Fasting with Dr. Daniel Pompa: Rational Wellness Podcast 161

Dr. Daniel Pompa discusses fasting with Dr. Ben Weitz.

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Podcast Highlights

2:37  Some of the smartest doctors in the Functional Medicine field just happen to be chiropractors.  The reason is because we share a major premise that the body has innate intelligence that heals itself if we just remove the interference for this. 

3:13  Dr. Pompa became interested in fasting in the 90s from his involvement with a vegetarian group that was inspired by some books by Herbert Shelton on fasting and he went to some of the seminars. At that time, fasting was not very popular.

4:15  Intermittent daily fasting is where you don’t eat for a period of time that could be 12 or 15 hours or even 24 hours.  Extended fasts are where you go without food for between 2 and 5 days. And there are certain conditions that will benefit from an even longer fast.  Dr. Alan Goldhamer, who I interviewed on episode 116, has patients do a 30 day medically supervised fast.  30 Day Fasting with Dr. Alan Goldhamer: Rational Wellness Podcast 116   

5:36  Dr. Pompa discussed a patient that he fasted years ago for a grapefruit sized tumor for about 26 days. It took that long to reduce the tumor to the size of a golf ball. She was detoxing and her tongue went from coated white to green to black and fuzzy her family had to cross ventilate their house since she smelled so bad.  When you do a 5 day fast, the magic happens after 3 days when you have lost your hunger and you get your energy back. Day four we hit max autophagy, which is when your body eats broken down and damaged cells, organelles, and even DNA and recycles these proteins and nucleic acids. So then you continue the fast one more day for 5 days to really take advantage of this autophagy and then you see a massive rise in stem cells to rebuild and massive rise in growth hormone as well. The benefits of a fast tend to decrease after 5 days, so multiple 5 day fasts is the way to go in order to maximize autophagy and allow the body to heal itself.

9:22  Dr. Pompa prefers to do water only fasts, but he often starts clients with a partial fast, such as using the five day partial fast developed by Dr. Valter Longo, which makes it easy. You just eat what’s in this box, nothing else, for 5 days. You can design such a program yourself and Dr. Pompa in his Beyond Fasting book explains how you can design a partial fast around the foods that you like.

11:12  With a partial fast you get a lot of the benefits of a full fast. You still get autophagy and stem cell production.  It is helpful to work up to a complete water fast by starting with a partial fast that contains between 500 and 1,000 calories, depending upon the person.  But such a fast does need to get the protein levels down to below 15-20 grams per day, depending upon the size of the person.  Many of the studies that look water only fasts do not see as many results as Dr. Pompa’s patients get because they prepare and train for the fast so that their body is fat adapted and ready for the fast, much as you would train to be able to run a marathon. He lays out a seven week program in his book, Beyond Fasting, for how to prepare to do a 5 day water only fast. With a water only fast you get energy divergent where your body uses it’s energy that does not need to help digesting food and this energy can be used to help the body to heal, whether it’s a knee or the kidneys.

14:18   Fasting can actually stimulate the immune system and that could be very helpful during this coronavirus pandemic. Back in the 90s fasting was considered to be harmful to immunity because during a fast you might see a drop in white blood cells, but this is actually part of autophagy and it is getting rid of old white blood cells which we call senescent cells that drive inflammation. Then, a month or so after the fast you will see an increase in the immune system to preventative levels.  With fasting we also see an improvement with patients with autoimmunity.

16:48  To prepare for a 5 day water fast, it is advantageous do a ketogenic diet to get your body to become fat adapted. If your body is fat adapted, you may start having autophagy on day one of your water fast instead of on day three.

18:12  The key to weight loss is to eat less often rather than eating less, according to Dr. Pompa.  If you eat too few calories for too long, your metabolism will slow down and your body thinks it is starving and it will hold onto fat but break down your muscle and turn it into sugar for fuel. Dr. Pompa noted that he eats only two meals per day in a 4-5 hour window and one of these meals he eats until he is a bit beyond full, which signals the body that you are not starving and you can burn fat for fuel.

22:32  For many years it was believed that the key to losing weight and being healthy was to eat breakfast and to have small, frequent meals throughout the day to keep an even blood sugar, so that you didn’t eat too large a dinner.  But by doing this, you never give your body a chance to burn its own fat because you are always feeding it.  And it’s a bit ironic that now one of the keys to losing weight and being healthy is to skip breakfast so that you are doing an intermittent fast. Dr. Pompa pointed out that because of the Dawn Effect, where you get a rise in blood sugar from the morning rise in cortisol, it is easy to have energy in the morning without eating anything. Hunter-gatherers in Africa usually just eat one meal per day. The men are up early and spend all day tracking down and hunting prey and they don’t eat until evening when they come back to the tribe in the evening and they would eat together.  And these hunter-gatherers were lean, ripped, and healthy.

25:48  On the other hand, Dr. Pompa said that if it works better for your schedule to skip dinner rather than breakfast, then that works as well. The key is giving your body time to go through autophagy by not eating for a period of time and it doesn’t really matter what meal you skip. 

26:33  When people follow a ketogenic diet for too long, the body will think it’s starving and will hold onto fat. We have to have periods of feasting as well as periods of fasting. And we should change our diet based on the seasons and environmental changes.

27:43  To measure cellular aging vs biological aging we can use telomere testing.  Telomere testing measures the length of our chromosomes and we now have DNA methylation testing. Looking at your telomere length is like looking at the tread you have left on your tires. To promote better cellular aging it is best not to do low carb or keto for too long.  It’s best not to do too much fasting since stimulating autophagy long term is not good. It’s also not best to do vegetarian all the time or to eat a bodybuilding high protein diet. For short periods, a high protein diet can be healing, but for long term, high protein will age you by stimulating the mTOR pathway. It’s best to alternate periods of fasting with feasting, moving in out of low carbs and higher carbs. The magic is in the change.

30:12  While a ketogenic diet has less fiber and stresses the microbiome, this will actually help to increase bacterial diversity once you come off the ketogenic diet.  By stressing your microbiome, you stimulate change and improvement, much like exercise stresses your system to make you stronger.

34:46  When you follow a ketogenic diet initially you start to burn fat for energy, so you produce ketones and during the first week or so you spill a lot of ketones into the urine and these can be measured with ketostix. But once your body gets used to using ketones for energy, when you become fat adapted, you will no longer spill a lot of ketones into the urine, so you need to measure ketones in blood instead of in urine.


Dr. Daniel Pompa is a global health leader and innovator on a mission to educate practitioners and the public on the origins of inflammation-driven diseases, cellular detoxification, fasting strategies, and diet variation principles.  Dr. Pompa is the host of Cellular Healing TV, and the author of the books Beyond Fasting and The Cellular Healing Diet. His website is DrPompa.com.

Dr. Ben Weitz is available for nutrition consultations, including remote consults via video or phone, specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111 or go to www.drweitz.com. Phone or video consulting with Dr. Weitz is available.


Podcast Transcript

Dr. Weitz:            Hey, this is Dr. Ben Weitz host of The Rational Wellness Podcast, I talk to the leading health and nutrition experts and researchers in the field, to bring you the latest in cutting edge health information. Subscribe to The Rational Wellness Podcast for weekly updates. And to learn more, check out my website, drweitz.com. Thanks for joining me and let’s jump into the podcast.  Hello, Rational Wellness Podcasters. For those of you who enjoy listening to The Rational Wellness Podcast, please give us a ratings and a review on Apple podcasts. If you’d like to see a video version, please go to my YouTube page. And if you go to my website drweitz.com, you can find detailed show notes and a complete transcript.

                                Today our topic is fasting with Dr. Daniel Pompa. Fasting is one of the oldest healing strategies in natural medicine. And it’s been advocated for thousands of years by alternative health care practitioners and utilized by almost every religion today that’s around. For years the medical community has essentially dismissed fasting as having no randomized double blind clinical trials, proving that fasting has significant benefits for reducing or curing diseases. But the studies have been accumulating especially on intermittent fasting. And Dr. Valter Longo of USC has been publishing a number of scientific articles and a book that have really been placing the spotlight onto fasting, highlighting some of the anti-aging benefits with his fasting mimicking diet program that involves eating a low calorie diet while eating only food products contained in his ProLon kit. That includes a low protein vegetarian nutrition plan.  Dr. Daniel Pompa is a global leader, and an innovator on a mission to educate practitioners in the public on the origins of inflammation driven diseases, cellular detoxification, fasting strategies, and diet variation principles. Dr. Pompa is the host of Cellular Healing TV, and the author of the books Beyond Fasting, which is going to be the focus of our talk today, and The Cellular Healing Diet. Dr. Pompa, thank you so much for joining me today.

Dr. Pompa:         Yeah, thank you for having me. I love these topics.

Dr. Weitz:            I just think it’s so interesting that I’m a chiropractor. You’re originally a chiropractor So many of the smartest people in the functional medicine world are chiropractors for whatever reason.

Dr. Pompa:         There’s a reason it’s because we share a major premise of the fact that the body has innate intelligence that heals itself and all we can do is remove interference and it does, right? And so fasting is one of those things that harnesses that innate intelligence and allows the body to heal itself, and that’s the magic. That’s why we all unite around that philosophy, honestly.

Dr. Weitz:            How did you get so interested in fasting?

Dr. Pompa:         It was back in the ’90s. I joke because I say it was just me and some natural hygiene society guys that were into fasting. That was a vegan vegetarian group, but they were all really big into fasting and there’s a guy named Herbert Shelton that read a lot of books on fasting and so I would go to the seminars. I was intrigued by fasting because again, it’s the philosophy of the innate intelligence, right? It’s like the body heals itself.   Yeah, I got very sick, so it was something I had to apply to myself but fasting does, it harnesses that innate intelligence and my fascination with it came out of that.  Back then it was very few people are into it.  And now it’s popular, I just had to stick around for 20 more years.

Dr. Weitz:            These trends in natural health world. So what is the definition of fasting? And then what is intermittent fasting? Because those are two terms you hear a lot, and I think there’s some confusion over exactly what fasting includes.

Dr. Pompa:         Yeah. So intermittent fasting daily is where you just don’t eat for a period of time, maybe it’s 12 hours, 15 hours, 24 hours, right? That’s an intermittent fast and you can do it daily. Now, extended fasts are when you take and you go without food beyond that, maybe it’s two days, maybe it’s three. I prefer and always have five-day fasts. And I believe there’s a magic number in that five days. But with that said, there are certain conditions that you will benefit fasting longer.  But there’s also a time to stop fasting and we talk about all those things but extended fasts has different benefits. Some of the same benefits is intermittent fasting daily, where you just do that 15 hours, 18 hours, whatever it is. So some of the same benefits you pick up even at a short fast like that, but certain conditions, certain health aspects, extending it longer is critical.

Dr. Weitz:            Yeah. I interviewed about a year ago Dr. Alan Goldhamer and he-

Dr. Pompa:         Yeah.

Dr. Weitz:            … puts people in 30 days medically supervised fasts.

Dr. Pompa:         Yeah, and there’s a time for that. Back in the day, I took some people through some really long fasts and they definitely have to have more body stores just to put it nicely. Certain tumors, a bit longer fasts. I fasted a woman, it was probably about 26 days, she had a grapefruit sized tumor and man it took that many days to bring it down to it was about a golf ball. And then she fasted like another week after three months and then she got rid of it completely.  But in that time, her first week was horrible. She was detoxing, her tongue went from coated white to coated green to black and fuzzy and her family literally had to cross ventilate the house. They had a fan on one side and they would open the windows and blow it through because she stunk up the whole house, right?

Dr. Weitz:            Wow!

Dr. Pompa:         In the first week, she came in complaining to the clinic everyday. Oh, my gosh. Right? And then after that she came bounding in every day with her reports of healing. So I’ve watched fasting really deep, deal with some incredible things and I’ve watched incredible things happen with the fast. But I learned through that process is shorter, five-day fast. You can achieve the same thing with a lot less pain, multiple five-day fasts. And why five days? Because look, it takes about three days for people to go, “Okay, I can do this. I actually lost my hunger. I actually have energy back.” So I would always carry them at least one more day, right? But again, three days is suffering. So day four was like, “Okay, it’s a good day.” So why not carry an extra day, day five, when they finally feel good to get that healing. Look, I didn’t know a lot of the science back then because there wasn’t any frankly on some of this.

                                Now, we know that some magic happens day four, we hit max autophagy. What autophagy is, is this happens during fast, the body to get energy eats. It’s so intelligent. Here’s that inborn intelligence thing right, that heals the body. It’s so smart, it wants to survive. It will eat only the bad cells of the body. It’s that smart to even know, here’s bad DNA, here’s a bad cell. It’ll take those out and not harm the good cells. So autophagy is the body getting rid of these bad cells and other debris and rubbish that it needs to get rid of. It’ll eat that first. That’s autophagy. So when I use that word autophagy, so think of auto automatic. Phagy as eating, so automatically eating the bad.  So what happens is, is during that this fast, day four we have max autophagy, meaning that all of a sudden the body’s just crushing bad cells, why would you cut it off then? And then day five, we see what we call max stem cell production. Because every time the body gets rid of a bad cell, it doesn’t just go, “Oh, you’re going to have to live without that white blood cell.” No, it stimulates and produces a new white blood cell via of the stem cell production. So about day five, we see this massive rise in stem cells.  And then after that, there’s a plateau effect. So if we do multiple five-day fasts, we maximize the autophagy, we maximize the stem cell production and we also maximize the hormones. We have this massive growth hormone rise that takes place day five. So multiple five-day fasts is how you can shut off autoimmune-

Dr. Weitz:           And a fast for you is water only right?

Dr. Pompa:         Yeah. I do prefer water only.  So you mentioned Valter Longo, right?  I love Valter and his group.  Pleasure to work with them.  I thank God for some of his studies because he really brought what we learned clinically years ago five-day fast is he’s the one that really spearheaded that max autophagy, max stem cell and some others have done that work too.  But so he’s brought a lot to this.  One of his studies was taking five months and this was an animal study, a rat study. Type 1 diabetic rats and fasting them. And really watching the beta cells regenerate because of the stem cell rise that takes place and after month four and five, we would see this the beta cells coming back and they were able to reverse the condition. So more and more studies, very exciting have been done, so I thank Valter for that.  But Valter and I definitely disagree in that I think that again, I train doctors on these topics. And clinically, I can tell you the most powerful still is a water fast.  Now, I still utilize partial fasting and I have for years.  So Valter’s fast where he boxed the foods for five days.  I’m a big fan.  I think it’s easy.  I think it’s a great partial fast, and I’ll explain what that really is because there’s a definition of partial fast.  I’ve used it for many, many years.  And oftentimes the first fast I’ll do with someone is in fact, a partial fast, and then move them to water fasting, which is a little more aggressive in getting rid of bad cells.  So I’m a fan of pure water fast.  But yet, I’m still a fan of partial fasting. Okay, so…

Dr. Weitz:            So partial fast, you’re not getting the same benefits as a full fast.

Dr. Pompa:         Yeah. You’re still getting a lot of benefits, you still get autophagy, you still get stem cell production. We have a way of measuring autophagy, and I talk about that in my book that doing your fast you can measure this in a very simple way. But we don’t see as much autophagy in a partial fast as a water fast.  And Valter really loves the partial fast. I have a lot of respect for him. But again, clinically, I just see, in a lot of the studies, they just put the average person into a water fast. It’s a mistake, you’re going to not see these major benefits. In my book. I have a seven week program. This is what you do five weeks up to the fast. Week six is the fast, week seven is breaking the fast. So it takes you through that whole process.  You don’t just run a marathon, you train for a marathon. So number one, you can finish it. And number two, you get the best result, right? So you don’t just do a fast. My book takes you through how to train for it. So a lot of the studies that just do look at water fasting or taking someone who’s not fat adapted, they’re not able to fast very well. So they’re not getting these benefits that I’m talking about right out of the gate.  So anyways, the bottom line is Valter has made the partial fast very popular, and he even boxed the foods that follow the rules of a partial fast. So what is a partial fast? If you have to get your calories, depending on body size down somewhere between 500 calories a day to 1000. Figure people can do a little more calories. Protein is important. You have to get your protein at least under 20 grams a day. The reason is, is if you have too much protein, it will knock you out of that autophagy. You won’t get any autophagy, so you have to get the protein down.

                                So a smaller person, you might need less protein, even under 15 grams of protein a day. So Valter put those in five boxes. So you have what it is you’re eating. In my book I give a partial fast, you can design it yourself around the foods you like, right? So I talk about that. But yeah, so partial fasting you still get the benefits, you still autophagy, you still get stem cell production. Water fasting, you get something a mass of what I call energy divergent, where your body has so much energy not eating any food, it has so much extra energy that it takes that extra energy and it just doesn’t sit on it and have a vacation. It takes it and all of a sudden the stuff that it wanted to heal, but it couldn’t because you never gave it a break. It takes energy and it starts healing it.  So maybe it was a knee problem from 20 years ago. All of a sudden, you get this knee pain, that’s the body healing it. It will divert these extra stem cells to the knee and start healing it. Maybe it’s kidney pain. Maybe it’s this pain, whatever it is, the body will take that extra energy, utilize its stem cells, and magic happens.

Dr. Weitz:            And of course, right now we’re going and at the time of this recording, we’re going through the corona virus pandemic. And fasting is actually something that can stimulate immunity.

Dr. Pompa:         Yeah, very much because, one of the things that back in the 90s was a criticism of fasting was it lowers your immune system. Because we would do blood tests, right? And you’d see this massive drop in white blood cells. Well, that can’t be good. But clinically, we’d say, “Wow! But we see the opposite.” We see autoimmune which is mean hyper immunity, which is really bad immunity, right? Where your body’s hyper responding, creating inflammation, sick people, people don’t feel well will have autoimmune even if you don’t diagnose, your body’s attacking itself, not good.  We see a lowering of the autoimmunity. And then we see this rise, especially a month or so after a fast of the good immune system would go up. Well, now, one of the Valter studies showed this drop in white blood cells is the autophagy, meaning the body gets rid of these old white blood cells, immune cells that are living too long. We call them senescence cells. They live too long, they cause mishit, they drive inflammation. They don’t work. They’re like union workers. I just insulted somebody out there. I didn’t mean to do that. I met like the bad union workers, the guys that sit around. The PennDOT guys or what are those? Government workers. There’s the word I was looking for, not union. Sorry, union people. My father was a union guy, didn’t mean that. The government workers they get paid anyway, so they don’t want to do anything.  So anyways, there’s probably better analogies out there but insult nobody. I don’t mean that. The point is, is these white blood cells that live too long, they just hanging around causing bad stuff to happen not doing their job. So what we learned is that drop in white blood cells, the body eats those guys out. And when we get rid of those, it stimulates a stem cell and it  creates a brand new white cell that is working and doing its job. So it’s like hiring the good employee again, right? It’s like, bam, doing everything correct. And so that’s how you end up with better immunity.  So right now, with this virus, I’ve recommended people to fast. My kids, they all fasted together, they did a five day water fast, and upregulated their immune system to preventative levels.

Dr. Weitz:            Cool. So, in order to do to get ready for the fast, in your new book you talk about putting people on a ketogenic diet. So what exactly does that consist of?

Dr. Pompa:         Yeah, so chapter one is fat adaptation, becoming fat adapted will get you into this autophagy instead of taking four days to get there, you can get there day one. And in the book I talked about, again how to measure that. We look at ketone levels, glucose levels, but there’s a ratio, but we can get there day one.  So chapter one is how to get your cells using fat for energy, because that will create more autophagy faster, and ketosis is that way of doing it. And then we take each chapter takes you through another step, then we start eating less often and we start doing some of that intermittent fasting. I call it mitochondrial fitness. We stress the mitochondria without eating in periods of time. Again, we’re training it for the fast that’s going to happen. And then I take you through some of my diet variation strategies, which is a whole nother subject, chapters four and five, really, how these various strategies take you to another hormonal level to become this efficient fat burning machine. So when you go without food, your body’s just crushing bad cells. So there’s a process there.

Dr. Weitz:            So in terms of weight loss, I know in your book, you say that the key to weight loss is to eat less often rather than eating less.

Dr. Pompa:         Yeah. Look, when we look at, especially in this country. We look at weight loss, you can’t flip a television on without a morning show anyway, talking about a calorie restricted meal, right? There’s a menu of low fat low calories, right? That is the cornerstone of weight loss still in this country, even though scientifically we know it doesn’t work. Now, when we say that though, people listening will say, “Yeah, okay. I want to believe you, but I restrict my calories, I lose 10 pounds.” And I would say, “You’re right, you do. And if you’re a bigger person, you may even lose 20. Gosh darn it, it works.”  Well, long-term it doesn’t because the weight loss ends up to be more muscle. Even if it’s fat, what happens is it’ll stop at a certain point because the metabolism gets lower and lower. As you restrict calories, the body eventually says, “I’m starving.” And when it says I’m starving, now it will start to use its muscle, break it down into sugar, it’s called gluconeogenesis. And then it will hold on to fat, which is not what you want. So therefore, now you can be down to 500 calories a day that used to work for you. Now you’re at 500 calories a day. And again, remember I said that a partial fast short-term, that’s great. But long-term, it’s very destructive to your metabolism and your health in general. So long-term caloric restriction does not work.   So how when we look at … we talked a little bit about anti-aging, right? You mentioned that I should say. When we look at that, there’s only one thing that really works for anti-aging, and that’s eat less. So you just said caloric restriction doesn’t work. So when we look at countries cultures that live long, healthy, we know they eat less, but they don’t do it the American way of pushing food away eating half your meal, caloric restriction. No, they don’t do that. They eat less by eating less often. And there’s our conversation of intermittent fasting daily.

                                So I typically eat two meals in a day in a very short window four to five hours. So I’m eating less often. At the end of the day, I eat less calories than the average American my age no doubt about it. But if I did the exact same amount of calories, but pushed my meals away, I still ate four meals a day or five meals or even three and I ate half of my meal my body would go, “You’re starving,” because you’re not eating too full. Something magic happens when you eat one meal to full a day.  So I always make sure I eat at least one meal to where I’m literally, even a little bit beyond full. The body likes that because it goes, “I’m not starving and I’ll keep using your fat.” If you start stopping meals and eating partial meals, the body will go, “I’m starving, and then it will start holding on to your fat.” So eat less often and eat too full would be the rest of that conversation.



Dr. Weitz:                            We’ve been having a great discussion, but I’d like to take a minute to tell you about the sponsor for this episode. I’m thrilled that we are being sponsored for this episode of the Rational Wellness Podcast by Integrative Therapeutics, which is one of the few lines of professional products that I use in my office. Integrative Therapeutics is a top tier manufacturer of clinician designed, cutting edge nutritional products, with therapeutic dosages of scientifically proven ingredients, to help patients prevent chronic diseases and feel better naturally.

                                                Integrative Therapeutics is also the founding sponsor of Tap Integrated, a dynamic resource of practitioners to learn with and from leading experts and fellow clinicians. I am a subscriber and if you include the discount code Weitz, W-E-I-T-Z, you’ll be able to subscribe for only $99, instead of $149 for the year. And now, back to our discussion.



Dr. Weitz:              I think it’s so ironic that I’ve been doing this for over 30 years. And when we started, the big key to helping people lose weight was the fact that people rushed out of the house with eating breakfast, and then they would eat too much for dinner. And so for years, the mantra was, you have to eat breakfast. You have to eat within an hour of waking up. You got to have small frequent meals throughout the day.  And it’s just so ironic that now … so before then the key to being healthy was having breakfast, having small meals spaced throughout the day so you can keep an even blood sugar. And now the key is skipping breakfast.

Dr. Pompa:            You know it’s funny as I some years ago, I think it was 2005 was the first time I had the opportunity to go visit this hunting gathering tribe in Africa. And I was still a four or five meal a day person, like you’re saying, right? That philosophy, and I saw something completely different. I saw a tribe, I said, “Where are the men?” They were up and gone at like 4:30 in the morning when it was still cool off in their hunts, tracking down pray, and they’d be gone all day to three or four in the afternoon. “So how do they eat? What do they do?” “They don’t eat at all.” They’re out all day tracking down pray. So oftentimes jogging, running, right? It’s like, “And they do without food?” “Yeah.” And then I noticed the women never eat, even the ones that were gathering. They weren’t eating because they would wait and eat one meal together as a tribe. Now that meal may have lasted three hours, right? They’d start eating and start preparing but, a very European way of eating.  And I was fascinated by it because these people were lean, ripped. Amazing, right? Without disease, it was a pretty amazing experience. It made me question that, like, what are we doing? It’s like, because every time you’re eating, you’re basically not allowing your body to burn its own fat. But like caloric restriction, it works in the beginning. Because if you’re eating five meals a day, your body’s not eating its muscle, it will prevent that. So it maintains the metabolism that way, and people feel that but the problem is, we never give it a chance to burn it’s stored fat, that’s what our bodies are designed to do.

                                So long-term, you want to live long, healthy, eat less, but eat less by eating less often, and that’s what we see very healthy in the Hadza people did this. So were basically short cutting something that works short-term, not long-term. And that was the five meal a day thing. And by the way, eating breakfast in the morning, that’s the most natural meal to skip. And the reason why is because you get something called the dawn effect. In the morning, oftentimes you’re not hungry because your body releases glucose. If you test your glucose, the highest glucose you have all day long in the morning, because your cortisol rises to get you up. That’s what gets you up in the morning. Glucose falls cortisol. So that just means your glucose goes up. And that gives you your energy for several hours after you get up, right? So that’s why you’re not hungry because your glucose is high because of your cortisol level. So that dawn effect of glucose we’re meant to run on, and then again, you can run on that for pretty long time.

Dr. Weitz:            Yeah. I know for me, for some reason, I do better if I have a good breakfast. And if I’m going to skip a meal, I’ll skip dinner.

Dr. Pompa:         I was going to say this. So people always asked me, “Well, which meal should I skip if I’m going to eat two meals?” I said, “Whichever one works best for you and your schedule.” In other words, if eating dinner is important to your family you can’t skip, then eat dinner. Skip breakfast. If for you it’s the other way around, right? And some people for diabetics, I’ll have them skip dinner and eat the breakfast and skip dinner. So it’s whatever works. The key is, is just opening up that time giving your body time to go through autophagy, and giving it time to fast. It doesn’t matter what meal you skip, really.

Dr. Weitz:            When people follow a ketogenic diet or try to follow a ketogenic diet, what are some of the biggest mistakes they make? Why are they not successful? Can’t produce enough ketones? What are some of the mistakes that people make?

Dr. Pompa:         One big mistake is, first of all, I’m not a believer that there’s one diet, you should stay on your whole life, right? That tribe that I spent time with, they were constantly changing their diet based on what foods they have, environmental changes. So in my book, I talk about seasonal variation, how important that is, and weekly and monthly variation. And if you’re low carb too long, the body will think it’s starving, and we need times of feast and we need time to famine. And that balance is emulating these really healthy cultures. So it’s really key for hormone optimization. And that’s really how we age slowly, right? So, I’ve been able to measure my cellular age every way possible. And I spent some time sick some years ago, and my cellular age was much older than my actual age. Now-

Dr. Weitz:            What method for measuring cellular aging have you found to be the most effective or accurate?

Dr. Pompa:         Well, telomere testing has gotten better.

Dr. Weitz:            Right.

Dr. Pompa:         That measures … It’s the biological clock that, protects our DNA and the shorter they get the closer you are to death, simply put. It’s gotten better and better and more accurate, but now that we have DNA methylation testing.

Dr. Weitz:            Right.

Dr. Pompa:         If the given analogy, looking at your telomere length is looking at the tread you have left on your tires. DNA methylation is looking at the parts of the engine, how well are your organs aging, compared to your … Look, I’m a mid 50s, I’ll be 55 this year. I’m getting younger every year at the cellular level compared to my actual age. And I was the opposite. And again, everything I’m saying right now is what I do and how I’ve done it, amongst other things. But you will age according to your cellular health. Honestly, on the outside is what I’m saying.  Right anyways, so diet variation strategies is a anti-aging strategy as well. Shifting your diet is critical. So the answer to your question is one of the biggest mistakes for people is they try to stay in ketosis all the time or low carb, big mistake. And again I’ll throw criticism both ways. Staying vegetarian all the time big mistake. Staying keto, paleo all the time, big mistake. If you want to die sooner, eat a bodybuilding diet high protein diet will age you sooner, right? But eating high protein for short periods is very healing, right? So it stimulates a pathway called mTOR, mTOR long-term is bad for you. Low mTOR stimulation short-term very good for you, that means high protein or high calories that stimulates mTOR.

                                So too much fasting is not good that stimulates the autophagy pathway long-term is not good. So variation, you need autophagy to get rid of bad cells, you need mTOR to stimulate production of new cells. So feast famine, I talked about in my book and how to do feast famine. So when people do ketosis, the big mistake is just staying in ketosis. Big mistake, you need feast, you need famine, you need moving in and out of high healthy carbs, low carbs. The magic is in the change.

Dr. Weitz:            Cool. You also talk about how ketones when you’re following a ketogenic diet helps to heal the gut and helps to diversify the microbiome. But one of the traditional criticisms of the ketogenic diet is that there’s not enough fiber which typically comes from starchy vegetables, beans, grains, seeds, and so that a ketogenic diet tends to starve the microbiome.

Dr. Pompa:         Great question. Let’s make it even more extreme. First of all, with the improved testing on being able to measure the microbiome or like the types of bacteria, the amount of bacteria in our gut, right, we call that the microbiome. That’s not just bacteria, but viruses, funguses, right? It’s all of these pathogens and everything that’s included in our gut.

Dr. Weitz:            Right.

Dr. Pompa:         Okay, so we have better testing to measure. The one thing that we can take away from all of this testing really isn’t what we thought in the beginning we would get, we thought, we’re going to be able to be able to, “Oh, there’s these bad guys, you have this too many bad guys, you have too many this.” It really didn’t turn out like that, it turned out to be diversity. If we look at very healthy people, their microbiome on a test versus unhealthy people, the one thing that stands out is not what type of bacteria, it’s the diversity of the bacteria. The more diversity, the healthier the person.  So the question should be then how do we increase the diversity? Stress the microbiome, honestly, just like how do I get more fit and healthy? Exercise, what’s good exercise? You have to stress your body, right. If you stress it too much, you won’t recover. Not good, right?  And the more the better shape you are, the more you can stress.  So fasting is a stress. When you change your diet, it’s a stress to your microbiome.  So my point is going to be this.  Take a carnivore diet, that’s an extreme diet of eating only meat and fats. Zero fat, okay. It’s caught on out there, right? People are showing their pre blood and post blood tests, you would think eating only meat and fat? Oh, my gosh, their cholesterol must go up. Obviously, it’s the opposite. Their blood test transforms.

                                Now, the challenge that I propose is stay on that diet.  Maybe genetics carry you a year, maybe two. But now all of a sudden, you’re going to see massive changes the other way.  Now, let’s pick on the other side, you have the vegans, right?  So I got on the diet.  I felt great.  Stay on that diet, we’re going to start to develop certain deficiencies. The point is, I love being vegan or vegetarian for a period of time, I love being on a carnivore diet for a period of time. So to answer the question how you increase the diversity of your gut, do those extremes.  So going without fiber for a month on a carnivore diet, it stresses those bacteria, oh, they don’t die, they back up, they get stronger, they get resistant, and then you start eating again. And they’re just they take off and they get four. So we know that the change of diet, the more you change your diet, like the Hadza people, the more diversity you have in your microbiome.  So it’s magic.  It really is.

Dr. Weitz:            Now it’s tricky to change your diet. I know over the years, when if I change from eating more animal protein to suddenly eating more fiber, initially, you start getting GI upset and your enzyme system isn’t ready for that change. So …

Dr. Pompa:         Yeah. To your point, and you know what’s happening because here’s what, your body has to change its microbiome to make the enzymes that it needs to start breaking down. Eventually, it adapts. So the advice is just take it slow. Take it slow. If you just drastically change, your body will catch up, but you’re going to have to deal with symptoms. All right, so if you just go slower, then maybe when you first start eating more meat, you’d have to take some HCL, digestive enzymes, HCl or bile, the body will change its microbial and start producing more bile, it will start producing more HCl. It’s that smart.  It is, but it takes some time.  So your question or your comment really gives an explanation for why the diversity increases because it has to survive.

Dr. Weitz:            Right. So when patients try to follow a ketogenic diet, a lot of people will recommend that they use these urine Ketostix. And that’s a way to measure if you’re excreting ketones in the urine, but some people use those through their whole ketogenic program and that’s not really appropriate, right?  Why is that?

Dr. Pompa:         Yeah. Ben, you’re well read. Yeah, you’re right. And I’ve had good doctors say, “Well, my diet gets you in ketosis in two days.” I’m like, “Really? How are you measuring that?” “Urine.” Okay. You eat more fat in the diet, you’ll start producing more ketones. You’ll see them in the urine. So what happens is ketones, let’s back up. What are ketones? I don’t know how educated you’re listening audience is. But ketosis means that where your cells can use two things for energy, sugar or fat. So when we become fat adapted or going into a ketosis diet, we’re shifting the cells energy to where 95, 98% of the energy is from fat, not sugar, right? So we reduced our carbs down to so low that it has to eventually to survive use fat. When it burns fat, it makes something called ketones because your brain can’t use fat as energy. It can only use sugar or ketones. So when we drop sugar down, it burns the fat. The body uses the fat as energy, and then it makes ketones and your brain uses the ketones.  Okay, so just a little bit of chemistry there. So ketones have a major healing effect on the body for your brain. We know that keto diets would take people out of seizures, neurodegenerative conditions, alters people’s brains wake up. Hugely healing for the brain and the gut. That was one of your questions earlier.   We also know studies the ketones help heal the gut. Again, staying on the diet can create problems, down the road, but by shifting people over into this fat about the diet and making ketones, it’s magic. So the first week or so we see this urine rise up if ketones, and then we see it go away. Well, where did they go? Because now the body’s actually using the ketones and you don’t see them in the urine anymore. So it takes about two weeks for someone to fat adapt to become keto adapted. And one of the telltale signs is you don’t have ketones in your urine as much anymore. So means your body’s finally using. So we can’t use urine as a good measurement. You have to use a little blood.

Dr. Weitz:            Right. So let’s see. How long do you recommend people follow this ketogenic diet?

Dr. Pompa:         Again, it’s different for everybody, and it’s interesting, because one of the things that some of your viewers may be saying is, “I tried it, didn’t work for me.” And, well, that’s just that it works for everybody because the body is meant to go in these ketosis states. But when you’re really stuck in is a sugar burner, you meaning your cells can only use sugar, it’s oftentimes hard to break out of that. It’s very dangerous just to be in that zone, it can lead to cancer and other problems. But what we’ll do clinically, is we’ll take somebody and put them in a keto diet for like, two, three months. They’re hardly getting in whether you’re measuring your blood ketones, and you have to be above 0.5 to say, “I’m in ketosis, right?” And their 0.5, 0.6, 0.3, 0.2, they’re in they’re out, they’re barely in. What’s going on?  We’ll pull them out of a ketone diet after two months, put them on a healthy higher carb diet. Two months later, we put them back into a keto diet. And by the way, when they’re on keto, they’re not feeling good yet, right? They’re just not using the ketones, their brain’s not using them, they don’t feel good. We move them back to a higher healthy carb diet. Now they feel good because they’re using more sugar again. So then, two months later, now we put them back into ketosis. Now their ketone numbers go higher 0.8, 1.2, 0.3. I still feel great, but better, and then we’ll move them out again.  So we’ll do that a few times. And then each time they get more fat adapted, each time they get more grit. So we actually use that variation strategy to help people break through into this phase that everybody should be able to get into. So answer your question, sometimes two months, sometimes three months, sometimes six months, and but I always move them in and out of the state.

Dr. Weitz:            Are there some people based on their genetics and their lab values that maybe shouldn’t do a ketogenic diet? For example, maybe patients who have APOE-e4 variation?

Dr. Pompa:         Yeah. Look at our bodies, everybody can benefit from it. Why? Because it’s survival mechanism. It’s a survival mode. And during survival modes, the body turns off bad genes that have been turned on. it’s called epigenetics. It resets the microbiome, right? You get rid of bad cells, because bad cells don’t adapt to the stress of ketosis. So I believe that it’s a stressor that everybody can benefit. Fasting is the same way, meaning we’re genetically programmed to fast. The problem is today is we’re always in a feast mode, whatever diet you’re on. We always have access to food, it’s not healthy. We’re meant to go through these resets and fasting gives us that reset. Ketosis gives us a reset.

Dr. Weitz:            Right? But what about, let’s say somebody goes on a ketogenic diet, and then you say, do lab testing and you find out that there’s small, dense LDL is shooting up?

Dr. Pompa:         Interesting. So when I am in a state of ketosis, my particle numbers of cholesterol rise up, which I always educate people that total cholesterol doesn’t matter.

Dr. Weitz:            Right.

Dr. Pompa:         Typically, with total cholesterol, you’ll see that drop and triglycerides will drop typically in ketosis, right? But total cholesterol doesn’t matter but the particle numbers and the size do in fact, matter. It sounds like you know that. When I’m in ketosis, I’m in about a 20% group that actually sees a rise in my particles. And yet, all of my inflammation numbers drop dramatically. So I struggled with that for a while, what’s going on? And I found out that there’s 20% of people that that happens. And there’s theories around why that happens. But one of the things is they learned that it’s not a dangerous state, the body’s raising up the particles to carry more cholesterol, and it’s doing … it’s an adaptation mechanism. But the fact is, as my CRP drops, all of my inflammation numbers that we possibly measure drop down, showing that it’s really not an inflamed state, and I’ve done that with some others like myself, who get that phenomena opposite.   So the point is, is when most people go into ketosis, we see a drop in particles. That’s most people, 80% of the people.

Dr. Weitz:            Right.

Dr. Pompa:         But again, I would argue if you stay in that state too long, you could see a shift again, right? So we’re all genetically different. I think that’s the point you’re making. But one thing is, is that we all need variation. I don’t care what diet is best for you. All we need is variation. Now, how long you can stay vegetarian successful without creating certain deficiencies, genetics will determine that. How long you can stay in a carnivore or keto diet without creating problems, genetics will determine that, but we all need change.

Dr. Weitz:            Can you do ketogenic diet and be vegetarian?

Dr. Pompa:         Yeah. No, you can because the key to it is low carb. So and when we look at ketosis, the average with the way to get into ketosis is get your carbohydrates down below 50 grams a day. Now that’s net carbs. What that means is you minus the fiber, so think of it this way, and a cup of blueberries. Let’s say it has 15 grams of carbs and seven of them are from fiber, you minus the seven and you’re left with eight net carbs. So vegetables typically, some of them can have high carbs, but when you minus the fiber, you’re at a much lower net. So it’s very easy to lower your carbs below 50 on even a vegetarian keto. I put people in a vegetarian keto for different reasons. And sometimes I put people on high fat, with a higher meat, so there’s a lot of different ways to do ketosis. You can do ketosis on any diet really, except high carbohydrates.

Dr. Weitz:            Do you lose muscle when you fast?

Dr. Pompa:         No, here’s the funny thing, right? So I told the story in my book. My son, Isaac was like, “I want to put on muscle. Why would I fast?” I said, because you need to get rid of the bad muscle that’s not adapting anymore. That’s why you’re not getting gains in the gym anymore.” And so I gave him a challenge. So he fasted and he lost about eight pounds. Very typical, I would say, I told him you’d probably lose 10. Anyways, and, “Oh my gosh, I’m losing.” I said, you only lost bad muscle, the body’s too smart for that. Now watch what happens the next month. So the bet was that he would put on not only that weight, but he would for the next few months, he would actually gain weight and he did. Because the body, it really gets rid of the muscle cells that aren’t adapting causing problems, inflammation.  You remember, you don’t make gains in the gym. You make gains when you’re recovering. So by getting rid of bad cells via autophagy, the body will recover faster. Arguably his microbiome got better, his assimilation got better. But we even use fasting for people who can’t gain weight and they end up putting on muscle after a fast so typically a month after you’ve gained your your weight back and then some muscle.

Dr. Weitz:            So it’s really about stimulating the body, stressing it and then having the body adapt in a positive way, which is as you mentioned, what happens with exercise.

Dr. Pompa:         That’s right. Yeah, exactly right. Everything is about adaptation. So the key to the stress of fasting is creating a hormone optimization. Because of forcing the adaptation, how does the body adapt? It does it via hormone optimization. So when we look at that day five of a fast, I said, we see this maximum growth hormone rise. Even after one day of fasting, the body raises up the growth hormone and you know why? It’s holding on to its muscle. It knows I need it to fight or flight. It knows it needs the muscle, so it raises a growth hormone, and it stops the loss of muscle, and it only allows the loss of bad tissue.

                                And even your cells become more sensitive to hormones, which carries on after the fast. So I talk about in the book, how to hormone optimize using these strategies, even when you change your diet. Let me give me a great example with exercise because I think all of your listeners can understand this. If you start exercising, you always get a benefit. I don’t care what type of exercise you feel better, whatever benefit is, you feel better, you get a benefit when you start exercising. However, if you still do the same thing over and over again in the gym, it plateaus. Oh, and then now there’s a plateau, you actually start losing things and you’re like, “What’s going on?” Hire a good trainer and he goes, “Oh, you just have to change your workout,” and you start getting benefits again. Why? And then a good trainer changes your even every routine, he changes things, right?

                                So because the moment you change, the body has to readapt and then it does it by hormone optimization. So every time you force your body to adapt that it does you get stronger, you get better. Same with diet. So you start the new diet, whether it’s vegan vegetarian, carnivore, whatever it is, I feel so much better. And then not maybe like this first few days, you know how it is your body shifts around but eventually you feel better. So you become a firm card carrying paleo diet person, right? That says me because it helped me I’m a vegan, and I always will be because it helped me.

                                Now here we are a year later. “Yeah, I’m fatigued.” It’s not the diet because this diet helped me, right. But then someone comes along, convinces you to change your diet. It’s like, “Oh, my gosh, I feel so much better.” Don’t be a card carrier, the magic is the change like exercise, just keep changing the diet, keep changing exercise force the body to adapt, and your microbiome will change. You’ll turn off bad genes. I hormone optimize. All of that happens when you change your diet, just like exercise.

Dr. Weitz:            That’s great. Dr. Pompa, any final words for our audience?

Dr. Pompa:         Well look, at this time, as we said, I would argue all of it starts with mindset, right? It’s like, during this time of this Coronavirus, I’ve told my family, the doctors that I train, this is an opportunity to change our lives for the better. Or you could focus on the fear and your life will get worse. It will, you’ll get more sick, you’ll gain weight, you’ll feel worse, you’ll make less money, all these bad things.  My heart breaks for people who aren’t able to work, but out of these times is a soil ripe for change. You will come out of this stress just like fasting, making less money, being trapped at home, you will come out better, but you have to choose it. You have to think about it now, set the intention that this is an amazing time. Thank God for this time, out of it will come creativity, a job change you needed. You’ll look back if you create these intentions and say, “That was one of the greatest times in my life.”    So even though the adversity is hard now for us, and I believe that they are not minimizing your stress, but you have to change the intention to opportunity in what you can change. And believe me, fasting is another way of changing those intentions and creating new ones, because it just adds that stress. So I challenge you to fast and I challenge you to change your mindset.

Dr. Weitz:            That’s great. And how can our listeners and viewers get ahold of you and find out about your books and programs?

Dr. Pompa:         Yeah. The link is … if you go to it right now, that’s a first book. We really haven’t even have the hardcopy yet. So there’s still one more editing that goes back so you all are getting a special prelaunch right there. So if you go to beyondfastingbook.com you can get that prelaunch, beyondfastingbook.com and you can check it out. And then you can go just to my website drpompa.com. So Dr like doctor. D-R and then P-O-M-P-A.com. So there you go.

Dr. Weitz:            Awesome. Thank you Dr. Pompa.

Dr. Pompa:         Yeah, you’re welcome. Thank you for having me.



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