Interview with Univ-Prof. Dr. med. Andreas Michalsen:
Nutrition and fasting as key to successful prevention
Interview with Prof. Dr. med. Michalsen, head physician of the Department of Naturopathy at the Immanuel Hospital Berlin, professor at the Charité Berlin and fasting expert, about nutrition as the most important factor for a healthy and long life and why regular fasting periods in particular have a demonstrable preventive effect against age-related diseases.
KM: At the beginning a personal question: How did you come to nutritional medicine?
Michalsen: I worked for a long time in cardiology, intensive care and in the cardiac catheter laboratory. Over the years, you realize that there is a revolving door effect. You see patients very often with a new coronary sclerosis or new constrictions. New stents are implanted, a bypass operation is carried out and the list of drugs is becoming longer and longer for patients… and that got me thinking. I focused on the question: “How can you avoid fate and prevent the disease causally, or if it occurs, prevent it secondarily?” I have read and trained myself in the field of prevention. If we look at all areas of prevention: stress reduction, exercise, social living conditions and nutrition, then nutrition is certainly the most important factor. The data tell us: nutrition is the key to successful prevention.
KM: Does that mean living longer or living healthier for longer and do you see a difference between conventional medicine and therapeutic fasting or alternative medicine?
Michalsen: Conventional medicine and naturopathy belong together and have the same goal. The orthodox or acute medicine has managed to make us live longer. This can be seen very well in cardiology. People die less often from a heart attack. But the consequence of a heart attack, heart failure, has been increasing in frequency for years. As a scientist, you want morbidity compression, i.e. a longer healthy life for people, and illness only just before death. This is the declared aim of naturopathy, complementary medicine and also conventional medicine. In naturopathy, developments and traditions, such as therapeutic fasting or interval fasting, are used to work even harder to achieve this goal.
KM: Why is fasting so important nowadays?
Michalsen: Food is now available around the clock. Due to the human ability to enjoy food, a process has developed which is not really intended in our biological, genetic program in such a way that we constantly eat too much, too irregularly and the wrong things. The consequences can be seen in the exploding prevalence of diseases, diabetes, high blood pressure, obesity, cardiovascular diseases, colon cancer, etc. There are only two ways to step on the brakes. On the one hand, to improve the overall quality of the food again. Less animal fats, less sugar, less energy-dense food, more fibre. And on the other hand to consciously bring back food breaks – i.e. periods of fasting. In the past, periods of fasting were an evil. There they were the evolutionary program, because you never knew when food was available. But that is over! We should now bring the fasting periods back into our lives with our own will, so that our organ systems are not overloaded.
KM: The positive influence of fasting periods has been proven according to our current state of science?
Michalsen: This research is now more than 100 years old and proved – first in animal experiments, then in humans – the positive effect. Whenever organisms observe fasting periods, they live longer, they do not get most age-related diseases such as diabetes, high blood pressure, dementia, arthrosis or they get them much later. For about 10 years now, the data situation has become much more dense and studies now prove the effectiveness on humans as well.
KM: Now there are many different forms of fasting. One of them is the sham fasting diet of Prof. Dr. Valter Longo. Where do you see the intersection with his research in your own research?
Michalsen: Professor Longo is one of the most renowned researchers on ageing in the world, and he is a biologist in his own laboratory, which has allowed these findings to mature. He is now in the process of applying them to humans. With me it is the other way around. As a doctor, I taught fasting and then began to set up studies. I am now more and more interested in the mechanisms and am now moving in his direction. In the end, one sees that both joint research paths are wonderfully connected.
KM: What is the difference between Longos sham fasting and your 10-day fasting program?
Michalsen: The traditional fasting that I present in my programme for healthy people as a guide, in print as well as online, is a fasting with 250 – 300 kcal per day (in the Buchinger tradition), in the form of filtered vegetable broth and two small glasses of juice. Valter Longo has conducted countless experiments to find the optimal strategy to induce these positive cellular processes in the body. Longo has clearly defined it in terms of calories and has given concrete thought to what the composition must be in order for the fasting effect to be optimal. His developments have been incorporated into the product ProLon, which from a scientific point of view can be seen as the optimal result of decades of fasting research. An important point with ProLon is its ease of implementation. Everything is in the product, it is tested, certified, works day after day and is safe for the user. The patient does not have to deal with fasting as intensively as is required for therapeutic fasting. However, it is also less self-effective as a result.
KM: Less self-initiative and self-discipline are necessary. Is that the main difference?
Michalsen: There is also a difference in the number of calories. The Buchinger fasting cure has about 300 kcal. You deliberately don’t go on a zero diet, as increased protein breakdown, i.e. muscle breakdown, is not desired. The limit is physiologically not 100 percent defined. Nobody knows exactly how many calories you can eat to achieve the positive effects of fasting, from stem cell production to autophagy. But Valter Longo suspects that the upper limit is just above the calorie limit of ProLon, and has good reasons for this. If you eat 770 kcal, as with ProLon, it is definitely easier to get through than with 300 kcal as with the classic fast.
KM: For which patients is therapeutic fasting, for which group is sham fasting or ProLon? What is your conclusion?
Michalsen: I would not see this as an alternative. For me these are two wonderful tools to bring the highly effective instrument of fasting to the patient. There is also interval fasting as a third option. Compared to the past, we have more options today, and I also recommend my patients to use these options more, this cosmos of fasting. For example, a therapeutic fasting week can be very well combined with a holiday. ProLon is certainly very well suited for everyday use, even if repeated several times, perhaps even in everyday life while working. As a small solution, if you do not feel like fasting for a longer period, interval fasting is a suitable form.
KM: In your opinion, who should fast when and how often in order to maintain the positive effects in blood values or BMI, etc.?
Michalsen: For healthy people there is no over fasting. With ProLon, as with fasting, the patient should pay attention to contraindications. People who have a history of eating disorders should not do either. Anorexia and bulimia are contraindications. In the past, the recommendation was to eat 1-2 times a year, but today there is no longer any reason for such a limitation. There is no precise information for which people and how often fasting is suitable. It is best to rely on your own experience. If you notice that the positive effects of the fasting period are slowly diminishing again, then it is time for the next fasting round or ProLon pack.
KM: Do autophagy effects only occur during longer fasting, so rather not during interval fasting?
Michalsen: The transfer of preclinical studies to humans is very difficult and it is not possible to give precise time specifications. If one regards the fasting studies with humans, there are clear indications that one comes already within 12 to 16 hours, if the glycogen storage in the liver and in the muscle is used up, into the fasting metabolism. Then lipolysis is used to provide energy. When the cells no longer regulate energy substrates via digestion, autophagy begins. Naturally, longer periods of fasting result in longer autophagy. But with interval fasting these effects add up and can be very strong over the year. ProLon or the healing fasting are, due to the sequence of 5 days in this case, in all areas, very strongly superior, in contrast to interval fasting. If the patient has to take anti-inflammatory drugs, for example, as in rheumatism or intestinal diseases, this fasting in one go is better.
KM: Does fasting also produce very good effects for dermatological indications?
Michalsen: The inflammatory diseases also include dermatology. Psoriasis, for example, reacts very well to therapeutic fasting. It is more difficult with neurodermatitis, there are less homogeneous reactions and the hit rate is lower. But despite all this, thousands of fasting fans with neurodermatitis swear by the accompanying fasting therapy. In practice we also have very good results with the indication acne and eczema. These can blossom again at the beginning of the fasting period, but then it gets better.
KM: Do you have a tip for your colleagues in dermatology on how to place the topic of fasting in the practice routine and how to offer patients different forms of fasting?
Michalsen: For example, fasting programs are a good supplement to aesthetic body fat treatments because they also reduce visceral fat, which is otherwise difficult to reach. But in general, patients will be grateful to you for having addressed the topic of nutrition and fasting. In my opinion, it is the basis of every chronic disease. In my everyday practice there is no disease, no patient, where I do not talk about it during the conversation, even if it is only for 3 minutes. I experience that there is a great awareness of it in the population. If this also comes from the doctor, who gives orientation, then it is very positively received.
KM: Prof. Michalsen, thank you very much for the interview.