Fasting’s Impact On Skin Health

Introduction to the Summit and Dr. Karp 0:00

If not just the subjective feeling of confidence, feeling better, and visible signs of decreased inflammation, you see it right away. It's pretty dramatic. And it's one of the most dramatic things that I'm part of. The fact that it is so safe in the right patients is really an impressive thing. This is the Longevity CEO, where we explore the science of metabolism, cellular renewal, Hi everyone. This is Dr. Joseph Anton, your co-host for the Longevity and Fasting Summit. Today is going to be a very special episode with Dr Jonathan Karp.

Dr Kharp has been a dermatologist for over two decades. And, but I think around 2004 is something happened with one of his patients where somehow like me, we all started with allopathic medicine and then saw the power of lifestyle changes in nutrition and fasting and other interventions and it changed our perspective on medicine. change our perspective of how can we effectively help our patients induce a disease regression or remission. And I think this is where he changes the way he practices and he's going to share a lot of this with us today.

Stay tuned. This episode will focus on skincare specifically. So for all of you interested in this topic, make sure that you watch the episode to the end. Dr. Karp, thank you very much for your time today! Yeah, my pleasure. Do you want to do a little bit more elaborate introduction so that people get to know you and your story and how you got into fasting and longevity? Yeah. Sure. So, you know, I grew up in a family of doctors. Father was a very traditional family doctor who had did house calls.

I remember as a kid. going up to farmhouses, carrying his doctor's bag. And I actually, from him, really realized he's one of the sort of longest in his community in terms of seeing the patient, not just as a specialty, but seeing entire patient.

From Traditional Dermatology to Lifestyle Medicine 1:56

That got me into medicine. went through to become a dermatologist. In 2004, I had a patient by the name of Karen. She had horrendous lupus. I have her on, of course, all kinds of organ transplant meds and nothing was working. We stopped all those med and she disappeared for around four months. When she came back, she was completely clear and came with a whole stack of studies as well as books. telling me how she did it. And remarkably, like other doctors, even though I had an interest in health, it actually took me a month or two to pick those up because there is unfortunately a little bit of a resistance by medical doctors just the way we're trained to sort of go deep into looking at some of these things.

So a couple of months later, I It was sitting there on my stack, and I brought it home with me for the weekend and pretty much devoured everything in there once I started reading it. And actually, there were some studies in their for lupus, specifically fasting, that I was introduced to. But also, she left a book with my called Fasting and Eating for Health, which was written by Dr. Joel Furman. This was back in 1995, he wrote this book. And while concepts like autophagy and such, I don't think were mentioned in that book, there were some really interesting case reports with lupus as well as psoriasis in the book.

And I really got into looking at lifestyle interventions and really became obsessed with that and started. started recommending diet specifically for patients with psoriasis and then over the years developed sort of a focus on psoriasis and lupus specifically when it comes to lifestyle interventions. And that's sort the medical kind of part of my history. It's fascinating what you said about us doctors, right? The way we're trained is so focused on categorizing a symptom to a disease and giving a pill solution, right?

And a lot of us are resistant to changes. And we don't know what we do know, and this is why the summit exists, because many of, us and I always say this, is I'm an MD and PhD and two masters, I only got one hour in nutrition. This is from top universities. So we're less trained on this topic, then we got a little bit scared or deterred with, like, And nutrition and lifestyle are just, you know, a little bit of almost a charlatans intervention. And we still see it today with, it surprises me because I think, I mean, should be malpractice today.

If you're especially an endocrinologist and dealing with diabetes, It's a foodborne disease. A lot of the autoimmune diseases, Alzheimer's now is called type 3 diabetes, cardiovascular disease. It should be close to malpractice if you don't consider these interventions that actually are treating the true roots of disease, right? We get a lot those chronic conditions, we get them with age and unhealthy aging and then lifestyle. And in autoimmune, obviously leaky gut and other lifestyles that are increasing the rates of these chronic diseases.

So it's fascinating. I did this intervention now just to, if there's doctors hearing us today and or patients, go to your doctors and please inspire them so that they go and read a little bit more about lifestyle medicine, because this is behind probably 60, 70% of the things that we're suffering from today. It's true. And I mean, there's the philosopher, Maimonides, who one of my favorite quotes of his is, and he was a doctor as well, that any diet that can be treated

Discovering Fasting and the Fasting-Mimicking Diet 5:34

by diet, essentially, it shouldn't be treat it any other way. This goes back to the 12th century or whatever. So this concept. But one thing I'd like to point out, since there are doctors that are probably listening that maybe haven't done lifestyle interventions, as you kind of inferred, you can feel a little bit uncomfortable in the beginning when you start start this because you almost feel like you're going against the grain in a sense, even though you know that it's sort of... You're learning from scratch, right?

You are the expert and you are learning it from the scratch again. Yeah. And I'll just share one brief story. I had a kid, well, he was around 17, bodybuilder. His father was a body builder. There were two humongous guys in my room and he had seen probably 15 dermatologists, really bad eczema. And it was pretty clear that he was basically living off of chicken and fish. You know, he's taking a little bit of a fish oil supplement. But it's pretty clearly he had an essential fatty acid deficiency or at least a disorder because his diet was so restrictive.

So, you know this was sort of one of my first like active... And I felt very uncomfortable doing it. I said, listen, you probably have an essential fatty acid deficiency, so I'm recommending that you take a tablespoon of hemp seed oil because that has a good ratio of essential fat acids. And even when I did that, again, this is very, very early on, I feel a little uncomfortable about it, and I think other doctors would feel the same. Subsequently, there are all kinds of studies showing hemp seed oil is actually good for eczema.

Regardless, at the time there wasn't. And when he came back, I was scared to go into the room because it was, again, sort of going against the grain. I walked in and they actually didn't look happy. They said, you know, we're really angry because he's all better and no other doctor ever told us about these sorts of things. So I'd say for doctors who are listening who feel a little uncomfortable with it, don't Don't. You're not making anything that's going to harm the patient necessarily. So anyway, just leave with that sort of anecdote.

That's fantastic. My next question to you is that, how did you get introduced to fasting? When did your meet this concept of fasting and what got you to believe in the science and bring it to your patients? And then as a transition, what kind of patients you use fasting with? Here, we're going focus on skin care. And which kind fasting you bring to them and and What are the results? Okay. Well, I learned about fasting right from the beginning because Karen left me that book by Dr. Joel Fuhrman, but I did not implement that.

And one of the reasons is because, and I still believe this, that for people who are doing water-only fasting, if you're, you know, the toxin load that people have, just going right into a water only fast without any fiber to sort of help re- help absorb some of those toxins that get shed in the initial phases of a, water, only, fast, it's probably not a good idea. And for people who want to do a water-only fast, I usually refer to them to a center like True North or one of those type of places.

I think that if people want do do water only fast then they should go on an incredibly high nutrient-dense diet for probably three to four months before doing a So my start with fasting actually was when I found out about Prolon, the fasting-mimicking diet, which probably goes back to almost the beginning of Prolong. Well, actually, I'm not sure when ProloN first came out and ordered it for myself. Did it for myself, had my sister do it. We did it sort of together. Had incredible just results in terms of how I felt and was pretty impressed by the science.

And I should mention that I have a company called Miracle Noodle, which makes what's called the cone jack shirataki noodle. The noodles are 97% water and 3% plant fiber. So they're virtually no calories and no carbs. My sister and I sort the noodles with the ProLon. It wasn't a difficult process and we had an incredible result. And I realized that here we have a way of introducing fasting in a safe way without it being all that difficult.

Using ProLon in Practice for Skin Conditions 9:42

That's when I decided that I would start to implement using Prolon for people who want to take up a lifestyle intervention process in my practice. Is this Coinciding with the publications by Dr. Walter Longo and USC on the science of fasting and a fasting-mimicking diet. Yeah, no, I think it was actually when his book came out more so than, because I'm sure the publication came up. The book is right here behind me, actually. It's probably one of the most read books now in nutrition and an international top seller for Amazon and others.

And this is just to shed a little bit of light to people listening here, to us, Professor Walter Longo. the head of the longevity institute at USC is probably like Dr. Karp said, there was a lot of books on fasting historically in the 1920s. There was wave that tried to bring fasting then in 60s, but the science was never like fully done in a randomized clinical ways. It was always clinics talking about. about their results because nobody makes money when you fast. So nobody's investing, nobody used to invest into fasting trials.

And then when Dr. Longo tried to do the water fasting clinical trials as Dr Carp, as you mentioned, they're difficult, there is drastic change to the body and this is when the National Institute of Health donated over $20 million now to developing the fasting-mimicking nutrition so that patients can eat food over five days and at the same time get the benefits of the water fast. So you get benefits without getting a lot of side effects. And the product is called Prolon and it seems this is what you use in your clinic.

Can you tell us a little bit what cases you used it for? What is the protocol? So I usually do it in a group setting, actually. We usually get several people together to do. Essentially, we share info on WhatsApp and have a call together. And that's how I've done it. But I also have people who decide to embark on lifestyle intervention. along with a whole host of other things. So it runs the gamut, but as I mentioned, sort of my specialty, or I should say my passion is lupus and psoriasis. And psoriasis especially, because the data on psoriaasis and systemic inflammation has really, over the last, say, six, seven years, really been dramatically demonstrated that when you have pshorias, there's There's quite a bit of systemic inflammation.

This is a doctor by the name of Dr. Gelfand at University of Pennsylvania. It showed aortic inflammation in people who have not even just a little bit. You don't have to be covered with psoriasis. So we know it's a systemic disease. If you can sort of quell some of that inflammation, which happens with an FMD, then you're going to see some improvement. But I think a lot of the effect is the fact that overall metabolic parameters are overall increasing. And that has been studied independently just with lifestyle interventions or even just weight loss to show improvement in psoriasis.

So while my experience is sort a hodgepodge of patients that are deciding to go on some sort lifestyle intervention, Generally, though, you can see some improvement just in looking at the skin. It decreases in inflammation pretty quickly. Does that decrease happen between day one, day six, or day seven, and day eight? The skin is starting to look different already or it takes longer time? Yeah, it's usually subjective because I don't necessarily see it, I'm getting a self-report. I am not seeing them exactly at the end of a fast necessarily because it is sort of an online group type of thing.

But when I see them back, they are sort variable intervals and for sure there is a decrease in inflammation in the skin. Ultimately, I consider it sort of one pillar of trying to get people into improving their overall lifestyle. And so along with that comes dietary coaching in between the FMD, you know, in the interval period of time. To clarify, FMG is fasting-mimicking diet for those who are new to the concept. What is the protocol that you use? How many times do you recommend they do the PMG or ProLon?

Yeah, I try to do it once a month for three months, so following sort of the standard protocol and then every three-months or every quarter thereafter. And oftentimes, because I do myself every-quarter, often doing it with them. As you lead people through this, each day has its unique challenges. for a lot of people and as you work with people who are going through a fasting mimicking diet, you really can help coach them in a way that is both educational but also inspiring because I have to say one of the greatest things about, I think, getting people into a Fasting Mimicking Diet for their overall improvement

How Fasting Helps Psoriasis and Lupus 14:32

in lifestyle is that they have an incredible sense of accomplishment when they finish it. And that in and of itself, and the fact that they've lost, you know, four to seven pounds or whatever the case may be. That really is one of the greatest things because for the first time they'd done something for themselves. They feel incredibly empowered and any kind of intervention afterwards. They're more motivated to do it. It can really be a turnaround for patients. And just if you're a patient, I recommend giving it a try just for that sense of accomplishment.

Not only that, but of course, everyone feels better the week after. There are all kinds of realizations about your body that happen as you go through the process. Your skin tightens, by the way, after you do a fasting-moving diet. There's definitely a physical improvement in the skin as well. So there's lots of things going on there that are pretty impressive. And Dr. Card, let's talk a little bit about the science of why fasting, how fasting works on somebody with You mentioned psoriasis or lupus.

What happens? Why the spots on the skin or why the disease is tapped at its root cause? Several reasons. Obviously, there's a down regulation of certain pro-inflammatory T cells as well as pro inflammatory cytokines. That's one thing that happens with fasting. Along with that, you can get some visceral fat reduction, which many of you probably know is sort of not just sitting there. It's incredibly, incredibly inflammatory. In terms of other sort-of skin types of things, there's increased insulin sensitivity, lower IGF-1 that happens.

which can help with a whole host of things like acne, for example. You're getting stem cell growth later on in the fasts. So you actually have activation of stem cells, which are going to help. There's the skin sort of gut access that is improved here. of your microbiome that is going to overall help with systemic inflammation. So those are just some of the amazing things that happen during sort of this process. You were mentioning to me before we started recording the autophagy and you discovering when it happens a little bit and in which days.

Can you talk a bit about Are the theories that the damaged organs also are trying to heal and trying rejuvenate? Is that part of the reason? No question about it. I think part part the misunderstanding of autophagy or autofage, I guess who knows how it's actually scientifically pronounced. is twofold. One is it takes a long time for you to actually get autophagy happening. So that's day three to five of your fast, of you fasting mimicking diet, let's say. And second, it's not necessarily recycling the entire cell.

It's recycling components inside the cell, so those cells are essentially the machinery of those cell is being updated. And as a result, the cells that were not functioning the way they were supposed to function and were sort of old, tired, and degenerated are now sort-of upgraded. You kind of think of it as new software almost and new machinery inside the cell. So all of these things, certainly for skin, there's no question that's going to lead to just physical improvements in the skin. But overall, some of the changes that happen when these cells start to degrade is there's inflammation that can take place because the cells are not really functioning the way they're supposed to.

Do you see any difference between, you mentioned the protocol is you do Five days prolon, the fasting maybe can die on month one, five days on months two, 5 days a month three, and then once every three or four months, right? The protocol that was tested by a lot of the clinical trials is they were called the three plus three. Three in a row, then, once, every 3 or 4 months afterwards. Do you see improvements on specifically cycle one two or three? Or is it incremental? There's already cycle 1 and use benefits.

Yes, absolutely. You see benefits in cycle one. And I might add that cycle two for people is a lot easier, not just because they're capable of, or not because of their understanding necessarily what the process is about, but also because are more metabolically flexible.

Autophagy, Inflammation, and Metabolic Benefits 19:08

They're essentially upgraded in a sense. So they can switch from burning sugar to burning fat a little bit easier. Second time around, it's, yeah, your question was what cycle do I see the most improvement or? Do you see it right away? Like in medicine typically, you know, and say, okay, you're going to go, especially in autoimmune medicine, right? You get away, there's a lack of time and effect to get results. And I was curious to know if a lifestyle change could go big and fast in parallel to medicine.

By the way, this is the other question. Do you stop any of the medication or you just add roll onto the medications? Okay. So if someone's on high blood pressure meds or diabetes medicines, I usually talk to their primary care doctor and get their approval or have them talk their primary care doctor. So the improvement is pretty rapid. I mean, if not just the subjective feeling of confidence, feeling better and visible signs of decreased inflammation, you see it right away. It's pretty dramatic.

And it's one of the most dramatic things that I'm part of. The fact that it is so safe in the right patients is really an impressive thing. Many of us talk about also the linkage because I think it's important for everyone with. And again, autoimmune is more of a medical language. There's always lower level of inflammation that we as allopathic doctors or traditional medicine would not call it inflammation, but actually you have a certain level inflammation. But I think it's important to clarify to everyone listening to us today, how important that is in accelerating aging as well.

And we have the word that would call inflammation right? Right. And when we intervene with the fasting, even though we're helping a short-term health condition, it's always in the back of our minds as physicians. It's like, okay, I'm also contributing to the longevity of that person. I also contribute. You mentioned that you said there's multi-system improvements that happens and there is a lot of it in a physiopathological current condition. But there are a lots of also that is preventative and helps the body to stay healthier longer.

Can you elaborate a little bit on if this is in the back of your mind when thinking about those patients and how you can help them with lifestyle changes so that they actually decrease that side effect of being in high inflammatory status? Yeah, so I would say that the concept of inflammation is important to understand only in diseases that we're suffering from all have an aspect that is inflammation-based. Also, the fact that some of this reduction in inflammation and some other results are persistent even after a five-day fasting-mimicking diet is really pretty powerful.

But if you can combine that with giving people a lifestyle program, diet, whatever the case may be, during the interval, it's even more powerful, So it's one of the reasons why I always recommend people, not necessarily people who have autoimmune disease, but getting a high sensitivity C-reactive protein is important for everyone. I think it is one the sort of seven blood, seven or eight blood tests I should be familiar with. And this gives you a general indication of your overall inflammatory level, I guess you could say.

So it's one of those blood tests that I think every patient should be conscious of and if they have to even order it on their own. But thinking about just overall the chronic diseases that we have, you know, everything from heart disease to high blood pressure. You know, just obesity in general. If you have an intervention that can help with that, that's pretty quick. That's a pretty powerful intervention. Dr. Karp, I'm just curious, how many patients historically have you seen at your clinic that you've done certain kind of fasting or the prolonged fasting maybe

Patient Results, Protocols, and Final Takeaways 22:58

can die? A couple of hundred. Okay. So that is pretty sizable. And not actually, I should say that some of them have come to me through my newsletter at Miracle Noodle, because I have sort of a health newsletter over there. So I've run some online groups, or I guess you could call them, yeah, groups I could say. It's sort a mixed bag between practice and sort my virtual group of people that follow me. And that's the first, I'll call it cheat sheet that I've heard with the Prolon. So you basically, some of your patients, you'll tell them, hey, add a little bit of miracle noodles to the soups and within Prolo.

Yeah. As just personally speaking, since I do it pretty frequently, I add the noodles and the miracle rice to the soups, both for lunch and for dinner. And it just makes it a lot easier. Of course, on the Miracle Noodle side, those people, of course we're all using it. I just find it easier, and it's easier because you get a greater sense of satiety from those soup. Sometimes when I look at the soups before I put my noodles in, I think, oh boy, if I just were only to have that, probably wouldn't be all that happy.

So having a big bowl of noodles inside your soup just makes it a lot more filling. Also, the fiber that the noodles are made from is called glucomanin. It's been extensively studied, and just adding a couple grams of that per day to your diet, which you get in a serving of noodles, is going to lower the glycemic load of your diat, it's going lower your cholesterol, your weight. You can lose up two to three pounds just not doing anything but adding couple of grams to that fiber. And it is one of the most potent prebiotic fibers.

So adding it to is like a no brainer for me. and makes it a lot easier for both for me and, of course, for my patients as well. Right. So I really, really appreciate you for your time today, Dr. Carb. Anything as a final word to say before we with the part today? I guess if you're interested in learning more. about some of the things that I do. I give a free class every Wednesday night for my miracle noodle customers and for patients. And you can just go to miraclenoodle.com and we send out notices for the classes on the newsletter.

Well, appreciate you very, very much. Thanks for your insights today. Thank you.