Longevity with Dr. Joseph Antoun: Rational Wellness Podcast 219
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Dr. Joseph Antoun speaks about Longevity and the Fasting Mimicking Diet with Dr. Ben Weitz.
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Podcast Highlights
5:35 There are five things you can do to prevent chronic diseases and keep your body younger: 1. Nutrition and diet, 2. Exercise, 3. Stress, 4. Sleep, 5. Happiness and receiving and giving love.
7:13 There are pro-aging pathways in a cell, including the PKA, the RAS, and the TOR pathways. If you trigger those pathways, it sends a pro-growth signal which is a pro-aging signal. These three pathways are triggered by protein intake and carbs and are inhibited by exercise and caloric restriction. Patients with acromegaly have very high growth hormone levels and they tend to die much younger. You also see bodybuilders and wrestlers who inject growth hormone and steroids tend to die in their 50s, 60s, and their 70s.
9:37 Is promoting growth good or bad for aging and longevity? When we get older, we tend to get weaker, our bones tend to get thinner, we tend to lose brain cells, and we get frail. Our thymus gland tends to shrink and our immune system gets weaker. We tend to get pathological fractures. Breaking a hip dramatically increases your mortality. This is why the anti-aging movement was mostly about giving hormone replacement therapy, growth hormone, and other interventions designed to keep people from getting weak and frail as they age. Whereas now the focus in the longevity movement is on reducing calories, fasting, and reducing growth, including reducing IGF1 levels by consuming less animal protein. On the other hand, Dr. Longo believes that at age 75 you should make sure that you get a good level of protein because increasing IGF1 at that age is important for longevity to maintain strength and mobility. When you are in your 50s you are at the pre-chronic disease onset age with significant risk of cardiovascular disease and cancer and fasting or the Fasting mimicking diet can have great value in reducing these risks, whereas it does not make much sense to fast someone who’s 16 and is growing fast or someone who is 82, who really needs more nutrition.
17:09 The Longevity Diet was developed by Dr. Valter Longo. It’s based on the science and they also studied centenarians to see what they have in common. It is a pescatarian diet that is mainly plant based but includes fish a few times per week and some red meat from time to time. People who live the longest do not eat red meat every day, but they are also not vegetarian. Keto is also not the best diet. While Dr. Antoun and Dr. Longo believe in precision medicine and that each person’s diet should be unique, those who live the longest are somewhere between pescatarian, flexitarian, and Mediterranean.
24:57 Dr. Antoun says that having more muscle in your 40s and 50s does not promote longevity and bodybuilders tend not to live as long. Most of the people who live to 100 and beyond did not have large muscles or six pack abs at age 55. While eating low carb should be recommended for diabetics, for most people, eating a plant based diet with complex carbs and moderate protein, such as .7 or .8 gms of protein per pound of bodyweight is best for longevity. But today many in the fitness world are eating too much protein and drinking protein shakes and this is not necessary and Dr. Antoun argues that cancer rates are increasing and he claims that cancer is driven mainly by protein intake.
32:38 Fasting. Fasting should not be equated with caloric restriction because they are very different. If you restrict your calories, your body will adjust and make some changes but not drastically. If you fast, esp. for more than a few days, your body is in a crisis mode and your cells will start eating debris and organelles, which is called autophagy. After a few days, you also stimulate stem cells to replace older cells, which is a regenerative phase, which goes beyond autophagy.
41:14 Fasting. We should all go 12-14 hours per day without eating, which should be called time restricted eating, but most of us are constantly eating and snacking and this is not good for longevity. Dr. Antoun recommends the Fasting Mimicking Diet which mimics fasting while eating a lower calorie, lower protein and lower carbohydrate diet contained in a kit called Prolon. This program, developed by Dr. Valter Longo at USC stimulates your cells to rejuvenate over a five day period.
Dr. Joseph Antoun is the CEO and Chairman of the Board of L-Nutra, which is the company founded by Dr. Valter Longo that developed the Prolon kit that is utilized in the Fasting mimicking Diet. Dr. Antoun is an MD who studied Public Policy at Harvard, Public Health at Johns Hopkins University, and has a masters in Medical and Biological Sciences from Saint Joseph University. The Longevity Diet from Valter Longo is available from Barnes and Noble.
Dr. Ben Weitz is available for nutrition consultations 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 and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.
Podcast Transcript
Dr. Weitz: Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talked to the leading health and nutrition experts and researchers in the field to bring you the latest and cutting-edge health information. Subscribe to the Rational Wellness Podcast for weekly updates. And to learn more, check out my website drwhite.com. Thanks for joining me and let’s jump into the podcast.
Hello, Rational Wellness Podcasters. My topic for today is longevity with Dr. Joseph Antoun. Among the topics, we’re speaking about the benefits of caloric restriction, fasting, and the Fasting Mimicking Diet. There has been a lot of ongoing research on potential benefits of caloric restriction and fasting to promote longevity and to reduce the chronic disease burden, but what if there is a way to get the benefits of caloric restriction without having to starve yourself and without the stress associated with the difficulty of not eating for days on end? Dr. Valter Longo worked in the lab of Dr. Roy Walford who pioneered the concept of caloric restriction to promote longevity and even took part living in the Biosphere 2 for two years during which he lost considerable weight and when he came out, looked particularly unhealthy. And Dr. Walford basically lived the life of caloric restriction. Unfortunately, despite much promising research in animals, Dr. Walford died at age 79 from ALS. And then, he speculate that his early demise may be linked to a combination of stress and prolonged caloric restriction.
Dr. Longo continued researching longevity at USC, and he wanted to find a way to get the benefits of fasting and caloric restriction without the downside and make it less painful and inconvenient. Dr. Longo developed the Fasting Mimicking Diet, which involves consuming the ProLon kit for five days, which is being sold and marketed through a private company L-Nutra, which Dr. Joseph Antoun is the CEO and Chairman of the Board. This program involves eating the contents of the ProLon kit for five days, and this is essentially a vegetarian low-protein, low-calorie program.
Dr. Antoun studied Public Policy at Harvard, Public Health at Johns Hopkins. He has a Masters in Medical and Biological Sciences from St. Joseph University as well as an MD degree. Dr. Antoun, thank you so much for joining us today.
Dr. Antoun: Thanks for having me, Ben. I look forward for a healthy discussion.
Dr. Weitz: Absolutely. We need to know the keys and we need to know them now. So, Dr. Antoun, before we get into diet and some of the things that we can do to promote longevity, what do you think are some of the most important mechanisms or processes underlying the aging process that we need to address if we want to live longer and live better? That is, if we want to not just extend chronological life but have better biological age.
Dr. Antoun: Yeah. Thanks for this question and I think it’s pretty important to understand the difference between chronological and biological aging, and the easy example for the audience is the car. I always give the example of our cars. You may have a 2017, whatever, Mercedes, but if it has been driven only for 100,000 miles versus a 2019 that has been driven for 300,000 miles. And actually, the one that’s younger, the 2019, is more exposed to having issues because it was driven for 300,000 miles. And this is what we need to do for our body is how do we keep our body healthy from the inside and our biological age younger than our chronological age. Experts talk about five things you can do to help your body stay healthy longer and, obviously, this is five natural things. And science and medicine and research are looking at potential pharmaceutical or nutraceutical intervention to bias biological aging, but I think five things that we can do, I’ll give you five tips that we could do naturally to-
Dr. Weitz: Oh, how about before we get to that, what are the mechanisms? The biological factors? People talk about a whole series of different things that we should be focused on. How do we prevent or delay the onset of chronic diseases? How do we prevent sarcopenia and osteoporosis? How do we prevent neuronal degeneration, the importance of insulin sensitivity, inflammation, oxidation, glycation, DNA damage? What are some of the most important things that we should focus on before we get to the interventions?
Dr. Antoun: Yeah. There are five things, five common factors that I think would help. All the things you mentioned are symptoms of aging, right?
Dr. Weitz: I’m trying to get to, I want to know what the underlying mechanisms are.
Dr. Antoun: Yeah. All the health conditions you mentioned are symptoms of aging and in order to keep the body younger, this is how you get the onset of all these age-related health conditions. This is how you postpone their onset, and there are five things you can do. Number one is we’re going to talk a lot about nutrition and diet today. What kind and how and timing of eating and all of that. Exercise definitely is very well known to be a slower or slower of the pace of aging. And then number three is stress. Decreasing stress and having that serene and happy inside. NIH is sponsoring studies on yoga today. We also know that people who are observing religiously tend to live a little bit healthier and longer. Actually, there are some documentations that are on that, so stress and serenity is an important factor. Sleep is emerging as a very important factor that now, not even on just as a prevention but also in the short term people with sleep apnea is others were seeing eminent direct cardiovascular and other consequences and actually event linked to the brain. And then, number five, very important actually, could be actually the second most important, is happiness and receiving and giving love. And what we call under social capital. So, people who are close to their families, they feel loved and they spend time with others, and these moments of human to human interaction seemed to be also very beneficial for longevity. So, nutrition, exercise, stress, sleep, and social capital.
Dr. Weitz: So let me ask the question another way.
Dr. Antoun: Okay.
Dr. Weitz: What are the most important physiological processes that makes you age faster than me, say? I’m not saying you’re aging faster than me, but… yeah.
Dr. Antoun: Yeah. You mean within the body biologically?
Dr. Weitz: Yeah.
Dr. Antoun: Oh, okay. If you’re talking about the perception of a cell, there are pathways in a cell that we call the pro-aging pathways.
Dr. Weitz: Okay.
Dr. Antoun: If you accelerate those, if you trigger those, so the PKA, the RAS, the TOR pathways, if you actually trigger those pathways, it sends a growth signal to the cell. And when the cell, we are born in a day and the faster we go, we go towards our end, we don’t go somewhere else. And the more you trigger a pro-aging signal to cells, the pro growth signals are actually related to pro-aging signals of the cell. And so, these three pathway cells are triggered by nutrition proteins and carbs that are also inhibited by exercise and caloric restriction. Our pathways that tell the cell, “Hey, you feel free to grow,” and when the cell grows it’s biologically aging is the same routes, common routes of growth and aging. One good example there is the overstimulation of growth is either people are born with acromegaly. They have a very high growth hormone in their body and the pituitary gland is producing the stimulus. And they actually tend to be giants but actually they die younger, so that’s an overstimulation. A more personal intervention is our bodybuilders that inject themselves with growth hormone or you’d say high level of proteins, it over triggers the TOR pathway, which tells the cells to age faster. And this is how we Ronny Coleman, for example, and was at his high level in the 40 suddenly and unfortunately, we lost him. In many of the big wrestlers or bodybuilders, you see them passing away at ages of 60s and 50s and 70s. Their inside from their biological clock is probably 10 to 15 years older.
Dr. Weitz: Well, I think this is one of the main controversies in aging is when I first studied to focus on longevity and anti-aging maybe 20 years ago, the big focus was on promoting growth that when people get older, they get frail, they get weak, their bones get thinner, their muscles get thinner. There’s people who can’t get out of bed because they’re simply too weak. They have sarcopenia. People get these pathological fractures. When you break a hip, your mortality increases dramatically. You’re much more likely to die. And the importance of maintaining a level of growth and regeneration, as you get older, your brain cells tend to break down and not get replaced this quickly. Your thymus gland tends to shrink and your immune system is weaker. There was a big focus in the beginnings of the longevity, anti-aging movement on giving hormone replacement therapy, giving growth hormone, doing various interventions that keep people from getting weak and frail as they get older. And now, the focus is on… So it was all about giving people more, yet so… Now, it’s all about taking things away, about reducing, about trying to reduce aging, about reducing IGF-1, about making sure… taking away, reducing calories, fasting, and I wonder if that has-
Dr. Antoun: It’s not-
Dr. Weitz: … become sort of a balance there because we need to maintain strength and structural integrity, and we look at a 25-year-old as the marker of great health, and they’ve got all these growth factors going on.
Dr. Antoun: Yeah. This is actually a really critical question, and science is lacking in the answer. So, everything you said, actually, is right on both sides. It’s about also timing. And we see this ourselves that one of the papers that was found there published, Dr. Longo. Again, Time Magazine nominated him among the top 50 most influential people in health for his work, but he discovered that, and there are other papers coming out, about IGF as stimulating the muscle and stimulating growth hormone is actually the value of the reader’s defer in life, right? So like you said, if you’re 75 and your muscle at that age, especially if you’re frail, is an organ of longevity. You want to maintain the muscle and you might need to feed more meat actually, and there’s more absorption at that age. Mobility is so important for so many factors. And in that time, feeding a good level of protein and increasing IGF is actually important for longevity.
Now, if you’re 50 or 55, you’re at that pre-chronic disease onset age. You have a good risk of cancer coming up from your genetics. If you have other risk of cardiovascular, and this is where at that age your muscle is probably not the most important longevity factor but actually your risk of cancer, your risk of cardiovascular. And this is where, at that age, you might want to have a different level of IGF in your body and different level of nutrition and proteins.
So, we’ve studied actually at L-Nutra and the USC, University of Southern California, as the main university that our research comes from. They’re looking in, as they have the longevity institute in the world, and they’re looking at different phases of life, examining each organ at different phases of life. When you fast, somebody who is 16 and is growing fast. When you fast somebody who’s 82 and needs actually nutrition, but there’s a great value of fasting somebody with certain health condition, which we’re looking into but also for longevity purposes at mid-age when you are pre-health condition and you want to create that gains you extra years of biological age before you see the onset of those. I don’t want to disclose things that we haven’t published yet, but even the value of IGF and insulin in the blood versus longevity is not linear. It’s not flat. It’s actually a U-shape curve, and there’s going to be different value for different… But the wave of, like you said, from a commercial perspective, there was a big wave of growth hormone injection for aging. And we got to be careful because on the short-term you look a little better, that’s the growth stimulus you give but not necessarily on a long-term, and hormone replacement therapy again has a lot of great benefits especially around the menopause age, where… And again, everything is depending on age and balance, right? Is that person has more cardiovascular risk or is the bone fracture risk higher in nutrition precision medicine and precision lifestyle is the future because, again, different age, different body, different risk, and the body has always been a balance. Thinking about one diet is right, one diet is wrong or thinking about we should inject this or that is definitely a wrong statement from the beginning.
Dr. Weitz: Okay. We are definitely in accordance with the precision personalized medicine approach.
Dr. Weitz: Interesting. I’ve really been enjoying this discussion, but I’d like to take a minute to tell you about a new product that I’m very excited about. I’d like to tell you about a new wearable called the Apollo. This is a device that can be worn on the wrist or the ankle, and it uses vibrations to stimulate your parasympathetic nervous system. This device has amazing benefits in terms of getting you out of that stressed out sympathetic nervous system and stimulating the parasympathetic nervous system. It has a number of different functions, especially helping you to relax, to focus, to concentrate, get into a deeper meditative state, even to help you sleep, and there’s even a mode to help you wake up. This all occurs through the scientific use of subtle vibrations.
For those of you who might be interested in getting the Apollo for yourself to help you reset your nervous system, go to apolloneuro.com and use the affiliate code, Weitz10. That’s my last name, WEITZ10. Now, back to the discussion.
Dr. Weitz: So, let’s get into diet, what do we know about what’s the healthiest diet to promote longevity?
Dr. Antoun: So, I don’t know if you’ve seen The Longevity Diet book, which Valter Longo promoted. It’s two-and-a-half year old now, but it still has the older foundations in the big discoveries, and we try to look at this topic from different angle. The angle of human evolution and what have we because our body at the end of the day has been sculptured by its interaction with nature. And we’re going to talk more about what that interaction led to. We’ll look at that topic also from a lab perspective and science perspective. If anything about L-Nutra, where our company is, where we start with science and trials before we start talking. And that’s important I think to give the right respect for nutrition, and we think nutrition is important as medicine, so we got to put the right science behind it. So we’ll go back to labs and we do trials and to prove what we’re thinking about.
Then, we look at people living long today. We studied the centenarians, people living 100 and beyond. What do they have in common? And how do they eat? And then, we come up and we look at system biology and we study the body and then from a multi-angle and we come up with the recommendations. But what makes sense and what this could talk about is that humans lived around rivers for the longest period. The river had the water that we can drink, and there was grass and trees and green and fruits and vegetables and things to eat, which you cannot find on the shores of an ocean, and definitely when you live in a desert or on the top of mountains. So, around rivers, the diet was mainly plant-based and fish is one of the few animals that cannot run or fly or see easily, so it was easy to fish. And so, pescatarian diet where it’s mainly plant-based and has fish a few times a week and we can go more into details. The sequence of amino acid in fish and the combination of the omegas that you eat with fish are also very healthy, but this is explaining downstream. I’m just talking the evolution and how [crosstalk 00:19:13]-
Dr. Weitz: So, I just want to push back on the evolutionary concept. I think if we really look at evolution, we’ll see that depending upon where human beings developed, diet was drastically different. Dr. Longo mentioned this, but if you were a Greenland Eskimo, you ate a lot of seal meat and whale blubber because that’s what you had to give you calories. If you were an IKung Bushman, you ate a lot of mongo mongo nuts. Within some other part of the planet, you might have eaten a lot of cows and drinking their blood-
Dr. Antoun: The reason we had to develop ways to domesticate animals and develop cows, but what everyone… what every human you mentioned from Alaska all the way to let’s say South Africa, we had to live next to fresh water. There was no way to survive without fresh water. Let’s agree… let’s start at there, right?
Dr. Weitz: Okay.
Dr. Antoun: So, you might have in Alaska, you had more reserve. You had to reserve some of the things you find and you had to live with more carnivore than herbivore for these extraneous circumstances.
Dr. Weitz: They didn’t have a lot of vegetables and fruits.
Dr. Antoun: Exactly, exactly.
Dr. Weitz: They certainly didn’t have grains or beans.
Dr. Antoun: I agree but this is why first, we’re going to the mainstream evolution but also we’re taking evolution as just one out of the five pillars. We go back and test. We look at centenarians. I can guarantee you that the centenarians living 100 and beyond, most of them are not sitting and eating red meat every day. And I can guarantee you that they’re just don’t sit and eat vegetables and they’re fully vegetarian every day. They are somewhere between the pescatarian and the flexitarian eating meats because also humanity had discovered how to hunt and that happened long time ago, so we evolved also with that. So anywhere between seafood being the main source of animal protein and plus or minus definitely flexitarian/Mediterranean adding some red meat from time to time seems to be, again, you’re asking me a generalist question, and we started the discussion by saying there’s no generalist question.
Precision medicine and precision nutrition, I think, is going to be. But if you ask me today, I can tell you probably if you eat meat every day, you’re not going to live the longest. If you can just eat vegetable every day, you’re not going to live the longest. If you’re going to do keto every day, you’re not going to live the longest. Now, you’re going to live the longest circulating in between a pescatarian, flexitarian, Mediterranean. I would put my money on that person rather than others.
Dr. Weitz: Yeah. So, let’s just put it out there that the longevity diet is generally a lower animal protein diet, right? Increased protein intake is associated with increased IGF1 levels, which is bad for longevity, right?
Dr. Antoun: But again, at certain age, so I would say yes if you’re, say, 30 to 55. If you’re 65, 70, Valter has published many times that at that level, like you said, muscle becomes an important organ for growth versus others. And this is where you have malabsorption, et cetera, so after age 65, the recommendation is you can go back and increase your animal source of protein intake.
Dr. Weitz: Yeah. I guess my response to that would be if you want to have a strong body when you’re 70, your best bet is not to lose muscle in your 50s so you don’t suddenly have to build muscle in your 70s. So, that would be why I would be hesitant to want to follow a lower protein diet. And the other problem with a lower protein diet is we only have three macronutrients, fats, carbs, and proteins. And if we reduce protein, then we’re left with carbs and fats. And the problem with the longevity diet, as I see it, is that it ends up being a high-carb diet and it’s hard for me to see how you… In a lot of people, they’re going to have trouble, in my opinion, from my experience, in maintaining insulin sensitivity and stable, lower glucose levels. I looked through the longevity diet two-week meal plan and almost every morning, there was either toast or a bagel or bread or cereal in the morning, there was often pasta or rice or a pizza at night for dinner, sometimes there was a snack that included some healthy version of a chocolate bar, and so from what I’ve seen is if I ate that way, and I ate that way at one time, I couldn’t maintain stable glucose/insulin levels. And by upping the protein and reducing those complex carbs, for me and a lot of my patients, we find that a better way to maintain higher levels of insulin sensitivity, which leads to lower insulin and glucose levels.
Dr. Antoun: A great question. We get this question asked a lot, right?
Dr. Weitz: I’m sure, I’m sure.
Dr. Antoun: Because we live in a craze of I should eat low carb, right? I mean, the craze went so far that I should eat almost no carb and be on keto every day.
Dr. Weitz: Those on the carnivore diet eat only meat.
Dr. Antoun: Yeah. Meat or fat, right? It’s either meat or fat, and this is carnivore or full-blown keto. First of all, what you’re saying is a reaction to what the market is saying, address everything you said, but the science doesn’t prove anything of what you’re saying. There’s no science saying that actually the buff guys that, like you’re saying, at your age have a lot of muscle and even see as you mentioned Roy Walford who passed away, unfortunately, at a younger age and he was big buff at 70. So, most of people who live 100 and beyond, since we’re talking longevity, did not have six packs at age 55 or big muscle and plus, I can show you many trials showing that. But this is great question because we live in multiple lies in nutrition. The FDA has done a great job regulating drug but has still some progress to do on food because food was for dieting. It was for lose weight, et cetera. They have not enforced heavy science so that people really know the truth rather than live in different waves of whatever the trend is. Let’s right books and publish them, make a little bit of vlogs and make buzz and generate some personal revenues. This is, unfortunately, what’s happening in nutrition, and hardcore science lack… And the most important input in our life which is nutrition. So, you’re right, it makes much more sense, say, let me eat protein and let me drop my carb. The biggest disease around the world today is diabetes. We’re all concerned with that, right? And you mentioned the word patients and yet the patient with diabetes should eat low carb for sure.
Dr. Weitz: And obesity. What do people overeat? People do not eat more chicken. They rarely overeat chicken.
Dr. Antoun: Exactly. The overeating is the problem. Let me go back to your question and address every part of it. The first part of it you’re talking about the protein levels and about Mediterranean and about the longevity diet being a low protein. The longevity diet is a lower protein. What we’re eating today, we’re over eating protein. Go to the WHO recommendation. Go to every longevity. You should be at 0.7, 0.8. We’re not saying go 0.4 or 0.5, but the marketing in the nutrition world has been so intensive. They took advantage of the carb craze, is that you should eat protein. And now, every bodybuilder, everyone going to the gym, or many people going to the gym were drinking the powders every day, were eating meat every day and trying to keep the proteins high. And the marginal increase in muscle by being over protein, you stated, is very, very low. So, what’s actually pushing aging so big with being in a high-protein setting versus… And when you push aging, you push risk of cancer, and the question that I would ask everyone is, “Hey, diabetes is increasing.” And because of the high concentration of glucose, we’ll talk about that, but cancer is increasing. Cancer is driven mainly also by protein. So, nobody tells you the other truth, which is cancer has increased tremendously but will tell you, “Oh, we have better diagnosis.” I mean, people were dying before of cancer as well and yet, we don’t have the sophisticated imaging but in the last 20 years we have those, we’re not in the ’80s now to say that. We have imaging. So cancer have increased tremendously but as being over proteinated, we have to watch for that.
The second thing is you’re saying a big part of the longevity diet is carb. It’s complex carb though. And this is why when we talk about the pasta and sugars, diet doesn’t assume that you’re going and eating dessert with it. It just tells you this is what your body needs to operate in a healthy way, which is actually the truth. Look at the evolution. We ate fruits, vegetables, grains, et cetera for years and years. These were the only things available for humanity.
Dr. Weitz: There were not a lot of grains available.
Dr. Antoun: Not a lot of grains initially, yes. But the fruits and vegetables that was the main source of… So, complex carbs is what we talked about, not refined carbs. And the body, by the way, truth for everyone to think about, the body works on carb. There’s no… every cell…ATP production. have actually realized [inaudible 00:29:42] now you tell me my patient is pre-diabetic. Unfortunately, we live in a sick world where most people are overweight. You’re starting with a condition and now on the short term, obviously, you take the low carb and you help them go back to normal. But once they’re normal, the longevity diet assumes you’re a healthy person trying to live longer, does not assume you’re a patient, does not assume you’re an athlete who wants to grow muscle. But in these conditions, it’s important to realize that our body lives on carb and you got to eat a good amount of complex carb.
Dr. Weitz: And by the way, I saw at least one study in Diabetes Care in 2010 that linked lower IGF-1 levels and increased risk of diabetes. [Association Between Serum IGF-1 and Diabetes Among U.S. Adults]
Dr. Antoun: Well, was that randomized or observational? Because it could be low. They’re eating high carb for a while. It doesn’t make sense to be eating less and dropping IGF and developing diabetes, so I would like to see it if you want to send it to me, but it could be observational, not randomized control.
Dr. Weitz: Yeah.
Dr. Antoun: So but there are probably, if you do meta-analysis there, many, many trials to show you that high IGF-1 linked with both diabetes and cancer. And high insulin, obviously, is linked to both as well. And it makes sense. Dr. Ben, we got to go with what make sense for us as doctors. You eat, you fill this body. This body has to get the growth.
Dr. Weitz: Right.
Dr. Antoun: The growth push. You grow a cell. A cell does a mistake in the application becomes cancerous. You grow forward, you increase insulin resistance, you increase aging. So, there might be satellite studies, observation, or some biases here and there, but I think to certain extent, we got the science today as trending in the same direction. But it’s important for people to… Because we live in a craze of carbs, we live in a craze of Atkins then and the protein, now we’re living the craze of keto, and these are craze because they don’t make sense from a longevity standpoint now. If you have a neurological condition you are diabetic kid, you should go on a low fat, low carb on a short-term, God bless, but good fats, low plant-based protein, not animal sources, and low carb would match as your obesity or diabetes control plus longevity. This is what we are, this is what we preach, this is what we study.
Dr. Weitz: Okay. Let’s talk about the importance of exercise for promoting longevity.
Dr. Antoun: Yeah. I mean, this is and we’ll talk about fasting as well. There’s a lot of concept that I would love to clear from science coming in here.
Dr. Weitz: Let’s go to fasting. Go ahead. Let’s talk about fasting.
Dr. Antoun: Probably that would be a little bit more because it’s more relevant to clear for people’s concept because every day you hear a new idea in that field, and I want to make sure people listen to what the science says and hear.
Dr. Weitz: Yeah. I interviewed a doctor who puts patients on a 30-day fasting in a medically supervised setting and claims to get incredible benefits from it.
Dr. Antoun: You would, if you have autoimmune disease you would, but what the other damages would be that’s different topic. And this is-
Dr. Weitz: [crosstalk 00:33:16].
Dr. Antoun: When I told you the way we look at things, one of the ways we look at things is just to embrace it. Again, it’s like also some of the diets where you get super low on carb but you’re doing other damages, and it’s all about balance and the best intervention is timely and gives you the most benefit with the least side effects.
Dr. Weitz: So what are the benefits of fasting?
Dr. Antoun: Yeah. And you equated almost calorie restriction with fasting, and they’re very different actually.
Dr. Weitz: Okay.
Dr. Antoun: I mean, obviously, fasting induces calorie restriction but the way fasting works is a little bit different than calorie restriction, and I’ll give you these examples.
Dr. Weitz: Okay.
Dr. Antoun: So, say, you’re the CEO of a company and you need a million dollar a month to operate and if I come and then tell you, “Look, I’m not going to give you a million. I’m going to give you 900K.” So, your bank account stops dropping. You’re losing 100K, so you’re fat, I’m equating… I’m going to compare your low-calorie diet with fasting and your body like your company. So your fat starts decreasing because you have 900 out of a million, and this is how most diets work historically. But you can cope with it, you have almost everything you need. You lose some adjustments on the way you manage your corporation and you probably decrease some of your investments or expenditures and you cope with it.
In fasting, it’s different. Fasting is, in a company, I say, “You need a million, I give you nothing.” And as you can imagine, your bank account will drop super fast, but you’re not going to sit and wait for it and cope with it. You’re in a big stress, and the word stress is very critical with fasting. That stress is going to make you as CEO go and restructure the company. You change structure, you let some people go, you change some of the titles, you merge some departments. And in function as well, you got to stop some of the not-so-essential investments and costs, but you’re going to take structure and function actually. And this is what we see with fasting. The stress is so high on the body that there’s a pressure on… The body tells the cell, “Hey, I have enough.” A little bit of reserve in the fat and some of it is in glycogen in the muscle, and we do have fat cells. We do have some reserve but it’s a crisis.” After a couple of days, this tells the body cannot nourish them any longer and then ask the cells to start eating the debris and organelles inside and try to fix some of the structure and function, and this is what’s called autophagy, and it won the Nobel Prize in Medicine in 2016.
We do believe that after… So again, going in the first two days you can live off your fat, then you ask the cell to eat whatever is inside. What after? In Valter’s research, at least in mice, it’s showing that there’s some level of preservation, meaning now you tell the stem cells that are younger to replace older cells. That’s going from rejuvenation to reservation, which we showed in fasting in mice, meaning you are the CEO, you change the structure, change the function and then now you have to let some people go and maybe you let the expensive salary, the ones in the body, the cells that are a little bit older. They consume calories. They’re not producing at their best, their job and you push a little bit the younger cells who are more cost-effective in the way they spend their calories to promote those. So this is why fasting, if you want, is now a big wave. It didn’t come as a… It worked only through low-calorie restriction. We have low-calorie diet. We don’t need to go and starve to achieve that goal. So, what people are trying to do with fasting, they’re trying to obtain certain level of autophagia at the cellular level, which hopefully biologically, it’s like taking your car to the mechanic and trying to a little bit fix your things and work with on them-
Dr. Weitz: Specifically, autophagy is when the body is consuming old bits of protein and damaged cells and it’s a regenerative process, right?
Dr. Antoun: The definition of autophagy is self-eat. Auto and phagia, self-eat. So the cell starts eating the inside because it doesn’t have enough calories from the outside. That’s the rejuvenation side. Now, there’s a post-autophagia stress, if the stress goes longer now the body starts trying to get rid of certain old cells because this is carrying dead weight that cannot feed or finance and pushes the younger cells to rejuvenate. That’s not part of autophagia. That’s a regenerative phase, which is the advanced phase of fasting we’ll see in-
Dr. Weitz: So what phase? The…
Dr. Antoun: The regenerative one. So, you have fast weight loss first two days, rejuvenation with autophagy, regeneration with younger cells being promoted to replace older cells, which again we have seen in some, after research in mice. And that, if you want very fast weight loss. And there’s something very important with the weight loss with fasting is muscle is protected, so as the stress, again remember fasting is calorie and stress component. With stress, you have a high stress hormone so you have a good muscle tone, and there’s some rejuvenation at the muscle. So in fasting, unless though you go for longer period, everything will be depleted. But on the short period, the muscle is more maintained with fasting versus other diets. So, you lose fat, it’s selective fat loss, which is important especially for many people mid-aged women who are after menopause. So, you get all the metabolic benefits the way it relates metabolic benefit, and you start working on the cells. And this is where you started to see now this therapeutic fasting emerging as when you put the body under stress, now the body is in fixing mode, is in coping, is not as stressed, and want to look after what’s going on and fix it. You start seeing these articles emerging on fasting for health conditions, and this is why fasting has been different from any other diets.
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Dr. Weitz: So do you recommend fasting?
Dr. Antoun: Again, there’s right fast and there’s dangerous fast. So, I’ll tell you what I recommend with fasting. I think for healthy individuals, doing 12 to 14 hours a day of fasting is important. We call it today fancy as fasting. It is how people should eat. We’re overeating today. That’s the problem, and we call fasting if you stay 12 to 14 hours. But the Nobel Prize in Medicine, people don’t talk about in 2017, was about the biological clock of the organs. And we have program with the sun as well and 12 hours of sleep is what our ancestors used to have or 10 to 12, whatever. The sun was down. There was no electricity. Our organs also track the daylight, cycle of the circadian rhythm. But also, it’s like, I go back to the bank account example, and if you keep putting money in, it will grow. So, if you keep eating all the time versus allowing some time to spend that money. So we believe the 12, max 14 hours, is the healthy way of time restricted eating and is how we, human, should eat. We call it, in a fancy way, fasting today, but it’s something I would recommend, again, for healthy people [crosstalk 00:42:36]-
Dr. Weitz: So, what you’re saying is this, I think the term that these people typically use is intermittent fasting. That’s really time-restricted eating and that’s what we should call it.
Dr. Antoun: Yeah. I mean, a fasting goes from several hours to two days, by the book definition, intermittent fasting. And after two days, you call it periodic fasting. So time-restricted eating is the time within one day how many hours you restrict your food intake. And so, periodic eating and time-restricted eating is a portion of intermittent fasting. Intermittent fasting goes a little bit one day up to two days before you start calling it a period-of-time or periodic fasting.
Dr. Weitz: Okay. So, you recommend eating within a 12- or a 10-hour window?
Dr. Antoun: Yeah. And then, in most people today doing intermittent fasting and going up to 16 or 18 hours and, again, there are some going beyond that. And this is where we go back to, is it good for who and what? Because you go back… Now, you’re reducing a longer stress, right? So it comes that you lose more weight, unless you binge eat after, you lose more weight the longer you stay. At the same time, you’re stressing your organs that need to eat, right? So your heart pumps every second or whatever. I don’t know the exact milliseconds or seconds. Your brain has to function in the morning because the muscle is active and you need to feed these organs. And the body doesn’t have a magic switch where, oh no, you turn it to ketones. It’s a process. Every organ has to go through the stress and then you switch to ketones and then the body has to… And by the way, that happens probably 15 to 16 hours after fasting. Nobody has that exact number. We have tested that and we start seeing ketones after 15 hours in the blood. So, it’s not a magic after 10 hours, the brain needs ketones, calls for it and it’s there, so there’s a stress that goes there. We don’t know how healthy it is for a normal individual to go 16 or 18 hours from a longevity perspective. And then, if that person wants to lose weight on a short term or is pre-diabetic or starting diabetes, I think that tips the balance so if you go a little bit longer and you get a little bit the short-term benefit. But from a longevity perspective, we don’t know.
The periodic fasting now is a different story going longer. We don’t recommend to go long on water fasting when you have the option to do it with food, and this is why we are in the business of the Fasting Mimicking Diet. People ask us why we try to mimic fasting with food. And by discovery, by the way, most people don’t know the fasting mimicking diet is funded by the National Institute of Health after seeing the benefits of fasting and it all comes from the studies at USC, University of Southern California. We’re studying fasting for cancer, for diabetes in the longer periods. It’s the same [inaudible 00:45:39], right? The longer you go, you have more stress on the cells, the cells try to rejuvenate, which is positive. You have more stress on fat, so you lose fat, so that’s positive. At the same time, you’re stressing your brain, your heart, your essential organs, and these are everything that needs to operate and it needs eats food. So, the NIH has funded that trials to make fasting a compliant and safe procedure, and they funded the creation of the Fasting Mimicking Diet at USC, and the goal was to make periodic fasting now a little bit healthy and safe and compliant. So, what we advise, what I personally would advise is most people to do your 12 hours of fasting, you can go all the way to 14. If you have short-term reasons, obesity, pre-diabetes, you can go a little bit longer. We always advise you do it with certain food just to keep that balance, again, we’re talking about. And if you want to do a five-day fast, which is what we have, we do it with food, and it’s called the Fasting Mimicking Diet.
Dr. Weitz: So tell us what does the Fasting Mimicking Diet consist of.
Dr. Antoun: So, in order to mimic fasting, the body, you mentioned, the body we ingest the macronutrients, fat, carbs, and proteins. And this tells the aging signals respond mainly to proteins and carb. So if you want to really mimic fasting, you have to be a little bit low on carbs and on proteins, and this is what we have mimicked and induced in our fasting mimicking diets. It’s a high fat but good fat. There’s the healthy medium chain fatty acid, so it’s the healthy fat. Everything is from plant-based sources. And then, it’s a low carb, complex carb, and it’s low in protein as well. And there are a lot of probably secrets there, which kind of proteins, which kind of amino acids. But in order to really mimic fasting and the stress of fasting, you got to be in [inaudible 00:47:45] of carbon IGF, and there’s a lot more. I’m simplifying this, but a lot more of which fast and when, which sequence of amino acids and when, and which sequences of carbs and when that would provide on a daily basis.
Dr. Weitz: Okay. What if somebody wanted to do the Fasting Mimicking Diet without ProLon? Is that something that they could do?
Dr. Antoun: I always say you can eat lettuce in the morning and you’ll be fasting. You can eat cucumbers and two pecans, you’ll be fasting. The Fasting Mimicking Diet’s objective is not to just mimic fasting because you can mimic fasting by barely eating or not eating. The goal is to make it safe. There’s three goals. So number one is to really keep the body in a fasting mode, number two is to nourish the body because, again, we want you to experience a healthy fast, and number three is how can we enhance the fast. Like you said, you can go and eat a cucumber in the morning a little bit and you’ll be fasting or you’ll be fasting by starvation. With the fasting mimicking diet, you’ll be fasting by nourishment. And so that makes-
Dr. Weitz: Is there an ideal amount of calories that somebody should eat and does it depend on the person, their metabolism, their metabolic rate, their size?
Dr. Antoun: Yeah. The calorie is one input and it’s not the most important. I don’t want to reveal a lot of confidential information, but we’ve tested the Fasting Mimicking Diet on many ages, many different sizes of the body, and because we have found the right amounts, combination, and sequence of carb and amino acids with the right level of fat under a margin of calories, we’ve been able to mimic fasting at different ranges and at different ingredient, so it works for most. Obviously, if you’re a 400 pounder versus a 100 pounder, we might in the future tailor that a little bit more. But today, with what we’ve tested all the way from age 20 to 70, different combinations and different calorie counting, it works. Calorie is on a signal but most important is the sequence of what we feed you with, at which time, and with which combination.
Dr. Weitz: So, essentially, to follow the program is you get the ProLon box and it tells you exactly what to eat. All the food is contained in the box, soups, and things like that, right?
Dr. Antoun: Yeah. So when you get the box delivered, you open the box and you have your food for everyday of the five days. And you open the daily box and it has… We try to be as consumer friendly as mimicking your daily normal foods, so you have a bar for the morning and you have soups and crackers for lunches and dinner. There’s a drink and there are some pills for supplementations. You’ll get everything you need to eat within one day starting from 1101 calories on the first day all the way to 800 calories. On the remaining days, that will nourish your body, will make your fasting safe. I think we’ve crossed now 700,000 or 800,000 unit consumption of ProLon, and we haven’t had any major safety or event.
Dr. Antoun: And again, going back to, can you mimic fasting at home? You can, but you’re taking the risk, the safety risk, and this is why science has shown you that you get the benefits that we’ve tested and [inaudible 00:51:40] at the same time.
Dr. Weitz: You get the same level of autophagy as you do with the water-only fast?
Dr. Antoun: So, we have never measured autophagy head-to-head on water in the FMD. Autophagy, again, is important and is the buzz word of the day, but-
Dr. Weitz: Sorry, how are you supposed to pronounce it, it’s autophagy?
Dr. Antoun: Nobody knows. It’s autophagy, autophagy, or yeah, autophagy, autophagy. I’ve heard all of that. But yeah, we haven’t gone head-to-head versus water fasting. When you do randomized clinical trials as well, you got to file for safety and going several days on water fast, I don’t know if that’s [inaudible 00:52:30]. This is why the Fasting Mimicking Diet was created. It was… people couldn’t comply. On water fast, it was risky as well for some patients. And the National Institute of Health tapped into how to create this. So I don’t know if we would ever do this. We would have to talk with the IRB Board, under safety on a water only arm and maybe do in the hospital, and that’s the main reason why we haven’t done it.
Dr. Weitz: Have you used the Fasting Mimicking Diet in cancer patients?
Dr. Antoun: In trials. We have multiple trials testing the Fasting Mimicking Diet in cancer patients, and several of them are ongoing. We have finished a couple last year. So today, we don’t sell the Fasting Mimicking Diet in the market for cancer yet. We’re still trying to translate the science of it with policy and regulatory to see whether and how we could do so. We’re very compliant as a company. It’s very important for us to follow all the regulations FDA, FDC, and others. And food as medicine is a concept we always talked about, but if you go under regulatory basis, food has no pathway to go as medicine. Even the word medical food or the class as medical food is actually restricted to nutrition being an issue for that person, not the disease itself. So, we are actually in the process of… We’re talking to regulatory about what we have discovered, and we have a lot of interesting findings, again, I don’t want talk openly today so that we don’t look like [inaudible 00:54:11] people to take some action today. But if we talk again a few months, you’ll have a better answer. We are planning to go to regulatories and talk with them how can the system embrace what we have discovered, which could potentially be food as medicine.
Dr. Weitz: Yeah. Going forwards, I hope that you, guys, can incorporate studies where the Fasting Mimicking Diet or the longevity diet are compared with other versions of what are considered a healthy diet because one of the issues with a lot of diet studies is you take any sort of healthier version of a diet and compare it to the standard American diet and you’re going to see significant better value.
Dr. Antoun: Yeah. We did actually. The article is being submitted. So we did with Dr. Mark Houston. We did a trial on ProLon versus Mediterranean diet. So, we were exactly what you said. We said, “Hey, how does finding a ProLon compared to everyday healthy diet?” and we went with the Mediterranean because that’s one of the healthiest from an American Heart Association’s standpoint. And so, I don’t know if we had results before we go up, but we are neck to neck with eating healthy food every day.
Dr. Weitz: And then what should the person eat when he come off the Fasting Mimicking Diet? Should they just go back to what they’re eating before or should they go on to the longevity diet?
Dr. Antoun: Yeah, so again, it depends on their goal. If they’re healthy weight and their first objective is longevity, they can go back to pescatarian diet or the flexitarian diet and continue that process. They could do a second ProLon within a quarter or two to three times a year. If they’re healthy, they don’t need to repeat it. Then, when another person might want to lose weight aggressively and that could be one of their concerns, then you can go on a weight-related dietary pattern after ProLon. Do a second ProLon second month and third month. We’ve tested ProLon in three months and four months, the first Mediterranean diet was four months. And a lot of great benefits there. So it depends on the goal of that person. If it’s longevity, we recommend pescatarian, flexitarian.
Dr. Weitz: Awesome. Okay. So I think we’d pretty much have a wrap. Any closing thoughts and then how do people find out about the ProLon program?
Dr. Antoun: My closing thought is really for people to read the science and think logic rather than think of anything they see in the media today as they give it and work with it. We respect food literally as medicine. We live by it as a company, as people, and we personally… I’m an MD with health policy, and I ended up in nutrition because that’s the biggest trigger I think for longevity and public health. So, we ought to identify and clarify the source of information before we start making conclusions because I think there’s a lot of ideas that are being spread out there that are not scientifically founded. We would love also for regulatory to intervene and come in and really put some discipline in nutrition because I think-
Dr. Weitz: I hope they don’t, really, because if we think that… We’re getting the most amazing experiments in nutrition. Where else would you get what’s happening…
Dr. Antoun: Oh, you can [crosstalk 00:57:53]-
Dr. Weitz: … happening with all these people following carnivore diet [crosstalk 00:57:56]-
Dr. Antoun: We should keep the entrepreneurship. We should keep the entrepreneurship.
Dr. Weitz: … all the intervention of the [inaudible 00:58:01] by everybody saying you can only say yes or you get kicked off.
Dr. Antoun: What you can say is definitely what you can experiment. The FDA and FDC they’re never recommended experimentation, but they would recommend with what you can say. And we’re seeing things that are killing people out there. I mean, you just mentioned people fasting for 30 days. You can talk about people eating protein at 3 grams per kilo per day, and-
Dr. Weitz: Well, the guy, the doctor who is doing that, he has people medically supervised every day, so [crosstalk 00:58:36]-
Dr. Antoun: It’s clear that we’re not doing better on neither obesity nor diabetes nor cancer, we’re doing worse as humanity. And there are billions of dollars invested in nutrition. There’s a book published every minute probably and as people are taking advantage of the system at the expense of life of others. So I agree with you, it does not mean that we need to reprimand innovation as much as we still need to put some boundaries and some scientific evidence behind what’s happening because there’s masculine, I mean, companies living off exploiting your taste, your bud taste, other just selling you books and diets, but at least it teaches us in medicine that hypertension is a silent killer. I think there’re many other silent killers out there that nobody talks about.
Dr. Weitz: How do people listening whether they be doctors, practitioners or patients, find about ProLon? And how-
Dr. Antoun: There are two ways-
Dr. Weitz: do they find the Fasting Mimicking Diet?
Dr. Antoun: Two ways to access ProLon, if you’re healthy, you can go and buy it online. You have to sign off that you’re healthy and can take it, and there are parameters of finding if you’re healthy while you’re checking out on prolonfast.com. And if you have a health condition, we actually have 13,000 clinics in the US, registered with us to recommend ProLon, so you can go to any of the ProLon practitioner. Otherwise, go to your practitioners and talk them on ProLon. We’re happy to then detail them about the product. So you can get it through your provider if you have health condition or online directly through us.
Dr. Weitz: Excellent. Thank you, Dr. Antoun.
Dr. Antoun: Thank you very much. Have a good one.
Dr. Weitz: Thank you, listeners, for making it all the way through this episode of the Rational Wellness Podcast. Please take a few minutes and go to Apple podcast and give us a five-star ratings and review. That would really help us so more people can find us in their listing of health podcasts. I’d also like to let everybody know that I now have a few openings for new clients for nutritional consultations. If you’re interested, please call my office in Santa Monica at 310-395-3111, that’s 310-395-3111, and take one of the few openings we have now for individual consultation for nutrition with Dr. Ben Weitz. Thank you and see you next week.
