Eat, Fast and Live Longer

Eat, Fast and Live Longer

BBC iPlayer > Alphabetically > H > Horizon > 2012-2013: 3. Eat, Fast And Live Longer

Michael Mosley has set himself a truly ambitious goal: he wants to live longer, stay younger and lose weight in the bargain. And he wants to make as few changes to his life as possible along the way. He discovers the powerful new science behind the ancient idea of fasting, and he thinks he's found a way of doing it that still allows him to enjoy his food. Michael tests out the science of fasting on himself - with life-changing results.

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Michael Mosley on screen - Michael Mosley on screen talking to camera or A.N.Other

#00:23 Programme Start

I love life so I want to remain young, energetic, enjoy it for as long as I can. I’m medically trained, I know all the standard advice for staying healthy, but in my case it doesn’t seem to be working #00:41

I have discovered that my body is not the lean, live long machine I would like it to be.

Prof Luigi Fontana - Third of your body is fat

Michael Mosley on screen - Thank you, for making that point so emphatically #00:57

I wanted to see if science can offer a different way to stop the rot, slow the clock. So I set off to find experts to are trying to combat the ravages of ageing.

Prof Luigi Fontana - We are re-writing human physiology here #01:12

Professor Valter Longo - If you can find something else that you can do that doesn’t hurt you that benefits you and that causes changes I’d like to know.

What I discovered was truly surprising. It involves no pills, no injections and no hidden cost. It is all a question of what you eat or rather what you don’t eat #01:41

Michael Mosley on screen - Last night I dreamt I ate a sandwich and then felt fantastically guilty.

It’s about fasting, but fasting made easier.

Michael Mosley on screen - If I were to go onto Joe’s lifestyle

Prof Luigi Fontana - In a year you are gonna, gonna be cured. #02:02

The big thing is that this is the beginning of something, which I think could be huge. If it takes off, and heads off in the direction that I imagine it will. This could be genuinely revolutionary. #02:14

Horizon Titles


There are plenty of people who stay young and fit well beyond retirement age #02:49

They mainly do it the traditional way, through lots and lots of exercise. Today I’ve come to the London Marathon, nearly thirty six thousand bodies of all shapes and sizes are tackling the 26 mile (42.2km) course. Some are young, many are not so young #03:13

Michael Mosley on screen - There is an absolutely fantastic atmosphere here. Now I have never run a marathon. And I have no plans to ever run the marathon. But there are plenty of people running today who are far older than me #03:34

There are seven thousand people in their fifties and incredibly enough there are seven people who are in their eighties or older. #03:44

I’m going to try and flag a few of them down to ask how they do it. #03:55

Michael Mosley on screen - How old are you?

Marathon Runner 1 – Seventy-eight

Michael Mosley on screen - And how old are you?

Marathon Runner 2 – Eighty-one

Michael Mosley on screen - What’s the secret of running

Marathon Runner 3 – Magic wand!

Marathon Runner 4 – Just eating well

Anyone who can run a Marathon in their seventies deserves my respect #04:23 But I’m waiting for a man who make septuagenarians look youthful.

Fauja Singh is amazing. He has been active all his life, but he only took up serious running in his eighties. So what is it that keeps him so remarkably fit and energetic? #04:48

Michael Mosley on screen - Hi there (shakes Fauja Singh’s hand) Nice to See you. How old is Fauja?

Fauja Singh Interpreter – One hundred and one born First April Nineteen Eleven. Unfortunately he hasn’t quite mastered the English language yet #05:00

Michael Mosley on screen - Do you mind asking how he is feeling?

Fauja Singh Interpreter – It is not easy, but the thing is the job’s got to be done. ‘cause he’s not finished yet. You’re not going to give up are you. #05:15

Although he is a hundred and one Fauja has never had surgery, he shows no signs of heart disease, and he takes no medication. He believes that his long life and incredible health is down to his diet #05:44

Michael Mosley on screen - So any particular diet?

Fauja Singh Interpreter – He has no particular diet. It is simple Punjabi farmer’s diet, so just fresh food but his secret is that he has smaller portions. In poor countries people die of starvation, in rich countries people die of over-eating. #06:03

Michael Mosley on screen - So much does he eat compared to you or I?

Fauja Singh Interpreter – He would eat what would be considered half a portion, almost a child’s portion. #06|:17

Michael Mosley on screen - So a child portion is about half the amount of calories you or I would eat?

By restricting his food intake so dramatically Fauja has been unknowingly testing a theory that has been around as nearly as long as he has. A scientific theory which only now really coming into to it’s own #06:42

I’ve taken the Tube to the finish line, I want to catch Fauja become hopefully, the World’s oldest Marathon runner. And after seven hours and forty nine minutes he succeeds #07:09

Michael Mosley on screen - That is absolutely unbelievable, he is a hundred and one years old and he has just covered twenty six miles. #07:40

Now, I can’t imagine that in fifty years time, I’m going to be running down the Mall, but I want to be like hike him. I want to be mentally active, I want to be physically active. I want to stay younger for longer #07:52

For decades teams of scientists around the world have been intensively studying ageing. #08:09

Now clearly genes play a significant part how quickly and well we age. But there is nothing much you can do about your genes. There is, however something you can do about what you eat. And here in America they are starting to turn out some truly remarkable research linking food with longevity. It seems it is not just about what we eat but how and when we eat it #08:42

Our story begins in the dust bowls of America during the nineteen thirties. There was a terrible drought, food was scarce and the whole country was in the grips of the Great Depression. #08:53

Now you would imagine in such difficult times that life expectancy would fall, but in fact it rose. During the darkest years of the Great Depression 1929 -1933 life expectancy increased by a remarkable six years. #09:14

Now on the face of it that is really surprising, and yet clues as to why could also be found from research done back in the nineteen thirties #09:27

Nutritionists at Cornell University working with animals that if you severely restrict the amount they eat, they live longer. Much, much longer. #09:42

So the next obvious question, if you do the same with humans will it have the same effects. #09:55

Well it’s been eight decades since that observation, and only now are scientists really beginning to understand the link between calorie restriction and longevity in humans. At long last it seems we are starting to get answers #10:14

Washington University is at the heart of this new science.

Prof Luigi Fontana Washington University and Salerno Schools of Medicine - We are re-writing human physiology here. Astonishing how simple dietary intervention can really change how the human body works, basically. #10:38

Prof Luigi Fontana has spent the last ten years studying a group of people who severely calorie restrict every single day. #10:47

And he is astonished by what he has found. #10:55

Prof Luigi Fontana - I mean these people they look like a different species.

Michael Mosley on screen - That’s quite a big statement isn’t it?

Prof Luigi Fontana – Yes, we are finding out that they are going to live longer than their parents and brothers on the typical American diet or Western diets. #11:09

Luigi is clearly impressed, so I wanted to meet one of this new species of human for myself. #11:22

Michael Mosley on screen – A lovely, lovely house.

Joe Cordell - Were the directions good?

Michael Mosley on screen - Very good, thank you

Joe Cordell is a CRONie, a Calorie Restrictor on Optimal Nutrition. And that means a lot of fruit and veg. #11:34

Joe Cordell - I went ahead and kind of put everything out because I thought you might want to have some breakfast?

Michael Mosley on screen - That would be delicious, thank you. When I imagine a calorie restrictor, I imagine someone who lives basically on a couple of carrots, or something like that. I didn’t think you’d go in for breakfast. #11:52

Joe kicks off his day with a mountain of fruit. Some of which he then throws away #11:59

Joe Cordell - And then I like to add some apple to it, but when you are in my position, you want to get as much nutritional value as I can for the calorie, and virtually all the nutritional value is in the peel.

Michael Mosley on screen - So then you are going to stick the peel in and throw away the rest of it? You’re going to do the reverse of what most people do.

Joe Cordell - It is great because it literally is ninety five percent of the nutritional value here . . .

Michael Mosley on screen - It is in the skin? #12:25

Joe Cordell - It is in the skin, the rest is sugar and it is calories. This is generally what I’ll have each morning.

Michael Mosley on screen - The whole thing?

Joe Cordell - Yes.

Michael Mosley on screen - That’s a big bowl. Do you ever think “what if I’m wrong? what if it’s all wrong?” I’ve done this for ten, twenty years and actually a new bit of science comes out which says it is actually all nonsense. #12:44

Joe Cordell - I’ll tell you actually my brother, who weighs a hundred pounds more than I do, he’s about my age. He’s all time making the joke to me that he is going end up out-living me, and in his opinion I will have suffered for nothing. But the point is I enjoy doing it. Living a healthy life style is fun. #13:03

There are an estimated hundred thousand CRONies world wide. People living on a diet which is rich in nutrients but low in calories. Joe looks fit but not impressively young, perhaps Luigi has been exaggerating. #13:22

Michael Mosley on screen - What I’d love to do is to take you off and do a number of tests and see how we compare. #13:26

Joe Cordell - OK I’m game for that. Is this a challenge?

Michael Mosley on screen - This is a challenge. A challenge indeed I suspect I may well lose. #13:34

For a decade Joe has been eating one thousand nine hundred calories a day. I’ve averaged around two thousand three hundred, quite a few of them doughnuts and burgers. #13:52

Weigh In Supervisor - How much do you think you weigh?

Michael Mosley on screen - Probably about a hundred and eighty, ooh, more than a hundred and eighty! Breathe in!

Joe Cordell - should be around one thirty four, one thirty five, one thirty six.

Weigh In Supervisor - one thirty four

Joe Cordell - Oh,Right on. yeah #14:08

We are both in our fifties and I really don’t think we look like different generations let alone species. #14:18

So how different are we?

Weigh In Supervisor - Just need for you to relax in there, sit still, no talking.

Some of the simple ways of assessing ageing don’t need specialist equipment. Balance is controlled by your inner ear. As you age your ear structures deteriorate and your balance gets worse. #14:46

You can test it by standing on your weaker leg with your eyes closed.

Michael Mosley on screen - How long did I make?

Weigh In Supervisor - Six point Five nine seconds

Michael Mosley on screen - That’s not very good. #14:57

That’s not good at all. The average fifty five year old should manage eight seconds. #15:01

Michael Mosley on screen - Yes you are doing well for the average twenty year old (thirty three seconds on stopwatch for Joe Cordell) Over thirty seconds is what most twenty year olds can manage. But it is one of those skills that drops off dramatically. #15:01

Michael Mosley on screen - I think you have proved a point (to Joe Cordell)

Another good test is reaction time. Which drops off with age. This one only needs a ruler. At our age you should be able to catch it around the five inch (125mm) mark.

Michael Mosley on screen – Very good, that was four (100mm). You’re doing pretty well, I must admit. (to Joe Cordell) #15:36

Luigi’s methods are rather more scientific. We did a range of other medical tests, including blood tests. Now he is about to give us our results.

Michael Mosley on screen - Feels like being in the headmaster’s office and we are waiting for the results. Will you get an A-star? Will I get a B-minus?

Luigi’s face tells me that what I am about to hear is not good news.

Prof Luigi Fontana - Total body fat in Joseph is 11.5%, this is typical of a super athlete. 11% is very low for a fifty four, five years year old man. Yours is 27.1% fat, a third of your body is fat. #16:29

Michael Mosley on screen - Thank you . . . for making that point so emphatically. #16:33

And he is still not done talking about my fat. #16:36

Prof Luigi Fontana - The abdominal fat is around 30%. Abdominal fat is really the bad guy. The higher the abdominal fat the higher the risk of developing Type II Diabetes, Cardiovascular Disease. No doubt about it. It’s also a risk factor for Cancer. So basically your cardio-metabolic profile iit s not good. For your age. I think you should do something to improve it.

What we can say it that Joseph is not going to develop Cardiovascular Disease, It is impossible to develop stroke, myocardial infarction or heart failure. These three diseases are responsible for 40% of the deaths now in the US and UK #17:18

Michael Mosley on screen - No chance he’ll die of that? #17:20

Prof Luigi Fontana - I mean, one in a million

Michael Mosley on screen - If I were to go onto to Joe’s lifestyle ?

Prof Luigi Fontana - In a year, you are going to be cured. #17:28

I now understand what Luigi means. It is as if we were two different species. Joe’s diet seems to be keeping his organs in pristine condition. My diet is undermining my health, and fast #17:49

Michael Mosley on screen - Well that was very sobering, Luigi did not mince his words. He talked a bit about that abdominal fat. In fact he talked quite a bit about my abdominal fat. I have never thought of myself a particularly fat. But it was the two visions he held out to me. One, where, if I continue as I am at the moment I am heading almost certainly for heart disease and possibly worse. The other is if I embrace the CR way, the calorie restriction way, he said that I could be effectively be cured in less than a year. That my risk factors would move from being almost certainly being a cardiac victim at some point to one in a million. And when you put it as starkly as that it certainly gives me quite a lot to think about. #18:36

Even though the evidence supporting the benefits of calorie restriction is getting stronger all the time I cannot in all honesty imagine myself doing what Joe does. Which creates something of a dilemma #19:07

So what I really want to do, is try to understand the ways in which calorie restriction works. Then hopefully I can get all the delicious benefits, without actually having to do it. #19:23

Michael Mosley on screen - I’m in Los Angeles, a city that is notoriously addicted to youth in fact many people here seem to think that growing old and wrinkled is optional. I’m not going to see anyone as superficial as a plastic surgeon. I’m actually here to meet one of the World’s foremost experts on ageing. #19:43

Michael Mosley on screen - Hi There.

Professor Valter Longo - Hey

Professor Valter Longo studies the complex mechanisms which control ageing. He has honed on a critical pathway that links what we eat with how we age.

He is taking me to see two mice. They are both the same age, same species, same sex. But there is one significant difference between them. The little one is going to be living an awful lot longer than the big one. #20:27

Professor Valter Longo - This little mouse right here holds the world record for longevity expansion in a mammal #20:37

Michael Mosley on screen - Oh, right that is remarkable. So how long would these sub-species of mice last?

Professor Valter Longo - The big mouse here about two years. And the little mouse about a 40% longer life span. #20:47

Michael Mosley on screen – Right. They are different aren’t they. Ouch! Yes he is trying to bite me. I could feel that one going through.#20:56

Professor Valter Longo - Should’ve had the double gloves.

Michael Mosley on screen - It works!

Professor Valter Longo - Yeah. I learned the hard way! The big mouse already has a 50% chance of being dead.

Michael Mosley on screen - OK so he’s doing well to be alive?

Professor Valter Longo - He is lucky to be alive, that’s right. The small one has probably another year to go.

Michael Mosley on screen - Alright. He will live on to the equivalent of 120 in human?

Professor Valter Longo - Exactly yeah. Another thirty to forty years in human years #21:23

Michael Mosley on screen - Can I pick him up?

Professor Valter Longo - yes by the tail.

Michael Mosley on screen - By the tail OK.

The little mouse I’m holding is actually a man made creation. The reason he is so small and so long lived is because he has been genetically engineered. He has incredibly low levels of a growth hormone called Insulin-like Growth Factor one, IGF-1. And it seems IGF-1 is a key factor linking calorie restriction and longevity. #21:55

Clues to the link come from this group of people who live in a remote region of Ecuador. They have a very rare condition called Laron syndrome which affects less than three hundred and fifty people world wide #22:18

Michael Mosley on screen - Is that you? It does make you look like a giant.

Professor Valter Longo - Yeah I’m the tall guy there. The shortest one is probably just a little over three and a half feet tall (1.07m).

Michael Mosley on screen - So up to my belly button, something like that?

Professor Valter Longo - Yeah #22:37

What interests researchers like Valter is not their size but the fact they seem to be virtually immune to two of the West’s biggest killers.

Professor Valter Longo - The big findings of course were, they didn’t seem to get diabetes or cancer #22:51

Michael Mosley on screen - Do they do all the normal, sensible things like we all do like smoke drink and things like that? #22:55

Professor Valter Longo - Yeah they do the normal and more, so they have a very unhealthy lifestyle. Most of them to some extent are a little overweight. #23:04 They seem to really not watch anything they do. They smoke or eat a very high calorie diet and then they look at me and they say “Oh It doesn’t matter I’m immune.” But the incredible thing is that there is no evidence of a single one of them ever dying of cancer yet their normal height relatives they get cancer like everybody else. #23:25

People with Laron Syndrome have a mutation which makes them small but which also seems to protect them against all these diseases. #23:38

Professor Valter Longo - It is incredible working with them. It is a great group and of course for us it is a group that one mutation can tell us about diabetes, cancer, cardiovascular diseases and ageing. #22:53

The Ecuadorian villagers and the long lived mice have something in common. Their bodies produce exceptionally low levels of the growth hormone IGF-1.

This discovery helped Valter piece together the role that IGF-1 plays in the complicated business of ageing. #24:18

Our bodies are normally in “go, go mode” Cells are constantly driven to divide by IGF-1. But when IGF-1 levels drop, our cells shift into a completely mode. The body slows production of new cells and starts repairing existing ones instead. DNA damage is more likely to get fixed. And that’s why the mice and the villagers are protected from age related diseases.#24:51

But what’s the link to calorie restriction in humans? Valter has lined up a very simple, very Californian analogy. It turns out there is something in the food we eat that affect how much IFG-1 our bodies produce. That something is protein #25:21

When we eat a lot of protein our cells get locked in “go, go mode” #25:27

Michael Mosley on screen - So it is basically like slamming your foot on the accelerator, go, go,

Professor Valter Longo - Exactly it is pushing the cells to burn fuel.

In “go, go mode” the body is more susceptible to some cancers and diabetes, because your cells are growing too fast for damage to be efficiently repaired. #25:47

Professor Valter Longo - So it’s like driving your car all the time and never taking it to the mechanic.

Michael Mosley on screen - Right, so right that’s the key, to some how find a way to switch your body from going vroom, vroom to into a sort of repair mode. Look after me, make my DNA better.

Professor Valter Longo - Exactly #26:07

So how do you reduce your IGF-1? Well studies on calorie restrictors suggest that eating less helps but is not enough. As well as cutting calories you have to cut your protein intake, not entirely - that would be a very bad idea #26:24

It is about sticking to recommended guidelines something most of us fail to do # 26:30

Any you don’t have to be a CRONie to lower IGF-1. There is another way, fasting. #26:39

Professor Valter Longo - In fasting is a much more dramatic and much quicker response and so, within twenty four hours you decrease your glucose levels and you decrease your main growth factor, which is IFG-1 #26:55

I do find it hard to believe that just a few days of fasting is going to be enough to jolt my body into a more healthy state. But I am certainly intrigued, and I want to find out more. #27:12

Michael Mosley on screen - So I have had my IGF measured back in London and they tell me it is 28. Is that good, bad?

Professor Valter Longo - That’s not very bad, but that’s high enough based on a number of studies, including our own that puts you in a higher risk category for several different cancers, including prostate cancer. #27:35

Valter believes I should start to see some pretty impressive results just after three days and four nights of fasting. But is a daunting prospec. t#27:47

Michael Mosley on screen - I think it’s quite tough, fasting’s is tough isn’t it? Have you done it yourself? #27:52

Professor Valter Longo - I have done it myself, yes I fasted for four days several times and to me it was very tough, yeah. And still, if I look ahead at doing fasting I see it as a tough fourdays, I’m not looking forward. Some people do, but I don’t. I’m Italian so I look forward to eating well, you know.. #28:12

Michael Mosley on screen - So bare that image in mind. #28:14 The gritty Italian stopping eating when I’m feeling weak about it.

Professor Valter Longo - There you go.

Michael Mosley on screen - Thank you.

Prolonged fasting can be dangerous and Valter thinks it should only be undertaken by people in good health and preferably under close supervision. So he will be keeping an eye on me #28:40

Michael Mosley on screen - So OK, I decided I’m going to try this fast, which is going to be a three and half day fast and all I’m going to have is lots of water, black tea and one fifty calorie Cup-a-Soup a day.#28:58

Now I have never done anything quite like this before so I imagine it is going to be really tough. But I’m interested, I’m also, I must admit, quite concerned about the bad news, health news I have been getting recently. So it’ll be a challenge, but I’m sure I’ll manage it. Reasonably sure.

And so my fast begins. #29:32

Michael Mosley on screen – Right. it is now 10:30 at night and I am hungry it has been just about twenty five hours since I last ate a meal and the prospect of going to bed while hungry is not a great one. #29:55

I think it is getting to me because last night I had a dream and I dreamt I ate a sandwich and then I felt fantastically guilty. So vivid, I had a look round to see if there were any crumbs in the bed, but there weren’t. I guess it is time to go to work #30:10

Professor Valter Longo - (echo)- Simple dietary intervention can really change how the human works. . . . It puts you in a higher risk category.

Just as Valter warned me the first day was tough.

Michael Mosley on screen - Not really because I was that hungry, but simply because I had never done anything like this before. It was fear of the unknown. By night fall, I’m beginning to think, “this is a very bad idea” . . . Particularly when I had dinner with the crew or rather, when they had dinner. Here I am in a nice old Korean restaurant with the rest of the crew and they are currently digging in . . . #31:07

Michael Mosley on screen - enjoying it guys?

Crew Member – Beautiful. Yes.

Michael Mosley on screen – It’s a good smell. I really, really wouldn’t mind a little bite #31:17

I do feel very hungry. Fortunately my dinner is waiting for me in my hotel room. #31:27

Michael Mosley on screen - I had to leave. I couldn’t bare it any longer. Right My delicious Miso soup here. Give it a bit of a stir with the hotel pen, because there is no other cutlery around. Health. Twenty five calories worth. And I’m looking forward to it. #32:00

Michael Mosley on screen - OK final full day of fasting. Deliciuous breakfast here, black tea. I’m feeling a bit light headed but I’m otherwise, actually, alright. So just twenty four hours to go and now I’m pretty confident I’m going to do it. #32:23

I have learnt that hunger does not build and build, but comes in waves that pass. By now I have depleted my body’s store of glucose and will have switched to burning fat for fuel instead. And if Valter is right, my liver should also have stopped producing so much IGF-1, putting my cells into repair mode. #32:55

Finally it is seven am day four I am getting my blood test done.

Michael Mosley on screen - After this I can go and have breakfast The first food for three and a half days, the first food for eighty six hours. Well, who’s counting?

I’m just hoping that this is going to show some changes in my IGF, ‘cause if I have spent the last three and half to four days not eating thes results have been absolutely zero, that would be very, very depressing.

Michael Mosley on screen – The fast is over. I can just sort of begin to feel the empty spaces. I wasn’t terribly hungry when I woke up this morning, but . . . when I start eating this, I realise what it is I was missing #33:48

Later that afternoon I meet up with Valter to find out if it has all been worthwhile.

Michael Mosley on screen - I broke my fast this morning. I had some porridge and I had some bacon and I feel better.

Professor Valter Longo - Oh good, good.

Michael Mosley on screen - I’ll feel even more terrific if these results are any good.

Professor Valter Longo - Let’s take a look at them So your insulin-like growth factor, IGF-1 this is the normal range. Wow. The bad news, you are almost at the top of the normal range. For American standards so you are doing good. #34:23

Michael Mosley on screen - but not good full stop. I’m an average American, am I?

Professor Valter Longo - Yes and the good news is with your fasting diet you drop to almost half

Michael Mosley on screen - That’s big isn’t it?

Professor Valter Longo - Yes

Michael Mosley on screen - That a big drop

Professor Valter Longo - It’s a very dramatic drop so you respond very well.

Michael Mosley on screen - I have to say it was fascinating. Seeing that is very, very surprising. #34:45

Surprising and a huge relief. Halving my IGF-1 should cut my risk of certain cancers, like prostate cancer which my father had. My blood sugar has also dropped to healthy levels, which I’m also really pleased about.

Professor Valter Longo - I challenge you to get in four days to get a more extreme metabolic changes than these with anything you want. #35:09

Michael Mosley on screen - I think this is quite extreme enough

Professor Valter Longo - But if you can find something else that you can do that doesn’t hurt you, that benefits you and that causes these changes I’d like to know #35:21.

Michael Mosley on screen - OK OK

But Valter says unless I switch to a lower protein diet more plant based diet the effects won’t last. I’ll also need to fast once every couple of months to maintain the benefits. Can I really see myself doing that? #35:44

Professor Valter Longo - You have to make a decision now, in your case what do you want to do. And there is a lot of drugs that you could be taking, and is that what you want to do? And if you do so, in a few years, or in a number of years, you are going to be the typical sixty five year old in Europe who takes eight drugs a day. Right that’s the option. And that’s your call. #36:10

Michael Mosley on screen - Thank you that’s quite an interesting choice! #36:14

Michael Mosley on screen - That is really, really impressive that in just three and a half days if this data is right and the animal data is right, I have massively decreased my risk of a whole range of age related diseases. The big question in my mind at the moment is “Can I do fasting for once a month for however long it takes or is there a better way, a different way a more manageable way out there, that can do much of what this does but perhaps a little less pain” #36:55

What I have discovered about myself is that the biggest problem with prolonged fasting, is me. #37:06

Professor Valter Longo (“echo”) – You have to make a decision now . Fasting is tough. #37:13

Despite knowing all the wonderful benefits . . . I just can’t bring myself to do it. #37:23

But the great thing about science there is always some one doing further work building on what others have achieved. Which is why I’m here in Chicago. Here they are doing studies not just on mice but also on humans. And they seem to have found a way of making fasting a lot more palatable# 38:04

I’m here to meet Dr Krista A. Varady who has been researching something that sounds easier. Alternate day fasting. #38:14

Michael Mosley on screen - Hello

Dr Krista Varady - Hi There

Michael Mosley on screen -very nice to meet you.

Dr Krista Varady - I’m Krista Varady

Michael Mosley on screen - Hello! So what have you got here, then? #38:22

Dr Krista Varady - so this is some of the components we’d use in an alternate day fasting diet. It basically involves a day of pretty heavy calorie restrictions. For women about four hundred to five hundred calories a day, and for men five to six hundred calories a day, and that’s actually just as one meal around lunchtime. We call that the fast day #38:40

So the fast day isn’t about total abstinence. it’s about meals that look like this #38:47

What is great about alternate day fasting is what happens on the alternate days.

Dr Krista Varady - And then that’s alternated with something we call the feed day, which is where you can eat whatever you want. Absolutely whatever you want. #39:01

So here is the pattern of alternate day fasting. Fast day, feed day, fast day, feed day. It certainly sounds easier than than either prolonged fasting or the daily calorie restriction I looked at earlier. But is it as effective? #39:20

Well, Krista is currently doing a trial with overweight subjects which suggests it might be. #39:27

Dr Krista Varady - What we saw was that the alternate day fasting group actually lost a bit more weight, about five pounds more after the six months period. And they actually saw some pretty nice decreases in LDL cholesterol as well as triglycerides. So LDL cholesterol is the bad cholesterol and triglycerides – basically higher amounts of that can lead to heart disease and age related disease. We also see really nice decreases in blood pressure over the course of the trials. So, again, another key heart disease risk factor. #40:01

In addition to so far rather limited human trials there is lots of evidence from animal studies that alternate day fasting, ADF, is safe and effective# 40:20

I’m convinced enough to try it. Yesterday I fasted. Today I feed.

Dr Krista Varady – So hopefully we will make it back . . . easily enough

Michael Mosley on screen – Oh magical mystery tour! I like that!

Waitress – Hi Thanks for stopping. May I take your order, please?#40:50

Michael Mosley on screen – A very good choice! I particularly like the green stuff that’s oozing out of it. #41:04 So, I must admit, I am surprised to be here. I kind of imagined you’d be sticking on a sort of, you know, a veggie diet or something like that . .

Dr Krista Varady – Or Yeah, a lot of salads or something on the feed day. No, actually as long as you stick to the calorie goals on the fast day, you can literally eat whatever you like on the feed day. #41:28

One of Krista’s most recent studies compared two groups on ADF one eating high fat the other low fat on their feed days.

Michael Mosley on screen – I’m concerned about my blood glucose, I’m concerned about my cholesterol, I’m concerned about loads of stuff. And are those not, sort of, made worse by eating high fat on the feed days.

Dr Krista Varady - That is actually what we thought would happen. But then surprisingly we saw the same decreases in LDL cholesterol, that’s the bad cholesterol and in triglycerides, and also in blood pressure. So in terms of cardiovascular disease risk, it didn’t matter if you are eating high fat or low fat diet. #42:05

Another big surprise is after a day of fasting people rarely gorge themselves on their feed days. #42:15

Dr Krista Varady – So when we ask someone to consume 25% of their energy needs on the fast day, I just thought that when I started running these trials, that people would try and eat 175% on the next day. But, right from the get go, no matter what, they cannot, people just can’t eat that 175% the next day. Most people eat around 110%. So just a little . . . slightly over what they usually eat, actually #42:39

Michael Mosley on screen – In essence you appear to be kind of slowing down the ageing process, or at least the diseases associated with it. #42:41

Michael Mosley on screen - You’re cutting the risks of diseases associated,

Dr Krista Varady - - Yeah. absolutely.

Michael Mosley on screen - Which is quite a profound thing to do. #42:46

Dr Krista Varady – Yeah. Absolutely #42:48

Krista’s research is still in the early stages. But from what I have seen and experienced. I am now starting to be won over by the idea that a simple pattern of feast and fast can be powerful. It seems to have an impact which goes beyond simply eating less. And I think it could work for someone like me. #43:17

My final stop is Baltimore. I’m here because I need a final bit of motivation. There is on aspect of ageing I find more terrifying than any other. The effects of ageing on my brain #43:40

I’m trying to catch-up with Professor Mark P. Mattson. Mark is a leading expert on the ageing brain. His research suggests that fasting may help delay the onset of diseases like Alzheimer’s, dementia and memory loss. #44:00

Professor Mark P. Mattson - How you doin’?

Michael Mosley on screen - Hi There, Michael Mosley

Professor Mark P. Mattson - Mark Matson, you work here?

Michael Mosley on screen - No nor do I want to work out here!

Professor Mark P. Mattson - Ok Michael here put some booties on!

We are heading down into the basement of the National Institute on Ageing.

Hidden away down here there is a special mouse he is keen to show me #44:28

Professor Mark P. Mattson - Radio alarm these.

This mouse is exploring a maze. It is a memory test designed to see how well he remembers where he has found food before. #44:47

Michael Mosley on screen - The food is in there?

Professor Mark P. Mattson - The food is in here.

The mice they study are destined to develop Alzheimer’s disease. Normally they succumb within a relatively short time. But when these mice are put on a diet of feast days and fast days what Mark calls, intermittent energy restriction, the results are incredible. #45:12

Professor Mark P. Mattson - The animals on intermittent energy restriction they will live much longer with normal at least, as best as we can test, normal learning and memory, before they start having problems. So . . .

Michael Mosley on screen - Significantly longer? #45:24

Professor Mark P. Mattson - Yeah highly significantly. We have found in one study, six months to a year.

Michael Mosley on screen - That’s the equivalent in a human of the difference to developing the signs of Alzheimer’s at the age of fifty and say the age of eighty. Is that right? So you . . .

On the other hand when the mice eat a fast-food diet they go downhill much earlier #45:45

Michael Mosley on screen - Give them lots of sugary drinks and . . .

Professor Mark P. Mattson - Exactly high fat and we put fructose in their drinking water, and that has a dramatic effect. In that the animals will have an earlier onset of the learning and memory problems. #46:00

Michael Mosley on screen - How much sooner?

Professor Mark P. Mattson - Three to four months sooner. #46:05

Michael Mosley on screen - Wow. So that is the equivalent of them developing Alzheimer’s in their thirties or maybe early forties?

Professor Mark P. Mattson - Right

So far they have only done studies on mice but they are about to carry out human trials.

Michael Mosley on screen - How good is the evidence they if some one like me were to start on intermittent fasting it would cut my risk of brain diseases?

Professor Mark P. Mattson - I think from the human standpoint, if we go on a scale from poor, to good, to very good, to excellent, to outstanding, it’s in the very good to excellent range. That the way I would categorise it #46:44

So what’s going on? Well when they examine the brains of the fasting mice they found something extraordinary. These green objects are newborn brain cells #47:06

Michael Mosley on screen - These three here are brand new?

Sporadic bouts of hunger actually trigger new neurons to grow #47:13

Michael Mosley on screen - Why should a brain start to generate new nerve cells when you stop feeding it?

Professor Mark P. Mattson - Well if you think about it in evolutionary terms it makes sense if you are hungry. You’d be better increase your cognitive ability. That will give you a survival advantage, if you can remember where the location of the food is and so on. #47:34

It seems that fasting stresses the your grey matter the way exercise stresses your muscles. #47:45

Michael Mosley on screen - So hunger really does make you sharper?

Professor Mark P. Mattson – Yes. We think so. #47:50

Mark’s research is starting to point towards a simple conclusion.

Professor Mark P. Mattson - Alternate day fasting has better effects on the brain than does a lower amount of daily calorie restriction. #48:07

It’s true of mice but he needs to do proper human trials to prove it’s true in us.

I’ve come to the end of my search to eat, fast and live longer. The official advice is eat at least two thousand calories a day and if you want to fast even on an intermittent basis see you doctor first. Because there are people it could harm such as pregnant women or those who are already underweight. #48:39

I’m going to be cautious and go with a pattern that Mark recommended. Not alternate day fasting but a less extreme five-two diet. Five days normal eating followed by two days’ fasting each week. #48:58

Michael Mosley on screen - It is my last day in the States and it has been absolutely eye opening. I had no idea at all that there was so much research going on into fasting, calorie restriction in all it’s forms, and sort of anti-ageing research. I have decided right now I am going to definitely going to try the five-two diet, that’s five days normal eating and two days of six hundred calories a day. I really, really hope it makes a difference because I’m conscious now that I’m at the foothills of what could be a steep advance into age, and if there is something that could slow that ageing process down and give me more years of healthy living then I would really embrace that. #49:44

I’m heading home to the UK. I’ve decided to give myself five weeks to get used to my new diet and see if I get results #50:06

Michael Mosley on screen - This is going to be one of my fasting days and I have decided I’m going to eat breakfast as my main meal. #50:16

Mark Mattson told me he doesn’t think it matters when you eat your calories on a fast day.

Michael Mosley on screen - I’ve tried other things but is quite discouraging going into work when you are feeling hungry #50:29

There is another reason I’m determined to try this regime. When I arrived home I had another IGF-1 test. Annoyingly, my levels were higher than ever. Turns out the hard-won effects of the four day fast only lasted a short while #50:47

"Work chat”

So this is something I hope I can stick to.

Michael Mosley on screen – Good. It is done. It is actually twenty to two and I don’t feel remotely hungry, but it is lunchtime so if nothing else, I think I’m going to go and prowl around #51:03

I have found that fasting when I am busy at work was doable. But the next big test is my holiday.

Michael Mosley on screen - I’m walking with some friends, we are doing a walk across the Trans-Pennine Way. I had breakfast this morning about two hours ago and I’m planning on eating next, breakfast tomorrow. So far, I am feeling quite good. #51:51

It is now about seven o’clock, haven’t eaten for about twelve hours. The others are behind me in the pub eating so I decided to come outside for a bit, because I’m not as strong minded as I thought I was. My stomach is beginning to rumble a bit, but it’s all right. #52:13

It’s been five weeks since I started the five-two diet. I managed to fit in two six hundred calories fast days each week, but they tended to be a bit scattered around. But has it been enough to make a difference?#52:36

Michael Mosley on screen - So today is results day. I have lost, I know, some weight I’ll find out in a moment, just how much but I’m mainly interested in the bloods because five or six weeks ago they were pretty terrible. I have high blood glucose, high cholesterol, high IGF. And I’m really keen to see them improve, because, frankly, if they haven’t improved, then I’m in trouble, and I do want stay young and healthy for my family, for myself. So, I’m quite anxious because this matters an awful lot to me. #53:11

Just to remind you this is what I looked like at the start of this film. And this is me today. I have had to add a few new holes to my belt so that I know something has changed, but by how much? #53:29

Michael Mosley on screen - Right the moment of truth when I discover how much weight I have lost. These are a special type of scales which are going to measure my weight accurately, but also, apparently, my body fat. Hey! That is fantastic! That is 173.8 pounds (78.9kg) which means I have lost well over a stone (6.4kg). And my body fat when we did it before was 27% and now it is below 20 (19.1 on meter display) That is really, really pleasing. #54:01

I feel good and my family say I look slimmer. It really hasn’t been that difficult. And I’m delighted that I’m no longer in the overweight category. But what I really want to know is what has changed inside my body.

Professor Luigi Fontana is about to call with my final results #54:29

Prof Luigi Fontana - Hi Michael

Michael Mosley on screen - Hi Luigi, how are you?

Prof Luigi Fontana - I’m fine and you? So we’ve got your results, just by fasting two days a week you made a great impact on your cardio-metabolic health and so I’m very proud of you.

Michael Mosley on screen - But what happened to my IGF-1? Is my body still in “go, go mode” #54:23

Prof Luigi Fontana - IGF-1 is a major factor for cancer. Breast cancer, prostate cancer, colon cancer. Both the three and a half day fasting and the five week intermittent fasting dropped your IGF-1 by fifty per cent.

Which is enough to reduce my risk of certain cancers. But what about my blood sugar? Which was borderline diabetic. #55:19

Prof Luigi Fontana - your blood glucose dropped to ninety. Fantastic so you know your glucose became normal again. #55:27

My final result is cholesterol.

Prof Luigi Fontana - So, you had a reduction in total cholesterol, and an increase in the good cholesterol this shows how little it takes, you know, to improve without drugs, without taking medications. #55:47

It wasn’t THAT little an effort, but I have cut my risk of developing diseases which could shorten my life.

Michael Mosley on screen - Thank you. So I should live happily ever after.

Prof Luigi Fontana - I don’t know if you are going to live happier but you have a lower risk of developing diseases. #56:03

Michael Mosley on screen - Thank you very much Luigi. Really. Thank you. #56:07

Well, I’m very pleased indeed. That was far better than I was expecting. I wanted my wife Claire who is a GP to share my results #56:18

Michael Mosley on screen - Luigi . . . so this is my IGF-1 which is kind of my cancer / ageing risk.

Claire Mosley – This one has come down to half on the two day fasting. All of them have shown the improvement that you kind of hoped for. That basically means that you are not going to have to take tablets, at all, at the moment. You are looking good on it #56:42

Michael Mosley on screen - Thank you

Claire Mosley – That is really amazingly good news #56:47

The results have been absolutely fantastic for me but that doesn’t mean that intermittent fasting will work for everyone. It is really important they do more trials on humans to find out if in the long term it is safe and effective. But having experienced intermittent fasting I plan to go on doing it. It seems to have undone some of the damage I have done to my body down the years. #57:25

It is very poignant looking at these photographs of myself and members of my family growing up and growing older but it doesn’t make me want to hold back the hands of time. I still sort of think that we do grow old, we should grow old there is very little we can do about it. #57:45

But fasting is somehow different fasting is not about trying to live to hundred and forty. It is about staying healthy as long as you can. And with the time bomb we are facing as a nation with obesity going up, diabetes going up, we desperately need something which can make a difference #58:05

Fasting is the first thing I have come across I genuinely believe if people were to take it up it could radically transform the nation’s health. So, I hope that we continue to see massive research going into this territory #58:25

Doing this fasting has been one of the most interesting, no, I would say THE most interesting sort of journey, film, whatever you want to call it, that I have been on. And I have never said that before. #58:37

#59:11 The End

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