Alan Goldhamer, D.C. www.TrueNorthHealth.com (707) 586-5555
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Alan Goldhamer, D.C.
www.TrueNorthHealth.com
(707) 586-5555
LIFE EXPECTANCY = 78
HEALTHY LIFE EXPECTANCY = 69
9.4 YEARS OF DEBILITY
17 YEARS IN POOR HEALTH
TOTAL HUMANS EVER BORN
= 109 BILLION
Humans Alive Today 7.5 Billion
# Humans well documented to live 117+ years:
FIVE
ODDS OF LIVING BEYOND 117
1 in 20 Billion
The World Health Report
ULTIMATE CAUSES OF DEATH
METABOLIC SYNDROME
Abdominal Obesity
High Cholesterol and Low HDL and High TG
High Blood Pressure
High Blood Sugar with Insulin Resistance
OBESITY TRENDS* AMONG U.S. ADULTS BRFSS, 1986
No Data <10% 10%–14%
OBESITY TRENDS* AMONG U.S. ADULTS BRFSS, 1997
(*BMI ≥30, OR ~ 30 LBS. OVERWEIGHT FOR 5’ 4” PERSON)
No Data <10% 10%–14% 15%–19% ≥20%
OBESITY TRENDS* AMONG U.S. ADULTS 2001
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
OBESITY TRENDS* AMONG U.S. ADULTS 2010
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
SELF-REPORTED OBESITY AMONG U.S. ADULTS 2012
SELF-REPORTED OBESITY AMONG U.S. ADULTS 2013
SELF-REPORTED OBESITY AMONG U.S. ADULTS BY 2015
0
5
10
15
20
25
0
1
2
3
4
5
6
7
8
1958 61 64 67 70 73 76 79 82 85 88 91 94 97 00 03 06 09
Nu
mb
er
wit
h D
iab
ete
s (
Millio
ns)
Perc
en
tag
e w
ith
Dia
bete
s
Year
Percentage with Diabetes
Number with Diabetes
Number and Percentage of U.S. Population with Diagnosed Diabetes,
1958–2010
CDC’s Division of Diabetes Translation. National Diabetes Surveillance System
available at http://www.cdc.gov/diabetes/statistics
Age-adjusted Prevalence of Obesity and Diagnosed Diabetes
Among U.S. Adults Aged 18 Years or Older
Obesity (BMI ≥30 kg/m2)
Diabetes
1994
1994
2000
2000
No Data <14.0% 14.0%–17.9% 18.0%–21.9% 22.0%–25.9% 26.0%
No Data <4.5% 4.5%–5.9% 6.0%–7.4% 7.5%–8.9% >9.0%
CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at
http://www.cdc.gov/diabetes/statistics
2010
2010
HEALTH FOOD VS HEALTHY FOOD
Olive Oil
Red Wine
Dark Chocolate
Coffee
Coconut anything
Diet Soda
Fish and Fowl
Dairy products
Atkins/Paleo
Fresh Whole Fruit
Fresh Raw Vegetables
Fresh cooked vegetables
Whole grains
Beans
Nuts, Seeds
Water
WPF- SOS-free
MODERN BRAIN VERSUS ANCIENT BRAIN
OUR BRAINS ARE
DESIGNED FOR AN
ENVIRONMENT OF
SCARCITY.
EXPENDITURE FOR ONE WEEK: $31.55
We Live in an environment
of abundance
DOPAMINE
Molecular Formula: C8H11NO2 Formula Weight: 153.18
FOOD AND SEX
SEX and FOOD
DOPAMINE SECRETION
SEX VERSUS COCAINE
0
10
20
30
40
50
60
70
80
90
100
ORGASM COCAINE
THE DIETARY PLEASURE TRAP
SPECIFIC CHEMICALS ADDED TO FOOD
TO IMPROVE APPEAL AND INCREASE
CONSUMPTION
TOTAL SUGAR CONSUMPTION
EXCEEDS 150 POUNDS PER YEAR
PER PERSON
HFCS use increased by 1,060%
CH3(CH2)7CH=CH(CH2)7COOH
WHAT DO WE EAT?
Animal/Processed 93%
Fruits/Vegetables 7%
CALORIC DENSITY OF FOOD
CALORIES PER POUND
SALAD 100
CALORIC DENSITY OF FOOD
CALORIES PER POUND
SALAD 100
FRUIT 300
CALORIC DENSITY OF FOOD
CALORIES PER POUND
SALAD 100
FRUIT 300
POTATO 500
RICE 500
BEANS 500
CALORIC DENSITY OF FOOD
CALORIES PER POUND
SALAD 100
FRUIT 300
POTATO 500
RICE 500
BEANS 500
---------------------------------------
??? 1200
CALORIC DENSITY OF FOOD
CALORIES PER POUND
SALAD 100
FRUIT 300
POTATO 500
RICE 500
BEANS 500
---------------------------------------
ICE-CREAM 1200
???? 1500
CALORIC DENSITY OF FOOD
CALORIES PER POUND
SALAD 100
FRUIT 300
POTATO 500
RICE 500
BEANS 500
---------------------------------------
ICE-CREAM 1200
BREAD 1500
SUGAR 1800
TOTAL CALORIES OF TEENAGERS
Total Calories 75%
Calories from POP 25%
CALORIC DENSITY OF FOOD
CALORIES PER POUND
SALAD 100
FRUIT 300
POTATO 500
RICE 500
BEANS 500
---------------------------------------
ICE-CREAM 1200
BREAD 1500
SUGAR 1800
CHOCOLATE 2500
WHAT ADVICE DO YOU PROVIDE
HIGHLY MOTIVATED PATIENTS WITH…
Metabolic Syndrome
High Blood Pressure
Diabetes
Autoimmune disorders (Arthritis,
Colitis, Lupus, Asthma, Psoriasis etc.
Lymphoma
HOW LONG WILL DRUGS BE
TAKEN?
For the rest
of your life$
FOREVER!
Types of Fasting
IF: Intermittent fasting: (reduced feeding
window or alternate day fasting, 5-2 etc.)
WOF: Water-only fasting: (5-40+ days of total
fasting)
Fasting Definition:
The complete abstinence from all substances
except pure water in an environment of complete
rest
Starvation Definition:
Abstinence from nourishment beyond the point where the bodies nutritional reserves are exhausted and impairment of vital organ function and structure ensues.
PATIENT SELECTION
Complete medical history
Physical examination
Laboratory evaluation
Chemistry Panel including:
Lipids -- electrolytes -- kidney function – glucose -- liver enzymes
total protein and albumin
Urinalysis
CBC and CRP
Specialized tests as indicated
Relative Contraindications For
Total Fasting
Pregnancy
Severe Kidney Disease
Cardiac Instability
Porphyria
Deficiency, Depletion or Cachexia
MCAD
Inability to be stabilized off most
medications
Determining Fasting
Duration
5 to 40 days
Average fast from 1-3 weeks
Some patients require multiple fasts
Case Report: Lymphoma 42 year-old female diagnosed with follicular lymphoma stage 3 by
excisional biopsy and tracked for 2 years with progression.
(Current treatment protocol for stage III follicular lymphoma
includes immunotherapy-based treatments, chemotherapy, and
radiation.)
The CT scan revealed enlarged lymph nodes at the bilateral
inguinal regions reflecting significant change compared to a study
in 10/29/12. The largest node in the right inguinal region measured
34x20 mm and the largest on the left side measured 22x16 mm.
She underwent a CT guided core biopsy and surgical excisional
biopsy which confirmed the diagnosis. Flow cytometry showed CD
positive monotypic B cells making up 15% of the specimen.
Lymphoma continued:
21 days of water-only fasting and 10
days of refeeding at TNH
Lost 22 pounds from 174 to 152
Resolution of all masses in her inguinal
and axillar nodes
Follow-up 2 months later was 139 and all
physical exams were within normal
limits. Some residual mild neutropenia
Follow-up at 12 months weight was 132
and all lab values within normal limits
Weight and BMI
Diagnosis Start of
Fast
End of
Fast
6-Month
Follow Up
12-Month
Follow Up
Weight
(kg) 81.6 78.0 68.9 63.0 59.9 BMI
(kg/m2) 29.40 28.62 25.29 23.13 21.96
kg, kilogram; kg/m2, kilogram/square meter; BMI, Body-Mass Index
FIGURE 1. RADIOGRAPHS OF RIGHT
INGUINAL REGION
BEFORE FASTING AFTER FASTING
FIGURE 2. RADIOGRAPHS OF LEFT INGUINAL
REGION
BEFORE FASTING AFTER FASTING
Follow-up at 2 years: Feeling Great!
130 pounds
CT-no signs of cancer
CURRENT TREATMENT FOR
HIGH BLOOD PRESSURE
Case Report: 16-Year History
Chronic Cephalgia
52 year old female dentist with TBI
MRI, neural workup,
16 year history of constant daily
headache (6-8/10) non-responsive to
multiple medications etc.
41-day water-only fast followed by 6
months of a WPF SOS-free diet.
2nd 40-day water-only fast
6 year follow-up with resolution
IS FASTING SAFE?
Assessed the safety of water-only fasting by reviewing and
characterizing adverse events (AE) experienced by patients at
TNH over a five-year period.
ADVERSE EVENT
CTCAE Definition:
Any abnormal clinical finding temporally associated with the use
of therapy; causality is not required.
Common Terminology Criteria for Adverse Events
National Cancer Institute
CTCAE GRADING SYSTEM
Grade 1 - Mild; asymptomatic or mild symptoms; clinical or diagnostic observations only;
intervention not indicated.
Grade 2 - Moderate; minimal, local or noninvasive intervention indicated; limiting age-
appropriate instrumental ADL.
Grade 3 - Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self care ADL.
Grade 4 - Life-threatening consequences; urgent
intervention indicated.
Grade 5 - Death related to AE.
VISIT CHARACTERISTICS
Visit Characteristics
Days Fasting
Overall 2-7 8-14 15-21 22+
Total Visits (n) 768 446 238 64 20
Total Days 9570 3197 3772 1750 851
Total Fasting Days 6265 2057 2491 1153 564
Median Days Fasting
(IQR) 7 (6) 5 (3) 10 (3) 18 (4)
27.5
(6.2)
Chief Complaints n (% of visits) n (% of visits)
Quality of life 384 (50) Autoimmune 43 (5.6)
Cardiovascular 193 (25.1) Dermatological 42 (5.5)
Musculoskeletal 147 (19.1) Cancer 36 (4.7)
Gastrointestinal 122 (15.9) Substance Abuse 32 (4.2)
Endocrine 107 (13.9) Dietary 25 (3.3)
Metabolic 66 (8.6) Infection 24 (3.1)
Neurological 62 (8.1) Unknown 20 (2.6)
Genitourinary 57 (7.4) Tumor 8 (1)
Psychiatric 57 (7.4) Immune 6 (0.8)
Pulmonological 56 (7.3) Laboratory Value 5 (0.7)
Ear, Eyes, Nose, & Throat 52 (6.8) Environmental 3 (0.4)
Patients may have indicated more than one chief complaint per visit.
CHIEF COMPLAINTS
TOTAL ADVERSE EVENTS
Total AEs AE Grade n(%)
Total 1 2 3 4 5
5949 4482 (75.3) 1155 (19.4) 310 (5.2) 1 (.0002) 0
Common Adverse Events:
Nausea, Fatigue, Insomnia, Back Pain, Presyncope,
Dyspepsia, Headache, Hypertension
95% of adverse events are mild to moderate!
HYPERTENSION AES
• Hypertension was the largest category of grade 3 AEs
(95/301)
• 97% of those had hypertension as chief complaint upon
arrival
• Blood pressure is lowered during water-only fasting
Hypertension is NOT a treatment emergent AE!
HIGHEST GRADE AE
Highest AE Grade Experienced by Visit
AE Grade n(%) none 1 2 3 4 5
Overall 50
(6.5) 186
(24.2) 311
(40.5) 220
(28.6) 1
(0.1) 0
(0.0)
71% of visits experienced grade 2 AE or lower
Only 1 visit with a serious adverse events.
Conclusion
• The majority of adverse events are mild to moderate
• The majority of events are known to occur during fasting
• The water-only fasting protocol implemented at TNHC is
safe!
FASTING MECHANISMS
1. WEIGHT LOSS
2. NATURESIS
3. DETOXIFICATION
4. ENZYMATIC INDUCTION
5. INSULIN RESISTANCE
6. GUT LEAKAGE
7. NORMALIZE SYMPATHETIC TONE
8. PSYCHO-SPIRITUAL IMPACT
9. IMMUNE SYSTEM ENHANCEMENT
10. TASTE NEUROADAPTATION
FASTING MECHANISMS
1. WEIGHT LOSS
Weight loss averages one pound per day.
FASTING MECHANISMS
1. WEIGHT LOSS
2. NATURESIS
During fasting the body eliminates excess salt much more rapidly than when feeding.
Even small amounts of carbohydrate, even a single juice slows this process dramatically.
FASTING MECHANISMS
1. WEIGHT LOSS
2. NATURESIS
3. DETOXIFICATION / AUTOPHAGY
Fasting facilitates the elimination of both exogenous (external) toxins and endogenous (internal) toxins
Hematopoietic Stem Cells HSC dysfunction, a major source of morbidity and
mortality and were thought to be irreversibly damaged by
aging.
The sensitivity of HSC to toxic effects of chemotherapy is
a major roadblock to cancer therapy.
Recent research shows that prolonged fasting can
rejuvenate old HSC and protect HSC from the toxic
effects of chemotherapy.
Prolonged fasting represents a profound way to reverse
aging of the immune system and enhance cancer
treatment.
Cancer Theories
DSR (differential stress resistance)
enhanced during fasting as oncogenes
negatively regulate stress resistance.
Healthy cells are protected during
fasting.
DSS (differential stress sensitization)
with cancer cells less effective at
adapting to extreme environments or
substances.
Fasting protects normal cells
“Combination of fasting and
chemotherapy results in dramatically
higher cancer-free survival than
chemotherapy alone.”
Mitochondrial benefits
bHB (beta-hydroxybutyrate ) increased
in fasting provides antioxidant and
rejuvenative benefits to mitochondrial
function and results in efficient ATP
production enhancing antiviral
immunity.
Fasting and Longevity
In lower eukaryotes, fasting extends longevity
by reprogramming metabolic stress resistance
pathways
In rodents, protects against diabetes, cancer,
heart disease and neurodegeneration
Delay aging by protecting against the diseases
of dietary excess
In humans, reduces obesity, asthma, arthritis
and high blood pressure.
FASTING MECHANISMS
1. WEIGHT LOSS
2. NATURESIS
3. DETOXIFICATION
4. ENZYMATIC INDUCTION
Enzyme systems are used to mobilize fat, carbohydrates and protein as well as in the detoxification process.
BDNF and TrKB
Brain derived neurotrophic factor
and its receptor TrKB increase.
BDNF mediates exercise and fasting induced
enhancement of synaptic plasticity and
neuronal resistance to injury
BDNF mediates fasting responses including
regulating appetite and autonomic control of CV
system
FASTING MECHANISMS
1. WEIGHT LOSS
2. NATURESIS
3. DETOXIFICATION
4. ENZYMATIC INDUCTION
5. INSULIN RESISTANCE
Insulin drives sugar from the blood stream into the cells. If there is resistance to insulin then blood sugars rise resulting in diabetes mellitus
FASTING MECHANISMS
1. WEIGHT LOSS
2. NATURESIS
3. DETOXIFICATION
4. ENZYMATIC INDUCTION
5. INSULIN RESISTANCE
6. GUT LEAKAGE
The gut is a tunnel through the body
Microbiome and microbiome metabolome and intestinal permeability.
HYPOTHESIS: GLUTEN IS ASSOCIATED
WITH MORE THAN CELIAC DISEASE
INCLUDING HASHIMOTO’S THYROIDITIS
Observation:
• Celiac disease results from our immune system’s response to gluten. The bodies immune system attacks GI tissues resulting in pain and debility
•The HLADQ gene associated with celiac disease is the same gene associated with Hashimoto’s thyroiditis.
Mechanism: Similar to Celiac with a different target organ
Supporting Evidence: When gluten is removed from the diet
clinical improvement results
Treatment: A diet derived exclusively from whole plant foods
that are free from added SOS (salt, oil and sugar, including
refined carbohydrates)
FASTING MECHANISMS
1. WEIGHT LOSS
2. NATURESIS
3. DETOXIFICATION
4. ENZYMATIC INDUCTION
5. INSULIN RESISTANCE
6. GUT LEAKAGE
7. NORMALIZE SYMPATHETIC TONE
Most natural therapies have an impact on the autonomic nervous system.
FASTING MECHANISMS
1. WEIGHT LOSS
2. NATURESIS
3. DETOXIFICATION
4. ENZYMATIC INDUCTION
5. INSULIN RESISTANCE
6. GUT LEAKAGE
7. NORMALIZE SYMPATHETIC TONE
8. PSYCHO-SPIRITUAL IMPACT
Most major religions recognize the use of fasting for physical and spiritual enhancement.
FASTING MECHANISMS
1. WEIGHT LOSS
2. NATURESIS
3. DETOXIFICATION
4. ENZYMATIC INDUCTION
5. INSULIN RESISTANCE
6. GUT LEAKAGE
7. NORMALIZE SYMPATHETIC TONE
8. PSYCHO-SPIRITUAL IMPACT
9. IMMUNE SYSTEM ENHANCEMENT Most objective measures of immune function are enhanced during fasting.
FASTING MECHANISMS
1. WEIGHT LOSS
2. NATURESIS
3. DETOXIFICATION
4. ENZYMATIC INDUCTION
5. INSULIN RESISTANCE
6. GUT LEAKAGE
7. NORMALIZE SYMPATHETIC TONE
8. PSYCHO-SPIRITUAL IMPACT
9. IMMUNE SYSTEM ENHANCEMENT
10. TASTE NEUROADAPTATION
Fasting acts similar to rebooting the hard drive of a computer. It helps to reset the “default settings”.
Fasting Effects
Fasting decreases glucose and IGF-1 similar to exercise
Fasting decreases BP and heart rate
Fasting decreases Insulin
Fasting decreases inflammation and oxidation
Fasting decreases total microbial load
Fasting increases Leptin “the satiety hormone”
Fasting increases insulin sensitivity
Fasting increases cellular stress resistance
Fasting increases cellular stress adaptation
Fasting increases autophagy
Fasting normalizes gut microbiota and stimulates B-cell
immunity
Reverses all major abnormalities of metabolic syndrome
Preceptorship/Residency
Research Affiliations
Alan Goldhamer, D.C.
www.TrueNorthHealth.com
(707) 586-5555
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