Tag Archive for: fast

BE FAST for Stroke

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So what did the Society of NeuroInterventional Surgery (actual brain surgeons) add to the mix? They added the acronym BE, which then makes the entire acronym BE FAST.

What do the new letters stand for?

B: loss of balance. I didn’t see any details about how to test that. It may be self-evident that someone cannot stand upright without tilting to one side or the other. Or it may be the while holding their arms to test their arm strength, they can be moved side to side to see how they respond.

E: loss of eyesight in one eye or blurry vision.

I think adding balance and eyesight are a good idea for the lay public. A physician or other healthcare professional may know to look for balance and eyesight symptoms, but it may not be as obvious to you and me. Here’s the whole list:

BE FAST

B: loss of balance

E: loss of or blurry eyesight

F: face drooping

A: arm weakness

S: speech difficulty

T: time to call 911

Commit those to memory and if you feel that you or someone you care about might be having a stroke, assess those symptoms and most important, take action immediately if necessary. I can’t stress that enough because the sooner treatment begins, the less function a person loses.

Enjoy your holiday weekend, and safe travels if you’re hitting the road. We’ll be back next week.

What are you prepared to do today?

        Dr. Chet

Reference: https://getaheadofstroke.org/call911/

Suspect a Stroke? Act FAST

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The other day, for no particular reason at all, I got really dizzy for a moment. I wasn’t spinning in circles or doing anything else that might have caused it, so I did what I always do: I acted FAST and looked for signs and symptoms of a stroke. The American Heart Association (AHA) has taught that acronym for years, but recently a group of neurosurgeons added more to it. Today, we review the original acronym FAST. What does it mean?

F: face drooping. Does one side of your face seem to be pulled down? If you smile—a really, really big smile—are you smiling equally on both sides of your face?

A: arm weakness. Typically, you would stand with your arms raised out to the side and parallel to the ground. You can check to see if one arm does not quite make it to parallel with the ground or if it drifts back down. I also grabbed a stick and squeezed as hard as I could.

S: speech difficulty. Try repeating a simple phrase to see if you can remember it and if it sounds clear. For some reason I chose the old “How much wood could a woodchuck chuck…” Not the easiest thing to try to repeat a couple of times, but I did.

T: time to call 911. Do you call if you just have one sign or symptom? Yes! Do you still call if these symptoms seem to resolve themselves shortly? Yes! I didn’t have any symptoms, but I still told Paula. I was going to do a song and dance, but I never could in the first place, so it wouldn’t have gone well.

The reason time is so important is that with today’s medical technology, the sooner treatment begins, the better the outcome to regain all functions. AHA says, “stroke patients who are treated with the clot-busting drug IV r-tPA Alteplase within 90 minutes of their first symptoms were almost three times more likely to recover with little or no disability.”

What did the brain surgeons want to add? I’ll tell you on Thursday. It’s Memorial Day weekend and you may need the information if you’re attending any gatherings.

What are you prepared to do today?

        Dr. Chet

Reference: https://www.stroke.org/en/about-the-american-stroke-association/stroke-awareness-month

The Bottom Line on Fasting

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In the past four Memos, I’ve focused on explaining fasting. The questions I left you with on Saturday were: “Is it worth it to fast? Is it effective? Is there science to support it?” The answer to all three is yes. I think it can be summed up in one quote from the reference.

“In response to starvation, mammalian cells enter either a non-dividing or a low-dividing state and invest energy resources in cellular protection against various insults.”

While the statement is complicated, it means that metabolism is decreased. That allows the body to shift energy sources from glucose to fat metabolites such as ketones. The body focuses on reducing the production of proteins that can be destructive, such as inflammatory hormones, thereby protecting cells. It also helps improve the immune system so it functions better. The stress of reducing food intake in a controlled fashion helps cells function better.

The research review is available for free; it goes into more detail but demonstrates that fasting is beneficial when used properly. The bulk of the research is on the two- to-five-day fast with fewer than 1,000 calories on the fast day; I’ll use a two-day version before my knee replacement next week to help my body prepare. Just be sure to check with your physician before you fast if you have any metabolic issues such as diabetes or if you take medications, both of which can be impacted by restricting food.

Wednesday is the final scheduled Insider call of 2021. This may be the time to join to help you achieve your health goals in 2022. Hope to see you (or hear you) at 9 p.m. Eastern Time.

What are you prepared to do today?

        Dr. Chet

Reference:Trends Endocrinol Metab. 2018 April; 29(4): 271–280.

Fasting: Two Approaches

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It’s time to get into some real fasting. While there’s nothing wrong with the abstinence approach, abstinence is not really fasting. I’m going to cover two different approaches. The first is known by the moniker 5:2. That means you eat reasonably five days out of the week and you fast two days per week. The second is a straight fasting approach of limiting calories per day that has been used in conjunction with cancer treatment. There’s no specified times to eat in either case, and you can drink any calorie-free beverages of your choosing.

The 5:2 Fast

The 5:2 fasting diet was originally developed about 10 years ago by a British physician/journalist. It’s become commercialized over the years with new additions and materials but essentially, this is how it works:

  • For five days a week, you eat your normal diet. The goal is to eat healthier, but there are no restrictions on the number of calories that you can eat.
  • For two nonconsecutive days of the week, you reduce your caloric intake to 750 calories per day, spread out over the day as you want. Again, the goal is to eat healthy food—and wouldn’t you know it, healthy food is generally low in calories! Your intake should include plenty of vegetables.

That’s it. It’s a way you can eat for the rest of your life if you want to. If you add some exercise and choose a better diet, you could lose weight and get some of the benefits I talked about in earlier Memos.

The Two- to Five-Day Fast

This approach is closer to a true fast than anything else because there are no gimmicks. The goal is to help the immune system and other organs by focusing less on growth and more on repair. This approach was developed by Dr. Valter Longo and has the most research behind it.

The goal is to eat healthy. A vegetarian approach with very low protein can make it very beneficial. Because this is a very low calorie fast, you have to check with your physician before you do it. Here we go:

  • Day 1
    Eat up to 1,200 calories, primarily from vegetables with some protein. Soups and broths make this approach easier. If you wanted to use shakes or smoothies, that’s acceptable as long as you stay under the 1,200 calories for the day.
  • Day 2 through Day 5
    On these days, your calories are restricted: 300 to 500 calories per day. The calories should come primarily from vegetables and again soups and broths are desirable.

When I use this approach, I generally do two days: one 1,200 calorie day and one 500 calorie day, and then eat normally the other five days. You have to be mentally ready if you’re going to do additional days. Eat when you want, whether a single meal or spread throughout the day. The choice is yours.

The Bottom Line

The last four Memos have talked about fasting and abstinence in relation to food intake. The question is why do this at all? Is there science to support it? Is it worth doing? That’s for next week.

What are you prepared to do today?

        Dr. Chet

Fasting: Abstinence Models

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How did you do on your 18:6 abstinence from food if you tried it? The ratio of abstinence to eating can vary. I asked you to try an 18:6 approach. Personally, I did fine—that’s just about my normal eating pattern anyway. I’m going to give you one version of an abstinence model today. I’ll give you two versions of a fasting model on Saturday.

The objective was to avoid food for 18 consecutive hours. The clock begins after your last meal the evening before. If you like to eat late or go out with the gang, that means that you might finish eating at 10 p.m. You wouldn’t eat again until at least two o’clock the following afternoon. Then you would have six hours to eat, ending at 8 p.m., and then the cycle begins again. Just to be clear: you don’t start the clock on the six hours for eating until you actually take your first bite of food. That’s why your last meal might have been 10 p.m. on one day because you didn’t start eating until 4 p.m., because let’s face it things don’t always go to plan.

The question: what do you eat during those six hours? Everybody seems to have an opinion. You could use a ketogenic or Paleolithic approach or you could eat a Mediterranean diet. You could also stuff yourself with all kinds of junk food. Regardless of which approach you decide to use, the goal is to eat better for maximum benefit. You can drink any calorie-free beverages of your choosing.

I’ll give you two different approaches for a fasting plan on Saturday. Until then, if you haven’t tried it, see how you do, with the same proviso for people with serious medical disorders.

What are you prepared to do today?

        Dr. Chet

Fasting vs. Abstinence

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Before I talk about the differences between fasting and abstinence, I want to make it clear that I’m in favor of both approaches when used wisely. I don’t think either is the way you should eat for the rest of your life, but if you have specific objectives to control your weight or to reduce your risk of degenerative disease such as cardiovascular disease, type 2 diabetes, and even reduce your risk of cancer, I think they both can be beneficial. Let’s look at the pluses and minuses of each.

Definitions

Fasting is a controlled reduction in the number of calories eaten in 24 hours.

Abstinence is the complete avoidance of food within a given time frame, whether that’s complete days or specific hours of the day.

Pluses and Minuses: Fasting Versus Abstinence

The pluses:

Both fasting and abstinence take in fewer calories than the body needs, which can help with weight loss if sustained long enough.

Fasting can help you handle hunger because you’re eating something eventually.

Fasting can also force your body to deplete all glycogen stores, depending on the source of the calories.

Abstinence forces the body to use all storage forms of sugars; then it uses stored fat as a fuel, increasing the supply of ketones for fuel.

When fasting, calories can be manipulated during the day to ensure you can eat before exercise if it’s required.

With abstinence, no thinking is necessary; you don’t eat anything when you’re abstaining from food.

The minuses:

With abstinence, you’re taking in no calories, so hunger can become an issue.

If you need to eat before you exercise, abstinence will limit the time of day you can exercise.

When fasting, deciding what to eat and when to eat it requires planning; that can be challenging for some people while making life easier for others.

There are more pluses and minuses for each approach, but I think that these are the most significant upsides and potential downsides of each.

The Bottom Line

As I said at the beginning, I’m in favor of both approaches. They both have merits and challenges—the key is using them wisely.

Next week, I’m going to give you examples of abstinence and fasting and how to use them. In the meantime, give the abstinence approach a ride around the block. Don’t eat for 18 consecutive hours on Sunday or Monday (that includes the time you’re asleep, limiting your eating to just six hours; you get to decide whether to eat the first six or last six consecutive hours you’re awake.) You also get to decide what you’re going to eat. Don’t try it if you have a severe metabolic disorder such as type 1 or uncontrolled type 2 diabetes.

What are you prepared to do today?

        Dr. Chet

The Fasting Dilemma

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I hope you all had a wonderful Thanksgiving. Because we’ve entered the “weight-gain portal” time of the year, let’s talk about the fasting craze that some people are doing and the rest are thinking about trying. As I see it, the problem is the lack of clarity in terminology and subsequently the execution of a fasting program. Terms such as “5:2” and “16:8” are thrown around. What exactly is a fast? What can it do for a person? What’s the best way to do a fast?

The problem begins with defining the term “fast”; there’s no consistent way the term is used, and that includes in the methodology of research studies. Fasting can mean avoiding all food and in some cases drink. That definition can describe fasts done for religious purposes as well as the fasts talked about for weight loss and controlling metabolism.

Another definition of fasting is severely reducing calories; if you lower your intake from 2,000 to 1,400 calories to lose weight, that’s a fast. If you’re drastically reducing calories for two to four days to help reset your immune system, that’s also a fast. But if you’re not consuming any calories, whether for a specific number of hours per day or a whole day, that’s more accurately called “abstinence from food.” Is that a big deal? Yes, and I’ll explain why on Saturday.

What are you prepared to do today?

        Dr. Chet