Even More on Intermittent Fasting

We wrote on January 10 and January 18 that I would be experimenting with more aggressive intermittent fasting than we had recommended in Beating the Dementia Monster.  In the book, we recommended fasting 12 hours between dinner and breakfast.  After reading the article in the December issue of The New England Journal of Medicine (NEJM), I decided to pursue this further. 

For the past month I have been fasting about 18 hours, rather than 12.  I have my last bite for the day at 7 p.m. and don't eat again until 1:00 p.m. the next day.

So, is my cognitive impairment going away?  It would be silly to say I can tell anything on my own after 1 month.  However, I will be tested again this summer, and I'll be (very) curious to see what happened to my cognition over the previous 24 months.

In the past, I've been tested at Harborview annually, the tests normally taking about two hours.  But I'd done so well in 2017 and 2018 that my neurologist decided I should take 2019 off from testing.  I went in to see her for a 2019 evaluation, but we omitted the neuropsychological testing. 

But I did clearly have some kind of hiccup on my cognition beginning the first week in April 2019.  This was my subjective assessment, but it was pretty clear to me that I was having trouble.  This continued for a few months, but seemed to bottom in late spring.  Things seemed to improve marginally after that (again, my very subjective assessment) but I seemed to stumble again in early 2020.  Nothing serious, but in April 2019, I couldn't remember to lock the car door no matter how hard I tried.  More recently, I find that I've put garbage in the recycle container.

While it's too early to see if intermittent fasting is helping my cognition, there is one thing that has gotten noticeably better.  And I didn't expect it.

The NEJM noted that an effect of intermittent fasting is to reduce inflammation.  This helps with Alzheimer's disease, because inflammation plays in important role in how the disease proceeds.  The article said that this effect will also help with arthritis.

I have troublesome arthritis in both my neck and my back.  This usually comes out at the gym when I start stretching to exercise.  It's a problem while driving when I want to look over my shoulder.  And then when I'm on an airplane and I want to look back to see if there's a line at the bathroom.

So after intermittent fasting for about three weeks, I was pleasantly surprised to find my neck pain had almost completely gone away.  Just a coincidence?  Will it come back?  Who knows.  But I'll take it.

When I talk to people about intermittent fasting they are usually horrified.  For one thing, we've been told "breakfast is the most important meal of the day!"  The breakfast cereal manufacturers have promoted this concept, but it has failed when tested scientifically.  It turns out that breakfast may be the most worthless meal of the day.  There's still plenty of debate about this, but the NEJM article and other reading I've done suggests to me that the breakfast paradigm is in the process of change.

But also, people worry about being hungry for so long.  All I can say is that, if you're on a diet that keeps carbohydrates low (like the Mediterranean, the DASH, or the MIND diets), you don't experience nearly as much hunger.  The insulin spike that follows the intake of carbohydrates increases your level of hunger, so suppressing intake of carbohydrates suppresses your hunger.  I won't try to tell you that you won't miss eating in the morning, but being on one of the recommended diets makes it a lot easier.

I don't intend to try the other forms of intermittent fasting that involve fasting for a whole day, twice per week.  But I do plan to continue on my current path for the foreseeable future.  I definitely want to see if I can perceive an influence on my cognitive test scores this summer -- likely early July.