What is the Fasting Mimicking Diet?
The Fasting Mimicking Diet (FMD) is a 5 day diet plan designed by longevity researchers and tested on yeast, mice and humans with encouraging results. Positive impacts of the diet include multi-body system regeneration, enhanced cognitive performance and healthspan. It is expected that the biomarkers that the FMD impacts upon can lead to reduced risk for diabetes, coronary heart disease and some cancers.
Full fasting or long term calorie restriction could also produce similar benefits but both are highly challenging and intolerable for most people and come with their own significant risks and downsides. By contrast the unique feature of the Fasting Mimicking Diet is the mimicking part. It is designed to deliver benefits similar to those achieved by fasting but also be far more tolerable and avoid the risks and issues presented by fasting.
The 5 day Fasting Mimicking Diet itself is a nutrient dense, calorie restricted protocol with very low protein and low carbohydrate content. The 5 day diet is intended for repetition between 2-12 times per year to fully enjoy the healthspan benefits. This means on the most frequent regimen the FMD would be followed for 5 days followed by 25 days of normal eating. Less frequent repetitions, such as 3-4 times per year, may be sufficient to enjoy many of the benefits.
Since it involves a caloric deficit the FMD does produce weight loss and this appears to be accompanied by decreases in abdominal fat and even increases in lean body mass. However this is only one of the outcomes of the diet, and it is not designed or intended to be used for weight loss alone.
Fasting Mimicking Diet Research
As of April 2017 outcomes from the first human intervention trial have been published and a larger trial is underway which will attempt to compare the FMD against other protocols which also produce weight loss to determine whether the FMD offers incremental benefits compared to weight loss achieved via any means.
The outcomes of the first small scale human trials of FMD are reported as including –
- Reduction in blood glucose and large increase in ketones
- 25%+ reduction in circulating Insulin Growth Factor-1 (IGF-1)
- Reduction in C-Reactive Protein (CRP)
- Positive changes in cholesterol and triglyceride levels
- Reduction in body weight
Fasting Mimicking Diet also appears to offer *some* potential for the reversal of Diabetes and treatment of Multiple Sclerosis, with further research intended.
Fasting Mimicking Diet Do It Yourself Guide
The lead researcher for the FMD, Valter Longo advises “not to do FMD at home” and I repeat that warning here. Don’t do this if you have any health issues. If in any doubt do consult with a trusted medical practitioner. That said, this guide will provide you with everything that *I* did to prepare for my first FMD cycle and what I learned from my first cycle.
There is a commercial product named ‘ProLon’ available already in US, UK, Australia and an expanding list of other Countries. ProLon is a package of soups, snack bars, crackers and drinks that can be consumed over 5 days in order to follow the FMD as designed by the researchers. I do not believe that use of ProLon is necessary to perform FMD safely and effectively however as ultimately, it consists of fairly conventional food, supplements and tea.
I used a ‘Do it Yourself’ approach rather than wait for the commercial ProLon product and believe on the basis of my experience and that of others that this is entirely feasible. Disclaimer – Whilst I believe that my “Do it Yourself” diet does follow the principles of L-Nutra, Inc.’s FASTING MIMICKING DIET® this has not been scientifically tested and there is no affiliation with L-Nutra, Inc.
Why follow the Fasting Mimicking Diet?
Here I explain my very *personal* reasons. There are certainly others. I love life and wish to live as healthily as possible for as long as possible. I think of this as ‘healthspan’ rather than ‘lifespan’.
I am aware of the correlation between age and disease risk. I cannot control everything but I can take some certain actions to mitigate these the risks where possible. I am therefore very interested in anything I can do to reduce the risk of neurodegenerative disease (such as alzheimer’s) metabolic syndrome leading to diabetes, and coronary heart disease, and cancers.
My starting points are –
- I don’t smoke or drink alcohol, ever (I simply do not enjoy alcohol)
- I exercise frequently both aerobic and anaerobic
- I maintain a weight at the lower end of the normal BMI range and a bodyfat around 13-14%
- I have excellent sleep hygiene and practice meditation for relaxation
- I follow a whole foods and plant based diet with minimal processed foods and added sugars
- I enjoy the company of friends regularly and am happy with my social life
With all these in place, the basics are covered. For me to further improve my current and long-term health requires something special. I already also practice intermittent fasting / time restricted feeding. I am aware of the potential benefits of calorie restriction but am unwilling to pursue it partly because of the certain downsides and risks but also because food is a major source of pleasure I am unwilling to reduce.
Enter the Fasting Mimicking Diet. This is the first intervention I have discovered that appears to offer genuine promise. It’s key and differentiating characteristics are –
- It is designed to provide benefits to people that are *already* generally healthy
- There is intervention study evidence for those benefits, mainly in rodents but also in humans
- The benefits can be obtained by short 5 day periods of dietary intervention
- It is possible to verify positive outcomes via (mostly) consumer available tests and tools
Fasting Mimicking Diet Goals
I was keen to experiment with the FMD as a pure quantified self practice and challenge. However before beginning I also set out the specific outcomes on which I would base a decision to repeat the FMD or not in future. Note that I picked these in advance by reference to both what the FMD is designed to deliver and what is of value to me personally. My top 5 hoped-for outcomes were –
- A significant (25%+) reduction in IGF-1
- A significant reduction in C-Reactive Protein
- 72 hours+ within optimal ketosis (ketones of 1.5+ mmol/L)
- Reduction in bodyfat by 0.5%+ sustained for at least 1 week following FMD i.e. no immediate bounce-back
- Absence of significant increases in measures of stress, cortisol, heart rate variability or sleep quality
Overall I was mainly interested in the longevity related outcomes whilst a friend I partnered with to practice FMD, David, was more interested in weight loss and bodyfat.
5 Steps to Prepare for FMD
There are five key steps to preparation. I offer direct advice based on my own preparation and first FMD cycle. I also offer a publicly shared Google Sheets FMD Do-It-Yourself file which features templates for preparation, planning and tracking. The file will open into View Only access. Make a copy of it within Google Drive to edit it as you wish.
1. Establish an outcomes measurement plan
Here are the key things you need to decide:
- Which of the potential FMD outcomes interest you, these are the ones you should measure
- The tools and tests you will you use to measure your selected biomarkers
- When you will begin and end measurement and the frequency and timing
- For self-administered measurement how you will maximise consistency, for example, by always taking blood glucose immediate after waking, prior to breaking fast
- For lab tests, when you will visit a lab or complete a home-use kit
The biomarkers I selected along with the measurement test or tool and frequency are all described in the ‘Metrics Protocol’ sheet within the Google Sheets FMD Do-It-Yourself file and in the picture below.
2. Source the measurement tools and tests
If you are UK based the tools and tests shown in the Metrics Protocol sheet of the Google Sheets FMD Do-It-Yourself file could be repeated in full. If you are based outside of the UK you will need to search for locally available lab tests.
It is *critical* to use the same tool at the same time and state in order to gain consistent data. I would favour consistency over accuracy given the choice so that the *change* can be observed. This is the reason I used home body composition scales rather than a more accurate BodPod or a gold standard DEXA scan. My RENPHO model scales are low cost and uncomplicated but also terrifically consistent. If you do value accuracy periodic DEXA scans could compliment daily monitoring.
Taking blood glucose and ketone samples using finger-prick tests is very quick and simple. I recommend combining a little practice at the same time as establishing your pre-FMD norms.
Taking Heart Rate Variability (HRV) is also very straightforward. Understanding it takes more time and connecting the readings to how you feel and what has impacted on that longer still. The more you practice, the more you will understand the context for your results and be confident that changes during FMD are *caused* by the FMD.
3. Plan ALL the food to be eaten on the diet
I emphasise the need to plan *all* the food you will eat during the Fasting Mimicking Diet. FMD is really not something you can carry out ad hoc as most readily available convenience and restaurant foods would not be suitable. Here the mantra “if you fail to plan you plan to fail applies”. You should have your food planned out for all 5 days and also make sure you have it in stock or know for certain where and when you will be buying it during the FMD period. This avoids the risk that you find yourself outside of the protocol and deny yourself the potential benefits.
There are two options here. You could copy the ProLon commercial FMD package, if you do this, the calorie and macro counts are as follows.
Alternately, you could follow the calorie and macro counts featured within a Fasting Mimicking Diet Patent. In contrast to ProLon the calorie count varies according to bodyweight. I think this is *probably* a superior approach. The ‘one size fits all’ approach used by ProLon is probably a compromise to provide a simple, standard consumer product. The bodyweight based variation works like this –
Day 1: 10 to 16 calories per kg bodyweight, 10% protein, 56% fat, 34% carbs
Days 2 – 5: 7 to 11 calories per kg bodyweight, 9% protein, 44% fat, 47% carbs
I consider the fat % as the only macro safe to exceed. Too much protein or carbohydrate will prevent or delay progression into ketosis. Too much protein is likely to interfere with reduction of IGF-1. Therefore if you struggle to match the macros precisely, go over with fat, don’t go over on protein or carbs. Note that the researchers also emphasise unsaturated fats in their design, which means choices like olives, rapeseed and macadamia nut oil rather than butter and coconut oil.
Based on my learning I also recommend limiting carbohydrate to 50 grams total. This is in order to enable progress into ketosis. Go higher only if you know you can enter and maintain ketosis.
The most challenging macro limit is that of protein. On Days 2-5 it is so low that most vegetables and even some fruits are too high in protein to include. Those veggies that are low in protein are often high in carbohydrate instead. The implication is that many foods are unsuitable to including in significant volumes, again making careful planning necessary.
My Google Sheets FMD Do-It-Yourself file shows almost exactly what I ate on my first FMD and under the Resources section further down, I provide links to alternative approaches for the food.
4. Establish the pre-FMD baseline measures
If like me you are willing to incorporate FMD into a longevity regimen but *only* if you see significant benefits then you need pre-FMD baseline values to compare to the post-FMD outcomes. Make sure you have the necessary tests completed before starting the FMD.
For some measures, like Blood Glucose, Heart Rate Variability and Bodyfat % you should ideally have at least several weeks of data since these fluctuate from day to day and time to time. I also highly recommend getting into a consistent routine of measurement prior to beginning FMD so that you do not have to begin everything at once.
For two weeks prior to my first FMD I established a routine. At 0600 I woke, hydrated with 2 cups of water and then:
- Took a weight and body composition reading using my Taotronic scales
- Returned to a lying position and took a Heart Rate Variability (HRV) reading using a Polar H10 and the EliteHRV app
- Measured my fasted blood glucose using an Abbott Freestyle Libre
3 days prior to beginning FMD I visited a Medichecks lab to have blood draws for my IGF-1, Cholesterol profile, White Blood Cell profile and high sensitivity C-Reactive Protein. I recommend having these done as close to the beginning of the FMD as possible so that there is a proximate point of comparison to the second set of measures you will take at the end of FMD for comparison.
5. Emotional & Environment Support
Preparation steps 1-4 are purely physical and practical. Don’t skip over this one. When you read about my experience, you will see that I might have quit on Day Two if I had not partnered with David for this first FMD practice. Here are my do’s and don’ts for success:
- DO tell friends and family what you will be doing, why, and how they can help you succeed
- DO write your desired outcomes down, visualise them, define why they are important to you
- DO prepare your environment too. If you know you are likely to struggle with the temptation of snack foods, remove them
- DO ensure you will be able to take plenty of sleep, you may be more tired than normal
- DO ensure you will have opportunity to be active with light exercise, such as walking, interval training or yoga
- DO consider your workload and stress
- DON’T do FMD for the first time if you will also need to manage higher than normal work, family & social demands
- DON’T perform heavy exercise such as lifting weights that will place significant demands on your recovery ability
- DON’T do FMD if you have any unresolved health issue which fasting might worsen
Thats it! You should be ready to undertake the Fasting Mimicking Diet. For further help, refer to the resources below.
Results, Learning and My Experience
Jump to my Results & Reflections post to read about my experience, outcomes and learning from my first FMD cycle. The spoiler is yes, I will repeat it, but with some very important modifications to how I ran it the first time thanks to lessons learned.
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Tools & Resources
Google Sheets FMD Do-It-Yourself file is my personal preparation file with details for biomarker tracking and food planning, all the further resources mentioned below are also captured in this file.
CRON-O-Meter is the most comprehensive food logging tool available, going far beyond the likes of MyFitnessPal by tracking almost all micronutrients in addition to the macronutrients.
Medichecks is the UK based lab test service I used for C-Reactive Protein, Cholesterol and Blood Count tests
Freestyle Libre is the device I used for blood glucose monitoring as it offers an adhesive which enables quick and convenient readings. I used a Freestyle Optium Neo for ketone monitoring and this also offers blood glucose readings, both via finger prick blood tests. You need both the device(s) and either a Glucose Monitor (Libre) or test strips and lancets (Optium Neo).
I used a Polar H10 heart rate monitor and the EliteHRV app to track Heart Rate Variability. There are other options but this combination is one I gained confidence in and EliteHRV provide some wonderfully educational articles to accompany the app.
Genova Diagnostics is the service I used for an Adrenal Stress Test. Note they do not sell the test kits direct to consumers, you will need to procure this through a practitioner. Many Nutritionists are able to order this test.
Further Reading
Original Cell Metabolism paper describing FMD in mice and humans (free full text)
Abstract only (full text behind paywall) of the published outcomes from the first human trial
Quantified Bob N=1 – Bob followed the FMD using the low end of the FMD patent calorie counts for his body weight and presented his outcomes along with reflections, a great read.
Quantified Body N=1 – Damien provides a fantastic article with lots of information about FMD. Be aware that he did not actually follow the FMD and instead did a water fast.
Narrative from a BBC Journalist who was part of the earliest human trials of FMD
Hi Is there any known specification pro/against taking any form of electrolyte supplementation while doing the 5 day fast? I am think for example of products like Elete or Nectar Hydro, which are sugar free.How would those impact on the ketosis? Thanks
Hello Valeria, the ProLon version of FMD includes an electrolyte enriched beverage which probably includes potassium, calcium, sodium and magnesium, similar to other electrolyte enriched drinks.
Given that FMD has features similar to both fasting and keto and electrolyte supplementation on both such regimens is advisable I will definitely supplement myself on my next FMD or fast. I believe that a big contributor to my initial sluggishness and low energy might be attributable to having not done so within my first FMD.
Electrolyte drinks with non-nutritive sweeteners in theory should not impact upon insulin, blood glucose or ketogenesis. However I would recommend ‘testing’ this directly by consuming your chosen drink in a fasted state and measuring your blood glucose response. I recently did exactly this for my favourite non-nutritive sweetener (erythritol) and was pleased to observe it had exactly zero impact on my blood glucose.
Hello, Thanks a lot for your interesting information and advice. There is just one think I have been think about, that is not really clear to me: When it says 9% protein and 44% fat, is this calculated as percentage of weight, or percentage of the number of calories? There is a big difference here, because 1 gram protein is 4 calories and 1 gram fat is 9 calories. It seems like people are calculating this as percentage of weight, but I have not been able to find the source for this — and people may be wrong… If you can help clarifying this it would be great.
Thanks, Peter
Thanks and most welcome Peter, and great question.
To determine the relevant calorific intake range for person you should use your body weight. However I think you are asking whether to translate that calorie count into macros by applying the macro %s to the calorie count or the weight in grams of the macro.
I am certain that the FMD macros ratios refer to a % of calories rather than % of weight. The 2015 Cell Metabolism Paper I link to below (and in my FMD template) has a downloadable full text pdf. On page 12 of that pdf is a table that specifies %s of macros by reference to calories, not weight. Within my FMD template the grams for each macro take into account the 4 / 4 / 9 calorie count for protein / carbs / fat.
http://www.sciencedirect.com/science/article/pii/S1550413115002247
Thanks a lot. I also think that it makes sense from a mathematical point of view. If calculating the percentage as weight the calculation becomes very complex — an equation system or an iterative solution. Thanks again for your reply! Best, Peter
Yes you are right Peter and I believe that applying and expressing macro ratios in % of calorie terms is the norm within similar studies.
Hi, how or why did you conclude that the grams for the carbs are “net carbs”?
I did not conclude that the carb grams were net rather than total carbs. However since in Europe the carbohydrate values for foods represent the net carbs with fiber already separated and I used several prepared foods I was effectively basing my plan on net rather than total carbs.
Since my first cycle I have read material like the Art and Science of Low Carbohydrate Living and am far more familiar with how to follow a well formulated ketogenic diet. Since achieving and staying in ketosis is a key part of FMD and I did not succeed in doing so I will restrict my carbohydrate intake further within my second cycle.
I remain uncertain which of net and total carbs is the intention of the FMD design. The FMD research is US based where total carbs includes fiber within food labels. On the other hand fiber is often regarded as having zero calorific value (to the human) and this being the case cannot contribute to the calorie count. This argues in favor of using net carbs as the basis. I believe and suggest the ‘safest’ thing to do if the goal is to achieve and remain in ketosis is to undershoot the carb count, whether by treating the carb grams as total carbs or by undershooting the carb gram allowance.
Of course if you have direct experience of the carb count that allows you to personally achieve nutritional ketosis you could ensure you undershoot that instead. For example if you know you are highly carb intolerant and cannot take in more than 30 grams total carbs per day and remain in ketosis then use 30 grams rather than whatever the FMD macros would suggest and make up the calorie count difference with fats.
This protocol can almost be called an intermittent restricted ketogenic diet or restricted LCHF diet. The fat percentage is a little low and the total calories are about half of a normal LCHF protocol. I am hearing that part of the battle here is poor compliance with fasting or CR. The biggest reason for the poor compliance is the steep decline in energy and mental clarity that happens in the first two weeks of low carbohydrates. If there was a way to hand hold the patient through the 4-6 weeks it takes to become highly fat adapted and then apply chemotherapy while on a high fat percentage fast, then the protective effects of calorie (carbohydrate and protein) restriction could reach a much larger population. It is too much to ask the average patient to simultaneously fast and undergo chemo. Food is one of the few pleasures a patient has between chemo applications.
The FMD is at an intermittent version of a hybrid LCHF/CR diet. The first problem to solve is broad compliance (how to get the horse to drink the water). Broad compliance will not happen on any carbohydrate or protein restricted diet until body has adapted to ketones for fuel. In my experience this takes 4-6 weeks but tends to stay with you even if you cheat.
It is likely that a personal dietary specialist will be required in this conversion phase for the public. This conversion should happen prior to chemo/radiation/surgery. Benefits are immediate. Alas, if you are a mouse, you are given no choice. People on the other hand have the freedom to opt out and potentially die as a result of leaving healthy cells in a vulnerable state during chemo.
As a side note, the use of long duration low effort aerobic exercise to reduce blood glucose levels can be very effective. In fact I use this method twice a week to gently drive glucose down to the mid 70s and ketones to around 1.2 mM/L. I do that because chocolate is a weakness I indulge.
Regards.
Bill Wightman
Houston, TX
Thanks for the thoughtful insights Bill. Am I correct in thinking you are in the medical profession and involved in clinical practice?
You prompt me to share a few learning points that I have arrived at fairly recently thanks to reading about ketogenic diets.
FMD vs Ketogenic Diet
I shared an intent to use a Ketogenic Diet to transition into my next FMD. Similarly I read within keto diet guides that fasting is an option to speed transition into a ketogenic diet! This emphasises that fasting and carbohydrate and protein restriction are both methods of entering nutritional ketosis. As you mention exercise is another accelerator.
Ketones vs Keto-Adaptation
I had no concept during FMD of the difference between being in nutritional ketosis and actually being keto or fat adapted. You mention a 4-6 week adaptation period and I have read Volek and Phinney refer to a 2 week minimum. What I am yet to come across is any form of test or measure to gauge progress towards this adaptation. Are you aware of any Bill?
Electrolytes replenishment
I fully expect that the worst of my lethargy during the first days of FMD would have been reduced had I properly replaced sodium and potassium that I was surely losing through increased excretion. When I next either perform a FMD or begin a ketogenic diet I will definitely supplement with sodium and potassium and ensure good intake of magnesium and calcium.
Lastly Bill, I have a keen interest in chocolate! Do not call it a weakness, call it a passion! Have you any taste for 100% Chocolate? If not, yet, let me encourage you to try just one bar, Le Pralus 100%. It is simply incredible how much sweetness and flavor is found in this remarkable 100% Chocolate Bar. If this leads into an increase in your Chocolate consumption I will accept both credit and blame!
Benjamin,
Thanks for the lengthy reply. Forgive me if I have misled you on my occupation. I am a 58 yo Mechanical Engineer with a road bike and a longevity fixation. Part of riding long distances is the inevitable decline in glycogen to muscles and it seems that reduced glucose to the brain is what shuts everything down and you bonk. So I was not buying the notion that you have to continuously feed yourself carbohydrates on long endurance events, once I began reading about ketosis. This (energy restriction) dovetails with the CR movement of the last 20+ years with the difference being that we do not need to restrict healthy fats on a CR diet (the name for this being LCHF).
The major difficulty people I ride with are unable to get past is first the assurance that ketosis is safe and second that they cannot fathom giving up or reducing processed carbohydrates. So with road cycling you end up with all of these powerful 60 yo “insulin belly” pre-diabetic cyclists in spandex who have damaged heart septums or kidneys and don’t even know it. With runners, the knees go out early. My opinion on that is that the vascular decline contributes to the joint (and any cartilage/collagen) problems.
On getting fat adapted, I simply use a blood glucose/ketone meter after every ride (gives me the lowest numbers which makes me happier…). Also I ride on an empty stomach and drink only water, regardless of the length of the ride. I would be careful in the beginning as you will have to be healthy, ride slower, and monitor your mental clarity. Your brain is used to 100% glucose and you are trying to push it down to 50% glucose and 50% ketones. The endurance type exercises seem to jump start the liver into producing both the ketones and the glucose needed when you exercise in a fasted state. After two to three weeks you start to pull out of the energy nose dive (your legs actually move when you will them to) and you have (fat) energy to spare. If you are pushing harder and going anaerobic I think it takes many months longer. I am not there now but I did go out once on a hard mixed easy sprints 70 mile group ride in a fasted state and about an hour after the ride my glucose was at 120 mg/dL. I started the ride in ketosis. On a slower ride it would be about normally 75. So a healthy liver can be trained to provide glucose to the brain if you are gentle but insistent.
I noticed other indications of low or transitional ketosis during a ride can be a 2 minute mild headache or in the winter I experience coldness and a mental loneliness. If you slow down at that point the liver will catch up to you and provide ketones and glucose, just slow into a more modest aerobic pace and continue (or go home and go to sleep…). I think the best indication of solid ketosis for me is that I can come home after a 50ish mile slow ride in a fasted state and my glucose will be between 60 and 70 mg/dL and I feel great, no fatigue. That is my experience. Do not try to force this condition.
You mentioned mineral supplements and this is critical on hot rides or runs. They all get sweated out and there is no way around it. I would pay attention to any edge of cramping. I have never had cramping so maybe I cannot address this properly. On hot days I ride with Enduralytes pills or similar but try not to overdo it. I will not consume carbs on a ride because it screws up my Zen or feel good deep down in ketoville. But that is just me.
I tried 100% fancy chocolate bars and retreated to the 85% as a middle ground. That is my everyday-while-I-am-working indulgence although last night I baked a double batch of chocolate chip cookies that totally violate the low sugar low protein requirements for longevity. I spiked them with hydrolyzed collagen and MSM. Will need to skip dinner tonight and do a solo local 56 mile ride. This is my go to behavior twice per week to keep the gut fat down and the speed up. Still not anywhere as fast as the racers, but so be it.
Regards,
Bill
Most interesting stuff Bill. Have you read the Art and Science of Low Carbohydrate Living and Performance books by Volek & Phinney? They address ‘bonking‘ extensively including explaining how a ketogenic diet can support endurance training and performance. There are some excellent presentations available on Youtube covering the same. Here is one of the best –
https://youtu.be/n8BY4fyLvZc
I particularly welcome your mention of the ‘transition’ sensations of headache, coldness and mental isolation. I have read about a typical 16 hour threshold for transition into nutritional ketosis i.e. ketones rise to 0.5+ after about 16 hours of fasting and exercise can bring the threshold forward. This matches my experience and I observe transitional effects of coldness, disinterest and something like hunger as I approach the threshold. Regardless of whether I eat or not these sensations pass within about an hour. I hypothesize that during this hour or so I have insufficient glucose and ketones OR my organs are making a switch from use of glucose to use of ketones or a combination of both.
What I have not yet tried, and perhaps will, is use of exogenous ketones as a means to ‘bypass’ this transition. It is bearable, but not pleasant to experience daily and my current time restricted eating protocol combined with a non-keto diet means I do experience it several days per week.
Do you continuously follow a ketogenic diet Bill? I ask because my current understanding is that this is required in order to actually be keto adapted rather than simply be in ketosis. Nutritional ketosis being something achievable within a day but keto-adaptation taking weeks.
I am very interested in following a ketogenic diet for hoped-for longevity benefits but am concerned about the impact on keto adaptation of non-compliance when travelling, vacationing and similar.
I have read The Art and Science of Low Carbohydrate Living and Performance books by Volek & Phinney but have not made great use of it as I am more of a recreational athlete. There is the idea that keto-adaptation takes about two weeks which was a minimum in my case. I think what has to happen is that you make a concerted effort to minimize simple carbohydrates to around or below 20 grams per day with increased fat and modest protein (and lots of leafy greens, asparagus, broccoli, etc) for at least 2-3 weeks while pushing through the change. That seems sufficient to cause changes in the body on a reasonable time frame. After six weeks of this behavior and with some periodic long distance aerobic exercise then I think the metabolic changes have occurred.
I am not on a continuous ketogenic diet. When I measure my ketones after a 3-hour bike ride they are always around 1.0 which is in the low range. I personally prefer to stay right on the border. Being right on the border (0.5 mM/L) lets you eat some breads, pasta etc without stressing over it. Also it lets you blow through a missed meal without the panic I see on some peoples faces when feed time does not present the habituated chow.
An important health feature of the ketogenic diet or FMD is that they reduce insulin and glucose and allow the vascular system to remain strong and repaired. This has the downstream effect of providing the joints and organs with the elements that can only be supplied by proximity to the tiniest of capillaries and veins. In the case of cancer therapy, apparently, these diets can be helpful in restricting cancer cell access to glucose and as a way of reducing healthy cell metabolism of chemotherapy poisons.
Valter Longo has shown a five-day pre-emptive fast in mice to greatly improve survival when combined with chemotherapy as compared to normal feeding. Some hospitals use a three day fast before chemo. I am currently doing a three-day fast to see what it feels like before recommending it to a friend with breast cancer and who is mentioning both chemo and radiation. She may have a much harder time doing this while not being adapted. I will have to warn her of that. I am only one day in so far on a water fast and can only report a fantastic night sleep, no other issues. This fast is a great way to burn off the holiday weight gain. Sorry for the wall-of-text again.
Regards,
Bill
Benjamin, first off great resource. I will have to try that chocolate you mention. I too have “passion” for chocolate. One that I have found which I really enjoy is Montezuma’s Absolute Black 100% dark chocolate. I encourage you to check it out. Trader Joe’s usually keeps it in stock. Thanks again.
Hola Nate, do try the Le Pralus 100%. It is available in the US albeit perhaps at premium imported prices. We do not have Trader Joes in the UK but curiously, you are recommending Montezuma’s, which is a UK brand!
Montezuma’s mainly make chocolate confectionery rather than fine chocolate and for this bar I notice they do not tell where the cacao is from or what type of beans which is something I would expect from any chocolate maker. Nevertheless, I’ll give it a go! They have made a Chocolate Egg version of it and it is Easter, so your recommendation appears to be perfectly timed to compel me to buy one 😛
I am unable to see the detailed list of what you ate. Can you send this information to me?
Hello Julie, the full list is within the Food Plan sheet of the Fasting Mimicking Diet Google Sheet. If you can access the Google Sheet at all you can see it, can you?
If you are planning to perform an FMD cycle let me emphasise the learning I shared about my carb intake being too high. My subsequent reading about ketogenic diets including calorie restricted ketogenic diets brings me to the conclusion that I should have limited at least net carbs to 50 grams per day. I might be able to tolerate more and still remain in ketosis but I also might not. I would therefore have eliminated the dates and increased fats from any source. This is also what I will do for my second round.
Hello Benjamin,
It is clear that the 5-day fasting recommended by Valter Longo has a specific caloric in-take for the first day (1,090), and 725 for days 2 to 5.
I was researching, alas, to no avail, the daily calorie-intake required for the “refeeding” weeks?
Most gratefully yours,
Farrah Taylor
Hola Farrah!
I caveat that it is only the ProLon version of FMD that has fixed calorie intakes. The version used within clinical trials varies the calorie intake by body weight. I believe the ProLon version is a compromise, a sensible one, in order to provide a simple standardized commercially viable product.
Within the ProLon FAQ there is guidance on refeeding, copy pasted in full below.
Q. Is there a ‘Transition Day’ diet for the patient after completing the ProLon diet?
A. On Day 6, after the ProLon® diet ends, users should avoid binge eating and resume their normal diet gradually. They should start with liquid foods, such as soups and fruit juices, followed by light meals, including rice, pasta and small portions of meat, fish and/or legumes. A normal diet can be resumed on day 7, or 24 hours after the end of the ProLon® diet.
My opinion is that since the fasting period is relatively short in duration, is not a complete fast, and electrolyte intake is maintained throughout the fast the potential complications of ‘refeeding syndrome’ are unlikely. For reference, this looks like a great primer by Dr Jason Fung on refeeding syndrome
https://idmprogram.com/refeeding-syndromes-fasting-20/
I do fmd about every 5/6 weeks. During warmer weather I would ride 10 miles a day on a varied course. (Think interval training.) The first time I did fmd I also rode . This probably gave me the equivalent of zero caloric input. My wife said I looked bad on the fifth day. The odd thing is after that first FMD I felt very strong. Like put your fist through the wall strong. I know what the placebo effect is and that did not seem to feel like it . So I do not do the exercise routine any more (its cold out here so I do all exercising indoors for now anyway. I tend to start feeling like doing the fmd after about 5 weeks. Its that much of a boost. I also hate doing it. One thing that was interesting is that my cholesterol went from 204 (with statins) to 137. Thats a lot. The other thing is I am 65 and just don’t feel old. Thats totally subjective but it works for me.
Heya Alex, great headline cholesterol result. Did you also look at the breakdown into HDL, LDL, Triglycerides etc?
I count every birthday as a milestone of progress towards immortality 😛
Thank you for the information. Do you know if this diet is affected by the use of medical marijuana oils? I am dealing with cancer and have been using Rick Simpson Oils due to the numerous stories of people having recovered from cancer. I am currently on a Ketogenic diet, too. Thanks.
Hello Andres, interesting question. I bet this question is relevant to many given that both medical marijuana, the fasting mimicking diet and the ketogenic diet are all of great interest to those dealing with cancer.
I had no knowledge of the interaction between cannabis and ketosis prior to your question. A quick google confirms that it is a popular question. The most interesting information I found suggests that regular majijuana use has a positive impact on insulin sensitivity
https://www.healthline.com/health-news/policy-marijuana-use-helps-with-blood-sugar-control-and-bmi-051613
My husband is on medical cannabis and during a 5 day water fast he does not feel the “high”. I am not sure if he is absorbing it properly. He has a very low body fat (7.5%). His medical cannabis is only diluted 1:1 with olive oil. Did you find any answer to this question?
Hola Myriam, please do help me, what is the question? 🙂
Caveat that my only knowledge of cannabis dates back about 20 years to my university days so if the question relates to that I will likely not have relevant experience or knowledge!
I just started yesterday and I’m alteady in mild ketosis, but I am hungry today. I’ve water fasted for 90 hours about six months ago and made the mistake of doing strenuous exercise. It took about four months for my arms to stop hurting.
I have recently read the Complete Guide to Fasting by Dr Jason Fung. Very interesting that within it he shows that the experience of hunger is typically worst, or limited to, the first few days of fasting and strongly influenced by hormones such as ghrelin and the ‘expectation’ of food at times it is normally consumed. It takes about 3 days to dismiss this expectation. FMD is designed to be a regimen that offers some of the benefits of fasting without the actual fasting but I increasingly wonder whether it may be *easier* to perform a water fast. There are certainly people that say it is, for them. What is your opinion Caroline?
Hi, I was wondering if you had any more details about exercising during FMD. I’m curious about doing this, but do about 11 hours/week (~2 hours/day 1 hour low intensity : 1 hour high intensity) and wasn’t sure if I’d have to cut back during the five days or if it’s manageable.
Hi Susannnah, I am confident based on reading about fasting, ketogenic dieting and calorie restriction, all things sharing characteristics with FMD, that some exercise is both possible and beneficial during FMD. You may already know that exercise is an effective way to accelerate progress into nutritional ketosis since it will deplete your stored glycogen in the liver and muscle.
The caveats I will highlight are
# The transition into ketosis may temporarily result in insufficient glucose and insufficient ketones to fuel extended periods of exercise or intense exercise – so be very mindful of how you are feeling and dial down the intensity or abbreviate the duration if it feels right
# Assuming you are not already in ketosis, the transition will also likely result in loss of electrolytes. Exercise, especially if you sweat, will do the same. So you may need to supplement with sodium, potassium, calcium and magnesium. Bouillon or a zero carb electrolyte drink would work well
# Research into the transition into fasting indicates there is a brief initial period of increased protein turnover and loss prior to stabilization and retention. The implication I take from this is that it is probably wise to avoid any form of muscle building focused exercise within the first 1-3 days, but thereafter resistance exercise is desirable to assist in retention of lean body mass
thanks for breaking it down for “dummies”…I am mainly interested in what to eat all the other measurements are not that important for me but your excel file makes it really easy to follow. moreover I have chron o meter so no need to download the app. Thanks again
Most welcome Daniela! Do I understand correctly you are using CRON-O-Meter via the web? I use it both via web and also via the smartphone App. The app offers some ease of use benefits if you want to capture things on the move.
Love CRON-O-Meter. Whether using it for FMD, or a ketogenic diet, or tracking micro-nutrient intakes, it is such a powerful tool. Every time I read a recommendation for MyFitnessPal I want to scream “NO, CRON-O-Meter!”. I do realize not everyone needs or wants the extra functionality within CRON-O-Meter 🙂
In your diet that you posted to Google docs you listed several foods with M&S preceding them. What does that stand for please?
Hola Von, M&S is abbreviation for the UK supermarket ‘Marks & Spencer’. Within the Food Plan sheet of the FMD template there is a link to a Google Photo Album providing screenshots of their FMD friendly foods. They happen to have a range of low calorie, low protein, low carb mixed vegetable packs which provide a great ready solution for FMD meals. Just chop and add olive oil.
Oh man I miss M&S! I used to live in England and since moving to Aussie really miss the amazing prepackaged healthy food range of M&S!!!
Thanks so much for your guide, this is THE MOST complete guide I’ve come across for FMD.
I look forward to giving this a go, soon as I plan out my food intake.
I was wondering if you’ve come across any particularly great resources for meals that follow FMD principles?
Thanks again!
Heya Dan, I can empathise all too easily. I lived in The Hague, NL for 5 years between 2006 & 2011. I arrived just after M&S had closed down most of their European stores include their store in The Hague. Shortly after I returned to the UK in 2011 M&S re-opened in The Hague!
It kinda gets worse. Just as I began making more frequent business trips to The Hague, M&S has closed again as of October 2017. What the deuce? It is like M&S is personally avoiding *me*.
The convenience is incredible but the feature that literally *everything* comes inside plastic does give me more and more concern for multiple reasons. I was pretty shocked to see they recently introduced plastic pouches of fresh passion fruit seeds. That is well across a personal line for me, no way!
The best sources for FMD meals that I know of are built into the DIY Google Drive file I offer within the Food Prep sheet. That has direct links out to several sources you might not have seen yet, do take a look. I am inclined to think that there may be value in putting together an FMD friendly list of foods that can be pick & mixed into meals and a diet plan. Practically it would however be just about a straight copy of a well formulated keto diet food list but with smaller serving sizes than the norm. What do you think, would it be useful to you?
Very interesting article, rich of useful informations.
The nutrients partition of the Prolon diet is strange. Walter Longo in it’s book speak about half calories from nuts and half from veggies. In this manner the diet is more ketogenic than that of the Prolon. For the record, my FMD (today is the 5th day of the umpteenth cycle) is based on max 10 gr of carbs and max 15 gr of protein. The rest are various kind of fats, predominantly unsaturated. I eat also 2-3 spoons of MCT C8 oil.
Moreover, for the transition day Longo advises to eat only foods containing carbs (cereals, veggies, fruits, etc.) and legumes, not fish or meat. Even in small portions. From this point of view Prolon’s advise seems better? I don’t know. Surely I will eat my homemade yogurt.
Thank you for the kind comment Massimo.
I am convinced that ProLon is very much a compromise in order to deliver a product suitable for commercial sale. The most obvious compromise relative to the patented FMD design is the feature of having the same calories regardless of bodyweight or lean body mass. Another may well be the choice of products since everything that ProLon supplies must be in a packet, box or tube. Dehydrated veggies could be included but they are far less ‘ready to eat’ compared to the things that are supplied. I will continue to prefer a fresh and whole foods approach.
I do not know this, but believe that the transition day advice is given to avoid or mitigate any refeeding syndrome effects. However those seem very unlikely to present following a ‘mimicking’ fast. I would very much like to understand the logic behind the advice and you are prompting me to search for it. If I discover anything I will share it and add it to the main article. If you know of any good source I welcome it.
Thank you for your reply, Benjamin.
I’m agree with what you wrote about refeeding syndrome. Most likely five days are too few to have that effects. Just to know, sometimes in the ‘transition day’ I had a large dinner due to social commitments with friends, and later I felt great. No adverse effect. However I don’t advise to do this. Surely from a food point of view a moderate day is better.
Hi Benjamin,
Thanks for the Excel FMD do it yourself worksheet. The Prolon isn’t shipped to Canada yet so Just started FMD with my own food choices. Your worksheet was incredibly helpful. Day 1 is good so far.
Very welcome Al. I reckon once you have become comfortable with preparing your own FMD food plan and food it is the superior approach. I *could* buy ProLon now, but other than as a curiosity and convenience I see no need to.
Great to hear Day 1 is good, may the remainder be so too!
Hi Benjamin
interesting articles thanks. I haven’t done a FMD yet but I’m building up to it!
My main motivator is loosing weight and I wonder if you had a few details about your friend who did it with you as you said he was more focused on weight loss too?
Thanks
Joe
Heya Joseph, I have pinged that buddy, he may drop by and post directly. However I share that although I was not interested in weight loss, FMD has actually directly led to me both losing weight, mainly fat, and maintaining a new, lower weight for a year so far.
I did not actually lose the weight and fat during FMD and instead this happened in the months following. So why do I credit this to FMD? Well following FMD very effectively reset my dietary habits. A few less positive habits had snuck into my routine which had resulted in me getting up to 67kg and around 14% bodyfat. Soon after FMD I was at 64kg and around 10% bodyfat and a year later my bodyfat is even lower.
Those bad habits? I had gotten into the habit of almost always having some kind of ‘dessert’ after my evening meal. Not necessary a bad dessert, or a big portion, but it added up. FMD simply wiped clean that habit and expectation.
Hey Benjamin
thanks for contacting your friend it’ll be interesting to hear what your friend says too
But yeah if it seems to work for you it could well show greater benefits for me (I’m a little overweight at the moment) as that’s what the research seems to point towards.
Re your desserts would you say its pure habit why you were having them and now aren’t or do you think there some physiological “stomach shrinking” going on?
Also interested in your opinion in the grand scheme of things and possibly in relation to the non-FMD times what you think about products like Huel?
Thanks again Joe
Definitely habit and psychology Joe and not stomach shrinking. In fact, I do not believe there is any persistent or impactful physical ‘stomach shrinking’ that occurs as a result of FMD or from extended fasting.
By contrast you may know that stomach stapling, or gastric sleeving, does have a high success rate for long term weight loss.
However another potential contribution is a change in gut bacteria. Gut bacteria can change significantly and swiftly as a result of changes in diet. Lets say I had cultivated some bacteria that thrived on the nutrients within the desserts I was eating. By ceasing their consumption I may have ‘starved’ these bacteria and advantaged others. We know that gut bacteria can influence human preferences and desires through chemical signals sent up the vagus nerve from gut to brain. So any dietary intervention is effectively a joint venture between human and gut bacteria!
On products like Huel . . . . . I am highly cautious and skeptical for several reasons. In brief.
1. Throughout human evolution ultra high processed food like substances such as Huel have not been part of the diet so consuming them is effectively an experiment
2. There is evidence that consumption of ultra high processed foods is associated with higher incidence of cancers and metabolic syndrome. This does not say anything negative about Huel specifically. It may be that some ultra high processed foods are benign or even health supporting and others, like Twinkies, M&Ms etc etc are the ones that do harm.
3. Real whole foods contain many properties, such as phytonutrients, which we do not understand but do appear to be strongly influential on various health outcomes. Products like Huel simply cannot replicate or substitute for the rich complexity of whole foods
4. Eat Food, Not too Much, Mainly Plants and Don’t eat anything your Grandmother would not have recognized as food – possibly the best dietary advice ever, credit Michael Pollan!
I do personally make use of protein powders, but moderately, and I favour those which have a closer relationship to a whole food. For example, hemp, pumpkin and sunflower seed proteins are mostly just the seeds ground up (which does mean less cellular fibre compared to the whole seed). By contrast whey and soy protein powders are very highly processed and concentrated fractions of whole foods that humans have never consumed within our long history of evolution. I do not avoid them but neither would I be comfortable having them as a significant part of my diet.
Hi Joe,
I am the “buddy”. I did the FMD protocol with Benjamin. As for using the FMD for weight loss:
1) You are likely to lose some weight by just following the protocol simply due to calorific deficit
2) In the longer run following the FMD the impact is less predictable. For me FMD did not lead to long term weight loss.
In my view and experience fasting or intermittent fasting will lead to weight loss if you incorporate it into your long term approach. E.g. if you follow 5+2 type diet, then you should be expecting weight loss (assuming you are not consuming excess calories on the 5 “normal” days).
Another anecdote from me: I found doing water fasts easier than doing food restricted fasts. When I managed to refrain from eating in the morning and during the lunch, it was easier to maintain no food intake without food cravings. On the contrary when I ate a little, sometimes that felt like a trigger point or an accelerator into craving more food. We are all different so you might not experience this.
For sustained weight loss, I found that being aware of calories and portion sizes helped.
I did a separate experiment that measured impact of various types of carbohydrates on blood glucose (also with Benjamin and I think he describes this experiment in another post). In order to have accurate measurements, I got into habit of monitoring all my food intake. That led me to (on majority of days) reduce my calorific intake. Only this led to weight loss. I am using the website and a mobile phone application called Cronometer (also recommended by Benjamin during this experiment). I had tried to use it in the past but found it too tedious. However for the blood glucose monitoring I found it necessary to monitor precise amounts and therefore got into habit of recording all food intake and it got easier after a while.
Good luck,
David
Firstly, huge thanks for providing such a comprehensive guide Benjamin. After stumbling across the documentary The Science of Fasting on Amazon, I started researching the Fasting Mimicking Diet and of course discovered you.
Health and fitness is a lifelong passion of mine. My mother is a serial dieter so I observed her in my youth. And have personally spent my own lifetime searching for the ambrosia of maintaining the ultimate fitness with the least effort involved (not that I’m lazy, far from it, but I admire Tim Ferris’ ethic and agree wholeheartedly with minimum effort required). So. In 2000, around when it first arrived in the UK, I started the Atkins New Diet Revolution. It was perfect for me. Weight simply melted away and, susceptible to hypoglyceamic episodes, it stabalised my sugar levels nicely. However I did have some nasty and inappropriate side effects, which I would happily divulge but not publicly, so I played around with my macros, maintaining low carb with a tolerance of minimal starchy mostly fibrous carb and all was good in the world… for a while.
Two pregnancies, two C-sections, PND and subsequent high carb convenience diet and sedentary (lack of intentional exercise) lifestyle lasted for three years. By which point I’d had anough. Clean low carb diet, trail running, HIIT and weight training rescued me. It was really really hard work (said I wasn’t lazy) but I got into a decent shape. So decent in fact that I placed 4th in a national figure competition (bodybuiding).
Late 2016 I had a depressive breakdown. I did minimal exercise for over a year. My diet was clean, but in slipped red wine and a few poor food choices. The weight crept on. And I hate to say it, but I am now it seems perimenopausal, and getting back into shape is proving much much harder than previously experienced. My body usually adapts easily and noticeably. But not this time.
I’ve just completed 5 days of the FMD by your macros (today). I was under day 1 and over calories day 2-3 but had cracked this day 4. Today (day 5) I had had enough to be honest. It’s not the tracking every morsel. I’ve done competition diets and planned before. But what I found demoralising is that I have not lost the weight I had envisaged. I do not weigh myself. I measure. And this has not budged. So I would really appreciate your feedback because I have a theory, especially now re-reading your page above.
I went on a residential course last year. It was strictly vegetarian and vegan food provided. By the end of 5 days I had ballooned. Water retention was dreadful. And I put this down to a high carb diet which does not suit me at all. And this I believe is the issue with FMD. I do not tolerate carbs well, at least not as a main source of calories. I am used to 40-50% protein and have been for dare I say 28 years!! So now I am looking at keto as a lifestyle change. My brother is an advocate of the Bulletproof diet and is supremely fit and youthful for his age, with excellent health and sterling immunity so great PR for this diet… but I am most interested in what you have to say. I am a qualified personal trainer with advanced sports and exercise nutrition, so should really know a bit about diet, but this is all highly specialised and you have done plenty of research and practice on the subject already. It would in great to hear your thoughts on this and any insights on subsequent FMD trials…… very much appreciated, Paula
Hello Paula, very interesting points. I may need to do some thinking, referencing and return to do justice to a reply! Some initial thoughts however . . .
Weight Loss during FMD – Given that the total calorific deficit for someone normally consuming 2,000 calories per day is around 6,000 in total I would not expect significant reduction in body fat from a single FMD cycle. A reduction in body weight is more likely if consumption of carbohydrate during FMD is significantly lower than normal but this would be mostly a temporary loss of retained water and regained following re-feeding. Other potentially significant factors are a reduction in energy expenditure due to change in activity and basal metabolic rate during FMD.
If my goal was body fat reduction I would prefer periods of water fasting over FMD, or potentially a well formulated ketogenic diet combined with regular resistance exercise.
Carbohydrate Intake – This needs an entire post, or book, and lots of expertise! However some concepts I would find interesting are –
1. Did your carbohydrate intake on FMD go up, down, stay the same, and did the types of carbs change?
2. Are you personally sensitive to any of the carbs you are consuming, meaning the blood glucose response?
3. What is the composition of your carb sources? How processed are they? I think this is relevant because whilst ultimately the ‘calories in vs calories out’ equation is correct in practice their are many variables affecting both sides of the equation to account for including for example how many calories you can actually digest from those you consume, with this varying considerably between people (and their microbiota)
4. How many AMY1 gene copies do you have and do you use this data to influence your regular carb intake?
Keto Diet – I am very interested too but am also cautious for several reasons, of which two have greatest significance. One is that I believe it true that there are no long-term, meaning a duration of years rather than weeks or months, studies on the outcomes of a well formulated ketogenic diet. There are some great and encouraging shorter term studies. Two is that I have the rare PPAR-Alpha CG genetic polymorphism that is correlated with an impaired response to both fasting and keto.
If I do decide to trial keto I intend to approach it as a thorough n=1 experiment and measure things of importance to me prior to beginning, then after becoming keto-adapted. These would include hormones, cholesterol, inflammation, HBA1C and real-world measures such as sleep quality, exercise performance, mental performance and general well-being.
Note to DIY
Hi! Sorry in advance for the long post, but I wanted to explain each point properly (sort of anyway). I have just finished my first FMD and when setting out I was craving I guide like yours, so I think it is important that you make a few corrections. And if I am wrong, PLEASE(!) correct me.
I browsed through the comment section and I did not find anyone else bringing up this major point in regards to the macro composition:
The prolon diet is actually high carb. You can verify this by looking at the actual prolon box contents by following the two reference links (early) on this page http://fastlifehacks.com/valter-longo-diet-plan-fast-mimicking-diet-longevity-diet-details/
Does it matter for 5 days every year/quarter/month (assuming caloric intake is the same)? I am wondering this myself. Probably not for weight loss, but then you are not doing “FMD”, but something different, I hope you agree.
Four other points:
1) Judging by how the FMD diet is described (all over the place) I also assumed that the macro percentages referred to calaries and not weight, but again referencing the actual prolon box contents you can gather that it is % by weight.
If you consider that the calorie count per gram is pretty much the same within each macro group (i.e. the same amout of calories for each type of fat), (coupled by the fact that is is the total calorie count that matters for starvation signaling IN GENERAL), it makes equal sense to count grams and in fact more practical due to how food products are labled. You would otherwise have to multiply each carb/protein gram by 4 and fat gram by 9.
Also, the most critical factor in the FMD protocol (weight loss aside) is the limitation in protein, and since it is the amount of amino acids etc. that matters it makes no sense to convert back and forth via clories.
2) Another critical factor is the protein source which should be void of all animal proteins. If this is ignored you will not have the proper IGF-1 response (perhaps other issues too, I will leave it to you to research).
3) “High carb” does not mean just any type of carb. FMD is restricted to high nutrient, complex, slow carbs. (Damn hard to find by the way when at the same time limiting fat and protein contents. I actually found getting enough proper carbs being the trickiest of all!)
4) Like you I am also critical to the fact that the prolon box is sold as a one-size-fits-all males/female. Disregarding individual weight and body composition is unscientific, especially since you will end up consuming too many calories/protein if you are enough lightweight! What one needs to do is to calculate one’s current caloric need and reduce it to:
Day 1: 50%
Day 2-5: 34%
By the way, I STRONGLY agree with “PLAN ALL THE FOOD TO BE EATEN ON THE DIET”. For anyone considering going DIY instead of buying the box – do not even try without a proper kitchen food scale! I started my FMD of getting the fat/carb ratio wrong (following another DIY guide) just as you, and trying to turn this around on 2nd/3rd day without a scale was a complete nightmare.
Thanks for making a DIY guide, again – it’s much needed!
PS. Could you please post a link to the patent you referenced? I would very much like to go through it and see how well it matches the actual prolon box.
BR
John Karlsson
A small correction on point #2:
I saw you wrote that you are using an all plant diet, but I think it is good to point out in the FMD protocol description that this is a requirement. I saw a comment (on another DIY guide) from a guy who used cheese as the core food source (pretty much the FMD protocol inversed plus calorie restriction)!
Very welcome comments and challenges John. Offering thoughts in response.
Sure! It is included within the ‘Resources’ sheet of the FMD DIY template, and also here https://patents.google.com/patent/WO2016168802A2/en
What do you mean by high carb John? I think you mean that the macro ratio is high carb and on that I agree completely. In absolute carb count terms I would not call it high carb albeit neither is the carb count during low *enough* to be a reliably ketogenic diet i.e. lower than 50 grams net carbs.
Regarding protein, I recently discovered the “Protein Cycling Diet” designed by Mignery and well described here
http://joshwhiton.com/posts/periodic-protein-restriction/
The very short version is that this diet involves consuming no more than 15 grams of proteins for short periods only such as a single day. The intended outcome is activation of autophagy. I am beginning to think of FMD as an evolution of the Protein Cycling Diet. However I remain a little puzzled by the inclusion of carb intake in excess of that likely to enable nutritional ketosis given that spending time in nutritional ketosis also appears to be part of FMD. By contrast the Protein Cycling Diet looks like it could not enable ketosis since it prefers carbs over fats and in significant quantity.
I did multiply protein and carb grams by 4 and fat by 9 to plot the actual grams of each macro to include. Do you have a box shot or similar source to help confirm that the ProLon approach is based on macro grams and not their calorie value? Please do share if so, I will review, absorb and adjust the template to reflect this if so.
Agreed, for three reasons. First that animal proteins are excluded from the FMD and ProLon design. Second that animal proteins are rich in the amino acid methionine and methionine restriction alone appears to offer many of the benefits of fasting. Third and more broadly, it is almost impossible to include any quantity of animal foods, exempting animal fats, into an FMD diet. Heck, you cannot include significant quantity of many vegetables, like broccoli and spinach, without going over the allowable protein!
Yes! Both for the Protein Cycling Diet and FMD I think the biggest challenge is selecting carbohydrate sources that do not also include significant protein. However . . . whilst acknowledging that this would be an FMD inspired rather than FMD diet itself I am in favour of reducing the carb count further and increasing fat to compensate. This would have the benefits of simplifying compliance and enabling nutritional ketosis. For the relatively brief period of FMD the only significant downside I perceive is that of digestion since consumption of fats alone can be quite distressing. What are your thoughts here?
I dare say it would be simple to adjust ProLon DIY style, with the full package being suitable for some people and others needing to consume only a portion of the daily calories. This might be the simplest way to perform an FMD cycle if one prefers not to get involved in food planning but does want to ensure the full benefit of appropriate calorie, protein and carb restriction for their personal bodyweight / calorie requirements
Hi Benjamin,
Do you think a FMD causes true autophagy (as opposed to a 3-day water fast, for instance)? I am a cancer survivor who is currently cancer-free for almost two years and not undergoing any treatment. I would especially love to take advantage of the “cleaning up of bad cells” that occurs during a fast. I’m just not sure of the best way to accomplish that. Would appreciate your perspective on this. Thank you!
Hello Lisa, my entirely lay person non-professional understanding is that there are two ‘main’ regulators of autophagy both of which are nutrient sensors. These are mTOR and AMPK. The most certain way to upregulate autophagy I know of is to water fast but doing so repeatedly and for extended periods (2 days +) does present some risks. Risks such as insufficient nutrition and loss of lean body mass and bone density.
If you read up on the work of Valter Longo, the lead designer of the Fasting Mimicking Diet, you will see that many of the theoretical papers and studies are focused on the utility of FMD or a similar fasting regimen for diseases including cancer, diabetes and multiple sclerosis. I am going to quote from one of those studies and link to several I recommend you review and perhaps dare I say it, discuss with your preferred medical professional. Emphasising that I am not at all medical trained, if I had a need to I would probably seek out an accredited Functional Medicine Practitioner familiar with FMD, water-fasting and oncology and agree with them upon a protocol including some tests that could be applied to assess the relative benefits for me of the alternate regimens.
Further reading recommendations –
Quoted from A Periodic Diet that Mimics Fasting Promotes Multi-System Regeneration, Enhanced Cognitive Performance, and Healthspan
Public Medical Library search result for Valter Longo + FMD + Cancer (5 Papers)
Functional Medicine Institute homepage including ‘Find a Practitioner’
Another reference and reading recommendation I will make is to the cancer and fasting series published by Dr Fung, the founder of Intensive Dietary Management and a strong advocate for water fasting. Link to just one part of this series which deep dives into autophagy, cancer, mTOR and AMPK – Autophagy in Human Disease – mTOR/ Autophagy
I hope you have appetite for reading Lisa, that some of this is useful, and that you enjoy ongoing health and happiness! 🙂
Hi Ben,
I am looking for macro nutrient proportion or kcal of the anti cancer version of the FMD Chemolieve. I know the Chemolieve product have much less calories, around 600 Kcal 1st day and 300 Kcal 2nd to 4th day but I can’t find that info. Do you know anything about it?
Searching in http://www.clinicaltrials.com I have found that they are now doing a new clinical trial with cancer patients that have 5 FMD days instead of 4 of the Chemolieve. So 5 days seems like the correct amount of time for the FMD. You can find the detail’s of the diet in the link, but they dont say the exact macro % for each day, and that’s what I am looking for:
https://clinicaltrials.gov/ct2/show/NCT03340935
“Fasting Mimicking Diet (or FMD) consists in a 5-day plant-based, low-calorie (700 Kcal on day 1, followed by 300 KCal/day on days 2 to 4 and 450 Kcal on day 5), low-protein (as much as 5% of calorie intake consists of proteins), low carbohydrate (as much as 5-35% of total calorie intake depending on the day) diet”
I am currently in my 5th day of my 2nd water fast (only salt added), done mostly for a big tyroid nodule that shrinks with the fast. In the first water fast I could only do 3 days. So it’s tough for me. That’s why I am looking for info for the FMD.
The thing is that I think the water fast produces the best positive benefits but the problem is that it’s not suited for everyone. Dr Longo said that in the BBC Documentary “Eat, fast and live longer” and also that the best thing to do was a 4 days water fasting because in just 24 hours your levels of glucose and IGF-1 drop significantly and your metabolic markers improve (then you have 3 days more). He only added to the water fast one 50 kcal cup of soup a day, to replenish the salts lost by ketosis process. In the FMD, that initial process could last 48 hours (and then you have 3 days more).
The documentary is from 2012. Maybe he later discovered that the FMD it’s not that far in results. I dont know.
The thing is that the FMD for cancer has much less calories, protein and carbs. And I think it’s like that because you need the maximum positive effects of fasting when you are dealing with a life threatning condition, like cancer. Understanding that that is achieved with the complete restriction of at least protein and carbs.
What are you thoughts about this?
Thanks a lot for the work, care and attention you put on this blog.
Amazing blog! Do you have any recommendations for aspiring writers?
I’m hoping to start my own website soon but I’m a little lost on everything.
Would you recommend starting with a free platform like WordPress or go for a paid option? There are so many choices out
there that I’m completely confused .. Any suggestions?
Appreciate it!
Hola Geraldo, thanks for the compliment!
I feel like I am at the very beginning of a never ending learning curve for blogging. There is so much too it. There is the technical website side, writing, pictures, social media, search engine optimisation, and so much more.
However, let me try to offer some top tips plus a link to an article I found extremely helpful early on.
Tip #1: Be very clear about *why* you want to start a site. Write the reasons down using pen and paper. Be honest. Do you want a very popular site? Do you want to generate cash? Will you be happy just writing regardless of how many people are reading?
Tip #2: After you get the basics of a site up and running, just starting writing, start posting. Get yourself into a groove of creating content. You will likely gain more enjoyment and learn a lot from the process
Tip #3: Meet up with other bloggers and take their advice. There are lots of online resources and guides, but depending on where you are you might find there is a Meetup group for bloggers you can actually meet.
As for WordPress vs a paid option . . . well already there is WordPress.org and WordPress.com, and they are very different! I use WordPress.org, which is the open source version whereas .com is a paid for platform. There are still however lots of premium packages you can buy if you use wordpress.org.
If you have the cash and do not have a big appetite to do it all yourself I would suggest getting an experienced wordpress site developer to sit down with you, discuss what kind of site you want and why, and get them to build but also coach you on how to tweak and adjust and maintain.
Finally, the guide I found very helpful early on, this one. One of many, but I like it 🙂
https://cookieandkate.com/how-to-start-a-food-blog/
Hi! Thank you so much for giving these free info, I have a little concern as I have calculated my macro intake for the first day as an example, I’m on a ketogenic diet as a type 1 diabetic and struggling to find a professional that would help me try this FMD, my concern is that the calculation of carbs comes down to 80g per day, wouldn’t that kick me out of ketosis? Also I’m worried that I will need fast acting insulin that I’ve been able to not use for a while. Do you have any resources or info about this issues? Thank you in advance
Hello Alessandra, I expect that 80 grams of net carbs would indeed be too many carbs to enable progress into or remaining within nutritional ketosis. That was definitely my own experience. A maximum of 50 grams net carbs appears to be a standard that works for many but some do need to go lower, and I read about 30 grams net carbs as a level used by some regular keto dieters.
Since I am neither diabetic nor pre-diabetic I am comfortable to take the approach of self-experimentation and monitoring. I know that I personally remain in nutritional ketosis, meaning minimum 1.0 mmol/L blood ketones, if I consume no more than 50 grams net carbs per day. I believe it entirely possible to find your own level through food tracking and blood ketones monitoring.
However as you are diabetic this approach may well not be suitable for you and pairing with a professional seems sensible and wise. I expect you want a qualified dietician, nutritionist or functional medicine practitioner to partner with. I would recommend making contact with one via endorsed by relevant governing / regulating body for your country. You may also choose to seek out a functional medicine practitioner via https://www.ifm.org/find-a-practitioner/ – which is how I have identified a practitioner to partner with for future interventions. I emphasize that I work together with a functional medicine practitioner AND relevant ‘conventional’ medical professionals too rather than instead of.
Thank you so much for your generosity in sharing all of this information. Would you be willing to share your recipe for the electrolyte drink?
Welcome Sundari, thanks for the thanks! I did not consume an electrolyte replacement drink . . . not doing so is one of my improvement ideas for the next cycle! When I do that I will prepare a simple non-caloric drink with sodium, potassium and magnesium. There is such a recipe here which could be used or easily adapted – https://ketodietapp.com/Blog/lchf/beat-keto-flu-with-homemade-electrolyte-drink
“Adrenal stress” is not a thing. If you’re at the low end of the BMI range, do you even have much body fat?
You are absolutely right, thank you for highlighting this. I have replaced “Adrenal Stress Test” with “Salivary Cortisol Test” within my articles. At the time of original writing I was not aware that “adrenal stress” was indeed not a thing and used a bad term. I meant “stress” or “stress indicated by cortisol produced by adrenal glands” or similar.
I was about 13-14% bodyfat pre-FMD which was above my historic norm as a result of fat gain following surgery and a period of relative inactivity. Use of FMD appeared to lead to a sustained reduction of 1-2%. This was not and could not have been due to the caloric restriction during FMD as it was insufficient to account for such a reduction. Instead, use of FMD effectively reset my eating habits in a way that led to the sustained reduction.
A year or so on I am maintaining at around 10% bodyfat so subsequent cycles of FMD or a water fasting regimen will not be motivated by body composition goals.
I have done the fast only one time so far. I find it very hard to do but felt much better at the end.. Will do again soon
Heya Geoff, I think the key questions are, is it easier or more challenging than a water fast for you? I believe that some people find FMD easier and some find it more difficult than a full water fast. Either way the first few days are probably the toughest. The days when your body is expecting to be fed at the same times it usually is!
Hello, I have just completed the program and I have lost more muscle than fat, my body composition has actyually worsen! I am also feeling weak and light headed.
While doing the program I felt weak, most of the days and on day 4th I had pain on the back of my legs.
I was doing further reading on fasting and I came across with the dangers of fasting on women (disrupts hormonal balances) is there any proper research on this?
Hola Alaide, I am aware of but not familiar with differences and potential differences between males and females in terms of response to fasting, time restricted eating and ketogenic dieting. I am unaware of any known differences specific to the Fasting Mimicking Diet and in all FMD material and Valter Longo interviews I have read I have never seen any mention of gender. My layperson expectation is that if there are indeed gender differences in response to fasting and keto dieting between they should be expected to be a feature for the Fasting Mimicking Diet too due to similarity.
I believe there is some good research evidence out there to read up on too. Again, I am not actually familiar, but here are a few suggestions to begin with –
Article from Dr Jason Fung, author of the Complete Guide to Fasting
https://www.dietdoctor.com/women-and-fasting
Review Article with links out to studies, caveat I am completely unfamiliar with the author
http://paleoforwomen.com/shattering-the-myth-of-fasting-for-women-a-review-of-female-specific-responses-to-fasting-in-the-literature/
Example published study finding difference in human male & female response to fasting (there are more to find)
https://www.ncbi.nlm.nih.gov/pubmed/17566089
I have done this diet on my own 5 times (I’m a doctor) and do well on it (though I am hungry a lot).
I am puzzled by your listing “broccolini” as having any protein at all, as the Google entry says it has none. I also looked in Cronometer, but I think they list a specific recipe “HEB-broccolini” which may not be what you ate.
At any rate, it’s a nice thing to support people in trying this, as you say, with the support of their physician.
Hola Myrto, love to read that you a doctor using FMD for you own benefit. Do you work with patients? Does FMD feature at all as a treatment you can or might discuss with them in future? In the UK, I visit with both a public (NHS) doctor and a private Functional Health practitioner. The latter is someone I can fully discuss FMD with. The former has no knowledge of it and cannot comment on it at all. That is not a criticism. Our UK public doctors typically have less than 10 minutes per patient and lack capacity to deep dive into topics like this for healthy people even if they personally are very interested.
Okay, on to the question . . . broccolini. Since I used CRON-O-Meter as the source for macro-nutrient data and I think it lacked any entry in 2016 I used that for Broccoli instead. That might be inaccurate but I really do expect that broccolini does have a non-negligible quantify of protein. My rationale is that broccolini is a cross between broccoli and chinese brocolii or ‘Kai Lan’ or ‘Gai Lan’.
According to CRON-O-Meter, Chinese Broccoli (raw) has 1.2g protein per 100g whereas Broccoli (raw) has 2.8g protein per 100g. The ‘HEB-Broccolini’ listing indicates 3.5g protein per 100g. I am sure none of these is precise but given that each indicates a protein count expect that broccolini does have protein.
By contrast the current Google retrieved macros look like junk data to me. Not only does it state 0g protein, it also states 0g carbohydrate and fibre and 7g fat! I cannot imagine how that could be true for a cross between broccoli and chinese broccoli! 🙂
Hi, thanks for the spreadsheet. I have yet to get access to copy it on my phone but will try later on my computer.
I had a look at cronometer but needing to add all the foods is tiresome. 2 years ago I did the FMD diet and used S Health which comes on Samsung phones. Most common foods are already there and accessed by Breakfast, Lunch etc. So easy to add the foods! Not sure on the accuracy but the foods can be added to.
For my purpose they are probably ok.
I use the FMD diet as a kind of detox.
Thanks Clem
Hola Clem, thanks for the comment, and you are very welcome! I receive prompts to grant edit access and action these within hours typically, never more than a day. What I do is enable folks to make a copy so that the original is kept intact.
A key added value of CRON-O-Meter is in tracking micro-nutrients, all of them, which I think no other diet tracker does. However there are certainly other simpler trackers for tracking macros and if you combine these with some thought about what you include in the FMD diet I reckon you are on a winner! CRON-O-Meter is for micronutrient junkies like me! 😛
Hi Benjamin. I’m in the USA, and cannot find Superfood XS here, however from the company’s website I’m wondering if their Total Nutri-Greens is a close match to what you added to the 5-day FMD (https://us.myprotein.com/sports-nutrition/total-nutri-greens/10915597.html)? Also, your plan does not address beverages much. Is the idea to eliminate all caffeine and only have herbal teas, but mostly water?
Thanks for sharing!
Hola Val, there is nothing at all special about the Superfood XS product and the Nutri-Greens is absolutely a suitable whole food based supplement to accompany an FMD cycle IMHO.
Caffeine may well be a helpful thing to compliment other types of fasting regimens including time restricted eating. Consuming caffeine definitely activates digestion and ‘breaks’ a fast but might ‘break’ fasting with an overall positive rather than negative outcome.
However caffeine is something to avoid during FMD as it can significantly influence insulin and increase blood sugar. If you drink caffeine during FMD and your blood sugar increases you may also have a reduction in ketones. Emphasis that this is a short term outcome as habitual consumption of caffeine appears to improve insulin sensitivity.
Here is the Q&A about caffeine from the FMD ProLon product site. The question refers to coffee but is relevant to any beverages, including black tea, that contain significant amounts of caffeine.
Can one consume coffee whilst on ProLon? Because coffee can interfere with the beneficial effects of the diet, it is not recommended to be consumed with ProLon®. However, if one must have coffee, we recommend minimizing coffee consumption to 1 cup per day.
I have been eating a keto diet for a few months now and love it. I want to add the FMD to my way of eating but the carbs seem really high to me. I have read Victor Longo’s book and pretty much everything I can find on the FMD – but I struggle to understand how we an be in ketosis with such high carbs. Can you help me understand that? Thanks so much. I appreciate your article and your responses to the other questions!
Hola Francie, the carbs *might* be too high. I believe consuming 47% of my calorific intake in carbohydrate *was* too high and prevented me from progress into and maintenance of nutritional ketosis. Whilst I do not have any comment on his analysis or credibility I link to a short Dr. Eric Berg video where within the first minute he also comments that the carbohydrate % is too high
I would definitely reduce the carbohydrate % on subsequent FMD cycles and combine this with monitoring of ketones. The Cell Metabolism paper description of the human diet protocol actually gives a range for the macros
“. . . 9%–10% proteins, 34%–47% carbohydrates, and 44%–56% fat”
Quoted from https://www.cell.com/cell-metabolism/pdfExtended/S1550-4131(15)00224-7
My suggestions are :
1. Use the 34% carbohydrate ratio and increase fats to make up the delta, or simply consume less calories total
2. Monitor blood ketones periodically
3. If not maintaining within nutritional ketosis, reduce the carbohydrate % further within subsequent FMD cycles
Whilst FMD has a clear purpose and there is increasing evidence for its efficacy and effectiveness I also suggest consideration of full water fasting for similar periods of time unless you have any health issues that would make this risky for you. A keto diet is a great starting point for a full fast given the body is already relying on ketones for most energy needs and will continue to do so during the fast.
When I initially left a comment I appear to have clicked on the -Notify me when new comments are
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Kudos!
Hola, I am unsure what options are you are offered and not offered within the notifications as those I get and can adjust are only for me as ‘Admin’. I would like to try and solve this issue though, can you please tell me?
Within the emails you receive are there any options to change your subscription preferences?
How did you ‘login’ to leave a comment and subscribe i.e. via Facebook, Google+, WordPress account etc?
For Indian vegan can you suggest what one can eat during FMD.
Excellent article.
Heya Josh, FMD is very vegan friendly. Many animal products cannot easily be accommodated within the very low protein allowed so vegan FMD is perhaps even easier than an omnivore FMD.
For a full vegan FMD I can suggest –
# Low carbohydrate veggies such as leafy greens, spinach, rocket, watercress, cruciferous veggies such as cauliflower & broccoli, also onion, garlic, peppers and squashes
# Fats from olive oil, coconut oil, coconut yogurt, & nut oils
# Small amounts of nuts and seeds (small due to significant protein content)
# Small amounts of legumes (small due to carb and protein content)
# As much spice as you can handle!
With big regret, no mangoes! Therefore do not attempt during alphonso & chaunsa season 😛
Thanks Benjamin