Posted on

Intermittent Fasting and Autoimmunity

Many millennia before fasting became of interest for medical reasons, the practice of fasting — abstaining from all meals — was seen as a way to achieve a higher spiritual purpose.

The main religions often have annual fasts, and some have rites of passage, that include fasting so that one can undergo “purification.” The Hindus and Buddhists do, “atonement” through the Jewish tradition of Yom Kippur or the Catholic tradition of Lent, for clarity of religious purpose or become close to God as the Muslims do for Ramadan. And so on.

It is clear, through the passage of time and tradition, that there is a benefit – spiritual, emotional, and sometimes physical – to the practice of fasting.

Recently, fasting has become vogue but it is stemming from the resurgent scientific literature showing great promise in various fields including cancer therapy, metabolic diseases like diabetes and obesity, and an anti-aging and longevity practice, cardiovascular disease, neurodegenerative disease like Alzheimer’s and dementia and autoimmunity.

The definition of fasting is the abstinence of food, drink or both. The various fasting that science is starting to look at has much more nuance to it than just plain not eating.

The popular 5:2 intermittent fast for weight loss was popularized first in the UK. It features a normal eating schedule 5 days a week and 2 days of the week calories are restricted to about 500.  

The more specific intermittent fast, known as time-restricted feeding, has now been gaining more momentum. With intermittent fasting, you abstain from eating for anywhere from 13-16 hours of the day and keep food consumption during the other hours.

The weight loss that occurs with this approach is supported by studies stemming from Dr. Satchin Panda’s work at the Salk Institute. His research looks at the connection between the time you don’t eat and how it plays into the workings of the circadian rhythm, our internal clocks that can govern metabolism and sleep, for example. Recently, the University of Illinois at Chicago enlisted 23 obese volunteers and had them eat only between 10AM and 6PM. They lost weight and dropped their blood pressure significantly.¹

At the other extreme of fasting are those that abstain from anything aside from water sometimes for a day, but sometimes up to 7-10 days. Other variations include bone broth or vegetable broth fasts often diluted. And there are now low calorie versions of packaged fasts called “fasting mimicking diets” that are essentially 500 cal per day over five days.  

Promising Research on Fasting & Autoimmunity

The only study that looked at the role of fasting on autoimmunity in humans were on people who fasted for Ramadan, the ninth month of the Islamic calendar. Fasting periods are typically around 12-16 hours but there is variation set by the individual. A systemic review did find a mild effect on the immune system but that was transient and returned to baseline once they resumed their regular eating schedule. Lipids improved in some and there was a reduction of oxidative stress markers in others.²

The most persuasive evidence of the benefits of fasting on autoimmunity come from animal studies. Mice that were bred to mimic an autoimmune disease similar to Multiple Sclerosis were used in the study. Multiple sclerosis is a neurodegenerative disorder marked by the demyelination of neurons in the brain that affect nerve conduction. This is in part thought to be due to the body’s own immune system causing the damage.  

The mice were put into 2 groups, one a ketogenic diet (high-fat ultra low-carb) or a fasting mimicking diet (very low calorie and protein) for 3 days every 7 days for a month.

Researchers found was that mice on the fasting mimicking diet had reduced levels of inflammatory cytokines, increase in endogenous corticosteroids and improvements in T cell immunity. Aside from markers they saw that mice actually had REMYELINATION meaning the damaged components of the neurons regenerated what was damaged by the body’s autoimmune process. This was specifically though to happen during the re-feeding periods. Amazingly 20% of the mice had a complete recovery and all mice had a reduction in symptoms.³

This is certainly a very fascinating finding that will spur on further research to elucidate the utility of fasting in certain autoimmune conditions and we’ll hear more as time goes on.

I am big proponent of fasting in certain circumstances and I utilize the full spectrum of fasting methods in the right person. Would I have this discussion on fasting in an autoimmune patient, yes. But given the current data in autoimmunity it is not a methodology that I advocate early on.

Caution: Fasting is something that one can consider exploring on their own if they are not within the extremes of ages, healthy and without any active disease for which they are taking medication but if one does not fit in this category, it is advised that they seek the guidance of a knowledgeable  physician who can advise and monitor them through this process or to be able to assess if they are the right candidate to go through the process.

Do you have a health condition and wondering if fasting is right for you? If you live in our neighborhood, make an appointment with Dr. Yee. Or, if you live afar, consider a Tele-Education call. Send us an email for more information — > Email Now

 

References
  1. https://today.uic.edu/daily-fasting-works-for-weight-loss
  2. https://www.ncbi.nlm.nih.gov/pubmed/29230208
  3. https://www.ncbi.nlm.nih.gov/pubmed/29230208
Posted on

Protecting our Youth from Colorectal Cancers

cancer

By: Pamela Yee, M.D.

A photograph of a beautiful, vibrant, 22-year old woman with the following headline recently caught my eye: Colon and Rectal Cancers Rising in Young People (1). As reported by The New York TImes, the American Cancer Society cites an increase in the number of young adults developing colon cancer, a disease most associated with that of an aging population.

Interestingly, researchers are at a loss to explain this rise.

The connection is obvious to me.

I strongly believe our diet foremost, and plethora of toxic environmental exposures, cannot be ignored. These exposures, both food and environment, begin in the womb and continue throughout childhood.

The larger question is, how can we collectively get our children to develop good eating habits to set the stage for optimal health?

FOOD

What’s Changed? The MEDIA!

As a kid of the 70’s I witnessed the early blossoming of processed foods.  Doritos, Lucky Charms, Kool Aid and Twinkies were common kids’ staples and few spoke of organic food. But, coming from a family that immigrated from China, these foods were kept at bay since my Grandma home-cooked almost all meals. There was no need, or pressure, for convenience foods — they were seen as treats.

Also, the art of corporations marketing to children had just began taking off. The allure of characters beckoning children to sample their spaceship-shaped waffles or cookies bathed in food coloring could not readily reach children through TV and other media. I believe the kids I grew up with benefitted from this relative media innocence.

A crucial point in 1980 changed everything.  The Federal Trade Commission had been trying to set restrictions on advertising to children. Their argument was that young children could not discern commercials from entertainment programs and older children could not understand the long-term health consequences of eating lots of sugar.  But pressure from the sugar, toy, candy and cigarette industries and farmers growing wheat for sugared cereals, all swooped down to prevent this from happening.

In 1980, Congress passed an Act that “mandated that the FTC would no longer have any authority whatsoever to regulate advertising and marketing to children, leaving markets virtually free to target kids as they saw fit,” wrote Anna Lappe, author and food advocate.

This one act launched the onslaught of marketing to children, and morphed into the complex state it is today where movies create characters which then show up on cereal boxes, plastic toys and candy wrappers.  [To read more about this pivotal act in detail, you can read Anna Lappe’s take on it here.

It’s surprising there was no extended commentary on the New York Time’s report on why this increase in colorectal cancers are being seen in young adults, and that the reasons are “baffling.” To me it all boils down to the environmental change that has occurred over the last four decades. And if food is the “medicine” that we put in our bodies all day, processed by our gut and microbiome, it seems that there would be an association between diet and incidence of disease.  Of course we can wait and wait for further studies to elucidate or we can do something about it now.

HOW TO HELP OUR CHILDREN

ROLE MODELS

From a preventative sense, one of the most potent things we can do for ourselves, and for our children, is to set a behavior we want modeled.  The younger you start with children, obviously the better. But, discussions with older children about why and how food impacts how they feel are powerful. They may not take to them right away, but you are sending a verbal message that you then reinforce by walking the talk. If mom and dad are eating sugar or convenient processed foods on a regular basis how can you expect your children to take you seriously?

MEDIA

Another way we can help our children is to limit media.  Easier said than done, I know as tech is the easy babysitter we employ so that, as parents, we can do chores around the home or placate an angry toddler on an airplane.  But the more we rely on that easy solution the more detriment it imposes on our children, not only because of the advertising and marketing, but also on the very relationships parents have with their own children.

Catherine Steiner-Adair Ed.D, a clinical psychologist and expert in child development and education, wrote the book, The Big Disconnect: Protecting Child and Family Relationships in the Digital Age after extensive interviews with children and parents on how social media and technology change the way children learn, grow and make connections with others.  She also gives advice to parents and educators on how to deflect the detrimental effects of media on our children.

These suggestions can all translate to better eating — not only because of the reduction of media influences — but because it will force us to pause, parents included. When both parents and their children employ awareness and make conscious choices surrounding food, media and their relationships with one another, family health automatically comes to the forefront. Suddenly you will find that you’re at the dinner table, without your devices, and enjoying a meal together, conversation included.

Reference:

(1) https://www.nytimes.com/2017/02/28/well/live/colon-and-rectal-cancers-rising-in-young-people.html?smid=fb-share&_r=0]

Meet Dr. Yee:

Pamela Yee, MD is an Integrative Physician at Blum Center for Health in Rye Brook, NY.   Dr. Yee has a special interest in integrative cancer care and creates highly personalized treatment plans for each of her patients. She lives in Nyack NY where she and her husband manage their own organic micro-farm.

CLICK HERE  to learn more about Dr. Yee.

Posted on

How to Manage Cancer Treatment Side Effects with a “Whole-Person” Plan

By Pamela Yee, MD

Breast cancer patients often see me to reduce a variety of treatment side effects. Side effects during chemotherapy. Side effects from radiation. Side effects from being on long term estrogen suppression, such as Tamoxifen or Femara.

For some women, estrogen suppression, and the assumption that they are going to hit menopause like a wrecking ball, induces more fear than either chemotherapy or radiation. One day you’re living with a certain level of hormones and the next day the cord is cut. It’s easy to start imagining what it means to suddenly live without the hormones that define womanhood.

Some of the side effects of estrogen blockers are much like those in menopause: night sweats, hot flashes, vaginal dryness, insomnia, mood changes on the spectrum of irritability up to depression. Additionally, the Aromatase Inhibitors, like Femara, can cause muscle or joint pain and stiffness. In my practice, this is actually one of the most limiting side effects and a cause for some to stop their treatment.

Good News: There’s Another Way

Treatment of the muscle and join pain associated with Aromatase Inhibitors does not have to come in the form of more pharmaceuticals like non-steroidal anti-inflammatory agents (NSAIDS), such as ibuprofen and naproxen, which are very disruptive to the gastrointestinal system.

For years I’ve been advising my patients to employ techniques like acupuncture and exercise to treat side effects. Now there is research to back up my approach.

A study recently published in the Obesity Journal (1) demonstrates that exercise — both resistance training and aerobic — mitigates the side effects of Aromatase Inhibitors. How much training did it take? Weight training twice a week and 150 minutes of moderate aerobic exercise. Not only were side effects reduced but patients had a positive change in body composition. This is very exciting news and shows how even a small amount of exercise can have a big impact.

In many prior studies looking at the role of exercise in breast cancer patients, exercise has shown to increase survive and weight gain has been been associated with increased mortality.

Exercise has always been an important part of my treatment strategy with patients with breast cancer. The data clearly reinforces my approach as I continue to support my patients in helping them prioritize exercise in their treatment plan to increase their lifespan, improve their quality of life, and prevent recurrence.

About Dr. Yee

Pamela Yee, MD is an Integrative and Functional Medicine Physician at Blum Digital, LLC in Rye Brook, NY.   Dr. Yee has a special interest in integrative cancer care and creates highly personalized treatment plans for each of her patients. She lives in Nyack NY where she and her husband manage their own organic micro-farm.

CLICK HERE to learn more about Dr. Yee

Reference:

(1) Thomas, G. A., Cartmel, B., Harrigan, M., Fiellin, M., Capozza, S., Zhou, Y., Er-colano, E., Gross, C. P., Hershman, D., Ligibel, J., Schmitz, K., Li, F.-Y., Sanft, T. and Irwin, M. L. (2016), The effect of exercise on body composition and bone mineral den-sity in breast cancer survivors taking aromatase inhibitors. Obesity. doi:10.1002/oby.21729