the Create Cures Foundation. We’ve been able to raise millions of dollars already, actually, from the book sales worldwide, so we’re very happy about that. We started a number of donations to continue to do this kind of research. Some of it comes here to USC or they send it to Milan. Some of it goes to other institutes and foundations that are doing research in this area.
The idea is really to help people that have real problems, big problems, to have integrating solution right now and not 10 years down the road, not 20 years down the road. I had so many cancer patients and autoimmune disease patient etc., etc. contact me every day, and I still do. I always thought that it’s amazing that we don’t have anything that people can trust and say, “Shall I do, say, fasting-mimicking diet plus chemotherapy?” Or, “What should I eat between a cycle and the other?”
These are questions I get all the time, and it is just really sad. I always thought it was really sad that these patients have to go to the internet and try to figure out what to do about something that may be life threatening.
Robyn: Yeah, actually, another reason I want to spend some time with you when I go to Milan this year, or whenever we can get together, is that I really believe people should have access to other ways of addressing their cancer than just standard of care’s chemo and radiation.
Speaking of that, and really, this’ll be my last question for you except where to learn more. You’ve touched on some places to learn about prolonged therapy, and thanks for sharing how you’re gifting all the proceeds of your book and your program to helping people with cancer and helping to increase research out there about what can be done beyond standard of care, but I really want to do more in that area. I think there’s lots of people who would like to be treated outside of standard of care but can’t afford it and don’t know where the resources are. I’m really super curious to hear how your trial goes because you’re focusing on Crohn’s and IBS.
When I first started studying fasting many years ago, it was when Dr. Thomas Lodi, who is a Columbia-trained medical doctor and friend of mine, gave me his whole bibliography on why the first approach he wants a cancer patient to take is a longterm water fast. I was sort of amazed by that because sometimes when I think of cancer, I think of stage 4 patients who are in cachexia and their body is metabolizing muscle.
I wonder, I’m really super curious to hear how it goes when you put Crohn’s and IBS patients through a fasting because, while I can see that really breaking down and rebuilding and letting them have a new GI tract in some ways [works], they’re also underweight, a lot of them. Are you worried about that? How are you addressing that in your research?
Valter: Well, first of all, to do a longterm, water-only fasting if you’re a cancer patient is a bad idea. To the point that, even the Russians that have been doing fasting clinics in Siberia and other places, and the Germans that have been doing this for a long time, cancer has always been one of the things they excluded.
Of course, we’ve been working on cancer for a long, long time and it is possible that in some patients, a long fast could [help]. If the cancer cells are very responsive, it could even cure a few patients, a very small percentage. But I tell you that even in mice, if we fast the mice, we almost never cured any mice with any cancer with just fasting. We cured a lot of mice with a combination of fasting, either water-only or fasting-mimicking diet, and chemotherapy.
Again, we’ve got to go back to the five pillars. It’s easy for people to come up with ideas, and they don’t understand. You have no idea the fights that I’ve had with oncologists all over the world. For example, the latest one is in Italy because basically, they’re showing, even the short fasting in clinical trials that we’re doing right now, the oncologists are come back to me and say, “Look how they’re losing lean body mass during your fasting-mimicking diet.” Not even fasting, so it is very tricky, so let’s put it this way. For cancer patient, if you are not advanced, if you’re not at risk, if your life is not at risk, it is best to maybe consider a combination of fasting-mimicking diet and chemotherapy if your oncologist is in agreement, but try to maintain good weight.
Now, if somebody was told, “You’re going to die. There is nothing else we can do,” then I will agree that under medical supervision, find somebody that can give it a shot. I would never do it alone because I’m telling you, I’ve seen it. I would tell people, if I saw the fasting cure cancer, even in mice, I will say absolutely, but I would say for the great majority of people combine it with the chemo because now we’ve shown even clinically that the fasting can protect against the chemotherapy side effects.
Now, even if you use low dose chemo, that’s a powerful combination. Because now, you’re protecting the normal cells, not the cancer cells, and the fasting is really making it very difficult for the cancer cells to survive. I would say, if I didn’t have any other options, that may be a very good thing to consider, but talk to somebody that has done hundreds and hundreds of them and knows how to deal with it. And it has to be done in a compassionate use. There are ways to do this formally for compassionate use, basically saying to the patient, “There is really nothing else we can do for you, so this is what we’re going to try. It might kill you, but there is nothing else, so it’s worth the risk.”
That’s how it has to be explained to the patient because, for example, your immune system, which is the number one protection against the cancer, is going to shut down or really be reduced after two or three weeks of fasting. That alone could make the cancer grow faster and not slower.
Robyn: Fascinating. Well, thank you so much for teaching us so much about longevity, and cancer, and addressing disease states, and reversing the effects of aging, and maybe even reversing some disease states. I think what you’re doing is so exciting. I’m so grateful that you’re with us today. Tell everyone where they can find you. The book is The Longevity Diet by Valter Longo, PhD. Where else?
Valter: Well, people can also follow what we do on Prof Valter Longo, P-R-O-F, Valter Longo Facebook page. There you can also get the book, and once every few days we put up papers. We try to filter papers that are looking at integrative medicine that are from high-reputation journals, and also we provide, usually, an article from a newspaper so that people can understand what the content was.
Those are the two main sources. Also, createcures.org, createcures.org is the foundation and people can go there and donate if you want, or also pretty soon we’re going to upload a lot of the papers, almost all the papers from my lab so people can download them for free and just follow the type of studies that we’re doing.
Robyn: Well, fantastic. I hope that next time we’re both in LA or the next time we’re both in Milan, I’m in both places pretty often, I hope we can get together and make plans for how to help more people. Thank you so much for being on the show.
Valter: Absolutely, yeah. Sounds good. Thank you.