The FastDay Forum

On the last 10 minutes of this programme yesterday the resident doctor Margaret McCarthy was very sceptical about any benefits of fasting, saying there had been no extenssive trials and the benefits of fasting were completely unproven.
http://www.bbc.co.uk/podcasts/series/medmatters

Thanks Susan for posting this, yes there is some negativity about our own darling 5:2 diet, but what a lot of other great stuff there is. Skip the opening section about NHS 111 and jump in at 07:20. Lots about IGF-1 and its link to cancer, also about apples (bad) and pears (good). Also about carbohydrate intake and about obesity.

Then a section about intermittent fasting featuring Dr Michelle Harvie who has to defend her '2 Day Diet', not helped by the fact that they have yet to publish the full results of the trial upon which it is based. (Bear in mind that the book is touted on the basis of being backed by proven medical research.)

Dr Margaret McCarthy does criticise Dr Michael Mosley's fast diet (BTW there must be a scientific study to be done into why giving your child a first name beginning with M predisposes them to becoming a doctor and working in the field of diet...), but the main criticism is that it is unproven, which is fair enough to be honest. Oh yes and she dislikes the suggestion that you can 'feast' on the 5 days, and I agree with her there.

Dr Harvie reckons that there may be some real benefits directly from the 5:2 regime (they found the intermittent fasters in their study lowered their insulin levels more than those on a nutritionally-equivalent regular diet) but didn't reject the main 'charge' that the biggest gain was from improving overall diet, and that IF works by helping subjects to make that change - a sort of trojan horse to good diet. That's still good enough for me to make 5:2 well worthwhile, and it fits with my personal experience.

Sorry for going on a bit but if you are interested in this stuff it is worth a listen.

That's a great summary, Dominic, thanks for posting! I caught the end of the section on 'apple' and 'pear' shape but not all of it. I'll listen to all of it again.

Very interesting programme - but the consensus appeared to be (regarding weight loss) that any loss is a result of calorie restriction overall, much the same as any other diet, however it is dressed up. It will be very interesting to see more clinical data, hopefully in the near future, about the IF method as it is gaining a lot of followers now and clinical evidence rather than anecdotal will be very welcome. Am a bit disheartened about the apple and pear, being an apple! Would this body type have had an evolutionary advantage in times when food was scarce? Maybe faster runners or something similar? Or is the apple shape a modern phenomenon?

Am a bit disheartened about the apple and pear, being an apple! Would this body type have had an evolutionary advantage in times when food was scarce? Maybe faster runners or something similar? Or is the apple shape a modern phenomenon?

Must have had an advantage of some kind or we would all be pears! But it seems to be a disadvantage now. Though there are one or two pears here who seem to wish they were apples. When an apple person gets to a 'normal' weight they look normal all over, a pear person may still have that great fat on thighs and butt and struggle to shift it without becoming too thin. Not that they need to shift it, but they might still want to...

[carorees]

I think there seem to be more apples than there used to be (among women who traditionally are not meant to be apple shaped). I suspect there is something about modern food habits that has increased the amount of visceral fat. If I am right then the return to real home cooked food being engendered by this WOL might result in some apples becoming pears! It will be interesting to find out!

The interesting stuff about IGF1 starts at 08:47 and goes to 14:10.

Then at 15:20 Dr Val Macaulay says that when you have high insulin (as a type 2 diabetic, but by implication more generally), this reduces the level of special binding proteins (IGFBPs) in the blood. These would normally reduce the power of IGF1, so by reducing them high insulin makes IGF1 more active and therefore assists cancer cell growth.

If you are type 2 diabetic this is exacerbated by a high level of blood glucose which also assists cancer cell growth.

This is fascinating, especially the relationship of carbs, insulin & cancers. It's also a reality check on the evidence base, and 'overselling' but I guess in the end we're all most concerned about an experiment of sample size 1 - ourselves. I fully appreciate long term results won't be known ... in the short term (!). But even if a statistically significant proportion of people benefited that's not a guarantee it would work for me. It's plausible so well worth trying and gauging the affects. Personally I find the simplest way of having ultra low carb days is simply to do the 600 cals fast; otherwise it's a complete faf as far as I'm concerned (especially if simultaneously trying to keep protein moderate).

So the programme says that the IGF/Insulin stuff is well researched. That's a good reason to follow the diet. Whether low carb or not.
I recognised it as a good diet and a way to lose weight and I think that is why people's imagination has been captured.
The results may only be for a few people, but obesity is such a problem that we need a solution. Starting this diet is a good start. The warning is it might not work - if it doesn't think of the IGF/Insulin results. It is not all bad...

A Greek doctor once (years ago) told me that in the very old days, women were pears and men were apples. I don't know if it's true or were he based that on, I just remember that he told me.