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1. Intermittent Fasting ‘’ Mens Sana In Corpore Sano’’

2. Intermittent Fasting What is it? What does it have to do with keto diet? How can it help me? How to do it ?

3. Fasting vs. calorie restriction FASTING Body turns on ketosis Ketosis causes fat loss No refeeding syndrome to cause later weight gain No stress response by body if not done in extreme CALORIE RESTRICTION Body never fully turns on ketosis Fat is lost, but refeeding syndrome occurs and fat is rapidly regained Body is stressed and cortisol is high In its extreme leads to starvation

4. Intermittent Fasting: what it is NOT IF is not STARVATION Starvation = involuntary lack of nutrition Extreme calorie restriction leading to bodily stress & protein breakdown

5. Intermittent Fasting is… A form of fasting Fasting = the voluntary & complete withholding of eating food, while maintaining fluid status Most commonly is a prolonged overnight fast But can be done over the course of days A few days/month or a few days/year as a “detox” A time of body healing and rejuvenation i.e. “ autophagy ” An enhancement of ketogenic diet

6. Fasting: a normal body process We were designed to NOT EAT for prolonged periods of time Religious fasting has been observed for centuries without harm to millions of people Everybody fasts overnight and between meals The body maintains energy production by a combination of glycogen burn, gluconeogenesis and ketosis The body maintains blood sugar Through breaking down stored glycogen first By gluconeogenesis in the liver

7. Fasting 101 "Fasted" just means no food is immediately available for energy production by the body. the body has to look inward for an energy supply. It will first burn through stored sugar called glycogen that is stored in the liver and muscles. Then, it will burn up its fat reserves by ketosis

8. Comparison EATING Burn primarily sugar Gain weight = high calorie intake No gut rest May proliferate wrong gut flora FASTING Burns fat Lose weight = NO calorie intake Rest the gut Turns on autophagy Lifespan advantage

9. Review of the medical literature Review article by Patterson, et al in the Journal of the Academy of Nutrition and Dietetics published 2016 Most were small studies Some mice, some human, a few cross-over Multiple types of “intermittent fasting” routines Complete Alternate Day Fasting Modified Fasting (based off 5:2 diet) Time-restricted Feeding (like 16:8 fasting) Religious Fasting (Ramadan, Seventh Day Adventists, Latter Day Saints) Source https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4516560/

10. Some general similarities Decrease in insulin and blood sugar Decrease in markers of inflammation ( hsCRP , TNF-alpha, etc.) Decrease in triglycerides, increase in HDL WEIGHT LOSS! Mood stable through the fasts Sensation of hunger was not severe NO HARM to test subjects Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4516560/

11. Source: Patterson RE, et al J Acad Nutr Diet. 2015 Aug, 115 (8): 1203-12

12. What you feed your gut matters! Good stuff AKA “pre-biotics”; BAD stuff = “junk food” These are preferred foodstuffs for “good” gut microbes Impacts their reproduction Impacts the mucus layer of the gut Impacts cell-cell signaling Impacts inflammation via the immune system Ultimately impacts your own MORTALITY AND MORBIDITY!!

13. Gut Microbiome and Human Health Nearly 80% of all basic biologic science papers written since 1977 have focused on the gut biome and its relationship to host health and disease ! This has been mostly ignored by the medical community 20 years behind “bench” research that is of clinical relevance  numerous studies have reported changes in the gut microbiota during obesity diabetes liver diseases cancer neurodegenerative diseases Autoimmune diseases

14. Intermittent Fasting is a strategy Use it to enhance ketosis Increase internal fat burn Improve blood sugar Increase weight loss Decrease inflammation Rest your gut Induce autophagy Kill cancer cells Recover from chemotherapy

15. A simple way to start Start with extending your overnight fast by 2 hours, 3 days/week (14:10) Once you’re comfortable, extend it out to 16:8 If you’re tolerating 16:8 three days/week, increase to 5 days/week Ultimate goal would be 16:8 every day of the week

16. Be mindful of these symptoms…

17. Contraindications to Intermittent Fasting All of the following people should NOT routinely intermittently fast: 1. Pregnant or nursing mothers 2. Diabetic patients (unless supervised by a physician) 3. Infants and Children 4. Those people who have suffered from eating disorders such as anorexia or bulemia

18. Conclusion It is to your benefit to NOT EAT Intermittent fasting by extending the overnight fast is easy and effective without adverse effects IF enhances ketosis IF helps you enjoy the benefits of autophagy as a cellular mechanism of rejuvenation Fasting is linked to longevity

19. Thank You