Many of you who know me might not know that my mom Tracey started to develop difficulty with her memory in her late 50s, and is now living with us because her Alzheimer’s disease is advanced enough at age 68 that she can’t manage to live independently anymore. Alzheimer’s is a terrible disease. Sometimes I want to kill my mother, who no longer even knows that I’m her daughter — like when she unloads all of the dirty dishes from the dishwasher back into the cabinets, or when I find the remaining marinara sauce in the cabinet with mold growing on top rather than in the fridge where I expected it to be. Right now, though, incidents like these are the worst we have dealt with (other than that one time this summer when the police had to bring her home to us after she took a walk down the road and got lost), so I should count my blessings! I know it will only get harder as time passes. I have tried to change my thinking about the situation, to help me become more accepting and less impatient with her in the moments when I get angry at her and feel overwhelmed with being a full time physician and simultaneously caring for her and Graham (Kevin and I sometimes joke that we have two toddlers in the house). I’ve tried to ask myself, “How is this happening FOR me rather than TO me?” I’ve come to realize that living through this devastating disease with my sweet mom has a huge benefit: it’s served to light a fire under my ass to change my own lifestyle (and hopefully inspire others, including eventually my son, to do the same) with the goal of preventing the development of cognitive impairment in myself. I have to do more than hope and pray that Graham won’t have to deal with me unloading dirty dishes into the cabinets — I have to do everything I possibly can to ensure he has a mother who lives into her 90s as sharp as the day he was born.
To that end, I have done an incredible amount of research about strategies proven to delay or prevent cognitive impairment. I’m sure future posts here on Diet Science will detail much of what I’ve discovered, but today I want to focus on the fasting mimicking diet (FMD) created by Dr. Valter Longo at USC. He’s dedicated his life to research on longevity and has found evidence that prolonged fasting – meaning, for at least 2-3 days – can trigger autophagy and help regenerate the body, including the immune system and the brain. He found, however, that humans who are willing to forgo food entirely for 3 days are few and far between, so he developed a “fasting mimicking diet” which consists of 5 days of very low calorie plant-based food intake with extremely low protein and carbohydrate content to allow you to eat least get a little sumpin’ sumpin’ in that empty belly and increase the chances that you will make it through the fast successfully. Eating about 700 calories per day with close to no protein/sugar for 4-5 days evades our known nutrient sensors that tell our bodies we have eaten, such as insulin and mTOR, and essentially tricks the body into thinking it’s fasting. What results once our bodies have eaten through the carbohydrate that we have saved up in our livers and muscles in the form of glycogen is the use of body fat stores for the generation of ketone bodies for fuel. Simultaneously, we break down proteins in our body to be used as fuel, starting with those that are somehow misshapen or broken – like cells with abnormal DNA that might be destined to become cancerous tumors, or misfolded proteins that are glomming up our brains like amyloid beta and tau protein. Then, once the animal (or human) eats a solid meal with protein again, the body’s stem cells get to work regenerating what needs to be fixed. Fasting and reseeding has been shown to delay and even prevent dementia in animal models, and it is reasonable to think that this might help prevent the development of Alzheimer’s disease in humans, too (though we don’t have clear proof yet).
Dr. Longo has partnered with a company called L-Nutra to create a commercial version of his FMD, which he named ProLon for “prolong longevity.” Their current pricing for this boxed FMD full of ready-made products such as soup mixes, teas, vitamin supplements and processed nutrition bars is $249 for the 5-day diet. I thought about it and decided that I’d rather make up my own DIY version of a 5-day diet which mimics fasting. I came up with one that improves upon this commercial version in that it is slightly lower in calories, protein and sugars and costs less than $50 for the entire 5-day food supply, with all but a few items readily available at your local Trader Joe’s (and the other two items available at Whole Foods and other grocery stores, as well as on Amazon). It takes about an hour of prep time to make a homemade vegetable soup, but the rest is ready to eat as is. Couldn’t be simpler – or cheaper – to try to prevent Alzheimer’s, cancer, and other inflammatory or degenerative diseases! I try to follow this diet once every 3 months, as Dr. Longo suggests, but I’ll be honest: sometimes I give up early. It’s not easy. You will be hungry. But if you can make it through, you’ll likely do your body and brain a world of good. ***REMEMBER that extended fasts or almost-fasts may not be safe for everyone and should never be undertaken without the blessing and supervision of your own health care clinician. Although I am a doctor, I’m not your doctor and I’m not monitoring you for safety!***
The day before you start, make sure you have all of your needed ingredients on hand and prep the homemade vegetable soup (recipe follows the shopping list below).
From Whole Foods or Amazon*:
Nutpods plant-based creamer (I like French vanilla), two 11.2-ounce containers
Better Than Bouillon organic seasoned vegetable soup base, one 8-ounce jar
Unsweetened sparkling water such as LaCroix or Bubly (optional)
Pro-Omega 2000 omega 3 fish oil capsules, or algal oil for a plant-based option (optional)
From Trader Joe’s:
Organic Tuscan kale, chopped, one 10-ounce bag
Two large organic zucchini (~20 ounces)
One medium yellow onion (~6 ounces)
One 6-count bag of “teeny tiny” avocados
One package of organic celery hearts
One 28-ounce can diced organic tomatoes
Ten 30g packages of “Just a Handful of Olives” pitted salted manzanilla olives
One 6-count package of “Avocado’s Number Guacamole to Go”
In Your Pantry (or purchase if needed):
Herbes de Provence (or a mixture of herbs such as rosemary, thyme, basil, fennel)
Sea salt (optional)
Apple cider vinegar (optional)
Vegetable soup recipe:
Dice the yellow onion (6 ounces) and the two zucchini (20 ounces).
Heat 4 cups filtered water in a large 6+ quart pot on medium-high heat.
Add 1 tsp herbes de Provence, 3 T Better Than Bouillon organic vegetable base, 1 tsp coarse sea salt, the onion and zucchini, one 28-ounce can of Trader Joe’s diced organic tomatoes, and one 10-ounce bag Trader Joe’s chopped organic Tuscan kale. Bring to a boil and then reduce heat to simmer for about 10 minutes. Once cool, add 2 T apple cider vinegar if you like. Measure the soup carefully into a 16+ cup storage container; add additional water if needed to make a total soup volume of 4 quarts or 16 cups.
(Nutrition info per 2-cup serving: 62 kcal, 0.2g fat (0.1g saturated), 1220mg sodium, 13.5g carbohydrate (2.6g fiber, 6.9g sugars), 3.2g protein
Each day for 5 days, have:
2 capsules of Pro-Omega 2000 omega 3 fish oil (25 kcal)
Two 12-ounce cups of caffeinated or decaf coffee with a total of 8T Nutpods plant-based creamer (can substitute up to 2T of heavy whipping cream instead… no sweeteners)
2 cups of the above homemade vegetable soup
2 packets of Trader Joe’s “Just a Handful of Olives” manzanilla olives
One “teeny tiny” avocado (up to 3 ounces of meat) with a sprinkle of salt if desired
3 stalks of celery (5 ounces) with 1 packet of Trader Joe’s Guacamole To Go
Lots of water (flavored unsweetened seltzer ok).
Nutrition info per day: 527 kcal, 42.5g fat (4.4g saturated), 31.2g carbohydrate (14.1g fiber, 10.1g sugars), 7.6g protein, 2523mg sodium
I find it easier to fast in the morning and harder as the day progresses, so I usually have a cup of coffee and the fish oil capsules for breakfast, then a cup of decaf and one packet of the olives around noon, then the vegetable soup and second packet of olives around 2pm, then the celery, guacamole and avocado around 5:30pm (3 hours before my target bedtime of 8:30pm). This way the majority of my fat and calorie intake happens during the latter part of the day when I struggle most.
I sometimes exercise and sometimes don’t; I’ve found that when I continue my usual 30-min elliptical sessions in the mornings during my fasting mimicking diet, I feel hungrier during the day. The trade-off is that exercise helps you burn through your glycogen and trigger autophagy faster than if you’re sedentary. So I usually truly to exercise but then end the diet on the early side and allow myself a nice protein-rich dinner on day 5 to break the fast rather than waiting until the morning of day 6. It’s a great way to spend Friday night when you’ve been starving all week!
Hope this has been helpful, and let me know what you think!
*Note that the above links to products available on Amazon.com are affiliate links, so I will get a small commission for any products purchased through these links.