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June 2, 2019 By spao 1 Comment

26 Fasting Days Completed!

I’m now turning the corner of this second round at the Buchinger Wilhelmi fasting clinic here on Germany. Now that I’ve been through 26 days of fasting this time around, “re-elementation” or “refeeding” is now the most important part. The body has torn down the old, bad stuff through fasting. I’m down over 20 pounds (spreadsheet here). Now it is time to rebuild but with the right foods!

I know from experience that this rebuilding is the hardest part. After 4 days of eating foods provided by the clinic, the hard part is coming home and staying very healthy for the next two weeks and beyond.

Everyone always marvels at the extended fasting, as the fast itself is the experience they can’t imagine. Buchinger takes care of that part. Doing the right thing is up to you and your support infrastructure around you. Most people fail at that part. Buchinger Wilhelmi has many repeat visitors who simply use the clinic as a recurring reset operation because of the challenges of maintaining the discipline at home.

As a second time visitor, I hope not to need to spend the time and money here for periodic resets! Still, I have to understand that 2 months of extended fasting in the last year may simply not be enough…

In Chapter 15 of The Diabetes Code, Canadian nephrologist and fasting expert Jason Fung (whose Intensive Dietary Management program I’ve mentioned here) provides further encouragement:

Certain general principles apply to fasting with type 2 diabetes. How long it takes to reverse the disease depends on the intensity of the fasting regimen and the length time you’ve had the disease. More intensive fasting will give quicker results, but if you have type 2 diabetes for twenty years, it is unlikely to reverse in several months. It will take longer, though the exact time differs from patient to patient.

So, this will be a process! Wish me luck!

June 1, 2019 By spao Leave a Comment

Exercise — integral to the Otto Buchinger fasting method

Yes! You can do a fasting program and still exercise!

There are different schools of thought with respect to fasting. On one extreme is pure water fasting, such as practiced at Goryachinsk on Lake Baikal in Siberia. In this program, exercise is not compulsory.

Otto Buchinger, on the other hand, created his fasting program 100 years ago with the thought of providing patients a small calorie intake but augmenting with daily walks as exercise. The idea behind providing of limited food (250 calories per day) with exercise is to make fasting more accessible, with fewer side effects. Daily walks in the forest (or Wanderung as they refer to them here) are every day, rain or shine. With a little bit of nutrition, people do have the energy to exercise!

Buchinger Wilhelmi Wanderung — View from a daily walk (Wanderung) at Buchinger Wilhelmi

The clinic is currently managed by the fourth generation of the family, and Otto Buchinger’s descendants have since further updated the program to augment the daily walks with an indoor fitness center. It’s a pretty sophisticated facility with great views of Lake Constance.

I just wish the fitness center opened earlier in the morning! The walks in the summer start at 6am, and the fitness center would have been a great alternative to walking in the rain!

For me, this month of fasting resulted in a personal record on my Garmin step counter, with over 600K steps in May, 2019. It also capped a personal record of over 5M steps in the trailing 12 months! In the month of May for me, 25 of those days were fasting!

Step Count During Buchinger Wilhelmi Fasting Clinic

Note that the daily walks are typically only about 4 miles for “Group A” (the fastest group of three), so you don’t have to break any records to participate! That said, after the morning walks, we just enjoyed walking around the lake and on the trails around the town, too! It’s really beautiful in this part of Germany when it’s not raining!

We were also able to squeeze in a 10K (the Volksbank Überlingen Lauf) in town. It certainly was not my fastest 10K ever (actually my slowest race), but I was able to complete it with a sub-10 minute per mile pace — even after 12 days of fasting!

Finisher Certificate - Volksbank Überlingen Lauf — Finisher Certificate – Volksbank Überlingen Lauf

So don’t be afraid to fast! You will have a lot of energy!

May 24, 2019 By spao 2 Comments

Resting metabolism not slowing…

I have known for quite some time that my system just wasn’t totally efficient, as I could eat an above average amount of food and not gain weight. While many might envy having this problem, my unusually high metabolic rate was actually a bad sign.

Many (pretty old!) studies have shown that Type 2 diabetics actually have a higher resting metabolic rate than non-diabetics and the high metabolic rate is associated with the progression of the disease.

Examples:

More recently, it was discovered that with no changes in body type, this resting metabolism rate doesn’t respond to interventions, such as interval or continuous training either in an attempt to reduce it. In other words, this high metabolic rate is pretty stubborn!

So far, I’ve completed 17 fasting days (19 total days) here at my second stay at Buchinger Wilhelmi. I started at roughly the same weight (actually 2 lbs heavier!) as last time, and I am losing weight at roughly the same rate. After 19 days, I’m down 8.5kg (18.7 lbs). Last time, by Day 19, I was down 7.9kg (17.4 lbs).

So why is this significant? I had noticed how easy it was for me to gain all my weight back after fasting. I was hoping my resting metabolism had slowed — a potential sign of reversal of the disease. Seeing my weight loss patterns with fasting this second time, this is apparently not the case!

Still the aim for this second round of fasting is to get the benefits of autophagy and mitophagy from the fasting as well as the benefits for promoting the diversity of my gut bacteria.

Something has changed in me given my fast return to normal blood glucose levels and blood sugar in a shorter amount of time. However, resting metabolism doesn’t appear to be one of them…

May 13, 2019 By spao 1 Comment

Back at Buchinger!

Life got in the way, and this is my first blog post of 2019. I’m writing this post on a return visit to the Buchinger-Wilhelmi fasting clinic in Germany. The clinic provides an excellent venue for a mental “reset” to capture thoughts and reflect back on life outside of the day-to-day!

Returned to share with family

The primary motivation for returning to the clinic was actually to share the fasting experience with our college-age daughters. Fasting is a centuries-old tradition (often accompanied with religiosity) which modern American society has stifled.

I’m currently at the clinic in Germany with our older daughter (rising college senior) who is on a 14-day program. My wife and our younger daughter (rising college sophomore) will join us after 10 days for a 21-day program. While our older daughter has to return the US, I will stay on the whole time, making for a total of 31 days for me!

Needed the visit for myself!

It turns out this visit to the clinic was well-timed. My weight (and the rest of my statistics) have largely reverted back to levels prior to my last visit to this clinic. Here for example is a graph of my weight, showing it returning to the level I was at before the clinic visit last year!

Weight Gain Since Buchinger 2018 — I gained back all the weight since my last stay at Buchinger in 2018!

Along with the weight gain, some other health indicators came back, too. 😢 More on this later!

High-level impressions

After completing the first 8 days of the program (arrival day, digestive rest day, and 6 days of fasting), I am reminded of the pros of the clinic and have picked up on (or been reminded of) some cons.

The pros

The fasting program. Buchinger offers a very repeatable plan to make long periodic fasts approachable for everyone. (I documented day-by-day experiences from my first visit previously on this blog.)I am personally down 4.2 kg (9.24 lbs) so far. My older daughter has also been successfully fasting!More significantly, my fasting blood glucose returned to normal levels (below 100) in 4 days with no drugs. This blood glucose normalization is a significant improvement over my first visit when it took 12 days for my blood sugar to return to normal! For this visit, I’m logging my statistics in an Excel Online spreadsheet.
The operations. Overall, this German clinic in Überlingen is very well run across the medical staff, nursing staff, labs, dining room, housekeeping, therapies, and facilities. (I have not been to the Buchinger-Wilhelmi Spanish clinic in Marbella).
The guests. The patients come from all over the world and make for interesting conversations!

The cons

The weather in May. This part of Germany can get COLD and WET. Visiting in August was nicer than visiting in early May. Even when it was raining here before in August, it wasn’t so cold. In our first eight days here, the weather has made the early morning walks uncomfortable (it was 36℉ / 2℃ on our first walk this visit!) and has discouraged participation in outdoor activities during the day.That said, we’re here to fast, and that part is going well!
The repetition. Revisiting the clinic feels a bit like the movie “Groundhog Day.” Part of the power of Buchinger is that they know how to use repetition and routine to foster “duration neglect” allowing the mind to handle a fast of a long duration. The problem is that this subsequent visit feels like a continuation of the first one. The program, the daily hikes, and most of the content are basically all the same from year to year.Still, most people here don’t seem to mind the repetition. I’ve heard that 65% of the visitors here are repeat visitors, and this statistic matches with my experience taking to people on an ad hoc basis. In one discussion group of 6 people, everyone in my group except for me had been to the clinic at least 4 times! On our last visit here, my wife and I met a gentleman from Egypt who had been here 37 times!
Cost. With our credit card bill coming due during our visit, I am reminded of how much money this place costs. Ouch!Still, this price for this stay for the four of us is cheaper than potential long-term medical bills or even a semester of private college tuition, room, and board! And, to be fair, there are costs on the clinic’s side, as there are about 300 very professional employees on staff to serve just over 160 patients at a time.

Watch this space

While I do not plan to post as frequently as last year, I’ll continue to update this blog with impressions from our second visit to Buchinger Wilhelmi!

December 27, 2018 By spao Leave a Comment

Is too much “good cholesterol” bad for you?

A good friend just pointed me to an interesting article from the New York Times that came out Christmas Eve Day.

It was based on a study out of Emory University in Atlanta that showed higher all-cause mortality associated with HDL levels above 80! Below is a screen capture from the press conference where the study results were presented showing “U curve” associated with adverse events with both low HDL (<40 mg/DL) and very high HDL (>80 mg/DL).

HDL-U-Shaped-Curve — Risks of mortality are higher with very low AND very high levels of HDL

The authors acknowledge some limitations of the study. The study started with patients that already had severe heart disease and speculate there may be some reverse causation. They also recognize that genetic mutations may be at play, citing LIPG, SCARB1, and CETP (which mean nothing to me right now!)

The recommendations were very nuanced.

HDL-Nuanced-Recommendations — Because the mechanism of high HDL and higher mortality is not known, the recommendation is to focus on risk factors we can control.

Because the mechanisms remain unclear as to why high HDL levels are associated with adverse events, they recommend focusing on the mechanisms we do know about! Still, this is the first data point I’ve seen speculating that HDL might not be protective at very high levels. This will be very interesting data to watch going forward!

The video of the press conference is accessible here.

December 25, 2018 By spao 3 Comments

Two Months After Fasting Retreat…

Catching Up

I have not been good at keeping up with blogging. After returning home from the fasting retreat, life got in the way! I took my labs on November 19th (approximately 2 months after returning from the fasting clinic) and had intended on blogging right away. However, moving into our new condo, my current consulting gigs, and the kids coming home from college over the holidays just kept me too busy. Here on Christmas morning, I am publishing a backlog of 3 posts while the kids are sleeping!

Glucose and HbA1C

The bad news here is that my fasting blood glucose during the test was 157! This number didn’t surprise me that much because it’s a number that I was measuring with my blood glucose meter. My blood sugar was running higher at the time of the test, as the instructions I received when making the appointment called for keeping a “stable diet and weight” for two weeks prior to the blood test. So, for two weeks, I chose to avoid the 36-hour fasts which does help control my blood sugar but also makes my weight fluctuate a lot between feeding and fasting. I won’t follow the instructions that way the next time!

That said, even with the two weeks of without fasting, the good news from my November labs is that my HbA1C (3 month average of blood glucose levels) went down — even after returning home from the fasting clinic! When I left, my number was 7.0, and it went down to 6.7 two months later! It’s still not where it needs to be (below 6.5), but it’s close and improving!

Change in LDL Particle Size?

While at the fasting clinic, I also was a participant in a study about the effect of prolonged fasting on LDL particle size. (For more information about LDL particle size, see my previous article). Alternate day fasting has already been shown to increase LDL particle size, and the prevailing theory is that prolonged fasting produces a similar effect. The significant reduction in my Triglyceride / HDL ratio from 4.1 before the clinic, to 2.2 immediately after the clinic, and down to 1.7 two months later does seem to support that hypothesis!

The Numbers

	Normal	23-Aug	17-Sep	19-Nov	Comments
Glucose in serum	60-100	133	106	157	High for 2 weeks…
HbA1C	< 5.7	7.5	7.0	6.7	Better!
Cholesterol Total	< 200	296	262	288	See note
HDL Cholesterol	> 40	52	62	83	Good!
LDL / HDL Ratio	< 3.0	3.8	2.9	2.1	Normal!
LDL Cholesterol	< 155	296	181	177	See note
Triglyceride	< 150	215	136	138	Normal!
TG / HDL Ratio	< 2	4.1	2.2	1.7	Normal!

Note: LDL and Total Cholesterol readings have been shown to be flawed predictors of heart disease. TG / HDL ratio was computed and added to this chart as an alternative predictor.