Fast-Mimicking Diets: Key To Healthy Aging

Valter Longo, PhD

Well, thank you. Thank you for having me.

Joseph Antoun, MD, PhD, MPP

I appreciate it very much. So, first, why fasting is a big pillar of longevity? People always ask what is that interconnectivity. Why is it so special for longevity? Can you clarify that concept for us?

Valter Longo, PhD

First of all, I always say that fasting doesn’t mean anything. It’s like eating can be good, bad, or neutral. So people shouldn’t think that just because they fast somehow that’s magic and it’s going to work no matter what. And so I think that there are lots, there are some ways to fast and that fasting has to be personalized in most cases. There should be a healthcare professional guiding that. And if it’s done correctly, I think that the effects can be tremendous. And most of it seems to have to do with the ability of these periods of fasting to clean up and use a lot of damaged components. But maybe even more important than the cleanup is the regeneration part. So I think for the past 120 years, the field has really focused on calorie restriction and restricting things.

But I think that we’ve sort of tried to push the second part, which is re-expansion, right? You restrict the calories and you shrink. And most organisms, this happens in probably all organisms that fast for long enough. But then the most interesting part and so lots of interesting things happen like autophagy during the shrinking and lots of killing of damaged cells as we’ve shown for cancer cells out of new cells, etc. But then the re-expansion is an opportunity to reprogram. So, the Yamanaka factors in these factors are epigenetic changes that occur on one side, and on the other side stem cells get activated and they give an opportunity to many organs and systems to re-expand but they do so using embryonic development like programs. So now and that leads to rejuvenation. This is very, very clear in mouse studies, in our studies, and studies of others. But now we’re starting to see evidence for the human body by doing the same.

Joseph Antoun, MD, PhD, MPP

And is it also and metabolic benefit when, you know, some 70% of Americans are a little bit struggling with weight with the latest statistics are showing 90% of all of us have certain metabolic issues beyond that cellular autophagy interest on the rejuvenation and the resurrection you talked about. Are there benefits we’re seeing with fasting on metabolism in general?

Valter Longo, PhD

Yeah, I think that lots of the benefits having to do with insulin resistance and just functionality have to go back to the same mechanism that I just described. So the major part is still about rejuvenating systems and resetting the system. And this is why the great majority of 20-year-olds, even the ones that are overweight and obese they tend to be still okay, right? Not all of them, some of them can be diabetic in their teens. But I think the majority, they can still be functional enough to deal with overweight and obesity. So a lot of it still has to do with if the system is young and highly functional, you’re probably going to be okay even with the excess weight. But then, of course, the nice part about the fasting re-feeding if done correctly. If done for five days and then the re-feeding lasts at least a month. Now the body goes to the fat, burns the fat first and it temporarily shrinks the lean body mass, the muscle, but then it re-expands that. And so this shrinking re-expansion is probably what’s so important also to just get rid of fat and out of muscle. And that’s exactly what we see. And now this is very clear in both mice and humans.

Joseph Antoun, MD, PhD, MPP

I think this is one of the impressive things that I discovered in my fasting journey, and with the fast significant diet we’ll talk more about chronic calorie restriction has a little bit failed on the muscle and you end up losing muscle and now we have to see my glutides. I had a big craze also where we’re seeing 20 to 30% of the weight loss is coming from muscle. Could fasting be the secret of sending the right signals to the muscle to rejuvenate and maintain, which is important for subsequent metabolism and longevity?

Valter Longo, PhD

I think that’s clearly the way so when we’re 20, everything is functioning and in most cases, the fat is limited let’s say less than 20% of the body or the body composition is fat. So I think as long as we go back to the function, I mean, the best way to do it obviously is to go back to turning the multiple systems to be as young as possible and at the same time reducing the fat back to a normal level. And obviously, there is no better way than that eating the fasting-mimicking diet. And the reason is that it doesn’t, it uses what I call 3 billion years of research and development to fix the problem rather than trying to interfere or activate GLP1, etc. So, I think that the FDA system is great, but at the same time is short-term. So it’s just looking at, okay, let me solve a problem for three months, six months, a year, and in fine you can solve a problem for a year. But I think we look at it from how can I make you live to 110 healthy? And that’s a much, much more difficult problem to solve. Right? So short term, you can solve things in a lot of ways. Some are good, some are bad and some are really bad. And the long term, it just really takes a lot of aspects to make somebody live to 110 and healthy. So when you intervene with the fasting-mimicking diet and repeating it. It looks like there’s so much functionality improvement and reduction of risk factors, and now soon enough will be published on biological age, etc. And really it’s hard to imagine that we drugs. So, now we see that GLP1 we see the initial problems and there are a lot of problems in doing the muscle loss. But I think as we get to five years, 10 years of millions of people doing it, we’re probably going to see much more problems as it is. It is standard and common for drugs that interfere with or activate specific pathways.

Joseph Antoun, MD, PhD, MPP

We have mentioned a couple of times the expression fasting-mimicking diet. And you are and the University of Southern California, the Longevity Institute. And now I think 18 other universities have tested the fasting-mimicking diet on different conditions. But can you explain to us from a high level, how is it possible to fast? I mean, the oxymoron fasting-mimicking diet. So we’re eating yet the body thinks it’s fasting. Can you talk a little bit about that discovery and then we want to address a little bit the benefits coming from it?

Valter Longo, PhD

Yes. So maybe around 2010 or so we were testing water-only fasting with cancer patients at USC Norris Cancer Center. And we were thinking, of course, that the cancer patient is highly motivated. They’re going to do it. But it turns out that it wasn’t the case. They struggled and the oncologists were not happy with it. And the patients were not happy with water only combined with chemotherapy in that case. And so it was then we went back to the government, the US government, and basically, the government funded research for the identification and testing of diets and mimic fasting. And that’s what we call the fasting-mimicking diet. And so we had been working by that time for many years on which ingredients activate the protein pathways, which ingredients activate or block the regenerative pathways, etc. And so the fasting-mimicking diet was based on coming up with a formulation that would be viewed by cells and systems and organisms as a water-only fast. So they get to eat but the effect will be very similar to water-only fasting. And we will actually quantify this by looking at IGF-1, IGF-1 glucose ketone. But these are like classical markers of fasting responses in many organisms.

So then for example, ketone bodies, if they go way up, then that’s a good sign that means that the body is in a fasting response mode. Now, we also are worried about health long-term consequences and so that’s why we decided not to exaggerate with these peaks of fasting response. So we wanted to have a fasting response, but we did not want to exaggerate. We do not want people to go yo-yo, your extreme fasting response, and back to lots of food data. Because of course, it is really not, no negative data that I know about this, but I think it was very, very important for us to design it in a way that it would be difficult to imagine. Even after 20 years of doing this at the right frequency, somebody’s being hurt by it. And really, that was the number one goal. Let’s make sure that it’s designed so carefully that nobody does worse. And then, of course, we see incredible benefits with the use of a fasting-mimicking diet.

Joseph Antoun, MD, PhD, MPP

I remember well, you can, you were studying the nutrient what we called nutrient sensing pathways, how the cell senses nutrition and how the systems with insulin and IGF get recognition of food and the FMD or the fasting-mimicking diet was designed to nourish the body. Why not trigger the recognition of the systemic and the cellular way? And this is how it mimics the benefits of fasting, while, as you mention, making it more safe and compliant to do.

Valter Longo, PhD

Yes. So basically the body during fasting understands having lots of fats broken down and so and so fat generally does not interfere with the fasting response. So if only fat is coming in, that’s, that’s okay. Now sugars and lots of different carbohydrates and proteins and especially certain amino acids can block or dampen or reduce drastically the fasting response. Right. So then the challenge was to come up with so many calories to be reasonable for a medical doctor to feed to their patients, but also to be reasonable for the patient and at the same time have ingredients that would not cause insulin to go up, would not cause glucose to go up, would not cause IGF-1, these growth genes to go up. And yeah, so that’s what was achieved with the fasting-mimicking diet. In some cases again, we did not want to overdo it, so we were okay with the ketone bodies getting to a certain point, but not too high with the glucose getting lowered to a certain point, but not too low. The same thing with IGF-1 and the same thing with the ketone body. So those are the four critical bodies, ketone bodies, glucose IGF-PP1, and IGF one.

Joseph Antoun, MD, PhD, MPP

Sometimes I call, FMD like a funded fast. Right. Because when you do only water fast there is a price of that is not only benefits as you mentioned, we start talking sometimes there are disadvantages of water fast, whereas with the FMD, the consumer or the patient are getting macros, they’re getting carbs, they’re getting proteins. Sometimes we get asked if the FMD gives a fractional benefit of fasting or actually in some cases actually is better than water fasting. Have we studied any of the effects of potentially fasting with food the FMD fasting versus water fast?

Valter Longo, PhD

We published lots of studies where we compare them and in some cases, if you look for an example of cancer in most of the papers where we compare a  fasting-mimicking diet with water-only fasting, they’re comparable. But in other cases, for example, in gastrointestinal inflammatory diseases, we saw the fasting-mimicking diet beating the water-only fasting and we concluded in that paper that this is an inflammatory bowel disease paper. We concluded that the ingredients so that the fasting-mimicking diet from the time I developed that, and my group developed that we wanted to combine the high longevity diet so that the nutrients from the longevity zones of the world, those that are uncontested pro-longevity food with, fasting mimicking diet. So we want to have fasting-mimicking diet properties and then pick all the foods that almost everyone will agree on. Yeah, this is a good food and it’s probably going to help people live longer and that was probably a good idea because it turns out we weren’t even thinking about it, to tell you the truth. But it turns out that these ingredients serve that prebiotic feeding the lactobacillus, bifidobacteria, and different bacteria species that are associated with anti-inflammatory effects and improvements in gut function. And so in that case the water-only fasting increased the leakiness of the gut and the fasting-mimicking diet decreased the leakiness of the gut. The fasting-mimicking diet was much more effective than water-only fasting in improving and reversing the symptoms of some colitis and Crohn’s essentially the mouse model of it.

Joseph Antoun, MD, PhD, MPP

It’s amazing. So I want to transition into talking about who should do the fasting-mimicking diet. What have you or your partner universities tested or we’ve heard you mention to get started the discovery started with shifting from water fasting to fasting with food on cancer. You mentioned diabetes and insulin resistance, you mentioned IBD. I want to start first with longevity. Say, you know, I’m a 45-year-old male or female and I listen to this conversation. I’m listening to this summit in general, and we’re talking about fasting for longevity in the fasting-mimicking diet. What would you advise for longevity? Say, I don’t have a health condition. What would you advise that? A profile such as that with how many times to do and how to do it?

Valter Longo, PhD

So as we are aging, lots of things, whether it’s white blood cells or muscle cells or liver cells or liver fat, and there’s a lot of things that start accumulating or becoming dysfunctional. We don’t think about it. I always show two slides at the beginning of almost all my talks and it show the number, of obesity and smoking a major risk factors for cancer, cardiovascular disease, and Alzheimer’s. Then I show in the next slide how they compare with 30 years of aging and they almost disappeared. Smoking and obesity as risk factors for all of these diseases. They disappear compared to 30 years of aging. So treating aging is the most important of all by far. It doesn’t mean that’s always the case, people can be young and have problems, but if you have to pick one thing and one thing only, you want to keep people young, as young as possible. And yeah, so I think that’s where the fasting-mimicking diet does lots of jobs. So one job, for example, reduces the white blood cells temporarily by a small reduction, then brings them back to the normal level during the refeeding insulin sense of that. So insulin in the people, in the patients where there was insulin resistance and high glucose level and then slower. But in those at very low glucose levels, it tends to make it higher, right? So somebody we’ve seen lots of patients where very low glucose levels and probably not healthy. Right. And it may make a higher rate. So you go from 55, then say, fasting glucose to 75. And 75 is probably a much better glycemia than 55. 

Yeah. So I think that is this ability to basically reset multiple systems as organs and making sure that they are now able to function as they should. So it is the first time in thousands of years of human existence where we eat all the time. And then in the last, so it was already bad I think in the twenties but then it got worse and worse and worse. And now it’s ridiculous and with 75% of Americans are overweight and obese and nearly 60% now, of Europeans are overweight or obese. So this is really a pandemic. And interestingly, nobody’s doing anything about it. And I think fasting mimicking diet needs to be at the center of that. And now why do I say fasting mimicking diet? Fasting, because, of course, we are big proponents of these 12 hours a day of fasting. Eat for 12 hours and fast for 12 hours. There’s clearly a very, you know, it doesn’t cost anything and everybody should do it.

But then as you try to compete with the efficacy of drugs they come with problems, but a lot of drugs do work for lots of things to do. Then I think, you know, you have to standardize, right? So you have to standardize it and you have to let hospitals and universities say, I’ll test that. You know, for example, Heidelberg University, they test the fasting mimicking diet on diabetes patients. Now, I think they were not trying to prove that the FMD worked. And so they compared it with the Mediterranean diet. It turns out that five days a month of the Mediterranean diet there is absolutely nothing. And five days a month of the fasting mimicking diet has a tremendous effect on the diabetes patients. So, but, I think that they would have been happy to show that the Mediterranean had worked and the FMD did not work. So I think it’s very important to standardize it and then let everybody test it. And, you know, so far the record has been remarkable. I’m very surprised. I mean, we would have thought there would be a lot more negative results. So far, the great majority of the trials have been positive, whether it was cancer, diabetes, pre-diabetes, or inflammatory diseases. And, well, soon enough, we’ll have the data analysis. So we’ll see what.

Joseph Antoun, MD, PhD, MPP

And I want to get into those why somebody with any of those conditions would consider the fasting. But before we conclude the longevity part, due to commend the people. How many times per year, and I heard you talked it’s a five day fasting mimicking diet, so how many times somebody an average person should do with per year?

Valter Longo, PhD

So I think that is the average person for about three times. And so in the diabetes trials that, of course, they start mostly obese and have lots of problems. So they do it once a month for six months and 6 to 12 months. And then they can go down from there and that’s the idea. So even if you start with diabetes and you have to do it once a month being followed by your doctor, that the idea is year two, maybe you do it six times in year three, maybe you do it three or four times and that’s your maintenance, right? And that’s what you stay with. But I would say yes, maybe three times a year seems to be a very good way to go for most people. And that’s really five days every four months.

Joseph Antoun, MD, PhD, MPP

So this is basically 15 days only out of the 365 days that an average, you know, let’s say healthy. And then we can we can always define healthy, what that means would be it would be a good average. Were there studies on the bio age? Like what does it do if I would have benefited from what you mentioned which is I want to reset my metabolism, and I want to help my cells go through autophagy or regeneration as well? I want to try to get my body a little bit biologically younger because the younger me is that little bit away from the onset of the conditions as you mentioned, what do I expect? What do I expect from a biological age? Did we, did you ever test or simulate what would that mean?

Valter Longo, PhD

Yes. So now we have three trials where we measure or we’re measuring biological age. And then the first two trials were a blood bio-age measurement. And in the latest trial, it’s going to be telomeres epigenetics so we’ll see what happens. But certainly, we suspect that biological age would be reduced in people that do enough cycles of the fasting mimicking diet but we have to wait and see. But every indication, so when you see IGF-1 being lower, then cholesterol being lower, then blood pressure being lower, and fasting glucose being lower, and then inflammation being lower. It’s hard to imagine all of these changes occurring in the absence of the system being younger and more functional. It’s possible, but unlikely.

Joseph Antoun, MD, PhD, MPP

Okay. And well, make sure to follow up with you when the results are out and published because this is the, I know that the fasting mimicking diet was the only or probably one of the first, if not the only, even technology, nutrition technology that was awarded the patent on longevity. So that would be a great fit to show clinically as well the results. So we’ll do a follow-up with you at some point to show that for everyone who wants to go deeper into what Dr. Longo is talking about, Dr. Longo has the longevity of Diet Book, which talks about the fasting mimicking diet but also what to eat every day. And it was a big international bestseller. You can buy it on any of the online platforms, the longevity diet, and you will get a detailed perspective on why fasting, why fasting, nutrition diet. There’s a chapter on health conditions as well to understand how to do it and how to apply it. Today, we’re going to give you almost the summary of it so would know for the ado, Dr. Longo you mentioned cancer, that this is how the fasting mimicking diet started. You mentioned diabetes. Can you tell us why a patient with cancer would even consider in doing fasting or the fasting mimicking diet?

Valter Longo, PhD

Yes, I think that the reason is probably pretty important, right? And so if you think of cancer, it is developed, it is started, let’s say, from a mutation and develops from that mutation in the presence of lots of food. And the great majority of people, as we say in so much and so in the evolution of cancer, it always had an excess of everything, lots of glucose, lots of sugar, lots of amino acids, lots of proteins. And so when that’s taken away, we now very clearly show over and over and over the cancer goes into an emergency mode right in. And people have this illusion that fasting can cure cancer. Well, I really don’t see that. What we see fasting and fasting making diet do is put the cancer in emergency mode. But the important, very important thing is when it gets into these emerging emergency mode it tends to rely on very few systems and pathways, what we call pathways. So there are now very few genes they are keeping that are essential to keep that cancer cell alive. Now the drugs can come in and they can do a very good job of blocking those. And so we’ve shown that for hormone therapy, for chemotherapy, for kinase inhibitors, for immunotherapy. So when you combine it now, all of a sudden this joining force is extremely effective in the mouse. And now we’re starting to see the data in humans are very much in agreement with that in mice and it makes sense, right? Because, unlike most therapies, there is just a fundamental reason why they should work. So be very, provided that we can match the fasting response in the mouse. It’s almost it’s extremely unlikely that all of a sudden it’s going to stop working in humans. It may not work in all cases, but it’s going to be a matter of finding out ways to revolutionize the environment of a patient so that cancer cell, no matter which cancer cell it is, struggles and then with the standard of care, drugs together with the standard of care drugs, then you can kill them all. Kill all the cancer cells.

And so we see that fasting mimicking diet may be putting at least in the early, early stages, by putting cancer, in the cancer treatment in the category of antibiotics. So it’s so wide acting together with, so the drugs plus the fasting making that there’s so wide acting, there’s going to be difficult, as you know, for the antibiotics and bacteria. It’s difficult for the bacteria to escape. Sometimes they do but if you take advantage of lots of different antibiotics, they work for the great majority of people. And that’s where I start seeing the least in the laboratory where we start to see this kind of potential. That we can get them all. Maybe not all of it, but we can get the great majority. So, I mean, it’s still, you know, years away to two of clinical trials, but believes that there’s that potential right then that maybe this that we just say that there’s it’s a high potential and we just as to be demonstrated in the in the clinic.

Joseph Antoun, MD, PhD, MPP

And so Dr. Longo,  you’re saying it’s not about fasting or fasting mimicking diet alone. You combine them with the standard of care and the fasting mimicking diet sensitizes it and puts the cancer into a difficult situation that then sensitizes it when the intervention is coming in to hit it and potentially could hit it even stronger.

Valter Longo, PhD

Yeah, it makes cancer dependent on very few things. And also and probably more importantly, it doesn’t just make so we look at a cancer, we think and I think pharmaceutical companies think of a cancer as one. Right. And so you go to the FDA and you’re thinking, I’m targeting the major cancer. I’m not targeting the 50 to 200 additional cancers that are within the cancer. Right? It’s impossible. You can’t go after all of it. And that’s the power of the fasting mimicking diet it’s targeting all of it. Why? Because it makes it so difficult to escape in resolve all the problems caused by so low energy F1, no glucose, increasing ketone bodies, decrease in leptin, and decrease in insulin. So all of these changes now all of a sudden are very difficult to overcome, especially when the immunotherapies have it, when the chemotherapy is there, etc.So that’s the key is going after the major cancer but it’s also making it difficult for the escapers, for the resistance cells. And those are the ones that usually kill patients, the ones that become resistant. So hormone therapy, for example, works for a year or two, then the cancer becomes resistant to the hormone therapy and then the patient is in trouble. And the job, what we’ve shown in mice, if you have the standard two drugs of hormone therapy. And now in mice, as for humans, eventually, the cancer adapts and starts growing. But if you have this fasting mimicking diet now that never happens and the cancer goes down, down, down until you see cancer-free survival. And yeah, so I think that’s why the potential is so high for humans. It’s just a question of as I happen for immunotherapy to see where there’s work and how do you apply so that optimizes overall survival, increasing overall survival and progression for survival.

Joseph Antoun, MD, PhD, MPP

I remember, Dr. Longo, you reported this word of or expression of differential stress resistance. Was it we talked about sensitizing potential cancer? Is there also any effect on the normal cells of the body when they go into a fasting nutritional state?

Valter Longo, PhD

Yeah. And so this differential stress resistance and also differential stress sensitization are really key because if you think about maybe all the treatments right now besides a few innovative ones, there are very futuristic, but all treatment with this chemotherapy or hormone therapy or immunotherapy even, it’s going after all cells. This is why there are a lot of side effects even from immunotherapy. So you’re basically blocking this PD-1 and PD-L1 dialogue. Let’s say, between normal cells and cancer cells but that can happen for any cell. In the case of fasting mimicking diet instead differential stress resistance and sensitization are clearly sending the normal cells in the cancer cells in the opposite direction. And this is very well established by us first and then lots of a lot of people. So the normal cells, they know what to do. They shield the slow-down growth. They stand by and protect, become protected. The cancer cells have different degrees but in most cases they disobey. And this is the definition of a cancer cell flight, disobedience from anti-growth signals and probably fasting and fasting mimicking diet are the biggest anti-growth signals and but they don’t care and that’s exactly what we want them. So that’s how we think that the chemo, etc. hurts them. But also the immune system recognizes that. Their rebellion may be very well at the center of immune recognition and meaning that now I know that you cannot possibly be one of mind because you just disobeying everything that a human cell knows about starvation or fasting responses.

Joseph Antoun, MD, PhD, MPP

Dr. Longo, I know your studies go beyond fasting and fasting nutrition for cancer. This is a lot of important information on what patients with cancer should eat in between the chemotherapy or the immunotherapy cycles. And it’s a full nutrition for cancer discussion. We cannot cover it today because they were focusing on fasting and longevity. But I just want to give a small secret here to the listeners. I think you have a book already published in Europe and cancer in Cancer in Nutrition. Hopefully, it will come to the US. Any expectation when if somebody’s listening to us, they very interested in fasting duration, but also how to eat when you have cancer and inflammation. What do we expect the book to come up?

Valter Longo, PhD

Yeah, it should be within 10 months. So it’s a sure thing. It’s already been almost finalizing in the American the English versions, and yeah, so 10 months. My suggestion is that, so I started our foundation years ago the foundation is both in the United States and Europe and is called Create Cures Foundation and we have a clinic, and the clinic follows, the clinics thousands of patients. Many of them are, about 50% of them are cancer patients. And so I encourage you to encourage people and oncologists to contact the Create Cures Foundation and consider entering the program. These programs are usually very long so that the idea is can we follow week by week a patient to make sure that whether it’s a fasting mimicking diet or say we also use the ketogenic diet in some cases or the longevity diet, etc., etc., etc., exercise, muscle training. So we want to keep the patient as strong as possible and keep a lot of these markers low but not so low to where the patient becomes malnourished and frail. And yeah, so it’s extremely difficult and people underestimate how difficult that is but we’re very happy now to see lots of oncologists and doctors working with us to say, okay, they do their job and we do ours. And together we’re really starting to see in, not just in cancer, but also in cancer, remarkable results that.

Joseph Antoun, MD, PhD, MPP

It’s fantastic and I’ve heard a lot of patients’ stories about the clinics and definitely encourages oncologists and patients to consider nutrition and food as medicine. It’s a big supporter and enabler of the care. Before we depart here and probably this is a homerun for the fasting nutrition is diabetes and maybe this is where we have you have a little bit more clinical data on it. And if you can share a little bit of some of the findings on cardiometabolic in general and diabetes specifically with fasting nutrition.

Valter Longo, PhD

Yes. So diabetes, I think now,  so I know of the trials that have been published but I also know the trials that haven’t been published. And I would say that that’s the one that we would be shocked to see a reversal of what we already seen in hundreds of patients. So it looks very, very good. You know, it looks like the patients that do 6 to 12 cycles, monthly cycles of the fasting mimicking diet see a regression of the disease. And in the absence of other interventions now in the clinic, we combine it in this lifestyle program and we see even better effects right now because we can sort of customize the everyday diet plus the fasting mimicking diet. So we see even better effects. But yeah, so a reduction of A1C without reduction of lean body mass unless the FMD is combined with drugs, then we see lean body mass reduction. So yeah. So then, but for the incredible difference is that when the FMD is done alone, we don’t see that. And that’s like trial number four or five that we see improvements in glycemia in the glucose level and insulin levels, A1C but no changes in lean body mass in muscle mass.

And so we suspect that because we only see those changes when the drugs are used that most likely it’s the drugs or you know, it’s a combination with drugs that causes the problem. It’s not a big problem but I mean, yeah, that’s really what you want. Don’t touch the muscle mass, maybe rejuvenate or have improvements in the muscle mass. So don’t touch. Its absolute composition and weight and potentially improve its function. And then have the metabolic or the cardiometabolic improvements. And we see pretty regularly all of that which go from the insulin and Glycemia, A1C, etc. all the way to blood pressure, cholesterol, C-reactive protein, etc. We don’t always see effects on cholesterol and blood pressure, but say the great majority of the trials we saw that in a few we didn’t see when we combined the FMD with hypertension drugs. We did not see the hypertension being lowered but of course, we already lowered by the drug, but we didn’t see a further reduction. So yeah, but in general we consistently, we see effects on lots of these markers.

Joseph Antoun, MD, PhD, MPP

Dr. Longo, Actually in typical diabetic type 2 patients, they come in 2 to 3 drugs. What is the protocol, what is the fasting mimicking diet protocol that has been the most tested for those people to go on?

Valter Longo, PhD

Yeah. The way to go I think, well, we followed dozens of patients at the clinic and the way to go is to personalize. So for example, I always tell the story of a doctor that had diabetes and hypertension and tried lots of the drugs GLP-1 and tried them all right then. And nothing works. People are very excited about these drugs but the minority or I don’t know if it’s a minority but certainly the group of people for which it doesn’t work. It’s a big group of people. And but this doctor comes in desperate, got diabetes. And so it does, I think, five cycles of the FMD in a year and a half. First of all, does nine months of the longevity diet and I’m telling this story because I think is very representative of what we see in the trials and what we see in lots of patients. So there are nine months of the longevity and this longevity diet it has Okinawa slash the Mediterranean. It’s a very tough everyday nutrition for longevity. It takes from lots of different diets, but try to optimize it. But even after nine months of that, there are improvements but not big improvements. A little bit of weight loss and a few things but the glycemia still up there is still, you know, in the diabetic range. And so then we start with the Fasting Mimicking Diet and then we see A1C collapsing. And so he does it five times and so I think it was a process of about two years. And then this doctor goes from lots of drugs to no drugs, no diabetes, no hypertension and yeah, so I think that’s what we see in the clinic.

If people are working with us, we have to personalize it. But you know, within a couple of years, the majority of them, we can get them back to health and not drugs. This does not mean it works for all of them, but it works for probably the majority of patients. And in the trials, you see 50% to 70% of patients regressing. And that’s so it’s very much consistent in regressing just with the FMD. So now if you have that personalized touch and we don’t revolutionize diet. So in the clinic, we’re basically saying, okay, do the FMD, and then can you make these small changes? And those are the long-lasting ones. So we want people to make small changes. They can live for the rest of, they can live with for the rest of their lives and then use the FMD to get into to drop in all those risk factors and markers for diabetes and pre-diabetes.

Joseph Antoun, MD, PhD, MPP

Dr. Longo, I know there are trials happening on autoimmune and Alzheimer’s, but I’m going to get into details today about those the focus was on longevity and maybe what already we had clinical trials on like cancer and diabetes. Before we depart here, any final words, any final recommendation to those listening here, maybe for the first time interested in fasting and longevity, maybe the first time being exposed to why is it important to do a fasting nutrition? What would you recommend for an average person? What could be the ideal pattern of fasting? I think you mentioned the 12 hours. You mentioned the FMD. How can you put it together as a final conclusion to the listeners today?

Valter Longo, PhD

I think that the, I mean, first of all, I hope that we get the medical community engaged, right? And not just the doctor but also the nutritionist, the dieticians, the nurses, and all of the health care professionals. And I really think that we need that minority maybe in the beginning to say, okay, we could do this with lots of drugs, but can we just can we focus first on getting all the patients that we can bring back to full health in a younger age, biological age? Can we just focus on that? And then and I agree, if we do that for two, three, four years, as we do in the clinic, sometimes we fail and we say, hey it’s not working on this patient. So now, yeah, that’s where in the drugs should come in or where the drugs should be the only intervention taken.

But yeah, I think for the first two or three years there should be a very coordinated effort from the healthcare professional and from the patient to say, okay, I need to go back to lower cholesterol, low blood pressure, or normal cholesterol, normal blood pressure, normal glycemia, normal weight, cognitive function that are, you know, as high as possible and inflammation should be very low or absent, etc., etc.. And that’s really it’s not going to happen with 20 drugs, right? You can’t go after and this is why the not the typical 67-year-old is taking four or five drugs. And by the time Americans are 45, the average number of drugs for chronic diseases, and chronic conditions drugs is two or more. So, yeah, that’s what we’re facing. And I really think it’s, there is an emergency to act and find the professional that says, okay, I’m going to focus on that from now on. I’m going to focus in making people younger, and healthier, and keeping them like that so that we can see them optimize their potential to make it to 100 and maybe even 110.

Joseph Antoun, MD, PhD, MPP

And I think you have a lot of this for humanity right before it was sick care and drugs. Then when we discovered, we as a physician community that okay metabolic and lifestyle was, is behind a lot of the diabetes now a little bit the type three diabetes, the Alzheimer’s we said okay, maybe dieting, right? Chronic diets, the diets came in. They’re difficult. They impose on lifestyles. They don’t get you younger. They slow down a little bit your metabolism and they’re much better than eating wrong. Don’t get me wrong on that. But you don’t like the way to hit getting the body biologically younger, protect that lean body mass, and then dealing with the root cause rather than the symptoms of the conditions happening today. This is why fasting is in the last seven, or eight years. We hear a lot of doctors, and a lot of clinics excited in the USA alone, with over 15,000 clinics, working with the fasting mimicking nutrition, that excitement is coming from unlocking aging. It’s all these four killers we talk about aging, protecting the organs of longevity, helping their cells, and dealing with the metabolic issues without having to impose and the consumer on the patient and lifestyle change from day one that is drastic enough that they kind of default and leave and then feel that chronic learned helplessness that we see with most most patients. So I want to thank you very, very much, Dr. Longo, for your time today. This has been an unbelievable discussion. Pretty sure, we’re going to come across again and in the future maybe. Maybe, in May or June, the cancer book will be out and the new trials on the reversing bio age would be probably published we can have another discussion about the FMD for those health conditions. I appreciate you very much today.

Valter Longo, PhD

Thank you. You’re welcome.