FMD is a 5 day severe diet. I do it once a month. Had personal issues in 2024. Ate SAD. Ballooned from 220 to 300+. Started eating right in October 2024. Got disciplined last month. Down to 235. If anyone is interested I designed a diet plan that seems to work. Love your comments Max. I designed the diet for fat loss, muscle hypertrophy, and PCa control.
Clinical trials.
Complete:
The impact of a fasting mimicking diet on the metabolic health of a prospective cohort of patients with prostate cancer: a pilot implementation study - PubMed
The originator of the FMD (Fasting Mimicking Diet), Valter Longo, has new book out, titled Fasting Cancer: How Fasting and Nutritechnology Are Creating a Revolution in Cancer Prevention and Treatment
I have not yet seen the book, but he has a recent Rich Roll podcast (his 3rd) where he updates the results of recent FMD trials with commentary specific to cancer. BTW, my Warrior friend, he says they are getting excellent results from a 1 x quarterly fast (combined with a relatively generous regular "time-restricted-eating" period of 12-15 hours), as opposed to the monthly fast that he used to suggest as optimum - and what you must have tired.
Here is a link to the RR podcast (his earlier ones are also provide excellent insights into the effects of fasting on health):
Unrelated to fasting, but on a recurring topic related to healthcare and cancer (i.e., exercise), you might also want to invest the time to watch this RR podcast with Dr. Rhonda Patrick. She is fluent in the current science on this topic and most other ones she pursues. Two other topics she has deep knowledge of are the effects of sauna use and of sulforaphane (produced by broccoli sprouts and now available in activated supplement form). Info on those topics can be found on YouTube and at her website, "Found My Fitness". One of the most thorough investigators around.
Eat a healthy diet, restrict eating for AT LEAST 12 hours daily, get 7-9 hours of RESTFUL sleep, reduce/eliminate stress, and exercise regularly. Those are the foundational elements of a healthy and robust life.
Thanks. Ill check the links out. I'm looking into the book now. Just came out. Perplexity: "Overall Quality of Evidence
Without access to the full book contents, it's difficult to assess the quality of evidence presented. However, given Dr. Longo's reputation as a leading researcher in nutrition and aging, the evidence quality is likely to be high."
As you may know, Longo started out researching longevity - based on the well-founded evidence for caloric restriction being strongly correlated to longevity in humans and confirmed in numerous animal studies. One of the most endearing qualities of Longo is his recognition of the difficulty most people with active lifestyles have with multi-day forms of water-only fasting. That is what led him to create the FMD in the first place, as reducing dietary calories to ~ 800 per day during the fasting cycle still provides enough calories for most people to maintain their essential daily routines. As clinical results have come in for the FMD, he has extended the fasting interval to quarterly, which should also allow more people to maintain it over time. The other components are the 12 hr MINIMUM time-restriction period for food intake, which also should not be difficult for even slightly- motivated people to maintain, and a near-vegan diet. (I would expect that something more like 15 hours is a better target.)
For the past several years I have been doing regular 3-day water-fasts. Starting last year, I am doing them once a quarter, with my next one coming up in several weeks. Sometime last year, I began to question multi-day water-fasting based on some discussion in a Peter Attia podcast about loss of muscle mass. Since I was likely sarcopenic when I rejoined the Y back in Jan 2023, my primary goal has been to rebuild as much muscle mass as possible.
However, when I listened to the RR podcast with True North Health Center founder, Dr. Alan Goldhammer, where he describe how they do long-term fasting at their clinic, I understood the need to chill-out for the fast period and ease back into a normal diet and lifestyle routine at the end of the fast. Attia described traveling, working, and being physically active during the water-fast period, so it didn't seem surprising to me that he might lose muscle mass, as sans food intake, the energy has to come from somewhere. And if you are as lean and fit as Attia is, it would likely at some point have to come at least partially from muscle.
I would venture a guess that Dr. Goldhamer has more experience with medically- supervised water-only fasting than anyone in the world, with some fasts extending to 40 days! This podcast is a perfect companion to that of Longo:
Episode #541,THE CRAZY BENEFITS OF WATER-ONLY FASTING WITH DR. ALAN GOLDHAMER
Short, long, or FMD, there can be little doubt that fasting contributes to better metabolic health. After all, when considering our evolutionary history, humans obvious experienced regular periods of scarce food supply and involuntary fasting of indefinite periods.
Eat less, mover more. Part of the way we can improve our overall health.
When I saw the quarterly recommendation I knew that was so it makes it easier to adopt. Same with the TRF window.
Make it doable or else nobody does it Many things work that way. I used to bodybuild and the more you put into it the more you got out of it. But is it maintainable?
I'll do a monthly FMD but an extended water fast? Been there, done that, and don't like them. I can go a day or so without too much pain. But after three I get so hungry that all I think about is food. Worse yet I have a hard time falling asleep.
It seems everyone must respond differently to fasting/being deprived of food. I've had one 3-day fast that went poorly. It actually caused me reconsider doing them, but after the Dr. Goldhamer podcast, I just took it very easy and was minimally active physically. Daily walks and a few minutes in the steam room at the Y and not much else other than reading, etc. That worked fine for me, so that is what I'll do going forward.
It seems to me the easiest fasting routine for people who are still working, is to do weekend water-fasts. You can even get close to a 3-day fast by not eating after lunch on Friday and starting back with breakfast on Monday. It is also important to stay well-hydrated and replenished with essential minerals daily. Since black coffee and tea are allowed, hydration becomes essential, due to them both being diuretics. I try to find a hydration supplement with zero calories (and no artificial sweeteners) to make sure once a state of ketosis is established, it is maintained for the rest of the fast period. I use urine test strips for ketosis and I can see the first signs of ketosis at about 24 hours in. I also usually lose about 5 pounds over the 3- 3 1/2 day period (mostly water weight) which comes back within a week. It is actually pretty amazing for me, as I can see a noticeably better definition of a six-pack at the end of each day. In fact, that's usually how I can tell it's time to do another fast,; i.e., when the six-pack becomes somewhat shrouded by some belly fat.(Understand that I'm not quite 150# in gym clothes, so at 5'-9", I'm a pretty lean 32-33" waist 22-ish BMI)
Many people lose the hunger sensation after a day or so - and once the digestive track gets to rest, some feel a resulting boost of energy (no longer needed for digestion). I can't say I've consistently experienced those sensations during a fast. However, producing the discipline to go without eating for 3 days should be a very empowering experience for anyone who can do it. As I read a comment somewhere to the effect of: " Once you have demonstrated that you can go 3 days without eating, resisting the urge to have a snack several hours before dinner becomes a breeze.
I used to do one week fasts once a month and OMAD the rest of the days (try downing 3500 cals in half an hour). But I don't want to do them so I stopped. I like working out (5x5s), hiking, basketball, etc. If you go hard during with no fuel, bad stuff can happen. Plus you can't work out with as much weight - probably saves you. I'm a wuss. I admit it. I want my cake and I want to eat it too (does that saying even make sense?). Yeah, we all react differently. I've heard over and over that fasts get easier and you just need to get over the hump. Lol! I just get hungrier and hungrier. And cranky. And I can't workout which makes me even crankier.
I did a 10-day water only fast at True North in 2019. After I left I switched totally to whole food plant based diet, no alcohol, soft drinks, processed boxed foods, etc Great experience with Dr. Goldhamer and his crew.
I tell people I'm wired differently re: food. I can easily eat 700 calories a day (FMD). Or I can go keto, or high carb, or OMAD. But fasting, different there too but in the opposite way. I just get hungrier and hungrier until I can't sleep and can't keep my mind off food. Usually around the four day mark I cave.
It's never pleasant to get started. Water only is especially tough. Even black coffee, even decaf, helps tremendously--but that's not water only. Fortunately colonoscopies consider black coffee a "clear liquid!"
Another example of my screwed up wiring. The first 2 days of a fast are super easy for me and almost a relief because I don't have to be bothered with food. Then it gets hard. I've gone a week several times. But I hate it after the first couple of days. Gets harder rather than easier.
I listened to the podcast some time ago and can't remember if Vit C was discussed. As you probably know, the story on Vit C seems to be that to get significant benefit from Vit C for cancer, it needs to be IV-infused. (I can't exactly remember the mechanism involved, but it goes beyond it being an anti-oxidant.) I also don't know if oral liposomal Vit C appreciably changes its effectiveness for combating cancer?. I do remember from way back that we excrete much of large oral doses out in our urine, so it's better to take smaller dosages throughout the day.
Underlying all this is that, taken orally, Vit C is primarily an anti-oxidant - and we know anti-oxidants (as a general cancer strategy) are better used to prevent cancer, rather than to treat it. That seems especially the case for anyone doing RT, as radiation kills by inducing oxidation, so anti-oxidants can possibly protect even cancer cells from the radiation induced ROS. (Note that when I was doing my IMRT, I did use the curcumin as I mentioned in another post, but I stopped all antioxidant supplements and reduced/eliminated as much as possible known anti-oxidant foods from my diet.)
liposomal Vit C.. I spent some time on that. I bought a number of expensive lipo formulas. I tried them with and without various absorption enhancers. I'd have my serum C measured. Over and over. My final conclusion: liposomal gets serum C conc up no more than regular oral C.
• Repeated dosing (e.g., 12–18 g every 4 hours) sustains >100 µM.
3. Oral Vitamin C:
• 3 g standard dose achieves 220 µM.
• Bioavailability limited by intestinal absorption; doses >3g do not significantly increase plasma levels.
My infusions were approx. 1.3 g/kg. I measured most infusions and, as I recall, the peak was always 22-26 mM. As you can imagine, taking orals, synergists, liposomal, didn't seem to budge the needle.
About what I expected on the Vit C, esp. the liposomal. Seems the only real ways to enhance absorption for poorly- absorptive supplements would be with nano formulations.
Our very long lost friend, Scott aka Lulu, did IV-Vit C and hyperbolic O2 treatments. He was even considering building his own O2 chamber, but I don't know if he ever did.
I am being contacted by Longo's team every month, sooner or later I will go to Milan when he is there and have some talk. Personally I used to do a 16-8 fasting that with daro is not sustainable so I am glad to know that a 12-12 can be effective! And I do 5 days of FMD (between 400 and 450 kcal per day) the week before my zometa, every 28 days. I am always surprised by the mind sharpness I can reach from day 2. And I get into ketosis by the end of day 2 normally.
Ask him about whether we need to have day 1 be a lead-in. Does it need to be higher in calories than days 2 - 5? And, if you could, ask him about BHB. It supposedly puts you into ketosis faster and deeper. I haven't tested that out and Longo likely already has data or theories.
I am taking my time to reply to them because if I must spend my $$$ for a customized plan at least I want to talk to him directly. I am sure his researchers are good but I want to ask a few questions to him directly. Personally I avoid the first day induction at 1000 kcal, but I try to stay lighter than usual the day before I start. And even if he suggests low proteins during FMD I workout as usual during those 5 days so I add one scoop (15g) of veggie proteins (80%) after my workouts.
That was another thing I was wondering about. Can I increase my protein a little. Maybe BCAAs? Whey? 10 extra grams. Reduce my fats or carbs to make room for the calories.
Technically Longo proposes high fat (olive oil mainly) low carbs and very low proteins for those 5 days. The idea is that low proteins block certain chemical reactions and this would help the body to reset. I am oversimplifying of course.
Yeah, makes sense. The reason I'm wondering about the extra protein is that intense resistance training results in micro traumas and hypertrophy. Estimates vary but 20-40 g of extra protein for a one hour intense session seems to be a ballpark. During FMD I don't have the energy for a full hour. 45 minutes is pretty doable though.
I'm wondering if he has characterized it. Maybe theoretically like for muscle protein synthesis. If MPS is higher and protein is shuttled into muscles, does it still stimulate IGF-1, etc?
Edit: I looked into it and it seems like a "usually it does, unless it doesn't" type thing.
Has he looked into supplementing sodium selenite during FMD? Maybe an experiment since we can measure IGF-a?
The SELECT trial found no cancer-preventive benefit from selenium supplementation despite preclinical evidence that selenium reduces IGF-1 (a growth factor linked to cancer). This discrepancy likely stems from key mechanistic and methodological differences:
Key Factors Explaining the SELECT Paradox
Factor Rationale
Baseline Selenium Status SELECT participants were selenium-replete (median baseline serum Se: ~135 ng/mL)[^4], unlike prior trials (e.g., NPC) that recruited selenium-deficient populations. Supplemental Se may only benefit deficient individuals[^5][^7].
Selenium Form SELECT used L-selenomethionine, which may lack the IGF-1-lowering effects of sodium selenite (used in animal studies)[^1][^3]. Sodium selenite inhibits IGF-1 signaling more potently[^3].
IGF-1 Reduction ≠ Cancer Prevention Lower IGF-1 alone may be insufficient to counteract prostate carcinogenesis driven by oxidative stress, inflammation, or genetic factors[^3][^6].
Trial Duration SELECT’s 7-year follow-up may have been too short to observe IGF-1-mediated effects, as prostate cancer develops over decades[^4][^6].
Participant Age SELECT enrolled older men (≥50–55 years). IGF-1’s role in early carcinogenesis may require intervention at younger ages[^3][^7].
Speculative Mechanisms
Selenoprotein Dynamics:
Selenium upregulates selenoproteins (e.g., GPx), which may paradoxically protect cancer cells from oxidative damage while lowering IGF-1[^3][^7].
Compensatory Pathways:
Reduced IGF-1 may trigger compensatory upregulation of FGF-21 or leptin, promoting tumor growth via alternative pathways[^1][^3].
Lessons from SELECT
Heterogeneity Matters: Selenium’s effects depend on baseline status, formulation, and genetics.
IGF-1 Is Not a Standalone Biomarker: Lower IGF-1 does not guarantee cancer protection in complex systems.
Conclusion: While selenium reduces IGF-1 in controlled settings, its cancer-preventive effects in SELECT were likely nullified by population selection (non-deficient subjects), suboptimal formulation (L-selenomethionine), and multifactorial carcinogenesis pathways.
The SELECT trial was so flawed I don't understand why people continue to read it - other than to find out how to select supplements destined to show no benefit for a specific disease.
It's become a self-perpetuating creature like the women's health study. Naysayers love to tout them and scientists have no choice but to discuss them when they point out issues.
WHS conclusively proved that women might want to think twice about synthetic hormones and mare piss. Ouch, lots of issues. Interpretation is terrible also. 1 in 100,000 participants got "x" when not given anything. Then we gave them unnatural toxins and the 100,000 got "x" twice. That's an increase of 100%!
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Many things work that way. I used to bodybuild and the more you put into it the more you got out of it. But is it maintainable?
Fish consumption and PCa Mortality. A meta-analysis.