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By Matthew Rees

Food and Health Fact #174:

Can fasting provide a fast pass to health -- and a healthy weight?

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One dimension of food and health I had never explored, until recently, was water-only fasting. The publications, websites, and newsletters I read rarely mention it. And I never thought it would be feasible for me, so I didn’t bother to investigate.

I now know a lot more about fasting, and understand its potential health benefits, thanks to a fascinating book: “The Oldest Cure in the World: Adventures in the Art and Science of Fasting.” I’ve written a review of it for The Wall Street Journal – you should be able to access it here. You can also find the review in today’s print edition of the Journal or you can read it below.

By Matthew Rees

The American diet—heavy on processed foods, light on nutrients—helps explain why life expectancy in the U.S. is lower than in any other developed country. The bill came due during the pandemic: Obese people with Covid had markedly higher rates of hospitalization and death. In fairness, Americans seem to want to slim down—dieting is a multi-billion-dollar industry. But more than half of the people who lose weight gain it all back in two years. Can anything be done about this state of affairs?

Stepping into the breach is Steve Hendricks with “The Oldest Cure in the World,” an illuminating exploration of the rich and varied history—and myriad health benefits—of fasting.

Mr. Hendricks reminds us that fasting is a long-standing practice in the major world religions, as a means of penance and purification. ­Beyond godly matters, he notes that hunger strikes have been a ­familiar mode of protest—­Gandhi famously held them to protest British rule in India.

Mr. Hendricks is a firm believer in the value of fasting, but his concern is the body more than the soul. He tells the story of a woman whose follicular lymphoma disappeared in 2014 after an extended fast at a medical facility in Santa Rosa, Calif. The reason, according to one of the doctors, was that her fasting reduced the levels of a hormone linked to her cancer. Mr. Hendricks sees fasting as a way of combating a range of ailments. (“Surgery without a scalpel” was how some doctors once described the practice.) He cites studies showing fasting to be effective against arthritis, hypertension and fibromyalgia, among other afflictions.The medical logic in these cases is that fasting reduces inflammation—the source of multiple maladies—while promoting insulin sensitivity, stimulating DNA repair and generating antioxidants that neutralize a harmful molecule known as reactive oxygen species. Mr. Hendricks argues that fasting leads to better outcomes from chemotherapy, too—by causing healthy cells to go dormant and avoid the treatment’s toxic chemicals.

And, yes, fasting triggers weight loss. The fasting Mr. Hendricks has in mind is periodic, its frequency and duration varying from person to person. He stresses that, if losing weight and staying healthy is the goal, the diet to return to after a fast should be plant-based.He cites Alan Goldhamer, a physician and fasting pioneer, who asserts that humans evolved to eat simple plants, not the processed foods and ­animal products that are a staple of the American diet.

Mr. Hendricks, a freelance reporter, is a deft stylist (fatty foods are “coronary and gastric assailants”; the marketing labels for a health fad are “linguistic casseroles”), and he excels at describing the experience of going without food—though not without water—for extended periods. Starting in 2009, he underwent several one-day fasts and then experimented with longer periods. One of his fasts lasted for nearly 20 days.When Mr. Hendricks had the inevitable hunger pangs, he followed Gandhi’s advice: dismiss thoughts of food the moment they appear. He experienced a range of sensations during his foodless journey: fatigue, a heightened sense of smell, moderate lower back pain, and sharp swings in mood and energy. He only slept 5-6 hours a night.

He struggled with what is said to be the hardest part of an extended fast: from the second day to the fourth. A dynamic biological process unfolds during this period, with glycogen, amino acids and glucose interacting with the liver and the brain. The body eventually starts producing highly acidic compounds known as ketone bodies, and they counter the hormone that causes hunger.Once the body reaches this state, known as ketosis, things get easier. According to Mr. Hendricks, “willpower plays only a bit part in prolonged fasting, and hunger none at all after the first day or two. . . . If I had had to resist hunger’s blare every day I fasted, I’d have given up before the first week was out.”

A theme running through “The Oldest Cure in the World” is the author’s exasperation with the American approach to practicing medicine. Few physicians, he notes, are knowledgeable about fasting, despite the benefits it provides. He favorably profiles two researchers—Valter Longo and Satchin Panda, at the University of Southern California and the Salk Institute, respectively—who have conducted ground-breaking studies on the value of restrictive food consumption.

The book’s most compelling story features an infant who in 1993 started having daily seizures after his first birthday. Neither medications nor brain surgery provided significant relief. Pediatric neurologists told the parents that their son, Charlie, faced a life of mental and physical retardation.

Charlie’s father discovered an obscure clinic at Johns Hopkins University that offered a treatment that involved brief fasting followed by a high-fat, ketogenic diet. The family’s neurologist dismissed the treatment as unworkable, but the family tried it anyway. On the second day of Charlie’s fast, the seizures stopped.Over time, his physical and mental development returned to normal, and he has grown up to be as healthy as his siblings. Later research has shown that fasting and a high-fat diet is a potent method for reducing seizures in epileptic children.

Today, Mr. Hendricks reports, fasting is undergoing a “revival,” and he points to “a small but growing contingent of doctors” who may help fasting gain wider acceptance. Whether one is fully convinced by Mr. Hendricks’ claims—so much depends on what further research will (or will not) confirm—he does seem to be onto something. But a ­prescription to substitute Whoppers and Wonder Bread with water? That’s going to be a tough sell. Mr. Rees is the editor of Food and Health Facts and a senior fellow at Dartmouth’s Tuck School of Business.