Time Restricted

Experiences with Time-Restricted Eating and Managing Chronic Disease

Archives for August 2018

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Our first sightseeing excursions

Surprisingly, we got to take a little break from the pure clinical fasting experience to enjoy a little bit of the area.

Every day here at Buchinger-Wilhelmi, there are guided walks from 6am-8am.  This morning we couldn’t join because I had my first laboratory appointment at 7:40am.  Instead, my wife and I went for a little walk in the morning along the Bodensee coastline into Ûberlingen.  The town is only about a 15 minute walk form our clinic. We look forward to exploring it more when we have more time!

Bodenseereiter Fountain
Bodenseereiter Fountain in Überlingen – what was this sculptor thinking?

Every Thursday, there is an optional excursion to sights around the area, so we happened to catch one on our first full day here!  This week, the excursion was across the border to Switzerland to see the Rhine Falls and the town of Schaffhausen.

The Rhine Falls is billed as the largest waterfall in Switzerland and all of Europe, at 150 meters wide! I was very impressed at how close visitors can get to the falls!


Rhine Falls, Switzerland

Schaffhausen was also very cool, with roots in the Middle Ages!

Note that in the Middle Ages, there were no street addresses, so the buildings all had names!  Below, one building was called “To the green mountain” and another was called “to the doe.”  Of course, today, these buildings have addresses!

Schaffhausen Buildings
Building names from the Middle Ages – “to the green mountain” and “to the doe”

This clock in the Fronwagplatz is over 500 years old, and it served many functions.  Note that it just doesn’t tell the time but also the zodiac and even the phases of the moon.  (Right now, we’re nearly at a full moon.)

Fronwag Tower
Fronwag Tower with Astronomical Clock

Probably the biggest difference we saw there was how sparse Protestant churches were compared to Catholic churches.  Here’s a photo inside Münster Schaffhausen.  Note that the lack of decor compared to the sights in Italy and Spain!

Münster Schaffhausen
Münster Schaffhausen

We hope to be able to do some more sightseeing as we continue to fast!

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Digestive Rest Day

Today was our “digestive rest day.”  The concept is to choose one main food staple to eat throughout the day to prepare the body for fasting.

Choices were:

  • fruit
  • potatoes
  • rice
  • oatmeal

For me, Dr. Lischke recommended oatmeal because it works best for diabetics.  My wife chose potatoes.

My breakfast was oatmeal with a cinnamon-apple sauce over it.  Lunch and dinner consisted of a savory oatmeal with tomato sauce, zucchini, and squash medley.  I was concerned about all the carbs and what that would do for my blood sugar, but I also have now learned that blood sugar seems to be way less about inputs and outputs and much more about hormones…  We’ll see how this looks tomorrow morning for comparison!

Every day, we have to see our nurse between 7am-9:30am.  I get my blood pressure, blood sugar, and weight measured.  I am also logging sleep, how I feel, and other symptoms in a diary.

Today’s baseline:

  • Blood pressure: 152 / 87
  • Blood sugar: 142
  • Weight: 73.5 kg (161.7 lbs)

I know my blood pressure and blood sugar are high.  This is why I’m here!  The nurse said she always sees these two measurements go down as the days go by.  Let’s see how it goes!

 

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Our home for the next 28 days!

The adventure begins!  Today was “arrival day” at Buchinger-Wilhelmi.

Overall, the 100 years of experience here shows in their execution.  The staff here is well-versed at dealing with travelers from abroad.  Once arriving in Zurich, I was welcomed with a friendly phone call from a fluent English speaker who told us where our driver was waiting.  We were driven in a Mercedes E-class sedan to the clinic, where we were then greeted by name, escorted to our rooms, and given a brief introduction to the set of materials we were to then receive, including handouts, newsletters, books, and an iPad with a proprietary “fasting coach” app featuring their own video content!  There’s a lot of homework involved here in fasting!

I am going to apologize in advance for not taking as many photos as I’d like to here.  The clinic has a rule against use of mobile phones outside of our rooms, and we signed a little contract agreeing to these terms!  They do provide Wi-Fi in our rooms but discourage Web surfing, streaming media (outside their own!), and other distractions to keep us from being present in the moment of fasting.  That said, reading, writing, and other creative endeavors are encouraged during this time.

My wife and I have adjacent rooms in the Park Villa, overlooking the Bodensee.  The rooms are very sparse but clean.  Like a hospital, each room has nurse “call” buttons both at bedside and in the bathroom.  During the day, we have a nurse in our building, and after that, there is a night nurse on call.  (Update: at 4am Thursday morning while half asleep, I accidentally pressed the “call” button while looking for a light switch in the bathroom.  My phone rang immediately!  That really woke me up!)

View Off Balcony at Park Villa (Buchinger Wilhelmi)
View from my balcony at the Park Villa

We also had our first appointments with our doctor, Dr. Lischke, who made a very good first impression!  I found it odd that the clinic specifies gender in their therapy schedules, as my handout referred to her as “Mrs. Dr. Lischke.”  Perhaps this is more appropriate for a very international audience.

Therapy Schedule for Buchinger Wilhelmi
Therapy Schedule – note the “Mrs. Dr.” designation!

For our first day here, we got to eat full vegetarian meals for both lunch and dinner.  The food here is excellent!  To me, it’s ironic that a fasting retreat has gourmet cuisine, but the doctrine here is as much about having a healthy lifestyle after the clinic to fully realize the benefits of fasting!  In addition, we were told that the first day of food is really to ensure that, after the weariness of travel, we’d have full strength to begin the process of fasting.

In the dining room, we have assigned seating.  We were situated at a table for four people, but we did not see the other two people at our table today.  Perhaps they are already fasting! Still, there were many people there either before their fasts, after their fasts, or, in some cases, enjoying the “calorie restriction” program here as an alternative to fasting.

On the way to the dining room, we pass the “salon” where the people who are fasting congregate during mealtimes to consume their vegetable broths.  I’ll be documenting what that’s like in a couple days!  Our first day of fasting will be Friday!

Tomorrow, we’ll be our “digestive rest day.”

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Leaving for Buchinger-Wilhelmi fasting retreat today!

Today is the day that my wife and I are leaving for a 28-day fasting program at Buchinger-Wilhelmi to (hopefully!) reverse my Type II diabetes.  We booked this trip back in April, and since then many people have asked me to chronicle our experiences.  As such, I started this blog, and I’m announcing it today!

I encourage you to go back and read the articles on this blog leading up to this one.  Before just journaling about the retreat itself, I wanted to provide some context to why I’m on this journey, and I encourage you to share the blog with others who may be diagnosed with Type II diabetes or prediabetes and looking to reverse it.

To stay up to date on posts, you can either follow my Time-Restricted Facebook page (you don’t need to be “friends” with me) or sign up for the time-restricted email list (again, separate from the now decades-old Pao Family Holiday spam list so that diabetes sufferers don’t have to hear about how our kids are doing!)

A Tale of Two Rooms

All that said, I wanted to start by thanking my wife for volunteering to come and fast with me.  She doesn’t suffer from diabetes and is really coming for moral support.  Already, that moral support is working, as I don’t feel “anxious” or “stressed” about the month ahead.  She’s going to be with me, as she’s been throughout this journey.

One of the more humorous aspects is that we’ll actually be getting two rooms — actually to get two toilets!  One issue here is that when you fast, you don’t really poop on your own the way you do when you’re eating.  I’ve only gotten bits and pieces so far, but it appears that this clinic has their own ways to keep you “clean.”

Here’s what the reservation agent said in her email to me.

With one room together it depends on you. Many people want to book two separated rooms because you have to sit on the toilet after the glauber salt and you will every second day an enema.

We also can offer you two Superior rooms with connecting doors or an additional Comfort room, so every person has his own toilett [sic] and bed but the rooms are connected.

The difference in cost between Superior rooms and Comfort rooms was significant, and my Chinese genetics couldn’t justify that for an adjoining door.  We were going to hang out in one room anyway, and simply retreat to our respective toilets to poop.  Is an adjoining door in that case a feature?

After some back and forth, the reservation agent simply replied.

I understand your point of view. We can organise that both Comfort rooms will be next to each other .

$3.56 to wash my underpants?

The other funny story about this retreat is that it’s 28 days, and the laundry is expensive!  Some sample laundry (“Wäscherei”) prices:

  • boxer shorts – € 3.10 euros
  • socks – €3.00 euros
  • T-shirts – €4.30 euros

At the exchange rate of $1.15 per euro (€), this is like $3.56 per boxer short, $3.45 per pair of socks, and $4.95 per T-shirt!  Call me weird, but I just didn’t think that was at all worth it.  So, I procured extra stuff at Target and Costco (as well as a larger suitcase!) and packed 28 days of the “essentials.”

My original concern about packing so much was that I wouldn’t be able to fit everything.  The issue was not space but rather weight!  (The limit for the “free” baggage for international travel is 50 lbs.)

That whole scenario with being constrained by weight and not cooling reminded me of life in the data center business.  We often found that we were not constrained by rack space but rather power delivered to the rack, and the associated cooling!

Anyway, we ended up working around the checked luggage weight constraint by putting a bunch of stuff into our carry-on luggage.  My second thanks go out to my wife (who is 5’1″) for carrying some of my stuff through airports!

 

 

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About to head off to a fasting retreat!

My wife and I will be headed to Germany for a 28-day fasting retreat!  (She is along for moral support!)

People often ask “why so long?”

I’ll cover more about the “why” and “how” of fasting in future posts.  However, to net it out:

  • I have excess fat in my liver, like many other TOFI Asian Americans, which led to a diagnosis of Type II diabetes back in 2003.
  • I want to do prolonged fasting to “stress” my liver cells to “restart” fat absorption and to reverse the disease.
  • Without all the science fully understood, there has been a centuries-old tradition of fasting for health and well-being across many different cultures.

While I’ve done 36-hour fasts and 3-5 day fasts on my own before, I wanted to learn more from extended fasting under medical supervision.  There were three different options I considered:

All three choices sounded viable!  However, the Buchinger-Wilhelmi option felt the most “immersive” to me.  In addition to just fasting, the program combines:

  • therapeutic fasting
  • integrative medicine
  • psychotherapy and coaching
  • nutrition and dietetics
  • exercise and relaxation
  • inspiration and spirituality
  • beauty
  • daily activities (e.g., walking tours, workshops and courses, lectures, training courses, concerts and literary evenings)

The clinic is a fourth-generation family-run business and started after the founder, Otto Buchinger, started a 19-day fast in 1919 to cure his rheumatoid polyarthritis.  They have been treating patients with therapeutic fasting ever since!

Plus, look at these surroundings!

Buchinger-Wilhemi-View-oer-the-lake
View on the Lake from the Buchinger Wilhelmi Web site

We will be doing a 28-day program, which we believe will involve:

  • 4 days to ease into fasting
  • 20 days of fasting-mimicking diets
  • 4 days to ease off of fasting

We will also get medical checkups to ensure all is going well!

We’ve been asked by many to keep them up-to-date on what happens.  We’ll let you know on this blog.  Subscribe for updates!

 

 

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Diabetes and non-alcoholic fatty liver disease

In my last post, I discussed the “fat on the inside” of people with diabetes.  One of the most insidious places for this fat to live is in the liver!  Science is now showing the relationship between liver fat and diabetes, and the potential cure for both — fasting!

Diabetes and non-alcoholic fatty liver disease (NAFLD) are closely linked, with studies showing that NAFLD is present in up to 70% of patients with Type II diabetes.

While the association between diabetes and fatty liver disease is well known, the relationship between the two has been unclear in Western Medicine.  Which comes first – diabetes or NAFLD? A study of a Korean population published in 2011 sought to investigate this question and found that the presence of fat in the liver was a good predictor of Type II diabetes risk:

Nonetheless, fatty liver detectable by ultrasound identified individuals with worse metabolic profile and greater risk for T2DM [Type 2 diabetes mellitus], regardless of baseline fasting insulin concentration. Therefore, our findings suggest that fatty liver, although associated with insulin resistance, is also an independent predictor of T2DM.

A newer analysis of Chinese patients published in 2017 demonstrated a bidirectional relationship between fatty liver disease and diabetes.

In conclusion, the present prospective cohort study provides evidence that the association between NAFLD and T2DM is bidirectional. Future studies are needed to investigate the potential mechanisms.

The irony is that despite the growing evidence of a causal relationship between diabetes and NAFLD, the current treatments don’t really address fat accumulation in the liver!  Diabetes drugs use different mechanisms, such as getting your liver to produce less glucose, getting your pancreas to create more insulin, or even getting you to pee out sugar from your blood excreted through your kidneys.  However, they don’t address what appears to be a root cause.

To that end, a recent study out of Germany has identified a specific protein responsible for controlling the absorption of fatty acids in the liver and associated blood sugar levels!

Subsequent simulation tests showed that GADD45β is responsible for controlling the absorption of fatty acids in the liver. Mice who lacked the corresponding gene were more likely to develop fatty liver disease. However when the protein was restored, the fat content of the liver normalized and also sugar metabolism improved. The scientists were able to confirm the result also in humans: a low GADD45β level was accompanied by increased fat accumulation in the liver and an elevated blood sugar level.

How do you restore the protein levels to normal?  By stressing the liver cells through FASTING!

“The stress on the liver cells caused by fasting consequently appears to stimulate GADD45β production, which then adjusts the metabolism to the low food intake,” Herzig summarizes.

While the follow-on to this research is to find other ways to stimulate the protein production through drugs, the easier mechanism I see now is through fasting!

This is why I am taking my journey!