I recently had the honor and privilege of presenting a talk at the first TEDx event in Jacksonville, TEDx Riverside Avondale. I'd like to share the content of that talk with you here. The video will be available soon, but you can read the content here. For the presentation, I cut out the comparison of fruit juice and Coca-cola to get the timing right.
Imagine you're celebrating your 100th birthday...What does that look like? What do you look like? How do you feel?
Now, imagine your celebrating your 100th birthday and you're on water skis. You feel the wind in your face, the water skidding under your skis. You approach the dock, you wave to your kids, your grandkids, your great-grandkids. You turn wide and splash them all.
When I asked you to imagine being 100, did you imagine yourself on water skis? Most people probably don't. Here's why...
This is an image of what a slice through the thighs of a 40-year-old athlete would look. The red is muscle, the yellow is fat, and the white is bone (the drawings are based on MRI images presented in an article by Wroblewski et al.)
And this is what a slice through the thighs of a 74-year-old sedentary man
would look like. With muscle wasting like this happening to people in their seventies, is vitality at 100 an absurd impossibility?
I think not.
The ten biggest obstacles to getting to the age of 100 in the US are the top ten killers: heart disease, cancer, lung disease, stroke, accidents, Alzheimer's, diabetes, kidney disease, lung infections and suicide. Back in the early '90s, I was working on killer #2 -- cancer -- at NIH, the National Institutes of Health. I had gained twenty pounds since leaving the Navy, but I wasn't worried. Being overweight is not one of those top ten killers -- even obesity does not make the top ten.
Besides, I knew how to fix it. Eat less, exercise more. So that's what I did. I rode my bike, I took the stairs, I tried to cut back my portions. But for every calorie I spent exercising, my body added a calorie to my appetite, so my weight didn't change. Has anyone else seen that happen?
I was following the rules. My food choices looked pretty much like this.You may recognize that MyPlate is the current government recommendation, but you may not know how much the food industry influences it.
To the food industry, mouths are money. They work hard to increase consumption. That’s why, after decades of epidemic obesity, the government dietary guidelines didn’t include the advice “eat less” until 2010.
Those guidelines say to avoid sugary drinks. They also say to drink 100% fruit juice. Eight ounces of Coca-cola has 26 grams of sugar. Eight ounces of 100% apple juice has 28 grams of sugars. If I should avoid sugary drinks, then I should avoid the one with even more sugar than Coke! 100 calories in the cola, 120 calories in the juice. Would you mix two tablespoons of sugar with eight ounces of water and feed it to your kid? Think there’s nutritional value in the juice? It has added vitamin C so they could put something on the label. You can get that without consuming more than enough calories to walk a mile. For a kid with a weight problem, the familiar juice box could be public enemy #1.
Harvard suggested changes to MyPlate in a recommendation called HealthyPlate.
It has more veggies, less fruit, no requirement for dairy – Harvard doesn’t kowtow to the dairy industry – and they put healthy oils and staying active on the front page instead of the fine print.
Again, I was eating like this, and gaining weight. My workday was squeezed between childcare drop-off and pickup, so to get more done I started skipping lunch and eventually breakfast. I was less hungry when I skipped breakfast than when I ate breakfast. At first I felt like I was doing something sinful – that’s how strong the industry-driven dogma is. I’d pick up my daughter in the evening and pillage her lunchbox and break my fast with her leftovers. After a few days of this routine, it became easy. Comfortable even. Then I noticed something…
My flab felt thinner. My pants felt looser. I followed my weight on a scale. As long as I ate according to appetite and ate within a five-hour window, my weight dropped a pound a week. After 20 weeks, my twenty extra pounds were gone and I felt great. The key was appetite. My appetite went down. I felt full – more decisively full – after eating less.
That was my study of one. I changed one thing. I observed the results. I was healthier and eventually made it a permanent lifestyle. Based on my success, my wife did her study of one and saw the same results.
Fast forward to 2005. The Internet and the obesity crisis were both exploding. Could our lifestyle work for others? There was a mystery here. Why would timing matter? It’s supposed to be calories in versus calories out! I dug into the science dating back to the 1930s. The picture that emerged not only made scientific sense, it was obvious. I also learned about the influence of industry and marketing. It was time to share this with others. Here’s the result.
Pretty, lean, huh? Fast-5 has only one rule: eat within five consecutive hours. Not a 5-hour feeding frenzy -- eating according to appetite. Where you position your 5-hour window in your day is up to you and so are your food choices. Vegetarian, kosher, halal, whatever you want. Heck, one Fast-5er happily reported losing a lot of weight on a strict beer and pizza diet.
There are Fast-5ers on six continents – seven if you count penguins, but some of them fast for three months. That’s a bit extreme, don’t you think? The free e-book’s been downloaded over 11,000 times since we started counting. There are about 3000 Yahoo and Facebook group members from all over the world. Volunteers who wanted to share the idea in their own language have translated Fast-5 into French, Swedish, Portuguese, German and Thai.
For some people, Fast-5 is like Cinderella’s slipper. It fits perfectly, and their whole life changes. Fast-5 isn’t perfect. A few have tried it without results. It has some social resistance. Virtually every social interaction includes food. Business lunches. Birthday parties. This event. Food’s everywhere, all the time. When you see the world from a fasting perspective, you see why obesity is a problem.
Fast-5 flies in the face of dogma popularized by industry. Fast-5ers frequently are told that it’s unhealthy to fast, even for a few hours.
Let’s go back to our top-10 killer list. Obesity increases the risk for the top 9 killers and there’s debate about the 10th. If Fast-5ers are getting lean and reducing their risk for 9 of the top 10 killers, it sounds pretty healthy to me.
For years slogans like “breakfast is the most important meal of the day” have fueled food sales. That’s advertising, not science. The truth is that breakfast is only the most important meal of the day for corporations like Kelloggs and General Mills. So important, in fact, that they’re major sponsors for the American Dietetic Association, now known as the Academy of Dietetics and Nutrition. Check their sponsor list. Hersheys. Mars. CocaCola. Pepsi. Kelloggs. General Mills. It’s no wonder they say “eat healthy,” or “eat right” but rarely, if ever, “eat less!”
You don't have to take my word for it.You can do your own study of one. Is there some change that you've wondered about? You can put it to the test. Before making some change in your lifestyle, check your waist, your pulse, your blood pressure. I suggest these two lab tests; depending on the change you're making, your doctor may suggest others.
HbA1c reports the average blood sugar over the last couple of months. HS-CRP measures inflammation, our body’s main response when things are amiss. The number you get for these two lab tests is less important than the direction they take. They’re a personal waypoint to guide you in your study of one. Things that drop these numbers are probably good. Wondering where cholesterol is? Checking cholesterol’s fine, but it doesn’t make for simple navigation.
A study of one is like navigating at sea, the old-fashioned way. Check your position, make your change, check again after you stayed on course for 2-3 months. It’d be nice to have something faster like a GPS. You have a candy bar, it says “You’re going downhill,” then you have some salad or go for a jog, it says “recalculating.” It'd be nice, but body changes aren’t that fast.
Our bodies have built-in monitoring systems called nerves. Can you use them too?
They don't print out numbers, but you can. Make a journal listing things like energy, initiative, memory, aches and pains. Score them 1 to 10 and compare them over time. The study of one doesn’t say whether a change is healthy for a lab rat or a paid human test subject. The Study of One helps determine if it’s healthy and working for you, for your life, your genes, your history, your choices, your environment, your stress, your habits, and your activity – all the variables that make studies on humans so prone to confusion and contradiction.
Now let’s talk about the other Fast-5 mystery. It’s really a mystery of mammals in general that Fast-5 reveals in humans. How do fat cells tell the brain’s appetite center – the hypothalamus – how much fat is stored? Think about it. All mammals have some fat, but they don’t tend to get fat in the wild, and they don't count calories. If they have too little fat they’ll starve when food is scarce and if they have too much, they’re encumbered. Fast-5ers appear to regain this mysterious mechanism that keep their fat stores at just the right level. Someday the mystery will be solved, but for now it’s the magic of Cinderella’s slipper -- powerful enough to change lives. It’s the magic that made Fast-5 an idea worth sharing seven years ago and makes it worth sharing today.
So is that the secret? Adopt the Fast-5 lifestyle and celebrate a vigorous 100th birthday? I wish it were that easy. Let’s take another look at our athlete.
You see here plenty of muscle, strong, thick bone. This guy isn’t 40. This is a 70-year-old who stayed very active.
Here are all three. Healthy aging, like biology in general, follows the use it or lose it rule. And not just with our muscles. It’s not enough just to ski on our 100th birthday, we want to remember it, and all the days in between birthdays. "Use it or lose it" applies to the neurons in our brain, too. We have to feed them and we have to need them.
It doesn’t stop there. “Use it or lose it” applies to the whole person. If we’re not needed, if we’re not subject to change and challenge, we’ll wither just like the unused muscle cell or the unused neuron. That’s why my idea of a healthy plate looks like this:
Whoa! – Where’d the veggies go? They’re in the physical part along with other important things like activity, safety, maintaining appropriate weight, hygiene, sun protection and alcohol moderation. A healthy diet is so much more than just food choices. Health does not stop at your skin. Many things outside your skin drive long-term health. Social contact and support is the biggest changeable factor in longevity past age 75. Enriching your life with activity and social contact, or enriching someone else’s life by mentoring, assisting, or teaching – It’s a two-way street. Like biologic karma, it comes back to you. It tells your body that you’re a useful, needed “cell” in the community. What does that mean for retirement?
You see and hear the word diet all over the place, so let’s put it to good use.
When you see or hear something about a diet on TV, at the grocery store checkout or elsewhere, let that word be a reminder. Ask yourself the question:
Did your day have something new in it? Maybe you connected socially, or offered needed and helpful advice, or played a new game. Maybe you generously gave your time, shared your skills, or arranged an event to enrich someone else’s day.
Now back to your 100th birthday. The sun’s setting. Your knees ache a little from skiing. After all, you’re not 90 anymore. You’re smiling. If you can profit from your own generosity, what better, what more precious dividend can there be than health?