Skeptical of health claims

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  • I believe fasting can help you loose weight because you are eating less calories over all. However, i’m skeptical of the added health claims made by Michael Mosley. If you are overweight and then loose weight you’ll likely see improvements in your blood work etc indicating a reduction in lifestyle related risk factors. I’m not convinced this is due to fasting itself, i think it’s more likely due to the weight loss and you will see health improvements if you loose weight, no matter how you loose it.
    The book seems to be implying that fasting should be a lifestyle choice for everyone, not just a diet for obese people, which will result in us all living longer and healthier lives. But these are big claims which lack the scientific evidence to back them up.
    I was reading that the researcher whose work the book is based on has complained that her work has been misrepresented:

    ‘My research on alternate-day fasting has been misrepresented in the book,’ Dr Varady told Healthista in September last year. ‘Mosley used my research, which looks at fasting three to four days a week, to support his diet, which encourages fasting two days a week.’

    “The Fast Diet is about his [Mosley’s] experience,’ says Varady. ‘But unfortunately he actually used all of my research on alternate day fasting to support all of his points. Scientifically you can’t take studies that look at three or four days fasting a week like mine and say it’s the same thing and that you’re going to get the same health benefits when you just fast two days a week.’

    http://www.healthista.com/nutrition/fasting-diets-krista-varadyscience-research-studies-52-diets/

    And there is also this excellent review of The Fast Diet book which looks at what evidence there is to support it. Spoiler alert: There’s not much.

    “Putting aside the fact that many of our closest primate relatives do in fact graze all day (chimpanzees for instance), I’m not sure this theoretical line of reasoning really matters in lieu of evidence, though certainly it does provide a reason to consider the possibility that fasting has interesting properties.”

    “When The Fast Diet does venture into evidence based research the bulk of it comes from mice and rats – useful models to start with no doubt, but of course results from rodent studies are not automatically translatable into humans. One of the book’s primary theories is that fasting is helpful because it reduces circulating levels of IGF-1 (insulin like growth factor 1) which in the case of a particular strain of mouse, might be implicated in many disease processes including aging and cancer. And while I am by no means an expert in intermittent fasting or IGF-1, it strikes me as odd that in the few studies I found on medline that specifically looked at IGF-1 levels and intermittent fasting in human subjects following the ADMF protocol espoused by The Fast Diet, there wasn’t a consistent effect on IGF-1. One study I looked at showed a decrease in IGF-1 only when energy restriction was accomplished by means of a 10 week liquid ADMF diet, while the other, actually showed little change or even a small rise in IGF-1 levels following a full 6 month trial of ADMF dieting by overweight women. But rather than report on the effect one of the longest and largest trials of ADMF dieting in overweight humans that showed no change to circulating IGF-1 Dr. Mosley chose to report on his own personal drop in IGF-1 levels while following his diet – an odd thing considering the randomized trial he didn’t cite was in fact conducted by Dr. Krista Varady – the researcher responsible for The Fast Diet’s actual regimen and one of the book’s most regularly featured personalities.”

    “”Dr. Mosley’s section covers other purported benefits of ADMF fasting – most propped up almost entirely by theoretical or non-human based underpinnings with his take being that ADMF fasting staves off Alzheimer’s, prevents cancer, improves chemotherapy, lengthens your lifespan, improves your memory, decreases depression, and of course helps you to lose weight and improves your cholesterol.”

    “Ultimately here’s a diet book based primarily on theoretical conjecture and mouse studies that’s propped up almost exclusively by the personal experiences of two professional journalists neither of which were obese to begin with nor working with patients trying to manage their weights, where statements such as,
    “studies and experience show that intermittent fasting will regulate the appetite, not make it more extreme”
    fail to come with citations, and where on the very same page the statement,
    “It all points to a healthier, leaner, longer old age, fewer doctors’ appointments, more energy, greater resistance to disease”
    coexists with the butt covering,
    “yet science is only just starting to catch up”.
    So if you want to try fasting as a means to control available energy intake – by all means go for it, but as the authors in rare moments of clarity between wild conjectures and unsupported statements point out, the science is still far too young to be conclusive.”

    http://www.weightymatters.ca/2013/04/diet-book-review-fast-diet.html

    So, I’m not convinced. As someone with a science background i can see that Mosley has cherry picked studies to support his beliefs while omitting large scale randomized studies which go against him. That’s bad science Mosley. Bad science. No wonder Varady is pissed off.

    Not sure what you want from us Demidog? There are plenty of people on here that can point to health improvements and yes, you might say “Oh, that’s just because you lost weight.” and in some cases I’m sure you’d be right, weight loss itself can and possibly is, in a lot of cases where the fasting period itself isn’t long enough to do anything anyway, responsible for the health improvements but it isn’t going to account for them all and isn’t going to account for everyone’s case.

    Personally (and everyone’s experience of 5:2 on here is going to be personal and anecdotal), I’ve ALWAYS had very high (high-high end of normal) blood pressure throughout my whole life. All of the women in my family do. I began putting on weight along with puberty and was at least 3 stone overweight and a size 16 from my late teenage years until the age of 34, when I started 5:2. 2 months into 5:2 I had my BP taken for a medical check, so I could go scuba diving and my BP was not ‘high-end of normal’ or even just ‘a bit high’ it was (and I quote) “perfect” and has been ever since. My BP is ‘perfect’ NOW as a (still a good stone or so) overweight adult than it was when I was a ‘fledgling-fatty’ early teenager, just starting out on the road to obesity.

    And then there’s the ‘perfect’ periods, compared to hitherto nightmare ones (which DO return if I stop fasting for too long or too near that time of the month) and the perfect ‘acne & eczema free’ skin.

    So yeah, it’s anecdotal and it’s personal to me but please don’t try and tell me that the health benefits I’m feeling are not to do with fasting – they are.

    If you have a problem with the science that’s fine but don’t come on here and expect to find an audience who are receptive to your skepticism – we don’t really care if you believe the science, we don’t really care what the science even IS. This WOE makes sense to us, it’s simple and easy to do and it REALLY, REALLY works for many, many people (including myself) for whom NOTHING ELSE ever has.

    That is all. 😉

    TracyJ,

    I’ll second that!

    Demidog,

    If you had been reading the forum this year, you would have seen some amazing stories, from people who are now controlling their diabetes with fasting to those recovering from strokes who notice a marked improvement in symptoms. [I’m with TracyJ on the benefits of fasting for menstruation btw and, although I wouldn’t put it up there with strokes and diabetes necessarily, I am now less anaemic as a result…]

    As someone “with a science background”, you will of course be aware that an absence of evidence is not the same as an absence of effect… I suspect that we will increasing see the ‘evidence’ catching up to support the claims.

    So you’ve done no research yourself, you’ve just read the book and someone else’s comments about the book? Not exactly a scientific basis for your conclusions! I’m skeptical about your ‘science background’. Also, it’s a bit weird (and rude) to put a post like this here – smacks of being a troll.

    Hi
    I think it’s fine to be sceptical about any study – surely that is the basis of all scientific enquiry? I think people should be free to post such opinions on here, even if, to some tastes, they are rather brusquely expressed.

    I watched the Horizon documentary in 2012 and even though, for my own reasons, I was interested in giving 5:2 a go, I did find the tone rather breathless! I have no scientific background (except for a couple of mediocre biology and chemistry exams grades from 40 years ago, at age 16) but even I could see that eg the results positing improved mental acuity in mice would need much further work to prove they were applicable to humans.

    I clicked on the links Demidog gave us. I read the review (2nd of Dd’s links) and subsequent comments (some of which echo @traceyj‘s points.) The article was fairly interesting but the arguments have all been well rehearsed elsewhere.

    As for Prof Varady’s well publicised ire, I guess there will always be professional rivalries in any field!

    I am sceptical about everyone’s motives in any lucrative field – for example health and weight loss.

    However, I have been able to follow this way of eating without huge expenditure, simply by having watched the tv prog and by joining in on this site, which is free to access and, mercifully, advert-free (except the plugs for the books of course haha). So I’m grateful for that.

    Nothing wrong with being sceptical. Certainly not a lot of evidence currently and Mosley has been clear on this as the quoted review admits. Personally I certainly don’t feel misled, however I do feel 10kg’s lighter and healthier than ever.

    Hi everyone, thanks for all your replies! I’m just hoping to be introduced to some real evidence of the health claims of the 5:2 diet, aside from weight loss. It’s great that you’ve lost weight and are feeling better, i’m not saying you can’t loose weight by fasting, a reduction in caloric intake will result in weight loss. However, anecdotal success stories do not equal evidence. The problem with anecdotes is that they are highly prone to bias. I’m sure lots of people on this site who are loosing weight will be posting on how great they are doing, whereas the people who are failing with this diet will just give up and leave the forum without bothering to comment. This results in bias where we see all these mainly positive stories and hardly any negative ones. To properly asses the effects of fasting 2 days a week large scale human randomized controlled trials have to be conducted. I’m looking for research like this to validate the health claims made by The Fast Diet. If anyone knows of any good quality research please post links. I’m genuinely interested. Thanks 🙂

    Hi Demidog,

    While you await the results of a large scale human randomized controlled trial to validate the health claims, I suspect that those of us who are finding benefits (weight loss and health) will just carry on reaping the anecdotal benefits…. 🙂

    I’m not sure though what you think you have to lose by just having a go, in the absence of the evidence you appear to need?

    I’d like to see those studies & results too but as it’s SO bloody simple and free to do this lifestyle, there’s unlikely to be any great economic impetus to proving the health benefits by clinical trials I expect as there’s no ‘selling point’ for the diet industry or drug companies, so I wont hold my breath.

    I’m the same as Bootsy Badger – watched the documentary in August 2012 and got on with it. Never really expected to lose anywhere near as much weight as I have – my aim WAS the health benefits and I never expected them to be as extensive or as quick to show up as they were either.

    You can grasp the concept of this WOE in a sentence and pop on this board whenever you have a question without spending a single penny. You don’t need books or a weekly weigh in or a special pill or any equipment and the results and benefits are very individual.

    Some people DO report difficulties with the WOE and it doesn’t seem to actually work for everybody. I’ve come across 2 or 3 individuals over the past year or so who asked for help and had lots of suggestions and support from the board but who still couldn’t find a way that worked for them, so we do see the negative results sometimes. It would certainly be interesting to study those individuals to see why it DIDN’T work for them. Just like someone somewhere would find my total negative reaction to losing weight via exercise (which DOES NOT work for me and has even managed to stop my 5:2 progress in its tracks) fascinating.

    Hello Happynow

    I’v been fasting to loose weight way before the Horizon documentary aired on TV. I know it works. That’s not my problem. I’m just interested in the validity of the claims that regular weekly fasting results in longer and healthier human lifespans. If it’s true that’s great, but i want stronger evidence before committing to starving myself continually for the rest of my life. I’m just looking for more convincing evidence and hope i can be directed to research i’m not yet aware of.

    I fast for the health benefits and to LOSE weight.
    It is possible to LOSE weight on any diet if you don’t cheat, but I’ve never come across a WOE before that enables one to LOSE weight and resolve or minimise health issues. I have seen a huge drop in my blood pressure, something that seems to run in my family and doesn’t discriminate according to weight.
    There are numerous cases of anecdotal evidence on this website that many of us are happy to believe without research based evidence.

    Have you thought of visiting a science based website rather than a diet website, as it is unlikely you’ll get what you are looking for here.

    Hello everyone, After 6 weeks of being on 5:2 (some weeks on 4:3) I have lost 4.5 kg and I’m feeling great. I said at the start that my motivation was to get my blood work in the healthy range and I wanted to share with you all my results.

    Cholesterol
    Before 6.9
    Now 5.4 (big yay!) Normal range is <5.6

    Glucose
    Before 5.9
    Now 5.6 (small yay) This normal range is between 3.0 and 5.4

    I’m now out of the obese range (how horrible is that term) and now in the overweight range. As the weight gradually comes off the blood sugar result should lower too. My normal weight range is up to 66kg so that’s the long term goal. I don’t think about that too much and try and focus on my short term goal with is getting to 70kg.

    Anyway I hope these results give you more incentive to continue with the 5:2 diet. I know not everyone’s blood work goes down but you need to find out thru diet and exercise whether you can get them down yourself. If it doesn’t work it’s obviously a gene thing and medication is the way.

    Anyway, hope you all have a great Saturday!

    BeeJay

    You might find this page of info about scientific studies into fasting helpful 🙂 https://www.fastday.com/fasting/latest-research/

    I believe that there are ongoing studies but long term trials by their very nature take time.

    Rather than wait and see if a majority of a randomised population gain statistically significant health benefits, why not just test it on yourself?

    I was right in the middle of the normal BMI range when I started, was physically very fit, but had a number or health markers such as cholesterol, blood pressure and inflammation markers which were higher than normal, but not to the point of requiring medication…. YET. I tested my own body’s response to 5:2 after 12 weeks and got a full suite of blood samples etc. In basic terms I’d gone from an average 39 year old, to an average 20 year old. Every marker right on the money. I lost a bit of fat and my body composition improved and I didn’t want to lose any more weight, so changed to 5 and a half : 1 and a half and use blood pressure measurements as a gauge to check if it’s still working.

    If I was to wait until a number of long-term trials were carried out, I would only know that a certain percentage of the population reacted with a mean difference of x to this way of eating. I would also probably be on medications for my rising blood pressure and cholesterol by the time the results were available!

    This is of course again anecdotal I know, but in the absence of random controlled trials that only tell you averages, and given the undoubted variability of people’s responses, the only action that made sense to me was to take responsibility for my own tests and see what the numbers did. My conclusion was indeed to partially starve myself for the rest of my life as it’s not particularly difficult, saves me money, clearly has had a long-term and repeatedly measured impact on the markers that modern medicine tell us to control, and has given me a six pack! No brainer.

    Haha – I love your conclusions there Sewerdoctor 😀 Good for you – well done!

    To answer your question, no I don’t know of any long term studies on humans because, as you well know, and as do we all, they haven’t been done yet.

    Some of us will be dead if we wait for long term studies. We’re making informed personal decisions, and observing our personal results. This isn’t a science reasearch forum.

    Disingenuous statements are hypercritical.

    Hi,

    There is a Canadian doctor working with patients based on ADF (Alternate Day Fasting) and Intermittent Fasting, to alleviate Insulin Resistance and Diabetes Type 2.
    URL here:
    http://intensivedietarymanagement.com
    From my very lay-person understanding, his study and lectures point to how it is insulin resistance that leads to obesity and how reducing food intake reduces insulin levels in the body, breaking the vicious circle.

    I’ve lost 15 pounds over 10 weeks which I’m still surprised by; I didn’t think I had that much to lose and I never thought it would be as easy as it has been. But the biggest shock was when my blood test results came back; my cholesterol and triglycerides are at their lowest levels since I began having them tested 12 years ago. Docs no longer threatening me with statins / fibrates.

    Whether or not this will lead to any long term health benefit for me, who knows. I’m just a sample of 1, so it would be foolish to extrapolate my experience to the population at large, but I can’t imagine it’s doing any harm. Certainly not compared with what I was doing before, which was steadily increasing body weight.

    Given the popularity of the 5:2 diet it should be possible in the not too distant future to compare health outcomes of those practicing it with those not…

    We have been on the 5:2 for 2 years now and our weight has ‘bottomed out’ at our goal weights but we continue with the 5:2 lifestyle – it has become routine.
    We are both 66 and it will be another 15 years or so before we reach our average life expectancy. If we get beyond that then it may be that the fasting lifestyle is extending our lifespan. If we get to 95 or 100 it may be more certain. I’ll let you know in about 30 years time if I think it has worked!

    I read that some doctors/radiographers are recommending people undergoing radiation treatment to try fasting (alternate days or 5:2) as there is evidence that the fasting kicks the body out of ‘growth’ mode into ‘repair’ mode and the radiation damage is repaired more quickly.

    This is not very scientific, but Marks & Spencer reckon I now have the body of a schoolboy! The smallest waist size in men’s casual trousers is 32″. I can once again get into a 30″ waist size – schoolboy trousers – much cheaper as there is no VAT!

    Very interesting post, Demidog – I too would like to see more evidence of the health benefits that doesn’t rely on n=1 studies.

    Simply asking if anyone knows of any more supportable evidence isn’t inflammatory imo, you’re just curious, but I do recall from the book that Dr M doesn’t say “x causes y” at any point, he couches it all in rather cautious terms, “this suggests that….” or “x points to y”. Mind you, I have yet to hear of any evidence at all, animal or human, that suggest IF is actively bad for your heart, brain or pancreas. Just a thought.

    @mogs: Not quite sure what you’re seeking. Clearly longevity studies on human subjects are not, and will not be, available, at least not in our lifetime. You might start with something like the following and drill down depending on your particular interest.

    http://www.pnas.org/content/111/47/16647.full

    Meal frequency and timing in health and disease
    PNAS 2014 111 (47) 16647-16653; published ahead of print November 17, 2014, doi:10.1073/pnas.1413965111

    Abstract
    Although major research efforts have focused on how specific components of foodstuffs affect health, relatively little is known about a more fundamental aspect of diet, the frequency and circadian timing of meals, and potential benefits of intermittent periods with no or very low energy intakes. The most common eating pattern in modern societies, three meals plus snacks every day, is abnormal from an evolutionary perspective. Emerging findings from studies of animal models and human subjects suggest that intermittent energy restriction periods of as little as 16 h can improve health indicators and counteract disease processes. The mechanisms involve a metabolic shift to fat metabolism and ketone production, and stimulation of adaptive cellular stress responses that prevent and repair molecular damage. As data on the optimal frequency and timing of meals crystalizes, it will be critical to develop strategies to incorporate those eating patterns into health care policy and practice, and the lifestyles of the population.

    I think a lot of people who take issue with MM can’t get beyond the title of the book, which definitely oversells the current state of fasting research. I think Varady’s problem was that he seemed to be applying her results on ADF to 5:2, which he definitely shouldn’t do.

    If I remember correctly, even in mice it was difficult to show any benefits of fasting independently of weight loss, because the mice always lost weight!

    I adapted this diet because it seemed like a sustainable way to lose weight and, importantly, keep it off. So far that has been true, so I’m happy. If there are any extra health benefits beyond those I gained by losing weight, all the better.

    Personally, I don’t want to live all that long anyway. Were I fantastically wealthy, or if I had kids, my perspective might well be different. My only goal is to look and feel as good as I can with minimal negative impact on my lifestyle. Also, I enjoy running experiments on myself, so hacking my endocrine system has become a shared hobby for me and my wife.

    Still, if you *are* trying to extend your life, 5:2 is not likely to hurt. Can’t be less effective than gulping down various ‘super foods’, and it’s costless. Regular 4+ day fasting, and extreme caloric restriction are more likely to extend your life, but I think they would make me want to end mine ASAP.

    MaryAnn

    It is possible to separate the benefits from fasting and those from weight loss. The changes in the markers happen quickly and are measurable after just 2-3 weeks. Since the amount of weight loss would be minor in this short time period you can discern the changes must primarily come from the fasting.

    For example my BP before beginning was 150:110 at 116kg
    After 2 weeks on 4:3 my BP was 120:80 at 113kg

    Losing those 3kg did not normalize my BP.

    I understand that the science of the 5:2 isn’t proven, but there are some aspects of it that fascinate me because of my own family history.

    As far as I know, my mother has always been overweight, probably from when she was a small child. For a large part of her adult life, during her thirties and forties she was obese, and her doctor warned her that she was damaging her health.

    But her longevity has not been affected by her weight problem. She is ninety next March. What is more, she has maintained her mental alertness and physical strength and mobility for longer than most. She is still living on her own with the minimum amount of care.

    I wonder if the reason is her habit of yo-yo dieting, and in particular, her preference for starting a diet with 3 days of crash dieting.

    The other thing that fascinates me is that if fasting has beneficial health effects, then it suggests a possible evolutionary advantage for migraineurs such as myself. If I have a migraine and it is untreated, I spend a day puking up. In other words, the migraine forces me to fast. After a migraine I often feel remarkably relaxed and well, better than before the migraine started. Maybe that isn’t an illusion.

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