What's the difference between eating less food and eating no food?

Well, Let's look at two different situations.

…In 1944, a study called the Minnesota Starvation Experiment was conducted and was designed

to understand the effects of caloric restriction on the body in order to gain some knowledge

that would help people starving in the aftermath of World War 2.

Thirty-six healthy men with an average height of 178cm (about five foot ten) and average

weight of 69.3 kilograms (or 153 pounds) were selected.

For three months, they ate a diet of 3200 calories per day.

Then, for six months they ate only 1570 calories.

However, caloric intake was adjusted to attempt to have the men lose 1.1 kilograms per week,

meaning some men got less than 1000 calories per day.

The foods given were high in carbohydrates- things like potatoes, turnips, bread and macaroni.

Meat and dairy products were rarely given.

During the six months, the men experienced profound physical and psychological changes.

Everyone complained that they were too cold.

One subject talked about having to wear a sweater in July on a sunny day.

The subjects' body temperature dropped to an average of 95.8 degrees Fahrenheit (35.4

degrees celsius).

Physical endurance dropped by half, and strength showed a 21 percent decrease.

The men experienced a complete lack of interest in everything except for food, which they

were obsessed with.

They were plagued with constant and intense hunger.

There were several cases of neurotic behavior like hoarding cookbooks and utensils.

Two participants had to be cut from the experiment because they admitted to stealing and eating

several raw turnips and taking scraps of food from garbage cans.

At first, the participants were allowed to chew gum, until some of the men began chewing

up to 40 packages a day.

Now compare all this to the case of Angus Barbieri, a Scottish man who in 1965 fasted

for over 380 days straight.

That is he took in no food whatsoever -nothing but water, black coffee and straight tea for

just over a year.

He lost 276 pounds, going from from 456 pounds to 180.

A case report published by the Dundee University Department of Medicine in 1973 said “...the

patient remained symptom-free, felt well and walked about normally,” and “Prolonged

fasting in this patient had no ill-effects.”

There were no complaints of mind numbing hunger and he kept the weight off- for several years

his weight stayed around 196 pounds.

This of course is not a perfect comparison, with the case of Angus, there's only one

subject and his starting weight was drastically higher compared to those in the Minnesota

Experiment.

However, it does illustrate some very interesting points about just how different of a physiological

response you get from fasting (that is, eating nothing) compared to eating less, or caloric

restriction.

Dr. Jason Fung, a Toronto physician specializing in kidney disease, and author of the Obesity

Code, says that compared to fasting, Caloric Reduction will result in: less weight loss,

more lean mass loss (i.e. more muscle loss), and more hunger.

Let's start by talking about hunger.

In Upton Sinclair's 1911 book “The Fasting Cure,” he writes about fasting as a means

to improve health.

In describing his first couple attempts at fasting he writes “I was very hungry for

the first day-the unwholesome, ravening sort of hunger that all dyspeptics know.

I had a little hunger the second morning, and thereafter, to my great astonishment,

no hunger whatever-no more interest in food than if I had ever known the taste of it.”

Sinclair recommends to do quite long fasts - around 12 days or so.

In a section addressing concerns about fasting he writes “Several people have asked me

if it would not be better for them to eat very lightly instead of fasting, or to content

themselves with fasts of two or three days at frequent intervals.

My reply to that is that I find it very much harder to do that, because all the trouble

in the fast occurs during the first two or three days.

It is during those days that you are hungry.”

Then he says: “...perhaps, it might be a good thing to eat very lightly of fruit, instead

of taking an absolute fast-the only trouble is that I cannot do it.

Again and again I have tried, but always with the same result: the light meals are just

enough to keep me ravenously hungry...”

In the book he says you will know when you should finish fasting, because your hunger

will “return.”

He quotes a letter he received from a 72 year old man saying “After fasting twenty-eight

days I began to be hungry, and broke my fast with a little grape juice, followed the next

day with tomatoes, and later with vegetable soup.

”

He quotes several other letters he received from readers and this disappearance and reappearance

of hunger is a common theme.

Everyone who wrote to him fasted for at least 10 days, saying they only broke their fast

when hunger “returned.”

This phenomenon runs contrary to the idea one would get hungrier and hungrier as long

as they don't eat.

However, most people have experienced for themselves that this is not the case.

Some will find that they are not hungry at all in the morning or at least they are not

as hungry as they are for lunch or dinner.

But unless you are eating in your sleep, the morning is when you have gone the longest

without food.

Some of this can be explained by the hormone Ghrelin.

Ghrelin, known as the “hunger hormone” has been found to increase appetite and weight

gain.

A study at the Medical University of Vienna looked at patients participating in a 33 hour fast.

Their ghrelin levels were checked every 20 minutes.

Here's how the levels changed over time.

What's interesting is ghrelin is lowest at 9:00AM, which is when they have gone the

longest without eating.

And, Ghrelin comes in waves and overall doesn't rise during the period the subjects were fasting.

Then, As you can see, ghrelin rises in sync with normal lunch and dinner times, as if

the body had learned to expect food at that time.

However, that ghrelin rise spontaneously decreases after 2 hours without food.

I've experienced this kind of spontaneous decrease in hunger myself many times when

I was working as a consultant.

Lunch time would come and I would be hungry, but I was too busy to eat so I just kept working.

Pretty quickly I forgot about eating and wasn't particularly hungry until dinner time.

This is very helpful to keep in mind if you're doing a long fast or even if you're starting

intermittent fasting - you're going to get annoying waves of hunger, especially around

the times that you usually eat.

But, it won't get worse, the hunger will simply go away if you are patient.

Another study concerning ghrelin was done at Aarhus University Hospital in Denmark and

it shows what happens if you do a longer fast.

They looked at the ghrelin levels of 33 subjects who fasted for 84 hours.

So, did they get increasingly hungrier throughout the fasting period?

Well, No.

Their ghrelin followed similar rhythms each day but actually decreased the longer they

fasted.

Going longer without food actually made them less hungry.

This gives credence to what Upton Sinclair and his readers said about hunger disappearing

after the first 3 days of fasting.

I've done a couple 5 and 6 day fasts in the past myself and this was indeed the case.

Actually, I did a 4 day fast last week and again the 4th day was when I had the least

hunger.

Another thing that may be contributing to this phenomenon is that you are entering ketosis.

Ketosis is a physiological state where your metabolism switches to using primarily fat

for energy.

For this reason ketosis is popular as a weight loss method, but it has many other benefits

including better physical and mental efficiency.

Ketosis occurs when you restrict carbohydrates down to 50 grams or less and you don't eat

too much protein.

Everyone's body is a bit different so you might have to eat even less carbohydrate or

may have room for more, but the recommended ratio of a ketogenic diet is to get 5% of

your calories from carbs, 25% from protein and 75% from good fat.

A simpler way to enter ketosis is just don't eat anything for a long enough time.

This is one of the major points in the difference between fasting and caloric restriction.

The problem with the subjects in the Minnesota Starvation experiment was that they were eating

just enough to keep them out ketosis and keep their metabolism primed for burning carbohydrate

(glucose), so they couldn't use their body fat for energy.

This explains a lot of things like why they were losing their strength and were very sluggish

and cold.

It also clears up why Upton Sinclair said fruit or light meals were just enough to keep

him ravenously hungry and far weaker than if he had just eaten nothing.

As I explained in my last video, insulin is necessary for glucose to get into the cell

to be used for energy.

When you eat carbohydrates, the pancreas secretes insulin to deal with it and too much insulin

hampers the action of something called hormone sensitive lipase which is necessary to mobilize

fat and use it for fuel.

Though, keep in mind that grains or refined carbohydrates will provoke a much higher insulin

response than say green vegetables.

Now because the body is having a hard time using its fat for fuel, it will do a couple

things: One, it will simply slow down metabolism to preserve energy.

In the Minnesota Starvation experiment, the subjects metabolism dropped by 40 percent.

Their bodies didn't have access to its stored energy, and their restricted calorie diets

don't provide much fuel so there's no choice but to slow down the metabolism.

Ironically, in the case of fasting, as Jason Fung points out - metabolism actually goes

up.

"If you don't do anything about your insulin and just reduce your calories, your metabolism

goes down.

But what happens during fasting?

Well, here's a study of 4 consecutive days of fasting.

What happens to your REE - this is this middle line here, that's the resting energy expenditure.

It doesn't go down, it goes up.

You're burning more energy than you did."

The other thing the body will do when it can't use fat for fuel is break down muscle into

glucose through a process called gluconeogenesis.

The body doesn't want do this too much because it's not very smart to completely eat through

something as important as muscle, but when it can't access its own stored energy it's

more likely to resort to this.

This is why you'll experience more muscle loss on caloric restriction than if you ate

nothing.

When you are fasting, Human Growth Hormone is released.

As the name implies, Human Growth Hormone is an anabolic hormone - a hormone conducive

to growth.

In Leningher's Principles of Biochemistry textbook they give the example of how injecting

the human growth hormone gene into a mouse makes it unusually large.

As explained in Guyton's Textbook of Medical Physiology: "...growth hormone also mobilizes

large quantities of free fatty acids from the adipose tissue, and these in turn are

used to supply most of the energy for the body cells, thus acting as a potent "protein

sparer."

"That is human growth hormone is protecting your muscles from breaking down.

The study I referred to earlier about subjects undergoing an 84 hour fast shows that growth

hormone rises significantly after the second day of fasting.

As mentioned earlier, you should enter ketosis sometime within the first 3 days or so of

fasting, and it depends on how much you are moving around and what your diet was like

before starting the fast.

The state of ketosis is a great indicator that your body is making good use of its stored

body fat for energy.

In Tim Ferriss' book “Tools of Titans,” Tim talks about his first clinically supervised

7 day fast.

For some sort of liability reasons, he wasn't allowed to exercise or leave the facility.

Considering exercise is a potent stimulator of human growth hormone and will help deplete

glucose stores, not getting any exercise is a great way to prevent yourself from getting

into ketosis during a fast.

It's also a great way to lose muscle.

Tim says he lost 12 pounds of muscle during the overly restrictive clinically supervised

7 day fast.

But, when following a protocol designed to get him into ketosis as soon as possible - involving

things like 4 hours of brisk walking, he did a ten day fast and apparently lost zero muscle

mass.

One last factor in Ketosis preserving muscle is leucine.

When you're in ketosis, you have a higher fasting blood leucine level.

And leucine is a key branch chain amino acid that has an anabolic effect on the body so

it preserves lean body mass.

A lot of people interested in building muscle may be worried that fasting or a ketogenic

diet wouldn't work for them because insulin and therefore carbohydrates are necessary

for protein synthesis (i.e. muscle growth), but actually this leucine fills that role

and is a good trigger for protein synthesis.

So, just to sum all this up: compared to a conventional calorie restricted diet, fasting

means you lose more weight in the form of fat, you keep more muscle, you have more energy,

and you are less hungry . If proper weight loss is your goal, it might be better to eat