Autophagy and Fasting: The Mystery Behind It

Autophagy. The literal translation of this word: ‘to eat thyself.’

Autophagy is a hot topic. Yoshinori Ohsumi’s 2016 Nobel Prize for Physiology and Medicine converted the medical world’s previous whispers and murmurings about Autophagy and fasting into a full-blown conversation. Ohsumi discovered how our body degrades and recycles its cellular components. Autophagy for short. 

Why should you care? Isn’t this a keto-focused site?

Well, it turns out ketones and autophagy are linked.  

Baby Boomers: please pay attention.

You endured the most abuse from the medical establishment over the last 40 years. Before it’s too late, we in the medical establishment might have a few years to redeem some of the atrocious recommendations that your generation lived were given. The science of how your body eats itself is something you should pay attention to and master.

It may sound weird, but this process of autophagy might be the saving grace to medical advice for your era. The science of autophagy surfaced in the nick of time for Boomers.

Autophagy removes debris found inside your body’s cells. All those years of poorly fed brain cells, sleep deprived hearts, smoking in your early years, and becoming fatter than any generation before has left you with lots of crusty cells. The debris within your tissue has been there for years. If you are overweight, this debris has been around for as long as those extra pounds have insulated you. PLUS ten years.  Brain autopsies tell the tale.

Proteins build up in a damaged brain. This damaged brain leads to Parkinson’s, Alzheimer’s disease and dementia. The beginning of these problems don’t start with your genetics; they begin with inflammation.

After ten years of constant inflammation, your gray matter’s genetics can trigger all sorts of brain diseases. The chemistry produced by the combination of fasting and high ketones reverses the inflammatory grime afflicting most Baby Boomers’ brains. In fact, this chemistry decreases the swelling of the brain. Fasting and high ketones trigger your cells to start eating the ‘junk’ that has been messing up your brain’s electrical signals and activity for years.  

Brains destined for dementia have been squirreling away extra proteins for years before you experience your first memory glitch. If you could take a virtual tour around your brain the year before your memory starts to go, you would see lots of these crusty, extra proteins also known as plaques or neurofibril tangles.

Are you already experiencing memory problems? Start eating up plaque! Stimulate autophagy by adopting a keto lifestyle with intermittent fasting.

Hopefully, I have your attention! That strange word with a comical definition should interest every Baby Boomer.

How do you switch on your autophagy processes? Thankfully, Nobel laureate Ohsumi’s research sheds light on this science. Autophagy is a very regulated process where your cells break down components and then use those parts as nutrition.

Our cells are programmed to die. When will your cells die?

That depends on how well you’ve taken care of them.

Apoptosis (pre-programmed death) is triggered when cells become old and worn down. Different cells in the body live longer than others, but they all have an end date – a predestined date that they will die. That date comes quicker if they are poorly built or inflamed continuously.

A similar process happens on the subcellular level. Instead of throwing out the whole cell via apoptosis, autophagy replaces just a section of the cell. This process doesn’t kill the entire cell.  

• APOPTOSIS says, “This cell is crap. Time is up. Throw it all away.”
• AUTOPHAGY says, “This section of the cell is crap. Let’s break it down and use it as fuel for the rest of the cell.”

Autophagy describes your cells’ internal housekeeping processes. Your cells vacuum up debris and recycle these parts as fuel. Cells clean up the old worn out or defective proteins inside them and toss them into the furnace, the mitochondria. Thankfully, those burning flames of the mitochondria are right there inside the cell too.

Why should you care? Answers: Flabby skin after weight loss.

It is embarrassing to share how many Boomer patients have said these words to me, “Doc, I don’t want to lose that weight. It will leave me with too many wrinkles.”  

I’ve got some great news for you. If you lose weight while stimulating autophagy, your body will ‘eat’ those deformed skin cells that caused your wrinkles. You will ‘eat’ those extra blood vessels, fat cells, and connecting cells as you lose weight. Without that left-over, unneeded tissue, your skin connects tightly to the overlying tissue. It results in tight, toned skin. No batty arm wings for you!

Take a trip through history. Lookup Holocaust victims in World War II concentration camps. The photos of these people show tight skin and no flabby or wavy folds of skin.

Some were overweight when they entered those camps. Sadly, they lost lots of weight during their months or even years of imprisonment. These individuals were in a state of ketosis with intermittent fasting for most, if not all, of their confinement.

A Tale of Two People who Lost 100 Pounds:

One loses 100 pounds while stimulating autophagy. The other woman used a low-calorie (a.k.a.torture) diet to lose the same amount of weight. No autophagy involved.

The autophagy patient’s body successfully absorbed all of her flabby skin cells and used the cellular parts as fuel. Additionally, there is no extra flesh in her arms, butt, or abdomen. Her body used that protein- and fat-filled tissue to feed her system during her fasting period. She saved herself the pain and expense of having to go under a plastic surgeon’s knife just to cut those ‘wings’ of flab off.  

In the medical field, these leftover tissues are collectively called a ‘curtain of skin.’ Removing all this excess tissue by way of surgery carries a massive risk of blood loss. Until I saw this with my own eyes, I underestimated how many blood vessels remained in that tissue after tremendous weight loss.

The restricted-calorie patient also lost weight and got skinnier. No doubt about that. But her weight loss program left behind thousands of blood vessels, connective tissue cells, skin cells, fat cells and more.

Patients who choose to cut that curtain of skin off after their weight loss suffer from large rope-like scars where the surgeon connected the remaining skin back together. They are not soft and flexible scars-they are keloid roadmaps.

Why?

One word: INFLAMMATION.  

Nothing says inflammation like blood when it is outside of your blood vessels. Thousands and thousands of little threads of blood vessels remain in that curtain of skin. Without the help of autophagy, there is no process to remove the leftover blood vessels and tissues that used to hold, feed and support those layers of fat. Regardless of how skilled your plastic surgeon may be, shutting down every tiny blood vessel before stitching the edges of the skin closed leaves some gnarly-looking scars.

The imagery unsettles my patients and me as I tell them of their options. However, it is inspiring to see folks lose 100 pounds and NOT have this ‘flabby arm-wings’ problem. People do manage to lose weight and avoid flabby skin-only if they trigger the process called autophagy. By activating the recycling process of the energy found in the leftover flabby skin, your body can eat itself into a tighter, firmer, and better-looking form.

How do you trigger autophagy?  

This answer involves complicated biochemistry. Thankfully, the cliff notes can be summed up in one word: FASTING.

As previously mentioned, your body chemistry during times of no eating is an enhanced version of the same chemistry you have during ketone production. By achieving ketosis before you fast, you set the stage for faster autophagy activation. Your ketone-burning cells can start ‘recycling’ their crusty parts in as little as 12 hours from the start of your fast. On the other hand, if carbs are your cells’ primary fuel source, autophagy kicks in several days after you stop eating.

Good news: When patients are keto-adapted you don’t have to fast as long as Grandma Rose did. She fasted for over forty days.  You don’t even have to fast 24 hours. By establishing a ‘fasting window’ of 12 hours every day (this includes 8 hours while you sleep), you benefit from your body’s recycling system. In fact, fasting can change the way you age.

Fasting’s anti-aging benefits come directly from the autophagy triggered when people stop eating for longer blocks of time. Fasting triggers two reactions. First, your body finds nutrition although you haven’t consumed any calories. Where? Your body converts old junky proteins from within your cells into energy. Second, your cells experience a burst in growth hormone production. Human growth hormone promotes muscle and bone growth. This compound also pushes your body to empty its fat cells.

As I write this post, I am on my fifth day of fasting. My average blood sugars hover in the 50-80s and my ketones have steadily risen to the 4.0-5.5 range. Because this fast occurred after months of ketosis, the transition was not difficult. In fact, I would agree with the literature that the first two days are the hardest. After that, each day seems to produce a higher level of energy and clearer thinking. Two of my patients in their 80s have recently fasted for seven days.

 IN THEIR 80s! They attend my weekly keto-support-group and shared their experience with all of us. They choose to fast this long after reading and learning about autophagy. For several months prior they had been in ketosis with pockets of intermittent fasting. Most of their fasts lasted 24 to 48 hours. A few times they did 72 hours. This week-long fast pushed them to a new level. I don’t recommend this long of a for most people … especially in their 80s.

However, these folks were very good at monitoring their biometrics of blood pressure and blood sugars and blood ketones.  They also had quick access to me if anything went awry. But it didn’t. They reached their goal of seven days with only salt, water, and tea. This fast certainly boosted their growth hormone, sparked their metabolism, and ignited autophagy deep inside their cells.

How do you stop autophagy?

Just start eating again. When your body gets glucose from your food, insulin production is triggered. Insulin slams the brakes on autophagy. Even the smallest amount of insulin can stop ‘energy recycling’ in its tracks. Autophagy is only possible through fasting. A ketogenic diet allows you to slide back into a fasting state much more comfortable and faster compared to multiple days needed with a carb-heavy diet.

BOOMERS: EAT YOURSELF!

If you want to learn more about the ketogenic diet, check out the book ANYWAY YOU CAN on Amazon or Audible by Annette Bosworth, MD.

RESOURCES:

1. Nobel Prize Honors Autophagy Discovery.” Cancer Discovery, vol. 6, no. 12, 2016, pp. 1298–1299., doi:10.1158/2159-8290.cd-nb2016-127
2. Ogawa, Chikako, et al. “Autopsy Findings of a Patient with Acute Encephalitis and Refractory, Repetitive Partial Seizures.” Seizure, vol. 35, 2016, pp. 80–82., doi:10.1016/j.seizure.2016.01.005.
3. Kerndt, Peter R., et al. “Fasting: The History, Pathophysiology and Complications.” THE WESTERN JOURNAL OF MEDICINE, vol. 137, no. 5, Nov. 1982, pp. 379–399. https://www.ncbi.nlm.nih.gov/pubmed/6758355
4. Fung, Jason. “Blog.” Intensive Dietary Management (IDM), idmprogram.com/blog/